Kidney Stones?
 

Twice in three days I have experienced excruciating pain in my lower back that lasted about an hour. The first time I experienced it, I went to my family doctor who basically said that the pain was non-specific, that it described several scenarios, and since that I'm young the best approach would be the "wait and see" approach.

Well this morning after my second experience with the back pain, I called my doctor's office who said there was nothing they could do on a weekend and if I wanted to I could go to the ER. My wife drove me to the ER where they ran a urine test and a CT scan.

The urine test detected a trace amount of blood, but the CT scan came up negative for kidney stones. The doctor gave me a referral to a urologist for further testing. The ER doctor suspects that I may have already passed the stone, or that I'm in the 10% of which the CT scan doesn't detect the stone.

I did a search on APC for kidney stones and read some testimonials, and I've got to be honest I'm pretty darn scared right now. Not so much about the pain that I'll have to endure if I do in fact have a stone (not that I'm looking forward to it), but about the hoops I'll have to go through to get a medical certificate when I'm due up for it again.

Please correct me if I'm wrong, but according to what I've read on AOPA, once the stone is passed I can return to work (CFI) without having to immediately notify the FAA or my AME. I'll have to report it on my next medical though and provide a status report administered by my urologist that was done in the last 90 days.

For you guys that have gone through this before or are familiar with the matter, what is the first step as far as the FAA and medical is concerned. If this turns up positive for kidney stones or something worse (God I hope not) what is the first step I need to take before jumping into the cockpit again?

I'm praying rather heavily that there's not a stone, but all signs are pointing that way. The earliest I could get in to see the urologist would be Tuesday since it's Memorial day weekend.

I'm already discouraged enough since I keep getting hired by airlines only to have classes canceled. This is the last thing I want to go through right now.

For the record, I don't plan on flying until after I see the urologist.

I've had a couple friends with kidney stones, both are back to flying.

I can't really address the treatment, but for future reference, they are preventable in many cases. Both of my friends acquired them in the desert, almost certainly due to poor hydration. Do some research, and hopefully you will not have a recurrence.

A good friend of mine has cronic kidney stones he made it back after having a couple of surgerys and a changed diet. Ill shoot him a message and try to get some info. MY BEST ADVICE IS get in contact with a Airman Medical Examiner NOW!!!! Get them into the loop. Perferably its a guy that only does medicals since they seem to care about their pilots more. A Lot of time the back ups in getting back in the cockpit is that you didnt have them there to make sure certain screening, procedures, and documents were done at the right time.

If you havent read my post of my experiences (which Im guessing you already have) here is the link - http://www.airlinepilotforums.com/sh...ad.php?t=16565

My experience with the FAA was a bit frustrating, but I hear it can be worse. I was out (no pay) for two months.

I talked with many different AME's, company lawyers, chief pilots, retired FAA guys, etc... and every one of them had a different answer for me. I finally got the cocconuts to call my FAA Regional Flight Surgeon. He was VERY clear in his answer to my querry about when I can return to work. "Not without their approval".

So after about a month of Passing and Dealing with the stones (A whole other story). I sent my paperwork in and a MONTH later I was working again. There was a list of things I need to send in...from what I remember: CT Scan showing I'm clear (since yours already shows clear you may not have to get another), Urologist statement, saying your clear and show no signs of producing more, analysis of the stone, and all doc visits. There might be more but thats all I remember.

I recieved my letter which essentially re-instated my medical (did not need to get another one). I gave the letter to my company just in case there was an issue, and when I went in for my next medical I reported the stones and brought the letter.

They said if you become what they call a "producer", you can permenantly lose your medical and Im not sure what actions you can take to circumvent that. Just do your best to drink lots of water and cut out the sodas...

PM me if you want to know more specifics. Good luck and let us know what happends.

DD

Fortunately I've only had kidney stones once, since my mom has been plagued by them for years. After the tests came back it was discovered that my body lacked a chemical that is used to break down calcium deposits in the body. At the time I was drinking ALOT of soda, and a lot of milk. So I decided to cutback on my soda intake and milk, and drink more juices like cranberry juice. Haven't had a problem since.

Also, while the kidney stone was still in my body I was medically grounded in case of another kidney stone attack. After I passed the kidney stone, I just reported that during my next physical and that was it.

UND and Ditch -

Would you guys recommend letting my AME know before I see the urologist, as Bored had mentioned, or after I have a definitive diagnosis? The ER doctor said that nothing turned up in the CT scan and clinically he said I had or have a kidney stone. I'm thinking I'll let my AME know before I go just so that all the tests and documentation required by the FAA get done.

Thanks for everyone's input.

Hold on there! Your AME and/or OKC will likely ground you until you can prove that you don't have kidney stones. Maybe you should talk to an aviation medicine consultant before the AME.

I would agree with Rickair....talk to a consultant first...or make some anonymous calls to get information before putting yourself at the mercy of the FAA.

I"ll e-mail or call em anyway, but would you guys think AOPA would be a good consultant as far as this stuff goes?

If it's free, it would be a good place to start. There are several professional services out there, I have used this one: http://www.aviationmedicine.com/

Rick - I ran across this website after a google search. I'll have to look into it a bit more.

I did talk to AOPA. The person I talked to said I only have to report the stone (assuming they find one) on my next medical application several months from now and that there is no need to get my AME involved. She mentioned that as long as the urologist says I'm free of stones, I can "self certify" myself for use of my medical privileges.

I did go to the urologist today. She did a urinalysis and said everything looked fine. I haven't had any pain since Saturday. I am going in for an IPV tomorrow just to make sure everything is clear. Hopefully everything is clear and I should be good to go back to work assuming that the AOPA medical person is correct in that I don't have to go talk to my AME.

Thanks for everyone's help

Good News -

I went and did an IVP scan yesterday, of which I just found out is negative for kidney stones. I called my AME's office this morning to make sure I was good to go. Unfortunately, my AME is not in the office today and won't be back until Monday. His nurse told me to call FAA Aeromedical. I sucked it up and called. The guy I spoke with said since there's no evidence of stones I should be alright to use my medical privileges and to just report it on my next medical application.

Multipilot -

Without knowing your age, medical history, family history, etc.., anything online here is total speculation. Being seen by a Urologist was a good move, but unless they deal with a pilot population routinely their impressions and advice are limited. Not by lack of intelligence but lack of knowledge in the Aerospace Medicine realm. I agree with some of the other posts in that you can get back to flying but the hoop process can be exceptionally frustrating. As we all are aware, the back of every medical certificate lets us know that we are to self ground ourselves during periods of medical illness, regardless of cause. The whole concept with grounding someone with renal calculi (kidney stones) is flight safety..... no big surprise here.... If you happened to be in the air with a student and had an "attack" it could have an unfortunate outcome. Your biggest risk factor at this time for having another kidney stone is a HISTORY OF A KIDNEY STONE. Getting into the loop with virtual flight surgeons in Colorado (or someone equivalent) might not be a bad idea if your AME is not a specialist in Aerospace Medicine..... not to suggest that he/she is a bad physician but in situations like yours you want someone who practices in this area exclusively..... Best of luck and hope you never have another stone.....

I just got off the phone with the FAA Medical Certification Branch. The guy I talked to was a lot more helpful than the last one. This is what the dude I talked to told me -

All I need to do is submit a copy of my CT scan, IVP scan, and a letter from my treating urologist that answers the following questions:

1. Are there any retained stones?
2. Is the issue resolved?
3. What is the clinical diagnosis/assessment?
4. Is the patient released from care?

I am supposed to fax this info up the FAA Medical Certification Branch where they'll review my case and then send me a letter of authorization (I think that's what he called the letter) in which I am to present to my AME for my next medical.

The good news is, he said I can continue operating under my current medical as long as I am released from care of my treating physician and I have no other occurrences.

Thanks for the link. The last post to this thread was in 2008. I'm pretty sure the OP was able to pass all his kidney stones by now. ;) If not, he's got more serious problems, wouldn't you agree?

:D

Still good to have updated information. Having an experienced and savvy AME here is essential. For example, IIRC FAA doesn't always require the latest and greatest diagnostic tests when looking for the possibility of a recurrence, which can be to the pilot's advantage. As always, get expert advice before submitting the medical application.

My dad has kidney stones and I hope I dont have it too in the future

Wow, this thread was resurrected from the dead.

Thanks for the link! It's always good to have more information.

Haha, thankfully I was. I consulted AOPA and CAMI prior to my medical appointment for the class 1 and the AME was able to issue it right there in the office (If I remember correctly as it was over 5 years ago now). It definitely pays to be proactive and have all of the information BEFORE you go see your AME. After that whole experience, I've changed my diet, mainly cutting back on sodas, and have been drinking a lot more water. I haven't had any problems since.