Will ear wax cost you your livelihood?

I’m a certified medical examiner for the Federal Motor Carrier Safety Administration (FMCSA). I am writing a lengthy post here because I’m on your side. I want you to pass.
How would you like to pass everything in your commercial driver physical exam but not walk out with a certificate because of ear wax.
That’s right…
There are many requirements for certification. Among them are ear issues. And one very specific and inflexible rule is that the medical examiner MUST visualize the tympanic membrane.
Now don’t go shoving q-tips in your ears just because you have a DOT physical scheduled! That may just cause the wax to get shoved deeper and become impacted. Or worse, you could accidentally contact and damage your own ear drum.
I spoke with a local hearing center about this and they recommend that their clients use an over-the-counter ear wax removal kit for 3 days prior to their appointment. That is what I recommend to drivers now, prior to their appointment. If the wax is still impacted after that, then I’d just send the driver to their primary physician. But, fwiw, this is one of those things you want to put in your doctor’s lap when you get your regular checkup a month or so before your certificate is due to expire. When you see him/her, tell them, “Hey, I have a medical certification exam coming up, make sure I pass”.
Among the things that hold drivers up from getting a medical certificate are things your doctor can and should treat on a preventive/maintenance basis, including:
1) ear exam (make sure you can hear and that you don’t have any wax obstructing the view of your ear drum), if they say there’s a lot of wax, then you’ll want to address that before your certification exam.
2) make sure you can see at least 20/40 in each eye alone and with both eyes (some people need prescription lenses to meet this requirement – time for an eye exam? This would be the time to do that, too)
3) make sure your blood pressure is consistently below 139/89. FWIW, that minimum requirement for certification is now considered Stage 1 Hypertension by the medical community at large since the standards were lowered a couple of years ago. Thankfully, the FMCSA has retained the more lenient requirement to give you some margin. That said, if you aren’t consistently measuring below 139 for the upper number and below 89 for the lower number, just know that if you go even a little over either of those numbers you may end up with a 1 year certification instead of two. And that is only allowed ONCE!
4) Are you overweight? Search online for a BMI calculator and if your BMI is over 130, ask your partner if you snore. If those two are a yes, talk to your doctor about getting evaluated for sleep apnea. This isn’t typically cause for failing your DOT physical, but this is SERIOUSLY worth ruling out because it will really hurt you over time and you may not even realize it is happening. Losing weight typically helps, but not always. But treating sleep apnea and losing weight do wonders for hypertension, for what it is worth. And if you are already under CPAP treatment, you will need to bring in documentation of treatment compliance (4 or more hours each night, 70% of the days of each month).
5) Do you take prescription medicine for any condition whatsoever? A checkup is a great time to have your doctor complete the FMCSA prescription form so that a non-medical doctor examiner (such as myself – I’m a chiropractor) can rely on your MD’s knowledge of your treatment to know that it is necessary, dosed appropriately, effectively treating your condition, and does not have the potential to negatively affect your ability to drive. If I have to make that decision, I may just provide you the form and ask you to have your doctor complete it and fax to my office before I can certify. It depends on the medicine, but if you are getting a checkup anyway, why not have have him document your treatment?
These are just a few of the most common considerations… Just know that I have absolutely NO interest in failing drivers without due cause. But on the other hand, I also don’t want drivers on the road (sharing a lane with my kids) while unaware of a condition that could cause them to lose full awareness without warning.
Let me finish by saying this: I charge less than any other FMCSA examiner in the area and inmy office you will have a dedicated appointment with no sitting around in a waiting room. I will do my job to get you certified if you do your job and stay fit to drive. Sometimes what is required for maintaining a professional license doesn’t seem fair. But it is what it is. Call me if you have questions or concerns. I will help advise you in any way I can, even before you schedule. I’m on your side.

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