Class 1 Medical Passed with bonus eye/lung tests - "Trip Report"

[JDA2012]

Hi again all - I posted in the Private Flying subforum back in December/January as I was considering starting a PPL with eventual progression through to CPL and ATPL. That discussion and information available online combined with my medical status (LASEK surgery, hayfever, allergies) made me certain I wanted to complete a Class 1 Medical before even starting training, so as to ensure there would be no unfortunate roadblocks down the line.

I am happy to report that I passed the Class 1 (with no limitations) on Friday, and am now ready to embark on the long journey towards a flying career (could be argued I've already done that, but still!) Before I do, I thought it might help others considering the medical to set out my experience here, particularly given the additional visual contrast and exercise spirometry tests I had to take.

First off, yes, the Medical Department closes at 16:30, but no, you won't get them to pick up after about 16:15 on a Friday afternoon. This was mistake #1 I made, having spent the afternoon figuring out the best date and transport method. Still, I spoke to them on Wednesday 6th June and successfully booked in for 09:30 on 15th June - payment of ~£350 taken over the phone at this time. I also booked a room at the very nice Ambers Guest House just down the road for £50.

Booking made, I soon received paperwork in the post detailing the location of the CAA building and various important points, and also downloaded & printed the MED160 form and accompanying instructions from the CAA website. Form filled in, I waited for the 14th (and a conveniently-scheduled business meeting in Bracknell - no sense paying my own petrol!) to arrive, then that evening headed to Ambers, shortly thereafter heading back out again to the nearby Jai-Ho Indian restaurant which, like Ambers, was hotly recommmended on Tripadvisor. Neither disappointed, but let us get to the actual medical shall we...

Setting off from Ambers at 09:15 with both in-car and phone satnavs targeted at the Beehive Ring Road (taking no chances on duff mapping data), it took only about 5-10 minutes if that to locate and park up at the CAA building. I took my travel bag (with change of clothes - I saw the "run around the building" bit coming) in with me, and had it tagged at the front desk as I picked up my pass for the day. The Medical Department is just to the left and behind the front desk, but must be accessed via the turnstiles on the right if only in possession of a paper visitor pass rather than a plastic employee one. The ladies on the Medical desk swiftly relived me of my MED160 form and pointed me towards the lockers, but my bag would not fit inside these so ended up residing behind said desk for the day.

Taking a seat in the waiting room, I acquainted myself with the first of many copies of National Geographic which I would read during the day; my visit totalled 5.5 hours! I was first called at 10:10, and proceeded to a room where a very friendly lady nurse/technician took my height (182cm) and weight (86kg and dropping!) explained the process of collecting a urine specimen, consisting of a metal conduit through the wall separating the consulting room from the gents with a hatch at each end. She places cup in, closes hatch, I wander round, open hatch, retrieve cup, relieve bladder (wish they'd called me earlier - I made sure to drink plenty of water, that's for sure), cup back in hatch, close up, wander back around. The urine is apparently tested whilst you're off doing other things, and indeed will not be mentioned again if there are no problems (i.e. sugar/protein/blood).

Next came the ECG, which was a simple matter of removing shirt and shoes, covering oneself with sticky sensor pads and lying on a bed for a few minutes to relax (ha!) before taking maybe 30-60s worth of readings. My ECG was perfectly stable, although resting heart rate was 82 at the time, which is on the high side, but they are used to this sort of thing and excused it as due to nervousness - I should say so!

After the ECG and peeling off of sticky pads (and various amounts of hair) came the audiogram. For this you sit in a rather small metal booth whilst wearing a set of headphones - remember, Red goes on the Right. These were quite effective at filtering out outside noise, although not so much my breathing, and as such I spent a good portion of the test holding my breath so as not to obscure the (very quiet) tones being played. These tones are of varying pitches and are played into the left ear, each tone being played at least twice, and a button is pressed if you can hear them, with the sequence then repeated for the right ear. The repetition of tones is rather fortunate as it must be said that the pattern of holes on the inside of the booth door also functions much like a "magic eye" image after you've been staring at it for a while and you end up focusing on a point several miles behind it; on discussion with other candidates back in the waiting area we all agreed that this effect was odd enough to put you off the test entirely and that closing the eyes might not be a bad idea! Anyway, my hearing was apparently superb, so on we went.

Cholesterol and iron levels were next to be checked, done via a pin prick blood test to the left ring finger (though I suppose you could nominate any digit you desire). Only a very small sample is required for each, and both are taken via the same hole, onto which a gauze pad and small plaster are then applied. Cholesterol was 4.58 - very good, probably due to my being on a very low calorie (1500) diet at the moment and thereby having cut out most meat, cheese etc. (and indeed most food) - and iron 15.4, within but towards the lower end of the acceptable range, no great surprise as I just gave blood a few weeks ago.

The spirograph was next in line, and if only this was just a case of drawing some pretty patterns. You must blow down a 1 inch wide tube into a machine which then measures the volume exhaled, first slowly to assess total lung capacity, known as FVC (then repeat to valdiate), then with the goal of expelling as much air as possible in the first second, known as FEV1 (and repeat once again). My lung capacity was in the region of 5.5-5.6 litres against a predicted volume of 5.74 for a 6' 30yo male, which is about 96% and therefore normal (82% of predicted is considered fine). Peak flow was a bit low at 517 against a target of 676 (up to 100 less apparently acceptable - not sure where the 676 came from as online calcs show 607/617/645 for my height and age - and a year later for my renewal 560 is apparently fine and prevent me being tested again for my 2015 renewal, so that's that put to bed), and FEV1/FVC came out at only 63%, which is quite a bit lower than expected (should be 82% again). A little surprising as although I have in the past had cat allergies, I have never had any sort of serious respiratory problems, no problems at all outside of the company of felines, and I also SCUBA dive so would expect any sort of issue to have made itself known. I have had what I would characterise as a rather minor cold-type illness (sort throat, some mucus) over the past week or so, so unsure if that would make a difference, I do sod-all exercise on a regular basis, and I hear a lot of this test is about technique, but anyway, whatever the reason my poor showing got me signed up for the exercise spirometry test AKA run around the building (nice day, no treadmill).

This had to wait until later however, as we moved on to the eye tests. These come in two batches, the first being performed by the nurse and then further tests by the opthalmologist. The first two tests were a scan of the surface of both corneas - showing up the LASEK surgery amongst any other anomalies - and then a visual field test, which I have done before and actually find quite fun. Here you cover one eye with special headgear and then concentrate on a bright orange dot with the other whilst white dots are flashed at various locations around it - some very close, some pushing the limits of the visual field. A button is pressed when you see a white dot flash. I got absolutely all of these with both eyes - very interesting to find my blind spot as well, indicated by being able to see the white corona but not the dot itself.

The visual tests continued with the opthalmologist. Many, many tests were done here, including the standard reading of letters from a chart, red/green circle test for astigmatism, colour-blindness number test, reading of F5 text at minimal distances, retinal examination, focusing on a variety of objects and answering questions about injuries, dates of past short-signtedness (I was -3.25/-3.00 before LASEK in 2003) and any infections. Interestingly, there was no intra-ocular pressure test - that's the one with the puff of air against the front of the eyeball. I was found to be very slightly long-sighted - an expected side-effect of the LASEK treatment - but well within acceptable limits and otherwise fine. I was also advised that a contrast test to check my night vision would be necessary as a standard precaution where any laser surgery has been performed, but this was saved for later.

Returning to the waiting room, I was soon called to talk to the MO. This was quite a pleasant chat, discussing general medical history and the many items I had checked on the form - best to be thorough! We established that the cat allergy was no problem, but the MO was very interested in a concussion I suffered following a rather enthusiatic attempt at backstroke back in 1999. No blackout then though, and no after-effects at all, with which he seemed happy. He also advised that my grandmother developing angina in her old age was to be expected and did not need further discussion, and neither did my father's allergy to horse hair. Arm and leg reflexes were checked with a small hammer, head and neck rotation were checked, lungs were listened to with a stethoscope, various abdominal bits were prodded, and eye/hair colour were noted, the latter with humorous comment as it is mostly brown but with copious blonde highlights and little grey bits near the ears.

This left only the two additional tests. Firstly the contrast test, again administered by the nurse and consisting of identifying in which quadrant of a very small black circle a white gap resided. They lull you into a false sense of security on this one - the example circles shown prior to the test proper have better contrast and are visible for much longer than those which comprise the actual test! Still, I scored 58.5%, which is apparently good enough, as the scores seem to count down and anything under 95% is acceptable. I believe this is a measure of the minimum contrast difference which can be observed in low light conditions.

Finally, the exercise spirometry test. First I paid for this and the contrast test - £78 for the pair - and then changed into my shorts and t-shirt. I was presented with an attractive hi-viz vest and sent outside the building to get myself out of breath, more specifically to run laps of the building (3-4 expected) for six minutes. Another chap has had to do this before me, and he warned me not to go full tilt and try and fit in five laps as he had. As it turns out, I got to four, but still managed to incur a slight injury to my right knee leaping off gravel and up onto a loading dock around the side of the building. Still, on returning back inside my FEV1/FVC had only dropped by 2.5% and returned to its previous value 15 minutes after exercise - what they are looking for here is a drop in excess of 10-15%, which would indicate exercise-induced asthma (note that you do NOT need an FEV1/FVC exceeding 70% as I have seen posted previously). Fortunately nothing of the sort here, but the nurse then took the results to the MO to look over whilst I had a nervous 20-minute wait to hear the verdict...which was positive - certificate finally handed over at 15:00, Class 1 achieved and so very happy!

As I said, hope this helps those "looking forward" to their medical, answers some questions and assuages some fears - or just provides a few hours' worth of reading material!

[ashdaman]

hi JDA2012

ive have just read you thread which was very informing.
im hoping to book my class 1 medical soon and im crapping myself

so what are you plans now?
I fly at liverpool out of lomac and mersyflight