Non-Allergic Rhinitis and Upper Respiratory Infections

S

SLK

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Male applicant, age 17+, applying, just finished personal interview with ALO.

History of "non-allergic rhinitis" on med records. Two times to allergists in pre-teen years detected no specific allergies. But, still experiences occasional allergy-type symptoms and occasionally takes OTC claritan, RX for flonase and duratuss (nasal decongestent), when runny nose problem surface. Sometimes hard to discern this from run-of-the-mill cold and often just resolves itself.

No diagnosis for allergies or asthma.

However, do get occasional sinus infections. Two-four times per year in recent years. No infection for last seven months. Getting less as gets older.

Years ago (say 6?) family switched to different private insurance carrier, and was exempted for upper respiratory infection coverage due to childhood history.

Very robust and healthy. Varsity high school sports including cross country, b-ball, track all through high school; no exercise-related problems. Just occasional "snotty nose" and trip for antibiotics.

Issue for Air Force? How to best address as DodMERB approaches?
 
DoDMERB will request an allergy questionnaire (can be found on the DoDMERB home page, click on "Forms"). Based solely on the allergy portion, I do not believe it will be an issue.

The sinus infections may be an issue. The frequency that you mention is of concern, so DoDMERB will most likely request copies of the medical records regarding that. If, as you state, they have become less frequent in the past couple of years, then there may not be an issue. If you have had 2 or more sinus infections per year for the past 2 years then you may get a disqualification for chronic sinus infections.

At this point in time, since it does not sound like you have taken the DoDMERB physical examination yet, I would not worry. Fill out the medical history questionnaire honestly, if DoDMERB requests additional information supply it as quickly as possible, and see what happens. If you do get disqualified, then post what the disqualification is here, and I'll assist you as much as I can.
 
Thanks, RETNavyHM

Thanks for the information. Will follow up. Helps to know a little more about the expectations.
Questions:
1. You sound pretty certain two or more sinus infections per year are too many and likely a disqualifier. Do you mean any two acute infections, even if they are resolved through a course of antibiotics? Or, ones that persist over time and are not resolvable (chronic)? Please advise as to how these definitions are sorted.
2. If DoDMERB initially disqualifies, is this the kind of condition that is difficult to appeal?
Thanks for your input. ~SLK
 
Two or more sinus infections that occur for at least 2 years or longer, even if cleared with antibiotics can be considered chronic sinus infections.

If disqualified for chronic sinus infections it can be waived. This is all dependant on how frequent the infections are, the severity and if they are able to be cleared with antibiotics.
 
Anticipating DQ

Sounds like we can anticipate a DQ at the initial stage. Of course we'll be straight on the DodMERB physical form. Nonetheless, any guidance as to honest explanatory statements that may reduce negative impressions?

I.E. is it okay to indicate things like: full participation in sports through mid and high school, including varsity, with no performance problems. High honor roll student throughout. Gone to at least 7 Civil Air Patrol encampments and national activities with no illness, etc. Or maybe include family physican statement that the condition presents no impairment and responds appropriately to antibiotics?

Or is the above too much editorializing on the initial physical form? Should these things be saved for later appeal? Should we just report the bare bones facts and elaborate later, when asked?

Thanks for feedback.
 
On the DD Form 2492 - Report of Medical History I would answer the questions as instructed. The instructions on the form for all yes answers is as follows:

"Every "yes" response in items 7 through 81 must be explained in the space provided. Give specific dates and details including names of physicians and hospitals or clinics and the current status of the condition."

The longer the answer is, the more attention will be focused on it. On the DD Form 2492 I would provide the answers that are requested and leave it at that. If additional information is requested by DoDMERB or a disqualification does occur, that is when I would include the sports information, a letter from the family physician, etc..
 
Prepping

Given what we currently know, we can expect a DQ on the sinus thing. We will start accumulating copies of records. I'm convinced from reading other posts that doing this takes time, so jumping on it now.

Good news that our local clinic will provide copies of all our records free within the next week or so. Then, will look for the gaps, especially specialists seen in preteen years, and contact them for their paperwork.

Then, we can be ready to respond in a more timely way to the expected DoDMERB request for further info.

A side question... don't know if this thread is the place or another... but was diagnosed with ADHD as a preschooler, on meds for about 1 year, ended, the whole issue fizzled. No school, civil, or criminal violations great or small. High honor roll, varsity sports, etc. Since this was an early matter and faded over a decade ago, is this something to report on physical form as an affirmative mental health thing?
 
More questions

OK, after some on-line reading and reflection, is the below a pretty accurate picture?

Got a medical history of sinus infections. <<We have some question whether some of these office visits/diagnoses truly accurate, as we’re in a remote rural area and the doctors were always happy to throw antibiotics at us for a snotty nose.>> Nonetheless, the records show high numbers/year as a child, reducing over time to now about 2 per year. Doctors told us many times "he'll grow out of it", and that seems to be the pattern. No diagnosed structural problems (per ENT) and no allergies (per Allergist); those assessment made in pre-teen years.

DoDMERB regs see sinus infections within recent years, more than one per year, as an automatic DQ. Check?

Sinus DQ code is not typically a remedial condition. Check?

So, once the DQ received, the next step depends on the program For us the target is AFROTC 4 year program. From the DoDMERB website:

"U.S. AIR FORCE ROTC SCHOLARSHIP PROGRAM (AFROTC) – There is no need for you to request a waiver. All applicants medically disqualified for the 4-year AFROTC program are automatically reviewed for medical waiver consideration by HQ AETC/SGPS. If the waiver authority requests additional information, tests, or consultations, you will be notified by DoDMERB. DoDMERB will notify you, in writing, if additional medical tests, evaluations, or consultations are required and of the results of the waiver decision."

I take it the above paragraph means we sit tight and wait for decision from the waiver authority, HQ AETC/SGPS, communicated to us via DoDMERB? About how long does that take?

Does HQ AETC/SGPS in the waiver consideration look at non-medical things? Like in application package things varsity sports, high academics, 32 ACT ~ things like that which indicate absence of physical or mental impairment???

If we get a follow-up request for additional information, tests, consultations, okay, we can follow through. Does that happen often in sinus code cases?

We could, as a preparatory measure, get evaluations from specialists (say, ENT and allergist) now to evidence no current problems. Since we live in a remote rural area, doing these things takes travel and time. That’s why we ask the value of doing so now, versus later in a time crunch.

What if instead we get a response saying basically, “that’s it, denied”? Do we have any further recourse?

Frankly, biggest question is, “is all this worth a fighting chance?”

I’m the mother, so am leery of giving my son a misleading picture. If he’s got an uphill battle but maybe winnable, we can deal with that. If this is a lost cause, then he needs to change his mindset and kick in gear other college plans. Time’s limited.

Is this posting appropriate for the forum thread, or better put in direct communication with the moderator, RetNavyHM?

Thanks for any observations or guidance.
 
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I am sure RetNavyHM will answer your questions -

allow me to tell you what I have learned from my own experience -

you may NOT get a DISQUALIFICATION right away. DODMERB may request a remedial. There is a chance that Dodmerb will qualify your son after the remedial if they request one.
The remedial for my daughter was the allergy/sinus questionairre and a request for all medical records birth to present.
I basically went through her medical records and recorded filled out the questionairre accordingly - that was alot better than going from memory.
She was dq'd for another matter but NOT for sinus infections - of which she had several. They were not even an issue after submitting the questionairre.

I understand your stress - while doing all of this I remember thinking - wow! I wish I hadn't taken her to the dr all those times for a cold/sinus infection!

I am confused as to what point you are at - has he had his physical?

As for whether or not it's worth it - depends on you and your son. It takes some extra paperwork and time but if this is what your son wants to do then YES! It's worth it!
Take it one step at a time! Good Luck!
 
Awfulizing or Not?

Thanks for the comments from a "been there, done that" Mom.

I might be over-anticipating the worst... or not. Who knows? I'm one of those who like to prep for any contingency.

To clarify current stage, my son will be going for AFROTC physical exam early this spring, so no, it's not yet done.

Just got my son's local clinic records going back to beginning of 02, when we moved here. In past three years he's had 3 sinus infections, the last one in May of this year. Terms such as "sinusitis with allergic component", "chronic sinusitis", "allergic rhinitis" are sprinkled in the medical log over the years. Even though as a preteen he was cleared by ENT for sinus and Allergist for allergies, these types of terms still pop up. So, there's many causees for concern, I believe. I've read different takes on the web, with the general theme being getting a waiver will be a very tough battle to win.

Coupled with my concern about getting things done in a timely and easy way. We live in rural SD ("Dances With Wolves" filmed in our region). Getting to see specialists is no simple task.

I got a 6'4" robust healthy son who had top scores on his PFT, but may face the axe. But, Uncle Sam doesn't want sick troops when duty calls, and I can't argue with that logic, either.

Thus, I'm trying to gauge how realistic the picture is.

Thanks for any feedback and guidance. ~S.
 
SLK, you are indeed posting in the correct thread. RetNavyHM is away from his desk at the moment. (Out obtaining a mule for tomorrow’s game day BBQ). DODMERB issues can be overwhelming to those seeking answers to questions such as yours. Sounds like you are a step ahead for what is to come between DODMERB and the application processes. He’ll be back to answer your questions soon. Until then, just know that you are on the right track here and it will indeed be worth a “fighting chance”. Best of luck to your son.
 
Alright, sorry for the delay, I was in Texas (not my choice) getting my CCNA certification and was not able to focus on anything else for a while.

I'll start with the ADD question. If it has not occured in the past year, its not an issue.

Now for everything else!

When DoDMERB reviews the physical exam, if they have enough information to issue a disqualification they will. For chronic sinusitis they will request additional information most likely before a possible disqualification. So have those medical records ready. When the DoDMERB reviewer and physician go through the records, they will see if the condition meets the criteria for a disqualification. Each applicant is an individual, and is looked at as such. There could be something that the physician wrote in the notes that makes the DoDMERB physician not issue a disqualification.

Part of the difficulty I have here, is the fact that I can only base my opinions from what the parents and applicants state here in the forum. Some people try to exaggerate their conditions and some will underestimate their conditions. I have to try to find the middle ground, without seeing the real information. So if my answers seem a little ambiguous at times, its because I have no other choice!

If your son is disqualified for AFROTC, the waiver process is automatic, and you sit and wait for an answer. The waiver process for AFROTC takes between 3 - 8 weeks from the date of the disqualification. If DoDMERB puts a remedial for your son before a disqualification, I would have your son write a letter explaining everything in his words. This will be sent to the waiver authority if he is disqualified.

As for is this worth it? That isn't my decision to make. Waivers can be granted for chronic sinusitis, and have been granted in the past for it. Some applicants get right through the DoDMERB process, others can see it drag out for months. The fact that you are on this forum asking questions months in advance leads me to believe that this will all be worth it. It may cause a few gray hairs, some teeth gnashing, maybe even some words that you normally wouldn't say and that you don't want your children to hear you utter, but if you didn't go through with it, even if it has a negative outcome, would bother you for much longer with the "what if".

I am here (be patient, I try to reply in 3 days, usually much less) to help and answer questions. Once your son has his physical examination and DoDMERB has a chance to review it we will see where we stand and go from there!
 
Devil is in the Details?

I have had a chance to review son's local clinic records going back through 2002. Prior to '02 have partial records in our family files, especially from specialists. Will have to go out of state to fully access earlier records; am in the process of obtaining.

During son's childhood years we had concerns about more than normal sinus infections. Born 90. In 93 saw ENT. ENT didn't see anything struturally wrong, but removed the adenoids as a likely solution. Also had immune system testing in 94, with no significant results. In 97 saw both allergist and different ENT with no allergies displayed nor any ENT-related concerns. With the absence of any obvious triggers, our family doc and the specialists told us "he'll grow out of it someday".

Infections continued, numbers up and down over the years. In 01 or 02 saw another ENT, no problems diagnosed. However, ENT did suggest to reduce intake of milk to less than 4 oz per day, as possibly that might be causing a delayed (over several days) swelling reaction in nasal tissues. Since then, son has avoided larger servings of milk and related products. Yet, don't see any smoking gun with milk, cause no official allergy test revealed sensitivity and occasionally son conumes amount >4 oz and with no consequences.

Thus, no obvious cause of frequent infections detected.

However, in the recent years have seen things get better. Maybe son's system has "matured" as docs predicted??? He still gets the occasional sniffly nose cold, but now seems to fight more of those challenges off.

Last three years local clinic's record shows:

2005 = 2, one visit labeled "sinusitis, chronic" (do not understand the chronic descriptor, as prior to this event no problems for one year), the second "nasal congestion viral v. allergy".

2006 = 2, one visit one month, second 30 days later (unresolved infection? but resolved second time), both labeled "sinusitis".

2007 = 1 epsiode, May, labeled "sinusits with allergic component". Did resolve, but used higher octane antibiotic (augmentin). Other meds used in May to fight this infection were decongestant/tussin and flonase spray. Son does have on-going RX for those meds in case of other "challenges" and has used them for, say a week or two, twice this fall. But, didn't get secondary infection like last May.

Curious to find a spectrum of terms related to allergies over the last five years: "with allergic component" (2007), "allergic rhinitis" (2003), "milk allergy" several times.

Lots of other medical terminology that escapes me, but those are the terms that jump out.

How's this perceived as a frequency and treatment issue? Looks more than a little bad to this layperson.

How to report this on the physical form in a truthful yet restrained way?

~S.
 
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I'm gonna start by saying that we need to take a step back, and take a deep breath.

Imagine you are a lay person filling out the form with only the information that your physician has told you. You know nothing else. You are like you were 3 weeks ago. Fill out the form like that person.

DoDMERB will request the records. They will go through and make a determination. If they do not believe it is an issue they will qualify your son. If there is an issue they will disqualify and the waiver authority will decide whether it is an issue that would preclude someone from serving in the military.

At this point in time, once you receive the DD Form 2492, fill it out according to the instructions on the form. If/when DoDMERB requests additional information then submit the records along with a statement.

We haven't even started the process, so it is WAY to early to start panicking about something that may not be an issue. Once we get to the point where DoDMERB is requesting additional information or has issued a disqualification, then we can go through all the routes available.
 
Inhale; exhale

OK, will approach it that way. Good reminder on perspective. I do not expect any further devolpments for awhile, say until after Xmas.

Does this thread stay active in the meantime, absent further postings? Or some other arrangement?

Thanks. ~S.
 
This thread will stay active forever. To reply to this thread you will just need to search for it and make your reply.
 
Post Christmas

Son got news of Type II AFROTC award (hooray), so are awaiting correspondence on DoDMERB physical. We feel better equipped to handle this next step, thanks to on-line and email input from members of this Forum.

One curious thing will be the site of the physical. If it's anything like our AFROTC Admissions Liasion Officer interview, that'll be a fun road trip. Even though we're 250 miles from UNL Lincoln Det (go Huskers) we were assigned for ROTC application processing via U of Wyoming's Det (500+ miles to the west). Ended up interviewing with an ALO from Sioux City, Iowa. Gotta love the wide open spaces of the great plains!

Do applicants have much/any input into the locale of physical?

~SLK
 
When you get the letter to schedule an appointment with Concorde, Inc (the physical examination contractor), they will attempt to schedule the appointment at a facility within 50 miles. Some locations that is not possible, but they will work with you as much as possible.
 
Physical Done; Waiting for Results

Got mailing from DoDMERB and filled out the on-line medical forms. Interesting. Each "yes" response opened a set of boxes asking detailed questions about diagnosis, date, doctors, treatment, outcomes, the like. Seemed pretty detailed, more than we expected.

Son had physical exam yesterday. Interesting in that the appointments were brief with quite limited interaction. No probing questions or even general inquires over the listed areas of concern. Son got the impression the doc just wanted to verify son was apparently healthy and that was about it.

The medical staff seemed up-to-speed on doing ROTC physicals and assured us the paperwork would be faxed to DoDMERB right away.

A complication might be our disclosure under the ENT and Sinus blocks that an ENT had diagnosed son with "milk hypersensitity" 7 years ago. We had recalled that as just a verbal suggestion, but when the report was re-read, there was the diagnosis, bigger than life. Did add to the comments section son now consumes milk products just fine... so hope this revelation not construed as an allergy.

Now, we want to see what DoDMERB has to say about the results.

Any idea about how soon results are typically posted, given this is early January?

A side note: we had to travel only 130 miles to do the physical. Out here in rural NE, that's a walk in the park.
 
The contract physician and optometrist fax the information to Concorde, Inc in Philadelphia, PA where they do an internal QA (make sure the physician and optometrist checked all the boxes and did all tests needed so they can get paid) before sending it to DoDMERB. Concorde, Inc has 30 days from the date of the last exam to get everything to DoDMERB. Once DoDMERB receives it they have another 15 days to review, but it is usually done within a couple of days. So at the latest, the middle of Feb, but I'd say more likely late this month.

As for the milk hypersensitivity DoDMERB will most likely request copies of the medical records as well as an allergy questionnaire. Have your son (and maybe mom or dad) add an extra sheet with comments concerning this, and based on previous conversations we have had, I don't believe it will be an issue.
 
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