PES FAQs
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Originally posted by Jerrick.lee.85:
Hi guys,
If i get skin rash quite often due to heat or perspiration, is there an exemption of any sort(e.g. down pes, excuse uniform......etc.)? Thx.
Downgrade the most likely to PES B plus excuse uniform....very serious allergy cases then PES C2 is possible. I had seen people downgraded before....
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Hey hi i recently was diagnosed with choledocal cyst and had a operation involving removal of gall bladder ( helps in emulsifying fats no more oily food for me forever :( ) and resectioning of my small intestine with my liver with 5 keyholes and one 6 cm wound on my stomach .. after the post op i have been having regular mild fevers and diarrohea with no appetite . Even after 3 -4 months i'm still having intense pain regularly ... can't eat oily food as it will cause tummy upset .. serious exhaustion and can't walk fast... wanna check up with you guys about something . I was given temp pes e9l9 for 6 months which expires a few days after i ord .. do you guys think i will be given a perm e9l9 after expire or will i be uppes?
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Originally posted by Mygamemylife:
Hey hi i recently was diagnosed with choledocal cyst and had a operation involving removal of gall bladder ( helps in emulsifying fats no more oily food for me forever :( ) and resectioning of my small intestine with my liver with 5 keyholes and one 6 cm wound on my stomach .. after the post op i have been having regular mild fevers and diarrohea with no appetite . Even after 3 -4 months i'm still having intense pain regularly ... can't eat oily food as it will cause tummy upset .. serious exhaustion and can't walk fast... wanna check up with you guys about something . I was given temp pes e9l9 for 6 months which expires a few days after i ord .. do you guys think i will be given a perm e9l9 after expire or will i be uppes?
most likely u will be Pes B or B1 again. L1 or L2
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hey thanks for replying .. is it possible to stay within C range or best E? By the way i'm currently a service medic now
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Originally posted by Mygamemylife:
hey thanks for replying .. is it possible to stay within C range or best E? By the way i'm currently a service medic now
Since you are a service medic, you are ought to know that for camp doctors, this famous phrase is most highly recommended in order to put up a case statement to a medical board review: "No specialist memo, no talk".As a medic, you are ought to know that since doctors need medical evidence for a finalised confirmed diagnosis of medical conditions, the best proof a patient must and need to get from a hospital is a specialist memo. So where's it for the basis to write a case statement to support a PES review to the medical board? It's even all the more crucial to support your claim for a renewal/ permanent status when you are still having the after-op effects, as the hospital specialist will write these after-op side effects on the latest specialist memo to update the camp doctor.
Seriously, you have had thrown the face of medics. When a medic doesn't even know this simple rule of thumb, then the people here are speechless... It's like a medic who simply doesn't even know how to do CPR...
Please read this: www.sgforums.com/forums/1390/topics/392446
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Originally posted by eac:
Since you are a service medic, you are ought to know that for camp doctors, this famous phrase is most highly recommended in order to put up a case statement to a medical board review: "No specialist memo, no talk".As a medic, you are ought to know that since doctors need medical evidence for a finalised confirmed diagnosis of medical conditions, the best proof a patient must and need to get from a hospital is a specialist memo. So where's it for the basis to write a case statement to support a PES review to the medical board? It's even all the more crucial to support your claim for a renewal/ permanent status when you are still having the after-op effects, as the hospital specialist will write these after-op side effects on the latest specialist memo to update the camp doctor.
Seriously, you have had thrown the face of medics. When a medic doesn't even know this simple rule of thumb, then the people here are speechless... It's like a medic who simply doesn't even know how to do CPR...
Please read this: www.sgforums.com/forums/1390/topics/392446
What are you talking about? Cut and paste text? This person had a surgery, surely he is already seeing a specialist. Please read what Mygamemylife is saying before replying, does not make sense... dude ...
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Originally posted by Mygamemylife:
hey thanks for replying .. is it possible to stay within C range or best E? By the way i'm currently a service medic now
Most people after gall bladder removal, maintain a normal life. You may be fitter than you are previously. Ensure you have a low-fat diet. Even if you eat KFC, at most you have is a diarrhea. But it depends on people also. After the surgery, let the specialist evaluate your blood test results. You may developed IBS later. And most likely, you will be downgraded for IBS rarer than gall bladder removal.
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hey dude relax man .. i was just posted as a combat medic when i went for the ops .. why are you getting so piss off for ... i haven't even been to medical center more than 4 -5 times as a full fledge medic .. i was posted to a service medic vocation after my operation and i was just asking for opinion if theres a chance to ask for a perm status .. and you are lecturing as if i didn't know what to do and a total idiot for asking ... hey thanks lokey again whats IBS btw .. i feel weird after the surgery as if something is missing in my body .. i 'm afraid of this .. i took this from the net ''
Presentation
Choledochal cysts and malignancies
Malignancies in choledochal cyst can arise from the distal CBD, the wall of the cyst (even after successful drainage at cystoenterostomy), or the intrahepatic bile ducts. The risk of cancer appears to be related to the age of the patient; it is high (>20 times) compared with that of the healthy population.12,31,32,7,2,33,34,35 The risk of detecting a biliary tree malignancy in a resected cyst is 0.7% in patients who undergo surgery before age 10 years, 6.8% in patients who undergo surgery at age 11-20 years, and 14.3% in patients who undergo surgery after age 20 years.
More than half of the cancers arise from the cyst wall, even after successful internal drainage. Total cyst excision has not prevented the risk of malignancy in the remaining bile ducts. Malignancy can develop many years after excision of the cyst and can develop in areas of the biliary tree remote from the cyst such as the gallbladder and terminal common duct, which is left behind after excisional surgery.
Any type of cyst is susceptible to malignancy, but the greatest prevalence is observed with types I, IV, and V. Factors thought to contribute to the development of malignancy include prolonged bile stasis and chronic inflammation of the cyst wall. Inflammatory and metaplastic changes increase with patient age, and they are frequently observed in association with carcinoma of the bile duct. The increased risk of biliary tract malignancy, even after surgery, warrants close surveillance in any case of choledochal cyst. ''
do you think the mo will look at this ? or even my specialist ? i want to settle my army stuff as soon as possible cause i'm going to ord very soon ...
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btw @ etc isn't this suppose to be a FAQ?? seems like you get flamed when posting questions .. sigh..
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Originally posted by Mygamemylife:
btw @ etc isn't this suppose to be a FAQ?? seems like you get flamed when posting questions .. sigh..
Without any latest memo to update the camp doctor about the side effects you are having now, it's rather often assumed by the camp doctor that you are gradually on the road to recovery from the op. So without any latest memo stating the side effects you are currently having to update the doctor to either extend your temp PES or permanent downgrade, you can say that your temp PES of 6 months will ceased upon expiry and put you to PES B after you ORD. If you go see your camp doctor and just use mouth to say the side effects only, he will automatically shoot you with, "Soldier, where's your latest post-surgery specialist memo as supporting document? How do you expect me to justify your case statement to the Medical Board Chairman for a permanent downgrade? Where's your black and white (written evidence)?"So now, if you want a permanent downgrade / extension of the temp PES, it's on you to decide on whether you want to get a latest specialist memo or not...
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Originally posted by Lokey:
What are you talking about? Cut and paste text? This person had a surgery, surely he is already seeing a specialist. Please read what Mygamemylife is saying before replying, does not make sense... dude ...
Obviously you have no complete idea of how the medical centre is running in a smooth operation inside out at the Formation / Division level where only each Formation's Medical Centre & MMI are having Medical Board Meets to discuss PES reviews.Can you tell if his specialist memo he had gotten now in hand is before or after the surgery?
Since individuals experience some differences in post-surgery side effects, can you tell me how's the camp doctor is able to know if this particular medical case is different/ similar from another one after the post-op, without any post-op correspondences between the hospital specialist and camp doctor?
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Originally posted by eac:
Obviously you have no complete idea of how the medical centre is running in a smooth operation inside out at the Formation / Division level where only each Formation's Medical Centre & MMI are having Medical Board Meets to discuss PES reviews.Can you tell if his specialist memo he had gotten now in hand is before or after the surgery?
Since individuals experience some differences in post-surgery side effects, can you tell me how's the camp doctor is able to know if this particular medical case is different/ similar from another one after the post-op, without any post-op correspondences between the hospital specialist and camp doctor?
There is such a thing called the "DATE". And PACES II can now check the medical report from ALL government hospital (including MRI, X-ray, blood test ... diagnosis), directly without presenting the memo to the doctor. Whether the Camp MO knows how to use it, that is another question.
It is important to update the SAF with specialist memo, there is no doubt about it. But SAF MO are not stupid. They get their MBBS by passing their NUS exam. It is not uncommon knowledge for people to know that people with gall bladder removal have to eat special diet, that is low-fat diet and something else. That means that he cannot eat normal canteen food, cookhouse food, combat ration AT ALL, else he will have frequent diarrhea.
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Originally posted by Mygamemylife:
hey dude relax man .. i was just posted as a combat medic when i went for the ops .. why are you getting so piss off for ... i haven't even been to medical center more than 4 -5 times as a full fledge medic .. i was posted to a service medic vocation after my operation and i was just asking for opinion if theres a chance to ask for a perm status .. and you are lecturing as if i didn't know what to do and a total idiot for asking ... hey thanks lokey again whats IBS btw .. i feel weird after the surgery as if something is missing in my body .. i 'm afraid of this .. i took this from the net ''
Presentation
Choledochal cysts and malignancies
Malignancies in choledochal cyst can arise from the distal CBD, the wall of the cyst (even after successful drainage at cystoenterostomy), or the intrahepatic bile ducts. The risk of cancer appears to be related to the age of the patient; it is high (>20 times) compared with that of the healthy population.12,31,32,7,2,33,34,35 The risk of detecting a biliary tree malignancy in a resected cyst is 0.7% in patients who undergo surgery before age 10 years, 6.8% in patients who undergo surgery at age 11-20 years, and 14.3% in patients who undergo surgery after age 20 years.
More than half of the cancers arise from the cyst wall, even after successful internal drainage. Total cyst excision has not prevented the risk of malignancy in the remaining bile ducts. Malignancy can develop many years after excision of the cyst and can develop in areas of the biliary tree remote from the cyst such as the gallbladder and terminal common duct, which is left behind after excisional surgery.
Any type of cyst is susceptible to malignancy, but the greatest prevalence is observed with types I, IV, and V. Factors thought to contribute to the development of malignancy include prolonged bile stasis and chronic inflammation of the cyst wall. Inflammatory and metaplastic changes increase with patient age, and they are frequently observed in association with carcinoma of the bile duct. The increased risk of biliary tract malignancy, even after surgery, warrants close surveillance in any case of choledochal cyst. ''
do you think the mo will look at this ? or even my specialist ? i want to settle my army stuff as soon as possible cause i'm going to ord very soon ...
IBS stands for irritable bowel syndrome. It can be frequent diarrhea, constipation or diarrhea and constipation (altered). The gall bladder stores the bile salt for digesting fats and many other stuff. So without a gall bladder to regulate bile secretion, if you eat normal diet, you will have problem with fat digestion, which will causes you to have diarrhea. It means that your stomach gets upset easily, for thinly little things. Which you will learn to alter your diet to cope with your "new" digestive system.
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Ya lor, no specialist memo no talk...Hahaha!
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Originally posted by Lokey:
There is such a thing called the "DATE". And PACES II can now check the medical report from ALL government hospital (including MRI, X-ray, blood test ... diagnosis), directly without presenting the memo to the doctor. Whether the Camp MO knows how to use it, that is another question.
It is important to update the SAF with specialist memo, there is no doubt about it. But SAF MO are not stupid. They get their MBBS by passing their NUS exam. It is not uncommon knowledge for people to know that people with gall bladder removal have to eat special diet, that is low-fat diet and something else. That means that he cannot eat normal canteen food, cookhouse food, combat ration AT ALL, else he will have frequent diarrhea.
Anyway, it's up to him and his willingness to put in his own efforts when he wants a permanent downgrade of PES.
It cannot all depend on the camp doctor and just the PACES2.
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Originally posted by eac:
Anyway, it's up to him and his willingness to put in his own efforts when he wants a permanent downgrade of PES.
It cannot all depend on the camp doctor and just the PACES2.
Okay. I will see my specialist next year. And make effort to downgrade further, instead of bulldozing my way through.
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Hi there.
I am graduating from poly next year, and will need to go for the army medical checkup.
I have Obsessive Compulsive Disorder, and on daily medication, clomipramine and fluoxetine. I have also been prescribed alprazolam before. All these are anti-depressants. I have regular sessions with both psychologist for therapy and psychiatrist for medicine prescription and review. Psychiatrist has said that I cannot have any stress, as it will be bad for my disorder. I having this for about 3 years plus already. I also have some anxiety issues my doctor didn't diagnose or specify.
Also, I have some conditions that have no doctor certification, like flat foot and lazy eye. For these conditions, how am I to get a specialist letter? Who sees a doctor for flat foot and lazy eye? Can I just declare on the army medical checkup or do I die die need to get a letter?
With regards to all my above conditions, what kind of PES status am I likely to be placed?
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Originally posted by anthonychua52:
Hi there.
I am graduating from poly next year, and will need to go for the army medical checkup.
I have Obsessive Compulsive Disorder, and on daily medication, clomipramine and fluoxetine. I have also been prescribed alprazolam before. All these are anti-depressants. I have regular sessions with both psychologist for therapy and psychiatrist for medicine prescription and review. Psychiatrist has said that I cannot have any stress, as it will be bad for my disorder. I having this for about 3 years plus already. I also have some anxiety issues my doctor didn't diagnose or specify.
Also, I have some conditions that have no doctor certification, like flat foot and lazy eye. For these conditions, how am I to get a specialist letter? Who sees a doctor for flat foot and lazy eye? Can I just declare on the army medical checkup or do I die die need to get a letter?
With regards to all my above conditions, what kind of PES status am I likely to be placed?
You just need to get a specialist to write in for your mental illnesses (albeit in a severe manner). You are guaranteed to be Pes E and below.
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Originally posted by anthonychua52:
Hi there.
I am graduating from poly next year, and will need to go for the army medical checkup.
I have Obsessive Compulsive Disorder, and on daily medication, clomipramine and fluoxetine. I have also been prescribed alprazolam before. All these are anti-depressants. I have regular sessions with both psychologist for therapy and psychiatrist for medicine prescription and review. Psychiatrist has said that I cannot have any stress, as it will be bad for my disorder. I having this for about 3 years plus already. I also have some anxiety issues my doctor didn't diagnose or specify.
Also, I have some conditions that have no doctor certification, like flat foot and lazy eye. For these conditions, how am I to get a specialist letter? Who sees a doctor for flat foot and lazy eye? Can I just declare on the army medical checkup or do I die die need to get a letter?
With regards to all my above conditions, what kind of PES status am I likely to be placed?
Please read this: www.sgforums.com/forums/1390/topics/392446
When strongly supported by written medical evidence in black and white (memos from hospital specialist/ psychologist/ psychiatrist), you can safely say that you are guaranteed to be within PES C to E range.
Otherwise, if you just declare by mouth that you have this or that, the CMPB doctor will still simply ask you to please go get hospital specialist certifying memos to proof and then come back another day for further review together with the memos.
So in the end, as always advised, "No specialist memo, no talk" applies.
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Ok, so for the psychiatric issue, I do have a specialist agreeing to write a memo for me. What kind of language he will use (convincing or severe) I do not know, but definitely I can get. My doctor may just write a neutral letter saying that I have this disorder, and I don't think he will write anything more? By the way, I happen to saw my medical record in the system when the doctor was viewing it on his computer, I'm stated as "active" being diagnosed with "neurotic disorder". Will MINDEF look at our health records in the system? The system is accessible by all doctors from the govt polyclinics and hospitals.
Regarding my lazy eye and flat foot, do I really have to see a specialist? These are very minor issues to be seeing a specialist. Lazy eye I have been to TTSH 10+ years ago for check but didn't follow up. Will it still be in the system, and will MINDEF go look at it? Cos I still have lazy eye now and its quite significant. For flat foot, can just declare without memo rite? Cos it dosen't warrant any specialist attention.
Many thanks in advance and for the above replies. They have been helpful.
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Okay, an update from my previous case which I posted here a while ago.
I have a tear in my abbrum smthsmth in my left shoulder, which basically means there's a tear in my left shoulder joint, which if not properly cared after can completely rupture which means going for surgery. At this point the swelling has not decreased and I'll be recommended to undergo injections to help relieve the pain and swelling if it doesn't improve over the next two weeks.
I'm currently OOT from BMT and I'm awaiting my new posting. My BMT batch will be POPing in coming week, but I'm not entitled to my 10 day leave since I'm OOT. Instead, based on protocol I can only recieve 3 days of leave and I can choose whether or not to use it. In my case, it makes no sense to go back home overseas just for 3 days since tickets are fairly expensive.
So in my case, I'm not going to use the 3 day leave, instead I've been advised to wait till my next posting and apply for overseas leave then. This brings up my question:
My specialist review from CMPB is in mid jan, which means that they can only post me permanently to a unit after my medical review. So during my temp vocation, is it possible to apply for overseas leave from them? And what are the chances of them granting my leave so soon after joining the unit? Most likely I'll still be under my company until I get my permamnent posting, so can they grant me the leave? Or will I have to wait for my permanent posting to apply for overseas leave?
Also I'm wondering what PES and Vocation will I most likely be posted to? I have three physio sessions a week with a bi-weekly specialist check up.
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Originally posted by pringo:
Okay, an update from my previous case which I posted here a while ago.
I have a tear in my abbrum smthsmth in my left shoulder, which basically means there's a tear in my left shoulder joint, which if not properly cared after can completely rupture which means going for surgery. At this point the swelling has not decreased and I'll be recommended to undergo injections to help relieve the pain and swelling if it doesn't improve over the next two weeks.
I'm currently OOT from BMT and I'm awaiting my new posting. My BMT batch will be POPing in coming week, but I'm not entitled to my 10 day leave since I'm OOT. Instead, based on protocol I can only recieve 3 days of leave and I can choose whether or not to use it. In my case, it makes no sense to go back home overseas just for 3 days since tickets are fairly expensive.
So in my case, I'm not going to use the 3 day leave, instead I've been advised to wait till my next posting and apply for overseas leave then. This brings up my question:
My specialist review from CMPB is in mid jan, which means that they can only post me permanently to a unit after my medical review. So during my temp vocation, is it possible to apply for overseas leave from them? And what are the chances of them granting my leave so soon after joining the unit? Most likely I'll still be under my company until I get my permamnent posting, so can they grant me the leave? Or will I have to wait for my permanent posting to apply for overseas leave?
Also I'm wondering what PES and Vocation will I most likely be posted to? I have three physio sessions a week with a bi-weekly specialist check up.
Pes "B2"(last time C1) L2. IPPT excuse chin up only (may be shuttle run). Vocation: medic, clerk, storemen, mechanics, driver...
I suggest you just do an MRI and sew back the torn tendon through surgery. This is because right now you are young so you may not find the impact yet. But this tear will get bigger. Eventually you may need to fix in using your own money, due to SAF's fault. So fix it now, even if it is one stretch.
Overseas leave ... forget it, save you the trouble from the procedure and being in the spotlight.
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Originally posted by Lokey:
Pes "B2"(last time C1) L2. IPPT excuse chin up only (may be shuttle run). Vocation: medic, clerk, storemen, mechanics, driver...
I suggest you just do an MRI and sew back the torn tendon through surgery. This is because right now you are young so you may not find the impact yet. But this tear will get bigger. Eventually you may need to fix in using your own money, due to SAF's fault. So fix it now, even if it is one stretch.
Overseas leave ... forget it, save you the trouble from the procedure and being in the spotlight.
I can get pes B2 even if I can't do any physical activity? My specialist said that I can't do the following: Push up, pull up, situps (arms behind my head), running, carrying heavy load, handling rifle (puts strain on my shoulder). The tear is caused by my shoulder blade being 2 cm higher than normal, which im doing physio to correct.
The MRI showed swelling of the joint coupled with the tear. My specialist said that as of right now there is no reason for surgery if it can recoup by itself, if not then it may be a possibility later.
And the overseas leave is not to go to bahamas or whatever, it's to go see my family. I came from overseas to do NS, so wanted to see my family =(
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Originally posted by anthonychua52:
Ok, so for the psychiatric issue, I do have a specialist agreeing to write a memo for me. What kind of language he will use (convincing or severe) I do not know, but definitely I can get. My doctor may just write a neutral letter saying that I have this disorder, and I don't think he will write anything more? By the way, I happen to saw my medical record in the system when the doctor was viewing it on his computer, I'm stated as "active" being diagnosed with "neurotic disorder". Will MINDEF look at our health records in the system? The system is accessible by all doctors from the govt polyclinics and hospitals.
Regarding my lazy eye and flat foot, do I really have to see a specialist? These are very minor issues to be seeing a specialist. Lazy eye I have been to TTSH 10+ years ago for check but didn't follow up. Will it still be in the system, and will MINDEF go look at it? Cos I still have lazy eye now and its quite significant. For flat foot, can just declare without memo rite? Cos it dosen't warrant any specialist attention.
Many thanks in advance and for the above replies. They have been helpful.
Bring along any medical documents to support your existing medical conditions.If you think that the psychiatrist memo is good enough, then just bring that and declare those minor ones by saying.
But if you think the doctor will patiently and slowly take his own sweet time to view your online record when there are hundreds of boys waiting in line to have their checkup, then you are just trying to play with your luck.
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Originally posted by pringo:
I can get pes B2 even if I can't do any physical activity? My specialist said that I can't do the following: Push up, pull up, situps (arms behind my head), running, carrying heavy load, handling rifle (puts strain on my shoulder). The tear is caused by my shoulder blade being 2 cm higher than normal, which im doing physio to correct.
The MRI showed swelling of the joint coupled with the tear. My specialist said that as of right now there is no reason for surgery if it can recoup by itself, if not then it may be a possibility later.
And the overseas leave is not to go to bahamas or whatever, it's to go see my family. I came from overseas to do NS, so wanted to see my family =(
You see. B2 is only talking about IPPT. That is excuse chip up and perhaps shuttle run (cose u need to pick up the stuff). You can still run 2.4 km, do sit up and standing broad jump (These are lower limb activities). The other part is the land deployment code, which determined your vocation.
SAF expect you to do physio and fix the upper limbs. And not leave it unfixed. Anyway, fixing the limbs through surgery is the best and fastest option. NS is only 2 years, nothing compared to a unusable arm for 80 years? Believe me, unfixed shoulder join can lead to shoulder impingement syndrome -> nerve impingement syndrome -> finally lost of limb function at 30s to 40s. (if you dont fix it now)
" if it can recoup by itself" - personally, I prefer to do surgery and walk around in camp with arm support for half to a year. Nobody will bother you then.