PE: Rejection?

[maphic]

Hello.

A few years ago I had Pectus Excavatum. It is hard to explain. There are pictures on google images. It happened to me when I got my first growth spurt. My PE was not severe at all. Since I was still a minor at the time I had no say so on whether or not I should get the surgery. My parents told me I was getting it. After the surgery I asked why and they told me it was for cosmetic reasons. The surgery is called "The Nuss Procedure", they put a bar in your chest and force your chest wall to a normal position. It is a 3 month recovery, and the bar needs to stay for 3 years. Kind of like braces, your teeth need to braces to mold and harden to there new position or else they can move if removed early. Same effect here.

There are zero limitations to what I can do, physically. It has been 3 years and I'm having the bar removed in December. My question is will this prevent me from being excepted to Navy Dive school?
My surgeon has told me there is absolutely NO restrictions or limitations to what I can do. But will a military doctor agree with my surgeon? My recruiter told me that the Navy doctor will want to have a say so as well.

I hold I wouldn't need to but would a Waiver be able to be used in this case?

Thanks,
Austin

[snow85]

i know what this is, it's congenital. you've probably had it since birth, and it only made itself apparent when you went through a growth spurt. it's advised to not have the operation on children 12 and under, because the problem will recur during adolescence.

it's VERY possible that it will completely DQ you. whether or not it caused decreased respiratory function, impaired cardiac function/chest pains, in you personally, or not, the fact that it could is something that the navy will worry about, especially if you want to subject yourself to the pressures and stresses of diving.

you're going to need a serious letter from your doctor explaining why it's okay for you to dive and not only to dive but to be exposed to diving situations that you don't find when you scuba in cancun.

you're going to have to talk to the Navy doc, and if they waiver, they'll give you outside consults, x-rays, chest ct, ekg/eeg, all kinds of stuff. or they'll just say no.

http://www.nomi.med.navy.mil/NAMI/WaiverGuideTopics/MANMED%20Change%20126.pdf

article15-42, page 15-32 (this is Acrobat p. 36)

(9) Current chest wall malformation (754),
including but not limited to pectus excavatum
(754.81) or pectus carinatum (754.82), if these conditions
interfere with vigorous physical exertion, is
disqualifying.

(1 8) Current atypical chest wall pain, incl~iding
but not limited to costochondritis (733.6) or Tictzc's
syndrome is disqualifying.

further down are the diving quals:

WAny musculoskelctal condition that is
chronic or recurrent which predisposes to diving
injury, limits thc performance of diving duties, ****or
may confuse the diagnosis of a diving injury is
disqualifying.****


you can do your own research in that document from here.


you MUST get the letter from your surgeon and take it with you to MEPS. you'll also have to provide your complete medical and surgical file. at any time, the dive docs can DQ you-- just remember that.

[maphic]

I really appreciate the research and information you got for me. I'm disappointed now, but I'll keep my head up and my goals in line. I know I can get a letter from my surgeon. I hope they will wavier me.

[snow85]

here's the deal:

you need to be within the accepted range for your height and weight, medically speaking.

but, you can't run out and gain weight super duper fast because that will stress your body, specifically your chest, in ways that could be very, very harmful.

what _i_ would do:

1. continue to see your surgeon.

2. tell him what your goals are.

3. if he is he doc that prescribed you the meds, no problem. if not, you need to have those doctors in conversation with each other about your future goals, and about the surgery and recovery.

4. ask them both to recommend a nutritionist.

5. they all need to work together on this to make sure that you have a successful surgery,

6. and to help you get to where you need to be Navy-wise.

7. report back here because i want to know what's going on.

[maphic]

I tried to contact my surgeon and i told the secretary that it is important and i had questions about my surgery and the navy. I guess they don't care because i still have yet to hear back and i have called a several more times.
I got Stew Smiths workout and I'm going to use this Nutrition program until i can see a nutritionist.
I'm just going to keep training.
Also when I read what you had shown me. Here is how I understood it, please tell me if im wrong. I will only be DQed if my PE slows me down, or keeps me from keeping up with everyone physically. Am I right?

Thanks,
Austin

I'll be sure to get back and let you know what my surgeon says and what a nutritionist does for me.

[snow85]

did you get in touch yet? call the office and ask to speak with Dr. So-and-so's surgical nurse. You might have to leave her a message, but that's cool. Just leave a cell phone or a number where you'll be, so that you're available when she calls you back. Nurses in Dr's offices don't really get to hang out by the phone much.

mmmm. almost. the problem is that if this causes a problem for you while diving, you'll be dq'd from anything that requires diving, aka BUD/S. your lungs expand and contract differently under water and differently at different depths. the air and fluids in your body also function differently than they do on dry land. do NOT tough out anything that causes you chest pain while diving, just "to make it through." honestly, you could kill yourself if you do. this goes for anyone, but moreso for you. i don't know what reactions you'll have, if any, to diving, but don't push it. really, your life isn't worth that. but... they can cover all this with you during a dive physical.

or, call down to navy diving and salvage, and ask for a dive doc. ask them what's up.

[maphic]

Finally I have got in touch. I made an appointment about the removal date of the bar. It will be removed this march. I talked with my surgeon and she said that she signs notes off for people in the military all the time. I have a Pulmonary Functions Test in 2 weeks. After I get these results I'm going to have my surgeon fax me my records with a note stating the confirmed removal date and a note stating that I'm not limited to what I can do, that my surgery was 100% cosmetic. Which it was my chest did not dip down far enough to cause problems with my lungs. After I get this information I will head down to my recruiter. He told me that he can fax this info to a doc at Meps and will find out where I stand.
I started to eat 6 meals a day and drink 2 Cyto Gainer shakes a day. I have went from 118 to 126 in the past 2 weeks. I hope I can get an ideal weight of 150-160 now that I have seen how much weight I have gained so far.

Also I scuba dive now. I know that the Scuba i do is NO where close to the exertions and work I would be doing with the Navy. But the deepest I have been is 90' and I have had zero problems other than my mask flooding.

After I get this info to my recruiter and get news from him I will be sure to let you know whats going on.
Thanks for all your help.

-Austin

[dive doc]

Maphic,

like snow mentioned the doctors MUST talk to each other. Unless you have all your paperwork, medically supporting letters in place it would be VERY easy to DQ you from diving as a result of this. All of the above advice has been right and helpful.

Im not trying to be negative, only encourage you to have your hosue in order because from a medical point of view your application will be closely scrutinized. Apart from your lung function, any kind of thoracic surgery will make a DMO nervous. In many cases this can be an automatic DQ no matter what the surgery was this is why it is so important for your surgeon and possibly DMO to talk to each other. One of the other reasons that thoracic surgery may be an issue is that once the chest wall cavity has been breached (and also that a foreign object has been inserted) there is always the risk of a pneumothorax (air in the pleural space between the lung and outer chest wall) or pneumomediastinum (air in the chest wall space between the two lungs).

Hopefully it will not DQ you. However, you will not be able to dive for a period of time after this surgery is done. Possibly 12-18 months or longer.

It is great to hear that it is not affecting your physical performance. I would suggest getting a set of PFTs (pulmonary function tests) both before and after your next surgery when you recover. This way you will also be able to show that your lung function has not been compromised as a result. it is only a small thing but it also makes your medical report more complete.

Best of luck.

DD