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The Doctor is in! Ask a Flight Surgeon!

Very true. I was hoping to apply for the upcoming April board. I will see what NAMI says, if I do have to get it removed I wont make the April board due to operational commitments.
 
USMC candidate here.
A circumstance that I don't think has come up in this thread yet: passing a methacholine challenge test(s), and failing another.

I was granted a waiver for MEPS for childhood asthma (2019), after having completed two methacholine challenge tests (MCT), one in 2009 and 2015,
along with assorted pulmonary function tests (PFT) from 2015 to 2019. Both times I have taken the MCT, the results for asthma came back negative, i.e. FEV1 stayed >80%
across all 5 doses, and got a Dr's note clearing me. Have had no use of inhaler, no hospitalizations, etc from age 12 onward.

After arriving at NAMI for my flight physical (Nov 2019), I was instructed to take another MCT at Pensacola (likely to have one within 1 year as per NAMI waiver requirements). However, this one
I failed, with a score of 75%. I passed all other tests at NAMI, but received word I did not pass my flight physical.

Over the following two weeks, what I thought was me feeling under the weather progressed into a full sinus infection, and when I finally went to the Dr, was stated as having progressed to bronchitis.
This was ascribed as likely due to allergic rhinitis (we got a cat in Sept, which I am allergic to). I took antibiotics for it, it cleared up. Cat is no longer allowed in the bedroom.

After antibiotics, I took another MCT with a private doctor (Jan 2020), and passed (90%). I submitted this result to NAMI in January, but was told after submitting it/review
this new result was not enough to get a waiver.

The NQP letter states:
  1. "Not physically qualified but aeronautically adapted" for all duties involving flying due to Asthma (J45) (disqualified).
  2. Waiver is not recommended
  3. This recommendation is permanent.
Report of medical examination states:
- hx of asthma, PFTs/MCCT abnormal - CD, WRN

Do I have any recourse to ask for a retest at Pensacola/another Navy hospital, or to ask to nullify the previous test? Or, is there anything else I can do to help bolster my case/get that waiver?

Thank you.
What antibiotics were you taking when you passed?
 

Chippewa19

Puts the cart before the horse
What is the letter of the law on "current" conditions listed in the NAMI physical?

I went to my cardiologist for palpitations (that turned out to be muscle spasms) and he was adamant that I get a sleep study done.
The sleep study showed that I had moderate sleep apnea, and I'm waiting to hear back from the doc on what to do next (Mouthpiece vs CPAP vs nothing). My heart monitor also showed some arrythmias that the cardiologist said he could correct with ablation

DD 2807 is clear on "do you now or HAVE YOU EVER HAD xyz", and I've double checked both DoDi 6130.03 (MEPS) and MANMED Ch. 15 which say that Current treatment of OSA is disqualifying, so if I am compliant with therapy and lose (honestly quite a bit) of weight, and show that I don't need treatment (with a clean sleep study and a letter from the doc) I should be clear with MEPS.

The NAMI waiver guide is less clear, it seems to be geared towards a diagnosis while at NAMI or for referral from someone who is symptomatic. If I go to Pensacola, and I don't have OSA (Because I have a clean sleep study and a letter from my doc saying I don't), do I have to worry about being NPQ?
 

FinkUFreaky

Well-Known Member
pilot
What is the letter of the law on "current" conditions listed in the NAMI physical?

I went to my cardiologist for palpitations (that turned out to be muscle spasms) and he was adamant that I get a sleep study done.
The sleep study showed that I had moderate sleep apnea, and I'm waiting to hear back from the doc on what to do next (Mouthpiece vs CPAP vs nothing). My heart monitor also showed some arrythmias that the cardiologist said he could correct with ablation

DD 2807 is clear on "do you now or HAVE YOU EVER HAD xyz", and I've double checked both DoDi 6130.03 (MEPS) and MANMED Ch. 15 which say that Current treatment of OSA is disqualifying, so if I am compliant with therapy and lose (honestly quite a bit) of weight, and show that I don't need treatment (with a clean sleep study and a letter from the doc) I should be clear with MEPS.

The NAMI waiver guide is less clear, it seems to be geared towards a diagnosis while at NAMI or for referral from someone who is symptomatic. If I go to Pensacola, and I don't have OSA (Because I have a clean sleep study and a letter from my doc saying I don't), do I have to worry about being NPQ?
NAMI is weird (bunch of uptight A-holes, in my experience. I know I'm wrong, and they are just following their book. Problem is when they don't know when not to follow it... we as aviators all have to understand it's ok to violate NATOPS if good headwork says to.,)

Do what you can (you mentioned losing weight) to make the process work for you. NAMI and MEPS are very different beasts. For good reason. in the end result.
 

exNavyOffRec

Well-Known Member
What is the letter of the law on "current" conditions listed in the NAMI physical?

I went to my cardiologist for palpitations (that turned out to be muscle spasms) and he was adamant that I get a sleep study done.
The sleep study showed that I had moderate sleep apnea, and I'm waiting to hear back from the doc on what to do next (Mouthpiece vs CPAP vs nothing). My heart monitor also showed some arrythmias that the cardiologist said he could correct with ablation

DD 2807 is clear on "do you now or HAVE YOU EVER HAD xyz", and I've double checked both DoDi 6130.03 (MEPS) and MANMED Ch. 15 which say that Current treatment of OSA is disqualifying, so if I am compliant with therapy and lose (honestly quite a bit) of weight, and show that I don't need treatment (with a clean sleep study and a letter from the doc) I should be clear with MEPS.

The NAMI waiver guide is less clear, it seems to be geared towards a diagnosis while at NAMI or for referral from someone who is symptomatic. If I go to Pensacola, and I don't have OSA (Because I have a clean sleep study and a letter from my doc saying I don't), do I have to worry about being NPQ?

you have a few conditions that are going to cause issues, not sure about arrythmias but on sleep apnea I have never seen a person diagnosed get cleared to enter the USN, you can of course try and your plan is one that is a good course to go down, I would expect MEPS to get the records and decline to see you, then your recruiter will send the documents to N3M, if they believe there is a chance you could become medically qualified then they will direct MEPS to give you a physical (called continued processing warranted) and then they will review the results. If N3M does not believe you have a chance they will come back with continued processing not warranted, and it pretty much ends there.
 

Chippewa19

Puts the cart before the horse
you have a few conditions that are going to cause issues, not sure about arrythmias but on sleep apnea I have never seen a person diagnosed get cleared to enter the USN, you can of course try and your plan is one that is a good course to go down, I would expect MEPS to get the records and decline to see you, then your recruiter will send the documents to N3M, if they believe there is a chance you could become medically qualified then they will direct MEPS to give you a physical (called continued processing warranted) and then they will review the results. If N3M does not believe you have a chance they will come back with continued processing not warranted, and it pretty much ends there.
Roger, thank you sir. My argument hinges on 6103 and Ch 15 not mentioning history as disqualifying, but rather ongoing treatment. Guess the only thing to do is run it up the flagpole.
 

mutanttrout100

New Member
Hi everyone,

I was wondering whether having a benign systolic flow murmur and respiratory sinus arrhythmia would be disqualifying for aviation. I was recently diagnosed with what he believes to be a benign systolic murmur from my pediatrician, and was referred to a cardiologist for a more in-depth check. I had an EKG, and everything was found to be normal except for a marked sinus arrhythmia on the EKG, along with the benign systolic flow murmur. He referred me for an echocardiogram to make sure the murmur was benign, as I'm an athlete, and I'm still waiting to hear the results on that. I've done a bit of research, and the information that I've found has been sort of mixed, with some saying they are a DQ, and others saying that it is waiverable or doesn't even require one. My situation is slightly different from the average person though, as my cardiologist believes my conditions are due to me being an elite athlete (high school track and field athlete recruited for D1), and believes that both would go away if I stopped training and possibly as I just generally age. Does anyone know if these would cause any trouble with the flight physical standards? And if said conditions disappear by the time I start the process, would having these on my medical history cause any problems? Thanks.
 

FinkUFreaky

Well-Known Member
pilot
Hi everyone,

I was wondering whether having a benign systolic flow murmur and respiratory sinus arrhythmia would be disqualifying for aviation. I was recently diagnosed with what he believes to be a benign systolic murmur from my pediatrician, and was referred to a cardiologist for a more in-depth check. I had an EKG, and everything was found to be normal except for a marked sinus arrhythmia on the EKG, along with the benign systolic flow murmur. He referred me for an echocardiogram to make sure the murmur was benign, as I'm an athlete, and I'm still waiting to hear the results on that. I've done a bit of research, and the information that I've found has been sort of mixed, with some saying they are a DQ, and others saying that it is waiverable or doesn't even require one. My situation is slightly different from the average person though, as my cardiologist believes my conditions are due to me being an elite athlete (high school track and field athlete recruited for D1), and believes that both would go away if I stopped training and possibly as I just generally age. Does anyone know if these would cause any trouble with the flight physical standards? And if said conditions disappear by the time I start the process, would having these on my medical history cause any problems? Thanks.
I can't answer this question; I have heard though that the elite athletes are 42% more likely to get jets.
 

taxi1

Well-Known Member
pilot
Mutanttrout, are you competing in D1 now? How far out are you from graduating college?
 

TimeBomb

Noise, vibration and harshness
When I was at NAMI, sinus arrhythmia was NCD. Quite common in young people, athlete or not. The echo will tell you the source of the murmur, and any gross structural pathology. Waiver recommendation will depend on the findings on the echo. Be aware that the echo may find other unrelated. abnormalities that may be disqualifying in their own right.

V/R
 

exNavyOffRec

Well-Known Member
Not yet, I'm a senior in high school, but I was recruited to compete next year in college.

requirements change, what you are told now might be different in 1, 2 or 4 years from now. The condition you have may or may not be an issue.

What you can do is go to college and do well, that way if you can join you have set yourself up right, and if you can't you have still set yourself up right.
 

FinkUFreaky

Well-Known Member
pilot
Not yet, I'm a senior in high school, but I was recruited to compete next year in college.
Fair enough; you're still young. Learning time; don't call yourself elite lol (it won't actually help you get jets! But the attitude might help you attrite!). I'm guessing you didn't detect the sarcasm in my post, and that's ok. Most of us were in your shoes at one point. Look up the NAMI Waiver guide; @TimeBomb 's post is your best gouge though. CD= Considered Disqualifying. NCD = Not CD. Even things that are CD, can be waived. Standards are far stricter for applicants than for student aviators than for winged aviators; in each phase, more money has been put in so they will deal with and pay to correct for more things.
 

mutanttrout100

New Member
Fair enough; you're still young. Learning time; don't call yourself elite lol (it won't actually help you get jets! But the attitude might help you attrite!). I'm guessing you didn't detect the sarcasm in my post, and that's ok. Most of us were in your shoes at one point. Look up the NAMI Waiver guide; @TimeBomb 's post is your best gouge though. CD= Considered Disqualifying. NCD = Not CD. Even things that are CD, can be waived. Standards are far stricter for applicants than for student aviators than for winged aviators; in each phase, more money has been put in so they will deal with and pay to correct for more things.
Thanks for the advice. I wasn't trying to sound conceited and boast by calling myself an "elite athlete" (definitely should have phrased that better), but I was just repeating what was said by my physician in his notes. Lesson learned. Also, was 99% sure you were being sarcastic, but wasn't positive haha. I checked the NAMI waiver guide originally before posting, but I couldn't find anything specifically related to heart murmurs or sinus arrhythmia, which is why I decided to go ahead and ask. I appreciate you and everyone else taking the time to help, really means a lot, and I'm confident that these issues will eventually be resolved. Thanks again!
 
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