Epidural steriod injection

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Since I had my last medical renewed, I was diagnosed with spondylolisthesis (no I can't pronaounce it either) - essentially a vertebra pushing on my nerve and causing pain in the lower back and leg. I was eventually treated with an epidural steroid injection, which helped significantly. The procedure is ambulatory and without anestetics, and 12h later life was going on as usual. To to be cautious I grounded myself for about a week after the procedure, but really couldn't find any side effect from the procedure 12h after it happend.

My question is: what is the FAA medical brach's take on that? I am not due for a medical for another couple of years, but I am curious what to expect - and I want to handle this the proper way.

Thanks in advance.
 
Oh, crap. In 1981, while in the Air Force, I felt some tingling in my shoulder. I was examined by the squadron’s assigned flight surgeon, who turned me over to an orthopedist on a visit from the big USAF medical center. X-rays, physical exam, and he writes "Spondylosis" in my medical record (it's all Greek to me -- even if it's in Latin). He gives me some exercises to do, and in less than a month the symptoms are gone, never to return. Unfortunately, while this guy is a board-certified orthopod, he’s new to the Air Force, and doesn't know he's supposed to discuss things with the flight surgeon any time a flyer is examined. The flight surgeon didn’t bother to follow up. My record goes back in the records room, and that's that. I'm happy, I'm flying, life is good (or at least as good as it can be in Clovis NM, which my wife called "The US Air Force's answer to Soviet internal exile").

Six months later, my flight surgeon happens to review my medical record. "Spondylosis"? OHMIGAWD! That's unwaiverably and permanently grounding. Panic and consternation (not to mention irresponsibility -- the flight surgeon is supposed to immediately review anything anyone puts in a flyer's medical record, but that's another story). Levy's grounded, and the wing commander is in the hospital commander's face over how one of his crewmembers could have been allowed to fly for six months with a grounding medical condition. (Had there been an accident, this would have come out, and the wing and squadron commanders would have been barbecued.) They compromise -- send Levy to the big USAF medical center for another consult, this time with a neurosurgeon.

More X-rays, more examinations, more tests. Fortunately, this particular neurosurgeon is a wily old colonel and a rated flight surgeon, wise to the ways of both the Air Force and fighter pilots. He looks at all the data and says, "Well, you really can't tell spondylosis from mild degenerative joint disease without going inside your neck, and that's pretty risky and pretty pointless since the condition is asymptomatic and not progressing noticeably. The difference is that while spondylosis is grounding, DJD isn't. So I'm going to rewrite the diagnosis as mild DJD and you're back on flying status." So after ten days grounded, I'm flying again, all's well, etc.

No problem, right? Guess what. That damn fool squadron flight surgeon, in reviewing the medical record, noted that I got a Class II FAA Medical last time I took my annual USAF flight physical. Suddenly, this guy is conscientious -- at the same time he grounds me and wraps the Air Force around the axle, and without telling me, he writes the FAA a letter telling THEM I've got spondylosis. About two months later, after the USAF situation was resolved I get a letter from ol' Audie Davis, MD (long-time chief FAA flight surgeon) telling me to send back my Class II FAA Medical Certificate because of the spondylosis. Another two months of back-and-forth between the neurosurgeon, the flight surgeon, me, and Audie before it's straightened out.

I was fortunate -- it didn't cost me a dime to resolve the situation, but had I been a civilian, the costs would have been in the thousands (thanks, taxpayers). But the point is that if you write or say the wrong words, it could be a nightmare getting it straightened out. So, pending a post from Bruce saying the rules on spondylosis have changed, I think you've been dropped in big pile of brown which will require a lot of money and tests to climb out of.

Oh, yeah -- I did get even with that bone-head flight surgeon. He was supposed to fly in our F-111's at least six times a half in order to keep his flight status and flight pay. He was deathly afraid of flying in fighters, and tried bagging flights on medevac C-141's that passed through in order to log his time. As Chief of Training for the squadron, I carefully documented this. He claimed the squadron didn't offer him enough flights, so they only put him on probationary status. We then had the squadron schedulers document their attempts to get him on the schedule for the next six months -- weekly calls asking when he was available to fly, calls to say flights were available and which would he like, etc. At the end of six months he hadn't flown once, and it was good-bye flight pay for him. GOTCHA!
 
Briefly: Spondylosis is arthritis of the spine nothing more nothing less. If you are over 20 you probably have it. Studies when looking at what a "normal" MRI is used medical students(21 to 30 years old if I remember correctly) without a history of back problems, and found that over 50% of them had changes in the spine that could be considered degenerative(read arthritis). Some of these changes were so severe that in the right presentation they could be considered for surgery. Spondylolisthesis is slippage of one vertebra on the adjacent one(can be foward or back wards). Many different causes. Typically it is long standing and is more often asymptomatic or minimally symptomatic than symptomatic. I would wait for Dr Bruce to chime in but my guess is you will need something from your physician who treated you for your issues stating the MRI findings, exam, and treatment, and that you are asymptomatic and not taking any prohibited medications.

Most important to stay better is to stay active, lift correctly, and stop smoking if you are a smoker.
 
Was it Col Lee Ansell, MD ???
I'd have to dig through my old USAF medical records buried somewhere in the attic to find out. What I remember is he was a full colonel in the neurosurgery unit at Wilford Hall (possibly the chief of the unit) when this happened in 1981, assigned as a neurosurgeon, wearing flight surgeon wings, probably mid-50's or older with gray hair, and IIRC had been a flight surgeon in an F-4 unit when younger. If memory serves, he was shorter than me, maybe 5-7 or so. If that's your guy, maybe it was him.
 
Whoa. Talk about a thread diversion!

Anyway the convention is down for a week after an Epidural Steroid Injection. 7 whole days, not six, and back into the left seat if everything is working correctly....

Provided the AME thinks your move normally, there is no documentation that you need- "manifest recovery after ESI" pretty much does it. If you are still on meds, however, that is a completely different problem :(
 
I've got to admit that's remarkable progress on the part of the FAA since Ron's time. That gives me hope that all the kids in this generation that have had psych diagnoses for no better reason than their parents want something to blame for the kid's bad behavior won't be excluded from flying when they mature.

Good job FAA
 
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