Reactive Airway disease

[tenlander]

Hi, long time lurker with the usual story-freshman in college, doing ROTC in fall, want to be an AF pilot, PPL, you know the rest. I have read the multiple threads on asthma multiple times, but I have kind of a specific situation, and I figured you guys might be able to help me out.

When I was 6 I was diagnosed with Reactive Airway disease, and I was only on prescription inhalers until the end of elementary school, when I essentially outgrew it. Unfortunately, two months after my thirteenth birthday, I had a wicked cold so my parents (both pharmaceutical scientists) figured, "hey, he's got asthma on his record, why not get him an inhaler." So, I kinda have a history post-13th, though it wasn't asthma related.

I think it's important to note that my RAD is NOT the stress-induced wheezing type-it's the coughing kind. Basically, I have as good a chance of having an asthma attack as anyone else. I scheduled a methacholine challenge test in a few weeks-I figure I'd rather know now than in three in a half years when I'm taking my FC1 and they say "oops, sorry, you don't qualify for AD, time to go work PR" or something.

Now, the reason that I'm posting, is that after extremely strenuous exercise, I actually do cough a bit afterwards. Only something like the pacer test, which has me sprinting for ten minutes. I've played paintball for 24 hours straight with marines, run 3-4 miles a day, etc., no problems, but I'm afraid it will still show up on the test.

Is this ever considered case-by-case, or am I more or less screwed if I have problems on the test? I can take it one way or the other, it's sitting in summer session for six weeks not knowing if I'll be doing ROTC that is killing me.

Thanks,

Brenden

[brabus]

They're not going to give you any kind of test for asthma at your FC1...unless it's in your records. So if you have no medical records saying "asthma" or related after 13, you should be fine. However, offering up this info about "my parents thought I did so I got an inhaler" could just nail your coffin just like that. You didn't have asthma after 12 or whatever (it doesn't count that your parents fvcked up and thought you did), so I would say NO when they ask if you have. Case closed, you're fine. Now, at the same time, you say you get coughing spells after working out, but then go to say you run 3-4 a day, pball 24 hrs, blah blah...which is it? If you can run 3-4 a day w/ no problem, you're going to be fine w/ AF PT.

This is all technique purely. I can't tell you what to do or what the right answer is. All I know is the AF is VERY VERY touchy on the asthma thing, at least in my experience w/ friends' cases. Technically it's not a big deal if you didn't have anything after 12 (hence why you're probably SOL if you mention the after 13 thing), but I've seen a couple friends bite the dust for asthma when they were several years younger than 12. So, who knows. Play it safe and don't offer any more info than you need to.

[tenlander]

To clarify, I cough some after extremely strenuous activity-such as sprinting for ten minutes. I can run, at a normal pace, 4 miles just fine, with no coughing afterwards. And the key word is after.

How closely do they go over your medical records? I figured they would see the prescription for the inhaler, which is why I brought it up. If I didn't think they would get those files, naturally I wouldn't volunteer the information. Hell, I wouldn't volunteer it anyway, but I assumed they would see it.

And btw, it totally doesn't matter, but my parents didn't fvck up. Inhalers alleviate coughing by opening the airway, whether you have asthma or not. I had one of those hacking colds, so they figured why not. I never even used it, it's sitting under the sink in my bathroom with the pharmacy label still over it.

Thanks for your help.

[Guest F16PilotMD]

"They" will only see your medical records if you give said records to "them". If you were treated on AD, or as an AD dependent, that's different. It's in your records--done. Stick to the facts. You were not diagnosed with asthma at 13. You were given an inhaler by your parents. That's not a diagnosis.

If you can do the PT that you claim, you don't have any problems. Why do you cough after sprinting? I have no idea. I think you're fine. Just be careful with the "have you ever" type questions. Again, stick to the facts, formal diagnoses, etc.

By the way, inhalers don't fix coughs. That's a myth. Most are bronchodilators designed to tx reactive airway diseases. Cough is a symptom of asthma sometimes but the two are not mutually exclusive. Don't treat a cough with your inhaler.

[tenlander]

Alright, thanks for the info. I know it all seems very minor but if I can avoid a desk job before I have no choice in the matter, I'd like to (naturally, after I sign the dotted line, I'll accept anything they give me).

I have been formally diagnosed, (technically with RAD, not "asthma" per se, so I can feign ignorance, but that might get me in trouble) so when asked on that general med form I'll get from my ROTC guys, I figure I'm still checking yes. I'm going to meet with the cadre CO sometime this summer hopefully and ask him about rumors I've been hearing about people being pressed out for any history of asthma and see what he says.

And, once again, completely irrelevant, but both my parents have doctorates in pharmacology and toxicology. My dad has worked for two of the biggest pharmaceutical companies on the planet for the last 35 years, and a good part of the last decade has been spent on finding a cure for asthma. If he says an inhaler will help alleviate a cough, (not fix it) I'm inclined to agree with him. Don't mean to be combative, but for some reason I feel the need to defend.

[Herk Driver]

Dude, you came here looking for answers. Don't be so combative about your parents or criticism. You need to develop a thicker skin.

Edit: Not that F-16PilotMD needs my help, but the MD part of his name means that he has a degree in being a Medical Doctor.

Anyway, as was said, stick to the facts. Have you ever been diagnosed with Reactive airway disease? Yes. Later they will ask you for more specifics. The answer is I have never been diagnosed beyond the age of 12 or my symptoms never occured beyond the age of 12. 'nuff said. Don't add, "but my parents gave me an inhaler at 13 because..." That won't help. No matter if you explain that your parents are the Surgeon General of the US; it won't help. Stick to what a doctor diagnosed and you will be fine.

[tenlander]

Big misunderstanding. To clarify again, I have no intentions of volunteering the information; it was done through my primary care guy who probably wrote it down. That is what I'm worried about. If you don't think they'll see it, there's my answer.

I'm not disagreeing with F16-his info was extremely helpful. I (and my parents) would agree that inhalers don't fix coughs, but they do relax the airway. Either way, it wasn't prescribed for asthma or RAD symptoms, and I'm not sure if they take that into account. The point of this all is that my biggest fear is taking a methacholine challenge test in three and a half years and failing. If you guys don't think they'd find any reason to give one (I thought the inhaler thing would), then I'm good to go. Thanks a lot

edit: Herk, I actually said, in my post, that I wasn't being combative. I was responding to a well-informed remark by F16, he thought I meant something and I didn't. As I also said, it's not important and not germane to the topic.

Edited July 4, 2007 by tenlander

[tenlander]

I apologize, I have forgotten how things work around here. Made a mistake while making a point, I was wrong and myself alone. So I'll just pose a quick hypothetical and then be on my way-somehow the flight doc sees prescription for an inhaler post-13th birthday, in a person with early history of asthma (that they most definitely will see). General consensus is that that's not good enough to give me a methacholine test, correct?

[Guest nick4060]

This forum has been very helpful for me but I also have questions on it. I'm currently a high school senior and am pursuing a career as an AF pilot. Im in the midst of applying to the AF Academy and I've gone through the DoDMERB evaluations. I'm medically fit, except for asthma. I recently got a letter from DoDMERB saying I'm disqualified for entry to the Academy for having a history of asthma after 13th. I'm aware that selection for pilot training has the same policy regarding asthma so this really disturbed me.

I had asthma from a very young age, until I was about eleven. My last athsma attack was at age eleven and since then, I've had no symptoms, no treatments, etc. So naturally, I was confused when DoDMERB told me I was disqualified. I think the problem was that they looked over my medical records and found that I had prescriptions for inhalers after age 12, even though I never used them or suffered any effects of asthma after age 12. I've contacted my doctor on this and he will write a letter explaining that he only gave me the prescriptions "just in case of an emergency" and that I didnt actually need them.

This is the first time asthma has ever been an issue on a medical exam. I run at least 2-3 miles each day, I play varsity soccer, and I easily attained a 1st Class FAA medical when I got my private pilot's license. Do you think that a letter from my doctor would convince DoDMERB that I really did not have any problems with asthma after age 12?

Edited August 26, 2007 by nick4060

[tenlander]

We're in pretty much exactly the same situation--except I've never actually been diagnosed with asthma, and I'm pretty sure they'll never dig deep enough to find the inhaler prescription (I hope, it wasn't prescribed by my primary care doctor). If they do, we'd be in the same boat.

[Jon - Trident Home Loans]

I'd look into doing a methacholine challenge test to prove you don't have asthma. Only tests/records mean something to the AF...doc note's don't carry weight.

[Guest nick4060]

Thanks for the info. Sorry about all the questions. Do you think that the Air Force would offer the methocholine test or would I have to get it done with my private physician and send results to DoDMERB. Would that be enough to convince them?

[tenlander]

I've been told you can do it either way, but it depends on what the AF docs want. I'm avoiding it unless I actually have to, because I'm pretty sure I'd fail it (I don't have asthma but as previously noted in this thread I still do have a touch of RAD, which isn't in the least bit dangerous).

[brabus]

Do you think that a letter from my doctor would convince DoDMERB that I really did not have any problems with asthma after age 12?

Probably not. From what I've seen, the AF doesn't give a shit what God says about your situation, they ONLY care about what their doctor said. Rage or F16PilotMD can back me up on that, but as far as I know, they could really give two shits about what anyone w/o rank on their shoulder says (i.e. civilian docs).

[Jon - Trident Home Loans]

The AF did my methacholine challenge test at Wilford Hall while I was in ROTC. They submitted my results to AETC/SP and DoDMERB to get me cleared. I tried all the other routes first, but without taking the test they wouldn't give me the time of day. The test measures your normal breathing and then your breathing after asthma inducing medicine. You can have a reaction, but not more then 20 or 25% change from normal breathing. Once they clear you you're good for any job. I head to UPT next week. Good luck! PM me if you need any other info.

[Guest nick4060]

Tenlander,

Id really recommend a methacholine test. I got it done, passed it, and got this whole issue sorted out. Its definately worth the time and effort.

[Guest P27:17]

OK...let's slow this train down a little. A MCCT is not an end all diagnostic test. It can do more harm than good and it's expensive. If you have not had an asthmatic, reactive airway, obstructive airway, or any other wheezing episode since the age of 12 to 13...I wouldn't worry about it. That's the "magic rule" or "silver bullet"...not the MCCT.

If you've been hitting on or been given an inhaler since then...you've got some "splainin'" to do.

[Guest USAFblue]

Hello,

I consider applying for commissioning in the USAF, and I just wonder what I should do about the steroid inhaler use in my records. One a year or once every two years I happen to get a bronchitis... It all started after my tonsils were removed when I was 19. It's always the same story - I get a good cold, with fever, runny nose and other "happy stuff" like that... Then I just cough (dry cough) for a longer while. My family doc believes that a steroid inhaler helps to calm it down, once the initial bronchitis clears out, so it's obviously in my records.

A few years ago, for some reason I kept coughing for like 2 months, so she sent me to a specialist. They said something about "cough variant asthma", did PFT, histamine challenge test, IgE levels for allergies in blood and it all came back normal.

I have never experienced any wheezing or any bronchial spams. I never used/needed any quick working inhalers to dilate my airways. I am really fit, I run quite a bit, and I am all fine after the runs. But I happen to get those stupid coughs. Maybe some kind of an allergy? (They did the skin tests for all the common allergens and it was all normal - not a thing).

Should I confess that to the Air Force or just forget about it? I don't want to lie but I don't want them to freak out about it either. Because there is no need to. I have never had anything that would be even close to a classical "asthma attack".

Any advice?

thanks in advance!

[Guest Blackhawks22]

Sorry for the miss post.. Reviving this thread,

Back in 2006 I was given an inhaler for bronchitis. This was the only issue I had using an inhaler. I just got accepted for pilot in the Navy and I was reading the pre-screen where it asks any usage of inhaler. So as I was researching I saw some people saying just by having the box check for inhaler usage they were PDQ with no chance of a waiver. Now I don't know if this people were miss informed or if this is the truth. One was a marine and one was army both enlisted (I also don't know if enlisted vs officer makes a difference for waivers). One states it's a new policy from the DOD and can't be overrided because the military has so many qualified members they don't want anyone with any use of inhaler. I find this a bit extreme.

One guy I talked to told me he had to wait 9 months last October to get a waiver for admitting to having been prescribed an inhaler once. He got a pulmonary fitness test done and then finally got it. At the same time though this guy trying to get in the army enlisted, in September 2009 was PDQ with no waiver.. Which doesn't make sense.

Has anyone had to deal with this in the recent year and had complications? I know this website is primarily Air Force but I'm sure the regulations for waivers and aviation are close if not the same. I told my recruiter and since I'm prior Air Force, he told me, "well you know how meps works, so it's your choice if you want to admit to it. I can't say the results but (sighhhh), you should know how the meps routine works.." So he's basically telling me to not say anything about it.. and I don't feel comfortable with that.

I worry because I have to put down acid reflux too. Which I hear is an easy waiver with an EGD. And they I have some minor stuff like a shoulder problem where I injured it 2 yrs ago working on my car, no surgery needed but I had physical therapy I went to for a month.. and then burning while I urinated. Docs tested me for UTI and std's .. everything came back negative. (the std was just routine).. Blood work and everything came back fine and the symptoms went away a few days later. So nothing really came about of that. Idk, I hear at meps they DQ for almost anything and in this day I'm just worried about having too much paper work and them showing me the door.

What are your thoughts?

[Bronco130]

I was prescribed albuterol and some other inhaler in my 22 years before applying to pilot training... at Brooks I was given the 'start looking for another job.' I took the pulmonary exam on steroids at brooks, and if you pass that it's undeniable that you are fine. I have a waiver for asthma and in the waiver it says I dont have asthma...so my current flight doc just saw that and said he's going to try to get my waiver removed period.

Granted the AETC surgeon still has to sign off on the waiver... so it took a while and I was still cringing for 6 weeks till I finally got it to work.

[Guest Blackhawks22]

Hey thanks for the response BroncoEN, I just don't understand why this is such a big deal for an isolated incident. I understand the severity's of asthma .. IF YOU HAD IT. But come on, It's becoming a trend these days for doctors to prescribe inhaler with an upper repository infection to prevent asthma from developing. At least that's what I read anyway. At meps they should just give you the PFT and if you pass it there should be no need even for a waiver process.. I guess there are somethings no one will ever understand besides the people who develop the rules, and even then I don't think they fully understand.

[tlr9489]

I was hired a few months back for a Guard squadron UPT slot. I have records at MEPS from years ago when I was trying to get into the military through another branch. When I filled out my medical forms, I included that I was prescribed an inhaler back when I was playing football as a college freshman. My PCP knew I didn't have asthma, but he prescribed me an Albuterol inhaler, likely to shut me up from bitching about getting gassed at practices/workouts... I have notation saying that I don't have, nor have I ever had asthma, and the inhaler was a preventative measure only. It didn't matter back when I filled out the forms- I was DQ'd. I had spoke with an experienced ANG recruiter (not from my unit), who I know pretty well, and he told me that all is not lost, and my best bet would be to go get a methacoline challenge test. I was tested a few weeks ago, and passed it easily- I actually did better as the test went on and more methacoline was added to my system... I have it all documented and ready to send in to MEPS. Is there ANYTHING else I can do to help my situation out? I am 28.5, and my squadron is looking for me to swear in and get to training ASAP, but there is real concern that if I don't get the medical processing taken care of immediately, I will be too old for starting UPT by the next available training date. I have landed the greatest gig on the planet, and I feel it slipping away... What can I do to help myself out here??? Thank you.

[tlr9489]

So, I submitted my methacoline challenge test results and summary, note from my former PCP who prescribed the inhaler, and note from my current PCP. Basically, saying I don't have asthma, never have had asthma, and my airway is perfectly healthy. MEPS is asking my recruiter to have me submit a note from my current doc saying I have never used the inhaler. I can try to ask for this, but I can predict the answer- why would a doctor say I never used a medication that he/she didn't even prescribe to me in the first place?? I understand MEPS doctors don't want to be on the hook, but is this even a reasonable request. What can I do?? I need to get to MEPS immediately, and swear in. I am the oldest of the UPT candidates hired at the board back in June, and I am holding everybody back from getting training dates (due to being 28.5 years old, my squadron wants me going first)... PLEASE ADVISE. Thanks.