The Doctor is in! Ask a Flight Surgeon!

[BleedGreen]

Hi thanks for the reply! I was reading the waiver regarding asthma/inhaler/advair usage and it said you can get it waived as long as you pass the PFT and MCT. For your case did they give you a NAMI waiver for just doing the PFT? Also, did you do this before, during, or after MEPS?

I had childhood asthma and can share my experience.
I was familiar with the NAMI waiver process and went ahead with getting the PFT and MCT done before OCS. The tests were complete at a naval hospital, but no waiver in hand yet.
Fast forward 11 months and I'm sitting at medical in OCS and the flight doc wanted to do the tests all over again. After some back and forth he accepted my previous tests and told me they're just barely valid. A requirement came out that year requiring PFTs and MCTs be completed within one year of waiver submission.
Another fun fact, MEPS doesn't route waivers to NAMI. BUMED will compare your entry physical to NAMI's waiver guidelines and give you the greenlight for SNA/SNFO if they think you meet the criteria. BUMED declined my first physical for a misinterpretation of the NAMI waiver guidelines, but that's another story for another time. Your official waivers are routed at OCS.
If you're worried about the tests and want to gauge what they're like before OCS then try them before arriving. If you are familiar with them and aren't concerned then don't waste your time.
I'm happy I knocked it out before OCS because the MCT was no joke for me. YMMV.

 

[fareastcruise]

Good morning,

I have a quick question about the NAMI waiver process. What does AERO, IMR, NAMI, QUALIFIED, UMO, and WAIVER GRANTED mean for applicants? I understand granted means you’re good to go but it looks like the statuses are ascending in that order and I’m curious what it all means.

Thank you.

 

[jleo_96]

Hello,

I was recently accepted to go to OCS as an SNA. I don't have a class date yet, most likely since I still have to graduate college this spring, but would presumably be in the Summer sometime. My issue is that I have an ingrown toenail that I would like to get fixed before I go. I believe that there is a 6-month wait period for surgeries, but I was wondering if this counts as a surgery since treating it basically involves numbing the toe and cutting the nail back. If it matters, the Navy already knows about it, since I had the procedure done once, but now the toenail is ingrown again. I don't believe I needed a waiver for it the first time, they just wanted something from my podiatrist.

 

[FormerRecruitingGuru]

Hello,

I was recently accepted to go to OCS as an SNA. I don't have a class date yet, most likely since I still have to graduate college this spring, but would presumably be in the Summer sometime. My issue is that I have an ingrown toenail that I would like to get fixed before I go. I believe that there is a 6-month wait period for surgeries, but I was wondering if this counts as a surgery since treating it basically involves numbing the toe and cutting the nail back. If it matters, the Navy already knows about it, since I had the procedure done once, but now the toenail is ingrown again. I don't believe I needed a waiver for it the first time, they just wanted something from my podiatrist.

No clue where you got the 6 months from. Get it removed ASAP, even if the "6 months rule" is still valid you can still ship around July timeframe.

 

[jleo_96]

No clue where you got the 6 months from. Get it removed ASAP, even if the "6 months rule" is still valid you can still ship around July timeframe.

To be honest, I've never actually looked into it, but I've heard that there is a waiting time for surgeries; just wasn't sure if this qualified as one. I will definitely get it taken care of as soon as possible, just trying to fit it between my classes.

 

[FormerRecruitingGuru]

To be honest, I've never actually looked into it, but I've heard that there is a waiting time for surgeries; just wasn't sure if this qualified as one. I will definitely get it taken care of as soon as possible, just trying to fit it between my classes.

I would describe it more as a procedure rather than a surgery. I wouldn’t categorize a cavity full as a surgery either.

 

[countchockula]

USMC candidate here.
A circumstance that I don't think has come up in this thread yet: passing a methacholine challenge test(s), and failing another.

I was granted a waiver for MEPS for childhood asthma (2019), after having completed two methacholine challenge tests (MCT), one in 2009 and 2015,
along with assorted pulmonary function tests (PFT) from 2015 to 2019. Both times I have taken the MCT, the results for asthma came back negative, i.e. FEV1 stayed >80%
across all 5 doses, and got a Dr's note clearing me. Have had no use of inhaler, no hospitalizations, etc from age 12 onward.

After arriving at NAMI for my flight physical (Nov 2019), I was instructed to take another MCT at Pensacola (likely to have one within 1 year as per NAMI waiver requirements). However, this one
I failed, with a score of 75%. I passed all other tests at NAMI, but received word I did not pass my flight physical.

Over the following two weeks, what I thought was me feeling under the weather progressed into a full sinus infection, and when I finally went to the Dr, was stated as having progressed to bronchitis.
This was ascribed as likely due to allergic rhinitis (we got a cat in Sept, which I am allergic to). I took antibiotics for it, it cleared up. Cat is no longer allowed in the bedroom.

After antibiotics, I took another MCT with a private doctor (Jan 2020), and passed (90%). I submitted this result to NAMI in January, but was told after submitting it/review
this new result was not enough to get a waiver.

The NQP letter states:

1. "Not physically qualified but aeronautically adapted" for all duties involving flying due to Asthma (J45) (disqualified).
2. Waiver is not recommended
3. This recommendation is permanent.

Report of medical examination states:
- hx of asthma, PFTs/MCCT abnormal - CD, WRN

Do I have any recourse to ask for a retest at Pensacola/another Navy hospital, or to ask to nullify the previous test? Or, is there anything else I can do to help bolster my case/get that waiver?

Thank you.

 

[TimeBomb]

You may be able to ask NAMI for a reevaluation, given that you were ill during the last (and disqualifying) methacholine challenge test (MCT). I would recommend talking with their internal medicine department and the ENT department as well. A negative MCT is useful in pretty much excluding asthma, but as you've seen, a positive test doesn't mean all that much. Yes, it is generally positive in asthmatics, but it can also be positive in people with acute bronchitis, allergies, and other conditions that affect the airways. The Navy has been been getting tougher on accepting candidates with asthma, and the positive test may be enough to set you aside.

Not sure how this is going to work out. You might get a break and be allowed to take the test again, but I'd be getting prepped to implement "Plan B". No guarantee that you'll pass another MCT, even if you've been treated for your underlying illness. The hyperresponsive airways that cause the abnormalities seen on the MCT can persist for weeks following an illness, and if you have allergies to the cat, I wouldn't be surprised if your repeat MCT is positive as well. Excluding the cat from the bedroom does nothing to reduce the total allergens in your house, since you're breathing in cat air in other parts of the house.

V/R

 

[Mike9595]

Hello! Should I be worried about the OCS medical screening?

I disclosed that I have psoriasis and am on a medication for it, and spoke to the doctor at MEPs at length about it which I ended up gettng a waiver for. The medication recommends not to have live vaccines while on it so I will stop taking it a little prior to OCS so not to have complications with it. The website says to take all prescription medication with you. So I can restart to take it after the round of shots. If I have a waiver for it and they know about it I should be ok right..?

I just hear horror stories all the time about getting into medhold. I would ask my recruiter but it is the weekend?

 

[FormerRecruitingGuru]

Hello! Should I be worried about the OCS medical screening?

I disclosed that I have psoriasis and am on a medication for it, and spoke to the doctor at MEPs at length about it which I ended up gettng a waiver for. The medication recommends not to have live vaccines while on it so I will stop taking it a little prior to OCS so not to have complications with it. The website says to take all prescription medication with you. So I can restart to take it after the round of shots. If I have a waiver for it and they know about it I should be ok right..?

I just hear horror stories all the time about getting into medhold. I would ask my recruiter but it is the weekend?

Read the NAMI guide. That would be a good start for your OCS aviation physical.

 

[picklesuit]

So, asking for a friend...cough cough...
The orthopedic section of the NAMI Guide that I could find via google didn’t have much about retained hardware.
If a certain DH shattered a finger playing basketball, has a plate and seven screws installed, and is worried about what it would take to get back up...where would they look?

How much feeling and/or range of motion do they need?

If they can’t meet that requirement, the orthopedic section also is very limited on amputations. Could said DH fly sans finger?

 

[SimpleJack]

Another question for a friend. What would the scenario look like if one was to need surgery with a 6+ month recovery period before starting API but after having been through NAMI? I believe I recall flight docs mentioning a time to train clock starting after getting an upchit.

 

[FormerRecruitingGuru]

So, asking for a friend...cough cough...
The orthopedic section of the NAMI Guide that I could find via google didn’t have much about retained hardware.
If a certain DH shattered a finger playing basketball, has a plate and seven screws installed, and is worried about what it would take to get back up...where would they look?

How much feeling and/or range of motion do they need?

If they can’t meet that requirement, the orthopedic section also is very limited on amputations. Could said DH fly sans finger?
View attachment 24720
View attachment 24722

Does it sting when you pee?

 

[FormerRecruitingGuru]

Another question for a friend. What would the scenario look like if one was to need surgery with a 6+ month recovery period before starting API but after having been through NAMI? I believe I recall flight docs mentioning a time to train clock starting after getting an upchit.

What kind of surgery?

 

[HAL Pilot]

So, asking for a friend...cough cough...
The orthopedic section of the NAMI Guide that I could find via google didn’t have much about retained hardware.
If a certain DH shattered a finger playing basketball, has a plate and seven screws installed, and is worried about what it would take to get back up...where would they look?

How much feeling and/or range of motion do they need?

If they can’t meet that requirement, the orthopedic section also is very limited on amputations. Could said DH fly sans finger?
View attachment 24720
View attachment 24722

Methinks the basketball story is a cover up..... A little too enthusiastic on the down stroke?