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The Doctor is in! Ask a Flight Surgeon!

picklesuit

Living the GeoBachelor dream...
pilot
Contributor
Does your "friend" go to the flight surgeon, because it sounds like he probably should. Also, when you say you don't go to the flight doc, what does that mean in a practical sense?
My friend (it really isn’t me) had the XO/CO visit said friend in the hospital...the command is aware. Very med down for the foreseeable future.

When it comes to me, I either don’t go to the doctor with an injury, because she is overly aggressive with down chits, or I ask for another doctor when I make an appointment and start the conversation with “I don’t want a down chit” and gauge their reaction before I press forward. You know which one will be a good doc in the first five minutes.

I also have access to lots of veterinarians. And a bachelor’s in Animal Science. And I’ve been treating my own animals for years (under the guidance of good vets); I can suture, splint, and treat injuries better than most people in flight medicine.

Anyone that is friends with me on FB can vouch that I walked off a pretty serious leg injury about six weeks ago. It sucked, I’d have loved some good pain meds, but I’d rather fly. I’m a little jaded after several overly conservative flight docs and watching people go med down for silly shit.

When I finally went to the doc (not mine) to assuage my family he started with “do you want a down chit or to keep flying?” I could have an honest conversation with a doc like that, and I consented to an ultrasound, some meds, and rehab.

And I kept flying, because I could.

Our doc would have downed me.
 

Brett327

Well-Known Member
None
Super Moderator
Contributor
When it comes to me, I either don’t go to the doctor with an injury, because she is overly aggressive with down chits, or I ask for another doctor when I make an appointment and start the conversation with “I don’t want a down chit” and gauge their reaction before I press forward. You know which one will be a good doc in the first five minutes.
Some Flight Docs haven't yet been faced with the fact that they're not just doctors - they're also like the NFL sideline Doc that keeps their athletes in the game so they can put a win on the scoreboard. Some Docs find that balance instinctively, other's have to be trained.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
I also have access to lots of veterinarians. And a bachelor’s in Animal Science. And I’ve been treating my own animals for years (under the guidance of good vets); I can suture, splint, and treat injuries better than most people in flight medicine.
Do you take cough medicine prescribed to Smuckers?

[thread dreail]

I've had a couple of good FS who knew what the overall intent of their job was while still working within the system. One was at the VTs, where keeping IPs up was mission #1. Mission #2 was keeping the immunization nazi nurse in check.

But my last FS was incredible, and a brand new FS as well. As a DO, he went out of his way to help helo guys with the various pains we suffer, and was very good at it. He also knew how to work the system to get you the care you needed as soon as was possible, which is of course never timely in the Navy. He even got me out in town, out of network, to address something that the Naval Hospital wasn't making any progress with.

I've also had to utilize flight surgeons/docs to find out what was going on with my people to ultimately figure out what they needed or if they needed to be put on the bench for a bit.
 

TimeBomb

Noise, vibration and harshness
Junior flight surgeons are often put into a tough spot. Most are fresh from internship, and that junior FS tour will be the first time they are practicing truly independently. "Conservative" doesn't begin to describe how the thought process goes. Despite the LT bars, most have only 2 years on AD and a 6 month run through NAMI when they hit the squadron. Think back to where you were in terms of flying, administrative and leadership skills at that point in your career.

Ideally, a junior FS will have a residency trained doc over the clinic to mentor him/her and work toward finding that balance of flight safety, mission completion and patient autonomy. Some get it fast, some get it eventually, and some don't ever get it. Pretty much like life in general.

V/R
 

LFDtoUSMC

Active Member
pilot
Contributor
@picklesuit , it took me almost 7 years to get a waiver for pleural effusion. Mine was surgically resolved and included the placement of four, yes four, chest tubes. 2 months post surgery I was totally fine and back to living normally.

Of course I was just an applicant trying to get a commissioning physical. That is what took so long. Once I got to NAMI they had no trouble with all of the documentation I had showing I was healthy.

Best of luck to your friend. And, of course make as much fun of him/her as you can as they use the incentive spirometer. But seriously, as much as it hurt to use that thing post surgery, they will need to. I am sure they have more than a few PFT (Pulmonary Function Tests) in the future once healed.
 
Hello Doc(s),

In May of 2017 I was unsteady and dizzy for a few days. I went to the ER and was diagnosed with Benign Positional Vertigo (BPV), where minerals or natural debris in the inner ear canals "break lose" from where they were attached in the ear canal and create the sensation of moving when you are stationary (dizziness). The doctor explained this is the most common form of vertigo, and in my case there is pre-existing condition that would case it. Fortunately for me, it did not hit me instantly and built up for a few days, otherwise if it was instant it would be Benign Paroxysmal Positional Vertigo (BPPV). The doctor also explained BPV can happen to anyone at anytime and there is no cause for concern it will happen again (i.e. having BPV once is not a predisposition for it happening again). The doctor did a head/neck movement to "shake out" the debris and for got medicine to reduce the dizziness. Two days later I was back to my normal life and routine. This was the first time I have every experienced something like this and have not had any symptoms or issues since then. I got cleared for MEPS and went in early December and will go back soon to finish the process because of an unrelated issue that actually turned out to be nothing.

According to the Aeromedical Reference and Waiver Guide chapter 6.6, benign positional vertigo may be waiverable.

I am wondering, would N3M/N33 take a look at the documents I provided before I was cleared to MEPS? Or would they only look at the documents if MEPS did not clear me? My OR gave no indication to that or if I need a waiver. I do not want to learn at OCS I need a waiver when I can do it now.
 

TimeBomb

Noise, vibration and harshness
What was your "pre-existing" condition?

I don't know the workflow betweem MEPS and N3M, so I can't speak as to whether a MEPS appointment is evidence that N3M has seen any medical information. I doubt that it does, however.

You probably meet commissioning standards without more workup. If you're trying for aviation you're going to need a lot more testing if NAMI would even consider waiver recommendation.

V/R
 
What was your "pre-existing" condition?

I don't know the workflow betweem MEPS and N3M, so I can't speak as to whether a MEPS appointment is evidence that N3M has seen any medical information. I doubt that it does, however.

You probably meet commissioning standards without more workup. If you're trying for aviation you're going to need a lot more testing if NAMI would even consider waiver recommendation.

V/R
OOPS, I misspoke.

I DO NOT have any pre-existing condition that would BPV. And having it once does not mean I will have it again.
 
First time post in this thread.

I got selected for NFO and went down to NAMI to have my physical in August. Everything turned out fine. Recently, I have been diagnosed with Tarsal Coalition in my right foot, which is where the bones in my foot are fusing together. It usually doesn't cause me much pain, but every now and again it will severely flare up. I baby it to make sure to avoid flare ups, but sometimes it just happens. (Like running over 3 miles at a time will usually make it flare up.)

The civilian orthos I have been to say the only way to truly fix the issue is to have surgery on my foot. Either I can just try and manage the pain as best as possible, or get this surgery.

My tarsal coalition issue isn't anywhere in my file and I hadn't been diagnosed with it when I had my NAMI visit. Should I go through with the surgery? How will this affect my career? I don't want to get DQ'd over this. I know Aviation is pretty strict on medical issues.

Any and all suggestions are appreciated. Thanks in advance.
 
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