NAMI Whammied

[StJP4Us]

It's been a while since I did my PFT during OCS for my asthma waiver, but I would think there should have been an intake prior to the test that asks if you've been experiencing any respiratory illnesses recently and the test should not have been done without at least a discussion with a physician.

Moreover, the Aeromedical Reference states in the Respiratory section: "When referring patients with remitted childhood asthma for pulmonary testing, avoid testing in the setting of a recent (within two weeks) respiratory infection to minimize confusion and ensure reliable results are obtained." (https://www.med.navy.mil/Navy-Medic...itute/Aeromedical-Reference-and-Waiver-Guide/)

Nope. No intake. No questions asked. No credence given to the aeromedical reference and waiver guide document. It's like they wrote it but want to ignore it. Might be time to give the Army a look...

 

[FloridaDad]

If they didn’t follow protocol can you appeal to someone above them in the chain of command?

 

[StJP4Us]

If they didn’t follow protocol can you appeal to someone above them in the chain of command?

I wish. Many flight surgeons in my recent experience are treating them as the top of the CoC. I've been given the advice for the congressional inquiry since yes, I do believe they didn't follow their OWN protocol.

 

[HSMPBR]

If they didn’t follow protocol can you appeal to someone above them in the chain of command?

Strenuously object?

 

[UInavy]

If you don't mind us asking- was this at NAMI pensacola? What do you mean by 'surgeon general' waiver?

 

[taxi1]

Yes. Every flight doc there that interceded on my behalf was just met with swift "hard no's". No consideration, even with all of my previous documentation. Even took another set of lung function tests after getting over Covid, a doctors letter saying I had Covid, but to no avail.

If it happened as you say, and you’re not forgetting to tell us that you took a dump in the med center OIC’s office, and all other avenues have been exhausted, contact your congressman. Nothing ventured…

I wrote this before I saw your last post. Yep, don’t let them break their own rules.

 

[StJP4Us]

If you don't mind us asking- was this at NAMI pensacola? What do you mean by 'surgeon general' waiver?

Yes NAMI pensacola. I was denied at MEPS for this and needed help from the flight surgeons to write me supporting letters so that the surgeon general of the navy would give me a waiver.

 

[StJP4Us]

If it happened as you say, and you’re not forgetting to tell us that you took a dump in the med center OIC’s office, and all other avenues have been exhausted, contact your congressman. Nothing ventured…

I wrote this before I saw your last post. Yep, don’t let them break their own rules.

Haha... I didn't do that and I'm not leaving anything out. I've had countless flight surgeons back me up but NAMI is telling me to go pound sand. No explanation. The only thing I was told is that this was an "occupational decision." Then it is like they shut down my file permanently.

 

[UInavy]

Yes NAMI pensacola. I was denied at MEPS for this and needed help from the flight surgeons to write me supporting letters so that the surgeon general of the navy would give me a waiver.

Ok, so you were at NAMI, they recommended the waiver to BUMED, but BUMED said no? Did you get the approved waiver paperwork from NAMI? Do you have the denial paperwork from BUMED?

 

[TimeBomb]

This whole thing is bizarre. Having had a normal methacholine challenge within the prescribed time frame should have answered the question regarding asthma. A negative challenge is quite good at excluding asthma, but positive test can be caused by a recent infection, as you've demonstrated. In my anecdotal experience, COVID seems to be especially likely to cause residual lung abnormalities long after the clinical infection has resolved, which should invalidate the results of methacholine challenge. NAMI doubling down on their position is also strange. Makes me wonder if something else is going on down there behind the curtain. They're going to have to get this sorted out, since there are going to a metric crap ton of positive methacholine challenges in the months and years to come as a consequence of the pandemic.

Keep us posted on this if you can.

V/R

 

[StJP4Us]

Ok, so you were at NAMI, they recommended the waiver to BUMED, but BUMED said no? Did you get the approved waiver paperwork from NAMI? Do you have the denial paperwork from BUMED?

I don't quite know what the waiver process is tbh. NAMI isn't an authority right? BUMED makes the final decisions but they rarely if ever deviate from NAMI's reccomendations. Which is what NAMI said they would do, not reccomend a waiver. They shooed me out of there so fast, didn't even let me talk to them. I tried to follow up with some emails and others on my behalf but it has been met with such swift resistance. If anyone has any success stories on this I wouldn't mind hearing them right about now. Not about to put all of my eggs in the congressional inquiry basket.

 

[FinkUFreaky]

It's been a while since I did my PFT during OCS for my asthma waiver, but I would think there should have been an intake prior to the test that asks if you've been experiencing any respiratory illnesses recently and the test should not have been done without at least a discussion with a physician.

Moreover, the Aeromedical Reference states in the Respiratory section: "When referring patients with remitted childhood asthma for pulmonary testing, avoid testing in the setting of a recent (within two weeks) respiratory infection to minimize confusion and ensure reliable results are obtained." (https://www.med.navy.mil/Navy-Medic...itute/Aeromedical-Reference-and-Waiver-Guide/)

Had to do the same, they sent me to take the test shortly before I was diagnosed with pneumonia (but I was already very symptomatic, and had already seen medical once for it and told it was just a cold). I couldn't even take a deep breath without coughing crazy. Luckily common sense prevailed, and they sent me for a re-take a few weeks later.

 

[StJP4Us]

This whole thing is bizarre. Having had a normal methacholine challenge within the prescribed time frame should have answered the question regarding asthma. A negative challenge is quite good at excluding asthma, but positive test can be caused by a recent infection, as you've demonstrated. In my anecdotal experience, COVID seems to be especially likely to cause residual lung abnormalities long after the clinical infection has resolved, which should invalidate the results of methacholine challenge. NAMI doubling down on their position is also strange. Makes me wonder if something else is going on down there behind the curtain. They're going to have to get this sorted out, since there are going to a metric crap ton of positive methacholine challenges in the months and years to come as a consequence of the pandemic.

Keep us posted on this if you can.

V/R

They ran a FeNO test on me as well. That came back astronomically high and was the reason why the waiver was denied. They didn't even let me do a methacholine challenge test down there. Just took the PFT, failed it, and told me to leave.

 

[UInavy]

I don't quite know what the waiver process is tbh. NAMI isn't an authority right? BUMED makes the final decisions but they rarely if ever deviate from NAMI's reccomendations. Which is what NAMI said they would do, not reccomend a waiver. They shooed me out of there so fast, didn't even let me talk to them. I tried to follow up with some emails and others on my behalf but it has been met with such swift resistance. If anyone has any success stories on this I wouldn't mind hearing them right about now. Not about to put all of my eggs in the congressional inquiry basket.

BUMED should be for accession waivers, while NAMI is aviation specific and more restrictive. @exNavyOffRec can probably expand on that. That said, an initial denial is not the end of the world. I had a waiver denial a couple years (decades) ago and just re-applied for the waiver after whatever time period they told me. I would work toward that, vice a congressional inquiry were I in your situation. (That is only if I’m understanding you correctly.)

 

[TimeBomb]

FeNO is high in patients with COVID (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471694/). Using that test as a marker for asthma in the setting of active or recent COVID infection seems ill-advised, in my opinion.

V/R