MEB for Syncope

[rodsgurl87116]

I PCSed to Kirtland AFB in April 2006 from Japan. Less than a month after arrival I started to pass out with little or no warning. Shortly after that with continued episodes I was referred by the AF hospital to the heart institute here. in the following months through Jan of 2007 I had an EKG, Treadmill test, EP study, two event recorders, tilt table test, and numerous other tests done. Of all those things done along with many others, the only one that came back with positive findings is the tilt table where I began to passed out after less than 15 mins. It was pretty scary with my drop in blood pressure.

I was diagnosed in Dec of 2006 with neurocardiogenic syncope.

Over the last two years, my heart doctor has tried numerous perscriptions to include midrodine, florinef, prozac, beta blockers, and many other meds, not to mention having me do wall sits and wear compression hose. He still looks puzzled every time we talk and every month that I come in with at least 4-7 episodes a month and different situations for each.

In March of 07 I was forced to move because of my health problems by my squadron commander since my husband was deployed and i had a 3 year old at home.

each time before i pass out the warning(prodome) varies. most episodes are while i am being active, cleaning house, taking a shower when my hands are raised over my heart, and even a few while driving. The thing is when I wake up I don't feel the best, but I have no headaches or seizures.

When I started to have episodes I was stopped from performing my job as a vehicle operator in the air force and was put on desk duty where I have remained for two years and was taken off deployment status immediately.

my air force doctor supposedly initiated my medical board back then, but i found out later that it was just passed from provider to provider since he did not know how to do a MEB. The second time he said that he was going to have help with my board to get it completed and a few months later when i checked I was told it was never started and the peblo didn't even know who I was.

It has now been just short of two years on a 4T nondeployable profile. I have passed out somewhere around or over 100 times since I arrived here. My husband and I just had a baby almost two months ago and he is getting ready to deploy again for a very long period of time. With two kids and so many past episodes, I am pretty nervous to spend so much time alone again.

Many believe that this very well could be altitude/elevation induced since i have never had any problems till i moved here, however, i was informed that I could not be moved because there is no way to rule out that it is not caused otherwise.

I recently returned to my "new" AF provider and he went through my records and three days ago contacted me to say that my Narrative was turned in that day. He told me that the PEBLO would contact me soon and for the third time I am wondering if the process will actually be completed without the 30 day mark being busted.

Any advice from anyone here? really discouraged. I just want this to be over with so I can attempt to get on with my life whether it be RTD, Discharge or otherwise.

[Jason]

rodsgurl87116,

Welcome! Sorry to hear about your conditions. But congratulations on the growing family!

It seems likely you will be found unfit. In most cases of syncopal episodes, whatever the underlying cause, I tend to think the result if rated 30% or above is placement on TDRL. Because you have this long history, though, I see a strong argument that you are stable. You would want to ideally have documetation of frequency of episodes, but arguing for this is something to consider.

So much in the process is wait and see. The previous observations are my thoughts based on what you wrote. Other than that, it is hard to predict much else without more info. Did you see your NARSUM?

I was a Transportation Officer prior to my JAG Corps time. So, it is nice to see a fellow transporter!

[rsmith]

I am so sorry you are going through so much. I understand how frustrating it can be as my husband was in the Military. Did you know that there is an organization that provides support and information on Syncope to individuals that suffer as well as their caregiver/family members. Its called STARS-US (syncope trust and reflex anoxic seizures)
The website is STARS US - Home. I think you will find it most helpful. Also, there is a message board on the site where you can talk to others who suffer as well.
I hope this helps.
Rebecca Smith
STARS-US

[rodsgurl87116]

Thank you all for the replies. the information is great. today i went for my narrative appointment with the PEBLO...this meaning of course, that for the first time out of the three attempts my board will actually be processed.

I was told that it would be hoo of me to have letters done of recommendation to say what I would like to have happen and how it is in the best interest of the air force. I seem to feel that the two best bets would either be to be coded and allowed to stay in for the last two years of my enlistment and just be nondeployable and do admin since i can't drive and i am veh. Ops. or to get the severance pay...the tdrl thing just seems wierd. I was talking to my flight and squadron leadership and they said that they would do letters for me recommending that i be able to finish out my enlistment and give the benefits to the air force of me being able to stay though i would not be able to deploy.

Unfortunately they don't have any sample letters so i have to wing it...what are the time frames for each board...the IPEB here at my base ...do they have 30 days from today or thirty days from when the narrative was submitted by my physician?? it is a little confusing and a little freaky to think that you don't know what your future will be. help?!?!?

[Jason]

rodsgurl,

It is to your benefit to get TDRL over severance pay. With TDRL, you will have all medical benefits of a retiree and get paid a minimum of 50% of your retired base pay. Later, if you are still unfit, but better, you will get severance. But what you want to have is Permanent Disability Retirement after TDRL (assuming that TDRL is the most likely outcome; as mentioned before, you may have a chance for PDRL).

Here is a post on Slide on Army PDES elements and timeline . The timelines are DoD-wide, so it should apply. Remember they are guidelines only. You can submit letters at any time in the process, but the earlier the better in most instances.

Assuming you want a fit finding, though, you want to have letters with the following:

1) A paragraph stating the author's duty position, supervisory capacity over you, and how long they have observed you and how often they observe you performing your duties. Especially compelling is if they see you perform in stressful situations, or deployments.

2) A paragraph describing, as much as possible, your ability to succesfully complete specific tasks. Abstract is worse ("She should be able to perform x,y, or z) than specific (She has been serving succesfully as a Parts Clerk, managing and processing all parts requests, and completing required paperwork for the last 3 months.) Of course, the closer the duties to your actual AFSC, the better.

3) A closing paragraph with recommendation as to fitness to perform your duties. If this is not possible, then a statement about disposition.

I have to say, though, that unless it ties to your current AFSC, such a letter is going to carry limited weight. I don't want to suggest that you should give up hope. Just recognize that fitness is judged against your grade and AFSC. If you cannot perform in your AFSC, unfit is the most likely finding. Weigh, as well, that fighting to appear fit may tend to diminish your chances for a correct rating if you are found unfit.

[rodsgurl87116]

well, unfortunately less than a month after my board was started it was put on hold for a second opinion appt.(which i had last week) and the second opinion appt. only consisted of them doing an ekg and then adding another med.(midodrine) and telling me that if that doesn't help since the one i have been on for the last 6 weeks has still seen episodes just as often that they were going to try a salt pill next. so seems to me as though they are now treating the symptoms since they can't figure out the cause of the syncope or how to treat it.

jamie

[Jason]

Sorry to hear that. Did they offer any other diagnosis? Usually, cases returned to MTF have instruction limiting the time for them to resubmit the case. Did they put a time line on it?

[rodsgurl87116]

Not that i am aware of. it was the board president from what i have been told that put it on hold. the PEBLO is the only helpful person i have dealt with, but still the same diagnosis. my profile is up in jul. but it has been extended for the past two years so they will most likely just extend it out further.

[rodsgurl87116]

well, it is now july...my profile is being redone as we speak and my narrative appt. was yesterday with my PEBLO appt being on monday. the diagnosis is still neurocardiogenic syncope and has gotten better with some meds, however, only time will tell. they are having a hard time determining the cause of the syncope. i have syncopal episodes while driving or while being upright, however, i have no seizures. this then makes me question the outcome of my board. i have just over 9 years, so if they do decide to seperate me i wonder what the outcome will be. The doc told me yesterday that most likely they will either attempt to move me with a aac of only sea level bases (conus, alaska, or hawaii) or they will seperate me.

when asked what i thought was causing it...i said that i never had this problem prior to two years ago and he asked me what happened two years ago. after i commented that i moved here to high elevation and dryness from sea level bases and home..he said..that is easy, let's move you.

anyone know or have any idea what i should expect? everyone seems baffled with my situation and there have been accusations that if i am not starting to get better one would wonder of compliance in my meds.

[Jason]

Well, it sounds like the doctor is getting ready to write up your case with a slant towards you being fit.

Is that the outcome you want?