O
Old student
Guest
I am a student pilot, I am over 60 years old, I recently had a kidney stone (first one ever); will this keep me from getting my 3rd class medical? I have no other medical issues and take no medications.
Matthew
Touchdown! Greaser!
No.
I had a kidney stone the day after my PP checkride.
There will be some FAA concerns: they really don't like the idea of "sudden incapacitation". You'll need to show you have no retained kidney stones, they want to know you don't have any more that could possibly dislodge and cause another episode. Hopefully you were able to capture that stone and get it analyzed. Different chemical compositions mean different things to FAA.
I'll let the resident AMEs comment on the documentation required.
AggieMike88
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The original "I don't know it all" of aviation.
This worksheet explains a few things
https://www.faa.gov/about/office_or...e/guide/media/kidneystonedispositiontable.pdf
https://www.faa.gov/about/office_or...e/guide/media/kidneystonedispositiontable.pdf
AggieMike88
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Applying some Google Fu (and remembering the coffee mug FlyingRon presented to Dr. Bruce)
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:
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.
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.
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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bbchien
Touchdown! Greaser!
If all you have is an internist (who will never write what Aggie knows to get) get two renal ultrasounds 90 days apart. It the first one has no stone, advance to “GO”. If there is one, get the 90 day later ultrasound an if unchanged this is an easy “special Issuance”. B
AggieMike88
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Okay... you have me as confused as if you put me in a round room and instructed me to go sit in the corner..... Your reference went right over my head....
Craig
Cleared for Takeoff
Prolly means that you need to deal with a Urologist rather than an internist...At least that's what I had to do when I had mine....
AggieMike88
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Okay. Like applying compound interest on a dime, that makes more cents.
gmwalk
Pre-Flight
I see this is an old thread, but then, I am an old guy. I just had my first kidney stone at 65. Is it ok for me fly with a safety pilot to maintain proficiency while I wait for the tests and approvals get processed? I only had one stone and no evidence of any others.
Or a nephrologist.
As was explained to me, the urologist is a plumber. The nephrologist deals with the underlying causes.
If the safety pilot isn’t upset when you start screaming and one of you tries to jump out the airplane.
Yes, you can go with a safety pilot. You can actually go fly by yourself if you feel have been told by the doc that there isn't anything else in the pipeline. The issue is, what evidence do you have that there is nothing else? Do you have a perfectly clean CT?
This is the time to go Basic Med unless you really need the Class 3. If there is the slightest of evidence of a remote chance of a recurrence, the FAA will make you go through the ringer on your Class 3 renewal. I had to spend thousands on scans and tests to prove what my urologist already told me, that I was good to go.
This is the time to go Basic Med unless you really need the Class 3. If there is the slightest of evidence of a remote chance of a recurrence, the FAA will make you go through the ringer on your Class 3 renewal. I had to spend thousands on scans and tests to prove what my urologist already told me, that I was good to go.
danhagan
En-Route
Working in the imaging area, specifically ultrasound and high risk ultrasound, I've seen a **LOT** of sonographers take images in a way that hamstrings the radiologist into calling kidney stones on targets that end up being long term focal fibrosis. The CT scan can do a better job even without contrast ...
Mongoose Aviator
Line Up and Wait
On the other hand, my AME did not blink an eye with regard to my kidney stone. My Kidney stone was 2 years, 10 months prior to the AME medical appointment so it was listed under both Q 18J (Kidney Stone) and Q 19 (Visits to Health Professional within last 3 years). My answer to Q 18J was:
Kidney Stone. Passed without intervention required.
For me there was nothing required beyond that. Perhaps there is a level of discretion allowed an AME?
This was my first and (so far) only kidney stone.
PaulS
Touchdown! Greaser!
Hmm, maybe the radiologist should be there while the sonographer is taking images.
danhagan
En-Route
That rarely happens ... as in 1%. At my facility, as we're high risk, we call them in if they want to see "live" images. When I started 40 years ago, sonographers cross trained after graduation for a year to two to get exposed to all the things they don't get in school ... that no longer happens, as the older expensive guy never cross trains because when things get slow, someone is clocking out and going home. Our company pays salary to avoid this, but no others do in my region as they're all about cost savings ...