PPL or RPP with heart condition?
 

I posted this in the AVCanada forum but I'm putting it here as well in case I don't get many replies over there (I don't know which forum is more active).

I'm in my forties and would like to get my PPL or RPP. Problem is, I have a congenital heart condition (transposition of great arteries). This was corrected during my infancy and I've never had any heart issue since: I'm in great shape, I play sports, etc. and get a thumbs up on my annual checkup with my cardiologist. However, Transport Canada specifically identifies this type of condition as potentially disqualifying, particularly if corrected with an atrial switch, which is the procedure I had.

So before I book a category 3 medical with a CAME, can anyone tell me if I have a chance to pass it, or at least qualify for a RPP?

Welcome to PPRuNe Neb,

Though I do not have a "medically qualified" answer to your question, I can offer the following thoughts: Go to see a medical examiner, and ask their opinion. Understand the distinction that the medical examiner is delegated by TC to report their examination results, but it is TC [their doctor] who issues (or not) a medical. The fact that the examiner advises or passes you does not mean that you get a medical. The medical examiner will be your friend, but doesn't hold the keys. TC holds the keys, but are neutral at best. They err to the side of being cautious, and my experience with them during a bump in my medical was non ideal. Perseverance (and actually being medically qualified) got me through, not TC help. So enter the process knowing that it's not a certain outcome until TC agrees, and you won't know that until your examination is submitted.

Consider what you'll use your license for. Generally, I'd advise an applicant toward a "higher" medical, to allow for license expansion, but I believe that having a non smooth Cat 3 medical can make the Cat 4 more difficult to get. So seek your medical examiner's advice on that. If you plan to simply use the RPP privileges, and not expand your goals toward PPL, seeking only a Cat 4 in the simple path is "safer" for you. If getting the medical you seek is difficult, there is a path for you to petition TC, so don't give up. As you're otherwise healthy, that is a great stepping stone toward getting a medical. I do know that TC considers your health and lifestyle in the bigger picture, so evidence of non smoking, non drinking, good body condition, and regular exercise will certainly be noticed and help you. In my first response to being summoned by the TC doctor (looking into my medical health following being in an accident) I had ridden my bike to the TC office, and had it folded with me in the lobby - I know that he noticed that with [good] surprise, and that had ultimately worked in my favour later.

Get your medical situation sorted before you invest "much" in training.

Good luck!

Welcome to PPRuNe!

I second this advice, and regularly give it myself. Don't spend a dime on training until you get your medical sorted out.

I also second going to have a chat. A CAME is there to assess your suitability to hold a medical and will provide professional advice on how to best to obtain or continue to hold a medical if, in their opinion, TC would begin to look sideways. TC really likes to cover their behind, so you'll find the phrase "potentially disqualifying" or similar all throughout the medical standards. A CAME will interpret those qualifications for you. In fact, I'd ask your cardiologist to provide you a history to take to your CAME. They could determine whether submitting that paperwork with the medical to get ahead of TC's questions is warranted.

Best of luck!

Thank you both for your replies. I didn't realize the decision was made by TC and not the CAME. I'll try to book a consult with a CAME before doing the Cat 3 medical. Meanwhile, as luck would have it, my annual checkup with my cardiologist is tomorrow, so I can ask him for documentation to bring to the CAME.

You have received some excellent advice from well-qualified PPRuNers.

Good luck and do let us know how you get on. We’re a very friendly bunch.

BTW, in spite of my location, I do fly in Canada, mainly Alberta and BC.

I’m only in Saigon to get away from the Prairie winter!

Update: I had my annual cardiology check up was fine, no issues and my cardiologist offered to write a note stating that my condition is great and there is no risk of sudden incapacitation.

I did my category 3 medical this evening and everything went well except my blood pressure was high - 143/90. I was nervous and I think that's why it was so high because I normally have exemplary BP (120/80 or lower) and a very low heart rate. Hopefully this won't be a problem with Transport Canada.

Other than high BP, all other areas of the exam were terrific and my CAME is fairly optimistic I'll get approved with some requirement for an annual checkup, ECG, etc.

Often known as White Coat Hypertension. My doctor says he routinely records readings 10 mm lower due to this effect. :)​​​​​​​

I am aware of the same thing, and am confident that medical examiners consider this as favourably as they can...

'Nice to hear your examination went well!

That's great news Nebensonnen, and Congrats. Let us know when you get the medical from TC.

My CAME is also aware of the White Coat Hypertension effect and she takes a BP reading at the beginning and end of the medical. I normally start the medical at a level considered Stage 1 Hypertension, and end in the normal to maybe elevated range. I'd imagine it is very common among pilots. As for low heart rate rate, I have that too. She's only just in the last year suggested I go see a cardiologist for a consult, but only to have a response ready should TC ever ask the question.

My CAME said I could send him a few BP readings taken at home using my own digital monitor, and he'd include them in his notes for my medical. So, I took 5 readings this morning: the lowest was 112/70 and the highest was 122/69. So, White Coat Hypertension is very real!

I'll post an update once I hear from TC (probably in 2-3 months time).

I can give you few recommendations:
Be ready to show tons of expert paperwork. You might even need a cardiologist input on this.
Secondly, understand that with RPP, unlike PPL, you can't get night permit or instrument rating in the future, can't even get a multi engine.

Lastly, if all else fail - check up the FAA. You might be able to do a Class 3 there and afterwards go on with BasicMed. It's not the best answer, but I find the US to be always 100 steps ahead of TC. Bonus fact - a AME in the US can issue you the medical on the spot if there is no requirement to defer.