Bad medicine

Gday all. I'll be putting most of the recent info on asthma etc into an easy to find and search thread.
Cheers,
BM

HomerJay

Thanks Bad Medicine, useful for searching.

I have a quick question before my class 1 renewal in Dublin next month. I started taking Singulair tablets once a day, the doctor said I might as well as they help with allergy induced asthma and they work well. I still take the seretide which the medical people know about but I'm wondering wether I should tell them about the Singulair.

They might wonder why I am taking additional medication? My asthma has not worsened in any way. My fear is there might be new EASA standards which throw a spanner in the works and I could be sent to a specialist. Basically I don't want to rock the boat. I have my class 1 and I'm fit to fly.

Any advice about this very much appreciated.

Thanks,
HJ

gingernut

I think you're duty bound to tell them homer.

Singulair does seem to work extremely well, I suspect the boys in the white coats would be more interested in this, rather than the drug itself.

Good asthma care invovles prevention of problems, rather than sticking a plaster on an exascerbation, so it sound like your GP's acted correctly in this case, but for future reference, it's worth informing him of the why's and wherefores of the dark art of aviation medicals next time he wants to fiddle with your regime.

Try pming AMEandPPL, he seems to know the ins and outs better than most.

And let us know how you get on for future reference.

HomerJay

Thanks very much Gingernut, I'll send a pm.

The doctor couldnt get a sentence out without me reminding him of my situation so he definitely knew. The key thing was that Singulair is not a steroid tablet which is what the caa do not allow.

Thanks again, I will update once I do the renewal.

HJ

RemotecUK

Yes, Singulair is acceptable as I had my class 1 issued when I was using it. I dont use it now because it didnt make any difference to my symtpoms which are very mild anyway. As you have said its not a steroid so thats one of the reasons why its accepted.

billabongbill

I underwent the lung function test for the ANA B767 recruitment and failed miserably. Blew with all my might until I turned blue but no luck, just hit 68% capacity. Despite all the encouragement and coaching from the guy administering the test, I could not make the required 80%. Was advised to see a pulmonary/sleep specialist. Did the required testing with CO gas and more blowing...got cleared of any lung problem ( specialist said I was born that way, gotta live with it. A capacity of 60 to 70 % is no big deal; he fail to see why the JCAB requirement is such for 80% )

Someone told me that passing the test require the correct technique. Trolled through various threads, only found some vague thingy about taking really small breaths and then big blow. Well that didn't work for me; IS THERE MORE TO THIS? Thanks.

CommanderRiker

billabong..........sorry about your predicament. I have only this suggestion; do lots of deep breathing exercises using your diaphragm and stomach muscles, not the pectoral muscles. During the test, have 2 initial shallow breaths followed by a huge inhalation using your diaphragm and abs and a forceful exhalation using the same said muscles. It worked for me and I sincerely hope it does for you too.

122.85

One thing that may be useful to all is a breathing resistance trainer. I have just ordered one as all info have read / rewiewer comments said that they found a positive improvement and in a lot of cases reduced / removed need for medication. I doubt that it will help a massive degree but any training of the lungs couldn't do any harm. I personnaly went for a Powerbreathe Sport device. Will let you all know in a few weeks if helped me get through Class 1 initial :-) Fingers crossed!!

Babablackship

Just a thought.........would having a few puffs of ventolin or any of the other puffs asthmatics use help in the lung function test?

I am sure there are guys who on puffs and can confirm if they can help in the lung function test, not amounting to cheating of course!

De_Vlegende_Student

Very interesting topic guys!! I've got exactly the same, had my initial class 1 in Amsterdam and they told me to go to a specialist due to low FEV1 and FEV1/FVC (Tiffenau index) readings. Now i'm going a lot to the gym and have seretide/ventolin and singulair to prevent any reaction from cats and dust, hope it will work for the next time. Just a question, are the examiners at Gatwick just looking at the FEV1 numberand peakflow or also to the FVC and FEV1/FVC? Thanks a lot!

Greetings Alexander

CommanderRiker

Baba raises an interesting question; will AMEs allow these puffs to be used prior to a pulmonary function test?

I guess if the puffs are prescribed for asthmatic conditions, they are probably legit for the lung function tests. Anyone willing to share their experiences?

Mach086

My experience with regards to asthma on my initial:

I'm 6'2 so naturally I would have a lower capacity than the less tall guys.
I Use the Brown Inhaler (morning and night)
I Use the Blue Inhaler (when req)
I take Singulair once a day.

Passed the initial.

De_Vlegende_Student

My AME said the asthma must be stable, with or without your puffs so you may use them before you have to do the test (and with puffs i mean ventolin/seretide)

Alexander

122.85

I got through my Class 1 initial last week with no problems I told AME about my condition and that I had previously used Beclazone. He reviewed my lung function results and was perfectly happy with these.

Good luck to all in same boat, I worried about it before hand as am sure many do. My advice is lots of running, lung training and be honest at medical.

De_Vlegende_Student

Nice to hear 122.85!! Congrats!! I was waiting to hear the result of you because of the power breath sport device, convinced it helped so i'll give it a try too! Keep you all informed!

Alex.

122.85

Fingers crossed for you!
I do think the power breathe helped but in conjunction with CV training. When I was going for a run I used to use the power breathe to 'warm up' as you then start running with your second wind so to speak and that seemed to help.

Good luck!
Matt

De_Vlegende_Student

Allright then, just for the info which power breathe do you use, the wellness, fitness or sport performance?? And is that the classic one or the plus version? Just curious

Greetings Alexander

122.85

I am using the sport version and its plus not claasic.

Cheers
Matt

Sparelung

First post!

Just some replies to some of the things I've read on here if I may, from someone who works with respiratory disease every day, and with an interest in aviation medicine (which is why i came here in the first place...)

The Powerbreathe will not increase your lung function dramatically, they are useful for those under physiotherapists because their respiratory muscles have wasted due to disease. Put simply, this is because the majority of the lung function values we look at such as PEF (Peak Expiratory Flow) and FEV1 (Forced Expiratory Volume in 1 second) to diagnose airway obstruction are not down to respiratory muscle strength, but a function of the air-carrying capacity of your airways, which stands to reason will be lower if they are narrower, such as in an asthma patient. If your airways are narrowed and your numbers reduced, no matter how hard you are able to blow you will always get the same numbers because there is a maximum rate at which air can travel through a small tube . This can only be increased by increasing the diameter of the airway by reducing long-standing inflammation (brown inhaler) and reducing muscle constriction by way of medication (blue inhaler)

To billabongbill: Even if your lung function values are reduced, you may be what we refer to as a 'normal variant'. Everybody has predicted values based on age and height, but that number will be within a normal range that depends on which guidelines you read. Occasionally we will see patients that are outside the normal range, both high and low; it just means that their lungs are smaller/larger than average, but that those lungs are working properly. Your specialist took a look at your full results and came to that correct conclusion, passing that on to the relevant authorities who should pass you fit. 'Passing' has no technique apart from blow as hard as you possibly can! People (mainly people with a little bit of knowledge of lung function) become too fixated on the patient's 'normal' peak flow readings and forget that there is a large variant in the population that have the same age and height as you!

For those who get wheezy on cold days and when exposed to dust, I find that a lot of my patients who report this have PEF and FEV1 within normal ranges and would pass any medical on these numbers alone. These patients require 'provocation tests' like running around the car park! It's an excellent test, especially on a cold day, although treadmill running indoors will give you a similar effect. Exercise induced-asthma is categorised by a fall in FEV1 of 15% after 6 minutes running. If you have an allergic type asthma we can induce airway constriction with chemicals such as methacoline or histamine - the amount needed to drop FEV1 by 20% will categorise the severity of your illness.

Regarding asthmatics taking inhalers to 'pass the test': if the person doing the test is only looking at PEF and FEV1 then it may work, but if they are experienced and look at other things on the test then they will still see that you have distinct characteristics on your results and flag it up regardless of recent ventolin use - I can spot a controlled asthmatic a mile off. I always ask that patients don't use any inhalers prior to testing, because it then allows me to perform a 'reversibility' assessment, ie how much the inhalers can reverse the airflow limitation, and whether their treatment is optimal.

Sorry for the long post - If anyone has any specific questions please ask away.

De_Vlegende_Student

Hi Guys!
Just to let you know, i've also got my Class 1 medical certificate!! Had to come back for the renewal (because i already had the initial and then the asthma problem occured), the AME just looked to my fysical health, eye check etc. the usual and told him what medication i take (seretide qvar and singulair) and asked if i do any exercise (fitness, rowing, running). He send it to the Authorities and it's fine according to JAR-FCL 3.160 b appendix 2 paragraph 2. Finally!!! So just for the info for other asthmatic (allergic) (student) pilots, asthma is not a big deal IF it is stable, the medication is approved to fly with (ask AMC) and your pulmonary graph is sufficient (FEV1/FVC >70% FEV1 > 70% and Peakflow >80%). And the keyword for me was...do a lot of exercise/sport, practise on a Peakflow indicator and never let you tell it is mission impossible. I want to thank all people on this site/forum for all the info and support, because this was the first site where i personally found out it is possibly to fly and make your dream come true, even with asthma!! All the best to the fellow asthmatic pilots!

Greets Alexander