Asthma

M

molonlabedoc

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Question for anyone out there. After CAS down at Bragg this August I noticed some peculiar "wheezing" and shortness of breath. I normally run a 12 minute 2 mile and struggled to do a 13 at the PT test. During the rest of Selection I continued to wheeze and felt short of breath but managed to get selected I assumed it was a black mold allergy as the stuff was all over the barrecks we spent the first few nights in. The wheezing carried over to daily activities and especially before bed. I was given an inhaler and it helps, but I'm using this thing two times or more a day, with a trip to the ER on Wednesday when I left it at work. I am baffled how at 35 years old and a constant excersise fruitcake how this happened.

Finally the question is. I planned on dropping an unqualified resignation from the Army (I'm a captain) in order to pursue SF in the Guard. If this is something as serious as it seems right now, should I hold out a little while to see if a MEB is warranted or am I reading into this too much?

I haven't been to SEREC yet and wonder how that would work if all the sudden I am wracked with one of the "attacks". I'm devastated over the feeling of betrayal by my lungs right now.

Thanks for any input.
 
Update. I have been perscribed a 4 time a day preventative inhaler and told I would be placed on a p2 and I coul walk the 2 mile PT test. This is a disaster as I have always been a pt leader my SOF career is essentially dead before it got past the start. I'm completely in limbo and am unsure what comes next. I'm still using the inhaler multiple times a day.
 
I see some folks are reading this so I will update. My allergy panel came in. Normal things like pet dander and grass I was slightly elevated on but black mold and fungals I was "rediculously" high according to the Asthma doc (who incidentally is not a pulmonologist just a family practice doc here on post. Now I know just where the hell thinout of the blue problem came from. Where I go from here?
 
Update




I saw my PCM on Tuesday and he ordered a battery of blood tests to verify I don’t have a lung infection to include fungal etc. I certainly appreciated his willingness to look further into my symptoms then the Asthma specialist. I do finally have a pulmo appointment in October for the Lung function tests, but I don’t think the Methocholine Challenge is being conducted. I have been placed on a temp P3 for 90 days; I am still unable to stand outside in dust or attempt to even Jog. It’s the most bizarre thing and trying to explain to my unit leadership my situation has been intensely difficult.

 
The only credible way to know what is causing your lung issues is to get a civilian pulmonary team to asses you. The correct workup includes (but not limited to): blood tests, pulmonary function testing (first is a baseline, then several more to check trending), meth challenge, CT scans/x-rays (to rule out/in interstitial lung disease) and a cardio-pulmonary stress test. Additionally, consider visiting a civilian allergist to confirm/deny your allergy diagnosis.
My base doc diagnosed me with "restrictive airway disorder" for my first MEB...a few months into being found fit by a fast track MEB, I signed on with Creighton Medical Center Pulmonary and found out that I actually have restrictive and obstructive lung disease, constrictive bronchiolitis, asthma, COPD and thyroid disease (autoimmune) and thyroid cancer (benign now). All tied to burn pits at Bagram and Balad. I hope things go well for you and it is just a bacteria or infection that can be treated.
 
Thanks for the heads up aviator. My pulmo visit is coming up next week so I should have an exact diagnosis at that point. I'm on the highest dose of corticosteroid you can be on for prevention, that stuff is foul and not something I can't fathom taking forever.
 
I'm there with you on the corticosteroid. I also take Singular, Spiriva, albuterol (rescue inhaler), occasional Prednisone bursts and have to hit my oxygen throughout the day and keep it on my BIPAP machine all night. I have to agree, the corticosteroid is nasty...make sure you are rinsing your mouth out because it will cause a bacterial infection in your throat and thrush.
 
Update. My pulmonary visit was fairly well predicted. The Dr is as baffled by this turn of events as I am. He is very helpful and has my career in the military at heart nd that's nice to see. He stated he isnwarybwith diagnosing me with asthma and ruining my chances at a SOF carreer. I appreciated that but I explained by unwillingness to be a potential liability on the ground somewhere austere. I did a pft and came in at 89 percent predicted which he stated doesn't mean I don't have asthma it's just controlled at this time. He is VERY focused on the amounts of corticosteroid and the other medications for allergies and the rescue inhaler. He wants to give this regimen another month then do a treadmill test to see if I'm excersise induced which I tend to disagree with as I have had more issues with being outside then raising my heart rate although a few emotionally charged issues at work has caused attacks indoors. Anyways the methocholine test was mentioned as something down the road and he wants to rule out bronchiolitis and not just diagnose me as asthmatic.

Anyone out there my concern. Does the diagnosis of asthma or bronchiolitis matter for 30 percent or is it based more on the medication load I am on in order to maintain a generally normal lifestyle?
 
6600 Bronchitis, chronic:
FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy 100%
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit) 60%
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted 30%
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted 10%

6602 Asthma, bronchial:
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications 100%
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids 60%
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication 30%
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy 10%
Note:In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.



The bolded line is what you will need for a minimum of 30% for the asthma. The corticosteroids/bronchodialators are the kicker.Glad to hear that you are getting good care. Remember, be honest with yourself and your doc about your conditions.
 
Since this all has come down the pipe, "work" has been miserable. There has been a culture of hate for anyone on profile around here, I was aware of it, but to be part of the broke crowd is an eye opener. I honestly am not sure how long I can hack waiting around to see if I am going to be MEB or not. I can drop my resignation any day and get back to being in a career field I left to join the Military. Sitting in meetings having your name come up as a P3 and or on profile, constantly having to explain my situation to people in a public setting is maddening . The fact I left and was selected for SOF and now back with no recourse to pursue my original goals is leaving the gate open for retribution from a few select higher ups. It’s only been going on four months, and my PCP told me on my last visit to see an allergist. I mentioned my lack of enthusiasm for waiting out this process if a MEB isn’t likely to be started and his reply was to not give up yet. I understand I have to spend some time in the Army medical system to show treatment protocols were followed, but I am also not willing to do every experimental drug and treatment under the sun either.

Just ranting here and updating.
 
Wow...Your situation sounds a lot like my husbands. I feel for you on how work treats/thinks of you. My husband has been sick now for 2 years this month. Shortness of breath, wheezing, coughing, and coughing up mucous. He's been on so many medications and had so many tests done. We still don't have a definitive diagnosis. Last week we were in a meeting with his Pulmonologist and finally just told her that "we" can't fight it anymore, to just start a MEB. Having to constantly prove you are sick/you have something wrong with you is so emotionally and physically exhausting. I wish you well, and that you are able to get your breathing under control and that it doesn't continue to affect your career.
 
Thanks for the kind words.

I wish your husband and yourself the very best in the future.
 
There is a great deal of information on here and I suppose I am just trying to get a clear answer.

I took the Meth/Challenge with a Pulmonologist in July and had they said that I had a 55% drop in the first round of the test. After that I was prescribed and now take daily:

Dulera 200mcg/5mcg (2 puffs morning and night)
Albuteral (I use this daily)
Allegra
Prednisone: 1 month at a time (two rounds so far)

I am trying to figure out where I fit within the VASRD because they tried a fast track which was denied and now I am have to put in a letter which declares my preference on either staying in or being separated/retired. If I am over 30% then I would not mind being retired however, severance is not a good deal for me. Thanks for any advice.
 
Hey Devin,

From what I have read and been told, you should be looking at 30 percent just based off your medication usage. That being said, who the heck knows if, when, or how you get to that point from where we are right now. I still haven't been given the methacholine challenge yet as the Pulmo I saw wanted to wait a few months (mainly I think to milk tricare for visits) and I haven't been back.
 
The comment about the burn pits makes me nervous. I did see civilian docs who did the tests you listed (allergen blood test, skin test, methacholine challenge, and x-rays. They did not do the cardiopulmonary stress test. I was diagnosed with "restrictive airway disease" by AF docs, and Asthma by civilian docs. Bagram was one of the places I deployed to most, and the burn pit was running full tilt 24-7. Here's hoping all goes well for you guys.
 
You must log in or register to reply here.
Top