Asthma (and waiver) info

[Guest dirtydog]

I'm in a bit of a fix! I always wanted to be a military pilot when I was young, but I gave up those dreams because my vision was just too bad. Now I've had PRK and am going for my PPL and then applying to OTS. After getting into the process I found that asthma was an issue. My problem is that I was diagnosed with asthma as a child, but now that I've been studying up on A.F. and general medical diagnostic criteria, I think I was misdiagnosed! After telling my recruiter my whole story, he thinks it's best that I don't go through a MEPS examiner and just go straight to the nearest base for an FC1. I think he figures a flight doc will be more likely to not just see the word "asthma" in my records and throw me out without at least allowing me to do spirometry and a methacholine challenge. In short, here is my history:

1. When I was around 6 years old I caught pneumonia. Soon after recovering, I woke up one night with some breathing difficulty. Over the next few days I was seen by an allergist, given a battery of tests, and then diagnosed with asthma.

2. I never had another episode of breathing difficulty. I didn't see the allergist for very long after that, maybe 2 or 3 years. My pediatrician kept giving me inhalers and theodur. I tended to get sick 3 or 4 times a year. The asthma medications and antihistamines never seemed to help me get better when I was sick, and they didn't seem to keep me from getting sick either, so eventually I stopped taking them regularly, and now I don't take anything but Benadryl, Nyquil, and Robitussin, and I get over colds about 3 times faster.

4. When I first found that my past asthma diagnosis could DQ me, I went to my current PCP and asked her to give me a spirometry test. My FEV1 and FVC are both a little low, but still within the A.F. definition of normal (80% and 82% of predicted). However, in the past few years I got married and had a couple of kids, so I haven't exactly stayed in top shape. My FEV1/FVC was 98% of predicted. After giving me a bronchodilator, none of the stats changed. All the data led my physician to say that I do have slightly abnormal lung function, but that it's not anything to worry about, and that it certainly is not asthma.

5. So then I found out that my former allergist ended up in the same group that my physician is in. I went to him and asked about getting access to my records. I was diagnosed over 20 years ago, and he deletes all records after 7 years, so he has no record of ever even seeing me. So now I've requested copies of my pediatrician's records. He never destroys records, so my full treatment history is available, although I don't recall him ever testing me for asthma himself. I'm hoping that the allergists records might have been copied and kept by my pediatrician at this point.

My recruiter is wanting to send me for an FC1 in April. I'm working on getting in shape and losing some weight. I'm hoping that will help my spirometry stats out. I'm just wanting to know if anyone else has gone through this sort of issue or knows of anyone else who has. Are A.F. flight surgeons more likely to focus on what my current results are or on what my records from 20 years ago say? Lung problems have never kept me from doing anything. I'm a SCUBA assistant instructor, I've been active in many demanding sports, including ice hockey, swimming, and long distance running, so I'm going to be really disappointed if I'm DQ'd simply because the word asthma appears on my childhood medical charts.

Thanks for any advice!

[Guest Flight Doc]

The key question is, ?Did you really have asthma?? Show the following to your allergist.

A3.12.4. Asthma, including reactive airway disease, exercise induced bronchospasm or asthmatic bronchitis, reliably diagnosed at any age.

NOTE: Reliable diagnostic criteria should consist of any of the following elements: (a) substantiated history of cough, wheeze, and or dyspnea which persists or recurs over a prolonged period of time (generally more than 6 months), or if the diagnosis of asthma is in doubt, (B) a test for reversible airflow obstruction (greater than a 15 percent increase in FEV, following administration of an inhaled bronchodilator) or airway hyperreactivity (exaggerated decrease in airflow induced by a standard bronchoprovocation challenge such as methacholine inhalation or a demonstration of exercise-induced bronchospasms) must be performed. Bronchoprovocation or exercise testing should be performed by a board certified pulmonologist or allergist.

A7.16.1.9. Asthma of any degree, or a history of asthma, reactive airway disease, intrinsic or extrinsic bronchial asthma, exercise-induced bronchospasm, or IgE (Immunoglobulin E) mediated asthma.

[ 04 May 2003, 10:21: Message edited by: Flight Doc ]

[Guest dirtydog]

Thanks Doc!

I have copies of all my pediatric records now, so I have a couple of follow up questions.

I was actually diagnosed in September of 1981 with "acute asthma secondary to upper respiratory infection." My records show that pulmonary testing was performed, but no results are given, and a note from one of the allergists to my pediatrician states that the results were considered inaccurate due to my age (6.5 years). I was found to be moderately allergic to some pollens and molds, but they weren't found to be asthma triggers for me. Asthma symptoms were only present during upper respiratory infections. A little over 3 years later, I quit going to the allergist. In his last letter to my pediatrician he wrote:

"Physical examination today revealed clear lungs and was otherwise unremarkable. Pulmonary function study was normal. Impression: Asthma and allergic rhinitis, controlled."

My main question after going through my records is, what is the difference between acute asthma and chronic asthma? Is acute asthma even recognized as a disqualifying condition? I'm looking at NIH pub 97-4051, "Guidelines for the Diagnosis and Management of Asthma." It defines asthma as "a chronic inflamatory disease of the airways." So I'm wondering how I could be diagnosed with acute asthma if by definition asthma is a chronic condition.

Thanks!

[Guest Flight Doc]

You're up against changing definitions.

The usual "book answer" now is that asthma is chronic, by defintion. In the past (and even now) you will encounter an acute asthma diagnosis.

You may be able to settle the issue with a methacholine challenge test.

[Guest chrarm80]

Does anyone know how long it takes to get a waiver approved at AETC? I went to a doctor to get a methocoline challenge (I think that's what it's called) and I passed it with no problem. The pulmonologist said that if you can pass this test, then you have no active asthma and that you should be able to get the waiver. The flight doc for the guard unit did the narrative at the base and it has been sent to AETC for approval.

What is the time frame that I can expect. I'm just trying to find out how long it takes due to my wife asking what the plans are. No one at the unit seems to know anything.

Any help/advise would be appreciated.

[ 31. August 2005, 10:51: Message edited by: Future C130 Nav ]

[Guest doctidy]

Would guess 2-6 weeks on average.

[VL-16]

My buddy (roommate) in ROTC had asthma as a kid, but has had no symptoms for ~13 years and is now PPQ according to the AF. He is going up for UPT boards in a few months and is wondering whether or not this will have an effect on him as far as being medically qualified to attend pilot training. The AF knows he had asthma, so will they require him to get a waiver? If so, what is the process/test for getting one? Thanks in advance.

[ 15. December 2005, 01:36: Message edited by: ENJJPTorBust ]

[Guest doctidy]

It sounds like if he has been deemed qualified for commissioning, he shouldn't have a problem getting medically qualified for aviation duty. If he truly has been diagnosed as having asthma he will require a waiver.

As for tests...just depends on how much info is already in his file.

[FalconXtreme]

Hey so one of my best buds in rotc with me just got his dodmerb(sp) done and he has been dq'ed for asthma and he has astrigmatism. he hasn't had a problem with asmtha since he was 13 and he wears glasses. our cadre has told them that there is nothing that they can do as far as waivers but i want to research more since they have been known to miss things. anyway he's not trying to go into flying he just wants to be an areospace engineer. so i'm just looking for basic commissioning waivers so that he can get through rotc and be happy in the force. i've searched but haven't found anything specific so i'm asking for help. plz let me know guys thanks!

edit: i'm hoping to get the ball rolling on this soon cause big week is coming up for field training and we're both 200s.

[ 06. February 2006, 20:01: Message edited by: FalconXtreme ]

[brabus]

Hate to say it, but he's pretty much screwed. I've seen multiple people gone for asthma. Our cadre tried hard for each one, but there's just no way to get around it...at least at this time (when the AF is overmanned for LTs in many positions).

[Guest chrarm80]

Have him go to a respritory specialist and take the Methocoline Challenge. I had to do this for my FCIA. I was told when I was younger that I had asthma. I didn't have any trouble from it except when I was younger. The flight doc had me take this test. He said if I passed it, I never had asthma. I did. The Dr said that I probably had a bronchial infection or something like that when I was younger and the Dr said I had asthma.

This test is a sure way to see if you have asthma. If you pass it, you don't have it, if you fail, you do. After I passed this, I took the paperwork and test results to the flight doc. He put it in my file and said that's all. I don't have asthma so no waiver needed.

As for the refractive error, it depends how much out of standards it is. I'm not sure what mine is, but I did need a waiver. I recently got it (it was within waiver limits). I would find out what his refractive error is and look at any post that Rage has made. You'll be able to see the limits in his footnote section.

[Jon - Trident Home Loans]

I went through the same exact thing and am on AD now. I had an asthma record up to 13 and then nothing after. After praying and begging for 2 yrs I got sent to Wilford Hall for a full pulmonary exam to include the the Methocoline Challenge test. The Good Lord was looking out for me and I passed everything with flying colors. Tell your friend not to give up! The AF is great and well worth all the waiting! A few prayers would definitely help out too! Let me know if I can be of any help.

[FalconXtreme]

dang man thats exactly what i've been needing to hear. our cadre here is like "we've done all we can" and my friend is believing them and kinda giving up so i'm the one trying to motivate to not accept defeat. so how did u go about getting that medical visit? another problem is that right now he cant afford to go see any other docs that he'd have to pay for. i'm sure thats bad in this situation.

[Guest chrarm80]

I don't know what to tell you about going about getting the medical through the military. I had to use my insurance with my civilian job. Does he have insurance? His or his parents? All I was responsible for was my $20 copay. It's an expensive test without insurance though. I didn't need a referral with my insurance (Blue Cross Blue Shield). I would have him call his insurance provider and tell them that he needs to go see a pulmonologist to have tests done for his childhood asthma (tell them he thinks it's acting up even if he doesn't have it, you need to tell them that so you can get the test [they won't keep you from seeing a dr if you have medical problems]). Call around to the pulmonologists in your area and ask if they do Methocoline Challenge. Not all of them perform the test so you don't want to show up and not be able to take it. Tell them it's for the military and you need a writeup stating the results.

If you have any questions about the test itself, ask here or PM me and I'd be more than happy to help. I like him thought it was the end of the road, but everything works out the way it's supposed to. Have faith!

[Guest doctidy]

Agree w/ most of what has been said.

He needs to submit more information along w/ the Methacholine Challenge results. The methacholine results are not 100%...but we usually accept them. Remember...the test may show he does have asthma!

As for paying, right now there are two options:

1 - have it done at a military base that is capable of doing the test (that is not every base, but some are. Your ROTC unit will have to put him on orders.

2 - pay out of own pocket (hey, ROTC is paying for school...there ought to be some money left over!)

There will be a contract where these follow-up tests will be paid for centrally. That contract will go into effect around 1 Oct.

[Guest dschmitz]

I have done a search and can not find an answer to this particular question. If you disclose that you had asthma, and they pull your records and find out you didn't have any history after age 12, you can take a Methocoline challenge breathing test, correct? If you pass this test with no history of asthma after age 12, is there any reason your waiver might not go through? or could you still get DQ'd.

[Guest doctidy]

First...if you said you had asthma and there is nothing after age 12, we wouldn't ask for a Methacholine challenge.

Second...there's a possibility of everything. You could show no reactivity and get DQed, but it is improbable. You could show reactivity and get a waiver, but it is improbable.

I know I didn't come out with a yes / no answer...but the point is, nothing is really black or white.

[brabus]

Are you ROTC? Just from what I saw at my Det, 100% of people who stated they had asthma at any point in their lives was DQ'd/kicked out of ROTC. Yes they were given the whole challenge thing, yes they passed, yes they were kicked out. Doesn't sound right at all, but ROTC is just looking for any reason to thin its ranks. Two people I knew had absolutely no asthma related anything pass the age of 5...didn't matter. Personally I would think about not mentioning it at all...let the AF find it if they really want to, but you mentioning it gives you a very good chance of being kicked out for some complete bullshit. It's one of those "if you check a single yes box, you just drastically magnified your chances of being DQ'd/kicked out." Just my opinion.

[ 08. October 2006, 10:45: Message edited by: brabus ]

[Guest cbire880]

IIRC, the question is worded something to the effect of "have you had a history of asthma after age 12." Don't lie, don't volunteer more than is asked either.

[brabus]

I think what happened to the aforementioned people was that they noted asthma on their DODMERB...which as I recall asks if you had any asthma at all, regardless of age. The FC1 is where it says after age 12...as far as I can remember.

[Guest dschmitz]

Yes I'm ROTC and this would be for my DoDMERB. Brabus, so you're saying they got kicked out even if they put in the remarks section that they had no history of asthma after age 12? Sounds like I would have no chance if I tell them I had asthma.

[brabus]

Sounds like I would have no chance if I tell them I had asthma.

That's pretty much what I'm saying. I'm not telling you what the right answer is, you have to figure that out for yourself. If you haven't had asthma since 5 or something like that, why should you volunteer that info? According to them it wouldn't matter (yeah right), so why should they know in the first place? Point being, if you tell them, you're at the very least heavily jeopardizing your ability to stay in ROTC. Another example would be if you had a minor broken arm when you were in 4th grade...do you really need to tell them about that as long as there was no hardware involved/everything healed fine?...hmmm. Catch my drift? It's your decision man, but just be forewarned what could very well come of this if you tell them.

[Guest nkwilson]

I had childhood asthma, passed the Methocolene challenge and got a waiver. I am now awaiting my pilot training class date in April 07.

I was told by many not to put anything on my DODMERB, but I decided to answer every question honestly and fully, which meant I had to admit it at some point (Can't remember which question). I was bummed because the waiver process took me over the academy selection date, but I still got full ROTC scholarship and now look back at the whole thing and see it as a blessing. Plus, I now never have to worry about my past medical history coming up since it is all on my records and my health is better than most of my compatriates.

GOOD LUCK!

[brabus]

Keep in mind, you did your DODMERB what, 4-5 yrs ago? If you had one arm, one leg and could add 2 and 2, you were in ROTC w/ a scholarship. Heck back when we were freshman, you could get a couple MIPs and no one gave a shit. Now you don't shave before coming to PT, you get the boot. Saying you had asthma wasn't such a big deal 4 years ago, now it's almost (note that I said almost) a guaranteed deal breaker.

[Guest dschmitz]

Just a question, if you get DQed/kicked out of ROTC for having asthma, would pursuing an ANG slot still be possible or am I completely out of the system for good.