Childhood Misdiagnosis- what to do

[DaveI]

So here's the story, I am set to head to OCS in a month. I started gathering immunization records, dental records and medical records when I realize I have a problem.

I was about 11 years old and on a medicine I ended up being severely allergic to quinine (which I disclosed to the Navy at MEPS). Turns out the medicine actually made my throat close up a few times, so when I went to the childhood doctor he said it was asthma. My mother didn't buy it so she took me to a pulmonary doctor, who tested me for several things and came back saying I did not have asthma, that it was just the allergy to the medicine irritating me.

Eventually, when I went back to my doctor, I told him that and he noted that I had an allergy induced asthma- f*ing idiot.

I don't have asthma, and did not have a history of it, which was proved by a PFT, so I said no at MEPS. It makes perfect sense. The problem now is that as I read through the file, I see that he has the notes about being 11 with exercise induced, but the file is missing the forms I should have from the pulmonary specialist. It has been over ten years since I saw the specialist and the documents have been destroyed by now. I did however get a waiver on the inhaler prescription from having bronchitis in 2006, which I knew about and disclosed.

Needless to say here, I did not lie at MEPS, but I did not realize there was a controversial issue that could come out of my civil documents.

I am thinking I am just going to explain that I went to a doctor that said I had it and then got checked by a specialist that said I didn't when I get to OCS. I know I don't have it, but I don't want to look like I was hiding something. If I take this route, they should just send me for a PFT and Methocholine test at OCS right? Or would I be opening a can of sh** and I should keep my mouth shut?

 

[Mos]

Your main problem seems to be that you're missing the PFT record, which would back up what you said at MEPS. This could present a problem since you have other records that indicate that you had EI asthma.

I think your first action, if you haven't done this already, should be to try to get a hold of that pulmonologist and see if he still has your record, however unlikely it may be. If he does, there is still time for him to send you a copy, and your problem would be solved.

If he doesn't have that record, then you will have to try to explain the discrepancy to the doc at OCS as best you can. To strengthen the case that you don't have asthma, you can also try to get a new PFT done before OCS and present the results to the doc. A letter from the new pulmonologist is recommended as well. You may have to pay for this PFT yourself, which could be expensive (couple hundred dollars at least), so consider whether this would be worth the expense. While it may not be necessary to get a methacholine challenge with the PFT (something that makes it even more expensive), that might be something worth considering.

Depending on how the OCS doc judges the situation, you may have to undergo a PFT with methacholine challenge while at OCS. No big deal if you don't have asthma. They'll send you to a local hospital that has the equipment and you'll be done within an hour or two. Pass and this won't be a problem anymore.

Alternatively, you could just opt not to say anything until asked about it. Personally, I don't think this is the best course of action, considering that you've already (unintentionally) omitted information, and that omission could be easily discovered.

I'm not a doctor and I can't predict how the Navy doctors or staff will react to this situation. I make these recommendations based on my own similar experience with asthma diagnosis. If you're interested in knowing my story, just PM me. Consider discussing this with your recruiter if you haven't already. Good luck.

 

[CAMike]

Your main problem seems to be that you're missing the PFT record, which would back up what you said at MEPS. This could present a problem since you have other records that indicate that you had EI asthma.

I think your first action, if you haven't done this already, should be to try to get a hold of that pulmonologist and see if he still has your record, however unlikely it may be. If he does, there is still time for him to send you a copy, and your problem would be solved.

If he doesn't have that record, then you will have to try to explain the discrepancy to the doc at OCS as best you can. To strengthen the case that you don't have asthma, you can also try to get a new PFT done before OCS and present the results to the doc. A letter from the new pulmonologist is recommended as well. You may have to pay for this PFT yourself, which could be expensive (couple hundred dollars at least), so consider whether this would be worth the expense. While it may not be necessary to get a methacholine challenge with the PFT (something that makes it even more expensive), that might be something worth considering.

Depending on how the OCS doc judges the situation, you may have to undergo a PFT with methacholine challenge while at OCS. No big deal if you don't have asthma. They'll send you to a local hospital that has the equipment and you'll be done within an hour or two. Pass and this won't be a problem anymore.

Alternatively, you could just opt not to say anything until asked about it. Personally, I don't think this is the best course of action, considering that you've already (unintentionally) omitted information, and that omission could be easily discovered.

I'm not a doctor and I can't predict how the Navy doctors or staff will react to this situation. I make these recommendations based on my own similar experience with asthma diagnosis. If you're interested in knowing my story, just PM me. Consider discussing this with your recruiter if you haven't already. Good luck.

My wife is a physician and she read your response. You addressed the correct points in your reply- nice job. Proof is always good.

Mike

 

[DaveI]

Thanks for the advice guys. The original doctor said the files were destroyed, but I took a pft and ekg for a job last year and I have copies of those reports if asked to present proof. My physician that diagnosed that incorrectly also made a note in my civilian file stating I have been fine for years anyway. I think I'm good to go and will continue to tell the truth

 

[feddoc]

I think you will be good to go also.

Waiver guide says this:
APPLICANTS: Waivers for applicants may be considered if all of the following are true:
1. The individual has been asymptomatic for a minimum of five years without medication.
2. Baseline pulmonary function testing (PFT) is normal
3. Methacholine challenge test is negative.


I doubt they will do a methacholine test..but, if they do, I think it will be on USNs dime.

 

[DaveI]

So Feddoc, are you saying that I should bring the pft results I have on hand from last year showing I'm fine, or maybe even get another done and bring it, and also bring a note saying I am asymptomatic to OCS?

On the other token are you saying I am good to go, but not bringing it up since it's really just an error in my documents, and have someone with the back up on hand if asked to present my case one day?

 

[feddoc]

Most assuredly bring those notes/papers/results. Make it easy for the NAMI/NOMI folks to make their decision. I think one PFT will do, along with the asymptomatic note...especially if it reads 'asymptomatic since XX, XXX'. I bet someone at OCS will ask you about the asthma stuff.

 

[DaveI]

Thanks for the advice, I have copies of everything and I will get a PFT done this week to just for my evidence. This is a shitty spot to be in, as I have been telling the truth all along, however given that it is the truth, I would think that this is no problem at all and it should be a quick and painless waiver process. I would hate to see all sorts of problems come in the future from not disclosing this now.

Is it quicker to get a waiver while doing a physical at OCS than it was with MEPS, or will I be in H for 2 months while they get it together?

 

[feddoc]

I disagree that this is a shitty spot to be in. You have kept your integrity intact and you are about to emark upon a career than many cannot obtain. Relax and plan for your future.


Someone at OCS will likely ask you about the asthma. IF they do, and only IF, show them your stuff. If they don't, I am certain that the folks a Pensacola will. Don't worry about the waiver, let it come to you. I think you are well prepared for it.

 

[DaveI]

I picked up the older PFT test from last year and will do the other this week.

On the last PFT I blew 125% of the predicted FVC and 114% of the predicted FEV1... I am not too sure about how to read these things, but after googling a bunch that looks like it should be good enough to prove my point.

 

[feddoc]

Predicted FVC = Forced Vital Capacity (the most you can exhale AFTER max inhalation ....sometimes it is referred to as the most you can inhale after max exhalation)

Predicted FEV1 = Forced Expiratory Volume (the amount of air you can push out after deep inalation) FEV1 = that in the first second of the FVC above.

Here are the formulas used.

http://www.hopkinsmedicine.org/pftlab/predeqns.html

 

[DaveI]

Okay so according to those formulas, the Pred. FVC (L) was 4.97 and I did 6.34 and the Pred. FEV1 (L) was 4.24 and I did 4.99, thus my %pred was above 125 for FVC and above 114% for FEV1. At the same time my FEV1% was 80, while the pred was 85. I suppose that means I only did 93% of the FEV1%, however from what I have read, it looks like the FEV1% is not an important number if your FEV1 and FVC results were healthy.

Beyond that, all I know is the doctor said I was fine haha I really have no idea what these numbers mean or how to read them.