Expert: MARK A. HOWELL - 7/11/2009

Question
Dr. Howell,

I am a junior/senior in college (I'll graduate in 2011 with a dual degree, with a previous Associate's Degree from high school) and I'm interested in applying for the Coast Guard's OCS.  I think I will be a competitive candidate- save some medical issues.  I contacted a recruiter but he would not meet with me because I'm still a couple years from applying and I mentioned childhood asthma.

I had asthma through the age of 13, which technically slides under the guidelines.  This is stated in my medical records, however my list of medicine I've been prescribed includes an emergency inhaler and refills for a nebulizer- which we kept on hand throughout my upbringing just to be safe.  Will these records harm my chances of acceptance?

Unfortunately that's not all.  My eyesight is pretty bad unassisted and I require contacts or glasses.  I was considering getting Lasik before I apply but I've heard that's also a DQ.  I don't mind wearing glasses but would prefer not to- should I get the surgery before or after I get in, and how would that affect my job once I'm out of OCS?

Also on my medicine list is a prescription for Strattera which is a non-stimulant, non addictive drug for ADD, although I was never diagnosed with ADD.  I have since gone off it and by the time of my application would have been off it for over 2 years.

When you add it all together it sounds worse on paper than it really is- it's pretty irrelevant in real life.  The recruiter I spoke with said the Coast Guard was not willing to grant waivers because there is a surplus of people trying to get in.  I want to serve my country in the Coast Guard and have two years to become the best possible candidate I can be.  Is it all for nothing?  Thank you for any assistance you can provide- I've found myself short on answers lately.

Answer
Patrick,
You're right, some recruiters won't bother with you until you're within a year of joining.  The reason is because by the time you will be eligible he'll likely have moved on to another job so you're not putting any $$ in his pocket.  That's unfortunate, but it sometimes happens.  A good recruiter will be glad to answer your questions, give you encouragement, and do what's in the best interest of the Service he's recruiting for.

As for your asthma, the regulations state exactly, "The causes for rejection are an authenticated history of Asthma, including reactive airway disease, exercise induced bronchospasm or asthmatic bronchitis, reliably diagnosed at any age.  Reliable diagnostic criteria should consist of any of the following elements:

(1) Substantiated history of cough, wheeze, and/or dyspnea that persists or recurs over a prolonged period of time, generally more than 6 months.

(2) If the diagnosis of asthma is in doubt, a test for reversible airflow obstruction (greater than a 15 percent increase in forced expiratory volume in 1 second (FEVI) following administration of an inhaled bronchodilator) or airway hyperactivity (exaggerated decrease in airflow induced by standard bronchoprovocation challenge such as methacholine inhalation or a demonstration of exercise-induced bronchospasm) must be performed."

Asthma is easily misdiagnosed and often confused with a mild allergy.  Also, young people often "outgrow" asthma.  Below is a quote from a medical journal:

"Asthma is usually diagnosed in childhood.  In many patients, however, the symptoms will disappear or be significantly reduced after puberty.  Around age 20, symptoms may begin to reappear.  Researchers have tracked this tendency for reappearing asthma and found that people with childhood asthma tend to experience reappearing symptoms through their 30s and 40s at various levels of severity.  Regardless of whether your asthma is active, continue to avoid your known triggers and keep your rescue medication handy in case you need them.  Approximately 50% of children with asthma appear to outgrow asthma when they reach adolescence.  Once someone develops sensitive airways, they remain that way for life, although asthma symptoms can vary through the years . As a child's airways mature, they are able to handle airway inflammation and irritants better, so their asthma symptoms may notably decrease. About half of those children find their asthma symptoms reappear in varying degrees when they reach their late thirties or early forties.  There is no way to predict which children may experience greatly reduced symptoms as they get older."

Trying to prove to the military that you no longer have asthma or that you were is misdiagnosed is not easy. As you can see from the medical journal quote, asthma may reappear later in life, so the military may think you still have it, you're just in a dormant stage right now.  Hopefully you've outgrown it and will never have any problems again.

You'll need a letter from your doctor addressed to the "Surgeon General" stating that your bout with asthma was simply a childhood problem that you've outgrown.  He/she should make no mention of an inhaler or nebulizer and should downplay the asthma as much as possible.  Normally you do not need to bring any medical records with you to the Military Entrance Processing Station (MEPS) where you'll go to take a physical exam when the time comes.  In your case,you will be asking for a waiver because of your childhood asthma so your recruiter will want to see your doctor's letter in advance so he can apply for a waiver before you even go to the MEPS.

As for your eyesight, that's usually not a problem.  If your glasses can correct your vision to
20/40 in one eye and 20/70 in the other eye or if your best eye can be corrected to 20/30 then the other eye need only be corrected to 20/100.  You will not be allowed to wear contacts until you've completed OCS.  Do NOT have corrective eye surgery BEFORE you join.  If you do you'll be disqualified.  This includes both PRK and LASIK surgery.  After you've been in the military for a couple of years, the military will give you corrective eye surgery for free.  They make you wait just to ensure they're not going to spend money on you and then you get out.  I had it done and believe me it's worth the wait.  I love it.

I don't think you'll have any problem getting in.  Meanwhile search the Internet and find out all you can about the USCG and OCS in advance.  The more informed and better prepared you are, the easier it'll be.  An excellent site is:
http://www.gocoastguard.com/find-your-fit/officer-opportunities/
programs/officer-candidate-school

Thanks for wanting to serve your country in uniform.
Best of Luck,
  Colonel H