Try a search tk.:)

Sure no flying school in lagos
 

sure You right that there is no flying school here in lagos, but my sponsors requested me taking the medicals before heading to Mid Rand, South Africa for my training.

The dreaded Weeze!!!
 

Went to the doctors recently due to slight weezing after exercise. I have been given a ventolin evohale inhaler and a peak flow meter to record my peak flow results over a period of time. From reading previous posts on here I have become slightly worried as to the results I have been getting. My highest peak flow is 570 with my lowest being 540. Just wonderiing if anyone on here could shed some light on this? Is there anyone who has had similar results and falied the C1 medical?

Any methods on how I could perhaps improve this? .. I currently am an active person.

Thanks in advance
MB

Hi MrBrightside.

The variation in your peak flow rate is marginal, but don't fall into the trap of placing too much emphasis on the figures alone. We have to look at the bigger picture.

A couple of points:

Asthma can sometimes be quite difficult to diagnose with any certainty.

Doctors (and nurses:), and sometimes surgeons) can sometimes be a"prickly" lot and resent being told what to do, but I do think that it is important that you stress the importance of an accurate diagnosis to your GP- does he realise the implications of labelling you as "asthmatic", on your future career.

He may even be aware of the newly released guidelines to managment and care of asthma.... http://www.sign.ac.uk/pdf/qrg101.pdf , although I'd resist the temptaion to print him a copy!

I know more about asthma than I do about aviation medicine, but from experience of these pages, it'd seem that mild asthma doesn't seem to be a problem for aviation medicals. (Try a search)- although the RAF seem to be stricter.

I expect the quack will be interested in the severity of your symptoms, how it affects your day to day life, and hospital admissions due to asthma.

Keep us posted.

G'day from one very mildly asthmatic person and a holder of a Class 1 medical and an ATPL.

Asthma is a condition that needs to be monitored and controlled to have the least amount on impact on your life.

If the doc didn't explain, take 2 readings of your peak flow per day. One in the morning (first thing ideally) and one in the evening. What the doc is looking for is a bench mark for yourself and to see if there's a 25% or greater difference between the readings. The morning one should be the worst.

Being active is good. You may find you'll need to take a puff before exercise.

My version is a cough and it took several trips to the docs and changing doctors to get it diagnosed.

An anti-inflamatry drug for me back causes really quite bad asthma. Couldn't get through the night without a puffer. Stopped taking it, and back to blowing nearly off the scale.

Some variation in peak flow is normal. Take it when you get up, and in the early evening and plot the results as a graph. If your morning reading is a lot lower that suggests asthma, but modern treatment guidelines suggest that inhaled steroids are the drug of choice for most asthmatics rather than relieves, which is what Ventolin is.

However, if you only get symptoms after exercise then pre-treatment with a reliever might be all you need - if indeed you have asthma!

The Asthma UK website is very good, plus they have a phone number that will let you speak to an asthma nurse:

http://www.asthma.org.uk/

Thanks for the replies. Greatly appreciated.

I have been recording my peak flow readings three times a day, morning, afternoon and before I go to bed. I do seem to find that my morning readings are slightly worse than my afternoon/evening readings but do not vary dramatically. I have been using the reliever twice after i take my readings.

I have managed to increase my peak flow to a maximum of 630 and I feel as if I may be able to improve upon this through time. What I would like to know is that if I was to stop using my ventolin evohale inhaler would my readings begin to drop substantially? Will this benefit me in the long term?

Thanks
MB

www.peakflow.com is quite useful too :)

I am not sure why you want a higher peak flow reading?

Sift through those links and educate yourself about what asthma is and how it's best managed. Then you can discuss it with your doctor as chances are, you'll know yourself better than s/he will. I spent a fair bit of time wading through the British Medical guidelines on asthma and it's well worth it.

Any way. How I understand the "reliever" eg Ventolin, it works when your bronchiols are playing up or as a temporary "preventer" if the asthma's exercise induced.

As I found out, as an adult you don't get cured, your condition is managed. Since I hadn't used my puffer for ages the asthma crept up and sidelined me for a week. Back to the preventer (steroid puffer) for 2 weeks to settle it down and also had to take the ventolin as well. Lesson learned. So, back to taking a puff before exercise.

It's not a crime or shameful to have to take a puff. Plenty of world class athletes are asthmatic eg, Kieren Perkins (Aussie swimmer) and Paula Radcliffe.

Neither do child asthmatics as there is not cure - all that can be done for any of us is management, and the better it's managed the less it's impact on your life. However, some shildren literaly 'grow out' of asthma as their airways enlarge. A fair percentage of those that grow out of it age back into it...

Doesn't everyone?

I think we're all in danger of labelling you with a disease which hasn't yet been formally diagnosed.

Go see the quack rather than diagnosis by internet. This is important- it may affect your future career.

Pre and post ventolin peak flows may be useful- remember that when recording peak flow readings, it's the "best of three" which counts.

It sounds like he did do it right.

If you look at the SIGN guidelines, you'll see that "getting it right" isn't always an exact science, and sometimes a trial with inhalers is the correct thing to do.

Cough medicines don't work. Full stop.

But I guess they're sometimes useful for placating the odd wimp with a sore throat and a sniffle, who probably doesn't know his gluteus maximus from his olecranium:)

really ?
 

You know what "olecranium" means ?

I'm all ears . . . . . . . . .

Actually, one part of the elbow joint is the OLECRANON


this might be of interest: http://en.wikipedia.org/wiki/Olecranon

Asthma
 

Hello all,

Is Asthma a problem for pilots??

I have mild asthma, never had an asthma attack or been hospitalised. Civil aviation have asked for a spirometry reading and status from a gp after passing the class 2 medical. Is this something to be concerned about considering I can only blow 350 on the peak flow and have a return reading of a moderate obstruction from the spirometry reading?

not very certain . . . . . . . . . .
 

An initial JAR class 1 at Gatwick would be seriously in doubt if a
candidate could not manage a PEFR greater than 350 l/min.

Just imagine a temporary WORSENING of that, for whatever reason at
all, and then combine that with the reduced oxygen content of a cabin at the equivalent of 8000 feet.

Still capable of dealing with any in-flight emergencies ? I don't think so.

Yes true this could become a problem in the case of low oxygen.

Thanks for your response I think I will have to reconsider my options.

Is there a training method that can improve lung capacity? After exercise I have blown >400. Also I have passed respritory testing and have gained a scuba diving licence.

Short of having an asthmatic attack at altitude, it's probably not going to be an issue operationally. Getting past the paperwork, however, could very well be. I don't know what Australia provides with respect to Asthma, but in the US it's considered childhood asthma if it hasn't been repeated since the age of 12. If the paperwork reflects a statement that asthma hasn't been experienced since the age of 12, that may well do the trick. If you tell the examining physician you have asthma...then you're opening up a can of worms.

I'm an asthmatic. I grew up at density altitudes in the summer of well over 10,000'. I have more problems breathing at sea level than at higher elevations, and I've found that I tend to handle an oxygen deprived environment better than most; I spent much of my early life in that condition. I worked as a firefighter in the smoke for years, and I have regularly been above FL180 doing parachute jumps without any difficulty. Don't assume that being asthmatic automatically pushes you out of the running, or disables you at altitude. I've experienced on decompression at altitude without any ill effects. A much bigger concern would be a sinus block at altitude, which has nothing to do with asthma, and is something to which everyone is subject.

Truth be told, if one is truly a severe chronic asthmatic, an oxygen deprived environment is familiar territory. I know.

what then . . .. . . . ?
 

And if that DOES happen ? For example, induced by the great stress of a mid-air emergency ? The name asthma covers a wide range of levels of disability. Admittedly, some can be pretty trivial, and lived with easily. Let it not be forgotten, though, that at the other end of the spectrum asthma can be life-threatening.

Bad news if you are at the controls of an aeroplane in flight.

A PEF of 350 is *very* low, especially if it's on the old scales for a Mini-Wright, for women of most ages let alone men. Somewhere in the region of 600 would be more normal, depending on your height & age, and AFAIK to a degree on your ethnic group.

That leads me to wonder if 1) your technique for producing it is flawed and 2) are you undertreated?

Technique isn't hard - stand up straight, take the deepest possible breath & blow like crazy.

Being undertreated is another issue. You don't mention your current regime but I assume it includes an inhaled steroid. Have you taken PEF morning & evening to see if they are pretty much the same? If not, I'd say that you are almost certainly undertreated. Also, have you had a trial of Singulair or similar drugs? They didn't do anything for me, but I'm told they make a considerable difference to 1/3 of asthmatics, they help another 1/3 and for the final 1/3 (including me!) they make no difference.

I wouldn't get too hooked up on the numbers, at this stage. (A peak flow of 350lmin-1 is on the low side, but is normal for an 85 yr old female midget!)

It does have to be said, that with the info. you've supplied, your asthma is far from "mild" at this stage.

It's likely that the authorities will take into account the facts you've mentioned. Hospital admissions, exascerbations, time off work school, affect on normal activities, need for emergency doses of steroids etc.

Reading between the lines, as my learned friends note, your control is not yey optimal. The "asthma" component of your underlying problem should be reversible and usually responds well to treatment.

I'd suggest an expert opinion, - seeing a GP with a specialist interest, or respiratory nurse may be a useful starting point.:)

Seritide
 

"You don't mention your current regime but I assume it includes an inhaled steroid"

My current regime is 2 puffs of seritide (morning and night) which is a corticoid steriod. After exercise i can blow 400 PFR. This is so frustrating becuase I am about to start a PBL and am not sure whether to submit my current reading or seek advice and testing from a specialist (re: new medication as you have suggested).

Should I go to a respirtory specialist and ask them to run some tests? Is the issue here whether I will have an asthma attack in flight and can this be tested in a lab?

Seritide
 

'You don't mention your current regime but I assume it includes an inhaled steroid'

2 puffs in the morning and 2 at night (seritide 250) which is a corticoid steriod. Yes i think you have all suggested i should reconsider my medication. I have booked an appointment with my respirtory specialist. I havent seen him for 7 years since I was approved for scuba diving. He actually suggested I start using seritide. Its strange, it never occurred to me that I suffer from chronic asthma. I have always played compeditive sports and run half marathons (on a regular basis) and never thought i could have been performing at a higher level if my lungs were functioning as they should.

In the end if I've never had an asthma attack requiring hospitalisation then this should be ok? Can they test this in a lab so that I can be cleared??

I'm not sure what your national asthma guidelines say, but here in England, you'd be seen as being about 3 steps up the asthma treatment ladder.

(Seretide is a long acting bronchodilator+steroid).

There is probably some scope for improving your figures, but this may depend on what has been tried before.

In all honesty, at this level, it's probably difficult and unfair to offer such specific guidance on this forum.

I would have thought a good starting point would be to discuss the specific requirements with your aviation medical authority and work backwards from there.

I can't think of a test designed to test whether you are going to konk out in the air, but if this hasn't happened in the past, and you're running marathons, then this is a good start.

Previous posts regarding asthma seem to suggest that piots can fly with well controlled asthma, but it looks like the objective readings your doc. has obtained, have caused some concern.

As I've stated, there may be room for improving these readings- that's where the specialist comes in.:)

Seven years is an awful long time to not see your specialist. I get called to the asthma nurse every year, and she checks that I'm OK, my technique is OK and also measures my peak flow - which has hardly changed in the 12 years since I developed asthma.

Do you know if your peak flow has altered since diagnosis? That it goes up after exercise implies to me it could be better all the time.

And is your diagnosis asthma, or ashtma plus something else?

BTW thought you might find the UK guidance interesting:

http://www.nice.org.uk/nicemedia/pdf/TA138Guidance.pdf

The interesting stuff starts at paragraph 2.5.

Am mildly asthmatic myself and, after leaving school in the 80s was initially turned down flat for a class 1 medical on these grounds. Around 2000 I found out that the CAA requirements were relaxing and decided to go for (and indeed passed) a class 1 check. Like you I had never had a major attack and always did plenty of sport, but with an inhaler to hand if necessary.

My goal was to be able to run round the CAA carpark at gatwick for 15 minutes and then pass a peak flow test (that is/was the criterion) and to do this I followed a simple plan of nothing more than running each morning for 15 mins for about 3 months followed each time by a self-tested peak flow until my re-found fitness and breathing technique left no ill effects such as wheezing, instead a positive attitude and a generally healthy feeling.

As it happens the test on the day of the exam proved to be a non-event after my preparation, easily achieving the required level (550-650 if I recall).

Incidentally my Dad (a GP) consistently reminded me that the technique for the peak flow test is not to blow.....rather to Huff with a very hard "H" for best results....could this explain the low readings you are experiencing?

My own AME tells me that many pilots (including me) carry a ventolin in their flight-bag so you are certainly not alone.

I carry a ventolin in my nav bag. I got a really cool Bart Simpson cover for it. :ok:

Much appreciated
 

Thanks all for your thoughts. I think I should be fine once I speak to the respiratory specialist next week. Cheers again :)

Interesting Read
 

That link was interesting cheers for that 'Cats 5' :ok:

Peak flow/Spirometry Advice
 

Hi Pprune!

Does anyone know what one should be hitting on a peak flow meter to be confident of passing the CAA spirometry test? :8

I plan on booking my medical later this summer and would appreciate having a ball park figure to work with.

Many thanks,

PoT

This will give you a rough idea of Peak Flow - but Spirometry is a bit more than a quick blow ;)

Peak Flow - Normal Values

Good luck with the medical!

your readings will depend on a number of factors including race, age, sex and height.

Try a search-discussed recently.

more here... Guideline 101: British guideline on the management of asthma

Thanks for the pointers, guys! Much appreciated.

Peak Flow Question
 

Hello,

Any advise on how to increase your peak flow will be much appreciated.
I know about like technique and all but i want to physically exert more air quickly. ?

Obtain a meter from your friendly nurse/gp/pharmacist,

and practice your technique.

Try a search using the term "asthma" or "peak"

Asthma
 

Hello! I'm a 14 years old boy. And of course i want to be a pilot in a A380 ,a B747 or somthing like that. But i have asthma and i wonder if I can be a pilot or if the asthma would stop me from that....
//Swedish Gurra

This is the answer you may not want,

"it depends".

It depends on how bad it is, how it's managed and so forth. If it's mild and under control, there's no problem (I have mild asthma and I fly a jet, not an Airbus though).

It's up to you and how you respond to your treatment. Do your best to keep yourself healthy and in good shape, listen to your doctor and most importantly, work hard at school. Have a chat with your doctor, make sure he/she is familiar with the medical requirements for flying. (They are less strict than for scuba diving)

Good luck.

Okey thanks I'm not sure but I think I just have mild asthma so I think it´s ok...thanks any way....I don't take medecin often...

try a search lfc, this has been covered a few times in the last year.

It seems many pilots fly with mild asthma, as redsnail states, it depends on severity, time off school, exascerbations requiring hospital admissions, history of collapse/use of steroids (tablets) etc.

The odd puff on a blue inhaler prior to footy probably 'aint gonna make a difference.

Good luck.:)