surgery before WP FC1

[dvlax40]

So two parter, is having a deviated septum a DQ condition and would i have more hoops to jump through if i had it fixed before FC1 vs waiting, getting cleared, and fixing it afterward?

i only ask because my FC1 date keeps moving further and further and would like to get it fixed if able.

[Guest]

Your nasal septum, correct? How seriously does it affect your breathing during exercise/exertion or during sleep? How many times and when have you fractured your nose? Have you been counseled that you should have it corrected for your health, or just for comfort/aesthetics?

[dvlax40]

yes nasal septum. ive never "officially" broken my nose, but i have been hit in the face a couple times by various sports equipment and body parts. running is not bad, i just notice when im breathing i have to more forcefully breath through my nose but its not bad, i attribute more to me not conditioning as much at this point. the real issue is sleep, get very congested if i sleep on my left side to the point that i will wake up at times. doctors dont think its affecting my health, but i have noticed more congestion on that side of my head (nasal) especially behind and around my eye leading to some eyestrain.

[Guest]

Disqualifying conditions for flying duty in the AF Medical Standards Directory (MSD) dated 6 Oct 2014, para.s B5, B10, E5, E15, G7 respectively state:

Multiple fractures involving skull or face.

Any anatomic or functional anomaly of head or neck structures, which interfere with normal speech, ventilation of the middle ear, breathing, mastication, swallowing, or wear of aviation or other military equipment.

Deformities, injuries, or diseases of the mouth (including teeth), nose, throat, tongue, palate, vocal cords, pharynx, or larynx that interfere with breathing, chewing, swallowing, speech, or clear verbal communication.

Deviations of the nasal septum, septal spurs, enlarged turbinates or other obstructions to nasal ventilation which result in clinical symptoms.

Current or history of sleep apnea or other clinical sleep disorders, regardless of prior treatment.

Read these standards and interpret them for yourself. I believe you should pass the flight physical, though you may require an eval by ENT and/or Sleep Medicine. If you have already seen an ENT within the last year, definitely get a copy of the clinical notes and provide that documentation. I recommend that you DO NOT pursue corrective surgery now, as it will likely indicate that your condition was significant and symptomatic enough to require surgical correction.

[dvlax40]

thanks for the heads up, the doc stated surgery would be more quality of life vs medically necessary so ill hold off. honestly its not bad, its just end of the year and with my civilian, use it or loose it healthcare , i was thinking now would be the best time with my deductible paid off.

looking at the regs and never having broken my face i dont see any think on there that accurately describes what im experiencing

follow up, is the whole issue surrounding this the risk of barotrauma ?

[Guest]

follow up, is the whole issue surrounding this the risk of barotrauma ?

Mildly.

It's more about making sure you'll be operational and fit. The Air Force doesn't like to "buy" broken folks that'll need significant care in the future, hence we don't accept people with, say, positive Huntington's disease genetic testing. Nothing wrong with you now, but the Air Force won't accept the future risks.

[dvlax40]

Mildly.

It's more about making sure you'll be operational and fit. The Air Force doesn't like to "buy" broken folks that'll need significant care in the future, hence we don't accept people with, say, positive Huntington's disease genetic testing. Nothing wrong with you now, but the Air Force won't accept the future risks.

makes sense... honestly i hate how medicine has become commercial, this all stems from when i got my tonsils removed 5 years ago and the ENT tried to get me to get my sinus fixed too. i swear it feels like car shopping when you go to the doctors now, trying to upsell you on everything even if you dont need it.

the flip side, you pay through the nose (pun intended) for everything that you actually DO need...

[Jedi Doc]

thanks for the heads up, the doc stated surgery would be more quality of life vs medically necessary so ill hold off. honestly its not bad, its just end of the year and with my civilian, use it or loose it healthcare , i was thinking now would be the best time with my deductible paid off.

looking at the regs and never having broken my face i dont see any think on there that accurately describes what im experiencing

follow up, is the whole issue surrounding this the risk of barotrauma ?

Dead debate is spot on with the reg that concerns you and your 'medical condition' though, it is more of just an anatomic variation. No biggie in the general public, but it could become an issue if your primary duties are being performed in flight. Most of the aeromedical standards really do try to associate the disease/medical condition/anatomic variation with an increased aeromedical risk. Dead debate listed some of the medical standards above. Each one is taken individually though and if you don't meet the standard, an aeromedical waiver must be requested by the appropriate authority.

The only medical standard that could concern you is MSD E15: "Deviations of the nasal septum, septal spurs, enlarged turbinates or other obstructions to nasal ventilation which result in clinical symptoms."

Unlike all of the standards, this one allows some flexibility because as you see at the end the 'which results in clinical symptoms' allows the doc to make a clinical determination if you need a waiver or not. If I saw you for the flight physical, I would check your past need for medication use, history of sinus infection, ear infections, barotrauma or other recurrent upper respiratory infections/problems. If you didn't have a significantly higher pattern than the general public, you'd likely not require a waiver. Just document the physical finding and go on our way...

Each standard also only applies to specific types of IFC physicals. The one above though is a disqualifying condition for all except retention of non-flyers.

Hope this make sense!

[dvlax40]

Dead debate is spot on with the reg that concerns you and your 'medical condition' though, it is more of just an anatomic variation. No biggie in the general public, but it could become an issue if your primary duties are being performed in flight. Most of the aeromedical standards really do try to associate the disease/medical condition/anatomic variation with an increased aeromedical risk. Dead debate listed some of the medical standards above. Each one is taken individually though and if you don't meet the standard, an aeromedical waiver must be requested by the appropriate authority.

The only medical standard that could concern you is MSD E15: "Deviations of the nasal septum, septal spurs, enlarged turbinates or other obstructions to nasal ventilation which result in clinical symptoms."

Unlike all of the standards, this one allows some flexibility because as you see at the end the 'which results in clinical symptoms' allows the doc to make a clinical determination if you need a waiver or not. If I saw you for the flight physical, I would check your past need for medication use, history of sinus infection, ear infections, barotrauma or other recurrent upper respiratory infections/problems. If you didn't have a significantly higher pattern than the general public, you'd likely not require a waiver. Just document the physical finding and go on our way...

Each standard also only applies to specific types of IFC physicals. The one above though is a disqualifying condition for all except retention of non-flyers.

Hope this make sense!

makes great sense! thanks for the further info. I have heard of some dude getting deviated septums fixed post FC1 so i wasnt sure how big a deal it was. seems like most people have a deviated septum to some slight degreee.

as to mine, honestly i get maybe a sinus infection once a year or two and even then they are probably just bad colds lol. never understood what enlarged turbinates meant... i have a huge honking nose so i would assume other anatomical structures within the nose would be large as well?

i think youre spot on with the "clinical symptoms" part. seems like theres no way to know, one docs clinical symptoms is another everyday normal am i right?

thanks again for the insight guys, going to put off "cometic/quality of life stuff" (thats literally how the doctor phrased it, which is what gave me pause at getting it done in the first place - chunk out thousands for something not needed...)

[Jedi Doc]

i think youre spot on with the "clinical symptoms" part. seems like theres no way to know, one docs clinical symptoms is another everyday normal am i right?

Yes, the clinical reasoning is the art of medicine and as such there will be some variation in different physicians' assessments. That said, I think most docs can differentiate a normal pattern of upper respiratory and sinus infections from what seems excessive. The big thing you need to do is find a doc who actually cares and realizes the importance to the AF of pushing through a flying class physical. I'd see the flight doc first for the flying class physical and they will make the determination if a referral and/or procedure is required. From what you wrote above, it doesn't sound like it, but I'm not your doc! Just speculating...