I recently had two open heart surgeries. I was sent to a German doctor who I did not feel comfortable with from the start but pretty much told tough luck.... The first surgery was to repair my aortic valve and install a stint. About a month after the surgery I got really sick and was told I had bacterea in my heart and it was eatting away the stitches which cause a hole in my heart and I need surgery ASAP.. once again I said I didnt feel comfortable with the surgery being done by the same doctor but was told the condition got to bad that they couldnt take the risk to fly me back to the states... so again after this surgery another hole opened up but it wasnt as bad and I havent been sick but before they were going to release me from the hospital they wanted to do a 3rd surgery and I refused I said I dont know heart surgeries but I know baseball and Im not going to let you get the third strike on me. I am just starting my MEB board.. I told them I didnt feel comfortbale being stationed in Germany in the chance the 3rd surgery becomes a emergency like the second one and if I could get PCS's to the states or if they could do something to speed up the MEB so its over with quick and I can just get home soon so I dont have to risk being over here and it happening again. They told me dont worry we will just fly you to the states. I told them when I learned I had to get a second surgery I didnt have an option of flying back to the states and its not a risk I want to take. They talked it over and said no to PCSing me or speeding up the MED. My mom is furious and contacted a Senator and I guess they are going through the Pentagon to get someone real high ranking to come in and sort everything out. My question is what kind of rating do you think I should get? The third surgery they said I have to have a mechanical valve installed and will require multiple surgeries through out my life. Also, is there any sort of option that I have that could get me back to the states during my MEB? I can tell the reason they dont want to is paperwork but I mean I've went through 2 heart surgeries I think that in itself shows Im not faking anything
MEB after 2 heart surgeries
- Thread starter carr23
- Start date
First to make a guess-timation on your possible outcome or rating we would need hte specifics. Why are you being MEB'd specifically? Was there an underdyling condition that neccessitated the aortic valve to be replaced. Did the infection cause any new/different ratable/un-fitting etc..
also, if your MEB has officially been started, then the following applies:
Per AFI 36-3212,
also, if your MEB has officially been started, then the following applies:
Per AFI 36-3212,
[FONT=TimesNewRoman,Italic]Physical Evaluation for Retention, Retirement and Separations, [/FONT]and
AFPD 41-1, a member pending an MEB or PEB may not be reassigned PCS or TDY (or granted leave
outside the local area, separated, or retired) until the MTF determines the medical disposition. If circumstances
arise regarding the assignment status of a member pending an MEB or PEB, for example,
for a member serving OS it appears the DEROS will expire before a final determination is made, then
AFPD 41-1, a member pending an MEB or PEB may not be reassigned PCS or TDY (or granted leave
outside the local area, separated, or retired) until the MTF determines the medical disposition. If circumstances
arise regarding the assignment status of a member pending an MEB or PEB, for example,
for a member serving OS it appears the DEROS will expire before a final determination is made, then
the MPF will advise the assignment OPR by message and provide complete details.
Here is what I picked up from my last visit for the Cardiologist and MEB visit:
They are wondering about my heart rate it went from 40ish BPM (I ran marathons and worked out alot) to after the surgery 100-113bpm. They havent put my package in yet because of this and its been 5 months. I think they are going to put it in at the end of the month though. Is there any rating for a high heart rate?
My blood pressure is 131/82 while I am on blood pressure meds.... when not on meds it jumps around it could be 131 or 167 while I am not on them.
My Mets is 11.7... which suprises me that with them just having me walk it could get that high.
While doing a stress test it was noted that my blood pressure had a exaggerated response it went from 131/82-201/65 in about 4 minutes of walking.
Reason for surgery siginificant aortic regurgitation that was complicated by a fistula forming between the non coronary sinus of the aortic and right atrium. A patch repair was performed of this defect. Small leak is now around the edge of the patch. The doctor pretty much said it was his bad and that the patch that was installed was made for older people not active 25 year olds. That the patch was not very flexable and shouldn't be used on active people.
Patient has mild fatigue and dyspnea on exertion
Past Medical history: Aortic root dilation with regurgitaion. Status pose repair with aortic root modification resulting in no residual aortic regurgiation but infectious fistula with patch repair
I had an Echo done and here are what they wrote down:
Reduction in right ventricual and right atrial size with mild resdual dilation
Mild aortic regurgitation and possible trace residual fistula between the aorta and right atrium (aortic regurgitation occurs near area, as well as a small amount of tricuspid regugitation)
unfortunate development of endocarditis with infectious fistula formation from noncoronary cusp of the aorta into the right atrium.
Right ventricle is mildy dilated. The right ventricular systolic is mildly reduced.
Right Atrium is mildy dilated. Catheter/pacemaker is inserted
Tricuspid valve trace tricuspid regurgitation.
Aortic Valve- Aortic valvular vegetation. Increased velocities appear due to increased flow. Mild Aortic regurgitaion. Fistula measures 2.4mm
Pulmonic Valve- Trace regurgitation
Small shunt at edge of patch.
This is what I got from my medical records. I dont know if any of you would be able to understand and help with what I should be rated for and what rating I should expect to get so when they do come along I will have an idea if I am getting really low balled on the deal or not. I know 30% goes to if you require medical care for when you get out and I will need to see a Cardiologist every 6 months for life when I do get out. I will also be getting a 3rd surgery hopefully I can hold out a year or two once I get out on that. But past supervisors and people who I usually go to for Air Force advice/experince are saying I'll probably get 100% since I've had 2 surgeries and its known that I have to get a 3rd but just through research I am doubting that it would be 100%... I wouldnt be suprised if it was just 30% at this point. Just want to make sure I have everything set up so if I do get low balled I don't have to go into panic mode trying to find why it should be higher and have all my facts and info ready for when the time comes.
They are wondering about my heart rate it went from 40ish BPM (I ran marathons and worked out alot) to after the surgery 100-113bpm. They havent put my package in yet because of this and its been 5 months. I think they are going to put it in at the end of the month though. Is there any rating for a high heart rate?
My blood pressure is 131/82 while I am on blood pressure meds.... when not on meds it jumps around it could be 131 or 167 while I am not on them.
My Mets is 11.7... which suprises me that with them just having me walk it could get that high.
While doing a stress test it was noted that my blood pressure had a exaggerated response it went from 131/82-201/65 in about 4 minutes of walking.
Reason for surgery siginificant aortic regurgitation that was complicated by a fistula forming between the non coronary sinus of the aortic and right atrium. A patch repair was performed of this defect. Small leak is now around the edge of the patch. The doctor pretty much said it was his bad and that the patch that was installed was made for older people not active 25 year olds. That the patch was not very flexable and shouldn't be used on active people.
Patient has mild fatigue and dyspnea on exertion
Past Medical history: Aortic root dilation with regurgitaion. Status pose repair with aortic root modification resulting in no residual aortic regurgiation but infectious fistula with patch repair
I had an Echo done and here are what they wrote down:
Reduction in right ventricual and right atrial size with mild resdual dilation
Mild aortic regurgitation and possible trace residual fistula between the aorta and right atrium (aortic regurgitation occurs near area, as well as a small amount of tricuspid regugitation)
unfortunate development of endocarditis with infectious fistula formation from noncoronary cusp of the aorta into the right atrium.
Right ventricle is mildy dilated. The right ventricular systolic is mildly reduced.
Right Atrium is mildy dilated. Catheter/pacemaker is inserted
Tricuspid valve trace tricuspid regurgitation.
Aortic Valve- Aortic valvular vegetation. Increased velocities appear due to increased flow. Mild Aortic regurgitaion. Fistula measures 2.4mm
Pulmonic Valve- Trace regurgitation
Small shunt at edge of patch.
This is what I got from my medical records. I dont know if any of you would be able to understand and help with what I should be rated for and what rating I should expect to get so when they do come along I will have an idea if I am getting really low balled on the deal or not. I know 30% goes to if you require medical care for when you get out and I will need to see a Cardiologist every 6 months for life when I do get out. I will also be getting a 3rd surgery hopefully I can hold out a year or two once I get out on that. But past supervisors and people who I usually go to for Air Force advice/experince are saying I'll probably get 100% since I've had 2 surgeries and its known that I have to get a 3rd but just through research I am doubting that it would be 100%... I wouldnt be suprised if it was just 30% at this point. Just want to make sure I have everything set up so if I do get low balled I don't have to go into panic mode trying to find why it should be higher and have all my facts and info ready for when the time comes.
Jason Perry
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It is hard to say which cardiac code they will rate you under, as there could be several possibilities. However, the cardiac rating schemes are pretty similar overall. Since they said you had endocarditis, lets use that for a baseline:
7001 Endocarditis:
For three months following cessation of therapy for active infection
with cardiac involvement 100
Thereafter, with endocarditis (documented by findings on physical
examination and either echocardiogram, Doppler echocardiogram,
or cardiac catheterization) resulting in:
Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less than
30 percent 100
More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60
Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30
Workload of greater than 7 METs but not greater than 10 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
continuous medication required 10
Looks to me that 30% is the likely minimum that you should get. However, I am quite confused/concerned about the METS test. I see this very often with exercise stress testing, that they crank up the treadmill and take your maximal effort, when they should be looking at the point when you have dizziness, dyspnea, angina, or fatigue. The difference between the two METS evaluations are great. Under your listed METS, you are at 11 plus, so this results in a 0% rating. I doubt this is correct.
Would be interested to know your ejection fraction, too.
Not sure if you are saying medical care required = a 30% rating (which is incorrect) or if you mean that with a 30% rating, you are retired and get medical care (which is true).
You would likely get a TDRL finding anyway, but this further suggests that this is the correct outcome, placement on TDRL.
Those folks may be knowledgeable about other areas and are probably just trying to be helpful. But, I don't know what they could be basing the 100% prediction on. Does not seem likely based on what you have written.
The biggest thing you would want cleared up/addressed is this issue of METS. However, compare the outcomes with TDRL (paid at 50%) with a likely VA rating (I don't know what other conditions/likely rating you might get) and remember, if you get a high VA rating (based, for example, on a more accurate METS test) then you can use that as evidence on subsequent TDRL re-evaluations.
Best of luck!