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Crohn’s disease?

Old 4th Sep 2019, 22:30
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Join Date: Apr 1999
Location: Manchester, UK
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Crohn’s disease?

The son of a friend is contemplating a flying career but suffers from Crohn’s disease. Is this a deal-breaker?
ShotOne is offline  
Old 6th Sep 2019, 06:35
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Join Date: Jan 2019
Location: England
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Unfortunately, whilst not a complete deal breaker it is likely to present significant hurdles. To hold a Class 1 medical (required for commercial operations) his condition will need to have been well controlled on 'minimal medication' for a minimum of 6 months (medications such as oral steroids are automatically disqualifying).

Even if his condition is well controlled he needs to be aware that any relapse in his condition will lead to lengthy interruptions of his ability to exercise the privileges of his license.

More information is available from the CAA if you search for 'caa inflammatory bowel disease'. (Sorry, I can't post links as a new user!)
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Old 10th Sep 2019, 17:44
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Hi ShotOne

I would suggest he considers his situation very carefully. I would also go so far as to say that the CAA and EASA guidance on this subject is poor, and that the understanding of the condition is equally as poor, resulting in an over-cautious approach by the regulators. I can understand why to an extent, but I do not entirely agree.

The key risks are:

1) If the medication required to keep his condition under control is not fully acceptable to the CAA then this will restrict the ability to hold an unrestricted Class 1.
2) If he suffers from any ongoing symptoms on a regular basis, i.e. any signs indicative of ongoing inflammation regardless of how minor, an AME is unlikely to be able to certify him as fully fit.
3) He will require a very understanding and flexible Gastro specialist, who is willing to read the CAA requirements and understand the background on what is required so that he can help the individual to be put on an appropriate treatment / maintenance plan and provide regular reports.
4) NHS specialists tend to not be able to provide the regular support needed in this case, therefore it is possible that seeking a private healthcare specialist may be the best option to obtain short-notice and regular follow ups, as well as providing timely reports.
5) In order to get certified in the first place, expect a very long process of having reports from the specialist > to the AME > to the CAA > back to the AME and specialist for further information > and repeat ad nauseam. Again, if using private health care this will be costly. The CAA apply requirements which are more stringent than the published regulations and guidance, therefore expect a headache when trying to get a clear answer on what they expect to see to demonstrate full fitness.
6) Upon successful Class 1 certification there may be an initial period (6-12 months depending on the circumstances) whereby an OML (Operational Multi-Pilot Limitation) applies; restricting the licence holder to exercising the privileges of a commercial licence only with a suitable co-pilot. Some employers may struggle with this, others are fine.
7) A very good approach to personal health and well-being management must be taken. I.e. exercise, nutrition, stress management and sticking to treatment plans. Each person suffers differently and has different triggers, so they must build up an excellent understanding of what makes them ill and avoid those triggers.
8) Any relapse or flare up will require instant grounding, resulting in the whole re-certification process starting again, with a long period of inability to exercise commercial privileges, followed by another OML period. This will be well over the 6 months indicated in the guidance in most circumstances unless it is a very minor flare or increase in symptoms. Even then I would expect a much longer delay, which ultimately equates to a lack of income.
9) Loss of licence insurance premiums may be higher, and there will be additional conditions on any insurance policy which may mean the condition is not fully covered for. Again, this might not always be the case, but it is certainly a risk.

I hope that this gives some idea to how difficult it can be. With that said, it IS possible to achieve it, and if the disease is controlled well then each hurdle can be overcome given time, a lot of patience, the right specialist and a good AME.

The information above based purely on my personal experience. I also suffer from Crohn's, however I consider myself to be one of the lucky ones only having three major flares in the 15 years since being diagnosed. Between each I have no symptoms, no real limitations on diet and on a very low maintenance dose of acceptable medication. Unfortunately my last flare happened as I was about to commence CPL/IR, which resulted in a two year struggle to get re-certified for Class 1 before my ATPL theory credits expired. Luckily I made it with 6 weeks to go this year, however in my whole training journey I think this was one of the most stressful periods in all honesty.

I hope that your friend's son isn't put off by this, and if he is determined to pursue becoming a commercial pilot the best way is to be well prepared and informed for the path ahead.

Best of luck - RR
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