Esophageal issues

[Guest Duder]

Here's the situation, a have my OTS class date and am all ready to go but the other day I am reading a list of medical disqualifiers and notice that I may have a condition that is on the list. I have had a couple endoscopies done when I was younger where they found "trachealization of the esophagus", and did dialations. I have not had anything done in about nine years, but the reason that I had them done initially was because I would get food stuck in my throat sometimes. It still happens to me sometimes, 3-4 times a month, but it only happens when I am trying to swallow too large of pieces of a fairly non-malleable food (ie. steak, also very large tablets). Generally, I just have to stop eating for a few minutes, sometimes I have to go spit the food out that is in my mouth, and just not try to swallow anything and it resolves itself. Since the first time I was dialated I have never had to have an endoscopy done due to having food stuck and not being able to resolve itself.

SO....I never mentioned anything about it to MEPS as it wasn't anything that they asked about, and didn't see how it could be a hinderance to my service, but I am now wondering whether I should tell my recriuter so that I can get a waiver???? Are waivers possible??? Should I go see a GI doc so that he can take a look now and see what he thinks??? I still have a few months before I my class date. Thanks in advance.

[Guest awfltdoc]

It sounds by the description of your symptoms that you may have dysphagia. There could be many reasons for you having dysphagia. The trachealization of the esophagus you described is interesting (no one likes to be the interesting guy to the doc). There is a relatively new condition described in the medical literature called Eosinophilic Esophagitis (EE) that can cause this "trachealization". As I recall we had a guy with this (EE) at my base not too long ago. Its thought the cause is due to food allergy, and is treatable. There could be other reasons for this as well. Anyway, the way I read and interpret the AFI, you would have a disqualifying condition. I think it would need to be evaluated by GI and a waiver requested. Maybe one of the other docs has some input.

BTW, do you or your close family have allergy, sinus, asthma problems?

Edited May 19, 2007 by awfltdoc

[capt4fans]

The only problem you'll have as far as swallowing once you get in is ending up in fighters and having to be the new boy......

I keed I keed

[Guest Duder]

Yeah, I have read some research done at the Mayo clinic about EE, and it sounds a lot like what I have experienced, but I was never told anything about any esophagitis. Have also heard that it can be treated with Singulair. The allergy part was the one thing that doesn't fit since nobody in my family, including myself, has any problems with allergies. I have also had a swallow study done with barium contrast that came back normal. That is why I never told them at MEPS, I don't exactly know what to call it, and it doesn't really cause me any major problems. I don't know, maybe I should have another endoscopy done here before I leave. How long does it usually take to get a waiver?

Haha at the fighters comment, but im going to be working in the hospital.

[I don't exist]

I've been flying on active duty for 4 years and this has been an issue for at least the last two. It took me having the Hemilich performed on me for my wife to insist I see the doc. My doctor and I suspect that I have a chronic esophogeal stricture due to chronic acid reflux. Even after treatment, will this disqualify me for continued flying duties?

[Guest Benko]

I'm not a flight doc but I am a SME that works side by side with flight docs. According to the medical examinations and standard AFI the stricture you have is considered disqualifying...

A4.3.1.15.3. Malformations, injuries or diseases of the esophagus, such as ulceration, diverticulum,

varices, stricture, achalasia, pronounced dilation, or peptic esophagitis.

It does not state if it is a history of it...meaning you had it, but were treated for it and have no more problems, or if you have it right now. Every doc has their own interpretation of this large AFI so my 2cents on it are you are disqualified with the diagnosis of the stricture, but after treatment it may be waiverable. I am not sure about it being waiverable but I would always try for one and see if it gets approved or not. This does not really tell you if you will be disqaulified after treatment but gives you an idea of what the doc is faced with as far as the reg and your condition are concerned.

[Danakonda]

I was diagnosed two days ago that I have Eosinophilic Esophagitis (E.E.). I am currently a casual Lt starting pilot training in aboput 6 months but have yet to go to IFS in Colorado. The flight doc interpreted the AFI as a disqualifying condition but said it could be waiverable based on the Gastroenterologist treatment recommendation. Next week I am going to visit the Gastroenterologist and would like some guidance on how to stress the outcome treatment could have on my career. I would not say my EE is severe by any means, just something I have been able to deal with for about 7 years. I have only had 3 episodes that i have been able to remedy on my own. Basically, I am just looking for a realistic outlook on obtaining a waiver and being allowed to start UPT? Any input would be appreciated.

thanks

[TheOtherBluto]

Ok...bit of a different spin. Regarding eosinophilic esophagitis:

1.) does this diagnosis (and subsequent treatment) require a waiver?

2,) does be use of Flovent WRT treatment require a waiver?

For background, O-5 recently diagnosed...been flying a long time!

[Guest]

1. Yes

2. I'm not seeing it on the "Official Air Force Aerospace Medicine Approved Medications" listing, however it is discussed in the Waiver Guide for EE. The waiver will be lumped together into one package.

For Initial Flight Clearance, this is a DQ, but trained personnel apparently have a very high likelihood of waiver. Approval rate of ~94% for FCII over the last 5 years.

Read the waiver guide if you want more info. Link in my signature block. Titled as "EOSINOPHILIC ESOPHAGITIS and EOSINOPHILIC GASTROENTERITIS"

[DirkDiggler]

Thread bump.

  Anyone have any recent experience with getting a FC1 waiver for eosinophilic esophagitis?  According to the AF waiver guide it's a DNIFing condition but waiverable.  Was curious if anyone had any data on likelihood of waiver, how long it would take, etc.  Appreciate any help anyone can provide.

[brwwg&b]

It'll likely mean a trip to Wright Patt and specialist to look and make a determination. I'd argue the waiver should be very likely, have heard of them being approved even if the condition wasn't totally under control by medicine.  Depending how long you've lived with it / potential damage to the esophagus would be the bigger concern.

Likely a non-issue, free trip to Wright Patt out of it - go check out the AF Museum during the stay.

[SocialD]

Late to the party.  I got my initial FC1 (circa 2005) with a waiver for GERD.  The waiver required an upper endoscopy every 3-5 years to keep tabs on my condition.  Nearly every time required a dilatation and they'd take a biopsy.  They actually ended up "retiring" my waiver even though I was "borderline" for eosinophilic esophagitis. We had a Guardsman Flight Doc who was a DO that was head of his department a local college hospital system.  He was the DO who did my last 3 scopes.  I was never actually diagnosed me with EE, but he said I'm headed that way.  FWIW, he wasn't too concerned with a possible EE diagnosis.  Hope it's a non-issue for you, but based on my experience, I'd thinks brwwg&b is probably on point.  

[DirkDiggler]

Honestly appreciate the replies, they were helpful.  I was considering pulling my retirement request and staying another couple years but in the end I've decided to proceed with retirement so this won't be an issue (at 21 and change total years).  Once again I appreciate the info.

[SocialD]

28 minutes ago, DirkDiggler said:

Honestly appreciate the replies, they were helpful.  I was considering pulling my retirement request and staying another couple years but in the end I've decided to proceed with retirement so this won't be an issue (at 21 and change total years).  Once again I appreciate the info.

 

Awesome!  I retired last summer at just over 22 years (DSG) and I haven't missed it at all.  The amount of free time I now have is unreal.  Congrats and best of luck in your next chapter!

[Smokin]

I was just diagnosed with this as well and the doc said to take "gaviscon advance".  It is OTC and available on amazon.  I've been taking it for about two weeks and I think it is helping.  Almost no instructions on the meds, but he told me one before and after breakfast and another after lunch and dinner.  Might be able to control it without any other medical intervention.