Medical crisis on a solo cross-country

April 10, 2018. I had just taken off from Aurora, Missouri (2H2) heading toward Grove, Oklahoma (KGMJ), flying at an altitude of 4,500 feet. I was a student pilot, and this was my first solo cross-country experience. I had flown this very same route a week earlier with my CFII. Everything seemed to be a pretty standard day; the weather was nice. I had performed a preflight on my C172M; all was well. The one big mistake I made I had no way of knowing or preparing for, but it happened all the same.

First, a little background, I was a student pilot with aspirations of becoming a commercial pilot. I had roughly 30 hours in a Cessna 172M Skyhawk, training at a Part 61 flight school – all pretty standard for a student pilot (in my opinion anyway).

Now back to that mistake. A rather large but unknowing mistake I made was the decision to eat lunch 30 minutes prior to takeoff.

For most pilots, eating lunch doesn’t exactly qualify as a medical crisis and reasonably so; however, for me it did. I had taken off, flying dead reckoning from 2H2 to KGMJ. I had noticed I was having difficulty focusing about 15 minutes into the flight. That was the first sign I should have recognized. Difficulty focusing is rather annoying when flying by dead reckoning, but I didn’t think much of it and continued flying. After all, I was a student pilot flying a solo cross-country for the first time – I assumed my excitement was getting the better of me.

Lakes by Grove
Are those the right lakes? And why is navigating so hard now?

Continuing into the flight, I began to realize I didn’t recognize the landscape, which was odd since I had flown the same course a week earlier. This led me to the conclusion I was off course. Not being able to hold a heading went from a minor nuisance of watching my compass sway 5 degrees in either direction, to being unable to get it back on a heading at all! At this point, I was somewhere over the Missouri/Oklahoma border (I could tell that much by the interstate that ran along the side of it). I had fully realized something wasn’t quite right at this point, but I still didn’t know what. I was very confused to be sure, half aware of what I was supposed to be doing but unable to do it.

I recalled my CFII saying that I could use the lakes surrounding Grove as a checkpoint. As I looked around, I saw the lakes appearing off to my right side and set my plane back on course. Happy to have that straightened out, but still a little rattled by my own confusion, I began making my way over to what looked like an airport. Crossing midfield and making a descending turn back into a left downwind, I completely botched the approach. I was about 1,000 feet above the traffic pattern trying to make it down after the descending turn.

It was in my traffic pattern when I got really scared. Abeam the numbers, I slowed to 90 miles per hour and put in the first notch of flaps. Making the base turn, I realized I was way too high to make the runway. Without thinking about it, I put in all 40 degrees of flaps. I was about 1,000 feet off the ground on final when I made the call to do a go-around. I’m glad I had enough sense about me to do that much. Now my problem was that I couldn’t gain altitude and confusion had turned to complete disorientation. I put in full throttle and pitched down to gain airspeed, but I was unable to pass 90 miles per hour. Pitching back to see if I could recover some altitude got my stall horn blaring!

Cruising at about 60 mph now, I had to pitch down again. At about 500 feet above the lake, panic had begun to set in. I was looking for a crash-landing spot when I looked behind me and realized my flaps were all the way down, which led to my next mistake. I took all my flaps out at once. In either my confusion or panic, I hurried to make a decision that cost me another 200 feet of altitude. Thankfully, I had enough altitude to gain back some airspeed. I recovered to pattern altitude and made a safe landing on the runway.

On the ground safe now, I knew something was very wrong. When I stepped out of the plane, I could barely stand. Very dizzy and disoriented, I sat down in the general aviation building and drank some water. Eight days later, when I went to a doctor (I didn’t fly for those eight days to be sure), I was diagnosed with type 1 diabetes. Thanks to the lunch I had eaten, I was in diabetic ketoacidosis, the symptoms of which include cognitive confusion. All of this was a fatal hit to my flying career, but it was a lesson I learned in not only aeronautical decision making, but in the importance of managing my newfound symptoms.

It’s worth mentioning that I have been flying since that experience and have managed my symptoms well enough to fly safely. I have never had a problem with diabetes affecting my flying capabilities since I was made aware of it. If anything, I have become much more cautious after this experience and my condition is always a part of my go/no-go decision. I did not do nearly as much as I could have to get down safely that day, but by the grace of God I somehow did.

In closing, the last points I want to make are these: there is no place for panic in a cockpit and there is always something more we can do as pilots to ensure we get on the ground safely in an emergency.

14 Comments

  • Thanks for sharing – I thought you did well given the circumstances. I sincerely hope you get to fly the way you wish.

  • Dont give up my man!!!! I dont have diabetes but I was denied a 3rd class medical at age 18. I am 31 now, work as an Air Traffic Controller and am going for my instrument rating. Stay healthy, manage the symptoms and you should be fine. Best of luck to ya young buck!

  • Very interesting (and scary) story. Thanks for sharing. I have heard of people who fly commercially with type 1 diabetes, it might be worth it for you to try!

  • I am 61 and a type 1 diabetic, I passed my check ride a year ago this March. It can be done, hang in there. One of the things the FAA is really interested in will be your a1c. I get one every 3 months and document the results, I then turn in the paper work with my yearly medical. There is also a relatively new sugar level monitor out that gives you constant sugar levels, it’s great when you are flying. It can Bluetooth to your phone and your phone can Bluetooth to your headset for audio alerts if sugar levels get low or high. It’s called a Dexcom, it’s a little pricey, but it’s a great added security when flying. I also heard that Canada has issued a few commercial pilots licenses to diabetics, I don’t know if that’s true or not. I have been a diabetic for 36 years and I’m still healthy. I have a little over 260 hours now and I’m working on my IFR. Hang I there.

    • Thanks! I just got my medical back a week or two ago I appreciate the advice! Last I heard Canada and UK both allow commercial diabetic pilots and USA will also but they take applicants on a case by case so there is no guarantee and nobody has been accepted so far. My plan, god willing, I plan to be the first! Dexcom is a great security I never knew about bluetoothing it to a headset thanks for that helpful information!

  • Re the “Aircraft would not climb” in your interesting article. The 40 degree flap setting was discontinued by Cessna because of student pilot mistakes of trying to do a “go around” with 40 flap still on. I think it was from the Cessna 152 that the flaps could only be lowered to 30 degrees to put the climb back in. Personally I take off from a grass airstrip where I have my C-150 L based. For take off I set 10 degrees of flap. During the take off run I pull the control wheel at 60 mph – level off in ground effect – when I reach 80 mph – that is my climbing speed to fly over the 60 ft trees at the end of our strip.

  • Thank you for sharing! I’m made more aware of what to look for when feeling confused in the air after reading your story, and encouraged to keep flying the plane. Thanks!

  • Hi Andrew, I am a former airline pilot from Australia. My flying career ended when I was diagnosed with type 1 aged 31. I’ve retrained as a doctor and am now an AME, and I also have my Class 3 medical. I’m in touch with a number of T1D pilots in the USA and around the world. I know two who work in the US as CFIs under a class 2 special issuance. I’d love to put you in touch with them. Drop me a line, my email is jr568 at gmx dot com, or find me via Instagram as @type_1_pilot.

    • Cfi in the USA are under class 3 medical. So far the faa hasn’t issued any T1D class 1 or 2 Medicals. Even though they pretend they are taking them case by case.

  • As a T1D (47 years) pilot (coming up on a year since I got my PPL), let me give you some advice:
    0. As your article states DKA is a threat but it is a minor one once diagnosed. Low blood sugar is a killer in the air. When reading your article, I thought, “This guy sounds diabetic…”. Then I got to the end.
    1. Get a Dexcom CGM and an Apple Watch. The others work OK, but having the wireless communications to an iPhone and not having to scan your arm makes it easy.
    2. Protein is your friend. It’ll keep the sharp drops from happening. Sugarmate will show your BG on an iPad with cellular connections as well.
    3. Get a TSlim pump. It works with the Dexcom sensor and has the insulin cutoff (BasalIQ) capability when your blood sugar drops.
    4. Learn your body. It will tell you when your blood sugar is dropping and when it is going high.
    5. Know what foods raise your blood sugar, how much, and how quickly they do it. The regulations say that you need to have glucose tabs, but a Snickers bar works better for me. I don’t let my blood sugar go below 100 in air, but I like at 75-95 on the ground, like the Muggles (non-diabetic folk) keep theirs

    As Jeremy put above, there is a Facebook group for T1D pilots, and there is a push to give guidance for Class 2 Medical SI to us.

  • In addition to the Dexcom, there is a FreeStyle Libre continuous glucose monitor which I use. It is a little less pricey and simpler to use. Either way, do not give up on flying.

  • The FAA has discovered and learned that Modern Medicine makes old diseases manageable. Years ago high blood pressure and either Type 1 or Type 2 diabetes was a complete bar to getting a certificate or an FAA Medical.
    As an ATP/CFI-ASMEI who developed high blood pressure while unemployed and also had un-diagnosed Type 2 diabetes that wasn’t diagnosed for years, the younger aviators should be aware that age will still make a career end.
    But the FAA does NOW allow many ailments IF they are under control.
    So avoid drinking a sugary soft drink because that is [ was ] often all that was available. Watch diet and exercise. Get a complete medical at least annually, including an A1c blood test.
    At least if I win the lottery I can buy an [ or a fleet ] of airplanes and teach rated pilots how to fly without a GPS and a moving map. A medical is not required to teach and the Part 135 age limits don’t apply either.

  • I am a type 1 and have been for 33 years. I’d like to learn to fly but have not so far. However, I do have the Dexcom G6 and the Tandem t:slim pump. The Dexcom talks to the pump and my phone via bluetooth and takes my bloodsugar every 5 minutes. If my pump detects that I will be below 80 within 30 minutes, the pump turns off delievery until the bloodsugar rises back above 80. This is to prevent lows. My A1C, since starting the Dexcom two years ago, has gone from 8 to 5.9. If you get one, you will love it. If you need more information, email me and I’ll help out. Good luck!

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