On Dec 27, 6:30 pm, Bullwinkle wrote:
For what it's worth, you should get competent advice from someone who knows
before flying after use of any meds.

But the truth of the matter is, FAR 61.53 makes you your own flight surgeon,
by placing the responsibility for medically grounding and ungrounding,
squarely on you.

Again, I recommend you make this kind of decision only after seeking
competent advice (which, in some cases is not your local AME: many of them
do so few medicals and have such little aviation medicine expertise that
they just don't know, no matter how well meaning they are).

Amen.

I wasn't going to take the time to add anything to this thread, but
can't resist a summary.

Pilots may be:
1: Unimpaired
1B: Unaware of impairment (feels the same as unimpaired)
1C: "Potentially" impaired (by meds, fatigue, etc.)
2: Impaired and aware of it.
2B: Able to compensate or escape to safety
2C: Unable to compensate or escape

Advice-givers should generally refrain from recommending anything that
could be associated with potential impairment (see elsewhere in this
thread for instances of such).

Pilots are responsible for self-assessment, but as this is difficult
(impossible to do objectively), should seek and welcome observations
and counsel of others in the decision not to fly.

Example of "medical" impairment: Simply stay sober while watching
other people consume ("medical") alcohol at a social gathering. If
you're watching carefully, just ONE drink changes the verbal and motor
performance of everyone except a daily-drinker. They s-l-o-w d-o-w-n
mentally, physically, verbally.

Example of physical impairment relevant to this thread: motion
sickness and the sopite syndrome (motion-induced drowsinesss): I get
very sleepy before I get sick; vomiting on my shirt on final (which
I've done) is not as distracting, in my experience, as experiencing
micro-sleep while thermaling (which I've done). I realized this
spring that this is getting worse for me; one April day at 3000 agl, I
forced myself to make 2 decisions: one, to return, land, and stow the
glider; two, to decide whether I should quit soaring.

My decision is relevant to the suggestion by some that motion-sickness
drugs are all right because they help, because the impairment of drug
(undetected by the user) is less than the impairment of the motion
sickness (unavoidable and distracting).

My decision was to *acclimate*, not to take medications - the
'treatment' was to take soaring flights more often, briefly, to
acclimate to motion sickness, and to drink a cup or two of coffee
before lunch (caffeine has been shown to enhance performance slightly)
on soaring days.

As an AME, physician, and opinionater, I feel quite safe in
recommending that one acclimitize. There are ways to do this other
than flying; I know of an aerobatic pilot who stood on his head
several times a day to maintain acclimation during non-flying periods;
or play that involves spinning and jumping should also help. On the
other hand, I do not feel quite safe in recommending that anyone fly
when potentially or actually impaired.

In saying this, I realize that some tasks are simple and hard to mess
up, e.g., local soaring on a sunny calm day. And other tasks are
exceedingly complex, e.g., single-pilot hand-flown IFR in IMC, at
night, in rain or snow, to minimums, in a complex turbocharged
airplane, or contest flying on the ridge with complex navigation and
planning tasks. (We just lost a colleague in NZ like this, obviously
one factor went undetected; what it was, we'll never know.)

Thus "Impairment" is relative to the task at hand.

Best wishes,

Dan Johnson