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Flight Physician - December, 2012
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This Newsletter is brought to you for free and open access by the Civil Aviation Medical Association Records (MS-526) at CORE Scholar. It has been accepted for inclusion in Browse all Civil Aviation Medical Association Newsletters by an authorized administrator of CORE Scholar. For more information, please contact library- [email protected]. VOL 15, NO. 3 ECEMBER 2012
President's Report La Jolla is a "Home Run" BY HUGH J. O'NEILL, BY DAVID P. MILLETT, M.D., MPH M.D., M.H.Sc, D.AV.MED„ F.F.O.M.I EXECUTIVE VICE PRESIDENT
OOKING BACK over 2012, one has a sense of sat• HE 58TH CAMA Annual Scientific Meet• In This Issue L isfaction and achievement with the workings ing held October 4-6, 2012, in La Jolla, of CAMA. Starting with a good board meeting TCalifornia, was a great success! Attendance in Dallas, we moved on to produce an excellent was very good with 120 full-time attendees, 12 participating staff, and 34 guests. The Educational CAMA Sunday in Atlanta. EXECUTIVE VP'S REPORT..,,3 Program Chairman, Dr. Clay Cowl, organized a The international focus and large attendance world-class program. COCKPIT FATIGUE 6 should be a source of encouragement to continue For example, there were lecturers from the Mayo this type of work. It indicates that we are con• Clinic, Scripps Institute Clinic, Johns Hopkins CLINICAL AEROSPACE sidered a worthy organization with something to University, and the Federal Aviation Administra• PHYSIOLOGY 7 contribute. tion. The program was unique and stimulating. I was personally very pleased to see four of our The FAA reported that 93 AMEs completed their THE FLYING BUG 10 Chinese colleagues attending. One hopes this periodic education requirement at this meeting. MEDXPRESS 10 will be the start of a growing friendship. Timely The meeting began Thursday, October 4th at advertising was, in my opinion, the key to this 8 a.m. After introductions, the scientific portion "OH, BY THE WAY,..!" ....11 meeting's success. of the program began. The meeting room was spacious, with comfortable classroom seating for The CAMA luncheon was very well attended NEW MEMBERS 12 everyone. Just outside the meeting room was an and, thanks to Dr. Cowl, we had excellent speakers information desk and demonstrations by our new• from Delta Airlines. As Delta is the world's largest AME: NOT A BAD GIG.. 13 est corporate member, Georgia Lung Associates. airline, it is no mean feat to get the CEO and his Representing the exhibit emphasizing sleep apnea SUSTAINING, CORPORATE, assistant to address our group. were Ms. Leanne Roberts and Ms. Nancy Ross. AND LIFE MEMBERS 14 The annual scientific meeting at La Jolla was After lunch and several presentations, the group one of the best meetings I have attended of any departed on a field trip. There were two venues, IN MEMORIAM: organization over the past twenty years. Again, and everyone had a chance to visit both. The first HALFORD R. CONWELL ...15 this was the product of tireless work by Clayton stop was the local King Aviation School with hosts
ON THE HORIZON 16 Continued on page 2 Continued on page 4 FLIGHT PHYSICIAN 2 December 2012
nj Lp President's Report from page 1 The next Board meeting will take FROM THE EDITOR place in Dallas in February. The year Cowl and our Executive staff. Clayton 2013 will be another good year for As editor of the "Flight Physi• received a well-deserved standing ova• CAMA. However, it will not be easy. cian," I thought it would be ben• tion at our honours night banquet. The financial report I received in La eficial start up a couple of new sec• The Board will have to work hard to Jolla was not as I had hoped. Now we tions in the publication. One such keep up this standard. face a great challenge. It appears we section would involve the aviation One of my particular interests is continue to hemorrhage some $10K medical examiner and real case to increase international involvement per year from our positive balance. scenarios involving certification. It in CAMA. In pursuit of this aim, Were this to continue then our next will be called "Oh, by the Way...!" I attended the Mexican Aerospace President, Mark Eidson's final task We have all had them during our Medical Association in San Luis Po- would be to turn off the lights and AME work and I would like to tosi. There I received a warm welcome close the door. This will not hap• invite anyone of you to write one from the President, Dr. Felix Poras pen. With nose to the grindstones, up for instructional purposes and and his executive. It was a great plea• shoulders to the wheel, and feet to the publication. sure to meet with Dr. Luis Amezqua, fire, the Board will solve this problem The other section will be "Just a former President of CAMA, who is starting immediately. for Fun." This could be anything still practicing aerospace medicine. I do not support increasing fees about flying, medicine, editorial Many of his old friends in CAMA will or cutting back on our traditional comments, human interest, or any be delighted to know he is in excellent program. We are successful and do subject your peers may be interested health, and we can look forward to much more than other medical asso• in and may enjoy reading. Again, I seeing him at CAMA. ciation of our size. This is the reason invite any of you to contribute and In 2012, CAMA became an associ• why they accumulate money while we forward your article to me by email. ate member of the European Society provide a program! My only regret is As always, I would appreciate of Aerospace Medicine. This is an that more members do not attend our any journal-style article for publi• association of the aviation medical functions where their dollars are spent cation, as there is not an overabun• societies of twenty-seven European in the organization. The value you get dance of new material on hand. countries. The organization has been from CAMA is in your involvement On another subject, the board is developing over the past five years and in the program that is created in your considering publishing the "Flight is now well established. It is tied to name and for your pleasure. Physician" journal electronically to organizations such as the Aerospace We have an exciting year sketched replace the mailed printed version. Medical Association (US). They held out with a CAMA Sunday on "Obe• To start out, both printed and elec• a joint session in London. There were sity" at Chicago and an annual meet• tronic versions of the next "Flight over two hundred attendees. It is on ing at Sea World in Florida. I do hope Physician" will be issued. The board the road to success, and we are well to see more members attending and will ultimately decide on future placed to play a part in this future appeal to you all to rejoin CAMA by publication methods. Your input endeavor. Perhaps a joint meeting in paying your dues early. on this subject is welcome. In our Europe could be planned? After all, To those of you who celebrate recent annual CAMA meeting, it CAMA had excellent past meetings Christmas, Ann and I wish you joy appeared that half of our attending in Austria and Amsterdam. and peace in the warmth of your members preferred electronic vs. a We need to encourage and help family. To our many members for printed publication of the journal. our international members to attend whom this is not a religious holiday, Again, please respond to me with our meetings. Fiscal restraint is put• we wish you rest and peace and ask your opinion. ting a damper on travel. We must do you to plan to join your friends next all we can, short of financing airfares year in CAMA. Happy Landings, to provide help. In addition, we must FP Dr. Mark (Eidson) seek to involve our Chinese colleagues whose aviation industry, including general aviation, is booming. ^1 rtj FLIGHT PHYSICIAN 3 December 2012
Executive Vice FUGHTPHYSICIAN President's Report BY DAVID P. MILLETT, M.D., MPH
A Publication of the Civil Aviation Medical s WE come to the end of Association (CAMA) 2012, CAMA remains Dr. Millett A strong and vibrant. Our membership is stable at 471 members President We will hold CAMA Sunday on
Hugh I. O'Neill, M.D. in good standing. We anticipate May 12th, with a program addressing attracting more new members and obesity. On Monday, May 13, the President-Elect welcoming old members back into CAMA Board meeting will be held Mark C. Eidson, M.D. our association. Please refer potential from 10:00 a.m. to noon, followed by new members to CAMA. Secretary-Treasurer the CAMA luncheon. We will have Gordon L. Ritter, D.O. The annual scientific meeting another excellent speaker, and you are in La Jolla, California, on October all urged to attend. Executive Vice-President 4-6, 2012, was another resoundingly The CAMA 2013 annual scientific David P. Millett, M.D., MPH successful meeting. Participation was meeting will take place earlier than Executive Editor very good with 120 physicians and usual. The meeting dates are Sep• Mark C. Eidson, M.D. 34 accompanying persons. The FAA tember 26-28, 2013, at the Renais• reports that 93 AMEs successfully sance Hotel at SeaWorld in Orlando, Associate Editors completed the FAA recurrent train• Florida. We are holding our meeting Petra A. Illig, M.D. ing. A more detailed report on the earlier so that our members may also Stephen Leonard, M.D. annual meeting appears on page 1 in Alex M.Wolbrink, M.D. attend the International Academy Ingrid Zimmer-Galler, M.D. this edition of "The Flight Physician." of Aviation and Space Congress in The next item on the calendar is Jerusalem, October 6-10, 2013. Historian, By-Laws/Constitution the annual mid-winter Board meet• Finally, I wish to add my personal A. Duane Catterson, M.D. ing to be held on Saturday, February tribute to Dr. Hal Conwell, who 2, 2013. The meeting will be held at passed away at his home at the age The editors of F/fg/ifPhysician wel• the usual venue at the Embassy Suites of 88 on September 1, 2013. Hal come submission of articles, letters DFW-South. The Board meeting was planning to attend the CAMA to the editor, news bits, interesting time will be on Saturday only from annual meeting in La Jolla with his aeromedical cases, and photos for 8:30 a.m. to 5:00 p.m. President son, Mark. publication. Please email text on a O'Neill feels that we can get all of computer file (MS Word preferred) He was registered and looking the necessary business completed in to: forward to making the trip from Mark C. Eidson, M.D. one full day. Houston to La Jolla. We all missed [email protected] After the Board meeting in Febru• his presence at our meeting. Just a few or: ary, next on the CAMA calendar is days prior to his passing, we spoke David P. Millett, M.D., MPH our participation in the annual Aero• on the phone, and he was looking CAMA Headquarters space Medical Association (AsMA) forward to seeing all of his CAMA P.O. Box 2382 meeting at the Chicago Sheraton friends. Hal was always a gregarious Peachtree City, GA 30269-2382 Phone: (770) 487-0100 Hotel from Sunday, May 12, 2013, and an interesting gentleman, and Fax: (770) 487-0080 through Thursday, May 16, 2013. we shall all miss him tremendously. Email: [email protected] FP FLIGHT PHYSICIAN 4 December 2012
To top off the evening, the group reunited at the nearby Home Run from page 1 Butcher Shop Steak House. This restaurant is a typical John and Martha King. The technology of the flight school 1950s steak house and entertainment restaurant. Accord• was very impressive. ing to local authorities, this restaurant was popular with the "Underground," and two of the owners who were frequent visitors were Frank Sinatra and Jimmy Durante. It was a charming venue to have a delicious Thursday dinner. Friday was a full day of presentations. That evening was a free evening for the individuals to enjoy the local restaurants in small groups. Particularly interesting was the Russian Deli. The final day of the meeting was Saturday. After a complete day of presentations, the meeting concluded with the Honors Night Banquet, a special after dinner guest speaker, and awards presentation. Thanks to CAMA Past- Members tour the King Flight School. President David Bryman, our after dinner speaker was The next stop was a visit to the Flying Leatherneck Colonel (ret.) Mark Tillman. Aviation Museum at the Marine Corps Air Station, Mira- Col. Tillman was the pilot-in- mar. It was a pleasure to view the exhibits and aircraft that command of Air Force One recounted the history of Marine Corps Aviation. from 2001 to 2009. Dur• ing those eight years, he was instrumental in successfully completing many dangerous Colonel (ret) Mark and exciting missions. Be• Tillman thrilled the sides maintaining the airborne Honors Night audience Presidency during 9/11, Col. with his account of Tillman was the first pilot to eight years as the fly a sitting Ptesident into a Commander of Air war zone. Col. Tillman's excel• Force One. lent presentation, along with his photos, kept the audience mesmerized. The final event of the evening and of the meeting was the presentation of the CAMA 2012 Awards. The first award of the evening was the Forrest and Pamela Bird Rec• ognition, presented every year since 1991 to the individual Members visit the Flying Leatherneck Museum.
Col. Tillman was presented the Forrest and Pamela Bird Recognition Award. (From left): Civil Aviation Medical Association President Members have Thursday dinner at the famous Hugh O'Neill, Col. Tillman, and Sammie and Jim Butcher Shop Steak House. Harris (representing Forrest and Pamela Bird). FLIGHT PHYSICIAN 5 December 2012 who has advanced aviation safety through his professional award is presented by actions. The award was presented to Col. Mark Tillman the CAMA President to in recognition of his skills and professionalism as Com• the individual who has mander of Air Force One for over eight years. provided exemplary as• The second award was the Audie and Bernice Davis sistance to the President Award, sponsored by Harvey Watt and Company, pre• during the past year. This sented annually since 2004. This award recognizes an AME year's recipient was Ms. who has demonstrated professionalism in promoting pilots' Sherry Sandoval, who is healthy lifestyles and prolongation of pilots' longevity. the CAMA Membership This year's recipient was Dr. Gordon Ritter, a longtime and Registration Coor• AME who promotes pilot longevity and provides the care dinator. During the last Dr. O'Neill presents the necessary to meet pilots' needs. year, she developed and President's Commendation updated the membership Award to Ms. Sherry database and automated Sandoval. membership and meeting registration data. The final recognition was the award of two new CAMA Fellowships: Doctors Jim Carpenter and Jim Fra- ser. Since the Fellowship Program began in 2006, 56 members have been recognized.
H Dr. Jim Carpenter (r) President O'Neill (I) presented the Audie H received his Fellows and Bernice Davis Award to Dr. Gordon K Award from Dr. Ritter (center), (r) Dr. Warren Silberman, O'Neill. representing the sponsor, Harvey W. Watt and Co.
The next award was the Jim and Sammie Harris Award. Presented since 2008, this award is named for the team that guided CAMA for 17 years. The award is presented Dr. Jim Fraser (I) received his Fellows Award from President O'Neill.
The new Board members were introduced for a two- year term: Jim Harris, Farhad Sahiar, Petra Illig, Russell Rayman, and Andrew Miller (photo, p. 16). Earl Beard was recognized as the first Emeritus Trustee.
The final act was President Hugh O'Neill's presentation to his bride, Ann O'Neill, with the First Lady's diamond pin. President O'Neill (I) presented the Jim and Sammie Harris Award to Dr. Jim Carpenter In closing, we at CAMA wish to thank the (r), as Sammie and Jim Harris (center) following people who helped make this meeting such a observe. big success: Mathias Kuo, Carlos Carrillo, Miriam Cline, Cindy Marquez, Chef Darren, and Rosie Zuno of the San to the CAMA member who has served CAMA with ad• Diego Marriott La Jolla; Elaine Heston of Goldfield Stage; ministrative excellence. This year's recipient was Dr. Jim Mike McCampbell of the Butcher Shop Steak House; Carpenter, who has served CAMA as a Board member and Bob Butcher, Dick Miller, and Ed Downum of the Flying Vice-President for Communications and Representation. Leatherneck Aviation Museum; and John and Martha King The fourth award, the President's Commendation, of the King Flight Schools. has been awarded in its current form since 1997. This FP FLIGHT PHYSICIAN 6 December 2012
Cockpit Fatigue This 10 hours includes time to travel approved of the statement, "An airline to and from the place of rest, and at• pilot who becomes drowsy should be This article is excerptedfrom the Aero• tention to personal needs. It does not allowed to nap if another qualified space Medical Association position account for circadian disturbances pilot is awake to take over during the paper, Fatigue Countermeasures in due to time zone transitions, and nap." Cockpit lighting, the equiva• Aviation, published in Aviation, Space, night vs. day rest periods, which can lent of a daylight room, is somewhat and Environmental Medicine, Volume disturb sleep patterns. Therefore, effective in diminishing circadian 80, issue 1, January 2009. It is impor• flightcrews often fail to achieve eight disturbances and has an immediate tant that our members are familiar with hours of uninterrupted sleep. Devel• alerting effect on mood and perfor• this subject since it impacts on CAMA's opment of ultra-long-haul aircraft mance. It is especially effective during mission promoting civil aviation safety. (flight durations >20 hrs.) will require night flights where conditions permit Reading the entire paper is encouraged new thinking in all aspects of crew its use. Illuminating the flight deck to since it extensively documents the science management. 100 lux (daylight room) does not de• underlying AsMA'sposition statement —Editor grade flightcrew visual performance. In-Fight Countermeasures
The Problem Attempts to increase crew alert• Rest Period Strategies No one questions the deleterious ness on commercial long-haul flights Achieving restful sleep is difficult effect fatigue has on pilot perfor• include cockpit napping, activity for reasons noted above. Therefore, mance. It is a pervasive problem in breaks, bunk sleep, in-flight rostering strategies utilizing hypnotics are in all branches of aviation. Pilots who (i.e., relief crews), and cockpit light• place. The Air Force and Army have are sleep-deprived think and move ing. Bunk sleep is the most effective approved the use of temazepam more slowly, make more mistakes, countermeasure to address circadian (RestoriP), Zolpidem (Ambien®), and have memory difficulties. Long- disturbances and cumulative sleep and zaleplon (Sonata*) for use when haul pilots (> 8 hrs. block to block) debt. Commercial considerations, sleep is possible but difficult. The use cite sleep deprivation and time zone i.e., costs to provide crew bunk space of each is predicated on its half-life transitions as causes of fatigue, while that is dark and quiet enough within (temazepam 9-h, Zolpidem 2.5-h, domestic/corporate pilots (< 8 hrs.) the cabin to allow sleep, have led to zaleplon 1-h). Temazepam is used report sleep-deprivation and heavy industry resistance, and bunk sleep for inducing daytime sleep of greater workloads as problems. Other factors does not appear to be achievable in than eight hours and to avoid early include night flights, jet lag, early the near future (see WSJ March 14, morning awakening. Zolpidem fa• wakeups, time pressure, multiple 2009). cilitates early sleep lasting four to flight legs, and consecutive duty pe• Activity breaks (leaving the flight six hours and early awakening for riods without adequate rest breaks. deck, conversing with relief crew or early duty (0500h-0700h). Zaleplon Using EEG tracing and rapid eye passengers, and mild physical activ• induces very short naps of one to two movement data, 87% of long-haul ity) are the least effective. Subjective hours, inducing early sleep. None is pilots experienced at least one micro- alertness and physiologic testing recommended if on call. sleep period of greater than 5 seconds, performance diminished within Current civil aviation policy al• and on average pilots experienced six 30 minutes after a 7-minute break. lows limited use of Zolpidem only. microsleeps in the last 90 minutes Cockpit napping during otherwise The FAA allows its use only twice a of flight. long periods of continuous wakeful• week. It cannot be taken for circadian ness is extremely effective in promot• adjustment, and a 24-hour ground• Current Regulation ing crew alertness. A 40-minute sleep ing period after dosing is mandatory. Current industry practices and period, which produces on average AsMA's position is that the use of regulations have largely failed to 26 minutes of sleep, resulted in faster hypnotics for circadian disruption by adopt new scientific advances in response times and fewer microsleeps the FAA is overly restrictive because sleep-deprivation research. The FAA than the non-nap controls. The FAA it is exactly here where they are safe defines crew rest in the CFRs as the does not sanction cockpit napping, and effective. AsMA's position is that time a crewmember is free of flight although eight foreign carriers do Zolpidem may be used by commer• or administrative duties and tequires authorize and regulate it. Eighty- cial pilots up to four times a week, a minimum rest period of 10 hours. six percent of the public surveyed Continued—• FLIGHT PHYSICIAN 7 December 2012 provided that 1) the pilot has been Clinical Aerospace Sometimes people ingest massive checked for unusual reactions while Physiology doses of caffeine all at once, and this off duty; 2) the dose does not exceed "Caffeine Abuse" is dangerous because it does not allow 10 mg in any given 24-hour period; the body time to react with the normal and 3) there is a minimum 12-hour Case Study: A first-class 27-year- warning symptoms that indicate too period between ingestion of the drug old female pilot was recently seen in much caffeine is in the system. Listed and return to duty. the emergency department for palpita• are symptoms from mild to severe: tions and mild hypertension (145/93). • Jitters Military Aviation The records showed an ECG with • Increased heart rate Fatigue management in the three sinus tachycardia and some unifocal • Nausea U.S. military services is somewhat PVCs. Her workup was otherwise • Anxiety less complex than in civil aviation unremarkable. She was dismissed and • Heart palpitations but generally, when operations re• advised to see her physician for a fol• • Insomnia quire, the commanding officer, with low-up visit. On follow up, review of • Sweating advice of the medical officer, may blood, urine, imaging studies, and the • Dizziness assign certain crews flight duty that physical exam were all unremarkable. • Vomiting exceeds rest minimums. On-call status A repeat ECG was normal and • Cardiac arrest clearly precludes use of hypnotics, and she was asymptomatic except for a Because of caffeine tolerance, it restrictions on their use tends to ap• reported mild headache the morning is hard to define an overdose level of proximate civilian guidelines. Use by following the initial episode prompt• intake, but generally a dose between crewmembers is voluntary. Extended ing the emergency visit. Further his• 300-500mg will produce mild to missions, where flightcrew wakeful• tory revealed her to be a nonsmoker moderate symptoms. ness is necessary and adequate crew and nondrinker of alcohol. However, Caffeine is the xanthine alkaloid rest is not possible, have led to policies the day of her episode she had con• structurally known as 1,3,7-trimethyl regulating the use of stimulant/wake sumed at least 12 cups of coffee in a xanthine. Caffeine is a purine de• promoting drugs. Dextroamphet• 12-hour period prior to her symptoms. rivative and structurally resembles amine (Dexedrine9) has been autho• This constituted an intake of 1200 mg theophylline and theobromine. Like rized by all three services. Modafinil of caffeine, which is four times the these other two methyl xanthines, it (ProvigiP) has been authorized by the maximum recommend daily dose. can excite the central nervous system Air Force. In sustained operations, The conclusion was that she had expe• as a nor-adrenergic stimulant. Second• their judicious use can enhance safety rienced caffeine intoxication. She was ary effects are increasing urine produc• and effectiveness of sleep-deprived counseled to moderate her caffeine tion, stimulating cardiac muscle, and crews. Modafinil, due to its efficacy intake, to which she readily agreed. relaxing smooth muscle. and safety profile, is gaining favor. Discussion: Caffeine is one of the Metabolically, caffeine is rapidly Conclusions. Technology and oldest natural stimulants in the diet absorbed through the gut and is dis• advances in aircraft performance have of human beings. Caffeine occurs tributed widely through body tissues. led to the physiologic insight that we naturally in coffee beans, tea leaves, Under normal circumstances, caffeine human beings like to sleep in the dark, cola nuts, cocoa beans, and many has a half-life of about 3 to 4 hours. at night. When asked to do otherwise, other plants. Today, coffee is the major It is metabolized in the liver through our brains and bodies don't do quite source of caffeine in Western civiliza• xanthine oxidase, a cytochrome P450. as well and performance and safety tion, although tea, chocolate, and now There are drug interactions such as degrade. More thought, science, and energy drinks rival it in many cultures. with allopurinol that will inhibit xan• money will be needed to upgrade the There are some common symptoms thine oxidase. Omeprazole (Prilosec) weak spot in the system, the human that indicate too much caffeine con• as well as cigarette smoke will induce factor. The position paper on fatigue sumption. These symptoms should the cytochrome P450 enzyme. countermeasures from AsMA is a be recognized, and further caffeine Other substrates that compete for good start. intake should be stopped to avoid the enzyme include acetaminophen FP more serious and even life-threatening and warfarin (Coumadin). These may symptoms. Continued on page 8 FLIGHT PHYSICIAN 8 December 2012 enhance or diminish the effect of caf• lar headaches, withdrawal will often 3. Caffeine used in moderation feine, depending on the interactions. precipitate a headache. Overdose does can benefit a pilot by: Caffeine penetrates the blood occur, but the acute human fatal dose a. increasing vigilance and decreas• brain barrier, and users will demon• appears to be around 10 grams. ing reaction times strate increased capacity for sustained Other drugs interact with caffeine. b. reducing the effects of alcohol intellectual effort, decreased reaction Alcohol does not mix with anything and hangover times, and improved vigilance. It will in aviation and "giving caffeine to a c. reducing anxiety, nervousness, and restlessness also induce a temporary diminution drunk only produces a wide-awake d. decreasing oxygen demands by of sleep deprivation or sleep demand. drunk." However, caffeine is a di• the brain These effects are achieved at a daily uretic and treatment of a hangover, consumption of 300 mg of caffeine, which is a partial state of dehydration 4. What is the average amount of or a single dose of 200 mg. Since a induced by the ketone and aldehyde caffeine contained in a cup of regular single cup of coffee contains about metabolites of alcohol, will only brewed coffee? 100 mg of caffeine, a cup of tea about be enhanced by the diuretic effect a. 3 mg 30 mg, and a cola drink about 50 mg, of caffeine. In addition, nicotine, b. 30 mg these levels are easily achieved. which has the synergistic effect of c. 50 mg Caffeine is ubiquitous and is pres• vasoconstriction and increased heart d. 100 mg ent in many other forms. Cold and rate, as well as increased blood pres• allergy relief drugs typically contain sure, along with a carbon monoxide 5. Of the following dietary foods, which one will NOT interact with 15 to 30 mg of caffeine. Headache effect of smokers, can adversely af• coffee to produce hypertension and drugs, such as Excedrin, may contain fect psychological and physiological headache? 65 mg per tablet, and larger doses are performance. a. Nutmeg found in drugs intended to keep a The stimulant effects of caffeine b. Cheese person awake, such as NoDoz (200 upon the heart and blood pressure c. Red wine mg) or Vivarin (200 mg). Caffeine can also interact synergistically d. Licorice is also found in migraine-relieving with other dietary intake, such as drugs, such as Cafergot (100 mg) tyramine-containing cheeses and 6. Rapid consumption of more and pain relief drugs, such as Esgic red wine, as well as licorice, which than 400 mg of caffeine (four cups (40 mg), Norgesic (30 mg), Fioricet contains glycyrrhizic acid. of caffeinated coffee or two NoDoz) (40 mg), or Migralam (100 mg). can produce what symptoms? Some drinks such as Mega Monster Questions a. Headache Energy Drink (240 mg), Baskin 1. Caffeine is ubiquitous in the b. Hypertension Robbins Cappuccino Blast (234 American diet. In addition to coffee, c. Tremor mg), and others contain significant caffeine can be found in: d. Tachycardia and dysrhythmia amounts of caffeine. Regarding illicit a. cocoa and chocolate e. All of the above drugs, many street stimulants such b. cold and allergy drugs as amphetamines are often cut or di• c. appetite control drugs (Answers to Questions d. headache relief drugs luted with caffeine in extremely large are on page 10.) e. all of the above amounts. Even decaffeinated coffee contains 3 mg of caffeine per cup. 2. If a pilot wishes to take advan• This study is from the Civil Aero• Caffeine, although a mild stimu• tage of the stimulant properties of space Medical Institute AME training lant, induces tolerance, which occurs caffeine but does not want to en• manual. at doses over 300 mg per day. Heavy counter adverse reactions, caffeine FP consumers of caffeine quickly lose consumption should be limited to a the mental stimulation effects and maximum of per day or in instead develop a tolerance and a single dose. withdrawal syndrome. Withdrawal a. 100 mg, 50 mg symptoms may include fatigue, b. 300 mg, 200 mg drowsiness, and decreased alertness. c. 500 mg, 300 mg In those prone to migraine and vascu• d. 1 gram, 1 gram FLIGHT PHYSICIAN 9 December 2012
CIVIL AVIATION MEDICAL ASSOCIATION
CAMA MEMBERSHIP DUES NOTICE FOR 2013
Member Name and Address:
RO, Box 2382
Peachtree City, GA 30269-2382
Voice 770-487-0100
FAX 770-487-0080 Please complete and return with your payment. Website: wwACivilavmed.com NOTE: Membership is from January 1st through December 31st. Membership dues $ 100.00 U.S. Dollars E-mail: [email protected] Sustaining Membership dues (optional) $ 200.00 U.S. Dollars Membership dues for Retired Members $ 35.00 U.S. Dollars CAMA OFFICERS Membership dues for Students $ 35.00 U.S. Dollars Life Membership $1000.00 U.S. Dollars President Hugh J. O'Neill, M.D. Payment Options: President-Elcct Mark C. Eidson, M.D. Check Enclosed # MasterCard VISA Immediate Past President James N. Heins, M.D. Credit Card Number:
Secretary-Treasurer Expiration Date: Total Amount $ Gordon L. Ritter, D.O.
Executive Vice President Print Name: David P. Millett, M.D., MPH Signature: Vice-President tor Education Clayton T. Cowl, M.D..MS Information provided will not be shared with any other organization. Vice President Communications & Representation PLEASE PRINT (* required information) James L. Carpenter, M.D.
Spouse/Significant Other Name: Vice President for Management Randall Caviness, M.D. Check if you are a member of: AO A Yes No
Editor AOPA Yes No Mark C. Eidson, M.D. *Pilot: Yes No EAA Yes No *AME: Yes No AAFP Yes No Photo Historian *AMA Yes No AsMA Yes No Randall Caviness, M.D.
'Specialty: Historian, Constitution and By-Laws A. Duane CaUerson. M.D. *Phone: # ( )
Cell # ( )
Fax: # ( )
"E-Mail Address: FLIGHT PHYSICIAN 10 December 2012
The Flying Bug airport visits. The more serious cases of TFB demonstrate behaviors that MedXPress No Known Cure for It facilitate the need to satisfy the "fly• Basic Steps for a Normal "THE FLYING BUG" (TFB) is a fairly ing void." These actions may include Examination by the AME common syndrome involving hu• shadowing others with a similar af• mans. It afflicts approximately 10% fliction at airport hangars, aviation 1. The airman accesses the MedX• of the general population in various mechanic shops, aviation fuel depots, Press website at: https*.//medx- degrees of intensity and is a lifetime and runway viewing areas and may press.faa.gov/ condition. culminate in a ride on a flying device. 2. The airman builds a MedXPress As the disorder progresses, account. it may actually involve finan• 3. The airman completes the medical cial obligations in order to history portion of the applica• gain access to flying devices. tion and MedXPress provides Although "The Flying Bug" is the airman with a confirma• not considered a true addiction, tion number. It also provides a various withdrawal symptoms printable summary sheet of the have been reported. applicant's answers that can be At the time of this writing, used to discuss the medical his• there is no known cure for tory with the AME prior to the "The Flying Bug," although exam, if desired. the symptoms may be allevi• 4. The airman arrives for the ex• Subject airman, a hopeless case of TFB, awaits clinical trials. ated by actively participating in amination (within 60 days) and the flying experience. Numerous gives the AME the MedXPress The onset is usually recognized ways to fulfill this experience exist confirmation number. in the early developmental stages of and may include: gliding, parachut• 5. The AME enters the MedX• childhood and intensifies just after ing, ballooning, ultra-light flying, Press number into the Aerospace puberty. It is most likely an inborn and airplane or jet flying. Jumping Medical Certification Subsystem phenomenon and possibly inherited, off elevated structures (device free) (AMCS) and the airman's history although environmental influences has been attempted with mixed and is populated automatically in the play an important role. TFB is a sometimes tragic results and is there• history field of AMCS. significant condition, and there is a fore not recommended. 6. The AME completes the exam and need to address this situation. The Aviation Medical Examiner prints the certificate. TFB is usually recognized in early (AME), although not considered an 7. The AME transmits the exam in childhood by observing the affected enabler, can assist those afflicted AMCS to the FAA. one's head and eyes being spontane• with TFB. The Federal Aviation ously directed upward at any passing Administration (FAA) has years of Airmen that do not have comput• mechanical flying device. Often, a experience and guidance in proper ers may use a library or other public reflex involving the right or left up• management of those with TFB and computer or borrow a computer from per extremity and index finger can be offers a safe course of action to miti• a friend. Airmen are reminded to seen pointing skyward in the direc• gate symptoms. The AME and other erase their privacy information from tion of the device of interest and the FAA designees (i.e., pilot instructors, the computer they borrow. voice, having a hint of anxiousness mechanics, and others) work on the or excitement, may spontaneously front lines to support those with verbalize the word "look." TFB abiding by these management Answers to Quiz, page 8: The manifestations of symptoms programs designed to safely allow 1. e those afflicted to live, as near as can b continue into pre-adolescent and 2. be expected, a normal life. a adolescent stages where behavior 3. d involves viewing or studying various 4. flying devices. This also may lead a t>%. Wank 5. e to manipulative ways of obtaining 6. FLIGHT PHYSICIAN 11 December 2012
"Oh, by the Way...!" He then revealed that in 1994, he had passed out while driving on a turnpike, and his wife was able to steer to the side of the road... BY MARK C. EIDSON, M.D.
57-YEAR-OLD MALE Class I would assist in his application for running mode, and unless contrain- III pilot desired to "get back which I did, and he later obtained a dicated, a sample strip with the pace- into flying" many years time-limited special issuance medical maker in magnetic mode. A after obtaining his license. certificate. 4. An assessment and statement On routine telephone screening, he Discussion: Class III, II, and I from a physician regarding general mentioned taking medications for certificates are all possible to obtain physical and cardiac examination to hypertension and mentioned no other for airmen with pacemakers through include symptoms or treatment refer• medical problems. He arrived with the special issuance process with the able to the cardiovascular system; the the proper information on hyperten• FAA. At this time, a 6-month limita• airman's interim and current cardiac condition, functional capacity, medical sion: a physician report with BP read• tion is placed on the airman to assess history, and medications. ings, medication list with dosages and routine pacemaker function. In the lack of side effects, lab reports, and a Guide for Aviation Medical Examiners 5. A report of current fasting blood statement for having no evidence of is found a list of decision consider• sugar and a current blood lipid profile end organ disease. ations in the disease protocols section to include: total cholesterol, HDL, LDL, and triglycerides. All appeared in order, but on for the implanted pacemaker. physical exam, he was noted to have A 2-month recovery period must 6. A current Holter monitor evalua• a pacer implanted into the left sub• elapse after the pacemaker implanta• tion for at least 24 consecutive hours, clavian chest area. He then revealed tion to allow for recovery and stabili• to include select tepresentative tracing. that in 1994, he had "passed out while zation. Submit the following: 7. A current M-mode, 2-dimen- driving on a New Jersey turnpike," 1. Copies of hospital/medical re• sional echocardiogram with Doppler. and his wife was able to safely steer cords pertaining to the requirement for 8. A current Maximal Graded Exer• the vehicle to the side of the road. the pacemaker make of the generator cise Stress Test with the Requirements He "awoke" and had "no other side and leads, model and serial number, per FAA. admission/discharge summaries, opera• effects." This was an "Oh by the 9. It is the responsibility of each tive report, and all ECG tracings. Way!" moment. applicant to provide the medical infor• On further review of history, he 2. Evaluation of pacemaker func• mation required to determine his/her had a subsequent complete neuro• tion to include description and docu• eligibility for airman medical certifica• mentation of underlying rate and logic and cardiac work up, and the tion. A medical release fotm may help rhythm with the pacer turned "off" diagnosis of "Sick Sinus Syndrome" in obtaining the necessary information. or at its lowest setting (pacemaker was made. A pacemaker was inserted, dependency), programmed pacemaker and he has had "no problems" since, parameters, surveillance record, and ex• Forward all information in one other than a "new battery placement." clusion of myopotential inhibition and mailing to: His physical exam was otherwise un• pacemaker-induced hypotension (pace• Federal Aviation Administration remarkable. He actually felt this was maker syndrome), Powerpack data, Aerospace Medical Certification Div. not an issue, as he is very active and including beginning of life (BOL), and Medical Appeals Section, AAM-313 has reported no further problems. elective teplacement indicatot/end of Post Office Box 26080 Oklahoma City, OK 73125-9914 I told the pilot that I had to defer life (ERI/EOL). FV his application, but a special issuance 3. Readable samples of all electronic of a medical certificate was pos• pacemaker surveillance records post- sible and that he would have to go surgery or over the past 6 months, or through a lot of hoops for the FAA whichever is longer. It must include a to ensure he was safe. I told him that sample strip with pacemaker in free FLIGHT PHYSICIAN 12 December 2012
New Members Complimentary Memberships Provided to Those Who Attended LaJolla Annual Scientific Meeting
Sanaa Mohamed Mohasib Abady, M.D. Robert A. Frampton, M.D. Frank Marinkovich, M.D. Airport Road, Ministry of Civil Aviation, 485 S. Towers Drive 11415 Slater Avenue, NE, Suite 102 Cairo, 11776, Egypt Salem, UT 84653 Kirkland, WA 98033 Aerospace Medicine AME Aerospace Medicine AME Internal Medicine
Ryan Joseph Abraham, M.D. Stephen E. Fry, M.D. Gregory Mattson, M.D. 4 Serpentine Road 10890 El Ranolo Drive 210 Coast Blvd. St. Clair, Trinidad Scottsdale, AZ 85259 LaJolla, CA 92037 AME Family/General Practice AME Pilot Family/General Practice AME Pilot Family/General Practice
Kehinde S. Ayotunde, M.D. Mattice F. Harris, Jr., M.D. George N. Merkle, M.D. Federal Airports Authority of Nigeria 14448 Florida Avenue 2910 Jefferson Street, Suite 103 PMB 21607 Modesto, CA 95350 Carlsbad, CA 92008 Abuja, Lagos, Nigeria AME Pilot Family/General Practice AME Pilot Family/General Practice Aerospace Medicine Dalia Ahmed Hashish, M.D. Valentin Milchev, M.D. Bashir Bashiruddin, M.D. Airport Road, Ministry of Civil Aviation, 11 Mulberry Lane 75 Springfield Road Cairo, 11776, Egypt New Hampton, NH 03256 Westfield, MA 01085 AME Ophthalmology AME Pilot Internal Medicine AME Internal Medicine Larry C. Hughes, M.D. Philip Monroe, M.D. James L. Christensen, D.O. 4020 W. Florida Ave 3623 S. Ridgeview Drive 209 W. 7th, Suite 5 Hemet, CA 92545 Spokane, WA 99206 Coffeyville, KS 67337 AME Family/General Practice AME Pilot Family/General Practice AME Pilot Family/General Practice Simon T. James, M.D. Susan Nasser, D.O. Timothy J. Coen, M.D. #203, 15 McRae Street 40250 Maestro Lane 1309 s. Mission Road Okotoks, ABT15 1A7 Palmdale, CA 93551 Fallbrook, CA 92028 Canada AME Family/General Practice AME Pilot Family/General Practice Family/General Practice George W. Nevatt, M.D. Kenneth H. Cooper, M.D. Bertram L. Johnson, M.D. 394 E. Yosemite Avenue 12200 Preston road 1821 Oregon Pike, Suite #2 Merced, CA 95340 Dallas, TX 75230 Lancaster, PA 17601 AME Pilot Family/General Practice AME Aerospace Medicine AME Pilot Internal Medicine R. Douglas Owen, D.O. Mark A. Crissman, M.D. Leland K. Krantz, II, M.D. 244 N. Kaweah 211 Shelburne Court 2811 Glenwood Drive Exeter, CA 93221 Burlington, NC 27215 Idaho Falls, ID 83404 AME Family/General Practice AME Pilot Family/General Practice AME Pilot Internal Medicine William R. Page, M.D. Peter D. Culotta, M.D. Mark S. Lane, M.D. 41440 Jamaica Sands Drive 14700 Albers Street 207 W. Avenue E Bermuda Dunes, CA 92203 Sherman Oaks, CA 91611 Lampasas, TX 76550 AME Pilot Urology AME Pilot Family/General Practice AME Family/General Practice Patricia L. Prince, M.D. Gerald Dubowitz, M.D. Bram Lermer, M.D. 7428 Oak Grove Avenue 1203 Waterview Drive 3239 W. 22nd Avenue Las Vegas, NV89117 Mill Valley CA 94941 Vancouver, BC V6L 1N1 AME Family/General Practice AME Pilot Anesthesiology Canada AME Family/General Practice Gary W. Ramage, M.D. William W. Eggimann, M.D. 525 N. Main Street P. O. Box 1107 Mary S. Lewis, M.D. Watford City, ND 58854 Bethel, AK 99559 4003 Kresge Way, Suite 410 AME Family/General Practice AME Pilot Family/General Practice Louisville, KY 40207 AME Internal Medicine Dana P. Richard, D.O. Milo M. Farnham, M.D. 6635 Forest Hill Blvd. 14505 E. 82nd Terrace David L. Lukens, D.O. Greenacres, FL 33413 Independence, MO 64055 1802 So. Union, Suite 200 Family/General Practice AME Pilot Internal Medicine Tacoma, WA 98405 AME Pilot Family/General Practice Richard S. Roth, M.D. Kenneth Fox, D. O 235 Lyman Hall Road 110 Cherry Lane Savannah, GA 31410 Doylestown, PA 18901 AME Pilot Internal Medicine AME Family/General Practice Continued CAMA, the Civil Aviation Medical Association, Welcomes Our New Members to the Growing Body of Aviation Medical Advocates'. FLIGHT PHYSICIAN 13 December 2012
Edward G. Shore, M.D. AME - Not a Bad Gig AVAILABLE appointments disappear 4139 Camino de la Cumare Sherman Oaks, CA 91423 Part-Time AME Solos on the from the schedule in real time, thereby AME Pilot Family/General Practice Cheap not allowing anyone to schedule an ap• pointment in the past. Roger Steele, M.D. BY JAMES L. CARPENTER, M.D. 1250 Peach Street, Suite H The next action of the pilot is to show San Luis Obispo, CA 93401 HAD THOUGHT about writing this up on time. I have 40-minute appoint• AME Internal Medicine I atticle fot several years but never ment blocks and pride myself on being Hilel Swerdlin, M.D. got around to it. I thought it could be on-time. The website and "on-time 3535 30th Avenue, #204 helpful to other AMEs. When I saw performance" are real practice builders. Kenosha, WI 53144 the email from the Federal Aviation The 40-minute appointments even allow AME Pilot Otolaryngology Administration stating that the use of me to do an ECG if one is needed. My Robert C. Thomas, M.D. the MedXPress online application would office is a two-toom office with a small P. O. Box 672134 become mandatory beginning in Octo• waiting room and an adequate office and Chugiak, AK 99567 AME Pilot Family/General Practice ber 2012,1 became determined and im• exam room. mediately set down to write this article. The MedXPress file is opened and Mohammad Ismail Wardak, M.D. Briefly, I am a senior aviation medical reviewed for accuracy with the pilot, and 3rd Microyan Shinozadah, Block FB Aph2 Kabul, 0093 Afganistan examiner in St. Charles, Missouri, doing then the exam is performed and entered AME General Surgery only aviation medical examinet wotk on directly into AMCS. I email the pilot a a part-time basis. copy of the FAA file, so he can refer to it Nathan S. Zundel, M.D. 1780 Dancer Place I retired from a urology practice in before completing his next MedXPress Escondido, CA 72026 2006 and set up my solo AME avia• application. I also reset the date (mo/yt) Family/General Practice tion medicine practice in a small office of his next appointment in my addtess NEW MEMBERS: in historic downtown St. Charles. I set book. Charles A. Camarata, M.D. up a website (www.doccarp.com) with Each month, I send out email notices P. O. Box 1377 online appointment scheduling, which that a FAA exam is due and with com• Chula Vista, CA 91912 AME Pilot Sports Medicine allows me to function as a solo AME. ments about my schedule and other hot That's right, nobody but me. Believe me, topics. My office is essentially paperless. Linda Garand, M.D. it wotks very well. I scan all correspondence and reports 56 Sweetbriar Beaconsfield, Quebec When the pilot arrives at the schedul• and Time-Machine™, a really cool Mac Canada H9W 5M5 ing page, he is given specific instructions computer feature, copies them hourly Regional Aviation Medicine Officer, Avia• for completing the MedXPress applica• and automatically to a large external hatd tion Medicine tion and a link to it. After completing the drive, thereby eliminating the risk of Kirk T. Harmon, M.D. MedXPress application and generating a computet hard drive failure and data loss. 1121 N. Sunset Court confirmation number, the pilot proceeds The pilot's Airman Medical Cer• Tacoma, WA 98406 AME Occupational Medicine with scheduling his appointment online. tificate is printed from the Aerospace I have about 98% compliance with Medical Certification Subsystem on a Leigh Lewis, M.D. the use of MedXPress. The only com• monochrome laser printer on 28# paper, 1618 3rd Avenue North Jacksonville Beach, FL 32240 plaint I hear is about expiring passwords. which is a little more durable than regu• AME Pilot Internal Medicine/Aerospace The website allows a pilot to browse and lar copy paper. Medicine find an available appointment and then Payment is made by check or credit Michal Plechas, M.D. select ("click") it to open a dialog box and card. No accounts receivable! The 1913 East 17th Street, Suite 110 enter his personal information, includ• website-based operation has allowed me Santa Ana, CA 92705 ing name, phone numbers, and email to be a solo, part-time AME, generat• AME Plastic & Reconstructive Surgery address. He also enters his MedXPress ing enough revenue to be worthwhile. I Randolph Sherman, M.D. confirmation number in the dialog box adjust my schedule so as not to interfere 8635 W. Third Street, #770-W and closes the window. with my golf and cycling. I urge you to Los Angeles, CA 90048 AME Pilot Plastic & Reconstructive The appointment then changes to take a look at my website www.doccatp. Surgery RESERVED. The pilot receives an email com, and if you have interest in creating confirmation and so do I. If he chooses a similat operation, please contact me Gregory D. Smith, M.D. 161 Thunder Drive, Suite 207 then or later to cancel the appointment for details: Escondido, CA 92083 he selects the CANCEL button and James L. Carpenter, M. D. AME Pilot General Practice enters the required information, and the (314) 616-7321 FV appointment resets automatically. An• Website: www.doccarp.com other good feature of the website is that FP FLIGHT PHYSICIAN 14 December 2012
Civil Aviation Medical Association SUSTAINING, CORPORATE, AND LIFE MEMBERS
The financial resources of individual member dues alone cannot sustain the Association's pursuit of its
broad goals and objectives. Its fifty-plus-year history is documented by innumerable contributions toward
aviation health and safety that have become a daily expectation by airline passengers worldwide. Support
from private and commercial sources is essential for CAMA to provide one of its most important functions:
that of education. The following support CAMA through corporate and sustaining memberships:
Sustaining Members
James R. Almand, Jr., M.D. DeWayne E. Caviness, M.D. Renee Roy, M.D. Estol R. Belflower, M.D. Daniel M. Ervin, M.D. James L. Tucker, Jr., M.D. Forrest M. Bird, M.D., Ph.D James N. Heins, M.D. H. Stacy Vereen, M.D. Per-Johan Cappelen, M.D. Hugh O'Neill, M.D. Rodney E.L. Williams, M.D. Richard Carlson, M.D. G. F. McNally, M.D. Ingrid Zimmer-Galler, M.D. A. Duane Catterson, M.D.
Corporate Members
Georgia Lung Associates, PC Medaire, Inc. Percussionaire Corporation 3820 Medical Park Drive 80 East Rio Salado Parkway P. O. Box 817 Austell, GA 30106 Suite 610 Sandpoint, ID 83864 Tempe, AZ 85281-9107 Harvey Watt & Company, Inc. Rummel Eye Care, P. C. P. O. Box 20787 1022 Willow Creek Road Atlanta, GA 30320 Prescott, AZ 86301
Life Members
Michael Boyer, M.D. Ernest J. Meinhardt, M.D. Sergio B. Seoane, M.D. John R. Capurro, M.D. Andrew H. Miller, M.D. Kazuhito Shimada, M.D. Halford R. Conwell, M.D. David P. Millett, M.D. Brian Smalley, D.O. George H. Coupe, D.O. Story Musgrave, M.D. E. Warren Stadler, Jr., M. D. Mark C. Eidson, M.D. Thomas Nguyen, M.D. Ruth Steward, R.N. Mohammed Eisa, M. D. Michael G. Nosko, M.D., Ph.D. Shepard B. Stone, M.P.S., PA. Daniel M. Ervin, M. D. Hugh J. O'Neill, M.D. Salil C. Tiwari, M.D. Donna Ewy, M.D. Michael A. Pimentel, D.O. Lars Tjensvoll, M.D. Edmond Feeks, M.D., MPH Jeffrey P. Powell, M.D., D.D.S. Dottie Hildbrand Trembly, R.N. Robert Gordon, D.O. Gordon L. Ritter, D.O. Harold N. Walgren, M.D. Ernst J. Hollman, M.D. Robert M. Roeshman, M.D. Rodney E. L. Williams, M. D. Atsuo Kikuchi, M.D. Mark S. Rubin, M.D. Alex M. Wolbrink, M.D. Stephen M. Kirkland, M.D. Gerald W. Saboe, D.O. Ingrid Zimmer-Galler, M.D.
Thank you for supporting the Civil Aviation Medical Association FLIGHT PHYSICIAN 15 December 2012
In Memoriam: Halford R. Conwell, M.D.
The Civil Aviation Medical Association was sad• national Academy of Aviation and Space Medicine, the
dened to hear that Halford R. Conwell, M.D., passed British AME Association, the Scottish AME Associa•
away suddenly early Saturday, September 1 at the age tion, the Latin American Aviation Medical Association,
of 88, in his home in Huntsville, Texas. He was a Quiet Birdmen, and the Friends of the Royal Air Force
long-time CAMA member, a CAMA Fellow, and a Museum. He was also a Charter and Life Member of
CAMA Past President. the Confederate Air Force, Honorary Captain of Texas
A native of Cincinnati, Ohio, he earned a Bachelor's International Airlines, and a Founding Member of the
degree from the College of Wooster, Ohio, in 1948, a RAF Bomber Museum. He was a fellow of the Aerospace
Master's degree from the University of Louisville in 1950, Medical Association (AsMA).
and the medical degree from the University of Cincin• Dr. Conwell received the CAMA-sponsoted John A.
nati in 1955. He enlisted in the U.S. Navy in 1943, was Tamisiea Award from AsMA in 2000 to honor his out•
honorably discharged in 1946, and started practicing standing contributions in the application of the art and
aviation medicine in 1964. He became a Senior Aviation science of aerospace medicine to general and commercial
Medical Examiner in 1966. He was also a Senior Medical aviation. He was a member of the medical committees of
Examiner for the Civil Aviation Administration-United the Airline Transport Association and the Aircraft Own•
Kingdom, the Civil Aviation Administration-Australia, ers and Pilots Association. He was a medical sponsor for
British Caledonia Airways, and a medical advisor to the alcohol rehabilitation programs for the Airline Pilots
Aeromexico. He later became Chief Flight Surgeon for Association, International (ALPA), and the Federal Avia•
Continental Airlines, where he also served on the Pilot tion Administration. He was honored by ALPA with a
Selection Board. lifetime achievement award in 2008 for his "rigorous
Dr. Conwell served as President of Walker-Trinity- aviation medical standatds," quick wit, and outstanding
Madison Counties Medical Society, Chief of Medicine at office staff. He earned his pilot's certificate in 1944 and
Huntsville Memorial Hospital, and was on the Board of later added to a commercial license. In 1989, he earned
Trustees. He also edited a column on aviation medicine an airline transport pilot rating and had logged more
for a local newspaper. He was a medical advisor to the than 3,000 hours.
Aircraft Owners and Pilots Association, a member of Dr. Conwell will be greatly missed by CAMA and
the Airlines Medical Directors Association, the Inter• the aviation medicine community. —David P. Millett, M.D. On The Horizon
Future CAMA Annual Meetings FAA Aviation Medical Examiner September 26-28, 2013 Seminar Schedule 2013 Renaissance Orlando at Seaworld Tampa, Fla. CAR Orlando, Florida Jan. 25-27 Basic October 9-11,2014 Feb. 25-Mar. 1 Oklahoma City, Olda. Silver Legacy Resort Casino Mar. 15-17 Dallas, Texas NEU Reno, Nevada May 13-16 Chicago, 111. AsMA July 15-19 Oklahoma City, Okla. Basic Aug. 9-11 Washington, D.O OOE Sep. 26-28 Orlando, Fla. CAMAt Oct. 28-Nov. 1 Oklahoma City, Okla. Basic Nov. 15-17 Sacramento, Calif. CAR (tentative) CODES CAR Cardiology Theme NEU Neurology Theme OOE Ophthalmology-Otolaryngology- Endocrinology Theme |This seminar is being sponsored by the Civil Aviation Medical Association and is sanctioned by the FAA as fulfilling the President O'Neill with newly elected Board members. FAA recertification ttaining requirement. Registration will be From left - Dr. Andrew Miller, Dr. O'Neill, Mr. Jim through the CAMA Web site: Harris, and Dr. Petra Illig. www.civilavmed.com.
International members gather together at Honors Night Banquet during the annual CAMA meeting and scientific seminar in La Jolla. (All photos by Dr. Randy Caveness)