The Doctor is in! Ask a Flight Surgeon!

[feddoc]

MCT: While doing a spirometry test, metacholine is released into the spirometer. Metacholine will cause your airways to spasm/constrict...IF asthma is present.
FWIW, spirometry is a test to see how well your lungs inhale/exhale.

What's the MC test like? Well, if you have asthma, this test will show it by you having some difficulty breathing. Metacholine does that to those who have asthma. If you don't have asthma, not much will happen

If I have no problems with breathing during exercise and the only thing that really causes bronchial tightness is dog fur, can I expect to pass? Yup. The dog fur thing sounds more like an allergy. If so, easy fix.

I know I can exercise, breathe normally, etc, but will a MC test be the nail in my coffin? Only if you are diagnosed with asthma.

Here is another link to look at: http://www.med.navy.mil/sites/navme...ments/Waiver Guide - Respiratory 080624r.pdf

Hey doc,

Just as a disclaimer, I hate to beat a dead horse here with the asthma thing. I've searched the forum and it's one of the most widely discussed topics on here. It seems like freaking everyone has had asthma at some point.

But, I'm not gonna ask you about "what my chances are" etc, cause I know this all works on a case-to-case basis. I just want to know a little more about the methacholine test.

I was prescribed with albuterol at eleven when my dad noticed I was wheezing after exercise. My doctor told me that I had exercise induced asthma and that I would probably grow out of it as i went through puberty. I've never had an "asthma attack" and all my asthma problems were exercise related. They made exercise uncomfortable in my early teen years, but never impossible or potentially harmful. However, I continued getting albuterol refills since this year (I'm a 17 year old senior in high school). Up until last year, I really did think I needed the inhaler (primarily during the winter--the warmer months never gave me issues) , until I exercised once without it and experienced no problems. I can run an easy four miles in 10 degree weather, snow and ice and not experience wheezing or thoracic or bronchial discomfort of any kind. I do have a slight allergy to dog hair, which does induce wheezing.

I realize that since I've gotten refills on the inhaler past age 13 that I'm going to need to get a waiver if I want to be successful in the Navy (especially aviation). This depends on my not using an inhaler for five years (which is fine, since five years will have passed since I join OCS), and my getting a methacholine test.

My question: What's the MC test like? If I have no problems with breathing during exercise and the only thing that really causes bronchial tightness is dog fur, can I expect to pass? I know I can exercise, breathe normally, etc, but will a MC test be the nail in my coffin?

Sorry if this is a redundant question...I'd just like some personal clarification.

 

[iff]

Thank you, sir. My peace of mind has been restored.

 

[feddoc]

Thank you, sir. My peace of mind has been restored.

Good. Then fax me a $100 bill...

 

[iff]

Only if I wind up getting in

Plus, I figure if that woman in the above picture can do it, I better be able to, too.

 

[Shakeszilla]

ADHD or similar symptoms?

Sir, I'm in rather a strange situation. I'm currently in OCS right now with an NFO designator and during the in processing I told the flight surgeon that I was diagnosed with mild ADHD when very young, though havent taken any medication for it in about 8 years. I just recently had to go to see a neuro psychiatrist to have an evaluation done, and upon completion he told me that he did see some difficulty with attention in a few of the tests, but also told me that he wouldn't likely be able to definitly confirm a diagnosis of ADD or ADHD in my case, that it may not be enough to signify ADD or ADHD, and that it may be due to lack of sleep or any number of issues from OCS itself. So he told me that he would forward it to the physicians at Pensacola and that they would be making the final call if I am NPQ'd or not.

What bums me out right now is that at this point, I have no way of knowing, or even speculating what might come of this, and I'll be sitting here wondering if I'll have a career while I'm going through a tough phase of training. While you may not be able to comment on my specific case, perhaps you could give me some insight as to what a flight surgeon would look for in a similar case when making the call. Would a specific diagnosis of the disorder be nessecary, or would even the suspicion of its existence be grounds for an NPQ?

Also my last question is; if NPQ'd and seperated from the Navy, would this also bar me from a medical certificate from the FAA? while my main goal is to fly Navy, I'd like to know if there are other options for me should the worst happen. Anything that you can comment on would be very much appreciated.

 

[craftingraptor]

How did MEPS not know about this?

IMHO, in-processing during OCS is the worst time to deal with any potential disqualification. A) You have zero time to worry about it or deal with it in a rational manner because you are in training. B) See A, with the follow on that being in training actually causes problems you might not have thought you had. Example, my vision was slightly worse with the exhaustion in full effect. Fortunately, I still passed Navy SNA standards, but that might not have been the case had I been borderline before I came.

Hopefully they pass you (I've heard good things about Newport, RI's flight physical in comparison to NAMI), because they've straight up told us that they're looking for reasons to fail us down here.

 

[feddoc]

While you may not be able to comment on my specific case, perhaps you could give me some insight as to what a flight surgeon would look for in a similar case when making the call. A good FS will look only at the facts. Be prepared for more tests.

Would a specific diagnosis of the disorder be nessecary, or would even the suspicion of its existence be grounds for an NPQ? A specific diagnosis, which I think is unlikely, would be necessary for you to be found NPQ. Go here for more details. http://www.med.navy.mil/sites/navmedmpte/nomi/nami/arwg/Documents/Waiver Guide - Psychiatry.pdf One thing is certain, you must be med free for at least a year, which is easily exceeded by your 8 year abstinence. My gut tells me you are just nervous and you are fretting over things for which you have no control of. Your job right now is to concentrate on where you are in the program and do that very well.

Also my last question is; if NPQ'd and seperated from the Navy, would this also bar me from a medical certificate from the FAA? Not necessarily and very likely not if you have ADD/ADHD....which I don't think will happen either.

Sir, I'm in rather a strange situation. I'm currently in OCS right now with an NFO designator and during the in processing I told the flight surgeon that I was diagnosed with mild ADHD when very young, though havent taken any medication for it in about 8 years. I just recently had to go to see a neuro psychiatrist to have an evaluation done, and upon completion he told me that he did see some difficulty with attention in a few of the tests, but also told me that he wouldn't likely be able to definitly confirm a diagnosis of ADD or ADHD in my case, that it may not be enough to signify ADD or ADHD, and that it may be due to lack of sleep or any number of issues from OCS itself. So he told me that he would forward it to the physicians at Pensacola and that they would be making the final call if I am NPQ'd or not.
What bums me out right now is that at this point, I have no way of knowing, or even speculating what might come of this, and I'll be sitting here wondering if I'll have a career while I'm going through a tough phase of training. While you may not be able to comment on my specific case, perhaps you could give me some insight as to what a flight surgeon would look for in a similar case when making the call. Would a specific diagnosis of the disorder be nessecary, or would even the suspicion of its existence be grounds for an NPQ?
Also my last question is; if NPQ'd and seperated from the Navy, would this also bar me from a medical certificate from the FAA? while my main goal is to fly Navy, I'd like to know if there are other options for me should the worst happen. Anything that you can comment on would be very much appreciated.

 

[Shakeszilla]

Thank you, that is actually very relieving to hear. Thank you for the quick response.

 

[Megzhoran]

Thanks feddoc!

 

[feddoc]

Ok here's my issue. I was disqualified by the Air Force SG because of pain history. However, my pain history is menstrual cramps that have been pretty intense my whole life and my doctor just wanted to make sure I didn't have endometriosis because of some family history. I had surgery in March 2010 and no endometriosis was found and I have been working out a lot more than I ever had before and my cramps are really not an issue at all. What do I need to do to not get disqualified by the Navy, too?? I will take any suggestions!! Thanks!

I moved your other thread to this section of the forum. Answer there. Oh, and you too can fax me $100.

 

[johnnyfive]

Greetings, Doc. I've got a few questions I was hoping you could answer. I'm considering application to be an NFO and I do have some medical history. Pre-boot camp, I had a Tympanoplasty in my left ear to repair a hole caused from an ear infection. After joining the Navy, I had a head cold on a flight to Hawaii and tried clearing my ears. Bad idea - I succeeded in blowing out my right ear drum that had to be operated on twice (first surgery unsuccessful) which were also Tympanoplasties. In boot camp, I developed stress fractures in my legs from running and had to be put on Limdu. The pain has returned in my legs twice since then (documented) but I figured out that I was slapping my feet while running. Since I corrected that, everything has been fine. Also, my hearing is in the normal range but my ears clear very easily when flying now (which I think is a benefit, if anything). I don't have any other issues. Can you see any problem with passing the physical? Thanks, Doc!

 

[feddoc]

Stress fractures....The docs will likely just see if you are pain free and have good ROM. What was the cause?

ENT docs will most certainly take a very close look at your ears. Shouldn't be a problem.

Greetings, Doc. I've got a few questions I was hoping you could answer. I'm considering application to be an NFO and I do have some medical history. Pre-boot camp, I had a Tympanoplasty in my left ear to repair a hole caused from an ear infection. After joining the Navy, I had a head cold on a flight to Hawaii and tried clearing my ears. Bad idea - I succeeded in blowing out my right ear drum that had to be operated on twice (first surgery unsuccessful) which were also Tympanoplasties. In boot camp, I developed stress fractures in my legs from running and had to be put on Limdu. The pain has returned in my legs twice since then (documented) but I figured out that I was slapping my feet while running. Since I corrected that, everything has been fine. Also, my hearing is in the normal range but my ears clear very easily when flying now (which I think is a benefit, if anything). I don't have any other issues. Can you see any problem with passing the physical? Thanks, Doc!

 

[johnnyfive]

Stress fractures....The docs will likely just see if you are pain free and have good ROM. What was the cause?

I was a little overweight in boot camp and slapped my feet when I ran. I'm fine if I don't run all the time. If I'm running a lot, I have to be careful to land on my feet a different way. Thanks, Doc!

 

[sickboy]

I'm just looking for a little clarification on the waiver guide. I recently dislocated my shoulder (for the first time) and was told by my flight doc that another dislocation is 100% DQ, Orthopaedic surgeon said that it's only DQ with surgery. The waiver guide says that "Surgical correction and rehabilitation" are required to be considered for a waiver. I feel like I was fed some bad gouge somewhere, could you set me straight on this?

 

[feddoc]

The FS was right, but did not give you complete information. I think the ortho doc was wrong, but, keep in mind my interpretation is based on my time on active duty. I've been retired for a few years...but, I don't think things have changed that much. For best results, go to the waiver guide and look up the info where it says "POC Physical Qualifications" and call them. Nice folks, just explain that your interpretation doesn't necessarily agree with the FS and that you, not trying to undercut the FS, just want some gouge from the experts. They can provide you with the ulitmate in clarification.

Another option would be to print out that section of the waiver guide, take it to the FS and ask for his interpretation. All that being said, since you haven't had a second dislocation, DON"T WORRY ABOUT IT NOW. Just be cautious and follow the advice given by your Physical Therapist. Do some dedicated strength training, (based on advice from someone who is either NSCA or ACSM certified) so that your shoulder does not want to dislocate again. Prevention is the cure.

Look at the first part below in bold. That is probably what he (FS) remembers. However, the second part in bold goes on to say that it, the dislocation, may be considered for a waiver. The rest of the paragraph provides further amplification of the conditions for a waiver.

One thing you youngsters should consider is that there are a lot of things which are considered CD. However, unless the following (or similar) words are included, a waiver is something you can ask for. "XYZ condition is CD, waiver not recommended". If you have XYZ condition, your chances for a waiver are next to nothing.


"WAIVER: More than one episode of dislocation is CD for both applicants and designated personnel. The condition, or history thereof, is CD regardless of interval since repair, but may be considered for a waiver. If a unilateral condition has been corrected surgically and heals without complications and full range of motion, the aviator may request a waiver."

I'm just looking for a little clarification on the waiver guide. I recently dislocated my shoulder (for the first time) and was told by my flight doc that another dislocation is 100% DQ, Orthopaedic surgeon said that it's only DQ with surgery. The waiver guide says that "Surgical correction and rehabilitation" are required to be considered for a waiver. I feel like I was fed some bad gouge somewhere, could you set me straight on this?