ITP and Splenectomy

[SkydiveMike]

Hey guys, first post here. Non-prior, selected by a guard fighter unit last month. Haven't even gotten to MEPS yet as my prescreen was denied "history of ITP" and now my waiver request was denied by the SG also (ironically for the same reason which doesn't say much).

10 yrs ago I was diagnosed with ITP (a blood disorder which causes blood clotting problems).  A couple months later I had a laparoscopic splenectomy which is the typical way to treat this. Almost immediately my blood labs returned to normal and have been there ever since. No sicknesses or infections, health as a horse ever since.

A history of ITP is disqualifying per the DODI 6130.03, but it is waiverable per the AF waiver guide which is strange. I traveled out of state to see a renowned Hematologist who looked at my file and wrote a letter saying it was an acute case treated and cured 10 years ago with 100% success, 0% chance for it to come back, completely fit and recommended for military service, etc. I thought it was no big deal until the waiver request was kicked back Friday as disapproved.

What in the hell else would they want to see? I'm familiar with the 6130.03 and AFI 48-123 and waiver guide and I just can't understand what the problem is. If it's cured a decade ago, will never come back, and therefore no risk of symptoms in the future, what logically is the problem? This seems to me like a textbook waiver case so it's really frustrating to see this dream getting ripped away without any good explanation.

Edited August 21, 2017 by SkydiveMike

[SkydiveMike]

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.