Well I got the so-called " Letter of Doom" today. It states I do not meet the common enrollment medical standards for the reg. and res. forces. It says my QT interval is too long. This is pretty deflating news and to be honest a little frustrating. I was in the Navy Reserve for 2 years. I do a lot of physical activity, like cycling a couple hundred km's a week on my road bike and running and have never had a single problem. Is there any form of appeal process or some way I can "prove" I'm fit, or am I just screwed?
Common Enrollment Medical
- Thread starter rcampbell
- Start date
- Reaction score
- 6
- Points
- 430
Has your family physician ever picked it up? See your family physician and see if you can get a test done. The only way you'll ever win is to prove that you didn't have it in the first place, or perhaps that you no longer have it. Regardless, you need medical evidence that contradicts the CF medical exam.
This information was part of a ECG that was done about 6 weeks ago as part of the aircrew medical. It was done at my local hospital and my doc filled out the medical form and indicated no issues. The medical officer in Ottawa says it's an issue though I guess. Also, I assume common enrollment medical means that I am out of luck for any of my three choices, as opposed to no luck for the aircrew choice right?
- Reaction score
- 6
- Points
- 430
Again, the only way you're going to get anywhere is for someone equally as well trained (specialist) as the person who reviewed the ECG for the CF to review it and say the results were misinterpreted/misread/incorrect. Unfortunately, the onus and cost of seeking that professional opinion is yours. Your first stop should be your family doctor, and they should be able to advise whether it's possible that they themselves missed the diagnosis. Go from there.
If you don't meet the common enrolment standards, you can't enrol - period.
If you don't meet the common enrolment standards, you can't enrol - period.
- Reaction score
- 3,980
- Points
- 1,160
Occam provides the best advice.
The cost of disputing this (save, perhaps, for the writing of reports specifically to a third party, i.e. The CF) should not be as onerous as you may think. The condition that has excluded you from the CF has a name, Long QT Syndrome (LQTS). It is recognized but is also largely underdiagnosed due to a number of factors. Because it "could" (say again - "could" - and a faint could) be a significant medical issue for you it should be investigated further for other than the reason of trying to overturn the failure to meet the common enrolment standard.
Here are a few links to info about LQTS
http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484075/k.F8EF/Heart_disease__What_is_Long_QT_Syndrome.htm
And something geared more to the medical professional.
http://emedicine.medscape.com/article/157826-overview
The cost of disputing this (save, perhaps, for the writing of reports specifically to a third party, i.e. The CF) should not be as onerous as you may think. The condition that has excluded you from the CF has a name, Long QT Syndrome (LQTS). It is recognized but is also largely underdiagnosed due to a number of factors. Because it "could" (say again - "could" - and a faint could) be a significant medical issue for you it should be investigated further for other than the reason of trying to overturn the failure to meet the common enrolment standard.
Here are a few links to info about LQTS
http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484075/k.F8EF/Heart_disease__What_is_Long_QT_Syndrome.htm
And something geared more to the medical professional.
http://emedicine.medscape.com/article/157826-overview
- Reaction score
- 3,448
- Points
- 1,090
I'm thinking this is the part that got you your "letter of doom". Sudden death seem like a pretty big risk for the CF to take.
It's unfortunate you had to learn of the condition in this manner, but at least now you know. I'm not unsympathetic to your situation, but I don't see any way around it.
- Reaction score
- 2
- Points
- 230
Recommend having the ECG repeated by your family doc, and if you still show QT prolongation, s/he could consider referring you to a cardiologist for a specialist opinion. Based on the specialist opinion, go from there. All hope is not yet lost.
OK, just an update for anyone who might be interested and/or in the same situation. I'm having another ECG done in two days, and my family doc said if there's still a problem we will go from there. My blood pressure was 120/80 and he said S1 and S2 are OK and no murmurs. So hopefully the ECG comes out better this time.
Just another quick update. I just got back from my ECG appointment. The ECG tech asked why I was having the test done, so I explained to her the situation. She told me that the machine they use has a tenancy to read the QT intervals high. She said probably 4 out of 10 people she sees read a longer QT interval just because of how the machine is setup. So anyway, we did the test and then I asked if I could see the output and it was completely normal. Normal QTc, normal sinus rhythm etc. So I'm hoping that if I send in these updated results then Ottawa will realize I'm in fine health. *crosses fingers*
*Quick note. Just got back from the recruiters. The Sgt. there said it was no problem to bring back my updated medical info. He said a medic was even going to be there the end of the month that I could talk with if I wanted. But he said it was no problem to get the info sent to the medical section and to the RMO. So I'm hopeful once more! 
I have a quick question for someone that might be in the know. I had my ECG repeated, and it came out fine. No warnings of borderline QT on it like the first one. My fam. doc. looked at it again and said that's what he expected and thought I was fine. There is still a frustrating part though. The dr. that looked at the ecg commented that "borderline QT was confirmed on ecg from date xx-xx-xxxx". He wrote this on the new ECG that says at the top, that it's normal. Is the RMO going to look at this and still think I am unfit, or will he know that this doc is just "covering his butt" by remarking that?
- Reaction score
- 0
- Points
- 210
rcampbell said:
I'm pretty sure this is common practice.
It'd be like if you had this reversed, and it first said you were fine but on the second try it said you were afflicted. It's best to have a complete history (or as close to it as possible) readily available when looking at a document like that. I'm sure it just means that the CF Medic will have to decide what is what and how to best get a conclusive answer.
- Reaction score
- 6
- Points
- 430
rcampbell said:
What doctor is this? Is this a cardiologist? And is it the same doctor that wrote the first report?
Your explanation is somewhat confusing.
You're going to have to try to explain the positions of the various players who are signing off on these reports.
Occam, I'll try to be a little more clear, I know it's sort of confusing to read...
ECG #1
Was sent to RMO as part of the Aircrew Medical requirements. RMO wrote back saying I was unfit for service because the ECG said I was borderline Long QT. When I received these results, I went to follow up with my fam. doc. and he requested another ECG be done as a starting point to see what might, if anything, would have to be done.
ECG #2
The doc that reviewed these results at the hospital before sending them back to my fam. doc. put a comment on this ECG saying that borderline Long QT was confirmed on ECG #1, even though ECG #2 indicates it's normal. So ECG #2 looks confusing because in one spot it says everything is normal, and then it has a comment that says the previous ECG was confirming borderline long qt. Got the results back and discussed with family doc. He said it was a normal ECG and that I have nothing to worry about.
My main concern is that RMO will look at the comment on ECG #2 about the first ECG and still think i'm unfit, and completely ignore the normal results of ECG #2.
ECG #1
Was sent to RMO as part of the Aircrew Medical requirements. RMO wrote back saying I was unfit for service because the ECG said I was borderline Long QT. When I received these results, I went to follow up with my fam. doc. and he requested another ECG be done as a starting point to see what might, if anything, would have to be done.
ECG #2
The doc that reviewed these results at the hospital before sending them back to my fam. doc. put a comment on this ECG saying that borderline Long QT was confirmed on ECG #1, even though ECG #2 indicates it's normal. So ECG #2 looks confusing because in one spot it says everything is normal, and then it has a comment that says the previous ECG was confirming borderline long qt. Got the results back and discussed with family doc. He said it was a normal ECG and that I have nothing to worry about.
My main concern is that RMO will look at the comment on ECG #2 about the first ECG and still think i'm unfit, and completely ignore the normal results of ECG #2.
- Reaction score
- 0
- Points
- 210
rcampbell said:
If the medical person is doing their job, they will take all information into account and likely have a recommendation for you in terms of how best to go about continuing the application process. It would be unlikely that they stick completely with, "Well, we found something and that means you're done." After a second opinion, I'm sure they will take it all in and then tell you what the next course of action should be to completely confirm your medical.
- Reaction score
- 6
- Points
- 430
rcampbell said:
I've highlighted something above that looks funny. Was ECG #1 the first ECG that you've ever had? If the answer is yes, then how can LQTS be confirmed when ECG #2 doesn't jibe with it? ECG #1 would only be confirmed if ECG #2 agreed with ECG #1.
Let me clarify where I'm going with this. Normally a technician does x-rays, CT scans, ECGs, ultrasounds, and the like. They don't interpret, they just do the procedure. The product of the test such as a CT goes to a radiologist for interpretation. Likewise, I would expect ECG tape or electronic version would go to a specialist (cardiologist?). If the cardiologist who read your first ECG came to the conclusion that you have LQTS, and then you were referred back for another ECG and the result was again interpreted by the specialist as LQTS, then you're in trouble. The specialist is going to trump your family doctor.
However (!), if the second ECG report from the specialist has conflicting information, for example stating that it's normal in one place, and borderline long QT in another, then that's something your family doctor should be taking up with the specialist. The family doctor should be impressing that you need either a clean bill of health, or a diagnosis of LQTS - not a report that is unclear and falls somewhere in the middle, or else they're just wasting their own time as well as yours. If the ECG was normal, then the report really needs to say that, and only that.
Don't make the RMO people try to read between the lines and try to figure out what your status is - the reports being sent up need to be clear and unambiguous. (That's directed to your medical people, not to you).
I agree Occam, I am getting somewhat annoyed with this foolishness. You are correct, ECG#1 was the first I've ever had in my life. ECG#2 was the second I've ever had. I explained my situation to my fam. doctor and he understands and realizes a more definitive answer is desired. He was on the phone with the Int. Med. Spec. that reviewed ECG#2 and they would not change or remove their comment about borderline LQTS being confirmed on ECG#1. I don't have much medical knowledge, but it doesn't take a doctor to realize the fault in this logic. The worst part is that now that it's in the system, I'm worried that even if I get a 3rd test done, the reviewing dr. will still feel the need to propagate this comment about borderline lqts being confirmed in ECG#1. I'm getting frustrated and trying to figure out the best next step.
