Flight Physical, Inhaler Question

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DrSeuss27

5-Year Member
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Dec 12, 2010
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I had a really bad cough after coming back from Field Training and went to the local Walgreens outpatient center. They thought I had bronchitis/pneumonia and prescribed me some meds, one of which was an inhaler to help clear things up. I have never had asthma or allergies and this was a one time thing. I used it for a couple days and then stopped. I was wondering if this is going to be a problem during my upcoming flight physical?
 
You should be fine but check the AFI's.

In regards to the physical itself, just shut up and go through the motions. Don't tell them any more info than they need to know.
 
BoneDust said:
You should be fine but check the AFI's.

In regards to the physical itself, just shut up and go through the motions. Don't tell them any more info than they need to know.
Click to expand...
Exactly this! If they don't ask do not tell them!
 
DrSeuss27 said:
I had a really bad cough after coming back from Field Training and went to the local Walgreens outpatient center. They thought I had bronchitis/pneumonia and prescribed me some meds, one of which was an inhaler to help clear things up. I have never had asthma or allergies and this was a one time thing. I used it for a couple days and then stopped. I was wondering if this is going to be a problem during my upcoming flight physical?
Click to expand...

"they thought you had pneumonia/bronchitis" which means it does not sound like you had an X-ray? So this should not come up in the physical, but even if you fill out a health history, it still shouldn't be a problem. there really isn't a direct question this would fall under. This would fall under a minor illness which is not a direct question on the questionaire. Which asks if there are any other times you went to the doctor, sought medical treatment, etc other than a minor illness. I can guarantee there is no way that anyone can list every time you consulted a doctor and it was a simple item like a sinus infection or treated for somesort of unknown upper respiratory infection that had with no further complications. Also, there is not a way to list every medication you took for a few days over the last 18 plus years. Had you had a chest X-ray, that would fall under, "have you ever had an X-ray?", then they would want to know the results and treatment. The medication questions asks for medications you have taken regularly. So I honestly do not know if this actually will come up. Just answer the questions honestly and if it does not come up, then it would fall under minor illness. This is only my opinion, you have to follow your conscience, but as mentioned above, only address what you are asked.
 
This is an older thread but I'd like to refresh the topic. My cadet (a military brat; this matters in a minute) attending his flight physical last August. Come to find out unlike the other cadets around him, because he was a brat the flight medicine staff had access to all of his lifelong medical record to scrutinize. Sure enough, there was and incident in his medical record, age 10, he had a lingering cold/cough and his parents were documented "asking" to have evaluated for asthma. The doc prescribes a "just in case" prescription for an inhaler and a referral to a pulmonologist/allergist. The referral comes back negative, cold clears up after 30 days, and the next 12 years of his medical record has no diagnosis of asthma.
But the inhaler is still in his record; as prescription which was never used/refilled and expired after 12 months.
Now fast forward to his per-commissioning flight physical.
Much like the original poster in this thread, my cadet had attended an all summer long training session. By the last month of his training, most of his class all had the same cold/cough crud. Which he was still recovering from at his physical.
Two things form the perfect storm at the physical; his shows up sick, with an upper respiratory infection, and they find an inhaler prescription with the question of asthma in his pediatric record.
The staff decides to have him take a pulmonary function test. I wish he had refused to take the test, because he was sick, but the staff insisted, his cold would not effect the PFT outcome (wrong). He took the PFT, failed it, then finally the lead flight doc stepped in, diagnosed him with a viral upper respiratory infection, discusses his childhood inhaler prescription (which he honestly never remembered or was aware of), sends him home to recover and reaccomplish a PFT to clear up the record. Great...right? But now.
He takes the PFT arranged by his doctor, passes the PFT perfectly. In addition, he provided a voluminous review of his medical record highlighting the negative test results from his PFT/Pulm consult at age 10 at the subsequent 12 years of pediatric care with no mention of any kind of asthma diagnosis.
Back to his healthy PFT. He passes it. Instead of this closing the subject. The flight medicine staff demand a methacholine challenge test MCT. Great. He takes the MCT and passes with flying colors.
The flight medicine people stop making demands for more tests (cost insurance $3000 and $1000 out of pocket) and tell him that have sent his package off to AETC (USAF) HQ for "processing and disposition".
 
His ROTC staff waited about 3 weeks and contacts the medical staff for a status on his physical. The flight medicine staff pass back that "waivers" require a month to process. His question was "a waiver for what?". Their response, "a waiver for childhood asthma"; a diagnosis that never existed in his medical record (which we provided PFT/MCT results and a very detailed chronological review to support). Our opinion of how this process appears to work: because that had access to his very disorganized pediatric military record (in pdf format) they word-searched key words like surgery ,asthma, eyesight etc. They found the word asthma in his record, went with it and stopped reading.
Finally, I'm sorry for the lengthy details....... the question.
My opinion so far, is that his "waiver" will be approved....still waiting though.
However, I'm aware of med waivers on active duty, which expire and require regular re-validating. I'm concerned that a hip-shot diagnosis of "childhood asthma" ( courtesy of an improperly administered PFT at his physical and a poor review of his record) follows him for life.
First question....is this a one and done waiver which is supported by perfect outcomes on both PFT and MCT, will never be discussed again after he's on active duty? ...or....
Second question..... if we do find he actually he has a mis "diagnosis" of childhood asthma based on a physical 12 years after the only event in his record mentioning asthma, what recourse do we have to correct his record/misdiagnosis? His civilian doctor is beside himself amazed at the military medical machine and the inaccuracies that have brought us here. His doctor has asked to speak with his ROTC CC and as offered to write a diagnosis memo of his own, based on a review of the same medical history, the PFT and MCT. We intend to ask to have his personal doctor's memo admitted/amended to his medical record as well, regardless.
Third final/question. The cadet and his family are obviously biased based on affection and recognition of a herculean collegiate effort and the shock that 4 months prior to commissioning his career plans are about to be de-railed due to sloppy medical diagnosis. That said, are we making much ado about nothing? Should we just let the waiver process play out?

To whoever jumps in to discuss. Thank you in advance.

Lesson learned for military brats. GET A COPY OF YOUR MEDICAL RECORD FROM THE MILITARY AND REVIEW IT WITH A FINE TOOTH COMB PRE DODMERB.
 
asthma is very tricky - DS had to get a waiver for USNA, and will probably need another waiver for pre-comissioning physical, even though he has never actually had asthma.

the standards for accession (DOD 6130) are slightly different that for flight physical. the link below shows the waiver guide for aviation. the standards change based on how much the Navy has invested in you. Ie. the standard is higher for an applicant than it is for a SNA, and the standard for a SNA is higher than it is for a designated (winged) aviator.

seems that, in the case of your DS, they see a "questionable history", and in that case PFT and MCCT is required.
it also seems that they didn't follow the direction at the bottom of the page that says "avoid testing in the setting of a recent respiratory infection"
could have saved a lot of stress


bold emphasis mine
DISCUSSION: The diagnosis of asthma is based primarily on history, with the aid of the physical exam and pulmonary function testing (PFT) demonstrating reversible airway obstruction. Regarding methacholine challenge testing (MCCT), it is currently required for all applicants with a known or questionable history of asthma in order to exclude current bronchial hyperresponsiveness. In designated personnel, bronchoprovocation studies (e.g. MCCT) may not be necessary to establish a diagnosis of asthma, particularly those with classic symptoms or documented reversible airway obstruction. MCCT is most useful in symptomatic patients when asthma is suspected, but spirometry is normal or shows borderline obstruction. In borderline cases, a negative MCCT can help to rule out asthma. In asymptomatic patients, a negative MCCT does not rule out a remote history of asthma and/or seasonal asthma. When referring patients with remitted childhood asthma for pulmonary testing, avoid testing in the setting of a recent (within two weeks) respiratory infection to minimize confusion and ensure reliable results are obtained.
 
Way too much in the weeds.

The True North of respiratory issues for all services, all flight physicals, and all medical waiver accession decisions is:

Waiver authorities change, BUT, if a waiver authority wants something to render THEIR decision or medical waiver, THEY will specify exactly what THEY want to render their decision. Many waiver authorities do NOT want MCCTs; some prefer MCCTs over PFTs; yada, yada, yada.
 
As far as the question of will the diagnosis follow him for life, I can only give the perspective of the spouse of a retired AF pilot, which of course may be different for other services and be different from someone entering vs. someone already rated. My dh was already rated when an AF flight MD noticed a grade-1 heart murmur. He had had it at his initial accession physical into the AF and others had mentioned that they "might" have heard it, but nobody documented it until then. He was immediately suspended from flying until he had a full cardiac work-up (negative) and waiver granted. Never was mentioned again as an issue until about 6 years later he had changes on an EKG that "could have" indicated previous cardiac ischemia. He then was immediately suspended from both the AF AND the FAA and we faced the very real possibility of the end to his career. But, again full cardiac work-up demonstrated no cardiac issues and he is just "abnormally" normal. I believe he has something permanent in his records to that effect, and unless he has additional EKG changes (he is required to get 2/year for the FAA), he is good to go. The waiver did not affect his career in limiting what airframe he could fly (F16's, T-38's, T'6's, etc). He also had a waiver for his back (surgery for bulging disc r/t his years F-16 flying), and that was another waiver that did not officially limit him, but he did voluntarily choose to not do the high-G flying as he didn't want to take any chances with damaging his spine further/reaggravating things. Of course, things may have changed, but if your child gets his waiver and becomes rated then at that point, the military has invested a lot of $ in him- they won't just willy nilly DQ him. In our experience, something new will have to trigger another DQ. Good luck!
 
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MullenME and Hawkeyemom, thanks for taking the time to go over this. We actually had the good fortune to have a conference call with the flight med staff, our cadet and former military nurse Mom this am. It became very clear that our cadets records review locked up on a mom’s question to evaluate a 10 yr old for asthma, and ignored the subsequent entries highlighting negative findings for allergies or asthma... plus the 12 years of no chronic conditions EVER noted in his record. Couple that with the improperly administered PFT (when sick) the only thing being waived is an organizations mistakes vs a real/suspected condition. HIPPA gives patients some recourse to address inaccuracies/mistakes in someones record. We’re exploring the pain involved in exercising those laws to correct a seriously odd outcome and diagnostic red herring in our cadet’s record. This is probably a
 
bureaucratic nightmare.... but we’re looking into it. Sounds like they recommended a recheck in 2 years (wierd... that will be after pilot training complete) then an indefinite waiver from there. We’re waiting to see what AETC comes back with.
 
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