Headache/Migraine info

[Guest bittercold]

This is going to be a long story so brace yourself...

In November 2004 I started getting some wicked headaches. So I went to my PCM. She asked me a few questions and basically freaked out and said I had migraines. She gave me medicine and said I will have to take them for the rest of my life. So I was like ok. So I took the medicine for a few months and honestly it made me feel wierd. So I went back again and she gave me new medicine. Yet again nothing but feeling wierd (Mind you the headaches had stopped the same month I complained about them). So finally I got fed up and stopped taking the medicine all together. Well flash forward 2 years to today and honestly I have not had one headache. I think I was honestly having tension headaches due to getting a new boss, a new job, and a death in the family (so I was really stressed out). Well now I am trying to apply for ABM and need a FCIII. I know this is going to come up. Honestly I 100% believe the military doctor misdiagonsed me. She never sent me to a neurologist and she honestly just looked at me and said I had migraines. So I am going to have my physical in about two weeks and I don't know what to do. I feel like I am going to get the shaft because of a doctor that had her heart in the right place but was a little gung ho. Since I know there are flight docs on here how should I approach this to a fellow flight doc? It has been my life long dream to fly and honestly if I really had migraines I would understand not allowing me to fly, but I am fine. BTW to give more back story I am a NCO in the air force with 7 years and I neve missed a day of work for my "migraines". They are just in my medical record. Thanks for any guidance that you can give me. I just want to know how to fight this.

Keith

[ 28. January 2007, 12:40: Message edited by: Toro ]

[Guest P27:17]

Your flight surgeon will have to "paint a picture" showing that the headaches in 2004 were an isolated problem. No matter the type, the key is severity, chonicity, and prognosis. The doc may order a neurology eval...

Here is an outline on the waiver criteria...

IV. Waiver Consideration.

A disqualifying headache for Flying Classes I, IA, II and III, ground-based controller duty, space and missile operations, and air vehicle operators is defined as any history of a primary headache with any of the following characteristics present:

-- Impairment in social, vocational or academic activities caused by the headache and/or its associated symptoms.

-- Medication other than OTCs is required for abortive control of the headache.

-- A prescription for prophylactic medication is required for the headache.

-- There is associated neurologic dysfunction or deficit including aura, with or without (i.e., acephalgic migraine) associated headache.

A secondary headache meeting any of the above criteria is disqualifying unless the secondary headache and its underlying cause(s) have resolved. Whether a history of the underlying cause is separately disqualifying must be considered.

The waiver authority will review cases of any aviation and special operational duty applicants with a history of headache to determine if the headaches are disqualifying. The waiver authority may consider for remote and isolated history of disqualifying headache in applicants.

There is no longer any minimum observation period before waiver application.

The MAJCOM may consider a waiver if there are:

-- Three or fewer disqualifying headaches per year, and

-- No associated neurologic dysfunction, deficit or aura, and

-- No or mild (i.e., did not cause any social or occupational impairment) nausea, photophobia, or phonophobia, and

-- No prophylactic medication is required.

For all other cases, the waiver authority is AFMOA.

[Guest doctidy]

We don't DQ for "migraines" any more. We DQ for recurrent, incapacitating headaches. The flight doc going into your physical has 2 choices:

- disagree w/ you that you have recurrent, incapacitating headaches and recommend DQ

- agree w/ you and ask for a waiver due to a past history of incapacitating headaches

[Guest nstallion]

I'm a UPT hopeful that has browsed these forums for a couple of years now without ever posting. I wanted to absorb as much as I could from the forums before posting so I don't look like a total idiot.

I have no medical problems and have never had any major injuries (no broken bones etc). The only surgery I've ever had was an appendectomy.

I do however have a history of headaches. These started about 6 years ago. At first I thought it was a sinus issue, but CT scans examined by an ENT expert show my sinuses to be normal and unblocked.

I have since seen a neurologist specializing in headaches. I've tried many different types of drugs - allergy medications, anti-inflammatories, anti-depressants, epilepsy/seizure medication and even Botox to disable the muscles that can cause tension headaches. None of these have been too effective and I had been reduced to simply being prescribed painkillers.

This wouldn't really be such a problem if OTC drugs worked for me, but they don't. They don't work for my father/mother/brother either. The opiate based painkillers (I am prescribed Vicodin/Hydrocodone) are very effective but have their own drawbacks. Sometimes they will alleviate the current headache but cause me to get a withdrawal headache (usually the next day) which can only be cured with more Vicodin. In this sense, the prescription painkillers are useless for me.

Over the years this problem seems to have died down, and nowadays I almost never get headaches. When I do, I'm so used to them that they are rarely anything more than an annoyance. Currently I have to go back to my doctor to get another prescription of painkillers for when I do get headaches, and I don't think I'm going to bother.

I'm at the point now that I usually just ignore any headache I might get, but I'm worried that this history may affect my chances of being given a pilot slot. I'd like to know if anyone can shed some light on the AF's stance on something like this. When doing background checks, will things like prescription histories be examined? Would the continued use of painkillers be a problem?

[Guest Rage_:P]

Not only will it be a problem getting a pilot slot, I frankly don't think you will be able to be commissioned or even enlisted. It sounds like you know you have a history of bad headaches.

[usaficeman1]

Hi. I'm currently a pilot on flying status, 2 years in on my 10. I've had headaches every once in a while for the past couple of years, nothing too bad, but recently I've been getting migraines multiple times per week for long periods of time that have been pretty bad (been woken up from migraines, nausea, and had to go home early a couple of times in the past weeks.....luckily nothing while I've flown yet). They're getting worse and I want to go see the flight doc, but I've heard that I could get permanently DNIF'd and taken off flying status. I've even heard that I could get MEB'd and kicked out of the Air Force since they're looking to cut down the numbers right now. Any truth to this stuff?? Any suggestions?? Thanks for any help.

[Learjetter]

Well...that's a quandary.

Im not a doc, but im on a long term DNIF so im getting smarter on med issues...My first reaction to potentially serious med issues is: choose life.

I'd probably try very hard to self-identify what is causing them...stress? Chocolate? Dehydration? Exercise? Allergy? High blood pressure? Etc. Do they respond to excedrin?

Do Flt docs visit your sq? Can you discuss your "brother's recurring headaches" to see what things OTHER than worst case could be causing them?

Obviously, if there are any neurological defecits (lazy eye, loss of vision, loss of smell or taste, weakness in arms/legs or loss of balance, loss of hearing, etc) then get thee to the ER right now. Choose life.

Once you tell the Flt doc you're having m-word, you're DNIF and headed for a MEB and your AF future is in jeopardy. But if it's something serious, not flying is a fair trade for long life.

Ultimately, the choice is yours...slug it out alone and risk something bad happening in the jet, or, more likely, finding out it was just stress and everything's AOK.

Good luck.

[POKESC17]

Well...that's a quandary.

Im not a doc, but im on a long term DNIF so im getting smarter on med issues...My first reaction to potentially serious med issues is: choose life.

I'd probably try very hard to self-identify what is causing them...stress? Chocolate? Dehydration? Exercise? Allergy? High blood pressure? Etc. Do they respond to excedrin?

Do Flt docs visit your sq? Can you discuss your "brother's recurring headaches" to see what things OTHER than worst case could be causing them?

Obviously, if there are any neurological defecits (lazy eye, loss of vision, loss of smell or taste, weakness in arms/legs or loss of balance, loss of hearing, etc) then get thee to the ER right now. Choose life.

Once you tell the Flt doc you're having m-word, you're DNIF and headed for a MEB and your AF future is in jeopardy. But if it's something serious, not flying is a fair trade for long life.

Ultimately, the choice is yours...slug it out alone and risk something bad happening in the jet, or, more likely, finding out it was just stress and everything's AOK.

Good luck.

Lear is telling you exactly what you need to be doing. Migraine and flying don't mix. You need to be thinking about life outside the cockpit on this one. wife and kids if you got them, mom, dad or the dog. What ever is important to you outside of flying. Quality of life is another. Living without the Migraines two or three times a week is probably worth not flying. I was in a very similar situation. Headaches every day, some of them migraine intensity. Got to the point that I couldn't concentrate in the jet and it wasn't worth strapping in. If you want my story go You will be DNIF'd immediately but experiences my vary with the MEB. I was DNIF for a year, had two visits to the ACS folks at Brooks and Wright Pat, one visit to Willford Hall (avoid at all costs), and two to the eye surgeon that fixed me. MEB was mentioned only once and that was only to tell me that if I was DQ'd then I would face an MEB. Take the reigns out of the Doc's hands once your DNIF'd and it's determined what needs to be done. Find your own civilian Doc's that specialize in whatever your case is. At the same time start exploring your options for life not in the cockpit. Like Lear said, the choice is yours but if your concerned enough to be asking out here on the board then it's probably time to go see the Doc once you've gotten yourself informed on what you think might be wrong. Hard decision I know but I would gladly have handed over my wings to get rid of the pain. Luckily for me it was correctable and I'm back in the cockpit.

[usaficeman1]

Lear is telling you exactly what you need to be doing. Migraine and flying don't mix. You need to be thinking about life outside the cockpit on this one. wife and kids if you got them, mom, dad or the dog. What ever is important to you outside of flying. Quality of life is another. Living without the Migraines two or three times a week is probably worth not flying. I was in a very similar situation. Headaches every day, some of them migraine intensity. Got to the point that I couldn't concentrate in the jet and it wasn't worth strapping in. If you want my story go You will be DNIF'd immediately but experiences my vary with the MEB. I was DNIF for a year, had two visits to the ACS folks at Brooks and Wright Pat, one visit to Willford Hall (avoid at all costs), and two to the eye surgeon that fixed me. MEB was mentioned only once and that was only to tell me that if I was DQ'd then I would face an MEB. Take the reigns out of the Doc's hands once your DNIF'd and it's determined what needs to be done. Find your own civilian Doc's that specialize in whatever your case is. At the same time start exploring your options for life not in the cockpit. Like Lear said, the choice is yours but if your concerned enough to be asking out here on the board then it's probably time to go see the Doc once you've gotten yourself informed on what you think might be wrong. Hard decision I know but I would gladly have handed over my wings to get rid of the pain. Luckily for me it was correctable and I'm back in the cockpit.

I've flown all my life.....not being in the cockpit would truly suck. I have no idea what I would do outside of it. And I'm even more worried about getting kicked out completely in these rough times. Lear, you said that my career would be in jeopardy.....how bad?

Thanks for the help guys.

[Learjetter]

I meant by "career in jeopardy" that the MEB could medically separate/retire you from the service. There are conditions that DQ you from flying but not from service, and then there are conditions that DQ you from serving at all. If any of us gets one of these conditions, and doesn't get a waiver or ETP, you're out of the USAF. Look, not flying for the AF would really really suck, I agree...but letting a very serious condition develop into something terminal would be worse, IMHO. That was the choice I faced not long ago...different symptoms than you have, but I knew SOMETHING was wrong, and put it off to keep flying. One day, I told my wife what was going on and she told me she'd rather be the wife of a c-word patient, than the widow of a AF pilot. I chose life. luckily, it looks like we didn't wait "too long", and God willing I'll be back in the cockpit again soon.

I'll sum it up here: if you can't explain your symptoms away due to generic causes, and feel SOMETHING is seriously wrong, selecting life over the AF and flying is a good choice. If you choose life, see the doc, get referred to the verybest civilian specialist you can, and get fixed. THEN, get busy working waivers to stay in/keep flying.

Good luck.

[POKESC17]

I meant by "career in jeopardy" that the MEB could medically separate/retire you from the service. There are conditions that DQ you from flying but not from service, and then there are conditions that DQ you from serving at all. If any of us gets one of these conditions, and doesn't get a waiver or ETP, you're out of the USAF. Look, not flying for the AF would really really suck, I agree...but letting a very serious condition develop into something terminal would be worse, IMHO. That was the choice I faced not long ago...different symptoms than you have, but I knew SOMETHING was wrong, and put it off to keep flying. One day, I told my wife what was going on and she told me she'd rather be the wife of a c-word patient, than the widow of a AF pilot. I chose life. luckily, it looks like we didn't wait "too long", and God willing I'll be back in the cockpit again soon.

I'll sum it up here: if you can't explain your symptoms away due to generic causes, and feel SOMETHING is seriously wrong, selecting life over the AF and flying is a good choice. If you choose life, see the doc, get referred to the verybest civilian specialist you can, and get fixed. THEN, get busy working waivers to stay in/keep flying.

Good luck.

2

[usaficeman1]

My wife and I had a long discussion last night. I also just spoke to a friend of mine who got MEBd for Type I Diabetes, and he explained the whole process to me......it doesn't sound like fun. But y'all are right and I thank you for the guidance. I'll be seeing a flight doc this week. Here we go........

Edited September 11, 2011 by usaficeman1

[POKESC17]

My wife and I had a long discussion last night. I also just spoke to a friend of mine who got MEBd for Type I Diabetes, and he explained the whole process to me......it doesn't sound like fun. But y'all are right and I tank you for the guidance. I'll be seeing a flight doc this week. Here we go........

Good luck. Very tough decision. Let us know how it goes.

[Catbox]

My wife and I had a long discussion last night. I also just spoke to a friend of mine who got MEBd for Type I Diabetes, and he explained the whole process to me......it doesn't sound like fun. But y'all are right and I thank you for the guidance. I'll be seeing a flight doc this week. Here we go........

Good luck man...I've been through the whole thing, long term DNIF turned medically DQ'd from flying which turned into an MEB which turned into a duty limiting code. Go into this like a prize fighter...if you are expecting those first few hits they don't sting as much. There will be good docs, bad docs, minimum wage bureaucrats who's sole purpose in life is to be a road block and 1 or 2 people who actually get things done. Most of all there is a lots and lots of waiting. Be patient but don't be afraid to pick up the phone and pester the f--- out of people to get you answers.

Most of all remember that you are absolutely doing the right thing.

[usaficeman1]

Good luck man...I've been through the whole thing, long term DNIF turned medically DQ'd from flying which turned into an MEB which turned into a duty limiting code. Go into this like a prize fighter...if you are expecting those first few hits they don't sting as much. There will be good docs, bad docs, minimum wage bureaucrats who's sole purpose in life is to be a road block and 1 or 2 people who actually get things done. Most of all there is a lots and lots of waiting. Be patient but don't be afraid to pick up the phone and pester the f--- out of people to get you answers.

Most of all remember that you are absolutely doing the right thing.

Just saw the flight doc today......DNIF 90 days and waiver req to get back on flying status......"F!!!". The doc said they've had about a 50/50 success rate ending up in flying waivers if they can get it under control. The not so lucky I guess get moved to a different career field; if this happens, anyone know if my ADSC changes? He said if they still couldn't help the migraines after moving me to another job, then theres a small chance of an MEB, just like y'all said. I've got an MRI next week, so I'll keep updating as I find out new stuff. I can already tell this process is gonna suck........

[H-10btr]

Just saw the flight doc today......DNIF 90 days and waiver req to get back on flying status......"F!!!". The doc said they've had about a 50/50 success rate ending up in flying waivers if they can get it under control. The not so lucky I guess get moved to a different career field; if this happens, anyone know if my ADSC changes? He said if they still couldn't help the migraines after moving me to another job, then theres a small chance of an MEB, just like y'all said. I've got an MRI next week, so I'll keep updating as I find out new stuff. I can already tell this process is gonna suck........

Good luck man... FWIW, I think you are doing the right thing even though it blows!

Edited September 15, 2011 by H-10btr

[POKESC17]

Good luck man... FWIW, I think you are doing the right thing even though it blows!

Keep us in the loop. I was told that my ADSC would be knocked back to a standard 4 year ADSC but I was later told that if Big Blue wanted to hold me to the original ADSC then they could. I never could get a definitive answer. Probably just never asked the right people.

[usaficeman1]

Had the MRI today, wont find out anything they said until I meet with the Neurologist on tuesday. The flight doc put me on Imitrex, though. Anyone have any experience with this stuff? I helps a little but I hate the way it makes me feel; almost AS incapacitating as the migraines. Crazy anxiety/sinking feeling in my chest/loopy/tingly all over......no bueno. I'm gonna be asking for different stuff.

[usaficeman1]

So, good news and bad news. MRI was clean = awesome! Bad news, migraines are getting worse and still no help with the meds. I'm freaking out because the neurologist said if they can't find a med that works in the next month or so, I'll be goin up for an MEB! WTF!

So my question to ya'll is.....what happens if I go up for an MEB? Whats the process? Is it an automatic out? And if so, now what happens to me an my family? Is there any severance pay or anything to help us out the door? What about insurance???

I'm kind of worried for my family here and would love to hear about any experiences with this. Thanks everyone.

[Catbox]

So, good news and bad news. MRI was clean = awesome! Bad news, migraines are getting worse and still no help with the meds. I'm freaking out because the neurologist said if they can't find a med that works in the next month or so, I'll be goin up for an MEB! WTF!

So my question to ya'll is.....what happens if I go up for an MEB? Whats the process? Is it an automatic out? And if so, now what happens to me an my family? Is there any severance pay or anything to help us out the door? What about insurance???

I'm kind of worried for my family here and would love to hear about any experiences with this. Thanks everyone.

Hey Ice, I realize its been a couple of weeks so things may already be rolling but having been through the MEB process a few things I can recommend. First of all there are several different outcomes, retain, retire or separated. If you get retained you may have an assignment limitation code which will limit some options for you in the future (as I'm finding out now and am beyond pissed). My advice on this BE PATIENT and don't plan for any particular outcome. Go to your appointments, take your meds and be 100% honest with the docs who are treating you.

The other piece of advice...if you do get into an MEB, go to Transition Assistance Program ASAP. I wish I would have, but most of your questions regarding post service disability, insurance will be answered there or at least you will get the contacts who can answer your questions. But remember what I said don’t plan for anything, you are just attending TAP to put yourself at ease and figure out what MIGHT happen with two of the three MEB outcomes.

Please PM me if you have more questions...happy to chat over the phone or email if needed.

[Old_Noob]

Question from the applicant point of view:

When I read the waiver guide, it sounds like a history of migraine with aura is DQ for FC1, with no possibility for a waiver. Is that correct, or is it that it changes the waiver authority?

I used to get bad headaches when I was a kid, though not bad or frequent enough to need to miss school. I can positively identify that I had some migraines, because three times in my life I got a visual aura. I haven't had anything like that for 5 years now. I have family history of migraine on my mother's side.

It seems like I'd be a good candidate for a waiver, but I'm not sure if it's an automatic ban if you ever had an aura.

[deaddebate]

The PUBLIC waiver guide was compiled in May 2013 and the Headache entry is dated Nov 2010. The OFFICIAL waiver guide maintained behind the AFMS network has a newer Headache entry dated Jan 2014. There aren't many changes, but know that yours isn't the most current.

As you know, headaches with aura are considered "Classical Migraines (ICD-9 346.0)." A quick review of historical waiver cases in AIMWTS shows no approval for Pilot initial applicants (IFC I). There are two Navigator/WSO initial applicants (IFC 1A) that I saw who were approved for history of migraines, but more were DQ’d. Other categories have a higher waiver potential (IFC III/MOD/RPA/etc.) though none are especially promising. I'd recommend you try for a Nav slot (if you want that job) but have a good back-up plan because chances are you'll be DQ'd, then go for one of the other positions with a lesser FC. Pilot is nigh impossible.

[kbronc]

I replyed to this dude in a PM but for anyone else's benefit... I have a migraine waiver as an Initial FC1 candidate back in 2010ish. A few stars aligned in my favor: I hadn't had a migraine in over 6 years previous, no Aura, had a positive diagnosis from a Nuero. that I had outgrew them, my civilian AME was a retired Flight Doc that wrote a letter of support, had been flying commercially for 4 years, and my Guard Flt Doc pretty much wrote the waiver that I hand carried to Brooks for my Initial FC1 which they submitted a variation of.

[Sakers1]

Hi all,

So I had a very similar experience to "usaficeman1". I was on flying status back in 2012 until my headaches led to an MEB, and eventually a med discharge. After several years of working with civilian neurologists I am happy to say I have been 100% free of headaches for about 4 years now.  My question is, how can I get back in and on flying status?  What would be required and is it even possible? Would guard/reserve units better bet?  I've heard anything is possible with enough push, but I don't know where to start.  Any help is greatly appreciated. Cheers.  

[WizzoWannabe]

Hey everyone. This is gonna be a little long-- sorry in advance!

I'm a firstie at USNA and will be commissioning almost exactly one month from now. I was elated to service select NFO and be one step closer to being a Super Hornet WSO. However, no one ever told me that it was career suicide to use the word migraine (which I used to think was synonymous with headache) or go see the doc for headache meds until it was too late.. I was told after service selection that I needed to get a waiver. I went to see a neurologist O-6 and he gave me a glowing AHLTA note (I do not have migraines and the problem has been resolved by not staying up for 24 hrs at a time), but NAMI still denied the waiver. However, they denied me due to having "migraine (G43) with presence of aura", which is completely incorrect. All of these headaches (five total over four years) were mild, were treatable with OTC meds, and were due to major sleep deprivation/all-nighters. My neuro guy was confident that it would get approved and is now helping me fight it (he is actually friends with the NAMI neurologist, so that's good I guess). I want to believe that I have a fighting chance, but I know headaches are bad juju and the pipeline is already so backed up due to the recent T-6B issues at Pensacola. Regardless, this is my dream job and I'm going to fight until every door gets slammed in my face. So, any advice??