The Doctor is in! Ask a Flight Surgeon!

[Gatordev]

For the heart issue all I know is the anesthesiologist said I need to get checked out by a cardiologist for something I don’t remember now because of surgery meds for disk replacement. Yes active duty, but worried about running out of time on limdu.

@Pianistwithwings Get it checked out, but understand an anesthesiologist isn't a cardiologist. He/she might not even have been a doctor, but instead a CRNA.

When I got my Class 1 FAA medical, I brought my EKG home. Nothing of import was stated at my doctor's appointment. My wife, who works as an extender (NP) in a Peds Cardiac ICU and manages the patients, saw my EKG and flipped out. She said I needed to see someone right away. She then took the EKG into work and had one of the cardiologists look at it.

He said I was fine.

Again, don't ignore it, but know not everyone in medicine knows what they're talking about all the time (including ER docs, which is also scary).

 

[DocHolliday]

Im currently trying to understand how this could impact me. Im an SNA hopeful, putting my packet together to send to the boards. A few months ago i saw a therapist about some relationship issues with my girlfriend. The therapist (who i think also doubled as a nurse practitioner) said he thinks i have ADHD and i could see a Psychiatrist if i wanted to but that would be over a year before they would be able fit me in. I declined his efforts. I know for a fact i dont have ADHD. Would his diagnosis hinder my chances of being accepted into the service? There was no prescription medications, no official tests done, and i never even saw an actual Psychiatrist.

 

[Nax]

Im currently trying to understand how this could impact me. Im an SNA hopeful, putting my packet together to send to the boards. A few months ago i saw a therapist about some relationship issues with my girlfriend. The therapist (who i think also doubled as a nurse practitioner) said he thinks i have ADHD and i could see a Psychiatrist if i wanted to but that would be over a year before they would be able fit me in. I declined his efforts. I know for a fact i dont have ADHD. Would his diagnosis hinder my chances of being accepted into the service? There was no prescription medications, no official tests done, and i never even saw an actual Psychiatrist.

If no medications, and no history, then don't say anything. If you do have a history, they will send you to do a Neuropsych exam in town when you are at OCS.

Source: I had a history of ADD and they made me do it, I am now in Primary so it worked out

 

[DocHolliday]

If no medications, and no history, then don't say anything. If you do have a history, they will send you to do a Neuropsych exam in town when you are at OCS.

Source: I had a history of ADD and they made me do it, I am now in Primary so it worked out

I was thinking about just not saying anything but wouldnt MEPS or NAMI just see it when they pull my Genesis records?

 

[Gatordev]

I was thinking about just not saying anything but wouldnt MEPS or NAMI just see it when they pull my Genesis records?

You need to see what your records say. They're your records, so you have the right to ask for them. Because a health professional says they think something doesn't mean it's a diagnosis.

Was the NP a family medicine provider? They can issue a referral in the notes, but that doesn't mean they can generate the actual diagnosis.

 

[BradL17]

SNA currently in CandiO phase at OCS. I have two waivers, one for Cardiology and one for Behavioral Health. The cardiology waiver is for a history of palpitations and chest tightness in 2021 when I was an idiot and decided to take 2 scoops of pre workout before lifting. I didn’t go to the ER or anything, I just told my parents that my heart felt weird and they insisted I go to the doctor to be safe. My PCP referred me to cardiology and I did an EKG, holter monitor, and echo. Everything came back unremarkable except for some occasional asymptomatic PVCs, mild mitral valve regurgitation, and evidence of 1st and 2nd degree (Mobitz Type 1) AV blocks. It was noted by the cardiologist that the AV blocks were likely due to me being an athlete my whole life and the vagal tone of my heart. He was not concerned and did not recommend any treatment.

However, they noticed my blood pressure was high 140/90+ each time I came in for a visit so they did end up putting me on BP meds. I took these for about 2.5 years and now I’ve been off meds since Feb of 2024. Just needed to make some lifestyle changes and my BP has been under 140/90 since.

Fast forward to today, I had the same tests done while I am here at OCS and everything came back normal. The cardiologist noted that any conduction delays during the holter monitor were only occurring during sleep when my heart rate would drop to like 48 BPM avg. There were also pauses during my sleep with the longest pause being 2.49 sec (200 pauses total over 2 sec during a 48hr period). Echo came back great and there were no signs on mitral valve regurgitation, only trace signs of regurgitation on my tricuspid and pulmonic valves. Also did a stress test and everything came back normal. All 3-4 EKG’s I’ve had done here have come back normal.

My behavioral health waiver is for generalized anxiety. I went to my PCP back in 2022 for an annual check up and she asked how I was feeling. I told her I was feeling a little stressed after moving to a new city and starting a new position at my job. Long story short she prescribed me meds and I took them for 9 months and then stopped completely. The BH specialists I’ve seen here recommended me for worldwide deployment and all aviation duties.

Posting here to get some insight from anyone, preferably a current or ex flight doc on how likely it is I’ll receive waivers. I’ve been a lurker for a long time so I understand the NAMI process for the most part, just want to set some realistic expectations for myself and hopefully help anyone else going through a similar situation. My package is getting sent to NAMI within the next week or two. Preparing for the worst, praying for the best!

Lastly, according to my actual flight physical notes everything was listed as CD WR. They are going to submit to AERO as NPQ/AA DIACA SNA WR. No idea what DIACA means.

 

[Nax]

I was thinking about just not saying anything but wouldnt MEPS or NAMI just see it when they pull my Genesis records?

You need to see what your records say. They're your records, so you have the right to ask for them. Because a health professional says they think something doesn't mean it's a diagnosis.

Was the NP a family medicine provider? They can issue a referral in the notes, but that doesn't mean they can generate the actual diagnosis.

This, if you were under Tricare growing up or prior enlisted, it will all be in Genesis, I heard they have some new system to pull any medical records anyway if you were civilian, but I cant confirm that. However, again - if you were never officially diagnosed with anything, I would say that you don't have it.

 

[DocHolliday]

Is there any chance of a waiver for a history of ear infections/eustachian tube dysfunction? I had tubes put in my ears as a toddler, then again as a young adult but that was 10 years ago. I havent had any problems or ear infections since then. I told my civilian ENT about how i wanted to be a Navy pilot and he said everything looks good and he doesnt see any problem with me pursuing that career choice. Since then, ive been on 100s of commercial flights and have even done some aerobatic flights (as a passenger) and never had any issue clearing my ears.

 

[joetting21]

SNA currently in CandiO phase at OCS. I have two waivers, one for Cardiology and one for Behavioral Health. The cardiology waiver is for a history of palpitations and chest tightness in 2021 when I was an idiot and decided to take 2 scoops of pre workout before lifting. I didn’t go to the ER or anything, I just told my parents that my heart felt weird and they insisted I go to the doctor to be safe. My PCP referred me to cardiology and I did an EKG, holter monitor, and echo. Everything came back unremarkable except for some occasional asymptomatic PVCs, mild mitral valve regurgitation, and evidence of 1st and 2nd degree (Mobitz Type 1) AV blocks. It was noted by the cardiologist that the AV blocks were likely due to me being an athlete my whole life and the vagal tone of my heart. He was not concerned and did not recommend any treatment.

However, they noticed my blood pressure was high 140/90+ each time I came in for a visit so they did end up putting me on BP meds. I took these for about 2.5 years and now I’ve been off meds since Feb of 2024. Just needed to make some lifestyle changes and my BP has been under 140/90 since.

Fast forward to today, I had the same tests done while I am here at OCS and everything came back normal. The cardiologist noted that any conduction delays during the holter monitor were only occurring during sleep when my heart rate would drop to like 48 BPM avg. There were also pauses during my sleep with the longest pause being 2.49 sec (200 pauses total over 2 sec during a 48hr period). Echo came back great and there were no signs on mitral valve regurgitation, only trace signs of regurgitation on my tricuspid and pulmonic valves. Also did a stress test and everything came back normal. All 3-4 EKG’s I’ve had done here have come back normal.

My behavioral health waiver is for generalized anxiety. I went to my PCP back in 2022 for an annual check up and she asked how I was feeling. I told her I was feeling a little stressed after moving to a new city and starting a new position at my job. Long story short she prescribed me meds and I took them for 9 months and then stopped completely. The BH specialists I’ve seen here recommended me for worldwide deployment and all aviation duties.

Posting here to get some insight from anyone, preferably a current or ex flight doc on how likely it is I’ll receive waivers. I’ve been a lurker for a long time so I understand the NAMI process for the most part, just want to set some realistic expectations for myself and hopefully help anyone else going through a similar situation. My package is getting sent to NAMI within the next week or two. Preparing for the worst, praying for the best!

Lastly, according to my actual flight physical notes everything was listed as CD WR. They are going to submit to AERO as NPQ/AA DIACA SNA WR. No idea what DIACA means.

Interested to know how this turns out for you as I’m heading to OCS in a few months and will likely be in a similar situation.

 

[Mouselovr]

Is there any chance of a waiver for a history of ear infections/eustachian tube dysfunction? I had tubes put in my ears as a toddler, then again as a young adult but that was 10 years ago. I havent had any problems or ear infections since then. I told my civilian ENT about how i wanted to be a Navy pilot and he said everything looks good and he doesnt see any problem with me pursuing that career choice. Since then, ive been on 100s of commercial flights and have even done some aerobatic flights (as a passenger) and never had any issue clearing my ears.

You should be good. I had eustachian tubes as a kid.
SNA I know had them put in as an adult post-COVID. He needed to wait the necessary time frame (6 months I think.... just looked in the NAMI waiver guide and couldn't find the exact timeframe).... with yours being out for over 10 years, it wont be a problem

 

[taxi1]

I had eustachian tubes as a kid.

Hopefully you still do.

 

[Mouselovr]

Hopefully you still do.

*I had eustachian tube tubes as a kid
Can confirm. I have retained my birth set of tubes.

 

[taxi1]

*I had eustachian tube tubes as a kid
Can confirm. I have retained my birth set of tubes.

 

[Joe-505]

SNA here, I just had a long form today and was told my blood sugar levels are high and that I have to come back in to do more tests. I suspect the results are swayed by the fact that I haven't exercised in a few weeks and my diet the days leading up to the exam was poor. I was looking in the regs, and there is no hard limit for glucose levels, it sounds like it is more or less the flight surgeon's call. Anyone know what kind of test besides another glucose blood test they will do? I've got no history of diabetes (personal or family) or anything like that. I've had long forms before and passed so I was kind of baffled.

 

[BearlingBababeano]

What's the current medical prognosis on melanoma wrt DQ'ing? I've got some moles I want to get looked at by a dermatologist, but am a little concerned on what happens if they come back as a "yup that's cancer".