# Enrollment standard with Sleep Apnea



## estoguy

Well, the wind was taken out my sails today.  I received a letter from the RMO saying that because I have sleep apnea and use a CPAP that I do not meet the "common enrollment medical standard" for the CF.  Which I find rather hard to believe, considering that I'm fairly confident that I could report for Basic right now and do well. 

According to the letter I can do the following: submit "new pertinent medical information through your local Canadian Forces Recruiting Center medical section; or to forward a request for secondary review of your existing file to the Director of Medical Policy through your local CFRC medical section being sure to outline the aspect(s) of the decision with which you disagree and the reasons why."

So, to the medical minds of army.ca - any suggestions/advice?

I know more than one doctor has remarked that my tonsils are quite large, and even the doctor who gave the original diagnosis said that removing them and any excess tissue  could have an effect, but it was not offered as a treatment option. I'm totally prepared to go under the knife for this, if that is what it will take.  I've come too far and worked too hard to give up now. 

Any thoughts would be welcome.  Thanks!


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## Blackadder1916

estoguy said:
			
		

> So, to the medical minds of army.ca - any suggestions/advice?



Yes, there is something you can do.   You can "submit new pertinent medical information through your local Canadian Forces Recruiting Center medical section; or to forward a request for secondary review of your existing file to the Director of Medical Policy through your local CFRC medical section being sure to outline the aspect(s) of the decision with which you disagree and the reasons why."




> . . . . Which I find rather hard to believe, considering that I'm fairly confident that I could report for Basic right now and do well.



What you believe, and occasionally what civilian physicians (particularly if they are unfamiliar with the CF CEMS) believe, are not pertinent to decisions concerning medically suitability for enrolment.  Any official objection to the decision of the RMO would have to be based on providing clinical evidence that refutes the RMO's opinion.


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## estoguy

I understood what the letter meant about submitting information... in terms of advice, what I meant was does anyone here have any experience with sleep apnea and suggestions how to not have this be a barrier to joining?


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## AGD

I can see why the RMO would not want to enrol somebody as a pilot who has a condition which contributes to fatigue and sleep deprivation. Anyway...



			
				estoguy said:
			
		

> in terms of advice, what I meant was does anyone here have any experience with sleep apnea and suggestions how to not have this be a barrier to joining?



It's certainly not a permanent condition...I know an individual who had terrible sleep apnea; lost 50 lbs. and it completely went away.

A tonsillectomy, as you have suggested, might work. I'm wondering why this wasn't offered as a treatment option. It's so common that it's like a trip to the dentist...

I believe the problem is the CPAP machine...if you can demonstrate that you no longer need it, that might be enough "new pertinent medical information" to see you through.


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## estoguy

I have lost some weight since my physical, but I don't believe my weight is not a terrible factor. I'm 6'2" and right now about 235 lbs.  So, technically overweight (if you go by BMI), but certainly not morbidly obese.

When I was originally diagnosed, the doctor did discuss having a tonsillectomy, but really pushed the CPAP.  Doing some further reading, they can also reduce other tissue while they are in there, so I'll definitely be talking to my GP about it and see what his opinion is.


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## aesop081

estoguy said:
			
		

> Which I find rather hard to believe,



Well, believe it.




> considering that I'm fairly confident that I could report for Basic right now and do well.



You know there is more to life in the military than basic, right ?


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## estoguy

Thanks for the input guys... and yes, I do understand where its coming from.  *I* just find it hard to believe.  I know that has very little bearing on the rest of the world! LOL

Have an appointment with the GP on Thursday, so we'll see what happens. Wish me luck!


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## Good2Golf

estoguy said:
			
		

> ...So, to the medical minds of army.ca - any suggestions/advice?



Embark on a fitness and dietary plan that sees you eating well and exercising to lose the extra weight.

There really isn't anything that any of us can reasonably provide as input to you that will help you other than the above advice.  There might be procedural "solutions", however, that is for medically-trained persons to counsel you.


Regards
G2G


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## medicineman

AGD said:
			
		

> A tonsillectomy, as you have suggested, might work. I'm wondering why this wasn't offered as a treatment option. It's so common that it's like a trip to the dentist...



Ever seen how long it takes for a 35 year old to recover from a tonsillectomy?  No?  I think you know where I'm going with that then right  :nod: ?.  

Other surgical options like a UPPP are great in that they work, but are quite nasty and take a long time to recover from...and then they tend to only buy people time.

My advice, ask your GP for a new formal sleep study (PSG) and a sleep latency test thereafter (which will likely take forever to get incidentally, depending on where you are) without your CPAP to see how where you're at...it'll either refute things or reinforce it.  You can also see if an ENT surgeon will entertain either a tonsillectomy or a UPPP and discuss it with you.  Be prepared for a wait , and then you'll have to be prepared for a fair recovery period as well after the surgery.  You'll then need evidence (ie a formal sleep study without CPAP and sleep latency test) that your OSA has resolved.

The reason I say a formal PSG vice home overnight oximetry is it's done in a lab or at home with witnesses to ensure you're not hooking yourself up to your CPAP at night to fool the pulse oximeter...unless your hospital can admit you overnight to do the overnight oximetry...either way, you'll need convincing evidence you're good to go without the CPAP.

One way or the other, be prepared for a long process.

Cheers.

MM


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## estoguy

Thanks so much MM!  

I know that I least have some direction anyway... and I'm willing to put up with some discomfort to make this happen.

Why did you say that the tonsillectomy/UPPP only "buys time"?  Just curious what you meant by that.  I take that as meaning that the problem can come back?


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## PrettyMaggie63

The tonsillectomy can be very hard on an older person. I've seen patients in their 20's have extremely long recovery periods, or even end up with lifelong problems because of the surgery. Both a tonsillectomy and a UPPP (or UP3) are surgical procedures and have risks and should only be considered as a last resort. My advice to you is follow medicineman's  advice, do the official sleep studies first, see an ENT for a consult, and prepare for a bit of a long haul.


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## cupper

Speaking from personal experience (after my military career) it's not just the current medical state, but also the long term potential problems from having sleep apnea.

Additionally, the need for the machine limits your deployment readiness, as there may not be electric trees to plug into where you get sent. Being off the machine for even one sleep cycle can cause the symptoms to return until you can get back on the machine, and some studies have shown that the symptoms can be more problematic when you've been on CPAP for any length of time.

Losing the weight will definitely help, and ironically the CPAP will help with losing the weight.

If you are a candidate for the surgery, it may be a better option, but I can't really speak to that. But having the tonsils removed will make a huge difference, and could reduce chances of other possible problems (infections etc)


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## estoguy

Cupper - yeah, I totally get where you are coming from and I understand those issues. If I had of known sooner that this would be an issue, I would have taken steps before now.  Oh well, can't cry over spilled milk, right?  I've been working on the weight loss since my physical.  I'm down about 10 lbs from that time.  Going to ramp up things even more on the cardio side to help shuck those pounds. 

I've been doing some reading about some of the possible treatments, including the tonsillectomy, and it seems that the adult experience of recovery can be varied.  Some people older than myself breezed through it, others had a hell of a time.  Knowing myself, I think it could go easy if it happens, as I do tend to heal quickly and there were some common threads in the comments from people who didn't have a rough time - keeping hydrated post-op was the big one, and several articles pointed that out as well. 

As the popular saying goes around here, "Hurry up and wait"... looks like some more waiting. 

I certainly appreciate all the advice and viewpoints!


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## medicineman

estoguy said:
			
		

> Why did you say that the tonsillectomy/UPPP only "buys time"?  Just curious what you meant by that.  I take that as meaning that the problem can come back?



Yeah, essentially - alot of people lapse back to having some of the tissue/weight replace what's taken out.  A friend of mine had it done, and still needed a CPAP in the end.  He did lose 35lbs as a direct result of the UPPP though...since he was gacking up blood and could barely swallow for 3 weeks.

Something else I forgot to mention was to ask about a mandibular advancement device - kind of a bite splint that shown some promise with some folks as far as tempering their OSA or better.  

Fact is, most people I treat with OSA (and alot of humans for that matter) are inherently lazy and would prefer what they think is the silver bullet like surgery or CPAP as opposed the real silver bullet - actually loooking after themselves.  I have one person that's having every issue you can think of as a result of their OSA, but still won't stop shovelling crap into themselves.  Maybe a UPPP will help them with that.  Granted, there are those of us that have been cursed with tonsilar infections throughout our lives that have left them big and in the way, but alot of folks are content to live out their lives under the adage of what my supervising doc says "Modern medicine allows people to live their lives longer in the [shoddy] manner they've become accustomed to".   I feel a rant coming on so I'll stop here  ;D.

MM


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## cupper

medicineman said:
			
		

> Fact is, most people I treat with OSA (and alot of humans for that matter) are inherently lazy and would prefer what they think is the silver bullet like surgery or CPAP as opposed the real silver bullet - actually loooking after themselves.  I have one person that's having every issue you can think of as a result of their OSA, but still won't stop shovelling crap into themselves.  Maybe a UPPP will help them with that.  Granted, there are those of us that have been cursed with tonsilar infections throughout our lives that have left them big and in the way, but alot of folks are content to live out their lives under the adage of what my supervising doc says "Modern medicine allows people to live their lives longer in the [shoddy] manner they've become accustomed to".   I feel a rant coming on so I'll stop here  ;D.
> 
> MM



We don't know each other do we?
You don't happen to practice in Virginia do you?  ;D


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## medicineman

cupper said:
			
		

> We don't know each other do we?
> You don't happen to practice in Virginia do you?  ;D



(1) - Possibly.

(2) - Fraid not...Manitoba...could just be a colder version of it though  ;D

MM


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## estoguy

medicineman said:
			
		

> Yeah, essentially - alot of people lapse back to having some of the tissue/weight replace what's taken out.  A friend of mine had it done, and still needed a CPAP in the end.  He did lose 35lbs as a direct result of the UPPP though...since he was gacking up blood and could barely swallow for 3 weeks.
> 
> Something else I forgot to mention was to ask about a mandibular advancement device - kind of a bite splint that shown some promise with some folks as far as tempering their OSA or better.
> 
> Fact is, most people I treat with OSA (and alot of humans for that matter) are inherently lazy and would prefer what they think is the silver bullet like surgery or CPAP as opposed the real silver bullet - actually loooking after themselves.  I have one person that's having every issue you can think of as a result of their OSA, but still won't stop shovelling crap into themselves.  Maybe a UPPP will help them with that.  Granted, there are those of us that have been cursed with tonsilar infections throughout our lives that have left them big and in the way, but alot of folks are content to live out their lives under the adage of what my supervising doc says "Modern medicine allows people to live their lives longer in the [shoddy] manner they've become accustomed to".   I feel a rant coming on so I'll stop here  ;D.



Again, thanks so much for chiming in on this thread.  Its been very enlighting and helpful.

I've wondered about those mouth devices as well.  Haven't heard much on possible effectiveness, but that will be something I'll bring up too! 

I can certainly see the point and the "danger" you made in your "rant".  Can't speak for others, but I've never been terribly overweight, probably at my heaviest, 25 pounds over where I should be.  I enjoy food, but I'm not shovelling it in.  I've also been working out much more regularly since even before I applied to the CF.  Just work and other commitments do get in the way.   I'd be really happy getting myself back to around 220 for starters and see how it goes.  If anything, the application process has given me a goal to shoot for and *possible* reward for doing so. 

I'm not just going to run off half-cocked on this.  Going to see my doctor next week and see what he recommends.  As I said in your MP comment, I'll definitely be taking your advice along to help keep me on track when I talk to him.


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## PrettyMaggie63

Estoguy, you have the right attitude and that will get you places. Until you get an actual letter stating it's the end of the road, then it's not the end of the road. So don't give up, you have several options to consider.
All the best to you, I am really hoping it all works out.


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## estoguy

Thanks Maggie!  I hope so.  When I got the news last night, I was down for about 10-15 minutes, but I also know that despairing is not constructive.  So I put it aside, refocused and started looking for answers and asking questions.

I knew starting out it was going to be a long and winding road... but the eyes are still on the prize.  Its moved farther away, but I'll keep on after it until its out of reach.  [mountie]


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## estoguy

OK, had appointment with my Doc today.  He's definitely supportive in helping me.  He's arranged for a new sleep test, a consult with a specialist and has encouraged to keep at my workout programme.  Ideally he'd like to see me around 200 lbs, and has some hope that the weight loss could help sidestep surgery.  Since its going to be at least 6-8 weeks before gettign the test or the specialist appointment, I got work to do!

Wish me luck!  :nod:


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## Jarnhamar

I sent you a PM on how to loose weight, it'll get you to 200lbs no problem.


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## estoguy

Got it!  Wrote back! Thanks!  :nod:


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## estoguy

Bit of an update... still waiting to hear back from the sleep clinic and the ENT specialist. More Hurry Up And Wait! LOL  Good thing I'm a relatively patient person! 

I started on the Paleo diet, and am doing pretty good.  Already down 6 lbs to 229.  I'd probably be further, but between work and having my son around, I haven't had a chance to workout much since I started it.


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## estoguy

A bit annoyed at my doctor.  I understand they were moving offices and such, but you think he could have sent out the specialist referral at some point before he went on holidays?  Too much to ask?  By the time he gets back, I'll have been waiting 6 weeks for nothing.  I know, I know... hurry up and wait, but jeez I'm a little frustrated. [END RANT]

Paleo diet is going well and have been ramping up my exercise routine. Hope all is going well with everyone else! 

Enjoy the last bit of summer!


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## Pusser

On the subject of weight loss, I can't say enough about Weight Watchers.  The program works!  And it's not that difficult.  It just takes a little thought and planning.  No special foods.  No restrictions on the kinds of foods you can eat.  No feeling hungry.  No whacked out regime of any sort.

I know a guy who lost over 50 lbs in six months, while still eating waffles and cheeseburgers (just not in the same sitting).  It's all about making better choices and living healthier.  It's not about deprivation.  Add a good exercise regime that fits conveniently with your lifestyle and the pounds will just fall off.


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## Scott

Pusser said:
			
		

> On the subject of weight loss, I can't say enough about Weight Watchers.  The program works!  And it's not that difficult.  It just takes a little thought and planning.  No special foods.  No restrictions on the kinds of foods you can eat.  No feeling hungry.  No whacked out regime of any sort.
> 
> I know a guy who lost over 50 lbs in six months, while still eating waffles and cheeseburgers (just not in the same sitting).  It's all about making better choices and living healthier.  It's not about deprivation.  Add a good exercise regime that fits conveniently with your lifestyle and the pounds will just fall off.



I figured you for a Sweating to the Oldies type of fellow.


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## Pusser

Scott said:
			
		

> I figured you for a Sweating to the Oldies type of fellow.



No.  I can't say as I see eye to eye with Richard Simmons (he's a lot shorter than I am).  I still have nightmares of a time back in the 80s when the Base Commander in Halifax ordered all personnel to attend weekly aerobics sessions.  The sight of 300 hairybags doing their version of the "20 Minute Workout" on the gym floor at Stad is burned in my memory far too deeply for any amount of therapy to erase.  Thank you for bringing it up.  Now I need to struggle to get back to my happy place.

Who says I'm talking about me anyway?  I said it was "a guy I know."


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## Scott

Pusser said:
			
		

> No.  I can't say as I see eye to eye with Richard Simmons (he's a lot shorter than I am).  I still have nightmares of a time back in the 80s when the Base Commander in Halifax ordered all personnel to attend weekly aerobics sessions.  The sight of 300 hairybags doing their version of the "20 Minute Workout" on the gym floor at Stad is burned in my memory far too deeply for any amount of therapy to erase.  Thank you for bringing it up.  Now I need to struggle to get back to my happy place.



Ah, so you've met?



> Who says I'm talking about me anyway?  I said it was "a guy I know."





			
				Pusser said:
			
		

> On the subject of weight loss, _*I*_ can't say enough about Weight Watchers.  The program works!  And it's not that difficult.  It just takes a little thought and planning.  No special foods.  No restrictions on the kinds of foods you can eat.  No feeling hungry.  No whacked out regime of any sort.


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## PWN

Gotta love all the weight-loss support in a military forum  

Never forget that they say weight loss is 70% diet, 30% exercise.  But no two people are the same; you need to know what kind of diet/plan will work best for your body and your personality.  I spent about 5 years trying to lose a chunk of weight with NO success (and not for lack of effort), then I found the right plan, and the weight melted off (30lbs) fast enough that everyone noticed. Hopefully the Paleo diet works for you, but if it doesn't, don't give up, try something else.

One other point, I was told directly from DRDC Toronto that there is a hard limit on max pilot weight. I don't remember exactly what it was, but I'd say 107kg is pretty close to it.  Hopefully the weight loss will help with the sleep apnea, but either way, I'd keep working hard on getting your BF% down.


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## bridges

I know there are other weight-loss threads in here, but I'll just chime in quickly with a recommendation for the Glycemic Index "diet" as one possibility, especially if you have a taste for carbs.  My MO recommended this one to me.  It identifies sugars that are processed too quickly, so you can replace them with better ones.  Also some recipes, snack ideas, etc.  It's been helpful, & easy to incorporate one idea at a time, if you don't need a whole overhaul.   

Alternatively, I recently had strep throat and lost about 8 lbs in 3 days...  not recommended.    

Good luck with the apnea.   :nod:


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## Pusser

"On the subject of weight loss, I can't say enough about Weight Watchers.  The program works!  And it's not that difficult.  It just takes a little thought and planning.  No special foods.  No restrictions on the kinds of foods you can eat.  No feeling hungry.  No whacked out regime of any sort."


All that says is that I've seen the results of the efforts of "a guy I know."  I admit to nothing else and that's my story and I'm sticking to it.


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## estoguy

Thanks for the replies and the support guys!

I'm really liking the Paleo diet.  Have cut most of my carbs (not ALL... still allow myself a few treats), but I've found that I'm eating less, but its not impacting my energy levels - Most of what I'm eating is fruit, veg and lean meat.  I find I've been feeling less sluggish, actually. One thing I switched to was grinding up nuts in morning for cereal.  Been eating that with almond milk and honey.  SO GOOD!

Just hurrying and waiting for the day after Labor Day, so I can give my doctor a bit of a nudge to get things rolling.  I'm on mission here! LOL

@ PWN - Well, I'm a good 6-7 pounds below that weight now.  I was at 244 about 3-4 months ago.  Thanks for that info!


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## PWN

estoguy said:
			
		

> @ PWN - Well, I'm a good 6-7 pounds below that weight now.  I was at 244 about 3-4 months ago.  Thanks for that info!



Awesome! It's not easy. Congrats and keep it up.


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## Scott

Pusser said:
			
		

> I admit to nothing else and that's my story and I'm sticking to it.



rancing:


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## cupper

Pusser said:
			
		

> "On the subject of weight loss, I can't say enough about Weight Watchers.  The program works!  And it's not that difficult.  It just takes a little thought and planning.  No special foods.  No restrictions on the kinds of foods you can eat.  No feeling hungry.  No whacked out regime of any sort."
> 
> 
> All that says is that I've seen the results of the efforts of "a guy I know."  I admit to nothing else and that's my story and I'm sticking to it.



Having done the program, I can definitely attest to it's success. However, I can also attest to the need to keep at it after reaching your goal.


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## antigone33

I also did weight watchers as well as support to friend getting married one fall. I loved the point systems and their program guides which make portioning easy to remember and follow- ie a deck of card is a portion of meat, a half a tennis ball is a serving of rice/cereal ect. You could also earn back points with exercise too.  They had a whole food program too that you could eat any amount of certain foods. (i never did this program so i don't really know how it works.) I know when I did a year of nursing, it was one of the support groups we could go to so that we could see what it was like and possibly have as a recommendation for patients/clients ect.

The only thing that I didn't care with Weight Watchers or perhaps it was the group I was in- the group was interested it seemed in food that was low points but it was also full of chemicals and crap to it! I am sorry if you are going to eat ice cream- do a small bowl of it- use your bonus points..don't suffer though crap because you want something low points! 

I can't afford it now so I am using a web site called myfitnesspal.com which is similar in tracking food and exercise- your exercise buys back calories. I have so far lost 7 bls on it.  I tried Spark people which is a great site over all but I found it a bit complex for what I needed.  I also use a website for tracking my exercise called fitocracy!

I hope that weight lost/ treatments  helps you or at least buy you time to have a career in the Canadian forces. Good luck!


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## bridges

antigone33 said:
			
		

> I can't afford it now so I am using a web site called myfitnesspal.com which is similar in tracking food and exercise- your exercise buys back calories. I have so far lost 7 bls on it.  I tried Spark people which is a great site over all but I found it a bit complex for what I needed.  I also use a website for tracking my exercise called fitocracy!



Thanks for suggesting some low-cost/no-cost options.. that's helpful.   :nod:   I'll be checking those out.   Currently paying $33 every two weeks for a membership to Goodlife that I hardly use... time to make a decision on that.


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## cupper

I really liked the program (although I agree the cost was a factor in the end), and the online tools were great. The groups were not too bad when I started, as we had a very good leader, but she left and the replacements were just glorified cheerleaders.


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## estoguy

Hey everyone!  Thanks for all the really positive posts.  Now for one of my own.  Got my sleep study and specialist consult booked!  ;D  Appears that some things went astray during my doctor's move, but I'm happy it hasn't cost THAT much extra time. Doing the sleep test next week on Thursday and seeing the specialist 3 weeks later.  Keep your fingers crossed, and I'll tell more when I know more!


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## estoguy

Well, I saw the specialist the other day. Will be getting tonsils out and both him and my family doctor would like to see me lose another 20-25 pounds. Once I get the surgery done, I'll get the apnea reevaluated. At most, could be another 6 months... grrrr. But I'm on the cancellation list, so it could happen sooner.  "Hurry up and wait" has become my mantra! Seriously! LOL


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## bridges

estoguy said:
			
		

> Well, I saw the specialist the other day. Will be getting tonsils out and both him and my family doctor would like to see me lose another 20-25 pounds. Once I get the surgery done, I'll get the apnea reevaluated. At most, could be another 6 months... grrrr. But I'm on the cancellation list, so it could happen sooner.  "Hurry up and wait" has become my mantra! Seriously! LOL



Progress!  Good.

The other day a friend (35-ish) relayed something their doctor had told them, about being significantly overweight:  "Even if you can't see consequences now, they're coming."   Bit of a knock between the eyes for me as well.  

Anyway, yes, the hurry up & wait... good training in itself.  Good luck with the wait list & weight loss.


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## estoguy

Another update, got my surgery booked... for next week! Originally it was supposed to be at the end of January, but a cancellation bumped me up.  Unfortunately, since its close to end of 2012, I was told my file was being closed for now and asked to refile my application next year.  Still with recovery and getting booked for another sleep study, I'm still looking at the start of the new year before the picture is clear for me. However, I will be waiting 2.5 months less.   Once I get my second diagnostic sleep study done, I'll let you all know what's what. Cross your fingers for me!


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## estoguy

Got lucky and had my tonsillectomy last week!  ;D My surgeon got a cancellation and they were able to fit me in! Breathing while sleeping seems to feel better already.  Still would like to lose another 20 pounds as well. After that, I want to look into having another sleep study.  I'm hoping this is all going to come together for me in the next few months!


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## JamesKEDU

Hey OP, I have just submitted my application through DEO plan. Problem is that I have been diagnosed with mild sleep apnea as well although my ENT did not deem using a cpap necessary. Was wondering what kind of sleep apnea you have and if they offered other positions to accommodate you?


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## seawolf

All applicants have to meet a common enrollment standard. That's what the OP didn't meet - they can't offer him other positions


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## estoguy

James... my understanding (and I could be wrong)  is that if you have diagnosed sleep apnea, you don't meet the medical standard. I have been using CPAP, but I don't think it makes a difference if you do or not.  Best to ask the medical people about it to be sure.


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## estoguy

Update time!

Had my sleep study last week! Got my test much earlier thanks to a cancellation. If what the nurse said in the morning was any indication, it went well, so I'm hoping the official results are favorable.  :nod: Looks like the tonsillectomy and weight loss were worth it. Will update when I have results. 

Have already re-applied and am waiting for North Bay to process and send my stuff back down to the RC.


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## estoguy

More updates:

Had the sleep study - my apnea has significantly improved to mild and doesn't require treatment.  Compared to my original diagnosis, its miles improved.  The doctor basically said that improved physical condition will only help things further.  According to medical section they do look at things case by case, and since I have new information, hopefully this will be helpful and get me through medical. Cross your fingers for me on July 3! 

Even if I still get flagged, I'm glad I've gone through all this, because at the end of the day, it has improved my quality of life tremendously.


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## ballz

Well done, estoguy, well done. What is your weight at now? 

I sincerely hope you get the chance to serve, you have already shown more commitment / drive than many, and that's really all we can ask of potential members before they begin.


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## estoguy

I'm down about 25-30 from last year (245 lbs). Haven't checked recently.

And thanks for the encouragement!  Will certainly keep things updated!  Medical is on July 3.  :nod:


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## estoguy

Well, the effort hasn't paid off... yet.  Technically speaking, I still have "mild to moderate" sleep apnea, but despite a letter from my sleep study doctor stating: "given his improving status and lack of symptoms, we agreed to continue with lifestyle measures primarily and I am comfortable with Erik not using nasal CPAP at this time unless his clinical situation should change... his improving symptom status, objective status an lack of any complications make it reasonable to proceed with this modality at this time." (added the underlining)

Got the letter back from RMO saying that I'm still unfit. 

At this point, I'm unsure what to do.  I'm considering the secondary review path, but don't know much about this.  Can anyone here offer any insight as to how I could proceed and what ducks I should have in a row before proceeding? 

Also, if anyone, especially any medical folks have any more advice to give specifically to further improving this situation, I'm all ears.

 Having come as far as I have, I'm not willing to give up yet until I reach a hard point where I can't do anymore.

Thanks in advance!


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## SquidMeister

So I did my medical and interview back in late August, then got some forms from the RMO in Ottawa earlier this month for further clarification due to some headaches and a previous car accident, got those filled out and they were back in Ottawa the day after I mailed them.  Now I am hoping to hear back from someone in short order, but my question is, what is the process past this?

Bit of a background, I applied in Edmonton as reserve for Recce crewman in the SALH back in May/June.  Assuming there's nothing more of concern on my medical portion, how will the recruiting office contact me?  Phone? Email? Mail, etc.  Would I be offered a position right away or would I be put on some list awaiting an opening?

This hasn't been the two ish~ months they told me it would take when I first applied, so I am kinda chomping at the bit to get started as it were.  ;D

Any info in regards to possible future developments is greatly appreciated.


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## mariomike

SquidMeister said:
			
		

> my question is, what is the process past this?



Information about the process here,

Expedited Reserve Enrollment (ERE) process [Merged] 
https://army.ca/forums/threads/124056.0
3 pages.

As always, your unit Recruiter is your most trusted source of information.

"Unofficial site, not associated with DND or the Canadian Armed Forces."


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## WannaServe123

1) sorry if I did not post this in correct thread-I searched and most recent apnea post was some time ago.  I was diagnosed some time ago with sleep apnea.  I used a CPAP machine.  I have had my tonsils out and a sleep study said mild apnea.  Now I have lost 25 pounds and I do not use a CPAP machine.

Is apnea an automatic bar?  I am applying for a job that need a Geographical Factor: 3	and Occupational Factor: 3. 

Any feedback would be helpful and appreciated.

WannaServe


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## mariomike

WannaServe123 said:
			
		

> I was diagnosed some time ago with sleep apnea.  I used a CPAP machine.  I have had my tonsils out and a sleep study said mild apnea.  Now I have lost 25 pounds and I do not use a CPAP machine.
> 
> Is apnea an automatic bar?



Sleep Apnea - letter from RMO  
https://army.ca/forums/threads/106690.0
3 pages

Prior diagnosis of sleep apnea  
https://army.ca/forums/threads/93201.0

The Sleep Superthread- Apnea/ Disorders/ etc.
https://army.ca/forums/threads/82.50
5 pages.

etc...

As always, the Recruiting Medical Officer ( RMO ) makes the medical decisions.

"Unofficial site, not associated with DND or the Canadian Armed Forces."


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## sarahsmom

WannaServe123 said:
			
		

> Is apnea an automatic bar?  I am applying for a job that need a Geographical Factor: 3	and Occupational Factor: 3.
> Any feedback would be helpful and appreciated.
> WannaServe



Regardless of what the specfic occupational medical category is, you first need to meet to Common Enrolment Standard which is V4 CV3 H2 G2 O2 A5. If you cannot be classed as G2 O2 you will likely NOT be accepted.


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## WannaServe123

Paleo,

thanks for the quick reply.  I appreciate all of the time you all put into this site.

I will keep going with weight loss and physio for snoring, and see about a further sleep study if the answer is no for now.

Sincerely,

WannaServe.


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## WannaServe123

UPDATE:

new sleep study found no sleep apnea-tested normal.  Still not using CPAP.  Weight loss, tonsilectomy and specialized physio did the trick. 
 Submitted results from sleep specialist confirming same, blood work all good, and was declared medically fit by  the RMO.

Just got THE call with an offer.  Thrilled, and now working even harder at gym and diet to get ready for BMOQ this summer.

YAHOO!!! Very proud and very psyched to have been selected.  

Thanks to Mariomike and Paleo and all the Army.ca contributors who give their time.

Thanks all.  Sincerely,

WannaServe


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## PPCLI Guy

WannaServe123 said:
			
		

> UPDATE:
> 
> new sleep study found no sleep apnea-tested normal.  Still not using CPAP.  Weight loss, tonsilectomy and specialized physio did the trick.
> Submitted results from sleep specialist confirming same, blood work all good, and was declared medically fit by  the RMO.
> 
> Just got THE call with an offer.  Thrilled, and now working even harder at gym and diet to get ready for BMOQ this summer.
> 
> YAHOO!!! Very proud and very psyched to have been selected.
> 
> Thanks to Mariomike and Paleo and all the Army.ca contributors who give their time.
> 
> Thanks all.  Sincerely,
> 
> WannaServe



Sincere congrats


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## mariomike

WannaServe123 said:
			
		

> Thanks to Mariomike and Paleo and all the Army.ca contributors who give their time.



Sincere congratulations.


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