DVT and medicals

[milski]

Hi, first time poster here.
After accumulating some XCountry time around New Year's, I ended up being diagnosed with DVT. It's not clear if the cross country flying had something to do with it or not, although it did have some of the factors that are mentioned when talking about DVT - extended periods of limited movement, dehydration, low oxygen (up to 16,000 in non-pressurized aircraft). The doctor put me on Coumadin for 3 months and expects that the clot will be gone by then and I won't have to take it anymore. I understand that I can get a special issuance while I'm on Coumadin if my blood tests are within certain limits consistently, but I'm more interested in what is my situation after I stop it. Will I be able to get class 1 medical? Or is continuing to take it the only way to have a valid medical after being diagnosed with DVT once?



Thanks,
Milen

[My Flight Surgeon]

The official stance of the FAA while you are taking Coumadin is With the possible exceptions of aspirin and dipyridamole taken for their effect on blood platelets, the use of anticoagulants or other drugs for treatment or prophylaxis of fibrillation may preclude medical certification. Yiu can get a Special Issuance if you are going to fly while on Coumadin. Remember, it takes about a month to get one issued usually.

A history of DVT does not preclude you from obtaining a First Class medical certificate.

The important thing to have done is an evaluation for why you clotted. You need to have a coagulation panel done to include a Factor 5 Leiden, protein-C and protein-S levels performed. If these are abnormal, you may want to be on aspirin prophylacticly for ever.

[milski]

Thanks for the reply. The special issuance while on Coumadin requires 4 out of 5 weekly blood tests to be within certain requirements. Doing them plus the one month that you mention to get the SI means that I'll get the medical pretty much around the time when I'll be off the Coumadin, so I think I'll just stop flying as PIC for a couple of months, that should not be a big issue for me.
Now, for the coagulation panel - do I need to be off the Coumadin to get that done? Is it ok to bring the results of such a panel done by my primary physician to the AME or he needs to order the tests himself? And finally, if the results are not abnormal, will the AME issue the medical or will he have to deffer it to FAA?

[My Flight Surgeon]

The coagulation panel can be done at any time. Your primary care physician can do the panel. You should also get copies of your medical records dealingwith the DVT to take to the AME for review. He can issue the medical but if he feels uncomfortable he may want to defer. When I am in that situation and have all the records at hand, I call the FAA and discuss it with the duty officer. He can give a verbal approval for the medical and just has us send the documentation to him for the record.

By the way, you can get a medical whether or not the coagulation panel is normal or abnormal. You just need that information to be able to prevent future DVT's.

[milski]

Ok, I have one more question, promise that's the last one. What about my current medical? Will it automatically be valid again when I'm off the Coumadin or do I need to do anything special about it?

[My Flight Surgeon]

I think it is valid once you are off coumadin. The DVT will have been resolved by then.