DODMERB Remedials and Anaphylaxis

S

steffi2014

5-Year Member
Joined
Nov 12, 2013
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6
So I accidentally originally posted this under USAFA...I'm not sure why but here are my questions:

Recently, I received a request for remedials from DODMERB.

So they are requesting that I have to take allergy tests to check for anaphylaxis.

In the past, about 5-6 years ago, I had a macadamia nut and I found out I was allergic to them because I ended up going to the hospital for swelling lips (an incident which I reported in my medical history).

So it sounds a lot like anaphylaxis and everything which is starting to concern me.

Is anaphylaxis still a disqualifying factor?

Does my case sound like a rare enough case in which I will be excused?

And if I do get disqualified because the allergy test shows that I have anaphylaxis with macadamia nuts, what should I do?

Is getting a waiver the next step?

Thank you for any replies (the help would be much appreciated since this is becoming a major concern for me).

I am not allergic to any other nuts (I'm good with peanuts, walnuts, etc.)
 
DS had food allergy issues but in the end AROTC waived them after being tested and found to no longer have them. Sorry to say history of anaphylaxis is a DQ. You certainly need to comply with the remedial request and let DoDMERB make the final determination. If in fact you are allergic to macadamia nuts my best guess is that you will be DQ'd and a waiver is very unlikely.Not sure how remedials work, you choose the doctor or DoDMERB. If you have the opportunity to choose then try to find one who is familiar with the DQ codes and if possible previously practiced medicine in the military. Have your medical records pertaining to your allergies close by. As with all of us make sure you have a plan B to fall back on. Feel free to PM me with specific questions. Best of luck to you.
 
sheriff3 said:
DS had food allergy issues but in the end AROTC waived them after being tested and found to no longer have them. Sorry to say history of anaphylaxis is a DQ. You certainly need to comply with the remedial request and let DoDMERB make the final determination. If in fact you are allergic to macadamia nuts my best guess is that you will be DQ'd and a waiver is very unlikely.Not sure how remedials work, you choose the doctor or DoDMERB. If you have the opportunity to choose then try to find one who is familiar with the DQ codes and if possible previously practiced medicine in the military. Have your medical records pertaining to your allergies close by. As with all of us make sure you have a plan B to fall back on. Feel free to PM me with specific questions. Best of luck to you.
Click to expand...

I'm not sure I agree a waiver is unlikely but I really don't know. Find myself wondering what you case this assessment on? My own thinking is that if it's only macadamia nuts then it's probably not a big problem, but I'm willing to be educated.
 
I agree with kinnem. Macadamia nuts are something that is rarely seen in any food served in the military. I would think if this is the only nut he is allergic to, than it would be waived easier than if he was allergic to multiple types of nuts, especially peanuts.

My thought when reading this was he may have a multiple nuts allergy, and they want him to be tested for all nuts. Sorry steffi, but you saying you have no other nut issue, doesn't mean it is true...have you eaten pine nuts? If you have eaten pesto, than you have. How about hazelnut? Have you eaten Nutella? I do believe you are not allergic to peanuts because many things that are fried are fried in peanut oil.

I do agree anaphylaxis is most likely to be an automatic DQ. However, by going to an allergist, if it is only the more rarer nuts like macademia, pine and hazel, I would think your waiver chances will increase.

Remember DoDMERB DQs. Branches waive. You do not apply for a waiver, they (AFA will) request it for you if you are deemed competitive. Waivers are case by case. Part of their decision will come down to the ability to be deployed anywhere in the world. They have to think about not only your medical needs, but also everyone else that will be impacted if you can't deploy or fulfill the mission.
~~~~ I.E. want to be a pilot. Deployed to Aviano, and have tortellini with pesto at a restaurant in town the night before a flight. You go into shock, and now you not only can't fly, but it will also impact the mission you were to do the next day, or for the next 3 days until you get off of DNIF (Duties Not Including Flying).
~ You just stated you have no problems with any other nuts, but like I stated have you ever eaten a pine nut?
 
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I'm not sure I agree a waiver is unlikely but I really don't know. Find myself wondering what you case this assessment on?

Please do not think my post below is defensive in nature as that is not the intent.

I based my comments on a conversation I had with DS allergist/MD that is a retired Army 0-6 and was chief of staff for allergy and immunology at 2 different army hospitals. This MD examined DS for the purpose of rebuttal to a DQ for:

D141.50

Allergic manifestations, history of systemic allergic reaction

Systemic allergic reaction (including insect venom, common foods, latex, etc.), history of.

In that conversation he said there are certain types of allergies the military is ok with i.e. seasonal. Another factor is severity. There are two widely recognized tests used to determine severity. Depending on where one falls on those tests is a big factor. DS allergist said (I’m going from memory here) “grass, pollens and other seasonal allergies are usually ok, dairy, soy can go either way but severity is a big factor. Nuts are a whole different story; they are looked upon differently due to severity and the potential of a fatal reaction and the likelihood of cross contamination in the food chain."

My intent was not to crush anybody’s hopes but to paint a clear picture of the uphill battle the OP will be facing, likely on two fronts. First on the medical side for the potential (hopefully not) DQ and secondly, as many have alluded to in past, the ever shrinking budget. If all things being equal between two candidates the one that requires a waiver of any kind may be at a disadvantage. The surgeon general for that branch may have different "marching orders" on how they view waivers now than they did even 6 months ago.

Lastly, I am a newbie on this forum and cannot offer much to the folks here. I have no medical training but I can say I have spent an obscene amount of time researching this particular DQ and do feel I have a better than average understanding based on actually going through the process with DS and doing research. Again, I have no expertise in this field just basing my opinion on
past experience.:thumb:
 
sheriff3 said:
I'm not sure I agree a waiver is unlikely but I really don't know. Find myself wondering what you case this assessment on?

Please do not think my post below is defensive in nature as that is not the intent.

I based my comments on a conversation I had with DS allergist/MD that is a retired Army 0-6 and was chief of staff for allergy and immunology at 2 different army hospitals. This MD examined DS for the purpose of rebuttal to a DQ for:

D141.50

Allergic manifestations, history of systemic allergic reaction

Systemic allergic reaction (including insect venom, common foods, latex, etc.), history of.

In that conversation he said there are certain types of allergies the military is ok with i.e. seasonal. Another factor is severity. There are two widely recognized tests used to determine severity. Depending on where one falls on those tests is a big factor. DS allergist said (I’m going from memory here) “grass, pollens and other seasonal allergies are usually ok, dairy, soy can go either way but severity is a big factor. Nuts are a whole different story; they are looked upon differently due to severity and the potential of a fatal reaction and the likelihood of cross contamination in the food chain."

My intent was not to crush anybody’s hopes but to paint a clear picture of the uphill battle the OP will be facing, likely on two fronts. First on the medical side for the potential (hopefully not) DQ and secondly, as many have alluded to in past, the ever shrinking budget. If all things being equal between two candidates the one that requires a waiver of any kind may be at a disadvantage. The surgeon general for that branch may have different "marching orders" on how they view waivers now than they did even 6 months ago.

Lastly, I am a newbie on this forum and cannot offer much to the folks here. I have no medical training but I can say I have spent an obscene amount of time researching this particular DQ and do feel I have a better than average understanding based on actually going through the process with DS and doing research. Again, I have no expertise in this field just basing my opinion on
past experience.:thumb:
Click to expand...

Thanks sherrif. It does shed some new light on the issue for me. My wife says I'm too old to learn but I think, with your help, she's wrong again! :biggrin:
 
Thanks for all of the responses!

And oddly enough, I have not ever had any case of allergic reaction to other nuts that I have tried (and on a side note, I actually love Nutella).

I really enjoy eating pine nuts and have never had an issue either.

I tried a macadamia nut and I definitely have a lot of swelling.....no breathing problems and I didn't die or anything but the swelling is pretty bad.

Hopefully I will be able to make a case for myself by noting that it is only macadamia nuts and that it is not the most commonly used nut.
 
Steffi2014: here is a response I gave to someone who PM'd me on this issue. I hope you find it helpful. This is of course assuming a DQ is forthcoming. Best of luck to you!:thumb:

Hello, feel free to PM anytime. Once we received DQ from DoDMERB we called DoDMERB and asked what we could do. DoDMERB advised we write a letter stating what, if any limitions DS allergies has on his lifestyle. Also they advised getting a letter from family doctor. We did all of this and I do not believe it changed anything in their mind. All they did was put the letter in DS file for review by the waiver authority. I tend to be more proactive than reactive so I googled " former military doctors with allergy training" and got lucky that a very good retired military allergist was only 45 minutes up the road from us. DS was examined and tested. The doctor was extremly helpful in that he knew the regulations inside out and was able to craft a letter/diagnosis that disputed the DQ. Even with this info DoDMERB did not reverse the DQ! I would follow DoDMERB's advice on the medical records for now. No reason to do much until/if you get the DQ. Research former military medical specialists in your area to have a plan in the event a DQ happens. Also you may want to contact Belle on this forum. I believe she used DoDMERB consultants to help her case. PM with any more questions. Good Luck.
 
I wonder if severity of the reaction will influence a waiver decision. If one has a reaction, but it is treatable with something like Benadril rather than an epipen or an emergency room visit, does that make the waiver possible?
 
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