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#174319 - 05/11/10 08:27 PM Looking for advice for Active Duty Army
60Driver Offline
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Registered: 05/11/10
Posts: 25
I have been dealing with flare ups of hip/joint pain 4 out of 5 years of being in the military. My dad is diagnosed with AS; and I am exhibiting the exact symptoms he had when he was my age.

I just got back from an appointment with a rheumatologist; and the x-ray of my hips indicates that I may have AS. All of my symptoms and the tests that I have undergone point toward an AS diagnosis. The doctor asked me if I wanted to pursue a diagnosis. I am not sure I want the Army to know I have it, as I really don't know what this will do to my career if I am diagnosed.

I am an Army Captain and helicopter Pilot. I have already been told that there is a waiver process to continue flying with the condition. However, I see on this board that people receive medical discharges for having AS.

A big concern about a discharge is that I am recently married and have a child on the way. Sudden unemployment, particularly in this economy, would be very difficult.

I would appreciate input from anyone who has been diagnosed with AS while on active duty. I have seen in reading this forum that some have even made it to 20+ years and retired (which is my goal). I would really appreciate any advice from anyone who has done that.

The bottom line is that I'm trying to do a cost-benefit analysis of getting diagnosed, or living with AS and mitigating its effects by staying active.

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#179323 - 07/10/10 08:19 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Tekaman2x Offline
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Registered: 07/14/09
Posts: 7
I am serving in the Air Force and was diagnosed with AS a year ago. I know that there is a slight differences between the branchs. I can give you a brief idea of what to keep in mind and how they may look at your file.

Time in service and Rank, Medications that may keep you from deploying (immune inhibitors) and range of motion (duty restrictions from the AS)

Medications will be the biggest thing, I got lucky being diagnosed with AS in my hip joints, now with medication I will not have many problems until my old age.

The bad thing is that I have to take Humeria the rest of my life which is an Immune Inhibitor and has to be kept cold.

That pretty much keeps me from deploying to locations that don't have the facilites to give me the medicaitons. That also means that I would not be able to go to areas with sickness.

I would recomend that you keep that fact that your father has been diagnosed with it so they will not be able to rule your AS as being prior to military. There has been no indication that my AS was prior to elisting into the Air Force so I will get somme VA benifits from it.

I can tell you that Aleave works well with the condition along with possible medications they give you. Also excerise is a good thing to, light running on a tred mill and keeping your hip joints moving.

There is more info that I could give you but can remember everyting, so just ask and I will help best I can. AS is not the end of the world though, its easly treatable if caught early. I was a Crew Chief and with the wear and tear that I have already experienced I was surprised on my recovery.

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#180276 - 07/21/10 06:21 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
EricaK Offline
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Registered: 06/24/10
Posts: 75
Loc: Washington, USA
Not saying that being discharged is going to happen, but is it possible for you to re-train to a different job? Even if you end up discharged, you'll be able to count on considerable use out of your GI-Bill, and since you're a Captain that means you've already finished your undergrad work, right? The jobs that are recommended for us are jobs in which we alternate standing and sitting, change positions often, and do no heavy lifting or joint stressing activities. If you could re-train within the military, maybe you could work in supply or logistics? Those are both jobs with a lot of moving around. I would talk to the military chaplain about this. They hear all sorts of things and often have the best big picture view of anyone. Plus which they're pretty closed mouthed. Good luck!
_________________________
ANA+ RF+ Rh- HLAB27+

Dx JRA age 9 & uSpA age 50

Water exercise has saved my life!
KickAS.org has saved my sanity!


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#180337 - 07/22/10 08:19 AM Re: Looking for advice for Active Duty Army [Re: EricaK]
WhiteCell Offline
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Registered: 05/31/10
Posts: 1259
I am not military but work with soldiers as an R.N. for myself with AS I place my faith in my abilities. If I cant do the job then I dont do it. When you have people in your hands you have to be honest with yourself. IF I cant do the job, then it is an issue, but like the military I have had to be tight lipped at times when my physical symptoms could have shut my career down. Be smart.
_________________________
Ank Spon since 18 years old began as Reiter's Syndrome. Diagnosed with Ank Spon 2001, Remicade since 2002 - 5mg/kg every 7 weeks. 8 hour Tylenol and hot tubs for pain.

Severe Right Eye Glaucoma- Trabeculectomy/lens replacement 2006. DSAEK Cornea Transplant 2009. Ahmed Shunt 6/2016. DSAEK November 2016.

Supra Ventricular Tachycardia. 2004. Cured by RF ablation 2006. Cardizem 240 CD.

ICU and ER; R.N. San Diego ~Grasp The Challenge and Succeed~

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#181784 - 08/10/10 11:03 AM Re: Looking for advice for Active Duty Army [Re: WhiteCell]
mapmaker Offline
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Registered: 10/25/05
Posts: 35
Loc: Virginia
60Driver

I was diagnosed while in my first contact. I was in the artillery as a SPC and had started teh paperwork for the heli warrant program needless to say prior to physical I was on a detail and got hurt. Next thing i know I'm going all over the hospital dept to dept cause they couldn't figure out why the pain wouldn't go away (in the course of a year). i wasn't until a chiropractor figured it out that I finally started receiving proper treatment.

Obviously i could stay Artillery so i reclassed to Topographical MOS (aka Maps). I got a great rheumy, he asked me if i wanted to med board i stated no, i wanted to do 20.....he stated he'd work with me so i could. He placed me on P3 and heli's were out (i've never even got 2 be a passenger...lol ;o(

around my 6th year in it got so bad i couldn't do the soldiering part of the job...so was med boarded.

So tell your doc you want to stay in see what you can do (probably P2..not sure about flight status) but worse case senario there are alot of jobs out there.

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#183139 - 08/27/10 08:06 AM Re: Looking for advice for Active Duty Army [Re: mapmaker]
60Driver Offline
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Registered: 05/11/10
Posts: 25
Thank you all for the insights. I have been managing well lately. I find that spending about 30-60 minutes on either a bike or stair stepper daily with a run about once a week, working in some moderate weights and doing a weekly kettlebell routine keeps the pain down and the flexibility up.

I have a deployment coming up; I'll just be doing staff work so even if I do have some pain it won't be detrimental to other people's lives. My rheumatologist prescribed a different NSAID which has really been more effective than the over-the-counter Motrin that I had been using.

So, I'll just keep managing it, keep moving and play it safe for now.

Again, thanks for the insights.

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#183612 - 09/01/10 01:25 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Gonzo_ Offline
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Registered: 11/29/05
Posts: 104
Loc: Clayton, NC
It's been a while since I have been on this site.. Thought I would see how things are.. I see you are in almost the same boat I was in. I was diagnosed with AS on active duty.. I highlt recomend you get a second opinion.. I was treated for AS for 2 years after being med boarded for it.. Now, they say I don't have AS just the normal "wear and tear" arthritis we all get...
(I have degenerative joint disease)

I too tried to dodge the bullet and stay in by volunteering for recruiting school. I wasn't able to pass the course. (Boy, they throw a lot of stuff at you and expect you to memorize all of it in a couple days)..
Anyhow, I recomend that you try everything to get diagnosed properly, and document everything. I was granted service connected disability and now collect a check from the VA every month. If I had dodged that and just kept going I might have shot myself in the foot and not have been awarded that service connected disability.

How many years do you have now? Any chance you can be medicaly retired? I had 13 yrs. if I had made 15 I could have medicaly retired.. Not the best but next best thing.. Insted I got a severance package.. My base pay x2 multiplied by years of service. (Paid LUMP SUM a couple days after discharge)
I would have loved to have stayed in.. bu, you have to look after yourself and your long term health, as well as health care. The drugs like Embrel are $$$! ($1200-$1500 mo. I hear)If you get out and get denied coverage due to a pre-existing condition the VA benifits would be real nice.

Everyones condition is different and only they can decide for themselves what is right for them. I just threw out a couple things you may want to consider before dismissing anything.. I(f you have any specific questions for me fire away.. I'll try and answer asap. I am away a lot and don't get to play on my computer all the time.
_________________________
Scott

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#187985 - 10/24/10 12:37 AM Re: Looking for advice for Active Duty Army [Re: Gonzo_]
sjelliott40 Offline
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Registered: 10/24/10
Posts: 3
New to this board and have a questions. I was recently found to have AS with sclerosis. I told the Dr. that I had back pain prior to joining the Army but was never treated. Can the Army say this was a pre-exsisting condition? I also just found out from my mother that my father had AS. He died when I was young and she never told me until I said I have it as well. I have 10 yo service. Will this effect any benefits such as severence pay or med retirement? Any help would be appreciated.

Steve

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#188157 - 10/26/10 02:44 PM Re: Looking for advice for Active Duty Army [Re: sjelliott40]
mmparker Offline
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Registered: 06/10/04
Posts: 573
Loc: Virginia
Steve,

If you are on activie duty, and have at least 8 years of activie duty, even if the conditon was EPTS it is still compensable. See 10 USC 1207a below.

1207a. Members with over eight years of active service: eligibility for disability retirement for pre-existing conditions
a) In the case of a member described in subsection (b) who would be covered by section 1201, 1202, or 1203 of this title but for the fact that the memberís disability is determined to have been incurred before the member became entitled to basic pay in the memberís current period of active duty, the disability shall be deemed to have been incurred while the member was entitled to basic pay and shall be so considered for purposes of determining whether the disability was incurred in the line of duty.

(b) A member described in subsection (a) is a member with at least eight years of active service.


See this link for information ont he Army DES process

https://www.hrc.army.mil/site/Active/tagd/Pda/pdapage.htm

Note the link for rating Ankylosing Spondylitis.

Ankylosing Spondylitis

Mike







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#201211 - 03/13/11 02:25 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
jgm Offline
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Registered: 03/13/11
Posts: 2
I hope things are going well for you. I am in a similar situation - humira and regular exercise keep me able to function pretty normal. Luckily I have 17 years in now, but I will deploying in the near future for the first time since diagnosed with AS about 3 years ago. I have pretty much a staff job mostly in the rear so I can live with some pain win I go off Humira for deployment. Have you had any experience with Humira and the anthrax vaccine? I am trying to find out if I can be on Humira will taking the anthrax vaccine - obviously I would like to be on Humira as long as possible before deploying.

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#203132 - 03/30/11 07:52 PM Re: Looking for advice for Active Duty Army [Re: jgm]
sjelliott40 Offline
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Registered: 10/24/10
Posts: 3
I just started the MEB process for AS. When the packet went to the board they decided not to foreward my packet to the PEB because the MEB wants me to take Humira for 3 to 6 months first to seee if the pain improves. This makes no sense to me. I know Humria can help with pain but the AS will never go away. Can the MEB make me take it. If not what can I do to proceed with the PEB. Any advice would be appreciated.

Steve

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#203136 - 03/30/11 08:36 PM Re: Looking for advice for Active Duty Army [Re: sjelliott40]
seekonk Offline
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Registered: 12/06/10
Posts: 1254
In many cases TNF blockers like Humira or Enbrel are almost a "cure", in the sense that as long as you keep taking it, it is as if you don't have AS. In other words, many AS patients on TNF blockers have no disability at all, so a retirement on medical grounds would not be appropriate. I would guess that this is the thinking behind their actions.


Edited by seekonk (03/30/11 08:38 PM)
_________________________
Spondylitis since '08, finally diagnosed Feb '11.
Enbrel 50mg/week.

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#203147 - 03/31/11 02:19 AM Re: Looking for advice for Active Duty Army [Re: seekonk]
sjelliott40 Offline
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Registered: 10/24/10
Posts: 3
Can I refuse the Humira? What would be the negative? Can they make me take Humira? I would rather just take Motrin. AR 40-501 states AS as a condition that would not allow me to be retained so whats the difference if I'm the drug or not? Any suggestions?

Steve

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#203149 - 03/31/11 05:17 AM Re: Looking for advice for Active Duty Army [Re: sjelliott40]
seekonk Offline
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Registered: 12/06/10
Posts: 1254
Why would you want to refuse the Humira? It doesn't just help with the pain - in many cases Humira alters the severity of the disease much more than Motrin. Don't you want to be better? Or are you just fed up with your work and want out? I'm not trying to judge you, but I can guarantee you that this is what the adjudicator of your case is going to think if you refuse treatment.


Edited by seekonk (03/31/11 06:06 AM)
_________________________
Spondylitis since '08, finally diagnosed Feb '11.
Enbrel 50mg/week.

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#203275 - 04/01/11 02:56 AM Re: Looking for advice for Active Duty Army [Re: seekonk]
mmparker Offline
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Registered: 06/10/04
Posts: 573
Loc: Virginia
Please send me a PM on this. You need to be aware of some complicated considerations in terms of your MEB/PEB process which will have a lifetime impact on your benefits.
Mike

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#246060 - 12/31/12 12:56 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
I thank you all for your input. So, during my last flight physical and shortly after another experience with iritis, my flight surgeon insisted on ruling out or confirming the presence of AS. So, off to the labs and radiology I went with a culminating appointment with a rhuematologist. And, no surprise, I received a diagnosis of AS. Now, he's having me take an MRI to see how active it is, and start a workup (TB test, Hep profile) to possible start me on a TNF inhibitor.

Since it seems like there are several of us in the same boat, and more unfortunately who will appear in the future, I'll keep updating as I go.

I have 7 and a half years of service at this point; but I'm not afraid of an MEB or separation. I am simply seeing this as an opportunity to possibly start a different (albeit difficult) chapter in life. My strategy moving through this process is honesty (no more hiding the pain), and ensuring primarily that I get the treatment I need to be able to live as painless a life (military or not) as possible. If I don't get a high disability rating on separation, I believe I'll be able to work or use my GI Bill for an advanced degree. As long as I get my AS service connected so that I can get the pricey medications I'll feel like I met my goal.

Thankfully, my AS has been relatively mild to the point where as a commander I've been able to do PT with my Soldiers and go on runs and such (not as fast as I'd like sometimes, but I hang with all but the fastest young guys). But I have that feeling in my bones (no pun intended) that I won't be able to keep up for much longer.

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#246215 - 01/03/13 03:14 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Snap03 Offline
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Registered: 01/10/12
Posts: 2
Hey 60Driver, Sorry to hear about the bouts with iritis. I am just starting the IDES (MEB) process for HLA-B27+ spondyloarthropathy in the AF Reserves. In my limited knowledge of this process and disease I believe the drugs are the big issue. I am currently on methotrexate, humira, and meloxicam which permanently ground me from flying and make me un-deployable in the military. I would think that if you are not on any TNF inhibitors and are able to still do PT you should be OK to continue to serve. I know Mike Parker has some excellent info on this subject that would be very helpful to you. You should be able to find it on this site or over on the pebforum. Good luck, hopefully this info helps some from a hawg driver. BTW, always loved working with the -60s.
Snap

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#246225 - 01/03/13 09:01 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
Snap,

Yes, it was explained to me that it's the drugs that are the kicker. Kind of a catch 22: go down the long painful path of fusion and range of motion restrictions, or start a drug that should make me better but forces me out of my dream job.

Right now, I'm just having a back and forth with my flight doc and the rheumie about TNFis, and alternate treatment options. I'm concerned about TNFis because I get an ear infection about every other year. One thought I have is that if it's the TNFi that makes one non-deployable, can't we stop the TNFi during deployments and training?

Another thing that occurred to me was that when I was on doxycycline (anti malaria application) during my deployment, I was asymptomatic. I did a bit of research and found that doxycycline has shown to have positive results when used in treating early onset of arthritis.

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#246244 - 01/04/13 05:27 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Snap03 Offline
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Registered: 01/10/12
Posts: 2
I held off on the drugs as long as I possibly could which let me fly in the military for 14 years. When it got to the point where I couldn't sleep, function, or even move during flare ups then I had to start on the meds. I was able to start flying again in the civilian world as the FAA will allow you to fly on these meds as long as you don't have any adverse side effects after a trial period. As far as infections on the meds, I do get more colds/etc now than I did before. I haven't heard that before about the doxycycline but do remember taking it on all my deployments, interesting. Have any of your flt docs looked into what triggered your condition? Walter Reed did a causality assessment on my condition and found that it was most likely triggered on my last deployment by a bacterial trigger in Afghan land or even possibly by my last Anthrax booster which led to my LOD as service aggravated.

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#246247 - 01/04/13 06:12 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
No casualty assessment for me, yet. My pain started about seven years ago, first year in the Army, when I was in flight school. I can't think of anything specific that would have triggered it. For me, since I'll have eight years of active federal service in a few months, I'm less concerned about service connection / aggravation as my understanding is that once you're past eight, it doesn't matter.

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#249437 - 03/06/13 06:10 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
Quick update: Rheumie looked at the MRI and determined mild active inflamation. That, in conjunction with my recent flares, makes him want to start me on Humira.

I'm going to start Humira in May, following my change of command and move to a non-deployable TDA position as a BDE S3.

I have another iron in the fire now. I've got a lead on a career change that can easily accomodate a non-deployable guy on a TNF blocker. I already talked to the respective branch manager; and at this point it seems like i'm a shoe in.

I should know prior to the initiation of an MEB for Humira whether or not I've been accepted to that new job. I'll use that new assignment as ammunition to convince the board to find me fit for duty due to the non-deployable nature of my (hopefully) new MOS.

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#251912 - 05/08/13 01:56 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
Another quick update: Been on Humira for almost a month now and it's really effective. In fact, I beat my whole company on a quick four mile ruck march this morning. Too bad this stuff renders me non-deployable; I feel like a lieutenant again.

My flight doc grounded me; but said he's not iniating an MEB right away and isn't even sure if that's required at all.

Just waiting for word on a branch transfer at this point. Looks like there is hope for at least a few of us on Active Duty with AS.

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#251914 - 05/08/13 03:01 PM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Ken Delano Offline
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Registered: 05/26/04
Posts: 1483
Loc: Minnesota
Good to hear that the Humira is working. Wish they had TNF's back in my day. Sad to hear you won't be flying again though. The one job I could not do when I joined as had to wear glasses.
_________________________
AS/PsA DX in 1988

Retired on disability
in 2005 at age 44

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#260881 - 11/18/13 10:08 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
My most recent SITREP: I've been accepted to my new career field, PCSed, and am now progressing through training. Just met with my new rheumatologist, and he's continuing my treatment without initiaton of an MEB at this time. It looks like AS is not always the death knell of a career. I think the key is being flexible (no pun intended) and looking for ways to continue to add value to your service regardless of your physical limitations. I will probably update this again if/when I begin the MEB process at some point in the unknown future.

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#260882 - 11/18/13 10:17 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
Ken Delano Offline
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Registered: 05/26/04
Posts: 1483
Loc: Minnesota
That is great to hear!
_________________________
AS/PsA DX in 1988

Retired on disability
in 2005 at age 44

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#267639 - 07/15/14 09:03 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
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Registered: 05/11/10
Posts: 25
A small update and point of interest for folks on flight status: After about a year of review, my flight status waiver for Humira was approved. It's not important to me, as I've already changed careers; but I just wanted to provide a data point for anyone looking for anecdotes about TNFis and flight status.

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#277118 - 01/22/17 10:41 AM Re: Looking for advice for Active Duty Army [Re: 60Driver]
60Driver Offline
Registered Visitor

Registered: 05/11/10
Posts: 25
Hello everyone, it has been a few years since I posted anything here and I just realized today that I should provide an update. I PCSed again in mid 2015, and when I arrived at my new assignment, my new PCM reviewed my case history and referred me to an MEB due to my Humira regimen. After an MEB concluding that I was not fit for duty, I was referred to the PEB. The informal PEB (IPEB) also found me not fit for duty and gave me a VA rating of 70%, so I requested a formal, in-person, board (at JBLM). I made my case to the formal board, and after reviewing my medical history, my performance record (I have a strong personnel file), and statements from my branch proponent and some O-6s that I had worked for/with previously, they decided to find me fit-for-duty with deployment limitations. The major factors for their determination were the strength of my file and recommendations as well as the statement from my branch proponent that I could serve effectively in my branch despite my deployment-limiting condition.

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