Fit to serve: Coeliac disease/Gluten intolerance

[Fray]

Hi,

Is there anybody currently serving (or who has served with HM forces) that has coeliac disase/gluten intolerance?

I have been diagnosed with it and my enrollment with the reserve forces has now been cancelled. Additonally, I was awaiting officer aircrew selection with the regular RN but have now been classed as 'unfit'.

The situation is rather confusing as the medical guidleines stipulate that coeliac disease is a bar to entry. However, I have been offered the chance to appeal to the AIB and told that I may re-sit my medical for the reserves (they have refused my pay unless I pass fit again which tops it all off).

I was also informed by my AFCO that he knew two serving officers that were gluten intolerant and I am trying to get hold of some concrete information on the matter before I go launching an appeal.

Can anybody offer some insight?

Thanks

Fray

[Herc-u-lease]

Have you considered why there is a bar on people with gluten intolerance? Mrs H-u-L was misdiagnosed with it recently and the diet is prohibitive to say the least. I'm not sure whether you would be able to guarantee food to meet your dietary requirements in the mess let alone on exercise. I am not trying to discourage you from your appeal; on the contrary I think it is commendable you want to join. But appeals aside, the practicalities could be a real challenge.

Good luck

[BigJoeRice]

I've just been diagnosed with Celiac and I don't find the diet that restrictive at all. I eat less Crappy Meals, more fruit and veg, substitute rice products for wheat products, and Johnny Walker Black for beer. If the military doesn't exclude veg heads, I would have thought that Celiacs would have been OK

Hint - If you buy Schar German Gluten Free Bread and it tastes like dog doo, then you too have missed the instructions to BAKE it before eating it.

[12 twists per inch]

A colleage of mine who developed a new found nut allergy and took a 'funny turn' when down south, has been given 18 months notice. After much visiting PSF letters and phone calls, it turns out that he is now 'undeployable' and his services are no longer required. So without knowing any rules at all about medical entry standards, I don't hold out much hope for your case.

[OneFifty]

If the two with the intolerance developed this WHILE they were serving then they are unlikely to be discharged because of it. The offer of an appeal is the general line to take with anyone barred from entry due to medical reasons. Basically, you send copies of your med notes to Occupational Medicine at RAF Cranwell and they will make the final decision.

There have been numerous examples of people developing certain allergies (nut for eg)... all of which have ultimately led to a discharge. I would avoid taking medical advice/anecdotal evidence from the AFCO as the AFCO staff are not medically trained to offer such advice, nor is it their remit to give it.

[Bob the Doc]

Nut allergy is a different kettle of fish. True nut allergy can be very dangerous if you eat nuts unknowingly. Combined food prep and service, especially when deployed makes deploying nut allergic people rather risky, hence the general move for medical discharge. Coeliac is a completely different type of reaction. The causative agent is easier to avoid and even ifyou accidentally have some gluten it is not going to kill you. Not so with true anaphylaxis to nuts

[OneFifty]

Bob the Doc provves why AFCO staff such as I shouldn't offer advice on med issues! Occ Med will review your appeal, based on the info on your med notes and decide on your individual case.

Good luck.

[Airborne Aircrew]

Silly question: (that'll start the usual suspects cawing)...

If you have a condition that "limits" your ability to survive in situations that certain trade groups might, not unreasonably expect to find themselves in, why do you think that the military should allow you to serve in said trade group?

Silly supplementary question in case you actually manage to provide a reasonable answer that OASC might give you some leeway on:-

Why would you put yourself at risk in such a cavalier fashion? Being "all gung-ho" is one thing but dying because you can't find an orange, (or whatever), isn't a good use of your life nor is it a good use of other's lives that might be expended trying to get you out of a rather silly situation that could have easily been avoided.

The military isn't all about the individual, it's a team that functions properly together to effect a goal. One shouldn't just wander on in because they think it might be fun regardless of the known risk they provide to both themselves and those they serve alongside.

Please feel free to return to normal programming... I'll just don my flak jacket and await the usual incoming.. :}

[Seldomfitforpurpose]

AA has a point

"If you have a condition that "limits" your ability to survive in situations that certain trade groups might, not unreasonably expect to find themselves in, why do you think that the military should allow you to serve in said trade group?"

When the military employs you it presumes you will honour your commitment and earn your shilling by going where you are told each and every time, it simply cannot afford to train folk, especially Aircrew who subsequently wimp out the very first time the going gets tough.

I fully accept your condition and almost certainly your personality will not fit the above but you have to understand why the selection process simply try's to take the risk out of the equation.

OASC are very good at deciding based on Med records who is going to be able to cope with the rigors of service life, pity they have not developed a sure fire test to identify those with LMF :(

[extpwron]

Mrs E is a coeliac. As Bob the Doc has pointed out, it’s in the combined food preparation (cooking oils and utensils etc) where gluten could be unwittingly introduced and contaminate your food. Again, as B the D has pointed out, it may not kill you but over the long term it could make you ill.

[Wrathmonk]

A colleage of mine who developed a new found nut allergy and took a 'funny turn' when down south, has been given 18 months notice. After much visiting PSF letters and phone calls, it turns out that he is now 'undeployable' and his services are no longer required

Does that mean the Services are now getting tough on all those other personnel who are also classed as non-deployable for one reason or another (fitness .....:E)? This may, of course, include those injured in the line of duty.:uhoh:

[barnstormer1968]

To the OP, I am sorry to say that Airborne Aircrew is exactly right in his
comment.

During my service time, I was very 'warry' and was as keen as mustard, one of
the top shots in my unit, received early promotion, passed all my courses, loved
the life etc. BUT when I suddenly developed asthma in my mid twenties, that
was the end of my military career:{. I could still do an assault course as fast as
anyone else, and could still pass all my fitness tests, but if I had ever been subject
to NBC conditions, or had to live in my respirator for extended periods, then I
may have let my mates down (for that, read would have, but it's hard to say that
one would let ones mates down).
I desperately wanted to stay in as it was my whole life, but I knew I could not
live a lie and ever risk letting my mates down when they needed me.

Maybe this sounds a bit harsh (and yes asthma can be more restrictive than your
dietary needs). The forces are a different world, and unlike in civilian life,
where illness and days off are routine, in the forces, each and every person will
need to be able to one hundred percent depend on the man/woman next to them
at some point.

[x213a]

If the two with the intolerance developed this WHILE they were serving then they are unlikely to be discharged because of it.

Thats gash advice, of the highest order.

[R 21]

I know a helicopter Crewman that was diagnosed with it while serving and he is still in albeit on a restrictive med cat ie no deploying... jammy git !!

[x213a]

Is that an RN crewie?

[BEagle]

Hint - If you buy Schar German Gluten Free Bread and it tastes like dog doo, then you too have missed the instructions to BAKE it before eating it.


...after which it probably tastes, as does most German bread, like plywood.

[airborne_artist]

You have to bear in mind that Armed Forces recruiting is in the main, very good right now. There's a bulge of under-employed sub 25 y/os who are keen. Why therefore should they hire anyone with known medical/fitness limitations when there's another 100 standing behind him/her who have no issues?

It's bad luck, but right now they don't need you that badly. I'm sorry, but it's the truth.

[XV277]

airborne_artist has it to a 'T', there is so much competition for places that they can afford to be picky.

In addition, there is a difference between a gluten intolerance and true Coeliac Disease. I have a couple of friends (non-Service) with the latter and one in particular gets very ill with even the smallest contact with wheat gluten (being in close proximity to flour dust can be enough).

With respect to serving people, then no doubt there may be circumstances where the severity of the intolerance or disease can be weighed up against the value of the individual and the amount invested in them, and any role which they can perform.

However, that differs from someone just starting, who requires a lot of investment, and who has a just-diagnosed condition, the severity of which may not yet be fully know.

Compare to eyesight standards for pilots - you won't get in with a level that might be acceptable in a trained pilot who suffers an age-related drop in visual acuity.

I very much admire your desire to serve, but sadly I can see why you are being denied.

[airborne_artist]

Look at it this way:

You are out in the field, rations are low, and the big Wokka drops a load of great nosh, but it's all got gluten in it, as that's all they had. Will you be able to do your job and look after your oppos?

[OneFifty]

x213a

I don't see how that was gash advise, it was merely a suggestion. I do not know if that was the case or not. Some people do develop conditions during service which would bar them from entry, some are discharged, some stay in.

[Bertie Thruster]

You are out in the field, rations are low, and the big Wokka drops a load of great nosh, but it's all got gluten in it, as that's all they had. Will you be able to do your job and look after your oppos?

Might affect everyone to some degree?


Foods with high concentrations of lectins, such as beans, cereal grains, seeds, and nuts, may be harmful if consumed in excess. Adverse effects include allergic reactions, nutritional deficiencies, and immune reactions.

[x213a]

Onefiftty,

You offered what appeared factual truth to somebody who did not know- as gash advice. I'm not questioning your service credentials, Im just saying you got it wrong. Unless the MOD is culpable in anyway then it's Goodnight Vienna in most cases. The only factor being the pension.

[OneFifty]

Most cases maybe, but not all. I am living proof of that. And I did state that the final decision is with Occupational Medicine at Cranwell. They do pass a surprising number of people on appeal.

[x213a]

Is it realistic to offer such advice to an wannabe when the MOD are freely able to go for the 'low hanging fruit'? I hate that cliche, its applicapble though.

I was MD'd for something the navy was culpable for (and accepted it), in reality, I could have stayed in had I changed branch. After 14 years doing what I did that was not an option for me really.
I find it hard to believe the MOD would recruit any liabilities given the numbers they are now able to shuffle.

[papercut]

Fitness for service (and fitness for deployment) with coeliac disease is an interesting question. It is possible for some people with coeliac disease to get away with eating gluten for a short period without major problems with their guts. Indeed I have come across coeliacs who miss proper bread and will put up with symptoms for a nice slice of "crusty white" occasionally. Oddly that bread can come in brown bottles with crown-corks too!

It is possible to produce rations that cater for a wide range of dietary requirements but in the field these cannot be guarenteed.

There is a known association between coeliac disease and increased risk of malignant disease such as non-Hodgkins lymphoma (NHL). There is strong evidence that sticking to your gluten free diet reduces the risk of NHL. Admittedly the evidence that the gluten-free diet reduces risk of other cancers isn't always as strong, it might well be difficult to find subjects for the clinical trial!

Whilst coeliac disease may be seen as easy to control with correct diet and the medics approach seen as overly restrictive I think you can see the issue of not being able to provide a gluten-free diet has significant implications; not just immediate but for future health.

(I can only speak for the RAF here) Generally therefore coeliac disease is seen as a bar to entry into the service. If you are diagnosed after joining you would be medically downgraded and protected from deployment (in all but the most minor cases). This would also restrict you from re-engagement at the end of your current service.

Richard

[Loose rivets]

For some years now I have been rather ill. Well before I was diagnosed with a fairly aggressive prostate cancer, I was feeling unwell almost every morning. By mid day, I was fair again, and by 7pm, ready for wine and a sizable dinner.

It seemed to make no sense at all, and the symptoms were often blurred with chronic back pain.

Go back a few years...my early 60s. I had a still got current Class I and a bad back. Other than that I seemed to be a very fit 62 year old. By the grace of God I'd finished flying. I was on my way home from Clacton Hospital where I'd had nothing but a session on a back stretching machine. The only possible intake of chemicals was from the strong hand wash dispensers. My hands started to itch.

By itch, I mean driving in thick Clacton traffic with my knees, while scratching my palms furiously. Before you say anything about driving like this, the decision-making was obviously being affected by whatever ailed me. The same logic that made me drive past a parked para-medic's car. I was feeling very ill and just wanted to get home.

The drive took me onto some hundreds of acres of farmland, where a windy road normally makes a very pleasant drive between the two towns. I made it to the first bend and dialed 999. The ensuing conversation was right out of Monty Python. What kind of feckwit I'd got hold of beggars believe, but she was insisting on an address. "we can't find you unless you give me an address"

I protested that the description I'd given would have allowed every policeman or ambulance driver in Essex to find me. She was in Swansea, so that didn't count.

I screamed obscenities at her in between screaming with pain. Again, whoever I was, didn't resemble my normal self. The pain in my chest was all consuming. My face in the mirror was ashen and my lips mauve. The elephant on my chest got off occasionally for me to have another go at pleading for someone with a brain. At first it seemed that I was dying with a major heart attack. Everything I'd been taught seemed to fit.

Loads of cars went by - including a paramedic vehicle - and no one stopped. I got better.

Anyway, back to the topic, three GPs independently came to the conclusion that it must have been Anaphylaxis. Other than this, all I do is carry an Epipen. sp?

So, a few yeas go by and I seem to feel more and more ill a lot of the time. To this day, I don't know if there's a connection. But now, beer, and horrors! Scotch, all make me feel unwell - but so does a packet of chrisps or brown bread. Nothing seems to make sense, and the GP finds nothing but blood platelets that are "too big" !!??

I can spend days feeling okay. Then something gets me and I feel like I'm getting the flue. Groaning around, aching, rheumaticy, 100 years old...then, as quickly as it comes, it goes again, say, 36 hours. Gone. Not a trace

I can't eve touch washing up liquid, or strong soap. Cake is just a memory. Two bottles of fine Scotch are still in the cupboard after 3 years. Perfect adherence to a gluten / wheat free diet can leave me okay for days. One transgression, and I may as well have walked in front of a truck. But worse, the chemical thing - which may be unrelated, but blurred in with - can get me anytime. Mosquito spray, break-cleaner, any volatile thing, are all suspects, but nothing is consistent enough to be totally clear.

At 65, despite not being able to run anymore cos of back pain, I could still cycle quite hard, and swim for hours. Slowly, this thing is getting me, cos something will creep out and cause 'that feeling' when I least expect it so making plans is almost impossible.

What I find very difficult to cope with is not knowing exactly what's going on. Two or more things blurred together making diagnosis difficult perhaps. But a huge amount of blood was pulled last summer, and nothing conclusive found.

There is no way on Earth I'd find myself in command of even a light aircraft without a safety pilot now.

[gingernut]

How was the diagnosis made?

[Loose rivets]

Sorry to highjack the thread, but I guess that it's germane. It's just that life is rather revolving around the subject at the moment.

Diagnosis?


In my case? Well, rather informal really. A neighbor, a lady GP, first suggested that I might have been hit with my first reaction. One of the GPs at my local practice concurred. His dad had practically exploded outside an Indian restaurant, with no time for a bacteriological reaction. His dad was also a GP, and in their ongoing investigation, got clued up on the subject. Another practice GP - much nodding and issuing with replacement Epipen.

Doctor said, "we're seeing a lot of this these days."

It seems that it doesn't get better. The reaction becomes more vicious as time goes by. Certainly feels like it.

My last 2 days in the UK were hellish. Again about 36 hours bedridden. Didn't know if I could crawl to the car. Suddenly, I felt better. By the time I was at LHR, I was chirping away as normal, nice dinner and wine. Beats me.:confused:

Odd this thing about enlarged blood platelets. You'd think they wouldn't fit down the little pipes.:}

Anyway, tonight, not too bad. Last night, crap. And so it's gone on for some years.

Thing about crisps. I noticed that I was getting 'that feeling' after going to the pub at lunch time. I changed to fruit juice. :yuk: BUT, kept buying the tasty crisps with all the sticky goop sprayed over them. Same feeling. Like a burning - buzzing throughout my whole body. A contemporary at home says that he can no longer eat Indian food. Knocks him for six, and he loves it. Monosodium glutamate was his buzz-word for the day. Who knows, perhaps at a certain age one becomes allergic to life. :ooh:


My wife thinks it's all in the mind. Heard that one before somewhere.

[barnstormer1968]

Loose rivets, check your PM's.

[Loose rivets]

barnstormer1968 Thanks for the PM


Yes, it's difficult to understand what's going on sometimes. A pal in the UK has just told me that his wife has had another attack - the 4th - that may well be a reaction to a specific substance. She's a very fit lady that belongs to a walking group etc.. First time she was rushed to hospital with blue lights going.

I'm not really able to get much medicine while I'm in the US, but having said that, while in the UK not much was really found. A lot can be achieved with self discipline - that's my problem.

The only way is a water diet...distilled and boiled again. But even then, I was going to introduce fruit after the first couple of days, but even that is listed as affecting some people!! After my last post, I spent some more time looking at typical allergies. There doesn't seem to be anything that doesn't affect somebody and some of the reactions a very severe, life threatening, even.

Any thought of simply brutalizing oneself with the suspected product, in the hope of desensitizing oneself, is a route to the morgue. Not many people die with the reaction, but a big enough proportion of sufferers die to make it inadvisable to experiment too widely.