The NVIC 04-08 Has been revised and is available on the NMC website. Maybe someone that doesn’t have a phone that sucks as bad as mine will post a link?
It’s Change-1. It looks like it expands guidance ICO waivers for folks with Pacemakers, seizures or convulsions.
http://www.uscg.mil/nmc/announcements/pdfs/NVIC_04-08_CH1_with_Enclosures_20130607.pdf