Question for flight surgeon

[jg54170]

I have been temporarily DQ'd for SNA pending a screening of my back pain. A quick history and explanation is..joined Navy in 2006 great health and no problems, went through the Marine Corps basic corps in Lejeune and their machine gun team trainer, following our work ups deployed to Iraq in 2008 for 7 months. At this point (during deployment) I started to experience lower back pain. Not shooting pain but right along the sciatic nerve...a pressure inwards is the best way to explain it. It is on both sides but stays localized to the lower back along belt line. Did another work up and deployment this past year 09-10 to Iraq for 7 more months. The pain has exponentially gotten worse..ie: it is getting more painful at a faster rate the longer I go.

Command would never do anything other than pain medication. When I went for SNA and flight surgeon saw that I was on Flexoral(sp?). He said it was a big no no for flying and if the command is giving me it than they need a justification basically. He sent me straight to radiology were I received x-rays showing transitional anatomy at L5 I believe. It also recommended an MRI which showed a pars defect...no idea what that is but my IDC said one vertebrae is longer and formed in a slightly twisted way.

He put in a consult to the spine folks at the orthopedics center down at Portsmouth Naval. They declined to see me until I had completed a physical therapy regimen. Next week we begin our training cycle for a deployment early next year. IDC said to schedule another appt. with flight surgeon to see if I would still be disqualified based on what we have found.

Facts: I am not in enough pain to where it is debilitating. I have bad days but nothing that has ever put me down from a mission or training. I PT with my detachment every week day and am in great physical shape.

Question: If I am able to function without the pain killers, is there any reason that the flight surgeon would DQ me at our next appt? I don't want to waste my time or his/hers.

Any input would be appreciated.

 

[ArkhamAsylum]

Note: I'm not a doc.

From what I've observed, the docs will DQ you for just about anything. Like almost everything else in the military, it's all about who sees you that day. I'm not sure if there's a manual out there that lists the specific conditions and medications that make you NPQ, or if it's all based on doctor judgement with the guidance from annual committee meetings. Since you probably have a slew of documentation in your medical records, any attempt to hide it might be futile. The best you can do for now is to say that your back has miraculously healed itself, and gut it out with OTC painkillers for the bad days. After you get winged, you can usually get a little more grace from the docs. Especially if you drink beer with them once a month.
I have two medical conditions that should technically down me, and the above techniques allow me to continue flying.

 

[jg54170]

Thats what I assume I am going to have to do. As I said, I am not incapacitated, I just ache and have some rough days. Thanks for your input.

 

[feddoc]

The drug you are taking is a muscle relaxer. Works pretty good.

I think your chances for getting what you want will dramatically increase when you can function without taking pain meds. I suspect your missions are much more physically demanding than flying. Maybe with some physical therapy and some time, your back pain may decrease enough to the point where you can function without painkillers/muscle relaxers

The doc will mostly look for two things...1. Good range of motion and 2. Minimal pain.

 

[jg54170]

So here is the update, I went to a physical therapist and they sent me away saying they could do nothing for me and I needed to see an orthopedic surgeon. I am in great shape, have good ROM, don't smoke, and am not over weight, physical therapy was useless was their view.. She then printed out the MRI report and explained it to me totally different than my IDC had. I have a bilateral pars lysis on both the L4 and L5 later referred to as a spondylolysis or fracture of the pars. When I asked my IDC, he said "well she explained it better" and "I wouldn't use the word fracture, there may be a crack or defect" Seems as if he is tip toeing around the situation. He was going to speak with his ISIC, a Dr. at RIVGRU to see what our next course of action is.

My concern is that the Dr. that I saw for physical therapy showed concern that it could lead to more problems specifically in a traumatic event. She also mentioned that it could never be a problem, who knows. My IDC said he thinks I should live with it and take medication. The only medication that has given relief is tramadol which had side effects I was not thrilled about. This is mainly the reason I take none of the medication prescribed.

Hopefully ortho will see me now that I have been to physical therapy.

Is there anything in the manuals that would keep me from flying with the spondylolysis/pars defects/fractures/or whatever they are? If anyone can find out, it would be greatly appreciated.

Again, I am not pain free but have good ROM and function well without pain meds. Been living with it for two years and doing fine.

 

[feddoc]

http://www.med.navy.mil/sites/navmedmpte/nomi/nami/arwg/Documents/Waiver Guide - Ortho.pdf

If you have been diagnosed with spondylolysis, things don't look to be in your favor for you to be an Aviator. Get a second opinion. Maybe the ortho doc will find that diagnosis to be incorrect. The Physical Therapis was right, assuming the spondylolysis is correct, in saying that traumatic events could make it worse. The wear and tear of flying would likely make it worse.

 

[jg54170]

Thanks again. It will be interesting to see what comes of this. I imagine my IDC is tip toeing around the issue cause he wants to minimize how it appears. Command is already undermanned and they would hate to descreen someone.