Undiagnosed problems and medical certification

[Unregistered]

So, about two weeks ago my legs started to hurt, specifically my knees and ankles. Thinking it was related to recent physical activity (car repair) I paid it no real mind. During the past two weeks I've experienced varying levels of pain and stiffness - sometimes I'll just hurt for the sake of hurting, other times I'll feel mostly normal and my ankles will only hurt if I do something "extreme."

A few days ago my ankles started to swell and I realized this wasn't just an injury that was taking a long time to heal, and went to see a doctor about it.

The doctor was fairly puzzled, saying she wasn't sure what was wrong with me, that I was two young for this (I'm 27) and she wasn't positive but thought I may have had an infection. She gave me prescriptions for antibiotics and a NSAID - Indomethacin. She sent off lab tests for gout and arthritis.

I'm a bit worried, as I'm positive this is going to be a long, drawn out process of diagnosis, and there's a chance I'll never get one.

Has anyone been through similar, and if so, how did you deal with it medical certification wise? Can I just report on my next medical "sometimes my legs hurt, sometimes they don't, for unknown reasons despite the amount of money I have thrown at this problem"

On a related note, I'm curious how much I want to chase the issue. I have high deductible insurance, so until I meet my deductible everything is out of pocket. $2,500 is a LOT of money to spend to NOT find an answer, not to mention the amount of time it will take.

Thanks in advance...

 

[Jim Logajan]

So, about two weeks ago my legs started to hurt, specifically my knees and ankles. Thinking it was related to recent physical activity (car repair) I paid it no real mind. During the past two weeks I've experienced varying levels of pain and stiffness - sometimes I'll just hurt for the sake of hurting, other times I'll feel mostly normal and my ankles will only hurt if I do something "extreme."

A few days ago my ankles started to swell and I realized this wasn't just an injury that was taking a long time to heal, and went to see a doctor about it.

There are many possibilities of course, but the ones mentioned by your doctor seem the most likely things to check for first.

The doctor was fairly puzzled, saying she wasn't sure what was wrong with me, that I was two young for this (I'm 27) and she wasn't positive but thought I may have had an infection. She gave me prescriptions for antibiotics and a NSAID - Indomethacin. She sent off lab tests for gout and arthritis.

With regard to an arthritis diagnosis: Rheumatoid Arthritis (RA) can and does occur regardless of age. Your doctor doesn't seem properly informed on that aspect, though she is at least is testing for it. Antibiotics and NSAIDs might both reduce the symptoms of RA, though, because they both can reduce its inflammation. Also, unfortunately there is no single or simple test for RA. Ideally she should refer you to a competent rheumatologist - but getting scheduled in may take a few weeks.

I'm a bit worried, as I'm positive this is going to be a long, drawn out process of diagnosis, and there's a chance I'll never get one.

Has anyone been through similar, and if so, how did you deal with it medical certification wise? Can I just report on my next medical "sometimes my legs hurt, sometimes they don't, for unknown reasons despite the amount of money I have thrown at this problem"

Absent a diagnosis, do what you think is prudent. Do you even want to go flying with those ailments? Think you would be able to fly safely for extended periods with those aches? Are you employed as a pilot or can you safely sit things out because you mostly just fly for pleasure?

On a related note, I'm curious how much I want to chase the issue. I have high deductible insurance, so until I meet my deductible everything is out of pocket. $2,500 is a LOT of money to spend to NOT find an answer, not to mention the amount of time it will take.

Thanks in advance...

It depends on whether it is transitory problem or not - if it a chronic disease you should consider spending the money now and find out what it is. Compared to the amount of money you can spend on aviating, $2500 is spare change. And you are spending that money on the only thing you have to hold your mind in for the rest of your life. Don't be afraid to spend the money up front when your body indicates it needs maintenance.

 

[Jim Logajan]

Next, end the public, online discussion in this and any other forums, even if anonymous.

Why should he do that? The feds can't do anything with what was posted.

Contact Dr Bruce Chien at [FONT=arial,helvetica,sans-serif]aeromedicaldoc@comcast.net[/FONT] for further information how to proceed.

Sigh. You'd think Chien is the only AME on the planet who knows how to handle a simple situation like this. The OP should first try contacting the nearest AME who also happens to be pilot (because it is nice if the AME can relate) and request a consultation (not an exam.) I did that with my local AME when I ran into a similar situation. If, and only if, it looks like the local consulting AME may be operating out of their depth should they consider a long-distance consultation with an AME in a distant state.