Old dog new tricks

[Camperman]

Hi everybody, this question is for the doc and whoever wants to weigh in. I'm new to flight. Years ago I was targeted on the Academy, had a Senator's nomination, and didn't get in. I let myself get off course after that. I could go more into detail if you want, but here I'll fast forward to today.

I turn 30 in a few months. I had planned to participate in the March board for USMC recruiting, but my medicals took a long time and I've recently been DQ'd, on account of undiagnosed but documented heart racing issues.

When I was an infant, I had SVT, but was cleared at age 1. In my early 20's, I had a very stressful time with school and a girl, and this is what I think triggered the first, and second major heart racing issues, the second being the worst episode I've had. I went to get it checked out, and did a stress test/EKG/etc (2005?). Nothing was diagnosed, and they chalked it up to panic/stress. I've since had about 10 distinct episodes, with none happening in at least a year. I remarked on this as a history item when I went for counseling early in the summer because I was in a funk; part of getting out of that funk was realizing I still wanted to serve my country. This documentation must be what put DODMERB on edge.

I didn't have a clear picture of the NAMI timetable from my OSO, but now that possibility is pushed back behind two options to clear DODMERB:

1- Waiver. I don't have the letter back yet but will look into this.

2- New study/clearance from a doc. I've already decided to pursue this route and I'm going Monday for an interview.

My goal now is to hit close to a 300 pft since I'll be 30 the next time I go for a board review. Here's the good news, I don't come in to brag, I'm almost more begging for advice. I've had no flight training other than maybe 10 minutes behind a Cessna yoke. Apparently God's gifted me in this arena, I took the ASTB for the first time last week and did 72/9/8/8. I followed some of your advice on this site and got some recommendations from an old friend who started as a Marine Hornet and is now a Navy reserve instructor. I believe I can do this and do it well, and I intend to work exceptionally hard in the next few months to get a second chance.

I feel like I'm a Marine who's been having an out-of-uniform experience for years now. Does anyone have any advice for me on how to address the medical reviews?

Also thanks to the Webmaster; I was having posting issues & he worked it out.

 

[Camperman]

Hi all. Here's an update, let me know what you think of this plan.
I've scheduled an appointment with an Electrophysiologist/Cardiologist today. I have not received my letter from DoDMERB yet, but will speak with them again before the appointment to get an email or other exact wording.
With that done, I will try to contact NAMI and coordinate activity between a flight surgeon and my Cardiologist, in the interests of efficiency.

Since it's already on my record, I don't see a point to trying to keep NAMI as a fresh & different study from what DoDMERB has decided, but will try to get everything done quickly, so if I am cleared for OCS I can simultaneously prep for the NAMI physical.

 

[Camperman]

Further update.

I spoke with NAMI yesterday prior to seeing the cardiologist. From the Cardio doc, I got the information about an electrophysiology (EP) study, with a concurrent ablation if some bad nerves are discovered. The process involves getting rigged up with a bunch of catheters and having chemicals cheese with the heart to induce tachycardia. I don't think I need it, and it sounds all kinds of unpleasant, but I'm willing to do it if it clears the air for BUMED and ultimately NAMI.

I'm grateful to have an OSO who went in at 29; she was younger at commissioning than I will be but has similar experiences to give me advice on going in at my age. My next big thing is to wait for BUMED to process the waiver? DoDMERB said I had the two options outlined above, but the impression I have is that #2 New Study is something that might be called for by BUMED. If I go this route, is there any way to be not only "medically acceptable", but "medically qualified", and does that matter?

 

[picklesuit]

At 30, I believe you are too old for a flight contract without a prior service waiver.
Might be a lot of work for nothing.
Pickle

 

[TimeBomb]

Camperman,
I'm with Pickle on this. Please be certain you can get a flight contract at your age before you spend a lot of time and treasure getting an electrophysiology study, and potentially, an ablation. Even after all is said and done, NAMI may not recommend a waiver depending on what your original arrhythmia was. Again, depending on the nature of the arrhythmia, the ablation procedure may permanently damage your heart, to the point where you need a pacemaker. Obviously, no waiver for that.

Catheter ablation for asymptomatic arrhythmias is a little controversial. If you have symptoms of light-headedness, chest pain or poor exercise tolerance when your heart is racing, the decision is a little cleaner.

Forgive my ignorance, but what career options would be open to you commissioning at age 30?
R/

 

[Camperman]

Forgive my ignorance, but what career options would be open to you commissioning at age 30?
R/

Hey guys, thanks for the response. I've already been talking about an age waiver; if I'm grounded then I will probably wind up in an MOS related to drones, but being interested in service I won't be disappointed in most roles. Is that your question?

Several years ago I had a few episodes where I could describe some lightheadedness, the most recent episodes, which were well over a year ago, were extremely brief and mild with no lightheaded feeling; the last one didn't stop me for anything. I've learned squeezing my core can control or even prevent an episode. I'm of the mindset now that being practiced with handling my blood pressure is actually a boon for flight; I'm a roller coaster junky when at parks and prefer to be under duress. Last weekend I did a tough mudder, and will be doing a mini-OCS at Parris in a couple weeks so I don't think my 102.95 "Unknown or unexplained cardio...impair an active lifestyle" is a complete explanation.

 

[TimeBomb]

Camperman,
The choice of MOS is what I was driving at. The chance of an age waiver for student naval aviator (SNA) is probably pretty low. Lots of supply means the aperture for waiver recommendations is small. If you're willing to serve in any MOS, your chances of getting a commission may rise a bit.

Physiologically, when you increase intraabdominal pressure by bearing down, you increase the discharges of the nerves that slow the heart. The EP study will tell the cardiologist exactly what is happening and the best way to deal with it. A history of SVT is disqualifying for commissioning. A waiver is possible after ablation therapy for specific dysrhythmias after three months have passed, and the ECG is normal. See DOD Instruction 6130.03 for details. Once you clear the hurdle for general commissioning, you still have to clear NAMI if you want to go aviation.
R/

 

[Camperman]

So I did something stupid. The annual mini-OCS is this weekend. Knowing I still had some time to talk with DoDMERB, I arranged to have a 48-hr mobile ECG study started just before I left for Parris Island. I spoke with my recruiting officer to seek permission, as I did not think that the electrodes would interfere with any activity. It turns out Parris is too concerned to bring me on even for two days.

Do any of you know who I could talk to about this? My recruiter is dealing with the people at Parris. I've tried to make the case that I know myself fairly well, and have solid confidence that nothing is going to happen to me during the weekend. Even if it did, I signed enough paperwork to know I can't hold the USMC responsible for my well being, and even if I could, that's not something I would do. My recruiter's told me not to worry about missing the mini-OCS, but I'm 50% of the contingent from my town and don't want to let the team down. Also I wonder about the long term precedent, when all someone may see later is a DQ on my list and nothing else.

 

[Camperman]

Hi all. I missed the mini-OCS, but that's not a major loss apparently. I did the 48 hr ECG and didn't have anything show up during rest or exercise. The cardiologist I'm seeing has spoken with DoDMERB; the path forward is either an EP study + ablation, or psychiatric to rule out panic attacks. Though I don't relish getting stabbed the former seems more solid. It's either that or wait 6-8 months for BUMED, the time I'm told it takes these days. If I get an ablation I could perhaps be reevaluated in a couple months and cleared at DoDMERB up front.

I was also told by the cardiologist that an ablation would only be suggested in my case, were I not an officer applicant, if I was an airline pilot. Since aviation is still in my sights, I think I should pursue this and shut down all concern. My recruiter's informed me that the SNA rating, as you mentioned with age, is a very slim chance at my age, but becomes possible if I get my PFT nearly perfect. That ball rests in my court so I need to run up to it.

 

[Camperman]

Beyond the story, here are some direct questions.
1. If I wait for the waiver, will I have to get another one to possibly fly?
2. If I go ahead with the ablation and it clears DoDMERB with no DQ, will I need a waiver to fly anyways?

 

[Camperman]

Camperman,
I'm with Pickle on this. Please be certain you can get a flight contract at your age before you spend a lot of time and treasure getting an electrophysiology study, and potentially, an ablation. Even after all is said and done, NAMI may not recommend a waiver depending on what your original arrhythmia was. Again, depending on the nature of the arrhythmia, the ablation procedure may permanently damage your heart, to the point where you need a pacemaker. Obviously, no waiver for that.

Catheter ablation for asymptomatic arrhythmias is a little controversial. If you have symptoms of light-headedness, chest pain or poor exercise tolerance when your heart is racing, the decision is a little cleaner.

Forgive my ignorance, but what career options would be open to you commissioning at age 30?
R/

It may seem foolish, but I think this may be what it will take for me to fly. I'm trying to contact NAMI to get an answer on whether this will help or hurt. I would describe more of a headache than lightheadedness during an episode, but nothing that would impair me, which is why for any other route I wouldn't consider the procedure. The cardio doc seems confident though.

 

[TimeBomb]

Camperman,
If you end up getting diagnosed with a dysrhythmia that needs ablation, you will then need a waiver for general commissioning. That is your first obstacle. You must be physically qualified for general commissioning (or have a waiver of standards) in order to be commissioned. See DODI 6130.03 for details on how to get a waiver for commissioning with a history of dysrhythmia.

If you successfully complete the process for commissioning, you are potentially eligible for student Naval aviator (SNA). The waiver process is tiered. You can't get looked at for flight unless you are PQ or have a waiver for general commissioning.

Your second obstacle to getting into Naval aviation is getting an age waiver for SNA. I don't know what the odds are of that may be these days, but historically I've never seen a waiver for SNA at your age without prior service.

If you successfully get an age waiver for SNA, you third obstacle will be your history of dysrhythmia (I'm assuming the cardiologist will find something and treat it appropriately). You will need a NAMI evaluation for that, and they may or may not recommend a waiver depending on the dysrhythmia and the outcome of the ablation process.

In summary, it's going to take a lot of long shots coming in for you to fly in the Navy.
R/

 

[Camperman]

Timebomb,

Thanks for the response & link to the DODI. I checked it, I don't know if I'm reading the wrong section or if it's been updated, but the waiting period post ablation is now 3 months under 12.g.(3). I don't know what, if any, particular dysrhythmia I have. I do know it's been at least a year, and close to two, since I've had any activity, and makes me wonder if I should argue for qualification based on 12.g.(2).

I already know I'm fighting for an age waiver for ground qual (is that PQ?), and that rests on my PFT effort. I'll be doing the same for Marine SNA, my recruiter thinks that if everything else is cleared up this could take a couple months. I'm looking at ~2-3 months clear with DoDMERB, 1 month ground age waiver, and ~2-3 months SNA age waiver, still beats 6-8 months BUMED ground waiver, certainly as I get older.

 

[Camperman]

Hi everybody,
Thanks for your prayers to my bros & sisters in Christ. I had an elecrophysiological study with a cardiac ablation Thursday. It took a few hours because he had a hard time getting the ablation catheter into the right spot, but he says he got rid of the extra pathway! The doc waited about 45 minutes after the burning to try to pace my heart into a tachycardia but he was unsuccessful. I have about a day of recovery left & then I'll hit the running again.

I spoke with DoDMERB, and -plot twist! BUMED approved my automatic waiver. I was expecting several months at least; my DoDMERB agent described it as miraculous. It happened literally the day after the procedure. The really weird thing is I have no idea how, if at all, the waiver, and the procedure, are related. I meant to do everything through DoDMERB & skip the waiver, so I wouldn't be carrying that through from here on.

Should I contact DoDMERB & still strongly seek to get the disqualification removed?

 

[Camperman]

Alright everybody, I need some good advice again. Since the BUMED waiver came through, I may be eligible as early as the July board. With my eyes I won't be eligible for an air contract and air age waiver yet, but could get in on ground and subject to demand compete for air at OCS. To do so I need to squeak in another PFT & get under the time for the 3 mile; my last was 24:23. I've beaten it before and know I can do it again. Unfortunately I just came off a segment of the A.T. and my knee is bothering me; nothing catastrophic but I don't feel up to running just yet. As I see it I have

1. Push for OCS now, run on iffy knee & perhaps get ground contract.

2. Get eye surgery now, re approach in 6 months for air contract and look at March review board; I'll be commissioning just after I turn 31. In this approach though I'll spend a lot more time doing PT & have a better PFT.