I figured I should update in case anyone searches this subject in the future.
I got my unit's flight doc involved and she concluded the DQ was completely stupid so she requested I get to WP anyways. Early this week I was scheduled for an FC-1 for Nov 27th. They requested additional paperwork for the splenectomy, and almost immediately came back with bad news. I am DQ'd with NO chance of a waiver and the physical is cancelled. Of course in my opinion it's laughable.
There's some studies that suggest that cases of ITP are slightly different in children versus adults. Namely, childhood cases tend to completely resolve while adult cases tend to be chronic and relapse. An overwhelming number of cases that relapse after splenectomy (the most common method of treatment with about 2/3 cases obtaining complete resolution) do so in 2-4 years after treatment. I have yet to find a case of relapse more than 8 years after treatment. I am 10 years post-splenectomy, normal platelet count the entire time, and no complications of any sort. I have letters from several Hematologists assuring that my case was cured 10 years ago with no chance of relapse or any other reason it would impede on military service.
For FC-1 only: In an effort to disqualify cases that have or could relapse (and rightly so, a very low prolonged platelet count could be dangerous during flying duties) someone decided to assume all "adult" cases are chronic in nature and disqualify those. The age of 18 is used as a cutoff to separate "childhood" vs. "adulthood" even though it is completely arbitrary as there is no scientific evidence suggesting a certain age where chances of a complete resolution decline. So if the condition occurred after the 18th birthday, it is not waiverable for FC-1. No study of the the actual case, treatment success, time of remission, etc. I was barely 19 years old.
For FC-2: It is waiverable, regardless of age, if resolved.
Most guys getting their FC-1 aren't 29 years old like me, so I'm willing to bet there's not too many guys who got ITP around 18-19 years old followed by 10 years of complete remission, but that's my case. I think it's pretty absurd to write a hard age cutoff that rejects any chance for a waiver at all, especially when no study suggests a certain age. Why not let the doctors look at the case and decide that? Even if by some miracle I did have a relapse, it is easily identified in a normal CBC, adds no added risk of incapacitation, and can now be treated with prescription medicine. According to the 48-123 Waiver Considerations, it shouldn't be an issue.
I know it's a written policy, albeit an absolutely stupid one, and I know there's nothing I can do about it. At this point I think it'll take an ETP but I'm not sure of my unit's opinion of pursuing that especially with my age. I'd still be really disappointed if it was a legit medical concern, but the fact that it's not (according to every doctor I've ever talked to) is pretty infuriating. I know I'm not the first person to get the shaft from a shitty AF policy and won't be the last, but it still sucks.