Primarily for general aviation discussion, but other aviation topics are also welcome.
#1593708
So I am thinking of getting my class one so I can get a CPL and then eventually and FI (A) rating. However I have a history of migraines (with aura I think- I honestly can't remember them) that prevented me from continuing planned activities. I had these headaches from the age of 9 to 16 and none since meaning I have been free of headaches for the past 17 years during which I have led an active and sometimes stressful life.

I am now concerned that the CAA won't issue a class 1 medical based on my previous history.

Has anyone with a similar medical record been successful in getting an unrestricted class 1 medical?
#1593710
Google CAA Migraine Flowchart, am I correct in assuming you already hold a Class 2?

Why do you want a Class 1?

You can do FI work with a Class 2 - in fact I know most FIs now do so on a Class 2.
#1593714
I am flying on a LAPL medical. I have seen the CAA flow chart but like a lot of CAA publications find it ambiguous since note 2 which is section that would apply to me is for those already holding a licence or medical not initial applicants.

I would like a class 1 as I would like to keep the option of a commercial career open and before I spend money on qualification aimed at a commercial career I want to make sure I am medically fit.

Even if I never go commercial (and the older I get the more likely that is looking!), I would still like to do a CPL to improve my flying skills.
#1593720
Ultimately the only way to find out is by making an application - even having ten others stating they managed it is of no value for your case as each applicant's medical history and assessment is unique to them.

What matters is whether it is possible - yes it is; whether you can will depend on your particular history. You will need to supply the AeMC with reports past and current.

If you want to consider other commercial options go for it.

BTW your FI course is more likely to improve your flying skills than the CPL course - any half decent PPL should manage a CPL flight test*





*I'll don my flak jacket here.
#1593738
I suffered migraines in my adolescent years which ultimately prevented me from flying with any of the services, flying was all I wanted to do regardless of who paid for it. But after knock backs from all the military options and then several none military options because of it I began to realise it was a problem; this was in the 70's.

To be fair when I suffered an attack it was debilitating, my loss of vision was significant (all be it temporary) but I now realise however temporary it was .... it was too much.

Over the years I've flown many hours with friends which has been most enjoyable but I've often asked myself how would I cope with an attack at less than 1000 foot on a landing approach. From a distance I can say I would call a missed approach and go off to fly a holding pattern while the worst of the symptoms wore off but in my heart I know that is not a thoroughly sensible outcome.

Because of this I have long since given up on the idea of solo flying, for 95% of the time it wouldn't be a problem, but there is that 5% that concerns me. These days (now age 62) the migraine attacks are less frequent, perhaps 3 or 4 times per year, but if they occur at the wrong time they pretty much take me out.

For a great percentage of the time I'm OK, but for a very small percentage of the time I know there might be a problem. It has been a very difficult pill to swallow, but that's what I've had to do.

In order to exorcise my aviation frustrations I've spent the last 30 years "pumping gas into planes"
Last edited by avtur3 on Tue Feb 27, 2018 5:01 am, edited 1 time in total.
riverrock liked this
#1593744
Flyin'Dutch' wrote:.... your FI course is more likely to improve your flying skills than the CPL course - any half decent PPL should manage a CPL flight test*

*I'll don my flak jacket here.




Incoming.................

Just kidding.

I would say though that the two courses improve different things. The FI course should polish basichandling and theory while giving you the capacity to teach/demonstrate/patter. The CPL should improve the basics, refresh and deepen understanding of theory but also give an idea of how to fly 'commercially'.



Both will do more than I've written but in my opinion those are the bare bones.




Edit. Upon re-reading swapped “Not really” for “Just kidding” re incoming.
Last edited by Flintstone on Tue Feb 27, 2018 9:21 am, edited 1 time in total.
Flyin'Dutch' liked this
#1593762
avtur3 wrote:I suffered migraines in my adolescent years which ultimately prevented me from flying with any of the services, flying was all I wanted to do regardless of who paid for it. But after knock backs from all the military options and then several none military options because of it I began to realise it was a problem; this was in the 70's.

To be fair when I suffered an attack it was debilitating, my loss of vision was significant (all be it temporary) but I now realise however temporary it was .... it was too much.

Over the years I've flown many hours with friends which has been most enjoyable but I've often asked myself how would I cope with an attack at less than 1000 foot on a landing approach. From a distance I can say I would call a missed approach and go off to fly a holding pattern while the worst of the symptoms wore off but in my heart I know that is not a thoroughly sensible outcome.

Because of this I have long since given up on the idea of solo flying, for 95% of the time it wouldn't be a problem, but there is that 5% that concerns me. These days (now age 62) the migraine attacks are less frequent, perhaps 3 or 4 times per year, but if they occur at the wrong time they pretty much take me out.

For a great percentage of the time I'm OK, but for a very small percentage of the time I know there might be a problem. It has been a very difficult tablet to swallow, but that's what I've had to do.

In order to exorcise my aviation frustrations I've spent the last 30 years "pumping gas into planes"


I am confident that migraines are behind me given my 17 years of perfect health. I regularly fly solo with non-flying passengers with no concerns over my health or fitness to fly.
#1593791
I got caught by this at my last (Class 2) medical. My AME told me the CAA have tightened up guidance and he no longer has any professional discretion. In particular a migraine with any visual disturbance or aura must be classified as severe and that path on the flow chart followed. He thought this was excessive and would be taking it up with the CAA, but his hands were tied. For a class 2 that's six months no P1. For a Class 1 it's career ending.

He did say that in the general population 1 in 7 have migraines. However amongst PILOTS almost zero get them, if his experience is anything to go by... :shock:

And since then I've been doing a survey of chums and I would say that 1 in 7 is a ridiculously low figure. More than half of them have had migraines, and many of them are pilots (mainly on self-dec medicals). One chap regularly gets them and had one with the full rainbow effect while flying a couple of months ago. He said he climbed a bit and bimbled about for twenty minutes and then landed with no issues. He felt he could have landed immediately but didnt need to so he let it wear off a bit.

Do any of our resident AMEs concur with mine's view of CAA guidance?
#1593793
Over the years the CAA's stance of how to manage people with migraines has relaxed - in the 'good old' days migraines meant end of flying career or hobby.

I see the 1:7 number comes from the UK Migraine Trust and I would be interest to see where that comes from - I suspect it includes folks who may have had a one time episode; it is certainly not a number I recognise from my clinical work.

Not having migraines myself but having the 'benefit' of some people with migraines in my family I know that people with migraines which mean they cannot carry on with what they intended to do should not fly P1 until the issue has been addressed.

The good news is that for most people migraines can be managed to get their severity and frequency improved.
#1593802
matthew_w100 wrote:I got caught by this at my last (Class 2) medical. My AME told me the CAA have tightened up guidance and he no longer has any professional discretion. In particular a migraine with any visual disturbance or aura must be classified as severe and that path on the flow chart followed. He thought this was excessive and would be taking it up with the CAA, but his hands were tied. For a class 2 that's six months no P1. For a Class 1 it's career ending.

He did say that in the general population 1 in 7 have migraines. However amongst PILOTS almost zero get them, if his experience is anything to go by... :shock:

And since then I've been doing a survey of chums and I would say that 1 in 7 is a ridiculously low figure. More than half of them have had migraines, and many of them are pilots (mainly on self-dec medicals). One chap regularly gets them and had one with the full rainbow effect while flying a couple of months ago. He said he climbed a bit and bimbled about for twenty minutes and then landed with no issues. He felt he could have landed immediately but didnt need to so he let it wear off a bit.

Do any of our resident AMEs concur with mine's view of CAA guidance?


Was this in reaction to a current diagnosis of migraines or a past history?
#1593804
Out of purely academic interest … the CAA flowchart makes no mention of using sumatriptan: is this disfavoured aeromedically speaking? (My partner controls her -- previously crippling -- migraines with this drug. For her, at least, it is highly effective.)
#1593810
4535jacks wrote:So I am thinking of getting my class one so I can get a CPL and then eventually and FI (A) rating. However I have a history of migraines (with aura I think- I honestly can't remember them) that prevented me from continuing planned activities. I had these headaches from the age of 9 to 16 and none since meaning I have been free of headaches for the past 17 years during which I have led an active and sometimes stressful life.

I am now concerned that the CAA won't issue a class 1 medical based on my previous history.

Has anyone with a similar medical record been successful in getting an unrestricted class 1 medical?


Have these previous migraine events been listed in your medical notes by your GP ?
#1593812
4535jacks wrote:Was this in reaction to a current diagnosis of migraines or a past history?


Bit of both. I'd had a previous history, one migraine every two to three years or so for twenty years. I'd mentioned this in the past and he'd said "not to worry" and ignored it. Then this time I had the Class 2 examination I'd had an eye problem during the year. I gave my AME the medical report from the consultant, saying "all is clear". Unfortunately the consultant's report started off with the line "Matthew_w100 presented having recently had a migraine with aura...." whereupon my AME ignoring it was no longer an option. So we had do do a complete medical history making copious notes and working together to justify the fact that he'd not written it down before. I was furious with myself, because I had another consultant's report also saying I was fine which made no mention of migraines (which were unrelated to the eye problem) which I could have used instead.

Which means I'm in the same boat as you; I'd like to do a CPL but can't.
#1593834
I often wonder what relevance all this childhood stuff has: In our eagerness to please, pilots shove everything down on the form with no thought of possible consequences.

ISTR a few years ago a forumite looking for a class 1 put 'childhood febrile convulsion' on his form. (Just about every child has had a febrile convulsion due to high fever at some stage in its life).

The upshot was numerous neurological consultations, brain scans, EEGs (private of course) months of indecision and worry and a bill for c.£800.

Peter
#1593856
PeteSpencer wrote:I often wonder what relevance all this childhood stuff has: In our eagerness to please, pilots shove everything down on the form with no thought of possible consequences.


Non-disclosure is something the CAA is very hot on and will prosecute for.

I get contacted a couple of times a year for people who 'have been found out' as they want some AME help - unfortunately for them they don't need an AME but a good lawyer.

PeteSpencer wrote:
ISTR a few years ago a forumite looking for a class 1 put 'childhood febrile convulsion' on his form. (Just about every child has had a febrile convulsion due to high fever at some stage in its life).

The upshot was numerous neurological consultations, brain scans, EEGs (private of course) months of indecision and worry and a bill for c.£800.

Peter


I don't know the specifics of that particular case but can share with you that it is not uncommon for something presented as straightforward on a forum, to have a lot more to it, than meets the eye.

Sure you have come across some of that yourself when you were practising in O&G; 'I never forget the pill/I always use a condom/I have never had SI with anyone but my spouse'

No?