What Is It Like To Be Put Through the Special Issuance Grinder? (Part 1)

By ANN Correspondent Juan Jimenez

This is a story that this reporter knows will strike a very loud chord in the pilot community. It tells the tale of what I have had to endure over the past nine months to try to obtain what should have been a straightforward special issuance for a third class medical certificate. It documents how, with few exceptions, all that I have encountered has been wave after massive wave of incompetence.

It all began on November 26, 2001, the day before I was scheduled to perform my first Angel Flight mission. That evening I had just come home from Thanksgiving Dinner. In the morning I was supposed to pick up the patient with terminal pancreatic cancer and her companion in Tyler, Texas and fly them to Houston for an appointment at a cancer treatment center. Unfortunately, it was not to be. The patient got to where she needed to go, but I did not.

By late in the evening I was having trouble breathing, as well as a terrible pain just below my diaphragm. Shortly before midnight I asked my wife to call an ambulance, and told her to call the pilot flying the leg to Tyler to tell him I would not make it. The last thing I remember is stumbling into the emergency room with two large paramedics at my sides.

I woke up several days later, with tubes coming out of every orifice in my body. I was told that I had suffered an attack of acute pancreatitis, and had barely survived after being unable to breathe on my own. I had been heavily sedated, intubated and flooded with intravenous saline solution to completely flush my system over a period of days. I somehow managed to recover almost completely in a couple of weeks - my doctor had predicted a hospital stay of anywhere from several weeks to a year - and went home after losing 55 pounds in 10 days. No, I do not intend to market this diet, so don't ask.

Soon after I went home, I began feeling bloated and full of liquid. By Christmas Eve, my abdomen was huge, I felt terrible and I could not drink or eat anything. Turns out that my pancreas was damaged, and was shooting pancreatic fluid into my abdominal cavity instead of into my circulatory system - a common sequel to pancreatitis. By the time I was taken to surgery to be drained, I had a total of two and a half gallons of fluid in me - the largest pancreatic pseudocyst my doctors had ever seen! In fact, my doctor said I now know what it feels like to be pregnant, to which I replied that that was fine with me, as long as he did not ask me to put my feet up on stirrups.

Unfortunately, the fluid they got from me was slightly infected, so I had to be cut open like a roast in order to have gauze shoved into my abdominal cavity to absorb what was left of the liquid. I went back to the operating room four times to be put to sleep and have the turkey stuffing changed. In the meanwhile, I was left open. Thank goodness I could not see the incision. I also had to have four drains installed, with their accompanying bags. For almost two months after that I felt like the Six-Dollar Drano Man. A small, battery-powered morphine pump that allowed me to self-administer 1cc of the pain-killing drug every four minutes became my very best friend during that hospitalization, and made the endless, droning hours of boredom and bad cable TV bearable. Four clicks meant a direct-to flight plan to La-La Land for me, and by the second day I had the departures timed to the microsecond!

I went home from that during the second week of January, just in time for my son's birthday. A few days later my body decided it had to teach me one last lesson for the abuse I had put it through. It blasted me with chest pain, so once again I went to the hospital, only to find out that I had a blocked artery. I was taken to the roto-rooter table, otherwise known as the Cath Lab, and a stent was installed in my heart.

Most of you probably know what I mean, but for those who do not, a stent is a small cylinder made from a screen-like material. A small balloon is inserted into the artery and inflated to force the blocked area open. The stent is then placed at the site of the blockage to keep it open. In most cases it "takes" and there is no further problem, but in some folks the stent slips or becomes blocked very quickly and fails, hence the six-month stabilization period required by the FAA. My doctor informed me the day after that I had suffered no damage to my heart, but I would need to take some medicine and an aspirin a day for the foreseeable future.

When all was said and done, I had run up medical bills that entitled me to the VIP treatment at area hospitals. In one of them, I found out that once my bill broke the $100,000 barrier - to the rousing cheers of the hospital staff - I was entitled to the VIP kitchen menu, and could order just about anything I wanted from the hospital kitchen, within dietary restrictions. I had fun with that one - all the other patients turned to whining to their nurses about not getting fat-free breakfast burritos in the morning! I am very lucky that my employer takes excellent care of us with a comprehensive health plan, because when all was said and done, my total bill could have easily paid for a very well equipped modern light twin.

Many things have changed since then. I quit smoking and am happy to say I have been tobacco-free for seventeen months. My diet has completely changed as well and I eat much better than I used to -- much to the chagrin of the food vendors at Oshkosh. I went through a comprehensive cardiac rehabilitation program and regained all my lost strength and much more, and I take my medicine religiously.

Six months after the roto-rooter session, I went to my cardiologist and scheduled a new thalium stress test to meet FAA requirements, which I passed with flying colors. Once that was completed, I decided to begin the process of getting back my third class medical - which I still had in my possession but considered null and void, of course. I decided that in order to keep myself honest, I would now use an AME, Dr. Richard Tafel, who works out of the same office as my family doctor. My thinking was that since my family medical records were in the same office, I would never have an opportunity to do anything but be completely honest about my medical condition.

That was my first mistake. It was also the beginning of a special issuance nightmare that has yet to end.

• Read Part Two

• Read Part Three

FMI: www.faa.gov