• Please take a moment and update your account profile. If you have an updated account profile with basic information on why you are on Air Warriors it will help other people respond to your posts. How do you update your profile you ask?

    Go here:

    Edit Account Details and Profile

The Doctor is in! Ask a Flight Surgeon!

Hello all, searched the entire forum as well as reddit but couldn't find the very specific answer I am looking for. For context; I currently have a peanut/tree nut allergy (mild anaphylaxis, only react when consumed) but can eat peanut oil, pesto, etc. I was NPQ by NRC/N33 last year in May for "Allergy to peanuts, with anaphylaxis - Unfavorable" as well as "Allergy to other foods". Never had a problem/reaction in my 20 years of life but did react during a skin prick test as well as an initial Oral Food Challenge 4 years ago.

I am starting Oral Immunotherapy this week for both peanuts and tree nuts. My civilian allergist is super supportive but unfamiliar with military accession standards. She needs a specific "Target Maintenance Dose" to aim for to ensure the final clinical notes satisfy a waiver board. My recruiter reached out to a source at N33, but the response was vague: "It’s not a numbers thing—they need to show that they can ingest and be in the vicinity of peanuts without any anaphylactic reaction."

While "vicinity" is clear (I can smell & touch no problem), "ingest" is pretty broad. To my civilian allergist "ingesting" could mean 300mg (one bite) or 8,000mg (a handful).

The Question - For those with experience in the waiver process or Flight Docs familiar with NAMI/N33 standards: Is there a specific protein gram amount or "number of peanuts/tree nuts" that the board expects to see passed in a final Oral Food Challenge? Thank you!
 
LowSpeedHighDrag said:
Hello all, searched the entire forum as well as reddit but couldn't find the very specific answer I am looking for. For context; I currently have a peanut/tree nut allergy (mild anaphylaxis, only react when consumed) but can eat peanut oil, pesto, etc. I was NPQ by NRC/N33 last year in May for "Allergy to peanuts, with anaphylaxis - Unfavorable" as well as "Allergy to other foods". Never had a problem/reaction in my 20 years of life but did react during a skin prick test as well as an initial Oral Food Challenge 4 years ago.

I am starting Oral Immunotherapy this week for both peanuts and tree nuts. My civilian allergist is super supportive but unfamiliar with military accession standards. She needs a specific "Target Maintenance Dose" to aim for to ensure the final clinical notes satisfy a waiver board. My recruiter reached out to a source at N33, but the response was vague: "It’s not a numbers thing—they need to show that they can ingest and be in the vicinity of peanuts without any anaphylactic reaction."

While "vicinity" is clear (I can smell & touch no problem), "ingest" is pretty broad. To my civilian allergist "ingesting" could mean 300mg (one bite) or 8,000mg (a handful).

The Question - For those with experience in the waiver process or Flight Docs familiar with NAMI/N33 standards: Is there a specific protein gram amount or "number of peanuts/tree nuts" that the board expects to see passed in a final Oral Food Challenge? Thank you!
Click to expand...

I don't think this is a number anyone can answer for you. In the end, whether you ingest a little or a lot and it shows a reaction, you are still DQ. By the way, in the MANMED it calls out no allergy immunotherapy within a year for aviation.
 
Does anybody have experience with nasal polyps becoming a problem with flight doctors. I had them in the past and not sure if they came back after past surgery to remove them. Would it be an automatic dq if I do have them?
 
Hey there, I currently have a ganglion cyst in my wrist, and I plan on getting it removed. The doctor said I will lose around 15 degrees of ROM in that wrist. It's not much, but is that something I should be worried about? I looked through the aeromedical reference and waiver guide and couldn't find anything regarding ganglion cysts or wrist ROM. I'm assuming if I make a good recovery and can still perform basic tasks, I should be fine. Is this a poor assumption?
 
Cyst should be fine, especially if asymptomatic.

As far as I can find, there's no exact standard for ROM in either NAMI waiver or anthro standards. Maybe someone else knows where to find them/has experience, but as far as I'm aware, as long as the limited ROM does not impact daily life or flight function, it should be fine.

I'm missing about 10* in a knee + elbow from injuries before the military. Flight doc tugged on my joints a bit and it was never mentioned again.
 
fighter-cat22 said:
Pretty strange scenario I’ve got. So I went to MEPS about little over a week ago. I’m cleared for everything except when the doc went over my medical history. — last year I went to a joint clinic about some shoulder pain I had from rock climbing. He assessed me, scheduled an MRI and arthrogram and sent me home. I waited a few days and the pain just kind of went away after I stopped climbing so frequently (still no pain to this day), so I decided to not get the MRI. — in the present, the MEPS doc tells me the other Dr had “diagnosed” me with a dislocation and torn labrum. The MEPS doc said the other Dr probably wrote this in and was going to rule it out after the MRI, but because of how it was worded in the note, it basically said I was diagnosed, and he hadn’t changed it because I didn’t get the MRI. MEPS doc did a focused assessment, said I have full ROM and function (noted that in my chart as well), but told me he would have to DQ me, because of the “diagnosis” and to just get a waiver for it since it’s too late to try and change the record (over 12mo ago now). Currently waiting on the waiver.

-Will this come back to bite me later on?
-Will this sort of waiver take longer than most because of the technicality?
-Will I even require a waiver after the navy docs see that I don’t have an MRI in my chart since it’s impossible to diagnose a torn labrum without soft tissue imaging?
Click to expand...
Reviving this post to provide update.

BLUF: Went back to original doc, he said my shoulder looks great and noted that in his opinion, I’m fit for service.

I had gotten the waiver from N3M shortly after my original post, but I know the OCS physical is a little more intense than MEPS, so I was still concerned. I decided to back to the original diagnosing doctor and explained to him my whole situation. He understood my concerns and checked me out accordingly. He noted my statements about the pain subsiding after I stopped rock climbing (hence no MRI), and after assessing my shoulder, noted I had no signs of instability, no weakness, and full ROM. This is now in my record, and I hope that it being the same physician that checked me before will carry some weight at OCS.

Thank you @Gatordev @exNavyOffRec and @taxi1 for the input on my original post, it helped a lot.

Let this be a lesson to anyone who comes across a similar situation. Always get your records straight BEFORE you get to OCS.
Fly Navy.
 
You must log in or register to reply here.
Back
Top