Right Bundle Branch Block (RBBB)
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The only thing that worries me is your AME grounded you whilst awating the review of your ECG by the CAA. As far as I am aware this also covers your class 2 untill a cardiologist at the CAA has looked at your ECG readout.If he says its nothing then he will contact you and say so.
May I sugest you contact the CAA by phone or e-mail to clarify this and not rely on the website or hearsay.
Sorry about this but I have been there a number of times.
Jarvy
May I sugest you contact the CAA by phone or e-mail to clarify this and not rely on the website or hearsay.
Sorry about this but I have been there a number of times.
Jarvy
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Whirls,
Just check that the quote is for the whole job.
I got a bill from the consultant for £300 ,I thought great!
Two days later got a bill for another £300 plus for use of hospital equipment and staff!
Hope your one is for total cost.
Lister
Just check that the quote is for the whole job.
I got a bill from the consultant for £300 ,I thought great!
Two days later got a bill for another £300 plus for use of hospital equipment and staff!
Hope your one is for total cost.
Lister
The Original Whirly
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Jarvy,
I have clarified this with the CAA medical dept by phone. I said I'd read it on their website, and was it correct; I was told it was.
Lister,
This was a quote from the AME who is a CAA approved cardiologist...also the one I should have gone to see in the first place, but...long story....
I have clarified this with the CAA medical dept by phone. I said I'd read it on their website, and was it correct; I was told it was.
Lister,
This was a quote from the AME who is a CAA approved cardiologist...also the one I should have gone to see in the first place, but...long story....
So, young healthy dude with RBBB and no previous= no worries
Older, still healthy dude with new RBBB and previous normal ECG's = risk stratification for e.g. Ischaemic heart diseae.
Older, still healthy dude with new RBBB and previous normal ECG's = risk stratification for e.g. Ischaemic heart diseae.
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You can do it on the NHS, but will take long time.
Private for the test to be done will cost more then £300 with aviation cardiologist. I do not recall all the details, I belive just the letter (report from the doctor cost £220 - the consulation)
Then you pay for each of the tests you need to do, Echocardiogram was £375, exercise Electrocardiography was £280, + the 24 hour Holte test, do not have the cost of that, but would probably be another £200 - £300.
This was by an aviation cardiologist - no way will you get away with all those tests private for much less. I could have got all trough NHS, but GP had to refer you, and by that time and you get appointment, it can already have passed 3 - 4 months.
I bit the bullet, and then I am told I did not need to be investigated. Anyway best of luck, but at least budget with around £1000, I phoned several of CAA's doctors, and it was all more or less the same price.
Private for the test to be done will cost more then £300 with aviation cardiologist. I do not recall all the details, I belive just the letter (report from the doctor cost £220 - the consulation)
Then you pay for each of the tests you need to do, Echocardiogram was £375, exercise Electrocardiography was £280, + the 24 hour Holte test, do not have the cost of that, but would probably be another £200 - £300.
This was by an aviation cardiologist - no way will you get away with all those tests private for much less. I could have got all trough NHS, but GP had to refer you, and by that time and you get appointment, it can already have passed 3 - 4 months.
I bit the bullet, and then I am told I did not need to be investigated. Anyway best of luck, but at least budget with around £1000, I phoned several of CAA's doctors, and it was all more or less the same price.
Dear Ms Whirly.
My (probably imperfect) understanding on this is that LBBB is bad news(very), RBBB shouldn't be. The issue with ECGs seems to be when they show a change. Mine was diagnosed on my first ever ECG (RAF Biggin Hill 1976) and has shown on every one since. 23 years of mil aviation and 9 of civ later I guess it's still there.
Hope this helps - good luck
DH
My (probably imperfect) understanding on this is that LBBB is bad news(very), RBBB shouldn't be. The issue with ECGs seems to be when they show a change. Mine was diagnosed on my first ever ECG (RAF Biggin Hill 1976) and has shown on every one since. 23 years of mil aviation and 9 of civ later I guess it's still there.
Hope this helps - good luck
DH
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hi there, an RBBB is not that big a deal. but if you have a left bundle branch block, then you need a pacemaker and I guess you'd not be deemed fit to fly.
I myself have an incomplete RBBB and am Class I fit n flying !
I myself have an incomplete RBBB and am Class I fit n flying !
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I have sometime LBBB and at no time had or likely to need a pacemaker. As has been said before the heart has a built in back up system in place should it detect either LBBB or RBBB.
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Class 2 priviledges
Whirly,
I have copied this from a Caa document which offers guidance as to the meaning of any of the limitations which can be placed against medical certificates.
SSL/FIL Limitation
Flight Instruction Using a JAA Class 2 Certificate to Validate a PPL (H)
In the UK it is possible to instruct on helicopters with a Flying Instructor (FI) rating and a PPL (Helicopters). Unrestricted Class 2 certification is usually considered as being compatible with a Class 1/OML certificate and this is the level of certification that is considered appropriate for a flying instructor. If a PPL (H) wishes to exercise the privileges of a FI rating but has a medical condition that would warrant an OML if he held a Class 1 certificate, he should be advised that he should not instruct ab-initio students. The AMS should be informed and the following limitation will be applied to his Class 2 certificate:
SSL/FIL “Flight Instruction Limitation”
No flight instruction prior to student's first solo cross-country flight.
I think its quite interesting as written, because you are a Cpl exercising your Class 2 priviledges with out pay! Not a PPL (Fi) Hope it helps
I have copied this from a Caa document which offers guidance as to the meaning of any of the limitations which can be placed against medical certificates.
SSL/FIL Limitation
Flight Instruction Using a JAA Class 2 Certificate to Validate a PPL (H)
In the UK it is possible to instruct on helicopters with a Flying Instructor (FI) rating and a PPL (Helicopters). Unrestricted Class 2 certification is usually considered as being compatible with a Class 1/OML certificate and this is the level of certification that is considered appropriate for a flying instructor. If a PPL (H) wishes to exercise the privileges of a FI rating but has a medical condition that would warrant an OML if he held a Class 1 certificate, he should be advised that he should not instruct ab-initio students. The AMS should be informed and the following limitation will be applied to his Class 2 certificate:
SSL/FIL “Flight Instruction Limitation”
No flight instruction prior to student's first solo cross-country flight.
I think its quite interesting as written, because you are a Cpl exercising your Class 2 priviledges with out pay! Not a PPL (Fi) Hope it helps
The Original Whirly
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cab 3707,
Thank you; that's exactly what I needed to know! Last time I phoned he CAA medical dept they told me I couldn't instruct ab-initio students, but I hadn't read it anywhere and thought they were making up the rules as they went along. It's not what I wanted to hear, but at least means everyone is being consistent. Please could you post - or pm me - the link to that document.
Extra tests now booked for early September...I'll let you all know what happens.
Thank you; that's exactly what I needed to know! Last time I phoned he CAA medical dept they told me I couldn't instruct ab-initio students, but I hadn't read it anywhere and thought they were making up the rules as they went along. It's not what I wanted to hear, but at least means everyone is being consistent. Please could you post - or pm me - the link to that document.
Extra tests now booked for early September...I'll let you all know what happens.
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Class 2 / OML
Hi Cab 3707 and Ms Whirlybird
Really interested in your topic as I'm in a similar position also. Had artery problems leading to angioplasty last august and have had to give up my beloved HEMS job in S.Wales as a result. I've had lots of contact with the CAA who have been very helpful and sympathetic but no chance of Class1 unresticted being re-instated. I was thinking of getting back into instructing with a Class 2 but obviously would not be able to make a living that way but then I saw Cab's post so perhaps there's a possibility after all. I have passed all the requirements on the CAA coronary algorhythm chart (except for perfusion scan , which I don't think will be a problem ) so think I will be able to get Class 1 OML / Class 2 unrestricted and then revalidate my FI ticket.
So, like Whirlybird I would also like to get a copy of the CAA document that was posted by Cab, so if you are about mate, please post a link or a p.m. so that we can go to the CAA with as much info as possible - it would be very much appreciated and thank you.
Regards............Tony Gilson
Really interested in your topic as I'm in a similar position also. Had artery problems leading to angioplasty last august and have had to give up my beloved HEMS job in S.Wales as a result. I've had lots of contact with the CAA who have been very helpful and sympathetic but no chance of Class1 unresticted being re-instated. I was thinking of getting back into instructing with a Class 2 but obviously would not be able to make a living that way but then I saw Cab's post so perhaps there's a possibility after all. I have passed all the requirements on the CAA coronary algorhythm chart (except for perfusion scan , which I don't think will be a problem ) so think I will be able to get Class 1 OML / Class 2 unrestricted and then revalidate my FI ticket.
So, like Whirlybird I would also like to get a copy of the CAA document that was posted by Cab, so if you are about mate, please post a link or a p.m. so that we can go to the CAA with as much info as possible - it would be very much appreciated and thank you.
Regards............Tony Gilson
The Original Whirly
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tgilson,
Cab 3707 may have contacted you already. If not, the paragraph he quotes is in a document called the "UK CAA Limitations Guidance document". I don't have the link to hand, bu a search should find it. It's guidance for AMEs on the limitations put on medicals.
Anyway, the last paragraph is the one quoted above. What it means, if I've understood correctly, is that with a Class 1 OML/Class 2 unrestricted, you can instruct, but NOT AB-INITIO STUDENTS. You also can't be paid unless you have a Class 1...or maybe you can, if you have a CPL, not 100% certain of that. Anyone know? I wouldn't have thought so, if you're instructing on the basis of your Class 2.
I now have my medical back with the restriction stated above.
Cab 3707 may have contacted you already. If not, the paragraph he quotes is in a document called the "UK CAA Limitations Guidance document". I don't have the link to hand, bu a search should find it. It's guidance for AMEs on the limitations put on medicals.
Anyway, the last paragraph is the one quoted above. What it means, if I've understood correctly, is that with a Class 1 OML/Class 2 unrestricted, you can instruct, but NOT AB-INITIO STUDENTS. You also can't be paid unless you have a Class 1...or maybe you can, if you have a CPL, not 100% certain of that. Anyone know? I wouldn't have thought so, if you're instructing on the basis of your Class 2.
I now have my medical back with the restriction stated above.
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LASORS gives some information about what instruction can be given by a FI with with an oml.
Have a look at page 76 and 77 of this... http://www.caa.co.uk/docs/175/Sectio...20(LASORS).pdf
Which is broadly similar to the entry above mentioned by cab3707 but I think the guidance documents on UK limitations refers to pre-JAR (ie pre 1999) CAA Class 1 medicals, not JAR class 1 medicals.
Edited to correct typos and clarify, (I hope).
Have a look at page 76 and 77 of this... http://www.caa.co.uk/docs/175/Sectio...20(LASORS).pdf
Which is broadly similar to the entry above mentioned by cab3707 but I think the guidance documents on UK limitations refers to pre-JAR (ie pre 1999) CAA Class 1 medicals, not JAR class 1 medicals.
Edited to correct typos and clarify, (I hope).
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Whirlybird,
How did you get on with your RBBB ?
Was reading this thread last night and the future Mrs. Wayne was getting rather irritated by the situation concerning your RBB. the Future Mrs. Wayne works in cardiology so took a professional interest in your situation.
(copied to your PM)
How did you get on with your RBBB ?
Was reading this thread last night and the future Mrs. Wayne was getting rather irritated by the situation concerning your RBB. the Future Mrs. Wayne works in cardiology so took a professional interest in your situation.
(copied to your PM)
The Original Whirly
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Extra tests being done today and tomorrow. I have my Class 1 medical back with an OML, which can also be used as a Class 2 unrestricted, so long as I get the tests done within two months. And after asking four people at the CAA, I finally have it in writing that I can instruct unpaid using my Class 2. If all is OK in a year, I get my Class 1 unrestricted back. Could be worse.
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Whirlybird..
this is from Ftr. Mrs. Wayne...
As a Cardiac Physiologist who does these tests daily, your situation seems ridiculous. First off, RBBB is a conduction abnormality which doesn't warrant any concern unless your ECG showed up other problems such as Left Axis Deviation. (If you have a problem with both the right and left sides of the heart this can be more serious but would need more factors again to make it of great concern.) However, to only have RBBB is not really a problem. On this side of the heart there are various other conduction pathways that can be used to make the heart contract.
With regards to the tests that they are asking you to do, I can't see the sense. A 24 hour ECG tape seems the most reasonable thing to do, yet this will just show a bundle branch block morphology, which we already know you have from your resting ECG. I can't imagine it showing up anything else if you are otherwise fit and healthy. Not sure how much you're being charged for this, my hospital charges 160 pounds to put it on and analyse the results as well. (though the cost varies regionally, I'm in Surrey)
The echo seems utterly pointless. This looks at the structure of the heart and having established you have an 'electrical fault' not a structural one, this won't give any info on the bbb. Lets hope nothing else structural is found though!
The Exercise test looks at ischemic heart disease. Again, this is structural (whether you have blocked coronary arteries) and they are also notoriously more difficult to do on someone that has RBBB as the morphology on the ECG is different anyway. So again, can't imagine they are going to find anything there. You should do about 9-12 mins (it's on a set protocol) and then that shows there is absolutely nothing wrong with you.
Can't believe how they are not giving you the full medical classs 1. RBBB is nothing to worry about and had you not had an ECG as a routine you probably would never have noticed anything was wrong with you!
GRRR!!!!
this is from Ftr. Mrs. Wayne...
As a Cardiac Physiologist who does these tests daily, your situation seems ridiculous. First off, RBBB is a conduction abnormality which doesn't warrant any concern unless your ECG showed up other problems such as Left Axis Deviation. (If you have a problem with both the right and left sides of the heart this can be more serious but would need more factors again to make it of great concern.) However, to only have RBBB is not really a problem. On this side of the heart there are various other conduction pathways that can be used to make the heart contract.
With regards to the tests that they are asking you to do, I can't see the sense. A 24 hour ECG tape seems the most reasonable thing to do, yet this will just show a bundle branch block morphology, which we already know you have from your resting ECG. I can't imagine it showing up anything else if you are otherwise fit and healthy. Not sure how much you're being charged for this, my hospital charges 160 pounds to put it on and analyse the results as well. (though the cost varies regionally, I'm in Surrey)
The echo seems utterly pointless. This looks at the structure of the heart and having established you have an 'electrical fault' not a structural one, this won't give any info on the bbb. Lets hope nothing else structural is found though!
The Exercise test looks at ischemic heart disease. Again, this is structural (whether you have blocked coronary arteries) and they are also notoriously more difficult to do on someone that has RBBB as the morphology on the ECG is different anyway. So again, can't imagine they are going to find anything there. You should do about 9-12 mins (it's on a set protocol) and then that shows there is absolutely nothing wrong with you.
Can't believe how they are not giving you the full medical classs 1. RBBB is nothing to worry about and had you not had an ECG as a routine you probably would never have noticed anything was wrong with you!
GRRR!!!!
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Thanks, Mrs Wayne!
Well, I had the tests done today, and FWIW, the cardiologist pretty much agreed with you. Apparently the RBBB hardly even showed on the ECG, but the computer said it was there, and once it's found, you have to jump through the CAA hoops. Everyone seems to agree that the CAA want to be seen to be checking everything out as carefully as possible. They didn't find anything, and all that happened was I came away £380 poorer, with aching knees from the exercise test (nearly 10 minutes, then I gave up; at 5ft 2ins I was running rather than walking as you're supposed to by that point; my legs weren't long enough!). But I still have an OML on my Class 1 (and an unrestricted Class 2) for a year.
Oh well, I make more money from writing about aviation than practising it anyway, so I'll instruct unpaid for a year to keep up my hours. Could be worse.
Well, I had the tests done today, and FWIW, the cardiologist pretty much agreed with you. Apparently the RBBB hardly even showed on the ECG, but the computer said it was there, and once it's found, you have to jump through the CAA hoops. Everyone seems to agree that the CAA want to be seen to be checking everything out as carefully as possible. They didn't find anything, and all that happened was I came away £380 poorer, with aching knees from the exercise test (nearly 10 minutes, then I gave up; at 5ft 2ins I was running rather than walking as you're supposed to by that point; my legs weren't long enough!). But I still have an OML on my Class 1 (and an unrestricted Class 2) for a year.
Oh well, I make more money from writing about aviation than practising it anyway, so I'll instruct unpaid for a year to keep up my hours. Could be worse.
RBBB
Hey Whirlybird,
Glad to know they have not grounded you permanently, but does the restriction mean you have to go through all this again next year, or will just lift the restriction without all the hoop jumping.
Aviation journo, in what field?
Congratulations anyway.
Regards.
Air pig.
Glad to know they have not grounded you permanently, but does the restriction mean you have to go through all this again next year, or will just lift the restriction without all the hoop jumping.
Aviation journo, in what field?
Congratulations anyway.
Regards.
Air pig.
The Original Whirly
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air pig, next year I just have to do another exercise ECG (yuck, I hate ******* treadmills) and my Class 1 medical. If all is well, that's it...for ever, as I understand it! Once RBBB has been proved to be nothing, the CAA won't bother about it again.
I write for several GA magazines, generally on helicopter related stuff, and I have a book on helicopter flying out too. But I call myself an aviation writer, not journalist!
I write for several GA magazines, generally on helicopter related stuff, and I have a book on helicopter flying out too. But I call myself an aviation writer, not journalist!