DodMRB Remedial Requested - what is this?

Discussion in 'DoDMERB' started by 2011's Mom, Jun 29, 2006.

  1. 2011's Mom

    2011's Mom Parent

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    My daughter took had her DoDMRB physical done early in June and today on the online DoDMRB web I checked her status and found a remedial. Below is a cut/past of what the said. Can you tell me what this could be about?


    R263.02 - Please provide the results of a REPEAT routine urinalysis to include a full microscopic exam, sugar, and protein determinations. You should empty your bladder just before going to bed, avoid any exertion before retiring to bed, and collect the specimen immediately upon arising in the morning. Three days later, submit another specimen collected in the same fashion (a total of two are required). The specimen should be a clean catch, midstream specimen (ask your doctor for further instructions on this technique). It is recommended you avoid strenuous physical activity for two or three days prior to submitting these specimens. Females should wait at least 7-10 days after their menstrual cycle.

    Thanks.
     
  2. barracuda57

    barracuda57 New Member

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    Hi

    My son had to complete the same remedial, R263.02, last summer. I asked his doctor what the problem was and he said my son probably had 'protein in his urine'. We were told that some people show protein in their urine that is not related to a problem and that a specimen taken after resting will yield a correct testing result. After submitting two specimens as you described and having them analyzed at a lab and reviewed by his doctor we sent the results to DODMERB and the remedial was removed from his file. (This is just one possibility.)
     
  3. RetNavyHM

    RetNavyHM USN (RET)

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    Candidate for 2011's mom,

    barracuda57 is probably correct. Protein in the urine is the most likely cause for the 2 repeat urines. Protein in the urine can be an abnormal finding, but it can also be the result of heavy physical activity. DoDMERB needs the repeat urines to ensure the protein in the urine is not caused by some underlying medical issue, and was cause by physicial activity. That it why the statement regarding restricting physical activities for 2-3 days prior to each urine collection. That doesn't mean that your daughter needs to sit on the couch and do nothing for 3 days, but she just needs to ensure she stays well hydrated and take it easy for a couple of days before.

    Of great importance is to make sure the urine collection is done at least 7 days after her menstrual cycle. The 2 urine collections have to be at least 3 days apart, but if you need to wait a couple weeks between collections there will be no problems.
     
  4. 2011's Mom

    2011's Mom Parent

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    Thanks!

    Thanks so much for your replies. It sure makes us feel better. She is soooo active / athletic. This makes a lot of sense now. We will be certain she follows the instructions to the "T". We can't do it for over a month though - she is out of the Country until August! But at least I have info to calm her anxiety when she logs in herself and sees the remedial! Thanks again, you guys are great. Of course, I realize this may not be the issue, but knowing how active she is and everything, I bet it is! :smile:
     
  5. RetNavyHM

    RetNavyHM USN (RET)

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    I would have to guess that about 95% of the repeat urines that DoDMERB requests come back normal. Unless your daughter has a history of having protein in the urine it should be no problem.
     
  6. 2011's Mom

    2011's Mom Parent

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    Do we begin the 7-10 day count on day one of the period or on the first day after the period? I ask because she is taking advanced conditioning in school and will be required to be very active by the time of the 2nd urine test - she simply will not be able to restrict her activity. So, is it better to begin the first test only 7 days after the period and still be able to have the second urine test done while relatively inactive or to begin test 1 on day 10 after period knowing that by the second test activity will be full? I know this is getting particular but with her having been out of the Country all summer, we cannot select our timing. She comes home soon and school begins almost immediately. That class is well known for a very high level of conditioning and she is the only girl in the class. It is predominantly the football team who have been training for weeks already. She'll have her work cut out for her from day 1 just keeping up with them - and she won't want to go easy on herself - she's already going to be a bit out of place - girls don't typically take this class - but that is another story!
     
  7. Stealth_81

    Stealth_81 Super Moderator Moderator Founding Member

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    We are going through this right now, also. Our son just returned today from a service trip with the church, and starts a passing league for football conditioning tomorrow. What we did, is talked directly to the football coach, and described the situation. Since he has not been doing any heavy physical activity because of the trip, we got him in right away for his first test on Monday, then he will do the repeat test on Thursday. Our son will be going to the football league, but will be excused from active participation for the three days it will take to do both urine tests. The coach was very understanding when we explained the long term benefit of passing these tests. He figured it was worth it, as did we. If these kids are in good enough physical shape for the Academy, they can afford to rest for a few days to get their tests done.
     
  8. 2011's Mom

    2011's Mom Parent

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    I agree for the most part with what you're saying, the glitch is that she is the only girl in the football conditioning and knows the guys don't want her there. She isn't playing football she is just using it as a means to help keep her conditioning ... Certainly the coach understands but the guys in the class may be another story. Ideally, beginning the testing on day 7 after her period would be best so she won't have to take it easy in the class. I guess it just depends on which is the lesser of two evils, early after the period or more active for the second urine test.
     
  9. USNA69

    USNA69 Banned

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    I'm not quite following the thread but what I think I hear you saying is that she had rather jeprodize her test results than embarass herself in front of the football team.
     
  10. 2011's Mom

    2011's Mom Parent

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    No, that isn't it at all! I see where you got that thought though. But I don't really want to go into those details here.

    The question is which is the better option, a or b (outlined below). There may be a "c" option that I have not thought of.

    Options are:

    a) having the 1st urine test begin 7 days after period (time frame allowed in test is 7-10 days) AND be very inactive for 2nd urine test

    or

    b) take first test 10 days after period (giving 3 extra days post period) and in exchange for those 3 days, be a more active than plan a) would have allowed for in the 2nd test.

    Is that more clear? There are many complex reasons, that I won't go into here, beyond the PE, that make plan a) a personal preference - but I want to know if one option is better than the other from a medical standpoint. Both options fit within the instructions of the test.

    By the way, logical option of day 8 or 9 won't work because of commitments out of the area that won't allow for 2nd testing.
     
  11. RetNavyHM

    RetNavyHM USN (RET)

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    Candidate for 2011's mom,

    Having the first urine on day 7 may work, and getting the second one 3 days after that as well. Or, you can always string it out just a little longer. The urines don't have to be exactly 3 days apart, just a minimum of 3 days apart. So if you take the first one 7 days after her cycle, then wait 2 weeks to get the second, that is fine.

    There are many different options, if your physician is willing to work with you, you can always try to get the first urine 5 days after her cycle, as long as everything is negative (no trace protein, no trace blood) then it would be an acceptable urine test, if not have another one in a couple of days and don't send that first one. The reason DoDMERB says 7-10 days after the menstrual cycle is because you can continue to get a trace of blood in the urine samples that long afterwords, so it is just a general guideline, not a hard and fast rule. If you want to wait until there is a break in the training regimen that your daughter is going to go through, that is fine, DoDMERB will hold her file open forever. You don't have to get it finished now, you can wait a couple more months if that is easier on your daughters schedule, and its not going to affect her admissions status at all.

    Stealth_81, you would be surprised at just how many coaches do not understand how important the DoDMERB physical is, and its not just football, but track, swimming, gymnastics.. the list goes on. I've even had coaches call me up at DoDMERB telling me I was trying to ruin their season, ect. And that held true with the coaches at USNA when I was doing the commissioning physicals there, trying to get the midshipmen to specialty appointments to be able to commission them in the field that they wanted, I would always run up against the coaches. I would have to tell the midshipmen, what is more important, the rest of your life, or this one game/meet that the coach was threatening to hold them out of? So your son is lucky that his coach understands.
     
  12. 2011's Mom

    2011's Mom Parent

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    Thank you RetNavyHM. I think I have the answers needed so when D gets home she can make an informed decision on what will be best in the situation. Delaying the testing will frustrate her - she feels like it has been delayed already by two months since she has been out of the country! But, at least she has the information necessary to make a decision. Hopefully I'll be writing back in a little bit that all is well in the world of DoDMERB - but that little bit may be a month or two!

    Thanks again - your presence on this forum is a blessing to those of us who have no idea what we are doin! I am so glad we found this forum.
     

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