The Doctor is in! Ask a Flight Surgeon!

[Flash]

Sorry, patience is a virtue.

Not just for you but for everyone on this thread, we are very fortunate to have Timebomb here providing his expertise that you will likely find nowhere else on the internet and it is solely out of his genrosity he is here so please be patient when inquiring about medical questions he may be able to answer.

 

[TimeBomb]

Flash,
Thanks for the kind words. I don't feel qualified to answer some of the questions posed here, because I'm not an eye guy, or an orthopedic surgeon, or whatever. I'll pass on those. For run-of-the-mill stuff, almost any flight surgeon can provide a decent answer and I'll chime in on them, but when it comes down to the unusual cases like some posts on this site, I don't want to offer up advice that isn't at least semi-reliable.
R/

 

[irish28]

Irish,
WRT the surgery, I have had it and it was no big deal. Not much pain at all from the actual surgery. YMMV. The plastic splints up my nose for a week to splint the septum were annoying but not painful. Getting them pulled out was interesting. I wasn't on flight status then, but I got a couple weeks off from work. That was great.
WRT the waiver process, follow the guide and you won't go far wrong. Figure on getting in the low pressure chamber about 4-6 weeks after surgery. By then, the goo inside your sinuses left over from surgery should have cleared out, and the flight surgeon with the concurrence of the ENT can get you back in the airplane. A Local Board of Flight Surgeons is just that...a way to temporarily approve an uncomplicated waiver pending final NAMI review.
R/

Sir,

I really appreciate the insights and to just hear from someone who has gone through it all. Not too big of a procedure or anything, but it gives me a lot of peace of mind prior to the surgery; I had it in my mind that I didn't do enough on my end to ensure I didn't inadvertently NAMI whammy myself or something. Thanks so much again!
V/R,
Irish

 

[irish28]

I hate to double post, but the surgery went well and just had a successful flight back in the T-6 without my sinuses exploding again. There is a God!
Does anyone have any info about grounding physicals? Perusing the waiver guide, it notes-

"REMEMBER: Grounding physicals are required for any condition resulting in a grounding of greater than 60 days and Local Boards of Flight Surgeons are not appropriate after grounding by the Waiver Authority." (Waiver guide "Sinus Surgery")

I've been down for 130+ days through this fiasco... My flight doc is sure we could get a Local board and get me back up on flight status pronto. Am I reading that waiver guide clause wrong? Is there some loophole or way to get a Local Board the doc knows, or since I've been out for over 60 days, are local boards not allowed?

Just trying to get a grasp of what's happening with this all, and thanks again to everyone who has helped me through this.

Irish

 

[TimeBomb]

Irish,
I can't find the primary reference that specifies a grounding physical is performed once the period of grounding passed the 60 day mark, but based on the waiver guide, your flight surgeon should have submitted a grounding physical to NAMI once that milestone was passed. I get the impression from your note that it didn't get done. Per the waiver guide, if a grounding physical was done, then a Local Board of Flight Surgeons would not be an appropriate action at this point. If a local board is done and you go back up based on that recommendation, you run the risk of getting re-grounding from NAMI unless you have their blessing in advance.

A phone call to NAMI ENT requesting guidance in your case would probably save everyone a lot of heartache at this point since it sounds like the admin wickets were not hit appropriately.

R/

 

[irish28]

@TimeBomb- much appreciated Sir! You are correct, sir, in that I didn't get a Grounding Physical. I called NAMI this morning and talked to someone who basically told me that any questions or concerns should be routed up through my flight doc. I called again and got a different person who said that they won't know until the waiver package comes in whether or not the Local Board is appropriate which just doesn't make much sense. I am certainly not trying to go behind my Flight Doc's back, just really trying to get a sense of what to expect and ensure everything is in order so I can get back to flying without any issues down the road. But again, thank you so much for your help and response, I genuinely appreciate it!

V/R,

Irish

 

[TimeBomb]

Irish,

My pleasure.

The flight doc should be the one making the calls to NAMI. He's going to be on the hook for the paperwork, so it would behoove him to make the call and find out what he needs to do to get you back in the pipeline ASAP. Might be an easy fix, but NAMI may require him to submit a full physical in support of a formal waiver request (instead of a local board) that they will then process.

Good luck! Now you know why I said to follow the waiver guide!
R/

 

[Invictus2011]

@TimeBomb , I'm currently undergoing treatment with INH for a positive PPD test I got back in bootcamp. Can this DQ me from starting OCS? Would I have to be complete the INH treatment before I start? or can this just be waived through NRC? Thanks!

 

[TimeBomb]

Invictus,
A little hard to say. I think it would might depend on where you were in the course of your INH regimen when you are slated to report to to OCS. Medically, there is no reason to hold you back after a few weeks on INH, since we should know by then how you tolerate the medication. There may be some features of OCS like an inability to monitor you for toxicity or perhaps increasing your risk of side effects that may make medical feel uncomfortable sending you to that environment. Sorry I can't be more concrete.
R/

 

[Randy Daytona]

To the docs, thought you might want to remind everyone what they need to do as they approach age 50. If the younger guys here are not sure, I will give you a hint....

 

[speedroller]

Would a broken/deviated nasal septum cause any problems for flight physical?

 

[David Patterson]

Howdy,

I just submitted my application to the May-ish aviation selection board. SNA is my first choice and SNFO is my second, but now realize that I will not get SNA because of a strabismus surgery I had when I was 4 years old. The difference in the alignment of my eyes is not noticable and I have depth perception to a degree (I failed DP at MEPS, but passed with civilian doc).

I know it is waiverable for SNFO, but I don't have the records from the surgery because it was so long ago and they no longer exist.
http://www.med.navy.mil/sites/nmotc/nami/arwg/Documents/WaiverGuide/12_Ophthalmology.pdf (see page 8) I also hear that NAMI will NPQ people just because of a prior issue that may not be a current problem.

Will this also be a big issue for SNFO?
Has anybody had any experience with this or have any advice for me?

Thanks

 

[brownshoe]

To the docs, thought you might want to remind everyone what they need to do as they approach age 50. If the younger guys here are not sure, I will give you a hint....

Just saw this and had a chuckle. My mom died of colon cancer when I was in my late twenties so I've been getting these things done for years now (I'm 69). The actual procedure is nothing at all, crap they even take vacation photos for you! It's the day before that I actually hate. Just remember chicken broth is your friend, it's okay to eat it the day before, but most doctors don't think of telling you that so you're just going to starve to death for 24 hours with what they tell you you're allowed to eat (which is practically nothing). Just ask the doc and he'll blink, smile, and say "sure chicken broth is okay." Oh and one more thing... make sure you're the first patient on the procedure day. That way you'll be able to scarf down real food by about 8 or so in the morning.

 

[TimeBomb]

Would a broken/deviated nasal septum cause any problems for flight physical?

Probably not, provided you don't have any limitations in breathing or recurrent sinus problems due to the fracture/anatomic abnormality.

Howdy,

I just submitted my application to the May-ish aviation selection board. SNA is my first choice and SNFO is my second, but now realize that I will not get SNA because of a strabismus surgery I had when I was 4 years old. The difference in the alignment of my eyes is not noticable and I have depth perception to a degree (I failed DP at MEPS, but passed with civilian doc).

I know it is waiverable for SNFO, but I don't have the records from the surgery because it was so long ago and they no longer exist.
http://www.med.navy.mil/sites/nmotc/nami/arwg/Documents/WaiverGuide/12_Ophthalmology.pdf (see page 8) I also hear that NAMI will NPQ people just because of a prior issue that may not be a current problem.

Will this also be a big issue for SNFO?
Has anybody had any experience with this or have any advice for me?

Thanks

This history and current findings may be problematic. NFO applicants must meet depth perception standards for aviation. The fact that you can pass at least some of the time may get you where you need to be. A history of strabismus surgery is disqualifying for aviation. Waivers may be considered on a case-by-case basis for personnel not in actual control of aircraft (e.g. NFO). An oculomotor worksheet must be submitted to NAMI for consideration of a waiver recommendation for both of these conditions. You may want to print out a copy and take it to an ophthalmologist before going much further to see if you can make it past that hurdle.
R/

 

[Ronny Hafeza]

Hey all,

New member here. I have been going through the application process for some time now, in attempt to pick up an aviation slot (pilot/NFO). I scored highly on the ASTB-E, have a degree in electrical engineering, so everything with the application seems to be building up fairly well. I did run into an issue today when my recruiter sent me an email with regard to a collarbone injury sustained in September 2012, when I received 1 plate and 8 screws. Mind you, the hardware is not noticeable. I have a scar. I filled out an LoA mentioning that I have full range of mobility, have no loss in sensation, and can sustain rigorous activity (competitive rock-climbing, triathlons, working out, etc.) with no issues whatsoever. The collarbone looks normal, feels very smooth, but has a scar. My recruiter mentioned the waiver upon speaking with MEPS, but seemed to press for consultation to get the hardware removed. They cause no sort of impedance, irritation, or distraction. What sort of recommendations do you have so I have the best chance at getting this waived?

Ron

Edit: I understand TimeBomb prefers to pass on orthopedic content, so any advice is welcome. Thanks again.