Common Enrollment Medical

[rcampbell]

Yes I've thought that. But I it went all the way to Ottawa and then a Major, who's name I forget, was the Dr. who reviewed and rejected it. I wasn't sure how to get a hold of him directly. Or if that was possible even.

 

[Occam]

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.

I still think your best bet is your family doctor.  I'm sure he's familiar with the politics of the civilian medical system, and is probably your best bet at getting a favorable ECG report from the people who are best qualified to interpret the results.  If there are two different interpretations written on the second report (one saying the ECG is normal, and the other saying you have borderline LQTS - who wrote that it was normal, by the way?  Is there a signature?), then there's something wrong.  Either it's normal, or it's inconclusive, or you have LQTS.  If it's normal, that's all the report should say.  If it's inconclusive, then one would assume that they're going to be doing more digging to find out for sure.

I really don't know what will happen if an ambiguous report is sent up to the people making the medical recruiting decisions in the CF.  It's a crap shoot.

Ever think of contacting the CF Medical Person and simply asking, "If the first test was incorrect, what is the procedure I have to undertake in order to have my medical cleared?"

The CF medical system just doesn't work that way.  You'll find that out firsthand.  Potential recruits just don't pick up the phone and call Majors in Ottawa.  You have to play by the system.  In the meantime, I don't really think you're offering much help as you're out of your lane. 

 

[owa]

The CF medical system just doesn't work that way.  You'll find that out firsthand.  Potential recruits just don't pick up the phone and call Majors in Ottawa.  You have to play by the system.  In the meantime, I don't really think you're offering much help as you're out of your lane.

Hmm, maybe you didn't read his posts completely or maybe my post came off too broad...  In any case, this is what he said:

"He said a medic was even going to be there the end of the month that I could talk with if I wanted."

I meant he should ask this person.

If that fails, he could go through the "system" by talking to his Recruiting Center as any questions I had over my colour blindness and vision problems were dealt with quite quickly and effectively.  Might take some time, but if he is truly medically able to be in the CF, the switch will be made.

But I never said he should contact a Major.  Not sure where you got that from! 

 

[Occam]

It's unlikely (possible, but unlikely) that a Med Tech will be able to offer up any more information about LQTS than what rcampbell has already gotten from his family doctor.  I didn't suggest that you meant to call the Major in Ottawa, but it needed to be said that the system works in a certain way, and if you take shortcuts, you may shoot yourself in the foot.

The OP's best friend right now is his family doctor.  What the OP needs is a clean bill of health.  The ambiguous reports coming from the specialists are going to raise eyebrows at the RMO, and that's not what anyone wants.  You want a nice, simple report that says LQTS has been ruled out, or that the most recent ECG is normal.  Nice reports that don't need a lot of interpretation and follow-up phone calls for clarification are going to get the OP through the CF's door.  I think the family doctor is in the best position to articulate to the specialist that the most recent report is ambiguous and needs clarification, be it either to say the ECG is normal, or that the diagnosis of LQTS after the first ECG was confirmed by the second ECG.  There can't be any middle ground.

 

[medicineman]

One of the problems with alot of electronic ECG machines is they have a habit of diagnosing and often, over diganosing things that aren't there.  However, ECG's tend to be interpreted by a cardiologist, who will either agree with or trump what comes out as the diagnosis.  They will also do the calculation for the QT/QTc on their own to verify in their mind if the computer is correct in it's measurements.  If they continue to feel that there is an LQTS situation going on, that's what they will/should write on the report.

MM

 

[Occam]

Ahhhh, thanks MM.  I hadn't even considered the possibility that it was the ECG machine that was writing "Normal ECG" on whatever it is that the OP is referring to, and not a human.  That makes a lot of sense.  I would say that adds more weight to the suggestion that the OP should check into this with the family doctor, to find out whether the conflicting diagnoses are between man and machine.

 

[Blackadder1916]

First, a bit of an explanation about the reading of EKGs.  Most modern EKG machines can provide a gross computer analysis of the reading; that analysis is not (or should not be) recognized by physicians as a valid interpretation of the test.  It is also not recognized as the "professional" component of the test for reimbursement by any of the provincial health insurance plans.  The only ones (in AB, BC and ON at least, but probably all others) who can interpret an EKG (and get paid for so doing) is a physician who is qualified in Internal Medicine (Cardiology is a sub-spec of IM) or a physician in another specialty who has completed additional training and certification in EKG interpretation.  While many family docs may be able to do a gross reading of an EKG (though I know some who accept their limitations and refuse to even look at an uninterpretated strip), they are neither trained nor certified to do so beyond recognizing obvious abnormalities, nor are they usually able to maintain competency simply because they don't look at that many.

As has been reiterated time and again on this forum, this is not the place to come for a diagnosis based on a person's description of his problem and even an interpretation of  test results is dodgy.  The best that can happen is an explanation of the process and not the outcome. 

It is highly unlikely that the specialist who read the second EKG will change his written interpretation.  Probably two reasons there, firstly is that he probably feels his comments best reflected his analysis of the test (in other words, he thinks he is right) and secondly, this has now changed from an interpretation of a diagnostic procedure in order to provide knowledgeable medical care to a patient to being part of a non-medically necessary process, i.e. getting hired by an employer.  The $15 (or probably not much more) that he was paid for his work doesn't cover that.

What does this mean to rcampbell and his next steps to overturn the decision of the RMO (who is in Borden not Ottawa, unless they have changed his location)?  If I understand correctly, his "letter of doom" simply stated that he did not meet enrolment standards because of the long QT; it was not an invitation to submit additional medical tests or opinions in order to clarify the circumstances and potential outcome of the condition.  Therefore, rcampbell probably has only two courses open to him if he still hopes to join the CF (edited to add this after ModlrMike's following post about reality).  He can submit the second EKG with a request that his situation be re-examined by the RMO; it may be helpful if the second EKG is accompanied by a report from his family doctor explaining the situation and containing his opinion that there is nothing wrong.  However, based on rcampbell's explanation of what his GP has done to definitively rule out LQTS, there may not be a lot of meat in such a report, even if his doctor would so state.  (Of course, my analysis of this may be wrong.)  His second option would be to have a diagnosis of LQTS definitively ruled out by a specialist which at the same time could provide an explanation for the long QT noted in previous EKGs.  If that was to happen, he could then submit that greater evidence for review by the RMO.

 

[ModlrMike]

Therefore, rcampbell probably has only two courses open to him.

You forgot the third option, and I don't mean to be cruel here, just a realist:

3. Accept that everyone gets to apply, not everyone gets to join.

 

[Blackadder1916]

You forgot the third option, and I don't mean to be cruel here, just a realist:

3. Accept that everyone gets to apply, not everyone gets to join.

But if everyone who visited these means were as grounded in reality as the "crusty*" senior members (*as proven scientifically by Mike Bobbitt) there would probably be a significant drop in the visits to the forums.

"Go, go, go, said the bird: human kind
Cannot bear very much reality."

T.S. Eliot  (1888-1965)
Four Quartets, Burnt Norton, I