Protein S Deficiency Curveball

[WarmWaters]

Doc,

Thanks for looking in on this thread. Long story short(ish):

Current rated senior pilot, ~3000 hrs

My father had 2-3 blood clots when I was a little kid and has been on blood thinners ever since.  When it happened, my parents got blood tests for my sister and I and they found that we had protein S deficiency. That was pretty much that and I had basically forgotten about it.  That is until my sister got pregnant, got retested, and just reminded me that I have it too.  Her retest showed that her level is 17 (I think normal is 60-150?) and her protein C was normal. She 'thinks' my level was lower than hers when we were kids (she was a bit older and apparently remembers all this stuff somehow). 

I guess I'm not even sure what to ask. Worst case, Will I still be good to fly? Will I need to be on some sort of medication? I was thinking of getting out and flying commercially soon..would that even be possible? If possible would it even be smart (one blood clot I assume = no more job)?  Sorry, this is just a sudden curveball and I'm wondering if this might throw the whole life plan out the window. All aside the whole staying healthy part of course as well.

FYI currently forward deployed. I plan on getting a test done when I get back soon. Headed back within the week (of course via nearly 28 hrs straight on airplanes which is a scary thought after finding all this out

 

THANKS

[WarmWaters]

For what it's worth, I did search the waiver guide but could only interpret some of it to English. I've spent a few hours on the web trying to dig up an answer. Seems like 'NBD' if it's just the risk factor alone? Couldn't quite tell regarding medications.

 

FAA guide reads somewhat similar I think...except they mention a few drugs by name. ( https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/thromboembolic/) Doesn't say anything specific between Class I-III.

I fly a 2 pilot normal category plane.

Let's be honest, flying is my only real marketable 'skill'. I obviously want to know if I'm still good to keep doing what I'm doing for the time being. And if the answer is yes, should I also most likely be able to continue this into my 60s...or should I start  leaning how to build websites or sell cars or something?  I've shot an email to my flight doc but he is apparently out of the office for awhile.  It'd be helpful for my mental state (especially since I have more lines to fly) to have some idea of what to expect instead of having to wait until Stateside in 1-2 weeks.    Thanks

 

Edit: Adding the following comment after rereading my own posts....Apparently it only takes a random and rare medical condition that may threaten my career to make me sound like a yammering 16 year old. My bad

 

Edited February 23, 2016 by WarmWaters

[deaddebate]

Because you haven't yet actually had a venous thrombus event (to your knowledge), you're in a much better category if you indeed do have this deficiency.  The deficiency alone is just a risk factor for Thrombophilia, but it's probably enough to require a waiver.  Read these MSD excerpts of "disqualifying" conditions:

N8 - Thromboembolic disease, recurrent, or when response to therapy is unsatisfactory, or when prolonged anticoagulation therapy is required. [...] N14 - Other hematological diseases when response to therapy is unsatisfactory or when therapy is prolonged or requires intense medical supervision such as use of anticoagulants or antiplatelet agents other than aspirin or persantine.

Remember "disqualifying" doesn't mean the Air Force will throw you out the door as soon as it's discovered.  It just means a waiver and further consideration is necessary.  Though the title isn't totally accurate, the Waiver Guide entry for "Deep Venous Thrombosis/Pulmonary Embolism" is most applicable to you.  Whether you will require anticoagulant therapy will be the deciding factor in your waiver consideration.  I imagine you'll be categorized as having a "Transient Risk Factor," meaning certain actions will increase your likelihood to experience a VTE.  Thus you'd only be DNIF'd in response to things like major surgery, trauma/bone fractures, etc.  You'd already get DNIF'd for such events, but the DNIF would last longer.

But what do I know?  You haven't been tested yet for anticardiolipin antibodies, lupus anticoagulant factor, protein C, protein S, factor V Leiden, prothrombin

gene mutation, and antithrombin III.  I don't have access to your medical records.  You might be mis-remembering whether you've had a VTE.  Or not.  Get tested, and go from there.

For the FAA, damned if I know, but I can't imagine it would be anything other than more lenient than the AF. Every interaction I've ever experienced with FAA clearances is how ridiculously low the bar has been placed.

[stract]

On 2/23/2016 at 2:59 PM, deaddebate said:

For the FAA, damned if I know, but I can't imagine it would be anything other than more lenient than the AF. Every interaction I've ever experienced with FAA clearances is how ridiculously low the bar has been placed.

derail (sorry): except for loss of consciousness events.  I know a dude who got kicked the curb for a minimum of 2 years even after 2 separate neuros gave him clean bills of health.

[deaddebate]

For the FAA, damned if I know, but I can't imagine it would be anything other than more lenient than the AF. Every interaction I've ever experienced with FAA clearances is how ridiculously low the bar has been placed.

derail (sorry): except for loss of consciousness events.  I know a dude who got kicked the curb for a minimum of 2 years even after 2 separate neuros gave him clean bills of health.

Yeah, I also know a guy who totally was healthy and like was friends with four different doctors and each one said he was good but then the dumb FAA guy was like "nuh uh," but I totally know the whole story and there's no way that my buddy didn't tell me everything and that he knew his whole medical record and I memorized the FAA standards last night.

[stract]

nope, not like that at all, but thanks for disparaging me.  My point is that you can't sweepingly say the FAA is more lenient than the USAF, when there is plenty of anecdotal evidence against this.  https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjpoI2swJ7LAhVKn4MKHdRTBB8QFggfMAA&url=http%3A%2F%2Fwww.dtic.mil%2Fcgi-bin%2FGetTRDoc%3FAD%3DADA392805&usg=AFQjCNEphyNjiAKopg5DzDeLwa9SEtsOpw&bvm=bv.115339255,d.amc