Didn't pass Cat 1 medical, what is going to happen next..?

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mcshock
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Didn't pass Cat 1 medical, what is going to happen next..?

Post by mcshock » Fri Jul 12, 2019 2:26 pm

I went to do my Cat 1 medical two days ago... and I failed the urine test.
It showed there was protein in it, the doctor called it plus one protein..so I didn't get a stamp that day.
So what should I do starting at this point? It never happened to me, and I am quite worried and lost now...
Am I going to get contacted by TC aviation medicine? or the doctor who did my exam will contact me for further testing?
I called TC like 20 times, all went to voice mail box and told me to leave a message...

(Some additional information..I did have some sexual activities with my girlfriend before the medical exam, so think it might be the cause of why there are traces of protein in my urine...but then I also did the urine test twice... I believe all the protein should be flushed out already in the first time...)

Can anyone with similar experiences give me some advice...?
I just passed my CPL flight test, and I don't want everything to end here...
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by 200hr Wonder » Sat Jul 13, 2019 10:14 am

First of all take a deep breath and relax. I have had a similar situation.

There are really four possible outcomes here,

1. Least likely is a false positive. Though I don't think the girlfriend activities would cause that, the little test strips don't have a long shelf life and unless the Dr. used a new batch for the second test it is a possibility.

2. There is a fairly minor underlying condition, get it treated, go back to your CAME get the stamp and move along.

3. There is an underlying condition that you may be affected with however with proper management and therapies you will be granted a Cat 1 medical with possible follow up required.

4. The least likely is that you have a disqualifying condition that would preclude you from holding a Cat 1 medical hence a CPL. This is very unlikely if your a younger person who is otherwise healthy, feels good, has not lost/gained a bunch of weight and so forth. The bright side is that you would be getting diagnosed and treated much earlier than other people.

So what do you do? As Douglas Adams would say DON'T PANIC. Go to your GP or a walk in clinic if you don't have one and tell them that you had a urine test for a medical conducted they found protein in your urine and you would like to get follow for it. They will ship you off to a lab, LifeLabs here in BC and you will be in a cup and give some blood. Couple days later go into your GP for the consult and follow his advice. In the meantime, get a hold of the RAMO for your region and he will provide you with steps to take.

Once the condition has been cleared up you will head back to your CAME he can resubmit your paper work and get you flying again. My problem was kidney stones (drink lots of water!), and while I was there my CAME called the RAMO and more or less badgered him into getting me back to work ASAP after I was stone free, right from the exam room with me listening. The good news is we are in Canada and everything involving going to the GP and beyond is part of your provincial medical so hurray for universal health care!

One last thing to consider, because you have not been approved with a CAT 1 medical I believe that would invalidate even a CAT 3 if you previously held that but certainly a CAT 1, so DO NOT go flying as it would be a contravention of CARs!

Good luck.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by J31 » Sat Jul 13, 2019 11:00 am

Just what 200rh said. Relax and go get another test. The doc that did your medical should have some ideas.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by altiplano » Sat Jul 13, 2019 12:03 pm

Didn't the CAME tell you?

Just failed you and sent you our the door, on your way?

I'd go see a different CAME...
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by J31 » Sat Jul 13, 2019 12:09 pm

altiplano wrote:
Sat Jul 13, 2019 12:03 pm
Didn't the CAME tell you?

Just failed you and sent you our the door, on your way?

I'd go see a different CAME...
I was thinking the same if the CAME was not helpful.....
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by jetblast09 » Sat Jul 13, 2019 12:34 pm

Get your gp to have you go to urologist. Scope check etc and get a report to clear you if nothing. If they find something get it fixed then get a letter.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Daniel Cooper » Sat Jul 13, 2019 1:00 pm

Just take the test again and abstain from orgasm for a few days before. Same thing happened to me before. It's very likely that that is the cause.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by telex » Sat Jul 13, 2019 4:09 pm

200hr Wonder wrote:
Sat Jul 13, 2019 10:14 am
First of all take a deep breath and relax. I have had a similar situation.
You know mcshock's girlfriend!! :O
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by 200hr Wonder » Sat Jul 13, 2019 10:45 pm

telex wrote:
Sat Jul 13, 2019 4:09 pm
200hr Wonder wrote:
Sat Jul 13, 2019 10:14 am
First of all take a deep breath and relax. I have had a similar situation.
You know mcshock's girlfriend!! :O
Badum tuss. No...

However I will add what others have said, if your CAME is not helping with this and just sending you on your way I would find another CAME. Mine was super helpful in making sure that my documentation from the urologist was worded correctly to satisfy TC and so forth. If he just shipped you off that's a red flag to find someone new. Also rather strange considering you have done a CPL flight test so had to hold a Cat 1 medical at the time.

Going forward I think it is super important to find a CAME you like and keep using the same Doctor year after year so you have a good relationship and work as a team through any issues that crop up as you get older.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by mcshock » Sun Jul 14, 2019 6:50 am

Thank you for all the advice.
The doctor did give me some suggestions of what to do, but they are not very clear
He told me to go find my family doctor, and he will also send my urine sample to Life lab.

Because I was super worried, so I went to a walk-in clinic yesterday and did another urine dipstick test.
And thank god, it was all negative. The walk-in clinic doctor also gave me a copy of the results.

Now, I am just confused of what to do next. Should I just wait for TC to call me?
Or I should go contact TC aviation medicine by myself? Or should I contact the CAME again with the new report?

Thanks all again
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by altiplano » Sun Jul 14, 2019 7:08 am

Sounds to me like a fussy doctor too.

The piss test is for diabetes. Not anything else... sounds like he figures he's facing the world one medical disqualification at a time...

It's find a new Dr. no matter what happens... you don't want a Dr. who looks for problems holding the keys to your paycheques.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by mcshock » Sun Jul 14, 2019 10:05 am

Daniel Cooper wrote:
Sat Jul 13, 2019 1:00 pm
Just take the test again and abstain from orgasm for a few days before. Same thing happened to me before. It's very likely that that is the cause.
Do you mind telling me what TC wanted you to do next?
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Daniel Cooper » Sun Jul 14, 2019 10:28 am

I'm not sure if TC was involved or not but the doctor told me to abstain from sex for a few days and come back and give another sample. I did and passed with no problem. According to Google it's quite a common cause of protein in urine. I think you're likely fine. Talk to your doctor about it.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Cessna 180 » Sun Jul 14, 2019 10:21 pm

Strange response from the doctor. Test is for diabetes, not urological conditions. It's actually somewhat common to have a false positive with those strips from what I've heard, especially if its not fresh pee etc. I had a buddy who had the wrong color on the strip one time. Doc said lets pretend this didn't happen, and came back the next day, peed again, and has never had an issue since.

If you're in Ontario, I'd recommend you go see Dr. Gilmore in Maple or Oshawa (airport). He's excellent, sits on advisory boards for the TSB and TC, and is the doctor to go to if you have any issues at all. He was very helpful when I had a minor issue that involved reporting to TC. He also got my FAA medical resolved in record time (and those guys can be slower than Transport Canada).
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Aviatard » Mon Jul 15, 2019 4:40 am

I think this proves scientifically that if you want to pass your medical, you should definitely not engage in “sexual activities” with mcshock’s girlfriend. Let this be a warning to you.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Daniel Cooper » Mon Jul 15, 2019 6:44 am

Another good idea I just remembered is to take your urine sample midstream. That means start urinating, stop, get your cup in place and get a large enough sample, stop, and finish going into the toilet. The urine midstream should be least contaminated with anything in your urethra or bladder. Also, make sure it isn't your first pee of the morning.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Capt. Underpants » Mon Jul 15, 2019 7:39 am

Cessna 180 wrote:
Sun Jul 14, 2019 10:21 pm
If you're in Ontario, I'd recommend you go see Dr. Gilmore in Maple or Oshawa (airport). He's excellent, sits on advisory boards for the TSB and TC, and is the doctor to go to if you have any issues at all. He was very helpful when I had a minor issue that involved reporting to TC. He also got my FAA medical resolved in record time (and those guys can be slower than Transport Canada).
+1 on that. If I had an issue with my medical, he's the one I would be calling. He's pretty much seen it all and has worked as a pilot too.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by photofly » Mon Jul 15, 2019 7:43 am

Cessna 180 wrote:
Sun Jul 14, 2019 10:21 pm
Strange response from the doctor. Test is for diabetes, not urological conditions.
I agree. TP 13312 - Handbook for civil aviation medical examiners says only this about urine testing:
Urinalysis
Routine dip-stick testing of the urine for glucose is required at each aviation medical examination.
There is an entry about renal calculi, but a dipstick test is a million miles away from a a diagnosis of this or any other condition. There doesn't appear to be any requirement for protein testing.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by carnie » Mon Jul 15, 2019 11:46 am

Just to clarify, the dipstick test while testing for diabetes also is an indicator if your kidneys are leaking protein. We are well versed with the drill as we have to test our 5 year old daily as he has an auto immune disease (childhood nephrodic syndrome) Protein in your urine points means your kidneys are likely not working properly. You would also have other symptoms such as edema (water retention) reduced urine output, weight gain etc. I hope you get everything sorted.😄
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Castorero » Fri Jul 26, 2019 4:57 pm

I am sorry that you have to go through this nonsense, as the issue could have been quickly resolved in the CAME's office by doing a midstream collection as suggested by Cooper and that would have been the end of it most likely.

Not a very helpful Came, I too would move on for your medical next year.

As far as the usefulness of a urine dip test? Not really that useful or revealing unless the results are significant, then the whole sample is sent for more analysis.

+1 protein? rinse and repeat a midstream.
+2 or +3 ? same thing, but chances are that there is a problem.

I would always do a midstream, for both men and women, anytime, but especially for the Pilots Medical.
May well prevent the problem experienced by the OP.

The dip stick urine is a very simple screening test, but if it is positive for "anything" it just needs to be sorted out. It could be the test that could lead to a number of serious diagnoses such as diabetes, cancer and infections anywhere in the urinary tract and sometimes outside of it, and so much more.

A long gone eminent internist by the name of Peter Banks, in Victoria, would swear by a complete urinalysis to point him in the right direction. In those days there weren't too many tests available to a physician, and the urine held a lot of secrets if one was trained to unlock them.

My suggestion to OP is to go back and see the original Came and insist that he repeat the urinalysis as suggested above, and have him send the results on to TC.
This is the fastest way to get this resolved.
If this fails, call the RAMO and he will ask the Came to repeat the test for you.

You can be 99% sure that there is nothing wrong with you.

Good luck
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by cncpc » Fri Jul 26, 2019 5:58 pm

Cessna 180 wrote:
Sun Jul 14, 2019 10:21 pm
Strange response from the doctor. Test is for diabetes, not urological conditions.
That is correct. I spent most of my flying career believing it was a drug test, but a few years ago, I was told it was a test for ketones. Which anyone who is on the keto diet may fail. Bad diabetes also produces excess ketones.
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by rigpiggy » Fri Jul 26, 2019 7:00 pm

I had taken some B50, and didnt hydrate enough, first thing in the AM. Doc told me to go and drink several litres, and come back in the afternoon(1620 cutting it close) 3rd wee of the day, passed with no problems. I actually used a certain doctor in YHZ who told me "I can only certify what is in front of me" He sent me to the shrink"for unknown stressors" SHrink listened to me rant for 15 minutes told me I had no pathological disqualifiers", and signed me off. I then spent 100$ more going to a military guy in Hammonds plains to avoid going back to old doctor. pay more now because my guy has an ecg in the office so I dont have to f@%k around going to the hospital
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Re: Didn't pass Cat 1 medical, what is going to happen next..?

Post by Castorero » Fri Jul 26, 2019 7:57 pm

Couple of more things...

A "mid stream" Urine sample is just that, one collected in the Middle of the stream,

so, you start a stream and pee a good third or half of what you feel is in your bladder, without stopping the stream, advance the cup into the stream to get a good sample and move the cup off the stream, then you might as well empty the bladder fully into the toilet.

Yes, you may get your hand wet in the process, but with some practice in your spare time you can get really good at it.
This is particularly important for women.

The idea is that with the initial evacuation you clean out the tube as well as the external opening of the urethra and adjoining skin, starting and stopping midstream can lead to more contamination, especially if the sample is for a bacterial culture.

A man's urethra will almost always have some residual protein, in between pees, from prostatic fluid, from natural glandular lubricant and other sources.
Ideally one should clean the area externally first and then collect the sample mid stream.
Lastly, if I have to give a urine sample, I will make sure that I have emptied the bladder a couple of times during that day so that you start with an empty bladder.

Some unlucky people ejaculate backwards into the bladder, and not know it, and you can see where the protein in the urine comes from...
Abstaining from sex for a few days is really not necessary if you start with an empty bladder, shower, collect the sample Midstream, and get on with your day.

Ok, one more Last thing, I dont know what TC wants tested with the dip test.
For sure Glucose, but most Dr offices have dip sticks that test for that plus a few other things, or a boatload of other things...so you may get glucose, ketones, protein,
blood, and whatever else, depending on which salesperson was there last...

If TC is only interested in screening for diabetes as has been suggested, then there is likely nothing on the TC exam form asking for protein or tiddly winks results and the Came has no business failing your CAT1.
As a good MD, he may repeat the urine test on the spot, or refer you back to your GP with a note to repeat the test and investigate further if needed.

+1 protein, whatever the cause, isn't going to be a hazard to aviation. There is plenty of time to investigate and get to the bottom of it, even if this were the earliest sign of a kidney stone. But in a young guy ? Highly unlikely.

Common sense being not very common, is a good quality to look for in both an MD and a Pilot.
It may save your job and possibly your life...
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