Kidney Stone

[BenderGonzales]

Went to the ER early this week for a kidney stone. They pumped me full of morphine, told me to drink, drink, drink and sent me home with a prescription for percocet.

Pain is in my back (kidney area) and occasionally lower abdomen. Other symptoms are fatigue, dry-mouth, frequent urge to urinate, and lack of appetite.

Doc at the ER said it was 3mm stone right at the entrance to the ureter on the xray.

Does not seem to have moved over the last few days. Still pain in the back. I'm drinking around 3 quarts per day.

Appointment with the urologist is tomorrow.

If the stone has not been flushed by this weekend i'm going to have to remove myself from flight status and, potentially, go on medical leave or short-term disability. (not sure which)

I understand that it's really tough to get the medical back once you take that step. Does anyone have any suggestions or information that might be of help?

I have Item 41 G-U system - Urinary system already printed to bring to urologist. ("if no residual calculi and metabolic workup is negative - issue")

Thanks in advance.

 

[h25b]

Call AOPA and get their opinion...

 

[BenderGonzales]

May have passed the stone this morning. Not sure. I got lazy and didn't strain the pee this time. (figures)

But mid-stream there was a "pause" and then when the stream continued lots of little black "flecks" in the bowl. Wasn't sure whether it was the stone (disintegrated?) or blood or what.

I feel a little better now, although I still have to pee about every 10 minutes. Headed to the urologist this afternoon.

 

[wmudriver]

If you're with an ALPA carrier, call ALPA medical...see what they say.

 

[h25b]

May have passed the stone this morning. Not sure. I got lazy and didn't strain the pee this time. (figures)

But mid-stream there was a "pause" and then when the stream continued lots of little black "flecks" in the bowl. Wasn't sure whether it was the stone (disintegrated?) or blood or what.

I feel a little better now, although I still have to pee about every 10 minutes. Headed to the urologist this afternoon.

That was most likely the stone... If it was you should start feeling better soon. My brother just went through this whole ordeal. I feel for you man.

 

[BenderGonzales]

Doc said that was probably the stone. Giving me the whole metobolic workup. 24 hr pee-test, blood test, etc.

Once I get the results from those I should have the data to go to the FAA. Question is, do I do that now? or wait until my next medical?

 

[h25b]

Doc said that was probably the stone. Giving me the whole metobolic workup. 24 hr pee-test, blood test, etc.

Once I get the results from those I should have the data to go to the FAA. Question is, do I do that now? or wait until my next medical?

Again, I would call AOPA... They will know exactly what to do. My best guess is that given the situation nothing is required at this time. However at your next medical you would have to check the box that you've have a Kidney Stone and would attach the resolution and further medical workup paperwork from your Doc.

Here is a cut/paste from the AOPA website...

[SIZE=+2]T[/SIZE]he FAA allows for recertification following diagnosis and successful treatment of renal stones. If you are reporting the history on your medical application for the first time, you will need to provide to the aviation medical examiner two reports from your treating physician (usually a urologist):

1. A summary of your history of stones, including the date of diagnosis, a metabolic evaluation, method of treatment, current status, and prognosis for recurrence; and
2. A report of recent ultrasound, IVP (intravenous pyelogram) or KUB (flat plate X-ray of the kidney, ureter, and bladder). If the reports confirm the absence of stones, this is the first and only episode of renal stones, and there are no other complications, the medical examiner may</I> issue the certificate.

A retained stone or a history of recurring stones is disqualifying and the AME should defer the application to the FAA for a decision. Recertification with a retained stone may be possible if there is reasonable evidence that the stone is not likely to move within the kidney or out of the kidney into the ureter. Depending upon the size and chemical makeup of the stone, any movement can result in very rapid and potentially incapacitating pain. Your urologist should provide a written opinion as to the likelihood for incapacitation.
If you have not previously applied for a medical certificate, make copies of all medical records and retain one set for yourself. Provide a separate set to your aviation medical examiner at the time of your FAA physical examination.
If you don't hold a current medical certificate, or your FAA medical application (Form 8500-8 that you complete at the time of your regular FAA physical examination) has expired, you should talk with your aviation medical examiner or AOPA medical services before you apply for a new medical. The FAA will no longer review medical records unless there is a current medical application on file.

Be sure to have all the necessary records with you when you see the medical examiner for an FAA physical exam. Your name, address, and date of birth should be on each page of the records.

If you choose to send the records to the FAA yourself, do not send them until after your FAA exam. Use express courier service, either overnight or 2-3 day delivery and mail to the address below. Double-check that you have all the required information. If anything is missing, it will take longer for the FAA to issue your medical.

When your case is approved, you will receive a detailed authorization letter with instructions for renewing your next medical.

Federal Aviation Administration
Aeromedical Certification Division
AAM 300
6700 South MacArthur Blvd.
Oklahoma City, OK 73169
Telephone: 800/350-5286, 405/954-4821

I would say that you are good to go. No need to do anything so far as the FAA is concerned... Do business as usual until your next medical. You need to relax. Reduce your stress levels, get some sleep, take care of yourself, make the diet changes you Dr. is likely to suggest, and I doubt you'd ever have another problem like this.

Here is another link to the faa.gov site addressing this issue...

http://www.faa.gov/other_visit/aviation_industry/designees_delegations/e_ame_guide/special_iss/all_classes/renal_calculi/

 

[SF3CA]

Hey there,

I had one about 2 years ago. I feel for you! I had an 8 mm stone that had to be lipotripsied (blasted) into small pieces. I passed a 3 mm chunk, the rest just sand.

Here is the deal with the FAA, according to the ALPA aeromedical and my experience. The do not care about your first one. I just had to have my uroligist write a letter to my FAA doc with that stated that I am now stone free. Consult your FAA doctor to see what has to be in the letter. You cannot fly if you are retaining stones.

Now if you have a second one, and statistically speaking, you and I are very likely to have a second one (lovely thought huh), the faa wants to know why you are having stones. So if it is several years go by until our next stone, no big deal, our FAA doctor just has to send some paper work to Oklahoma City. If we start having them on a regular basis, the FAA will want more and more documentation. The FAA will not deny your medical if you are stone free, but they might send you through a year long doctor and paperwork trail if you have stones on a regular basis. I guess they could make it such an ordeal that it might not be worth going through the process every medical.

As for me, I drink a gallon of water a day, and every time my back hurts, I freak out and think.......oh no here it comes again. Nice way to go thru life huh.

good luck and PM me if you have any questions

SF3CA

 

[Kaman]

Hello,
I'll second what SF3CA said about the kidney stone deal. My experience was literally and figuratively painful. I am still dealing with it today, but it has improved.
Four years ago I was lying in bed the night before my Comm ME checkride, and had an awful pain in my right flank...To the point that I had to awaken my aunt and uncle that I was staying with and have them take me to the hospital. I did finally pass a stone at the ER, and I declined to finish my training at that time given the circumstances. Ultimately, I had another stone blasted and have had Ureterscopy surgery TWICE...
Here are some lessons learned:

1. DON'T go thru Oklahoma City! Fortunately, I was given good advice by the FAA person at the regional Flight surgeon's office in NY. She has been terrific and breaks all the stereotypes of government employees.

2. Get consult with a Urologist that knows something about the limitations on pilots, or at least has a working knowledge of what's involved. Mine didn't initially, but referred me to a Urologist at Duke Univ. that had done a paper on returning pilots to duty "stone-free". He is something like 99%, but the guy is a jackass, so I have never gone back to him, but rather stuck with my present Urologist.

3. Don't give up!!! I still have a retained stone, and have a letter of special issuance on in my record for my medical. Since I have had no change in my condition, my local AME is able to issue my medical based on a letter from the Federal Air Surgeon guy at the regional office.

4. Educate yourself on the type of stone that you have and how you can prevent a reoccurance. Fortuantely, most of the stones are oxcylate-based or calcium and can be avoided thru diet most of the time...

Good luck,

ex-Navy Rotorhead

 

[Razorback Flyer]

Ouch - Kidney stones are no fun!
I had one about 6 years ago, and everyone so far has given good advice, and accurate information. One stone is no big deal, so long as there are no retained stones.
One thing that I would add that is very important in preventing new stones is drinking LOTS of water - especially if you are working as a piston or turboprop driver where you are out in the heat a lot. I generally try to drink about a gallon a day. I've also been told that drinking water with lemon juice or drinking lemonade (if it contains real lemon juice,) is good for helping to dissolve stones (or prevent formation,) if they are of the calcium-oxcylate variety (which is the most common kind.)