I am currently a Navy flight student, but have recently been disqualified from naval aviation due to blood clots in my Vena Cava and Illiac Veins. After a year on Xarelto, I had stents placed in my Vena Cava and Illiac Veins. 3 months later, the stents occluded, and I had thrombolysis to remove the occlusion and additional stents placed to fix the problem. I am now stable, but will probably be on Xarelto for at least a year, maybe much longer. I currently have a third class medical that I have not flown on since the first blood clot. My goal is to become an airline pilot after the Navy discharges me. What are my chances of getting a first or second class medical? I have over 100 pages of medical records pertaining to this. Do I just send in all records I have related to this? How hard will re-issuances be in the future?
DVT with Stent Placement
- Thread starter PatPaap
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Velocity173
No waivers for acute DVT in the Navy?
P
PatPaap15
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Maybe if I had wings or the stent hadn't occluded. NAMI was considering a waiver until the stent occluded and I needed thrombolysis and a second set of stents. Also, NAMI is more strict on flight students. If I was a winged aviator, they may have given me a waiver.
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Velocity173
OK, I know it's waiverable in the Army on a case by case basis.
What everyone will tell ya here is to contact Doc Bruce Chien. I'm sure you can find his profile on here somewhere or he may be by shortly. He's a former Naval Aviator himself and a senior FAA AME HIMS guy.
Good luck to ya.
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AggieMike88
Touchdown! Greaser!
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The original "I don't know it all" of aviation.
Where to get started discussing your case with Dr. Bruce Chien -- http://www.aeromedicaldoc.com/how-to-start.html
Doggtyred
En-Route
As an aside, I hope they found the reason for the clots in the first place. Plan on anticoagulation for life, since you had recurrence 3 months later. If you can get under control without recurrence you should be issuable. Dr Chien can provide certification advice as an AME.
bbchien
Touchdown! Greaser!
LOL 
So have you had the Protein C and Protein S workup (Antithrombin 3, etc)?
It looks like you'll need to be on chronic warfarin - but mostly you need an expert Hematology workthrough. There is a special issuance for Warfarin, though it requires dietary discipline to attain- 4/5 successive regularly spaced INRs between 2.0 and 3.0. An extra salad can run a certification....
So have you had the Protein C and Protein S workup (Antithrombin 3, etc)?
It looks like you'll need to be on chronic warfarin - but mostly you need an expert Hematology workthrough. There is a special issuance for Warfarin, though it requires dietary discipline to attain- 4/5 successive regularly spaced INRs between 2.0 and 3.0. An extra salad can run a certification....
mkosmo
Pattern Altitude
So many acronyms in there. And I thought aerospace was bad.LOL
So have you had the Protein C and Protein S workup (Antithrombin 3, etc)?
It looks like you'll need to be on chronic warfarin - but mostly you need an expert Hematology workthrough. There is a special issuance for Warfarin, though it requires dietary discipline to attain- 4/5 successive regularly spaced INRs between 2.0 and 3.0. An extra salad can run a certification....
But you perked my interest with an extra salad being bad for something. Tell me more
Jr Hampton
Pre-Flight
Lifelong Warfarin user here. Most anything leafy green has vitamin K. As well as a host of other foods. VitK is a protagonist of Coumadin/warfarin. VitK is a used by the body to help form clots. If someone taking Coumadin/warfarin eats more salads then normal, the Vit K will lesson the effect of the drug. It is vitally important to maintain the same diet (exactly) of anything containing Vit K. There are some newer drugs on market for DVT, but most don't have the reversal (vitamin K) that Coumadin/warfarin have, say if a bleeding episode happens. INR's are a pain but so is bleeding to death internally..
mkosmo
Pattern Altitude
So, INR is measuring clotting times? That's the part I just looked up briefly.
Salad has Vitamin K, which negates warfarin. Ergo, salads makes some people bleed out.
Let's ban salads. There has to be a congressman who will follow my logic.
Jr Hampton
Pre-Flight
Yes INR is a measure of clotting times. Backwards on "salads make people bleed out". Coumadin/warfarin does that. Vitamin K stops the bleeding. If you go the emergency room for bleeding while on Coumadin, they will give you a big ol shot of vit K. I'd prefer a salad but....
Jr Hampton
Pre-Flight
Interesting to boot, Coumadin/warfarin is used in some in rat poison.. YUM
LOL
So have you had the Protein C and Protein S workup (Antithrombin 3, etc)?
It looks like you'll need to be on chronic warfarin - but mostly you need an expert Hematology workthrough. There is a special issuance for Warfarin, though it requires dietary discipline to attain- 4/5 successive regularly spaced INRs between 2.0 and 3.0. An extra salad can run a certification....
I had a full blood workup, and I don't have any of the blood clotting disorders. The cause of the original DVT was that my Vena Cava is too small, so my blood had a hard time draining from my legs. It was a very weird case, it confused multiple vascular surgeons that I saw.
The stents occluded after 3 months, because they were not placed correctly. It was not because the surgeons at the Mayo Clinic are not good, it was just a very difficult surgery. They told me going in there wasn't a 100% chance of success.
I have been on Xarelto the entire time, and I intend to stay on it as it is an FAA approved drug.
I contacted Dr. Chien, thanks for the recommendation!
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Doggtyred
En-Route
It is, indeed. When taken in excessive doses, the rats bleed to death.
If you want to really bone up on trivia, you should look into the history of how Coumadin was discovered, in Wisconson, by people observing that cows who ate moldy grass subsequently bled and died.. at the Wisconsin Animal Research Farm (the WARF in warfarin)... I knew a guy who knew a guy who was there...