ADD Meds & SP

Here's the place to ask all of your medical questions. But don't believe everything you read!

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NCPilot
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Re: ADD Meds & SP

Postby NCPilot » Tue Sep 17, 2013 3:02 pm

drseti wrote:NC, my ADD wife just added:
"tell him caffeine and decongestants work too. 12 hour psudofed.
Most adhd adults self medicate with those."


Ehhh, I'm weary of self medication because I'm not a doctor, I think I'll talk to my doctor about this. I'll keep y'all updated.

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MrMorden
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Re: ADD Meds & SP

Postby MrMorden » Tue Sep 17, 2013 7:48 pm

FlyingForFun wrote:
MrMorden wrote: I canceled a flight one time because I had taken a Benadryl the night before and still felt fuzzy-headed the next day. I didn't have to do so, but I could not honestly certify that I felt safe to fly in that condition, so I self-grounded.
Good call. But if that's how you felt, then you "had" to ground yourself for that flight.


It was a judgment call, I was not dizzy or anything, just not quite myself. I chose the safest most conservative course.
Andy Walker
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nbjeeptj
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Re: ADD Meds & SP

Postby nbjeeptj » Wed Sep 25, 2013 2:27 pm

You will want to really think about that decision. Once you have the ADD on your medical records, if you want to upgrade to a PPL later it will be very expensive with no assurance that you will get the special issuance. If later you get denied on the special issuance then you can no longer fly as a sport pilot. In the past there was no standard to the additional test they require for this, however in the last month the FAA has on there guide to examiners, the guidelines for special issuance testing required with ADD in your past, so at least it will not be a mystery. I do think if you have ADD, you will be safer to yourself and everyone else if you were taking a prescribed dose of ADD meds.

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drseti
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Re: ADD Meds & SP

Postby drseti » Wed Sep 25, 2013 3:04 pm

nbjeeptj wrote:I do think if you have ADD, you will be safer to yourself and everyone else if you were taking a prescribed dose of ADD meds.


Absolutely. There is an analogue here, with regards to cardiovascular disease. A person can have an FAA medical, and untreated arterial blockage, and be a ticking time bomb waiting for a heart attack, but still be legal to fly, because of no history of disqualifying drugs or surgeries. The moment that person gets the disease treated (through medication, stent, or arterial bypass grafts), he or she is no longer at health risk, but is now no longer legal to fly; the medical is void. Does that make any sense?

So it is with ADD. leave it untreated, and you are a legal aviation risk. Treat it, and you are safe, but grounded. Does that make any sense?
The opinions posted are those of one CFI, and do not necessarily represent the FAA or its lawyers.
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Re: ADD Meds & SP

Postby Merlinspop » Thu Sep 26, 2013 7:35 am

drseti wrote:
nbjeeptj wrote:I do think if you have ADD, you will be safer to yourself and everyone else if you were taking a prescribed dose of ADD meds.


Absolutely. There is an analogue here, with regards to cardiovascular disease. A person can have an FAA medical, and untreated arterial blockage, and be a ticking time bomb waiting for a heart attack, but still be legal to fly, because of no history of disqualifying drugs or surgeries. The moment that person gets the disease treated (through medication, stent, or arterial bypass grafts), he or she is no longer at health risk, but is now no longer legal to fly; the medical is void. Does that make any sense?

So it is with ADD. leave it untreated, and you are a legal aviation risk. Treat it, and you are safe, but grounded. Does that make any sense?

I noted that paradox when I went for my first medical. I think the overall health of the pilot population would increase if this were addressed. A health issue that is treated and under control shouldn't be disqualifying (with specifically defensible exceptions, not the other way around).
- Bruce

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Re: ADD Meds & SP

Postby CTLSi » Thu Sep 26, 2013 10:32 am

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Last edited by CTLSi on Mon Dec 01, 2014 11:08 pm, edited 1 time in total.

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Re: ADD Meds & SP

Postby FlyingForFun » Thu Sep 26, 2013 10:37 am

Delete
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Jack Tyler
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Re: ADD Meds & SP

Postby Jack Tyler » Thu Sep 26, 2013 12:36 pm

Paul, I'm a little troubled by your two logic samples because they may look the same to the reader but, like cheese and chalk, are not.

If someone unknowingly suffers with cardiac blockage, there's no judgement call to be made by the pilot. S/he feels normal, the annual physical rings no alarm bell, and so the issue does not knowingly exist. (In fact, if it's the case that the pilot is symptom free then the pilot may in fact not be the ticking time bomb you describe, tho' of course that's not always true). Once the blockage becomes known, then there is an opportunity to exercise judgment - by the pilot and the medical community - and a judgment call is warranted. Where the FAA draws the line - in SI requirements and which conditions are ultimately accepted or rejected by the FAA - might be (Ha! Always are...) debatable. But the scenarios are not equivalent sides of the same cardiac health issue.

Nor does it seem to me the ADD issue is comparable. Apparently, NC is posing the question while already knowing the issue exists, so judgment is required. The good news here is your advice was spot on and he appears to be acting on it: seek qualified medical guidance when self-evaluating. But I don't see this being analogous to the seemingly healthy pilot who feels fine, passes his/her physical and yet has cardiac blockage.
Jack
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FlyingForFun
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Re: ADD Meds & SP

Postby FlyingForFun » Thu Sep 26, 2013 12:57 pm

Delete
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rsteele
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Re: ADD Meds & SP

Postby rsteele » Thu Sep 26, 2013 4:36 pm

ADD is not something your GP is likely trained to diagnose. (S)he may may prescribe medicine for it, but is unlikely to actually be able to diagnose it. The thing is, once you have filled the script the FAA is going to claim you have ADD. Convincing them you don't have ADD will require an expensive psych eval. More than likely you would never be able to get or keep a medical.

ADD drugs can have dramatic effects on personality. You may be safer flying without any drugs than with side effects of Adderall or Strattera. They effect different people differently so there is no predicting the effects. For some people they are magical and for others a nightmare. But if you take either of these, carefully evaluate your own behaviors and attitudes. Also, the side effects may occur immediately or over time so you need to be constantly evaluating yourself. I assume the side effects of stimulants are going to be more predictable.

Next time you see the guy at work who is alway drinking coffee, consider that he may be self medicating rather than trying to stay awake.

Ron

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Re: ADD Meds & SP

Postby drseti » Thu Sep 26, 2013 5:33 pm

Jack Tyler wrote:Apparently, NC is posing the question while already knowing the issue exists, so judgment is required.


Agreed. Another difference that I had failed to mention is that clinical tests (stress echocardiogram, cardiac catheterization, etc.) exist for the diagnosis of cardiovascular disease. No such diagnostic tests exist for ADD, which in fact (as in fact is true of nearly all mental health issues) the DSM defines only in terms of behaviors, not biochemical or radiological evidence.
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Re: ADD Meds & SP

Postby FlyingForFun » Thu Sep 26, 2013 5:56 pm

Delete
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newamiga
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Re: ADD Meds & SP

Postby newamiga » Fri Sep 27, 2013 4:38 am

Interesting with the pilot having the apparent heart attack on the commercial flight last night and diversion of the jet. I guess we may never know if the heart problem was a known existing condition on the pilot's medical or not but presumably as a commercial pilot he probably had a class one medical and was getting his medical updated every 6 months. Despite this he still had a heart attach on an aircraft he was flying. I guess it is just further proof that you can never be 100% sure what will happen when.

Carl
Private Pilot and RV-12 Builder

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drseti
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Re: ADD Meds & SP

Postby drseti » Fri Sep 27, 2013 4:55 am

Five years ago I passed an FAA medical exam, and shortly afterward my primary care physician did a routine EKG and noted an inverted t-wave. Further tests (stress echo and cath) found four blocked cardiac arteries, including 95% obstruction of the left anterior descending. We caught and corrected that before there was any cardiac damage, but if I hadn't gone to my GP, I could easily have been that guy with a heart attack in the cockpit. Kinda made me lose faith in aviation medical exams...

BTW, I was asymptomatic, and suspect that pilot was as well.
The opinions posted are those of one CFI, and do not necessarily represent the FAA or its lawyers.
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drseti
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Re: ADD Meds & SP

Postby drseti » Fri Sep 27, 2013 4:59 am

For those who didn't see the article, here's the link:

http://edition.cnn.com/2013/09/27/us/boise-airline-pilot-heart-attack/?hpt=us_c2
The opinions posted are those of one CFI, and do not necessarily represent the FAA or its lawyers.
Prof H Paul Shuch
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