by Richard A. Hansen, M.D., AME

 

 

Leon was an old pilot, age 74, now coming back to the local airport with renewed interest. He had just completed restoring his 1946 Luscombe, and was eager to get airborne with it. Now he sat in my office for his long-awaited Pilot Medical Certificate, which had expired 5 years ago. But there was problem. In 2001 Leon had experienced sudden chest pain. Family members called 911 and after a fast trip to the Emergency Room, the doctor told him that he was having a heart attack, and should be admitted immediately. Following standard coronary care protocol, an angiogram was done, a dye injection with imaging of the heart's vital arteries. Yes, there was blockage, but a stent could be placed to open up the vessel, and probably prevent any heart damage long term. With medication to lower cholesterol, Leon was discharged, to continue his peaceful retirement, sans aviation.

 

Now that the flying bug had bitten him, and with eager stories of former piloting adventures, Leon was ready to get his wings again. But, not so fast, I reluctantly had to tell him. According to FAA protocol, any person who has had heart surgery or an actual heart attack is automatically grounded until he has not only recovered, but can demonstrate satisfactory heart function with tests such as a normal electrocardiogram (ECG), treadmill stress test, and blood parameters such as normal electrolytes, blood glucose, and safe cholesterol readings. Leon should see his cardiologist, which his wife was already asking him to arrange anyway. For now, the certification would have to be deferred to the FAA for final decision.

 

Meanwhile, our airplane-restorer would fly dual with his fully-licensed partner. And, his tales of emergency off-field landings, flying cross-country with only chart, compass and watch, and other close calls and cockpit escapades could entertain both grandchildren and hanger flying friends for hours. There is a lesson in this experience, though, which needs further elaboration.

 

While Leon was fine-tuning his Luscombe, there was a little fine-tuning his body needed, too. Why pay so much attention to the tire pressures in his landing gear, and fail to notice a spare tire that has grown around the seat belt impression? And, while the air intake filter is studiously cleaned and inspected, why not check his own air intake system, avoiding tobacco and other noxious fumes that can put a good pair of lungs out of commission, at any altitude? Then there is the compression check, the dual mags and spark plugs, all of which are important to make the engine fire smoothly, without preignition or detonation noises. However, what about his own power plant, the heart and its pacemaker, for perfect circulation and blood flow. Are we as diligent to keep the cholesterol under control, supplying the best dietary octane that our body needs, while avoiding harmful substances such as excess fat, too much salt, or caffeine which can trigger ominous and annoying arrhythmias, even a sudden heart attack?