Question on DQ 241.30 History of airway hyperresponsiveness including asthma, reactive airway disease, exercise-induce bronchospasm or asthmatic bron.

American Mom

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Hi Folks,

Question from a mom here. My son, who was given albuterol as a preventative, used it once due to smoke inhalation from the burning brush with his dad and was flagged (no surprise) for DQ241.30. Even though his primary care physician stated in a letter that he was not asthmatic, the issue has been resolved and that he never used the inhaler, only had it for preventative measures, which made no difference.

To those in the know, do you have any suggestions for having him see a pulmonary doctor and go through a PFT to dispel any assumption that he has what they claim "he could still have issues," even though the kid is as fit as a fiddle?

His caseworker from DoDMERBS is not helpful, and I want to steer this kid on the right path. I would greatly appreciate any info/expertise.

Thank you.
American Mom
 
We have a very similar situation (and DQ) on our hands. My son's primary wrote us a letter as well and also had him take a methacholine challenge and spirometry test out of precaution (which all came back normal). We did this over summer so when the DQ showed up we had the documents. Although DS has posted all this to DODMERB we still haven't been notified if the SA's he's applying to are considering a waiver. Entire process was expensive fyi and since it was a precaution, we have to pay out of our own pocket. Hoping and praying.
 
We have a very similar situation (and DQ) on our hands. My son's primary wrote us a letter as well and also had him take a methacholine challenge and spirometry test out of precaution (which all came back normal). We did this over summer so when the DQ showed up we had the documents. Although DS has posted all this to DODMERB we still haven't been notified if the SA's he's applying to are considering a waiver. Entire process was expensive fyi and since it was a precaution, we have to pay out of our own pocket. Hoping and praying.
We are wishing your service academy candidate all the best. Personally, I am astonished at the lack of common sense used for this process. Our children's PCP words should be good enough as they are vouching for our kids and know their history. If I can inquire, what was the ballpark $$?
 
Thank you for your well wishes and we extend the same to you and your candidate! After what our insurance covered it was right around 1k. Certainly, worth every penny especially considering the reward. And yes, this process is frustrating. Only thing we can do is advocate for our kid!
 
We are wishing your service academy candidate all the best. Personally, I am astonished at the lack of common sense used for this process. Our children's PCP words should be good enough as they are vouching for our kids and know their history. If I can inquire, what was the ballpark $$?

You wouldn't believe how many times a diagnosis was put in an applicant's medical records at the age of 14 years (if it smells like a duck, walks like a duck, then it probably is a duck) and then the primary care provider pulls it back later when the diagnosis isn't a good thing to have in the medical records.

I mean, you have to assume the diagnosis was correct the first time. I'm not saying this is what happened to your son, but when people ask why no one believes what the doctor said (which time? the first or the second time?), it's hard to know what to believe sometimes.

As an aside, firefighters don't take inhalers before they go into the fire. There must be something in your son's history that caused you to ask his doctor to give him an inhaler when being exposed to smoke/fire. I don't know.

The DQ isn't just "asthma", it's reactive airway disease, airway hyperresponsiveness, bronchospasm, etc... In this case, you wanted your son to get an inhaler in the event the smoke causes bronchospasm/airway hyperresponsiveness. That's ok to do. Nothing wrong with that at all. We need to make sure our kids stay safe.

However, that type of action causes the military to look at those cases more closely. Trust me, as someone who has deployed to Afghanistan and Iraq, we don't get issued inhalers in case we get exposed to smoke.

I don't know your son's history. I don't have access to his medical records. It's just pure speculation on my part why your son could have been DQ'ed for getting prescribed an inhaler in anticipation for smoke exposure.

People are built differently. Some can be exposed to smoke and react to it as expected. Some can be exposed to it and the airways "hyper react" and become hypoxic. Those are the ones worth looking into for the military.

Most of the time, I advise people to wait until you know what the waiver authority wants before you go out an get an expensive test that may not be needed. In general, it seems the USNA wants methacholine challenge tests. Other WAs, are good with pre-/post-bronchodilator PFTs. Who knows what they really want until they ask for it though.

Good luck!
 
We are wishing your service academy candidate all the best. Personally, I am astonished at the lack of common sense used for this process. Our children's PCP words should be good enough as they are vouching for our kids and know their history. If I can inquire, what was the ballpark $$?
Respectfully, while your PCP knows your child’s history, they are not experts at fitness for military duty. With working environments, locations and conditions that ‘aren’t traditional’. And a potential lack of access to medical care. All while in charge of people’s lives. Literally.

Don't be afraid of the DODMERB process. If a DQ’ed condition truly ‘isn’t a big deal’, there is a process to accommodate that.

Good luck to your son on his application journey!
 
You wouldn't believe how many times a diagnosis was put in an applicant's medical records at the age of 14 years (if it smells like a duck, walks like a duck, then it probably is a duck) and then the primary care provider pulls it back later when the diagnosis isn't a good thing to have in the medical records.

I mean, you have to assume the diagnosis was correct the first time. I'm not saying this is what happened to your son, but when people ask why no one believes what the doctor said (which time? the first or the second time?), it's hard to know what to believe sometimes.

As an aside, firefighters don't take inhalers before they go into the fire. There must be something in your son's history that caused you to ask his doctor to give him an inhaler when being exposed to smoke/fire. I don't know.

The DQ isn't just "asthma", it's reactive airway disease, airway hyperresponsiveness, bronchospasm, etc... In this case, you wanted your son to get an inhaler in the event the smoke causes bronchospasm/airway hyperresponsiveness. That's ok to do. Nothing wrong with that at all. We need to make sure our kids stay safe.

However, that type of action causes the military to look at those cases more closely. Trust me, as someone who has deployed to Afghanistan and Iraq, we don't get issued inhalers in case we get exposed to smoke.

I don't know your son's history. I don't have access to his medical records. It's just pure speculation on my part why your son could have been DQ'ed for getting prescribed an inhaler in anticipation for smoke exposure.

People are built differently. Some can be exposed to smoke and react to it as expected. Some can be exposed to it and the airways "hyper react" and become hypoxic. Those are the ones worth looking into for the military.

Most of the time, I advise people to wait until you know what the waiver authority wants before you go out an get an expensive test that may not be needed. In general, it seems the USNA wants methacholine challenge tests. Other WAs, are good with pre-/post-bronchodilator PFTs. Who knows what they really want until they ask for it though.

Good luck!

You wouldn't believe how many times a diagnosis was put in an applicant's medical records at the age of 14 years (if it smells like a duck, walks like a duck, then it probably is a duck) and then the primary care provider pulls it back later when the diagnosis isn't a good thing to have in the medical records.

I mean, you have to assume the diagnosis was correct the first time. I'm not saying this is what happened to your son, but when people ask why no one believes what the doctor said (which time? the first or the second time?), it's hard to know what to believe sometimes.

As an aside, firefighters don't take inhalers before they go into the fire. There must be something in your son's history that caused you to ask his doctor to give him an inhaler when being exposed to smoke/fire. I don't know.

The DQ isn't just "asthma", it's reactive airway disease, airway hyperresponsiveness, bronchospasm, etc... In this case, you wanted your son to get an inhaler in the event the smoke causes bronchospasm/airway hyperresponsiveness. That's ok to do. Nothing wrong with that at all. We need to make sure our kids stay safe.

However, that type of action causes the military to look at those cases more closely. Trust me, as someone who has deployed to Afghanistan and Iraq, we don't get issued inhalers in case we get exposed to smoke.

I don't know your son's history. I don't have access to his medical records. It's just pure speculation on my part why your son could have been DQ'ed for getting prescribed an inhaler in anticipation for smoke exposure.

People are built differently. Some can be exposed to smoke and react to it as expected. Some can be exposed to it and the airways "hyper react" and become hypoxic. Those are the ones worth looking into for the military.

Most of the time, I advise people to wait until you know what the waiver authority wants before you go out an get an expensive test that may not be needed. In general, it seems the USNA wants methacholine challenge tests. Other WAs, are good with pre-/post-bronchodilator PFTs. Who knows what they really want until they ask for it though.

Good luck!
Appreciate it. We will have to wait and see.

Best,

AM
 
We have a similar issue, DQ for childhood viral related asthma that began at age 3 with pneumonia, he truly outgrew it but we kept filling inhalers at his well checks out of habit, and because we had no idea it would ever be an issue. So I made an appointment with a pulmonologist. He still has to do his CFA and finish a couple of essays, so probably no waiver would even be requested until that is complete....
 
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