Managing Chronic Health Issues Before Military Service: A Guide

Pre-enlistment Consultation

Hello, doctor.
I have been seeing various doctors since middle school.
My symptoms include pain around the joints at night, sometimes accompanied by redness and swelling, headaches, dizziness, and low-grade fevers (around 37 to 37.9 degrees Celsius, which often led to me being stopped at the school gate).
I also experience lower back pain, oral ulcers, and have had genital ulcers, along with a family history of similar conditions.
However, my ANA is 1:40, HLA-B27 negative, HLA-B51 negative, and my inflammatory markers are normal, so I have not been able to obtain relevant documentation.
Currently, I am only using colchicine and have previously used cancer treatment medications for about a year and a half to two years, but the effects have been limited.
Given the situation where I have no hope for exemption or alternative service, how can I manage my condition while serving in the military?

Wang, 20~29 year old female. Ask Date: 2022/01/11

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
I recommend discussing your situation with your attending physician to assess whether you meet the criteria for a change in position.
If you do, please ask them to issue a medical certificate, which you can then use to apply for a military re-examination at your local township office.
If you do not meet the criteria or cannot obtain a medical certificate, you can also discuss with your attending physician about management strategies during your service, including medication (in principle, colchicine should be continued) and adjustments to your daily routine, which may also be helpful.
Additionally, please continue taking vitamin B complex, as it can help reduce the frequency of episodes and accelerate ulcer healing.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, cares about your well-being.

Reply Date: 2022/01/11

More Info

Managing chronic health issues before military service can be a daunting task, especially when dealing with symptoms that can significantly impact your daily life and overall well-being. It’s crucial to approach this situation with a comprehensive plan that involves medical management, lifestyle adjustments, and effective communication with healthcare providers and military authorities.

Understanding Your Symptoms
From your description, it seems you are experiencing a range of symptoms, including joint pain, headaches, low-grade fevers, back pain, and oral and genital ulcers. These symptoms can be indicative of various underlying conditions, including autoimmune disorders or inflammatory diseases. The fact that your ANA and HLA tests are negative, along with normal inflammatory markers, suggests that while you may not have a classic autoimmune disease, there could still be an underlying issue that needs to be addressed.

Medical Management
1. Continuing Medication: You mentioned using colchicine, which is often prescribed for conditions like gout or familial Mediterranean fever. It’s essential to continue this medication as prescribed by your physician. If you find it ineffective, discuss alternative treatments with your doctor. There are other medications available that may help manage your symptoms more effectively.

2. Regular Follow-ups: Ensure you have regular appointments with your healthcare provider. This will allow for ongoing assessment of your symptoms and any necessary adjustments to your treatment plan. Keeping a symptom diary can help your doctor understand the frequency and severity of your symptoms.

3. Specialist Consultation: If you haven’t already, consider consulting a rheumatologist or an immunologist. These specialists can provide a more in-depth evaluation of your symptoms and may offer additional diagnostic tests or treatment options.

Lifestyle Adjustments
1. Diet and Nutrition: A balanced diet rich in anti-inflammatory foods (like fruits, vegetables, whole grains, and omega-3 fatty acids) can help manage inflammation and improve overall health. Staying hydrated and avoiding processed foods may also be beneficial.

2. Exercise: Engage in low-impact exercises such as swimming, walking, or yoga. Regular physical activity can help reduce pain and improve mobility. However, it’s important to listen to your body and avoid overexertion.

3. Stress Management: Chronic stress can exacerbate symptoms. Techniques such as mindfulness, meditation, or deep-breathing exercises can help manage stress levels. Consider seeking support from a mental health professional if anxiety or depression is a concern.

Communication with Military Authorities
1. Documentation: If you are unable to obtain a formal diagnosis, gather all medical records, treatment histories, and any documentation from your healthcare providers that outline your symptoms and treatment plans. This information can be crucial when discussing your situation with military authorities.

2. Requesting Accommodations: If you believe your health issues may affect your ability to serve, discuss this with your healthcare provider. They can help you draft a letter or a medical report that outlines your condition and any recommended accommodations.

3. Understanding Military Policies: Familiarize yourself with the military’s policies regarding medical exemptions or accommodations. Each branch of the military has specific guidelines, and understanding these can help you navigate your situation more effectively.

Conclusion
Managing chronic health issues before military service requires a proactive approach that combines medical management, lifestyle changes, and effective communication. By working closely with your healthcare providers and being informed about your rights and options within the military framework, you can better manage your health and reduce the impact of your symptoms on your service experience. Remember, your health is paramount, and taking steps to address your concerns now can lead to a more manageable and fulfilling military experience.

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