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 Diabetes mellitus – diseases that affect how your body uses blood sugar
Disturbance of consciousness – i.e., blackout or faint- ing without explanation
Epilepsy – chronic recurrent, unprovoked seizures Heart replacement
Myocardial infarction – a heart attack Permanent cardiac pacemaker
Personality disorder – that repeatedly manifested itself by overt acts
Psychosis – thoughts and emotions so impaired that reality is lost
Substance abuse – typically drugs or alcohol Substance dependence – compulsive drug-seeking (why isn’t nicotine included?)
Mega-Corporation Mentality
Other medical conditions may be temporarily disqualify- ing, such as acute infections, anemia (lack of healthy red blood cells), kidney stones and peptic ulcer (sores in the lining of the stomach, lower esophagus or small intestine). If you’ve ever wondered if you could fly with a kidney stone, wonder no further. Once in the ureter, the pain will decide for you (see “Kidney Punch,” T &T, November 2012). As a DC-10 Flight Engineer, I awoke on the floor of the pilot restroom in L.A. operations having passed out from the pain of what turned out to be a traveling kidney stone. Imagine if the passengers had seen an in-uniform airline pilot being wheeled-out under critical care. Instead of fol- lowing the EMT protocol of sporting an O2 ensemble and an IV bag while riding in a wheelchair, I walked through the passenger filled terminal to an ambulance. The stone soon completed its trek, and after the requisite tests the next day to confirm the event was over and there would be none to follow, I flew my next trip the day after the tests.
Management never thanked me for avoiding national news by avoiding the wheelchair while writhing in agony,
nor for my returning to flying duties quickly. Instead, the chief pilot chastised me for waiting until so late to call in sick. This corporate mentality was demonstrated again after my aforementioned Puerto Vallarta, Acute Mexican Rhinovirus event. When talking to crew scheduling after the trip with ears blocked and a fever over 100, I was told to “enjoy my time off.” If you have a supervisor to whom you report when medically disqualifying yourself for flying duties, there may be friction. Make the right decision as PIC about your condition regardless of external pressures from employers, passengers and perceived time commitments. Here are some guidelines to help make that tough call.
• Illness
o Illnesscanproducefeverimpairingjudgment,
memory, alertness and the ability to make calculations. The safest rule is not to fly while suffering from any illness.
• Medication
o Performancecanbedegradedbybothpre-
scribed and over-the-counter medications. Any medication that depresses the nervous system, such as a sedative, tranquilizer, or antihista- mine, can make us more susceptible to hypoxia. The safest rule is not to fly as a crewmember while taking any medication unless approved by the Feds.
• Stress
o Stressandfatigueareahazardouscombination.
When more than usual issues are encountered, we should consider delaying our flight until these difficulties are resolved.
• Alcohol
o Aslittleasoneounceofliquor,onebottleof
beer, or four ounces of wine can impair flying skills. Alcohol also renders us more susceptible to disorientation and hypoxia. We may still be under the influence eight hours after drinking a moderate amount of alcohol. A guideline is to allow at least 12 hours between “bottle
and throttle.” • Fatigue
o Acutefatigueisthetirednessfeltafterlong periods of physical and mental strain, including strenuous muscular effort, immobility, heavy mental workload, strong emotional pressure, monotony and lack of sleep. Acute fatigue is prevented by adequate rest and sleep, as well as regular exercise and proper nutrition.
o ObstructiveSleepApnea.OSAinterruptsnormal sleep and is associated with chronic illnesses such as hypertension, heart attack, stroke, obe- sity and diabetes. If you have a neck size over
17 inches in men or 16 inches in women, or a body mass index greater than 30, you should be evaluated for sleep apnea. A rough estimate of
  36 • TWIN & TURBINE / March 2020

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