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Medical Renewal risks and Cardiovascular Health

Peter wrote:

In the US, the AME is working for you.

True, but even in the USA you don’t want to treat your AME as your buddy or primary doctor. If they find something is wrong, they are also obliged to report it to the FAA, causing a lot of hassle. Max Trescott had a podcast recently where he was talking to a “well-known” AME, which was very interesting. I’ve heard the advice to not mix your normal medical stuff with your AME since I got my first medical in the 1970s, and the situation has only gotten more complex.

Fly more.
LSGY, Switzerland

I agree re separating the two, although

If they find something is wrong, they are also obliged to report it to the FAA

is not strictly true; the FAA AME is required to report only the specified conditions. There is also the list of “self grounding conditions”, whereas in Europe the whole of Part-MED is a list of self grounding conditions

I don’t doubt that many FAA AMEs don’t understand the rules…

The FAA Special Issuance process is horrible, especially in Europe where many FAA AMEs will tell you straight that they want “only simple work”.

I would also separate the FAA and CAA/EASA AMEs. I used one for both and then suddenly he packed it up (without emailing any clients) dropping me (and a large chunk of Ryanair, AIUI) in the s**t

Administrator
Shoreham EGKA, United Kingdom

There seems to be an attitude on here of “avoid medication at all costs”

I have taken medication to control my blood pressure for 30 years, and have fully disclosed everything to my AME and hence the CAA, and also the FAA when I used to fly on a US Certificate. It’s never given me any problems for flying medicals, and I believe it’s better for me to be medicated with a low BP than rather on the high side scraping through a medical every year.

A good friend of mine declined Statins due to rumours of side effects. After he had a stroke he now takes them.

Last Edited by Neil at 18 Jan 12:05
Darley Moor, Gamston (UK)

Neil wrote:

I believe it’s better for me to be medicated with a low BP than rather on the high side scraping through a medical every year.

My AME joked that maybe everyone should be given low doses of Metformin, statins, and high blood pressure medication to prevent health problems…

ESKC (Uppsala/Sundbro), Sweden

Based on my own experience, when choosing an AME (EASA) make sure you have one that does this for a living and is up to date with the regulations and has a flying attitude. In The Netherlands there are a lot of AME’s that do this on the side of their regular practice and they can make your flying life difficult. Had one very bad experience and now I only go to the KLM Health Centre at Schiphol. It is a longer drive, and being over fourty y/o I now have to go every two years, but they know the rules and regulations very well and have all the contacts with specialist, they helped me out in one month what another local AME couldn’t fix in five years. Stay healthy!

Last Edited by Bobo at 18 Jan 12:48
EHTE, Netherlands

Buckerfan wrote:


Our regular doctor also has been telling me for years that in her opinion EVERY male in the UK over the age of 60 should take statins and blood pressure medication, and she wants me to do this as well obviously, as a preventative measure.

The medical community is discussing measures such these for years, but the evidence is conflicting and the ethics around this aren’t simple. The major guidelines on cardiovascular health do not generally support such an approach.

Statins are, most certainly, one of the most effective drugs of all as far as their effect on life expectancy and morbidity is concerned. There is only a handful of medications which very clearly and unambigously actually prolong life, and statins are among them. As @BeechBaby wrote:

Peter wrote above, the most effective of the statins is Rosuvastatin. The group of statins is widely different in their effectiveness. The most commonly prescribed statin (in Germany), Simvastatin, needs about 4x the dose to reach the same level of effect as Atorvastatin, which again is less effective than Rosuvastatin. Side effects are similar for all of them but some people react better to some of the substances than others.

This video by Sanjay Gupta will explain the BP.

Life style changes, subtle changes will assist you on cholesterol. Keep away from processed foods, 20 minute walk each day, sleep, hydrate.

I took the time to view the whole video despite me of course knowing all this. It is indeed excellent for the layperson to grasp the basics of blood pressure therapy. As the colleague says, you should first get your individual risk assessed and wheter low-level damage to your smaller vessels has already taken place before deciding on medication, unless the BP values are high enough to warrant immediate treatment, which is roughly when the systolic (higher) number is over 160 mmHg.

Low-hours pilot
EDVM Hildesheim, Germany

Is this guy a quack? I’m not a doctor, and thankfully don’t need statins, but seems like he raises some interesting points.



Fly more.
LSGY, Switzerland

There seems to be an attitude on here of “avoid medication at all costs”

I don’t think anyone has said that. But too many (most?) people get pains from statins, so it has to be weighed up whether the (dose reduced to the level at which you don’t get pain; life with chronic pain is not really an option in this case) benefit is worth it. Statins clearly do work well.

Is this guy a quack?

I didn’t watch the video but there are many like it, on every topic imaginable, and the big pharmas have not done themselves favours by selectively using data to get approvals, not to mention getting drugs approved which are only some 20% better than placebo.

Administrator
Shoreham EGKA, United Kingdom

eurogaguest1980 wrote:

Is this guy a quack? I’m not a doctor, and thankfully don’t need statins, but seems like he raises some interesting points.

It is impossible to discuss or refute everything he says in brevity. But yes, he paints a misleading and one-sided picture for sure.

A more evidence based evaluation on statins can be found here for example, based on Cochrane reviews which generally are a very well resepected aggregation of different medical studies.

The article is worth a read, but the gist of it is: Statins work well for secondary prevention, that is preventing anyone who had a heart attack or stroke or other vascular event from getting another one. They work less well for primary prevention, i.e. preventing people from getting one such event in the first place if they have previously been healthy. The side effects for statins are rather manageable, the most common being muscle pain which can, in some patients, be severe enough to discontinue the treatment. Everything else mentioned in the video is exceedingly rare or nonspecific.

Low-hours pilot
EDVM Hildesheim, Germany
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