Boys 'grow out of' asthma

[minigundiplomat]

Just seen this story on the BBC news, and wondered how many youngsters have had their dreams of becoming a pilot/aircrew dashed by having asthma on their medical file, when they may well have been clear of asthma for years.

The 'experts' reckon boys can grow out of asthma at around the age of 13, so by the time they get to 18-21 and are looking to join the RAF/AAC or indeed RN, they would have been clear of asthma for 5-8 years.

Never had asthma myself, but it made me think.

[It's Not Working]

MGD

Keep your fingers crossed, I grew into it at about your age! It didn't do my aircrew prospects any harm however, pi$$ poor eyesight poleaxed any hope of being paid to fly at a very early age - now if only I could have grown out of that.

[Pontius Navigator]

B*ll*cks

Read the Torygraph article.

One in four boys show improvement. One in six girls.

Put it the other way, three out of four boys did not and four out of four were not declared free.

Where enough candidates of suitable aptitude and wholly acceptable medical standards apply, why should those that do not meet the criteria be considered for exceptional treatment.

Sorry, A-word NO. H-word probably NO. Summer cold - no problem.

The ONLY sure way is to stop the doc EVER using the A-word in the notes. Asthma is a prevalent diagnosis and is an easy one for a GP to write down. As Mrs PN says, Asthma is easier to spell and comes higher up the list than bronchitis etc.

[CirrusF]

I would be interested to see the statistical studies behind the reasoning. When was the last time it was studied?I'm just one data point, but I suffered from asthma from about 8-11 years old - probably due to growing up in a damp house without central-heating in northern england then going to an even colder and damper boarding school. So the RN turned me down for aircrew, despite having been in the UAS, winning a blue for modern pentathlon at Cambridge, getting a first class aero engineering degree, and being the only candidate ever to succeed in doing a supposedly impossible shark-infested custard test at the AIB. Anyway, I went on to pass SAS selection instead, can still (aged 45 now) row 2000m in 6:45, did the 52nd fastest C2 marathon rowing time worldwide last year, needless to say have never had a stroke of asthma since, and now hold ATPL.

[Pontius Navigator]

Cirrus, I would hazard a guess that it is down to money. There is no incentive, at the moment, for the armed forces to undertake an asthma study. Such a study might be undertaken at a research institute if anyone was interested and could gain funding.

As for your suggested causative life style, join the club. However Mrs PN says that lack of central heating is not a cause.

The following link and extracts would seem to suggest that cold and damp were not the problems but that atmospheric pollution has a significant effect. Without doubt pollution from hydrocarbons and aerosols has increased dramatically but les visibly than the fossil combustion of the 50s and before.

<<Controlled human exposure studies of acid aerosols suggest increased responses among adolescent asthmatics. Increased ambient and indoor levels of bioaerosols (e.g., house dust mite, fungal spores, endotoxin) have been associated with exacerbation of asthma. . . studies focus on the effects of exposing humans and animal models to a combination of various PM samples (e.g., diesel exhaust particles, oil fly ash) and allergens (e.g., house dust mite, ovalbumin). . . PM exposure can promote allergic sensitization and exacerbate existing asthma . . . Exposure of healthy human volunteers . . . promotes inflammation and increased indices of oxidant formation correlating with the quantity of transition metals in the samples. . . PM promote the formation of reactive oxygen species and subsequent lung injury, inflammation, and airway hyperresponsiveness leading to airflow limitation and symptoms of asthma.>>

The Role of Particulate Matter in Exacerbation of Atopic Asthma

[davejb]

Sadly there are still more people wanting to be pilots than can be accomodated - so some very simple filters are applied, which undoubtedly reduce numbers to a more manageable amount whilst filtering out some really top notch people. There is currently no incentive there for the RAF to change the flitering system - they still get all the applicants they need.

You have to show the RAF (etc) that there is some overwhelming benefit to be gained from changing the system - meanwhile a large number of top blokes (and blokesses!) will be rejected, tough luck I'm afraid.

On a more general point the human race seems to be a great deal more fragile than it used to be - how on earth 83%* of the human race suddenly became allergic to nuts is beyond me. How about a study to find out why so many people have allergies we had hardly heard of 30 years ago?

Dave

*83% is a figure I concocted, as everyone knows it's easier to 'prove' a case by quoting statistics, no matter how baseless.

[CirrusF]

What is even more ridiculous about the "asthma question" at aircrew medicals is that it rewards the dishonest. I was well aware (and this was way before the internet made the knowledge even more widespread) that if I answered "yes" to the question, that I would probably be disqualified. I was equally aware that if I lied, I would almost certainly never be found out. However, I decided to tell the truth. I often wonder what the MOD prefers - candidates who lie at their medicals, or candidates who might have a very small chance of subsequently having an asthma relapse?

[Airborne Aircrew]

At the risk of sounding crude - Nuts is bollox...

Half a dozen "noisy" people got themselves noticed. Now, something that almost the entire planet eats and enjoys is banned from schools...

I'm in agreement with Pontius... If you have a child that you think might, (even remotely), want to go down the pilot route you should make sure that, at worst, the doctor reports "some respiratory issues"... Never asthma.

[CirrusF]

[QUOTE]If you have a child that you think might, (even remotely), want to go down the pilot route you should make sure that, at worst, the doctor reports "some respiratory issues"... Never asthma.[QUOTE]And there you have a perfect example to prove the point of my last post - the policy encourages dishonesty and unfairly handicaps honesty. I'd rather my children grow up to be honest non-aircrew than dishonest aircrew!

[Airborne Aircrew]

I'd rather my children grow up to be honest non-aircrew than dishonest aircrew!

Frankly, I'd rather my children have basic comprehension skills. I did not say that I would encourage dishonesty in my children. I stated that, where there might be a question of the longevity of the symptoms that might disaffect the child's career choice, as a parent, it might be a good idea to encourage to the doctor to refrain from an overzealous diagnosis.

I'd hesitate to guess that, while they might have used it against you, asthma was not the reason you were rejected... But that's just me...

[CirrusF]

Who are you to "encourage" a doctor to change his diagnosis? You appear to think that it is fine to "encourage" a doctor to change his diagnosis of your child, so that he/she can subsequently dishonestly claim without fear of being found out that he/she did not really suffer from childhood asthma. I don't think that is in the long term interest of your child nor of the services.The remainder of your posting is equally gratuitous, unmeritous and disgraceful.

[tarbaby]

I just love these 'holier than thou' replies. I will admit that when they asked if I had ever been knocked out, I replied, "No." Playing rugby in NZ as a 10 stone weakling put paid to that big time.
I do not know why the doc at Biggin did not examine for haemorrhoids but I wasn't going to volunteer information. Did not volunteer about migraines also. In fact the biggest headaches I had were S/Ldrs who were power mad.
The KOs were found out when the brain scans were done but by that time I was in. 16 years later I was out. Did I feel guilty about the initial porkies, NO! I wanted in and did everything possible to achieve that.

[Pontius Navigator]

Cirrus,

I take your point.

Mine however was that doctors take/took the facile option - asthma use this ventelin (sic?) inhaler 3 times a day.

Rather than accept this easy, 10 minute appointment at the GP, ask for a second opinion at a centre of excellence. How many children of military aircrew have a diagnosis of asthma I wonder?

In 1978, or thereabout, ventilin was all the rage and AFAIK new. Now I am susceptible to chest congestion etc and around this time caught pneumonia. The Doc, not for the pneumonia but probably for residual problems proscribed ventelin. I took a couple of puffs, neither liked it nor did it seem to do anything for me; I stopped using it.

I think he simply wanted to give it a try out. Doctors do that. They are 'encouraged' by drug companies and 'drug-lunches' to adopt their new wonder drugs.

Asking for a second opinion is your right.

[CirrusF]

I think your point proves that there is a lot that can be done to improve medical and psychological selection of aircrew.The "asthma" question is about as outdated a way of failing military aircrew candidates as the gunshot test in WW2. They could now use genetic profiling which would identify susceptibility to all sorts of illnesses and maladies that could ground air crew - eg it can even identify those who are susceptible to back pain which seems to ground a fair few aircrew. It also surprises me that smokers are still not automatically disqualified.

[GreenKnight121]

Originally Posted by Airborne Aircrew

At the risk of sounding crude - Nuts is bollox...

Half a dozen "noisy" people got themselves noticed. Now, something that almost the entire planet eats and enjoys is banned from schools...

Hmmm... "noisy people".

Peanut Allergy Information
"Peanut allergy symptoms affect various systems of the body and include:

• Hives/urticaria/wheals (small raised itchy areas likened to bites)
• Itchy red skin, rashes
• Congested runny nose
• Pain in the stomach, vomiting, nausea, diarrhea
• Swelling/edema of the lips, skin tongue and airways (causing constriction, wheezing and difficulty breathing)
• Shock (as blood pressure drops and the blood struggles to pump blood around the body)

The smell of peanuts or even second hand contact like kissing or shaking hands with someone else who has eaten a peanut product has been reported to produce an allergic reaction. People with severe peanut allergy are at risk of suffering anaphylactic shock."


Fatal Nut Allergy - DrGreene.com
"Some individuals have reactions to particular foods. These reactions can range from mild intolerance to fatal allergies. Most of the children who develop life threatening food allergies either have asthma or a family history of asthma, eczema, or hay fever. Most of them have mild to moderate reactions (rash, wheezing, tingling, diarrhea, etc.) to the offending food before the allergy becomes severe. In a few children, the first time they eat the particular food, they become sensitized and the second time they eat even a miniscule amount of that food, an explosive reaction occurs.
Life-threatening food allergies (most commonly to nuts, peanuts, or shellfish) can kill children in two ways. The first is called laryngospasm. As the food is swallowed, it produces immediate swelling that spreads to the vocal cords. If the vocal cords swell shut, the child is unable to breathe and dies with terrifying rapidity. The second mechanism is called anaphylactic shock. The child swallows and digests the food and, as long as two hours later, goes into shock and dies.
Children with life-threatening food allergies do not grow out of them. Without treatment, these are lifelong conditions."


Elsevier Article Locator
...
"Also similar to the 1997 survey, the severity level was high, with 79% reporting respiratory or multiple organ system reactions and 66% experiencing more than 5 lifetime reactions."
...
"Although the rate of peanut allergy, TN allergy, or both was not significantly different from 1997 to 2002 among adults, the rate increased from 0.6% to 1.2% among children, primarily as a result of an increase in reported allergy to peanut (0.4% in 1997 to 0.8% in 2002, P = .05)."


You don't have to worry about some of them being "noisy"... they are dead!!

The "noise" is about keeping the rest alive.

But who cares, right? Not you, AA. As long as you are not inconvenienced, the rest can go to h&ll?

[SNS3Guppy]

I'm a diagnosed, long term severe chronic asthmatic. When I was younger, I spent three or more nights a week in the hospital emergency room being treated for asthma, and typically several weeks at a time, about four times a year, in the hospital undergoing treatment at a time. I never met a doctor who didn't say it was the worst case of asthma he'd ever seen. It was bad. Very, very bad.

In my teens I began exercising, trying to get it to go away. I ran, but running is one of my triggers, and running a very short distance usually resulted in my being unable to breathe for several hours, my lips and fingers turning blue, and much of my body going numb, losing vision, etc. Bad asthma. I kept running anyway. Eventually I also took up karate as an aerobic exercise, with the same results. But given time I got to the point where I would run a mile in the morning, two in the afternoon, and three at night...and spent hours after each run in a lot of pain and extreme discomfort.

When I was fifteen, I visited an Aviation Medical Examiner to enquire about a flight physical, and was told to pay at the front desk and take the exam. The doctor took the money, gave me a medical disqualification, and told me to get out of his office. He said he'd never let anyone with asthma fly. I took my case directly to the FAA, and eventually was able to convince them it was a childhood issue; the magic thing they *want* to hear is that it hasn't been a problem since age 12...the cutoff point for childhood asthma.

Exactly where it really cuts off...that's another matter. Asthma is caused by various triggers. Mine is exercise, and illness. If I get sick, I get really sick, and am very susceptible to upper respiratory and lower respiratory complications. Not uncommonly, double pneumonia (can't count the number of times in school I came back after an extended hospital stay, only to hear other students say "they told us you had died."). In the airplane, I don't exercise. I don't do aerobics (though sometimes in some types of flying, is certainly feels differently). If I'm getting sick, I don't fly anyway. So those are non-issues to flying.

I obtained notes from a doctor stating that my asthma wouldn't be a problem with flying, and submitted those to the FAA. Today, I hold a Class 1 medical, and fly as an ATP. I have no restrictions. When I fill out my medical each year, I simply put under Asthma "previously reported, no changes."

I don't encourage nor condone falsification of a medical certificate. Looking back, I can only imagine that things would have gone much smoother if I had, but I have to live with myself, and elected to put it all up front. A very wise physician once told me, however, that if it's going to be a problem, let the doctor find it...that sometimes volunteering everything isn't in your best interest. What you do with that chestnut is up to you. I very nearly never had the chance to find out if I was any good at what I do. If you never give yourself the chance to find out, how will you ever now if it's possible?

Yes, you had asthma...before you were 12. Keep that in mind.

[Pontius Navigator]

Originally Posted by GreenKnight121

"Peanut allergy symptoms affect various systems of the body and include[*]Hives/urticaria/wheals (small raised itchy areas likened to bites)

Wow, thanks for that, it explains a lot.

During the groundnut scheme the dockside used to be 3 inches or more deep when the monkey nuts were being offloaded. I used to scoop up handfuls of the nuts and then eat them as a treat.

I got massive attacks of 'heat lumps' or hives. In retrospect I wonder if the two were related and that monkey nut cargo was usually landed in the summer; I think it was.

Oddly I hated peanut butter. Many children with allergic problems can instinctively avoid allergen products - so no peanut butter, but perhaps unprocessed monkey nuts seemed different.

I like roasted peanuts now but eat them rarely. I have no problem that I know of now.

[Pontius Navigator]

Originally Posted by SNS3Guppy

I'm a diagnosed, long term severe chronic asthmatic.

Asthma is caused by various triggers. Mine is exercise, and illness. If I get sick, I get really sick, and am very susceptible to upper respiratory and lower respiratory complications. . . .

In the airplane, I don't exercise. I don't do aerobics (though sometimes in some types of flying, is certainly feels differently). If I'm getting sick, I don't fly anyway. So those are non-issues to flying.

And this explains everything from a military perspective.

There is no military aircraft where it can be said that you will have no physical exertion prior to flight.

Even a sedate AT may require the crew to change jets at short notice and that can entail a fair amount of bag heaving and fast walking. On the sharp pointy things or egg beaters running from crew-room to jet or down the flight line can be an every day occurrence.

War Story:

Once our jet went U/S. We jumped into the spare and got airborne on time. The spare however had been over a mile away, we had had to shut down the primary, offload all our kit, jump in the crew bus, run to the spare where a backup crew had everything burning and turning, doors closed, taxy, strap in, and off. IIRC we got our pulse rates steady and sweat dried after about 20 minutes.

[SNS3Guppy]

Believe me, some of the flying I do is enough of a workout that I can't climb out of the cockpit at the end of the day, and there have been days when my legs hurt so badly from the rudder work and my arms were so tired I literally couldn't get out of the seat...I know you'd like to believe that the military aviator experiences things in ways that nobody else could possibly conceive...but the truth is that flying is flying, and jumping from one airplane to another or lifting a heavy bag isn't exactly a hard days work.

jump in the crew bus,

That does sound tough.

[Airborne Aircrew]

Cirrus:

Who are you to "encourage" a doctor to change his diagnosis?

I'm the parent of the child, silly... and, where it to be me that was the child I'd want my dad to do the same for me. You can do what you please. I'll ensure that the most courses are open to my child. Should it turn out to be a long term issue I would counsel my child to avoid activities/careers that would cause them further problems or that they would be unable to be a part of.

Now, climb down off that great big high horse of yours, you sound like such a pompous git up there.