Asthma waiver denied

Discussion in 'DoDMERB' started by laxmom4boys, Feb 10, 2010.

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  1. laxmom4boys

    laxmom4boys Member

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    Just saw on son's DoD site that his asthma waiver has been denied. Needless to say, he is heartbroken. He is seeing his dream of attending USCGA slip away before his eyes. I have already e-mailed Larry and his admissions officer with hopes they might give us a glimmer of hope that this is not the end of the line for my son. My question is.... who out there has had a waiver denied and, what, if anything did you do? Is it worth a phone call to the Academy or maybe even a visit (we only live 5 hours aways)? Any help or advice anyone might have would be greatly appreciated. Thanks so much...
     
  2. Fuji

    Fuji Member

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    Laxmom,

    I am sorry he got that news.

    If I could;

    I encourage him to consider the Senior Military Colleges and the State Maritime Academies in the U.S.. We do not have the same DODMERB requirements as the Service Academies - but, do offer similar uniformed, regimented college lifestyles and similar career opportunities.

    I stand ready and willing to assist your son.

    Fuji
     
  3. kaylasmom

    kaylasmom Member

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    Larry, may be able to help: I saw this on another thread:

    Forums is NOT something I can access at work. It is BLOCKED at USAFA. While traveling, I can access Forums on my IPHONE, but I'm a pretty busy guy. My easiest access to help you, help yourselves, is my email address Larry.Mullen@dodmerb.tma.osd.mil. I say this NOT to defeat the purpose of the FORUMS as a social networking tool, but to enhance individual reponses of those folks in need of answers, guidance, and assistance. Therefore, I dod not use PM, profile messaging, friends, and those other more subtle tools of the FORUMS. Sometimes I'm able to answer in nano seconds, other times, it may take a few days. But, I will respond. We thank you for your patience.

    The FORUMS have proven to be a fantastic tool for group discussion. Even moreso, as a public place where folks can read, digest, and handle issues on a more discreet level. I serve as the "Bureaucratic Buster" for folks caught in the net somewhere along the medical processing line. While NOT every story will end in the individual's desired outcome, I WILL ensure they receive due dilligence of review and the answer to their question.

    There have been two folks that regardless of my response as to the basis for their waiver denial and DoDMERB determination, refuse to accept the answer. They continue to "argue," for lack of a better term and I can no longer assist. The final answer after re-re-re-review is no. I will no longer entertain their assertions. That said, I've answered and worked with several hundred folkssince May 2008....those who directly post on the Forums and a much greater percentage of folks that deal directly with me. (I'm not a math guy but it started out of 1/3 posts and 2/3 that contact me directly....but it's now about 1/4 that post and 3/4 that read the FORUMS, but "lurk" in the background OR would prefer to work on a one-on-one basis). So, the fraction of people who were "helped" (assisted towards a successful outcome ---DoDMERB determination of DOES meet standards; waiver granted; or a complete understanding of "why" their conditions are not compatibile with military service) over those that disagree with everything =
    Several hundred/2.

    DoDMERB's motto is "leave no applicant behind." There is NO doubt that the Director and entire DoDMERB staff live that motto each and every day. We are here to help, not be an obstacle to dreams.
    __________________
    Larry Mullen
    Deputy Director, DoDMERB
    Larry.Mullen@dodmerb.tma.osd.milAvailable 24/7/365 ( I do NOT use Forums PM. Send me an email:thumb:)
    90% of my responses are within the hour
    100% of responses are within 24 hours
    I am ONLY able to view the Forums late at night during the week and on weekends. So, the timelines above refer to when I can see your messages
     
  4. usna1985

    usna1985 USNA Alumnus

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    USNA has said that asthma after age 13 is nearly impossible to waive -- i.e., it rarely happens. I'm guessing USCGA has similar standards. However, all is not lost until Larry says it is, so definitely go with his guidance. What's happened to others is interesting, but really has zero bearing on your son's situation. Sorry, but that's the truth.
     
  5. laxmom4boys

    laxmom4boys Member

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    Thank you everyone for your responses. I do realize each situation is on an individual basis. We are just hoping with each and every finger crossed that there might be some additional steps we can take (i.e. additional testing, travelling to New London for the USCAG to examine him, ???). I'm sure Larry will get back to me and fill me in on what steps, if any can be taken to appeal this decision. So, we'll just wait patiently to hear from him and we'll go from there. Forgot to mention in previous post that he has already received a Conditional Appointment. Not sure if that will help or not.
     
  6. shellz

    shellz Parent

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    LAXMOM-
    Sent you a pm.
     
  7. flieger83

    flieger83 Super Moderator Moderator

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    USAFA is pretty much the same.

    FWIW...I think I saw the reason this came about during/after Desert Shield/Desert Storm. Folks that had asthma "as kids but never since, they're fine, etc..." were in uniform and deployed to Saudi Arabia and other locales nearby. We had several in my wing.

    The "dust/sand" there (the locales we were at) is like talcum powder in many ways...and these folks suffered HORRIFYING attacks (sadly some were lethal) and were rotated out of the theater. That impacted many units.

    It wasn't long after that I started working as an ALO and the word came out that asthma was probably not going to be waived again.

    THE answer of course comes from DODMERB and Larry Mullen has been superb at working with "our kids" both privately and publicly here on the forums.

    Steve
    USAFA ALO
    USAFA '83
     
  8. MullenLE

    MullenLE Member

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    Our computer system was disabled today, due to a faulty air condition issue. DoDMERB will be closed tomorrow until it's repaired. I will have lots of emails to cacth up on this weekend:thumb:
     
  9. laxmom4boys

    laxmom4boys Member

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    Still no word on whether we'll be able to appeal this decision or not. We are getting very frustrated. If we can appeal, we would like to be able to act on this immediately. It is scary thinking that my son's future lies in the hands of someone who knows very little about him. We just want the chance to be able to explain to someone his medical history in more depth, but right now that is out of my control. We will not give up without a fight!
     
  10. usnahopeful2014

    usnahopeful2014 Member

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    I'm with you on that one
     
  11. mariner116

    mariner116 Member

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    Have you gotten any information on the criteria for appealing a wavier denial?
     
  12. shellz

    shellz Parent

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    The Methalcholine Challenge Test is the gold standard in determining if a person has continuing issues with asthma/bronchial hypersensitivity. The drug used in this test is a broncho-constrictor and properly administered, generates very few false positives or false negatives.

    I can see why the armed forces are leary of kids with asthma, but so many really do outgrow it. Not all, but many. This test is a good measure of bronchial hypersensitivity and I for one am glad my son had the chance to prove his childhood (very mild) asthma was gone and a non-issue.

    For those who are in this same boat, I wish you the best. It's hard to see the end of the tunnel when this seemingly impossible roadblock is in the way.
     
  13. laxmom4boys

    laxmom4boys Member

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    Mariner116 - no we haven't heard about any criteria for apealling the waiver. I don't even know if we'll be able to or not. This is one of the things that is so frustrating!

    Since my son's asthma was so mild and basically non existent, his doctor of 14 years cleared him of this condition last year. We are hoping and praying USCGA will allow additional testing to prove this.
     
  14. MullenLE

    MullenLE Member

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    2 things -

    There is NO gold standard for determining asthma. The methacholine challenge test is used when the history is vague, but it is NOT a gold standard

    Appealing a waiver denial is only accomplished by contacting the Academy or ROTC program directly and providing DoDMERB irrefuatble documentation that was not available when the waiver authority reviewed the case the first time (DoDMERB then posts the information to a secure waiver website for the waiver authority to review/consider.):thumb:
     
  15. Lilly

    Lilly Member

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    Methacholine Challenge Test is a Bad Test!

    The methacholine challenge test is a terrible test for the purpose of trying to diagnose "latent asthma" (or whatever other term you would like to call what they are looking for, and I bet most of them would admit it too.) This test was developed to diagnose asthma in those with uncertain respiratory symptoms. It was not designed or developed as a litmus test for asthma in aymptomatic folks or those who had some respiratory issues as children.

    A study done in 2001 in which ROTC cadets with NO history of asthma, I repeat, NO history of asthma were given the methacholine challenge test. The results? 10% FAILED the TEST. So, if you gave it to every cadet at the Academies 10% of them would be sent home.

    It is the test the military uses, but this "gold standard" is badly tarnished.
     
  16. Lilly

    Lilly Member

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    Mr. Mullen, great minds think alike:thumb:
     
  17. shellz

    shellz Parent

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    The reason for so many "fails" as you put it...the test relies on the patient to blow into a tube at a consistent rate. Too much airflow or not enough will skew the results. Easily fixed by practice prior to testing.

    By the way, the pulmonary doc I spoke with over the course of my son's battle did indeed call it the gold standard. But, of course, I am no doctor, so who am I to argue? :thumb:
     
  18. Lilly

    Lilly Member

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    Well, I am an MD (as my avatar might suggest I know Labs tests, sorry for the pun) so I'll keep going. Your pulmonologist friend is right about most pulmonary function tests, particularly in the folks that he is dealing with on a daily basis, the elderly and the ill. But these guys are young, smart, can follow directions and they still failed. They failed because the bronchoconstrictor, methacholine, did exactly that, it constricted their bronchial tubes restricting air flow so that these completely normal ROTC cadets were diagnosed as having asthma, this is known as a false positive result. Not a good thing for your application to an Academy

    Another thing to note is that when my son took the methacholine test, there was no "practicing" as you call it. Does you pulmonologist friend let his patients practice their pulmonary function tests before he does the real thing? Doubt it.

    And yes, my son is now a C4C at USAFA but the methacholine challenge test is still bad for this purpose, it may be all they've got but it's bad.
     
    Last edited: Feb 17, 2010
  19. shellz

    shellz Parent

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    Well, since you're a doc, who am I to argue. :wink: But, I will...

    I have no reason to disbelieve what my son's doc said or did.

    The fact that he "practiced" prior to the inhalation of the methalcholine did nothing to skew the results, just helped son realize what he was supposed to be doing. His first few practice breaths were all over the place in terms of velocity. Nerves may have played a part as well. That's all. This doc, who btw is not a "friend", probably had plenty of experience administering this particular test and evaluating the results, so I am assuming that his experience was such that in the past, some folks needed to practice maintaining a steady flow of air. His goal was to get an accurate picture of what was going on with my son's lungs and thank goodness he did.

    BTW, your 10% fail rate is only a little higher than the statistical average of 7.5 % of asthma prevalence in the teenage population (NIH data, 1995). I would assume that many of those might not even realize that their symptoms could be indicative of asthma.

    But again, you're the doc, so I'm out. Just trying to give a little hope to those who wait on a waiver, and to share OUR experience. Who knows, we might not be as unique as we'd like to think we are. :thumb:
     
  20. Lilly

    Lilly Member

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    Shellz, I know these things can be hard to parse out for the non medically trained but the statistics you quote from the NIH about a 7.5% incidence of asthma in kids are "self reporting" asthma folks, in other words these are people who think they have asthma and are answering a questionnaire given to the general population.

    That really has nothing at all to do with false positives of the methacholine test in normal ROTC cadets with no history of respiratory problems. You've got to be careful what kind of message you think you are giving when you quote statistics, you've got to know what the statistics are all about in the first place.

    Folks are used to the sensitivity and specificity of something like a pregnancy test where if the lab comes back that you are pregnant, then you are pregnant. So, they think, "well the test says I have it, so I have it." Some medical tests are just not that clear cut. Just ask your pulmonologist what a "positive lupus blood test" means in a patient with no symptoms or signs of lupus. If he knows his stuff, he'll tell you it can mean nothing at all, in other words, a false positive test. Same with a positive methacholine challenge in an aymptomatic patient, it may not mean anything.

    Methacholine tests in asymptomatic patients are just not as reliable as what most of us would want something called a gold standard to be. I don't mean to impugn the integrity of your pulmonologist, and I didn't mean to suggest that somehow he swayed your son's test in any way shape or form. I'm glad your son passed and God's speed to him in his career.

    I hope the original poster gets good results if they choose to take the test, but I think everyone would agree we wish there was a better test.
     
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