Military flying status and ascending aortic aneurysm

[Guest]

I am a 30 year old male in the Air Force. I am Aircrew, more specifically an in flight refueler on KC-135s. I was recently diagnosed with a 4.0cm ascending aortic aneurysm and awaiting my referral to go through so I can see a cardiologist to get more explanation of my echo findings as well as a treatment plan going forward.

My father was diagnosed with the same thing 18 months ago. He was put on a wait and watch plan with medications. Two follow up checks after initial diagnosis showed no change in his aneurysm. On July 1st his aneurysm ruptured in his sleep and he passed away at 59. Both of my grandfathers on either side died from the exact same thing but it wasn't known they had an aneurysm until found as the cause of death at autopsy.

i was hoping someone on here may have any answers on my chances of keeping my flying status/ as well as my military career? I have been in for almost 12 years and was planning on doing 20. I am hopeful that I will be able to stay in. Thanks in advance for any advice you might have

 

[Quarry1]

Not sure how the military looks at these kind of things but for what it's worth I am a 73 yr old male who had an Aortic Valve relacement on May 2 of this year. My background is a corporate pilot retired. However I still held a 2nd class FAA medical. Flying is still very much part of my life and I am planning on getting a special issuance medical. I have just enrolled in Mayo Clinic's program to help in this endeavor. They have a special unit dedicated handling these types of problems. You will find the contact for this using Google. In the civilian world,after taking a battery of tests and if the Doctors at Mayo think you have a chance, they will send the required reports to the FAA and then you will have to sweat it out.

 

[ClickityClack]

I'm sorry for your loss.

I'm very surprised that you're not on limited duty right now. 4.0cm is usually in the monitor category unless there is rapid growth. As I recall, 5.5cm is the point where surgery is indicated for people without complicating conditions. 5.0cm is generally the trigger if you have a bicuspid valve and I think Marfan's also lowers the surgery threshold. As I understand it, some doctors are starting to add body size into the decision of when surgery is appropriate.

The huge red flag in your case is your family history of rupture - especially because your father was monitored and appeared stable. The cardiologist will have more insight, but make sure he/she knows about your father and grandfathers.

Just a disclaimer: My wife got medically retired from the US Navy so that's where my knowledge comes from. The Air Force might do things differently.

Aortic aneurysms are a disqualifying condition but since you're already in, it's all up to the cardiologist. He should tell you what your duty status is and if he doesn't, ASK. If he tells you that you're limdu/non-deployable you'll probably get med-boarded eventually. DO NOT get out or let them kick you out without getting the aneurysm repaired and/or being medically retired - ideally both. Get Legal involved if you have to. It'll be a long process full of BS duty while you're waiting on the bureaucracy but it'll be worth it. Use your chain of command and any other resource you can to help you through the process. If USAF is like the others, they'll want to be rid of you as quickly and cheaply as they can (cause you're broke and useless in their eyes). But, you were a whole, healthy individual when you signed; they have an obligation to return you to civilian life as close to that as reasonably possible.

When you get out, go to the VA and submit a claim ASAP. Some of your benefits have a clock on them. I let the clock run out on my SGLI and found out a few years later that, due to my heart issues (bicuspid aortic valve and aortic aneurysm, both repaired now) private insurance companies won't give me the time of day. SGLI isn't a great deal but now that I'm the sole earner for a young family, I wish I had it.

My wife's health insurance (when you get retired, medically or otherwise one of the benefits is TriCare-like covereage) has been the single biggest benefit of either of our military careers. Even compared to pre-Obama health insurance, it would be considered really good. These days, nothing else available to the private sector is even in the same universe.

I know you don't want to hear your military career is done, and I might be wrong considering that I have very little experience with the USAF, but I know the Corps would give you your DD214 as fast as they could get away with it.

 

[cldlhd]

I'll look for it but there was story on the news regarding a military pilot who had the same surgeon I ended up with and he went back to active duty. If you do leave the military at least now you can't be denied insurance because you might actually need it.
https://www.cbsnews.com/news/pilots-fight-to-return-to-the-skies/

 

[ClickityClack]

...If you do leave the military at least now you can't be denied insurance because you might actually need it.
https://www.cbsnews.com/news/pilots-fight-to-return-to-the-skies/

As long as you (OP) have no documented history prior to your PEBD, the aneurysm should be considered a service-connected condition. The VA will provide any treatment necessary, including the routine. No matter the outcome, if you get out in 8 weeks or 8 years, go to the VA and put a claim in. In my opinion, there's a good chance that you'll be rated high enough to qualify for ALL of your healthcare through the VA. In other words, you won't need private health insurance.

cldlhd, good find on the article. I love that the guy with a pig valve flies a Warthog.

 

[cldlhd]

As long as you (OP) have no documented history prior to your PEBD, the aneurysm should be considered a service-connected condition. The VA will provide any treatment necessary, including the routine. No matter the outcome, if you get out in 8 weeks or 8 years, go to the VA and put a claim in. In my opinion, there's a good chance that you'll be rated high enough to qualify for ALL of your healthcare through the VA. In other words, you won't need private health insurance.

cldlhd, good find on the article. I love that the guy with a pig valve flies a Warthog.

Ya I guess it's a case of when pigs fly? ....sound of crickets? That base is about 15 to 20 miles from where I live but since that story it's mostly closed.

 

[SumoRunner]

I have nothing to add to what these guys said. Was wondering if you are in the 100th ARW? My wife and I are going to the 100th bomb group reunion next month. Her father was a pilot in a B17 in WW2 and we've done a lot of research into their goings on. Our nephew, Mike Hirata, his grandson, was also a refueler but now with American Airlines.

 

[Terry45]

First, my deepest sympathy to you and your family for the sudden loss of your father. I know how that feels, my dad died at the age of 48 from heart issues.

I am retired Army and had an ascending aortic aneurysm dissection at 49 years old and while still in service. It is a very tricky situation for you and you have several issues concerning continued service as I'm sure you know. First is obviously the aneurysm. Hopefully the Air Force will refer you to a civilian cardiologist. If they do not you really need to push for it. You may have to talk to your patient advocate to get the referral. Luckily, I was on Tricare Remote when I had my dissection and did not have to deal with the Army medical clinics or hospital or I probably would not have survived. A 4cm aneurysm may just put you in the waiting room on a wait and monitor every six months or so with the cardio unless you have a connective tissue disease such as MARFAN Syndrome. MARFAN is an inherited genetic disorder that effects connective tissue in the body and can have a direct impact on the aorta and causes life-threatening dissections. With your dad dying from a dissection with a relative small aneurysm and you having one as well, I would ask questions and do a little research on MARFAN Syndrome. I obviously do not know what your physical nature is, but people with MARFAN Syndrome are normally very tall and thin. I am 6'5 and have a lot of the classic signs yet still went undiagnosed. If the cardiologist does think that you nay have MARFAN they will want to intervene at a much smaller size than the usual 5 to 5.5cm.

Without a diagnoses of MARFAN, like others have said, you may be in the waiting room. I seriously doubt if the Air Force will allow you to continue your current flight duties simply due to the limitations on physical exertion they will put on you. Even if a civilian cardiologist does not place physical limitations on you, your flight surgeon certainly will. You will get either a T3 or P3 profile that limits physical activity and makes you non-deployable. You will be grounded with either one. They should give you a T3 until a treatment plan is put in place. If surgery is recommended they should wait until that is done and recovery period completed before you are referred to an MEB. If you are just placed in the waiting room, I would almost bet on being given a P3 and referred for an MEB. The Air Force simply will not risk it. It is possible they will allow you to reclass into another career field and remain on active duty but that is a longshot.

If you do end up with surgery you will most likely end up with aortic valve replacement as well. With your age your surgeon will recommend a mechanical valve that will not need to be replaced in 10 years. Unfortunately mechanical valves require anticoagulation therapy (blood thinner) such as Warfarin. The blood thinner will also cause you to be non-deployable and trigger an MEB.

While I certainly understand and appreciate your desire to remain on active duty, you need to focus on what is most important for you and your family long term. You can and will be able to live a full life after any treatment you receive with little to no physical limitations. However, that may not be in the Air Force.

Best of luck to you, I understand that it is a very stressful and challenging time but you will recover. Feel free to e-mail me anytime if you need to talk...

God Bless you and thank you for your service!

 

[AFBoomOperator]

Hi everybody, I'm the Original poster, my account just got verified and I thought I would post and say thank you for all your kind words and advice.

as of right now the Flight Doctor on my base is not putting me on any restrictions, but has referred me out to a cardiologist to get answers to my questions and get a treatment plan in place. Ultimately it will be the Cardiologist that has the final say in me flying and my military career.

I did get a copy of my echo report and overall things look good other than the dilation. I do have mild mitral regurgitation, trace to mild tricuspid regurgitation, and trace pulmonic regurgitation which I understand is all very normal.

my left atrium is out of the normal range for volume, and right on the edge for volume index. I was hoping one of you might know what LA Major is in reference too on an echo mine is 5.6cm and everything online says that is the diameter of my left atrium and of so it's way above normal.

overall I'm remaining optimistic about my cardio appointment I have talked with my chain of command and they are supporting me and are willing to help me out with whatever the decision is and are willing to fight for me to stay in the military even if it's not as a flyer.

Thanks again for the kind words and I'm glad I found this place!

 

[spartangator]

Thank you for offering the update, and as always, my compliments to all the earlier posters for offering so much good information. What a community!

You are correct that 'LA Major' is about the left atrium measurement, but it's only one part of the measures that come on an echo, and the whole package of assessments is what your cardio will interpret.

Great to hear about all the support up your chain of command and that you're getting good care. Please keep us in the loop and welcome.