Positive Outcomes from an Early IgG4-RD Diagnosis

tim bagot igg4-rd patient

Many IgG4-RD diagnoses take years, though others can happen in a matter of months, as was the case for Tim Bagot. Tim, a longtime pilot, shares his story and the impact an early diagnosis and a medical team knowledgeable in IgG4-RD can make. (While early diagnosis and healthcare professionals well-versed in IgG4-RD aren’t the norm, the IgG4ward! Foundation is working to counter this.)

Tim’s Story

“My IgG4-RD story began in 2013. I had trouble breathing through my nose and went to see an ENT. During the examination, my doctor found a lump in my neck around the salivary gland and asked how long it had been there. “Beats me,” was my response. She scheduled a biopsy, and they found the lump to be benign. Since I was getting sinus surgery to fix the breathing problem, she asked if I would like to have the lump removed from my neck, explaining the risks. It sounded like a good idea to me, so the lump was removed concurrently with the sinus surgery.

About a month later, the doctor called and told me that I had been diagnosed with IgG4–RD. She didn’t know much about it and told me it was very rare. I Googled it and found less than a page of information. The big takeaway at the time was if it found its way into my pancreas, it could be a problem. At the time, I was a pilot for a federal agency and the National Guard, so with the little information we had, the military doctors decided to do a full body scan annually to make sure nothing new showed up inside me.

This lasted until 2018 when my right eyelid started swelling around my lacrimal gland, and my vision in that eye started deteriorating rapidly. By this point, I had retired from the National Guard and civil service and was a government contractor in a non-flying job. Though retired – my goal was to get back in the cockpit.

I went to an ophthalmologist who, by coincidence, was familiar with IgG4-RD and said it was most likely the reason for the eyelid swelling. He prescribed prednisone, which lasted three months. Within a week, my vision was back to normal. In the meantime, I went to my flight surgeon and told him what was happening. He, in turn, called the Federal Aviation Administration (FAA) in NYC and handed me off to them. I don’t believe the FAA doctor was familiar with IgG4-RD at the time, but she learned quickly. I was concerned this might cause me to lose my FAA medical certification and ultimately my flying career.

Not a fun prospect to say the least. The FAA doctor had me see a Hematologist/Oncologist for further testing. The Hematologist recommended I see an expert on IgG4-RD and sent me to see one of the physicians in Dr. Stone’s office. Dr. Zachary Wallace saw me and after examination, recommended I be treated with Rituximab. I checked with the FAA doctor for approval and began treatments in 2018. I had no adverse reaction to the Rituximab, and the FAA issued a special issuance medical allowing me to get back into my chosen career.

It’s fair to say that I haven’t had a bad experience with IgG4 RD, which I attest to being diagnosed so early and being treated by an excellent team of physicians. I’ve been lucky!

If any pilots read this and discover they have IgG4-RD, please feel free to reach out to me. I’d be glad to help in any way I can. If nothing else, I’ll point you to the FAA office familiar with IgG4-RD.

While Tim was fortunate to receive an early diagnosis and be treated by a skilled team of healthcare professionals, our goal is to make IgG4-RD stories like his the norm, not the exception.

Whether a physician, caregiver, or someone living with IgG4-RD, we invite you to join our IgG4ward! Online Community, and learn more from others within the IgG4-RD community.

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Responses

  1. Timothy, wow thank you for sharing your story. It was nice to read a story where there was an early diagnosis! I hope you continue to do well and so glad you are a part of our community!

  2. Tim, I am doing the happy dance reading your story! Believing that this can become the norm has added fuel to my fire. I also love that you offer yourself as a resource to other pilots needing FAA clearance.