DoDMERB Asthma PART 2 (Interesting Situation)

toddjaro

5-Year Member
Joined
Nov 6, 2011
Messages
9
Hello all,

My name is Todd and I applied to both the USAFA and for the AFROTC scholarship. Received my DoDMERB packet in the mail, filled out the survey, indicating that I have asthma and was on ADVAIR for a period of time, took the physicals, and received my disqualification. I then proceeded to go to a pediatric pulmonologist, took a spirometry, passed with almost every statistic above 100%, had the doctor write an affidavit, and submitted to DoDMERB. I didn't even receive a waiver submission to the academy (probably because I waited until 1/31/12 to submit the completed packet and someone else was already qualified with a nomination, possibly the primary), however I did receive a Type 2 AFROTC scholarship. A waiver was submitted and consequently denied due to having listed being on ADVAIR at the time I had taken the DoDMERB survey.

After talking to my mom about this whole deal, when I asked when I had been diagnosed with asthma, she said I had never been diagnosed (I have had the same PCP for my entire life). When asked why I had been assigned as having asthma, she replied that she didn't know when it caught on but somehow it did. Believe me, I don't understand this whole situation, but I know my mom wouldn't lie to me about that. Evidently as a child I had some kind of airway infection and had been preventativly prescribed an inhaler. When I was prescribed ADVAIR (which I was on during the DoDMERB survey), I had contracted a some kind of viral respiratory infection and was given it as a preventative measure; had refills, never used them. I was on my schools varsity cross country team for two years, one of which we were state runner up; my time (I have records if they request), was 17:15 for a 5k, which is ~ 3 5:35 miles back to back to back. I also ran track and have a recorded 2:08 minute 800m.

SO, my question is, for anyone familiar with the DoDMERB process, how can I go about explaining this situation? Since I have had the same PCP my entire life, I was planning on making an appointment tomorrow and explaining this whole situation for her, and then she can look through my records to determine where this entire thing started, pull them out, make copies, and explain the situation to DoDMERB. I know that it is possible to request a reevaluation of my case by the waiver review board if new information is submitted. At this point, it's not even about receiving the scholarship money (well, maybe a little bit), but more of attaining my dream.

If they determine that not even being diagnosed with asthma and just thinking I have it isn't enough to grant a waiver, I have read that it is possible to join my schools detachment as a non-scholarship cadet, and that a satisfactory completion of one or two years may persuade the review board to grant a waiver. Is this true?

Respectfully, and thanks a ton,
Todd Jarolimek
 
I will let someone like kp answer the question about how ADVAIR and how long you need to be off of it to not place you into the DQ pile.

A friend that was a C200 in AFROTC as a walk on, Nationally ranked TKD black belt champion, never on ADVAIR, never knew she had asthma was medically DQ in Jan., because the AF would not waive it.

Asthma is an issue because from the military's perspective due to your health limitations, it can tie their hands regarding not only career fields, but the ability to deploy you around the world. They look at the AD world and at your age it could become an issue later on that you can't fly, and deploying you to the sandbox where you need special medication, makes it a logistics question. Thus, you have limitations, and others may have to take your place to fill that need.

I would move forward, be pro-active, see a specialist, and hopefully one that understands the DoDMERB system. Do a walk on as an AFROTC cadet. For all you know in 2 yrs., you will call the ball and say you don't want to be in the AF.
 
Pima, I too am hoping that someone sees this and responds!

Anyways, that is extremely interesting; how was she diagnosed if she never knew she had it?

I totally and completely understand that asthma is an issue from the military's perspective, however like I said, I do not suffer, nor have I suffered from any ailments for the past 6 PLUS years (which puts me back before 13). The reason I was on ADVAIR at the time of the survey was because I was at Daytona Beach a ton over the summer and had developed some kind of respiratory tract infection towards the end (Probably the flu from tourists). Went to my doctor and she said just in case, here is some ADVAIR and a rescue inhaler, which has been the entire depth of my prescription for the past 6 or more years. I've never refilled any of the prescriptions either.

This is my plan of action:

I was on the cross country team at my high school for 4 years and the track team for three years, both with the same coach. I've never had to use a rescue inhaler during/after races and workouts, so I'm going to ask him to write me an affidavit, and then have my school's sports director to write me one as well, since he has seen me race numerous times (one of which was the aforementioned 17:15).
I have been a lifeguard at my local YMCA for a year and I regularly swim laps, as well as have a monthly in-service where we practice towing people across the pool and swim laps, and have never used an inhaler there, so I'm going to get her to sign an affidavit.
I've been in marching band for all four years of high school and have never used a rescue inhaler while marching or anything (I know marching band isn't that physically difficult, but it can't hurt!), so I'm going to have my band director write an affidavit.
Additionally, I have a doctor's appointment tomorrow and am going to go talk to her and figure out what has happened from her standpoint. Since I was never retested before or after age 13 until recently, she may realize that I never needed the inhalers (since I never really took them anyways).
Finally, I've never ever refilled an inhaler, so I am going to try to go to CVS and Walgreens and see if they carry electronic files with all the prescriptions I've ever had and not refilled. Hopefully this is the case, and that can do nothing but help my story.

If none of this convinces them, I'll just participate with the detachment as a non-scholarship cadet if they allow me, kill the workouts, and then maybe they will realize that I don't have asthma.
 
Todd,

I will leave it to people like KP to discuss how to work the medical issue with your doc. for the fighting the AF's denial of a waiver for the DQ.

I will say, just hitting it out of the ballpark for PT at AFROTC will not be enough to get the AF to reverse the denial.

AFROTC will follow AFHQ's direction. It is a chain of command. AFHQ denies the waiver from DoDMERB, AFROTC HQ passes that down to AFROTC Det XXX.

I only say that so you don't create an illusion in your mind that getting a 100 on the PFT will reverse the decision from AFHQ. It is medical.

Again, this is about you to you, but to the AF it is about every AF AD member and you. They have to remove emotions, and deal with the medical facts.

The only comfort I can give you is, this issue is always the big issue. Kids at a young age maybe mis-diagnosed by a doc, and parents, loving their children will follow the docs diagnosis, never thinking at 13 this maybe a factor at 18 for their career.

I really would go to a DoDMERB doc and not your doc. Caveat: Your doc is a specialist in asthma, and renown in this field; if not your doc does not know the parameters for DoDMERB.

FWIW, the friend I wrote about was a military child. Misdiagnosed as a child, never prescribed an inhaler. Went to Asia during the SARs outbreak, came home with a respiratory infection and the military doc wrote on her records, may have asthma, prescribed an inhaler, never used, never knew of the inhaler (Mom had in the house JIC).

Just like you, she had 2 different times in her life that docs said asthma.
 
My daughter, now a C2C at USAFA, had a somewhat similar experience. In our area, doctors often prescribe an inhaler for a respiratory infection that keeps hanging on so that kids can get better and back to full functioning. My daughter was prescribed an inhaler for that purpose once after the age of 14 -- and it led to DodMerb requiring her to undergo a methacholine challenge test (see my other postings on this topic elsewhere). She flunked the test -- we discovered through a friend who is a pulmonologist that some percentage of the population will flunk that test because of sensitivity to the protein in the test -- even if they are not asthmatic. We had to have her undergo a full pulmonary work up at the same respitory hospital/facility (at our expense) and that test turned out negative. She was never DQ'd because we scheduled the retest immediately. As you can see from this site, asthma is a problem for the military and is a frequent disqualifier. You may need more than the involvement of your GP doctor -- your parents will (probably) have to help you get through the work up, paper work, etc. that may be required of you. Good luck!
 
Todd,

I will leave it to people like KP to discuss how to work the medical issue with your doc. for the fighting the AF's denial of a waiver for the DQ.

I will say, just hitting it out of the ballpark for PT at AFROTC will not be enough to get the AF to reverse the denial.

AFROTC will follow AFHQ's direction. It is a chain of command. AFHQ denies the waiver from DoDMERB, AFROTC HQ passes that down to AFROTC Det XXX.

I only say that so you don't create an illusion in your mind that getting a 100 on the PFT will reverse the decision from AFHQ. It is medical.

Again, this is about you to you, but to the AF it is about every AF AD member and you. They have to remove emotions, and deal with the medical facts.

The only comfort I can give you is, this issue is always the big issue. Kids at a young age maybe mis-diagnosed by a doc, and parents, loving their children will follow the docs diagnosis, never thinking at 13 this maybe a factor at 18 for their career.

I really would go to a DoDMERB doc and not your doc. Caveat: Your doc is a specialist in asthma, and renown in this field; if not your doc does not know the parameters for DoDMERB.

FWIW, the friend I wrote about was a military child. Misdiagnosed as a child, never prescribed an inhaler. Went to Asia during the SARs outbreak, came home with a respiratory infection and the military doc wrote on her records, may have asthma, prescribed an inhaler, never used, never knew of the inhaler (Mom had in the house JIC).

Just like you, she had 2 different times in her life that docs said asthma.

Yeah I understand that killing the workouts won't necessarily negate the possibility of asthma, and the chain of command. Its just extremely difficult to accept that this is where it ends when, in my opinion, it shouldn't be. I'm extremely type A and it's unbelievable disconcerting to work this hard throughout high school with the goal of serving your country and then I run into this seemingly impenetrable wall on my path there.

My doctor isn't an asthma specialist, I was referred to one after the disqualification to take a spirometry. He is a pediatric pulmonolgist however, so maybe I need to see an adult one. How would I go about seeing a DoDMERB-familiar doctor? Just call around and ask if they're familiar?

Additionally, I've been reading around, and this is interesting to me:

11. LUNGS, CHEST WALL, PLEURA, AND MEDIASTINUM
A.....
B.....
C.....
"D. Airway hyper responsiveness including asthma (493.xx), reactive airway disease,
exercise-induced bronchospasm (519.11) or asthmatic bronchitis (493.90), reliably diagnosed
and symptomatic after the 13th birthday."

(1) Reliable diagnostic criteria may include any of the following elements: substantiated
history of cough, wheeze, chest tightness, and/or dyspnea which persists or recurs over a
prolonged period of time, generally more than 12 months.
(2) Individuals DO MEET the standard if within the past 3 years they meet ALL of the
criteria in subparagraphs 11.d.(2)(a)-(d).
(a) No use of controller or rescue medications (including, but not limited to inhaled
corticosteroids, leukotriene receptor antagonists, or short-acting beta agonists).
(b) No exacerbations requiring acute medical treatment.
(c) No use of oral steroids.
(d) A current normal spirometry (within the past 90 days), performed in accordance
with American Thoracic Society (ATS) guidelines and as defined by current National Heart,
Lung, and Blood Institute (NHLBI) standards.

Does part 2 apply as long as I am not over 23? I'm 18 now, and the last time I was perscribed an inhaler was in August 2011, when I was 17. So in a little over two years, will I be able to reapply and receive a waiver?

Todd
 
Todd,

My only guidance for you on the DoDMERB doc issue is to try contacting DoDMERB for a list of specialists in your area.
 
My daughter, now a C2C at USAFA, had a somewhat similar experience. In our area, doctors often prescribe an inhaler for a respiratory infection that keeps hanging on so that kids can get better and back to full functioning. My daughter was prescribed an inhaler for that purpose once after the age of 14 -- and it led to DodMerb requiring her to undergo a methacholine challenge test (see my other postings on this topic elsewhere). She flunked the test -- we discovered through a friend who is a pulmonologist that some percentage of the population will flunk that test because of sensitivity to the protein in the test -- even if they are not asthmatic. We had to have her undergo a full pulmonary work up at the same respitory hospital/facility (at our expense) and that test turned out negative. She was never DQ'd because we scheduled the retest immediately. As you can see from this site, asthma is a problem for the military and is a frequent disqualifier. You may need more than the involvement of your GP doctor -- your parents will (probably) have to help you get through the work up, paper work, etc. that may be required of you. Good luck!
Dohdean I sent you a PM.
 
Sports mom -- got your PM but cannot figure out how to reply. Please send me your email address (dohdean@aol.com) and I will respond.
 
Sportsmom -- I figured out how to send pm -- check your messages.
 
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