Peter wrote:
the bad thing is that the moment you have any sign of a heart issue, your EASA (or FAA) medical is gone unless you have “surgery”.
That depends on the heart condition. I have a friend (CPL/IR/FI) who has had heart issues that can usually be fixed by medication. He’s had a valid medical on and off for the last few years as the severity of his condition has changed. Now apparently the side-effects of the medication is enough to keep him from flying. AFAIK he is going to have surgery (not “surgery”) which apparently have a very high success rate and will give him back a full medical.
(No, sorry, I don’t know what his condition is called — I’m sure he has mentioned it but I don’t recall it.)
I wonder what the heart condition was, because AIUI all angina medications are banned for an EASA Class 2 (probably the FAA Class 3 also – not sure). So your only ways out are
On the last one, with a really tough veg diet it can disappear in months rather than years because generally once you get back from say a 95% occlusion to a 90% occlusion, you won’t be aware of the problem even on the Bruce Protocol treadmill, and probably much of the population is at 90% anyway, in places…
In the UK you have the NPPL with the self declaration too…
Most people give up flying at this point. One friend of mine just has. His cardiologist, typical of the profession, said diet has NO possible unblocking effect on his arteries 
That 19th century view probably incidentally means you will find it very hard to get a cardio to support you, following a diet change, for getting your medical back. If you tell these guys to watch the video above they will probably just tell you to not waste their time. And if you have an angiogram, and it shows blockages above 30% which probably most people have in this situation, you can’t get your medical back anyway…
So one has to look after one’s health before getting any issues, because once you get them you are likely to be buggered.
When I put surgery in quotes I meant a stent.
Peter wrote:
But the dietary option for sorting this out is not available, AIUI, even though it has been demonstrated (above) that you could reverse atherosclerosis almost completely in something like 2 years.So much of medicine is still in the 19th century. If your only tool is a knife…
This is a bit unfair on us doctors. Lifestyle change is something we regularly advice patients on, even decades before they experience the effects of what they are doing wrong (usually a combination of smoking + overeating + lack of exercise ). The sad fact is: usually it doesn’t work because of incompliance. As long as people don’t feel any symptoms, they have no motivation to change their habits.
Once they do, there is usually no going back to the status quo ante.
Once they do, there is usually no going back to the status quo ante.
That belief is however at the root of the problem. You often can reverse stuff.
And it’s worth a try, they were about to send my Dad to the hospital for high blood pressure when he had a racing medical about 5 years ago, his level of high blood pressure supposedly not fixable by diet change. He changed his diet, lost a bit of weight, and sure enough the blood pressure came down to a level typical of someone his age in good health.
Peter wrote:
That belief is however at the root of the problem. You often can reverse stuff
Alioth already mentioned the example of Hypertonia, where exercise and less salt in your diet can lead to significantly decreased blood pressure, sparing one from the need to take antihypertensive medication.
Same with Diabetes mellitus.
What I meant to say is that once you’ve done lasting damage, e.g. a heart infraction or a stroke or your Diabetes has become insulin-dependant because all the beta-cells in the pancreas are wasted, this cannot be easily fixed by changing your habits. Nor through medication, this only reduces the symptoms. So the important thing is to change habits early enough or not get into bad habits in the first place (i.e. never start smoking at all).
There are cardiac conditions other than ischaemic heart disease.
Sure but I’d say the main Q is how they map onto getting one’s Class 2 back. There are several AMEs on EuroGA; maybe one of them might post something
Traditionally it has been rare for AMEs to comment openly, possibly because it is not legally possible to have an off the record (“what if”) conversation with an EASA AME (I got this little fact from a couple of them years ago – every contact is supposed to be reported to the “CAA”) and a forum post by an AME might be seen as amounting to that.
Peter wrote:
I got this little fact from a couple of them years ago – every contact is supposed to be reported to the “CAA”
The only case I know of personally that needed to have a what if / informal chat managed to do so – from an AME he didn’t know at all before (e.g. not a friend).
Not sure what the rules though, and of course a informal chat is very different than posting in a forum, where everything will be dissected, extrapolated, and potentially have a lot of exposure.
I have tried to find more information on what criteria are used to determine whether to grant ’s class 1 / class 2 medical but this information is not easily accessible to other doctors it seems. Most medical associations publish guidelines on their speciality that are openly and easily accessible to other doctors or even the public at large. The aeromedical association apparently does not.
