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kidneys stones

Old 06-11-2018, 08:49 AM
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Default kidneys stones

Anyone have recent experience dealing with the FAA after a second kidney stone occurrence?
Curious how long it is taking to get a special issuance nowadays. Are they just requiring annual scans?

-Bob
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Old 06-11-2018, 10:42 AM
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Hi Bob,

I would contact these guys for a consultation and they will put you on the straight and narrow. I used them once in the past and it was money well spent and not expensive at all.

https://www.aviationmedicine.com/abo.../contact-info/

Here is some info from their site:

https://www.aviationmedicine.com/article/kidney-stones/

FAA Policy on Flying/Controlling After Kidney Stones
Historically, the FAA would certify a pilot/controller who has had a single episode of kidney stones to fly after all stones are cleared, the individual is stable and documentation is forwarded to the FAA for clearance. As of Oct 2015, the FAA further authorized AME’s to clear airmen back to flying even with retained kidney or bladder stones as long as they are not having any pain or indications of impending passage. The documentation should include reports of the evaluation and treatment, as well as a report of x-ray confirmation that the pilot/controller is stone free or any retained stones are stable. Controllers do require specific clearance from the Regional Flight Surgeon prior to returning to controlling. The following criteria must usually be met:

Radiographically stone free or stable retained stones not likely to pass or incapacitate
Normal renal function,
No evidence of metabolic stone disease.
Individuals with recurrent episodes of kidney stones are generally required to present information to the FAA that they are free of stones before returning to aviation duties. Recurrent episodes generally require a 24 hour urine analysis as well.

As noted, for those pilots/controllers who have retained stones that do not pass, the FAA or AME will consider clearance if their physician can affirm that the stone appears stable and is unlikely to pass spontaneously or if they are so small that they would likely pass without incapacitation. The hazard is that a retained stone may pass during flight and compromise flying safety.

For the first episode of a stone, the FAA will not generally require follow-up reports from the pilot or controller’s personal physician on subsequent FAA medical examinations. Those with a history of recurrent or retained stones should expect to be required to submit these reports for several years at the time of their FAA medical examinations.
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Old 06-11-2018, 10:59 AM
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Look up the CACI worksheet, it isn't a big deal in most cases.
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Old 06-11-2018, 02:09 PM
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I just went through this with a 1st class just 2 weeks ago. Had a 2nd kidney stone roughly 6 months after the first. AME asked for a letter from my attending doctor who asked for some pictures of a clear system. I never even saw the doctor. He looked a the pictures and sent me a letter saying stone free and to call if any questions. I gave that to my AME and he issued on the spot.

As sonicflyer said its really a non-issue according to the CACI. A third one I am told and you start to get issues with the FAA but up to that point its a AME issue.

On a side note, my stones ended up being related to a diet I was on. I was dating this chick who was a health nut and had me doing copious amounts of blueberries, spinach and hazelnut milk (Not all at the same time). All are known to cause kidney stones. I had a daily protein shake in the morning with blueberries and hazelnut milk and was eating spinach salad basically every day. I cut that stuff out and the kidney stones went away.
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Old 06-12-2018, 04:02 PM
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Anyone who has passed a kidney stone can tell you about the excruciating and disabling pain that typically comes with it. Now imagine single seat shooting an approach to minimums with that going on. Heck, the guy in the tower wouldn't even be safe. And that's what the FAA is trying to avoid. It isn't just about you, it's a public health issue.

But all the FAA really cares about is that you have done everything currently medically indicated to see that the above scenario doesn't happen. They will waiver you even with retained stones in the kidney, as long as those stones are in areas where they won't get passed into the ureter and cause that incapacitating pain. And yes, if your stones are diet related or related to some other metabolic or hormonal problem (parathyroid disease for example) they want you to get that corrected too, but really, they are pretty reasonable about this.

The only complaint is a lot of these decisions don't appear very timely because they are civil servants and they are covering their own backsides because they are assuming a professional risk, so if you are dealing with a urologist/nephrologist or AME who isn't giving them exactly what they need to feel comfortable about the decision, it can drag out for a LONG time.
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