Skip to main content

The FAA Revisited

Six years ago I was fresh out of college and attempting to begin my Aerospace career as an Army Flight Test Engineer. Little did I know how difficult it was going to be to obtain an FAA (Federal Aviation Administration) Class 3 medical just to fly aboard (not pilot) experimental Army aircraft. It took nearly six months of back and forth with the elusive FAA doctors in Washington, mountains of paperwork and heartache over the frustrating difficulty of a seemingly straight forward task before I was finally granted a Special Issuance Class 3 medical waiver.

In the spirit of tenacity, I recently looked up the Class 3 guidelines to see if anything has changed in the 3-ish years that I have been away from the Army. I was pleasantly surprised.

It appears the FAA has updated their hardline stance on Type 1's only being eligible for a Class 3. From the FAA website, "First and second class applicants will be evaluated on a case by case basis by the Federal Air Surgeon's Office." Essentially, at least how I read it, a well-controlled Type 1 can apply and potentially obtain a medical certificate that would allow them to be Pilot-in-Command of an airline transport.
Screen captures from faa.gov
This really is a huge step forward. Granted, I no longer have a need to maintain an FAA medical and therefore have not attempted to obtain a Class 1 or 2, but I imagine with enough paperwork and diligence someone can get through!

I actually had a hard time finding the legislation trace that allowed these new insulin-treated diabetes provisions. It looks like the FAA requested the American Diabetes Association to convene a panel of experts "to form recommendations for a protocol to identify a subset of pilots who use insulin who pose no great risk of incapacitation from hypoglycemia than any other pilot in the general population." The panel convened on June 27, 2014 and created guidelines for a policy to "permit the special issuance medical certification of certain insulin-treated applicants for first-, second-, and third-class medical certification." They go on to mention that the applicant will need "substantial documentation"...ha...I ended up sending them my entire medical record from 11-years-old on before they would issue me a third class. I'm just not sure where they are going to get all this extra paperwork from ;-)

My favorite paragraph from the report states, "The enormous progress in management of the disease justifies a change in FAA policy, which dates from 1949. [nerdy April note: 1949?!?!?!?! kthnxbye] That policy is that pilots with insulin treated diabetes may not receive first or second class medical certificates, thus barring them from commercial operations. While the 1949 ban was justified by the science that then existed, it is no longer justified by evidence based medicine."

The main point that the panel stressed is that airmen should be medically reviewed on an individual basis - and I think this is so, so important. Diabetes is not a "generalized" disease - it is an individual one. Not every Type 1 walks around with an insulin pump and continuous glucose monitor, because, they don't have to - treatment and management is extremely individualized. What management works for some doesn't necessarily work for all and what blood sugar ranges are recommended for some are not necessarily recommended for all. Heck, there are even a plethora of different types of insulin that react differently in patients bodies. We are all different, and so is our treatment, management and control of this disease. Can I get an Amen?!

A couple additional sections that highlight why I feel so strongly about this issue:

"The panel also considered the data from Canada's experience certifying pilots with insulin treated diabetes to fly since 1992 as well as the data from the United States allowing pilots to fly with third class medical certification, including solo operations, since 1996. The twenty years of data from these two countries indicate that there has never been a diabetes-related accident or incident involving a pilot with insulin treated diabetes who has been granted certification to fly while using insulin."

"After considering all the evidence and clinical experienced outlined above, the expert panel concluded that there are pilots with insulin treated diabetes whose risk of incapacitation in flight is equivalent to, or lower than pilots who do not have insulin treated diabetes."

This.This is what made all the trouble with the FAA worth it. 

I'm not sure how I lost track of these changes, but I'm glad I circled back around to find them. With more Type 1 pilots flying comes more data, and hopefully, continued updates to the FAA's (and other organization's) policies.

Comments

  1. This is good news about the FAA update. I feel it is long overdue. Now to get one approved.

    I referred your blog to the TUDiabetes.org blog page for the week of June 20, 2016.

    ReplyDelete

Post a Comment

Who has two thumbs and loves comments? Nerdy April!!! Type one out and hit publish!

Popular posts from this blog

The road to curing Type 1 Diabetes

From the moment of diagnosis, the road is rough, the learning curve is steep and the stakes are literally life or death. The map is less-than-helpful - paths originating from virtually every corner, coalescing at a center point (aka "diagnosis") and bursting back outwards - some paths cross and wrap around each other but others are isolated. And even with all of these roads, most of the territory is uncharted - how did we all get here and how will we all exit? Where are the obstacles we haven't found yet? Which passage holds the key to unlocking the solution?

On any given day I feel pretty isolated with this disease - I'm the only T1D in my group at work, the only one in mission control, the only one in my family. I go through the logistics of calling insurance companies, ordering supplies, changing sites and troubleshooting malfunctions mostly on my own. Even those pesky carbs really only get counted in my brain, no group think for a meal bolus here. But there is b…

Critical Space Item: Handle With Extreme Care

Someday I want to open a box. The box will be neatly wrapped up with an excessive amount of packaging. Its contents will have been years in the making, and even though it won't weigh much, this small box will represent a huge step forward.


As most flight hardware begins, the space-rated closed-loop insulin delivery and monitoring device inside the box will be sterile and stark. But as the batteries whir to life and insulin is placed within, it will become an extra appendage, an external pancreas, for this Type 1 astro-hopeful. Bluetooth connections will be made and doctors, hungry for telemetry from my bionic body, will be at the ready. We will rely on each other - he on I for his very existence, and I on him for my continued existence. Together we will make up one whole, completely functioning, Type 1 Diabetic astronaut.

Admittedly, this dream feels further and further from reality. I have lived with this disease just under 20 years now, and the cure has always been "just 5 …

On 20 years with Type 1 Diabetes

I think it's finally time to hit 'publish' on this post, considering it's been sitting here for, oh you know, like 2 weeks now ;-) Sometimes I "April" about things too much (this is Chris's term), and with my dad here for Christmas I realized that it's definitely a trait passed down, haha, love you dad!


To be honest, I never thought the day would come when I would say, "I've had Type 1 Diabetes for 20 years."

20 years ago a cure was 'just on the horizon' and as an 11 year old kid I took that phrase to heart - I had to. My continued existence was based solely on whatever the endocrinologist said - pancreas, insulin, autoimmune, blood sugar, islet cells, shots. I didn't know what I didn't know at that point. I had never heard of an insulin pump or glucose meter. Ketones and hyperglycemia were just big, meaningless words. Carb ratios and counting might as well have been formulas for travelling at light speed. I wasn't ov…
01 09 10