Eye problem and BP issue?

[cat79]

Hi Dr. Forred,
About five weeks back I was planning a flying trip but the weather did not cooperate and I had to take the airlines and as usual I ended up with a nasty head and sinus cold. Around the fourth day of the cold I woke up and found that my left eye would converge on my right and I had double vision. I saw an ophthalmologist and he told me I had a 6th nerve palsy that could have been from the cold virus, blown blood vessel caused by a sneeze or something else and there was no way to tell the cause. He said, there was no treatment but it would most likely clear up in 4 to 6 months. He suggested I see my PCP and have him run some tests to rule out more serious things. My PCP ordered up some labs, EKG, MRI and carotid ultrasound which all came back ok. My blood pressure was a little high (160/80), and my LDL was 162 with a total cholesterol of 227. So he put me on Lisinopril/HCTZ 10-12mg and Zocor 20mg. I do suffer from “white coat high BP” and still had the cold.

My eye mostly cleared up in the first week or so and now at 5 weeks I would say its 99.5% normal, we rechecked the BP at three weeks and it was 130/76. I believe the eye problem was partly caused by the nasal spray and menthol-lyptus drops I used the night before the problem occurred, never used that spray brand before.

I am due to renew my 3rd class medical in August and wondering what sort of issues I face? What paperwork do I need to get from the ophthalmologist and my PCP? This will be the first time reporting being on BP medicaiton.

Thanks,
Jim

[My Flight Surgeon]

1) Get a From 8500-7 completed by the ophthalmologist and submit it to the AME at the time of the physical. You can get one at www.faa.gov.

2) You will need a blood pressure evaluation documentation for the AME. It should include http://www.faa.gov/about/office_org/...nsion/initial/
It is all pretty simple.

[cat79]

DR. Forred,
Thanks for the reply. I have a couple more questions for you if you don't mind.

I asked my DR to take another look at the EKG to make sure there was nothing that was going cause problems. I got an email back yesterday that it was ok but it had a single PVC but it was not an issue. Is the PVC going to be an issue for the FAA and should I have another EKG? I was under a lot of stress that day had just got done getting a small biopsy for a suspected basal cell carcinoma on my face?

I had Moh’s surgery to remove the small spot yesterday, it was completely removed and the margins were clear. I asked and received a copy of the post operative reports to give to the AME but still waiting on the pathology report (I guess that is different than the post operative report). Do I need to supply anything else and is this going to cause a deferral?

Thanks

[My Flight Surgeon]

The ECG is not an issue.

The skin biopsy will depend on the pathology report. If it is benign, no problem, if not it will depend on the diagnosis.

[cat79]

I had my PCP fill out out a hypertension evaluation worksheet, gathered up my lab reprots, EKG printout and an FAA 8500-7 form form my eye problem and took them to my 3rd class medical exam this morning. The exam went well, he told me I had all the reqired documents, the BP meds were ok and that I should have no problem with the FAA approving the 3rd class medical. He told me that since this was the first time reporting BP medications he would have to defer it to the FAA. I questioned why he couldn't issue and was told "he has been doing this for a long time and if FAA the FAA didn't like something they would send me a letter voiding my medical and asking for more tests or documentation and it was best to just let the FAA approve it". I didn't want to argue so I came home dissapointed.

Called the AOPA, they told me the FAA doesn't really want to process BP approvals and the AME should have issued the certificate if everything was ok. They suggested I call the AME back and ask if there was any issue with the EKG or labs and if not, suggested that he call his regional office to see if he can get approval. I called the AME back but he was no longer in the office, spoke with his assistant and she told me she would talk with him when he got back next week to see what they could do.

Is this just passing the buck or is it a liability thing? This is a new AME for me, my old one retired.

[My Flight Surgeon]

If everything was OK, the AME should have issued. He probably does not do enough medicals to be on top of the FAA guidelines. This is why I always say "find someone who does more than 20 a month" if you want to reduce your hassels.