About the Exam
Every week, people come to Dr. Hargrave of Palmetto Flight Physicals for their annual or biannual flight physical. Some are students, just learning to fly. Others are experienced pilots, who have hundreds of hours of cockpit experience, and who have been through the examination many times. There is always some apprehension, though, because of the implications of pilot privileges. We always reassure the applicant that this test is mandated by the FAA, not to keep people from flying but to help them fly safely. There are four areas that receive special scrutiny, in which a little coaching and preparation can make for a better outcome. These are the ones you can prepare for, and breeze through without a stall.
Vision heads the physical senses essential for good flying. A blind pilot is virtually worthless in the air. It is not only distant vision with which we are concerned, but also near vision – the ability to read charts, to see the instruments, to do a calculation, or to see those faded designations on the lights and fuses and know what each button means. Fading near vision, or close-up eyesight, begins to go first as we reach our 40s, that mystic number where middle-age starts to show, not only around the waistline but throughout the human physiology. I would recommend that you bring your reading glasses if you think you might need them. There is no penalty for taking the eye exam with glasses, though a visit to the optometrist might be in order if there is a question about the prescription. Since so many eye disorders can be corrected these days, there is no need to withhold information, guess at letters or try to argue that your color blindness is really no problem in the cockpit.
Then there is the blood pressure. One pilot recently came in for his examination just after an exciting flight in his performance-rated Pitts biplane. The adrenaline was still pumping, and the blood pressure reflected the exciting rolls and spins that he had experienced just an hour before. Blood pressures around 185/100 are not good enough to pass the examination; the FAA requires your blood pressure less than 155/95, still quite generous, considering our usual medical designation for a diagnosis of hypertension which is 140/90. I would recommend that you come before such a performance flight or any avoidable stressful activity. Domestic disputes, job conflicts and other stressful events should ideally be avoided just before the examination because of their obvious effect on blood pressure and inner peace. One aviator recently came straight from the espresso house, having had a double dose of caffeine to wake him up for the morning. I would recommend a breakfast instead, avoiding the jumpstart of caffeine, which often has an adverse effect on blood pressure.
A third pre-exam check you could do would be of your medical records. If you have seen a doctor in the last two or three years, note the exact date, the doctor’s full name and address and the reason for the examination, and be prepared to discuss pertinent details. While many physician visits are completely irrelevant to flying skills, they still need to be reported and, once this is done, do not have to be discussed each year. I would recommend that, if possible, stay with the same AME physician so that your time can be better spent on preventative health issues, or the answering of health-related questions, rather than a frantic telephone search for historical medical details.
Be sure to read the form carefully and answer with honesty and accuracy, issues pertaining to your flying experience, medication usage, and particularly any legal issues that have arisen, such as traffic tickets, alcohol or drug-related issues. The FAA reserves the right to scrutinize those legal records. While the AME may not know about those events, such issues will eventually catch up with you. So be transparent and honest, and things will go better. If you have any questions, do not hesitate to ask!
It is certainly a privilege to meet aviators, some of the most interesting people that I know. The stories are varied; for every pilot has had exciting adventures. My own flying interest has increased and been enriched as well, with personal time in the cockpit and providing this special branch of preventive medical care. For a student pilot ready for solo or cross country, it is a great time to consider lifestyle issues such as quitting smoking, curtailing or eliminating alcohol consumption, and avoiding drugs that can effect alertness, vision or otherwise jeopardize pilot skill. With these few thoughts in mind, remember that you the pilot, need a checkup as well as the airplane before each flight. You will find that not only the exam, but your own daily health assessment, will make flying more fun and safe for you and your family.