Post Surgery PIREP

[FlyingGringo]

Good Morning,

My name is Brett, and I'm a corporate pilot by trade, and the owner / operator of an On-X mechanical valve.

I wanted to document my story for the pilots out there that are either going through this, or approaching it, as it's a terrifying change that threatened the way of life that is not just a profession - but a passion.

For my background, I'm a 47 year old commercial pilot flying Gulfstreams Part 91. At my baseline EKG done at 35, the AME (Aviation Medical Examiner) who reviewed mentioned that there was something unusual in the traces, but said not much more. By chance I changed AME's in the years ahead, and ended up going to Dr. John Raniolo, who is a cardiologist, a pilot, a really nice guy, and happens to be local to me. John is an amazing dude, and a helluva resource if you're facing cardiac issues. I cannot recommend him enough. You can find him by googling aerospace cardiology - he'll be the first response, as his site is a combo of those two words.

John started me into testing. First another EKG, then an echo to attempt to visualize the structure within the heart, as he was suspecting I had a bicuspid aortic valve. It took a few attempts, and eventually a trans esophageal echo-cardiogram, to get a clear image of what was a bicuspid aortic valve with significant regurgitation. We discussed matters, and it was time to surrender my medical.

That was June 1 of 2019. It was a crushing blow, and hit me harder emotionally, as I felt a real disconnect with my physical side, as I was feeling fine. Asymptomatic. My spirits sank, but I kept myself busy with finding the right surgeon, and getting the last tests prior to surgery on the morning of August 16th of 2019.

The morning of the surgery, I laid down on the gurney still wondering why I was going through this - as I was feeling fine. It was 4AM, but I never had a problem with early calls. I was all in. Showtime. The needle went in, and I went out.

Surgery was minimally invasive (Dr. Riley was my surgeon - Scottsdale Honor Health Hospital). The details of which are mundane - and there are a lot better writers here about the process and the choices involved.

The surgery and recovery went well, although there were some delays in my release from the hospital, and I spent nearly 2 weeks in a hospital room. It's tough. They were the hardest days of my life - but every day things got better. I focused on my recovery, and I watched a lot of streaming shows (bring an iPad and some good wireless noise cancelling headphones).

Anyway - I took it all as my job, and did my best to attend to the recovery plan. I attended every session of cardiac rehab, and worked hard to get back in shape to get my medical back.

As I'm sure you've heard - there's a six month mandatory wait before you can reapply for your medical. The application mainly requires good record keeping, so keep copies of every scan, every CD, every test result, and anything written the hospital gives you on discharge. Keep it organized, and turn in copies to your AME for submission as part of your application.

The FAA moves at their own pace. The cardiac board moves even slower.

Apparently they meet every other month, and that was slowed down by the pandemic. As Tom Petty said - the waiting is the hardest part, and keeping your chin up during that time is a full time job. You've really got to have a plan, and a couple of hobbies, and a new exercise regimen to keep your attitude positive while waiting for the wheels to turn at the FAA. It's frustrating, and a little scary, as you'll be sent copies of all correspondence sent by the aeromedical branch. Their letter writers have an endearing way of making you feel both threatened, confused and scared simultaneously, while also making you think now is the time to give up all hope. Don't worry - there will be many, many letters (sent both regular mail, and a copy via registered mail.) ...it's not really a fun time.

Cutting to the close - on June 1st of 2020, and with very little fanfare, I got an email with my new first class medical. Words cannot describe my elation, and joy. Less than a week later, I was back in the left seat for landing currency (yeah - I did a recurrent on speculation with no medical).

I'm back flying again, and I couldn't be happier.

I wanted to document my experience here as a PIREP for all those other pilots out there that are staring down the barrel of a cardiac issue.

If you've got any questions - reach out to me, and I'll be happy to chat with you.

You're going to get through this. There's a little bit of chop through the line - but it's smooth and clear on the other side.

best of luck.

bt

for the non flying folks - PIREP is a PIlot REport - it's a report from one pilot to all those that happen to be following of what the conditions are as they're experienced, not as they're forecast. One good report is worth a thousand words in brief.

 

[Protimenow]

You referred many times to a 'Medical.' I can assume what this means - but can you explain further -- for non-pilots like me, it's just a single word that doesn't really tell the whole story.

 

[FlyingGringo]

Sorry about that. A medical refers to a pilot's required medical certificate. A pilot's license is just that - their license to operate an aircraft. However - of equal weight is their medical certificate. Without both - the license and the medical certificate - you're grounded. The medical certificate is earned by examination and testing by an FAA approved Aviation Medical Examiner.

Commercial pilots (flying as a commercial pilot) are required to have either a first or second class medical. Recreational pilots are only required to have either a third class, or in some cases self certify - I'm not entirely clear on the recreational and self certification rules, as they don't apply to me in my line of work - but I'm sure someone else would better remember those rules. First class medicals are good for six months and have the most stringent requirements, second class medicals are good for a year, and have less stringent requirements, and this carries on down.

The criteria to both earn and maintain any given class of medical vary with your age, and the class of medical you're applying for, and all medicals must be renewed on a set schedule. In my line of work - I retest and recertify every six months, as I'm required by law to maintain a first class medical to transport passengers in a jet internationally.

When you get into specialized cases - like myself with a replaced heart valve, the certification criteria requires your Aviation Medical Examiner to consult with the FAA's aeromedical branch for tailored testing and ongoing certification requirements. In the case of my procedure - they won't even begin to consider your case for reapplication until 6 months after the date of surgery. The testing and whatnot required to recertify is extensive, specalized, and much of it is paid for in cash, as your insurnace companies don't like paying for what they view as elective tests.

I hope this helps.


... also - a big shout out and thank you to this board. I know I never posted or donated until today, but in the months before and just after my surgery I spent countless hours reading thread after thread. There's some really incredible people here, and a wealth of information. Thanks to all who have shared their knowledge and experiences.

 

[Seaton]

Good Morning,

My name is Brett, and I'm a corporate pilot by trade, and the owner / operator of an On-X mechanical valve.

I wanted to document my story for the pilots out there that are either going through this, or approaching it, as it's a terrifying change that threatened the way of life that is not just a profession - but a passion.

For my background, I'm a 47 year old commercial pilot flying Gulfstreams Part 91. At my baseline EKG done at 35, the AME (Aviation Medical Examiner) who reviewed mentioned that there was something unusual in the traces, but said not much more. By chance I changed AME's in the years ahead, and ended up going to Dr. John Raniolo, who is a cardiologist, a pilot, a really nice guy, and happens to be local to me. John is an amazing dude, and a helluva resource if you're facing cardiac issues. I cannot recommend him enough. You can find him by googling aerospace cardiology - he'll be the first response, as his site is a combo of those two words.

John started me into testing. First another EKG, then an echo to attempt to visualize the structure within the heart, as he was suspecting I had a bicuspid aortic valve. It took a few attempts, and eventually a trans esophageal echo-cardiogram, to get a clear image of what was a bicuspid aortic valve with significant regurgitation. We discussed matters, and it was time to surrender my medical.

That was June 1 of 2019. It was a crushing blow, and hit me harder emotionally, as I felt a real disconnect with my physical side, as I was feeling fine. Asymptomatic. My spirits sank, but I kept myself busy with finding the right surgeon, and getting the last tests prior to surgery on the morning of August 16th of 2019.

The morning of the surgery, I laid down on the gurney still wondering why I was going through this - as I was feeling fine. It was 4AM, but I never had a problem with early calls. I was all in. Showtime. The needle went in, and I went out.

Surgery was minimally invasive (Dr. Riley was my surgeon - Scottsdale Honor Health Hospital). The details of which are mundane - and there are a lot better writers here about the process and the choices involved.

The surgery and recovery went well, although there were some delays in my release from the hospital, and I spent nearly 2 weeks in a hospital room. It's tough. They were the hardest days of my life - but every day things got better. I focused on my recovery, and I watched a lot of streaming shows (bring an iPad and some good wireless noise cancelling headphones).

Anyway - I took it all as my job, and did my best to attend to the recovery plan. I attended every session of cardiac rehab, and worked hard to get back in shape to get my medical back.

As I'm sure you've heard - there's a six month mandatory wait before you can reapply for your medical. The application mainly requires good record keeping, so keep copies of every scan, every CD, every test result, and anything written the hospital gives you on discharge. Keep it organized, and turn in copies to your AME for submission as part of your application.

The FAA moves at their own pace. The cardiac board moves even slower.

Apparently they meet every other month, and that was slowed down by the pandemic. As Tom Petty said - the waiting is the hardest part, and keeping your chin up during that time is a full time job. You've really got to have a plan, and a couple of hobbies, and a new exercise regimen to keep your attitude positive while waiting for the wheels to turn at the FAA. It's frustrating, and a little scary, as you'll be sent copies of all correspondence sent by the aeromedical branch. Their letter writers have an endearing way of making you feel both threatened, confused and scared simultaneously, while also making you think now is the time to give up all hope. Don't worry - there will be many, many letters (sent both regular mail, and a copy via registered mail.) ...it's not really a fun time.

Cutting to the close - on June 1st of 2020, and with very little fanfare, I got an email with my new first class medical. Words cannot describe my elation, and joy. Less than a week later, I was back in the left seat for landing currency (yeah - I did a recurrent on speculation with no medical).

I'm back flying again, and I couldn't be happier.

I wanted to document my experience here as a PIREP for all those other pilots out there that are staring down the barrel of a cardiac issue.

If you've got any questions - reach out to me, and I'll be happy to chat with you.

You're going to get through this. There's a little bit of chop through the line - but it's smooth and clear on the other side.

best of luck.

bt

for the non flying folks - PIREP is a PIlot REport - it's a report from one pilot to all those that happen to be following of what the conditions are as they're experienced, not as they're forecast. One good report is worth a thousand words in brief.

Thanks for the detailed write-up, Brett. Great to hear you’re back in the air.
Wishing you the very best of future health and many more hours of flight!

 

[Cactus52]

Great to hear Brett!! +1 on Raniolo, don't know what I would have done if I had been somewhere else. Feel really lucky to have him for my special issuance all these years. He is also working with my chief in getting his first class medical back after a heart transplant, he'll be the first.

I am going out July 2nd for my valve replacement up at the Cleveland clinic. Pretty set on the OnX as well. Glad to hear someone else got their 1st class back, it makes feel a little more confident going back in.

Stay in touch!!
Start in touch

 

[Quarry1]

Good Morning,

My name is Brett, and I'm a corporate pilot by trade, and the owner / operator of an On-X mechanical valve.

I wanted to document my story for the pilots out there that are either going through this, or approaching it, as it's a terrifying change that threatened the way of life that is not just a profession - but a passion.

For my background, I'm a 47 year old commercial pilot flying Gulfstreams Part 91. At my baseline EKG done at 35, the AME (Aviation Medical Examiner) who reviewed mentioned that there was something unusual in the traces, but said not much more. By chance I changed AME's in the years ahead, and ended up going to Dr. John Raniolo, who is a cardiologist, a pilot, a really nice guy, and happens to be local to me. John is an amazing dude, and a helluva resource if you're facing cardiac issues. I cannot recommend him enough. You can find him by googling aerospace cardiology - he'll be the first response, as his site is a combo of those two words.

John started me into testing. First another EKG, then an echo to attempt to visualize the structure within the heart, as he was suspecting I had a bicuspid aortic valve. It took a few attempts, and eventually a trans esophageal echo-cardiogram, to get a clear image of what was a bicuspid aortic valve with significant regurgitation. We discussed matters, and it was time to surrender my medical.

That was June 1 of 2019. It was a crushing blow, and hit me harder emotionally, as I felt a real disconnect with my physical side, as I was feeling fine. Asymptomatic. My spirits sank, but I kept myself busy with finding the right surgeon, and getting the last tests prior to surgery on the morning of August 16th of 2019.

The morning of the surgery, I laid down on the gurney still wondering why I was going through this - as I was feeling fine. It was 4AM, but I never had a problem with early calls. I was all in. Showtime. The needle went in, and I went out.

Surgery was minimally invasive (Dr. Riley was my surgeon - Scottsdale Honor Health Hospital). The details of which are mundane - and there are a lot better writers here about the process and the choices involved.

The surgery and recovery went well, although there were some delays in my release from the hospital, and I spent nearly 2 weeks in a hospital room. It's tough. They were the hardest days of my life - but every day things got better. I focused on my recovery, and I watched a lot of streaming shows (bring an iPad and some good wireless noise cancelling headphones).

Anyway - I took it all as my job, and did my best to attend to the recovery plan. I attended every session of cardiac rehab, and worked hard to get back in shape to get my medical back.

As I'm sure you've heard - there's a six month mandatory wait before you can reapply for your medical. The application mainly requires good record keeping, so keep copies of every scan, every CD, every test result, and anything written the hospital gives you on discharge. Keep it organized, and turn in copies to your AME for submission as part of your application.

The FAA moves at their own pace. The cardiac board moves even slower.

Apparently they meet every other month, and that was slowed down by the pandemic. As Tom Petty said - the waiting is the hardest part, and keeping your chin up during that time is a full time job. You've really got to have a plan, and a couple of hobbies, and a new exercise regimen to keep your attitude positive while waiting for the wheels to turn at the FAA. It's frustrating, and a little scary, as you'll be sent copies of all correspondence sent by the aeromedical branch. Their letter writers have an endearing way of making you feel both threatened, confused and scared simultaneously, while also making you think now is the time to give up all hope. Don't worry - there will be many, many letters (sent both regular mail, and a copy via registered mail.) ...it's not really a fun time.

Cutting to the close - on June 1st of 2020, and with very little fanfare, I got an email with my new first class medical. Words cannot describe my elation, and joy. Less than a week later, I was back in the left seat for landing currency (yeah - I did a recurrent on speculation with no medical).

I'm back flying again, and I couldn't be happier.

I wanted to document my experience here as a PIREP for all those other pilots out there that are staring down the barrel of a cardiac issue.

If you've got any questions - reach out to me, and I'll be happy to chat with you.

You're going to get through this. There's a little bit of chop through the line - but it's smooth and clear on the other side.

best of luck.

bt

for the non flying folks - PIREP is a PIlot REport - it's a report from one pilot to all those that happen to be following of what the conditions are as they're experienced, not as they're forecast. One good report is worth a thousand words in brief.

 

[Quarry1]

Brett, Thanks for the post. I too was a corporate pilot , retired, but still flying warbirds and one day the ax fell on me. I needed an AVR. the operation went well but I wound up with sepsis and cellulitis. A month in the hospital. Waited the 6 months and then went to the Mayo Clinic's Aerospace Medical Dept. Spent 3 days doing all sorts of tests which they put together and made application to the FAA. Like you, then the waiting started. It just so happened that my application corresponded to the govt. shutdown which was followed by the Xmas holidays. So from my initial medical application during second week of Nov 2017 it took 3 months to finally get an approval. At least I got approval. I applied for a 2nd class but was issued a 3rd class. The letter I received was kind of strange. On the first page it said I was not eligible for a second class was issued a 3rd class. On the back page it referenced that when my 2nd class expired I would have to do a lot of retesting to keep the 2nd Class. That's an other story.
The point is that something as serious as open heart surgery is not always the end of your flying career . Keep in shape, do the rehab, do all the medical testing and if things are normal you will get your medical back.

One final note. My experience with the Mayo Clinic was super. I would highly recommend it to anyone who is going through something similar

 

[Billy777]

Wondering what you meant by " Surgery was minimally invasive" and you spent 2 weeks in the hospital. Did you get a TAVR? I'm expecting 2 days in the hospital. And yes I have played the special issuance dance too, the FAA is the quintessential bureaucracy.

 

[FlyingGringo]

Billy -

Minimally invasive in that I ended up with a three inch scar in the right side (towards the top of my ribs) of my chest running side to side. This was the primary incision, with a second incision in my groin.

I was initially hoping for TAVR - but for reasons I don't really remember - I wasn't a good candidate for that... it may have to do with the On-X valve - but I don't exactly recall.

Bottom line - my sternum wasn't broken, and I never had any of the post surgery limitations that folks had the full sternotomy (split rib cage) experience.

The downside of the surgery I had was they collapsed the lung for access, and that has it's own challenges, and ventilators aren't fun.

As far as the 14 days I spent in the hospital - that was related to some unfortunate complications with blood chemistry, and stabilizing my INR. It got resolved - but I ended up staying a lot longer than anticipated as I initially had some pretty wild swings as they chased the correct dosages. I think I'm the aberration here - don't plan for my kind of time in the hospital - it happened - but it was far longer than expected, and much of my time was spend waiting for stabilized INR numbers. It got real old walking the halls waiting for a daily blood test.

Much of this stuff I've kinda dumped from memory. It was vital at the time, and on the forefront of my mind then - but now that it's in the past, and the scars have healed - I'm just glad it's behind me.

I'm playing with the houses money from here on out, and I plan to enjoy that.

 

[Billy777]

I had a pilot friend in a group before I got my ticket. Called himself Mortimer Snerd. His advice: The Medical Examiner is not your friend or your doctor. Don't tell them anything... don't check any box "yes" on the form. After a few years of dealing with Aeromedical I wished I had follower his advice. :- )