Kidney Stones

QUOTE: ".although he offered another suggestion of him putting me out, and him physically removing the stones. No thank you."

Somewhere on the net awhile back I came across a photo of the kidney stones that had been removed from Chief Justice John Marshall - in perhaps the first operation of it's kind. They were awesome! Unfortunately, I am unable to find a link to it now. BTW - this was in 1831 (no anesthetic in those days).

Dave
 
Quick question. Today I went to the E.R. because of severe lower back pain and vomiting. The CT scan confirmed that I had a very small kidney stone passing that was close to entering my bladder. The doctor said it should pass on its own quite soon. Just looking to clarify whether or not I need to contact my AME or the FAA asap or if I just need to report it when I renew my medical. Thanks!
 
SkyHog said:
So here's the update:

I have successfully passed one stone. The other two are still in my kidney. I keep having pain as if I am going to pass another one, but the pain is short lived and not as intense as the one I passed, so I know its not "ready" to go yet.

I talked to my Urologist yesterday, and as soon as I told him I was a pilot, he immediately changed tune from "you'll be fine" to a more serious "we need to figure this out." Which I like...apparently, he has a lot of experience with pilots. Good news.

Bad news: He can't do a KUB because the stones are too small. Unfortunately, because the other two have not passed, and they are confirmed via CT scan, I need to wait until they pass....although he offered another suggestion of him putting me out, and him physically removing the stones. No thank you.

He is going to do a 24 hour urine scan, where I save all of my pee in a jar for 24 hours and they do some analysis of it. Additionally, he took the one stone I have passed and is going to do some analysis of the make up of it to determine what it is made of and what likely caused it.

But - my understanding is that I am grounded now until I pass those two stones, right?
Click to expand...
Yes, unles you can show ZERO movement in 90 days from the preceeding CT.
The urologist said that may be a few days, or it could be a few years.
Click to expand...
I actually agree with Jesse. When the next ones really lodge, they will really hurt. Who wants that?

But far be it from me to tell you to go to sleep and wake up with them gone...
 
bbchien said:
But far be it from me to tell you to go to sleep and wake up with them gone...
Click to expand...

That sounds very much like common-sense advice from a professional who knows that of which he speaks.

But don't let THAT affect your decision! :D
 
Well, I got to join the POA kidney stone club last weekend...

I've had them before, twice, but those were both over 20 years ago. Just as much fun as I remember. All three times though the pain came on relatively gradually, at least 30 min to an hour before it got ugly. This time it was about 6 hours before I felt it wasn't going anywhere easily and went to the ER for the quality painkillers.

One main stone on the CT, but other small ones supposedly seen too that the ER said were not an issue - don't know the details on those yet. Now rereading this thread I can wish they did a KUB Xray instead... The hospital doc confirmed it had moved into the bladder. I've been straining most, but not all the time, and haven't caught it - don't know if it's out yet for sure or not. I caught one of the stones 20 years ago and it was calcium oxalate.

I have an appoinment with the urologist tomorrow.

So, what I'm still not clear on is "when" I need to apply for the SI and when I can PIC again. Do I go to the AME right after I have the 90 day stable report for the SI, or am I ok to fly after I have that "stable" report until my next normal renewal?

Irony of course is that I just renewed my medical a month ago and had a routine physical with my GP just 2 days before with no issues. More irony is that I suspect this event was triggered because I *stopped* (gradually, over about a week) drinking coffee and other caffeinated drinks, and it is probably because I didn't replace that 12-16 oz of fluid/day with other beverages it pushed me over the edge. I've quit caffeine before without this issue. One of the reasons I stopped the caffeine is was concerned about kidney stones, since my second episode many years ago was time-correlated with me drinking *a lot* of coffee. Everything in moderation, I guess...

Jeff
 
Last edited:
Actually, Jeff, the best thing is to get an Rx to alkalinize your urine. If they're oxalate they'll be mostly gone in 90 days. You should be chonically taking NaHC03. Oxalate is many many times more soluble even if the average pH is moved upwards by .04 points.

They use buffered citrate to do that too
 
Jeff Oslick said:
One of the reasons I stopped the caffeine is was concerned about kidney stones, since my second episode many years ago was time-correlated with me drinking *a lot* of coffee. Everything in moderation, I guess...

Jeff
Click to expand...

Jeff, if coffee / caffeine caused kidney stones I'd be passing the things weekly. :)
 
Out of curiosity, I searched the FAA incident database for "kidney". In 28 years of records, it came up with only 8 incidents of kidney stones, and all of them were air carrier incidents. All, of course, ended fine with the other pilot landing. I think this shows evidence that sudden, truly incapcitating pain from kidney stones is very rare, and is a non-factor in general aviation incidents/accidents. Much like how the FAA medical folks hamstring people who have undergone chemo (I know someone in this situation) - they are setting standards that have little to do with legitimate, statistical probabilities of in-flight medical problems endangering the outcome of a flight.

Has anyone ever heard of a GA pilot having a major kidney stone incident in-flight?

I'm certainly not advocating that it's a good idea to go flying with known unstable stones, but I'm looking ahead at what I'm going to need to go through to get flying again and how much it's going to cost me on an on-going basis, and I'm not at all happy about it.

Jeff
 
Jeff, I suspect - if your database search is accurate :) - that FAA is playing "edge odds". In poker you'll take a bigger chance as the pot increases. Here the odds may be small, but if it happens you're essentially dead if you're alone.

Also your data is tainted. It's taken from a pilot base that's essentially been "cleaned" of prior kidney stone events. You're searching for first time events (or of those who have shown to be stone-free, but had one redevelop), like it or not.

At least you've a chance of getting recertified. Like I posted elsewhere, in much of the rest of the world you'd be SOL.
 
Last edited by a moderator:
rotorhead1026 said:
Jeff, I suspect - if your database search is accurate :) - that FAA is playing "edge odds". In poker you'll take a bigger chance as the pot increases. Here the odds may be small, but if it happens you're essentially dead if you're alone.

Also your data is tainted. It's taken from a pilot base that's essentially been "cleaned" of prior kidney stone events. You're searching for first time events (or of those who have shown to be stone-free, but had one redevelop), like it or not.

At least you've a chance of getting recertified. Like I posted elsewhere, in much of the rest of the world you'd be SOL.
Click to expand...
My kidney stone experience was as painful as advertized but I think I could still have managed to fly to an airport and make a safe landing at the worst of it. Probably wouldn't be one of my better landings and there would be some pressure to get on the ground ASAP but it's not like you lose consciousness (although that might have been preferable.
 
gismo said:
My kidney stone experience was as painful as advertized but I think I could still have managed to fly to an airport and make a safe landing at the worst of it. Probably wouldn't be one of my better landings and there would be some pressure to get on the ground ASAP but it's not like you lose consciousness (although that might have been preferable.
Click to expand...
Of course had you done that, would you need to report it to the NTSB as in-flight pilot incapacitation, or would the fact that you were able to land the airplane show that you weren't incapacitated? What if it happened to me and, rather than try to land myself, I had Leslie land. Would I need to report that? Hmmm....
 
rotorhead1026 said:
At least you've a chance of getting recertified. Like I posted elsewhere, in much of the rest of the world you'd be SOL.
Click to expand...

I do not compare the US to other countries when it comes to personal freedoms. Maybe if we stopped doing that so much we wouldn't be losing so many of them.

I would argue that very little "cleaning" of the database has occurred through the FAA's medical process. Many folks - in the prime of their GA flying years, get their first stones after being certified. Again - not a single FAA-documented case in GA in 28 years of an in-flight incident. In my case, I was certified 7 or so years after my first episodes - I was young at the time, and it was before the FAA required all these expensive hoops to jump through in many cases. It had been 22 years since my last stone. I'm now at the whim of improvements in technology, since what has been seen on a CT can't be undone, even if it wouldn't have been seen on a KUB X-ray. At the same time I'm going to get hit with expensive bills for the CT scans when the same thing might have been accomplished with an X-ray. I'm at the mercy of what the ER doc ordered up.
 
Jeff Oslick said:
I do not compare the US to other countries when it comes to personal freedoms. Maybe if we stopped doing that so much we wouldn't be losing so many of them.
Click to expand...

??

Cheap shots like this belong on AOPA. :(

Comparison with, for example, Europe is used more as an excuse - the erosion would occur regardless.

I would argue that very little "cleaning" of the database has occurred through the FAA's medical process.
Click to expand...

I'll argue that it has. You and several others here have been "filtered", right or wrong. "Unforecast" stones (like yours - 22 years counts as new in my book) are what we're concerned with. Your chance of an inflight recurrence is next to zero because of FAA (and your honesty).

I'm going to get hit with expensive bills for the CT scans when the same thing might have been accomplished with an X-ray. I'm at the mercy of what the ER doc ordered up.
Click to expand...

Yes, you are. That's unfortunate. gismo thinks he might be able to land safely after an attack. That's not good enough. Statistical considerations aside, medical technology has shown you, in the short term, have a real chance of having another attack, and same would affect you to the point that "the completion of the maneuver is seriously in doubt". So you can't act at PIC until this is cleared up, and that's not changing in the short term.

I hope the urologist visit was encouraging, at least. :)
 
Last edited by a moderator:
gismo said:
My kidney stone experience was as painful as advertized but I think I could still have managed to fly to an airport and make a safe landing at the worst of it. Probably wouldn't be one of my better landings and there would be some pressure to get on the ground ASAP but it's not like you lose consciousness (although that might have been preferable.
Click to expand...
I've driven myself to the hospital - wasn't fun, but it was just a matter of focusing on what had to be done.
 
I'm sure this question has been covered but for the life of me I cannot find a clear answer. Sunday I went to the E.R. and it was found that I had a single small kidney stone. I passed the stone on Monday and I have it in a bag. I'm going to schedule an appointment with a urologist to have it tested. What I am not clear on is if I need to contact my AME or the FAA about the event or if I don't need to worry about it until I renew my medical in 2 years? In the meantime, since I passed the stone am I cleared to fly?
 
Last edited:
rotorhead1026 said:
Statistical considerations aside
Click to expand...

Why do we put statistics aside? I work in the environmental remediation business, and risk/cost factors are constantly at play when deciding "how clean is clean enough". Risk/cost factors seem to go by the wayside when it comes to the FAA, and not just aeromedical. Again, 28 years of reports with no GA incidents/accidents caused by kidney stones. I'm sure folks are having stone pain start in flight, it just isn't incapacitating - especially when your brain tells your body the first priority is getting on the ground.

Doc Bruce seems to be in favor of CDL licensing in lieu 3rd class. Do kidney stones keep you from getting a CDL? Do you have to go through expensive tests every year to keep your CDL?
 
Ryan7943 said:
I'm sure this question has been covered but for the life of me I cannot find a clear answer. Sunday I went to the E.R. and it was found that I had a single small kidney stone. I passed the stone on Monday and I have it in a bag. I'm going to schedule an appointment with a urologist to have it tested. What I am not clear on is if I need to contact my AME or the FAA about the event or if I don't need to worry about it until I renew my medical in 2 years? In the meantime, since I passed the stone am I cleared to fly?
Click to expand...

How do you know that you had a single stone? Was that confirmed by a CT?

IF the doc told you that you had a single stone and that was confirmed with a CT (or by other means)...THEN you are now able to fly (you can unground yourself). You need to follow up with the urologist and get a letter from them. It should be similar to this...

Ryan _____ blah blah blah a single stone as confirmed by a CT scan on 02/??/2012. The stone was subsequently passed and captured. We tested the stone and determined that it was a _______ _____ and was likely caused by lifestyle factors. We counseled Mr. ______ on lifestyle changes to prevent future stones and have no reason to believe that there will be a reoccurrence.
Click to expand...

Don't let them put in any more information than is necessary. What you basically want it to say is


  • We know that there was only one stone (state method used to confirm)
  • We got the stone
  • We analyzed it and found that it was caused because he didn't drink enough water and ate too much salt
  • We've told him to drink more water and not eat as much salt
  • We have no reason to believe that it will happen again


Assuming that all of the statements are true, it should state all of these things in one manner or another. Nothing more. Nothing less.

Once you get that letter, you take it to your AME when it is time to renew your medical. It would be a good idea to call them before you go in and ask if they want anything else, but they shouldn't. Dr. Bruce issued my medical with nothing more than this letter.
 
Thank you so much for the reply Jason. Yes, it was confirmed by a CT scan that there was only one stone. I'm going to schedule an appointment with a urologist ASAP to get the letter. Thanks again for the help, I really appreciate it!
 
Again, my total sympathies. Kidney stones are one of the very few things of which I am actively afraid. I hope you guys can get past these things.
 
I'm amazed at how many of you are part of this club. Seems like an interesting statistical anomaly here on PoA with y'all here? ;)

An ex-boss (who won't set foot in a light aircraft) claims that his dad passed a stone somewhere over Wyoming in a Cessna 210 flying buddies home from a fishing trip and fought with multiple stones in the 1970s. Whether he ever reported them, I doubt.
 
There were several at the old airline. They all drank water religiously - did not want to relive the experience. Hearing their experiences was an education.
 
Everskyward said:
So am I. I had no idea it was so common.
Click to expand...

Apparently, 12% of men and 7% of women. Mostly occurring - for the first time - ages 20-49.
Still, amazed that this seems so common - among male pilots participating in online forums.
 
I freely admit that I fly a lot, and almost NEVER drink fluids enroute, for not wanting to pull over for a restroom break, and not wanting to show up in the FBO with the hot gatorade bottle of shame.

I am also in the stone club currently, waiting for some little crystal pineapple caltrop to take its tour of my jazz hose. :(

I wonder if it's a cumulative situation from the flying? I drink lots of water otherwise, and am careful about salt moderation.
 
jason said:
What you basically want it to say is


  • We know that there was only one stone (state method used to confirm)
  • We got the stone
  • We analyzed it and found that it was caused because he didn't drink enough water and ate too much salt
  • We've told him to drink more water and not eat as much salt
  • We have no reason to believe that it will happen again.
Click to expand...
I think the wording on the letter from my doctor had the last one reading more like: "Chances of a recurrence are no higher than an individual with no prior kidney stone history".
 
Last edited:
Jeff Oslick said:
Why do we put statistics aside? I work in the environmental remediation business, and risk/cost factors are constantly at play when deciding "how clean is clean enough". Risk/cost factors seem to go by the wayside when it comes to the FAA, and not just aeromedical. Again, 28 years of reports with no GA incidents/accidents caused by kidney stones. I'm sure folks are having stone pain start in flight, it just isn't incapacitating - especially when your brain tells your body the first priority is getting on the ground.

Doc Bruce seems to be in favor of CDL licensing in lieu 3rd class. Do kidney stones keep you from getting a CDL? Do you have to go through expensive tests every year to keep your CDL?
Click to expand...

It takes a lot less concentration to take your foot off the gas and stop on a roadside than it does to land a plane. I've had a CDL, a PPL and have seen enough folks with kidney stones to know I don't want one while I'm trying to land.
 
Doggtyred said:
It takes a lot less concentration to take your foot off the gas and stop on a roadside than it does to land a plane. I've had a CDL, a PPL and have seen enough folks with kidney stones to know I don't want one while I'm trying to land.
Click to expand...

Well, I haven't "seen" folks, I've had three, and none of them resulted in sudden incapacitation such that I couldn't readily land a plane in a reasonable amount of time after the discomfort started. For me, at least, it starts with discomfort, not pain.

It's one thing for NASA or the Navy to not want someone with unlikely but potential kidney stone issues in some remote location where treatment is difficult or impossible, quite another for pilot flying a Part 91 flight.
 
Jeff Oslick said:
Well, I haven't "seen" folks, I've had three, and none of them resulted in sudden incapacitation such that I couldn't readily land a plane in a reasonable amount of time after the discomfort started. For me, at least, it starts with discomfort, not pain.

It's one thing for NASA or the Navy to not want someone with unlikely but potential kidney stone issues in some remote location where treatment is difficult or impossible, quite another for pilot flying a Part 91 flight.
Click to expand...
There is a big difference between true incapacitation (unconsciousness, paralysis) and I don't feel too good decrement in piloting performance. Let's keep that straight.
 
Gary F said:
There is a big difference between true incapacitation (unconsciousness, paralysis) and I don't feel too good decrement in piloting performance. Let's keep that straight.
Click to expand...
I almost hate to admit it but I completed a flight (including a landing) many years ago when I was feeling so ill I had one of my passengers drive me home from the airport. I started the flight feeling a little queasy but not bad enough that I was concerned about being able to fly and that aviation disease (get-home-itis) was doubly in the mix since I didn't want to strand everyone and I wanted to recover in the comfort of my own home. Part way through the flight I began to feel a lot worse with abdominal cramps, significant sweating, and a strong urge to empty my digestive system via both orifices. I finally started upchucking about the time I was turning final (had a few bags handy) and while it probably wasn't the best landing I ever made, I never felt a safe outcome was in doubt (I do remember assuring my passengers that I was still able to fly the plane while barfing).

Now the sensory symptoms of a bout with "stomach flu" are quite a bit different than a kidney stone the intensity is fairly similar (I have been through both) so while I'm not likely to initiate a flight when either seems imminent, I have little doubt about my ability to safely land under the influence of a stone.
 
gismo said:
I almost hate to admit it but I completed a flight (including a landing) many years ago when I was feeling so ill I had one of my passengers drive me home from the airport. I started the flight feeling a little queasy but not bad enough that I was concerned about being able to fly and that aviation disease (get-home-itis) was doubly in the mix since I didn't want to strand everyone and I wanted to recover in the comfort of my own home. Part way through the flight I began to feel a lot worse with abdominal cramps, significant sweating, and a strong urge to empty my digestive system via both orifices. I finally started upchucking about the time I was turning final (had a few bags handy) and while it probably wasn't the best landing I ever made, I never felt a safe outcome was in doubt (I do remember assuring my passengers that I was still able to fly the plane while barfing).

Now the sensory symptoms of a bout with "stomach flu" are quite a bit different than a kidney stone the intensity is fairly similar (I have been through both) so while I'm not likely to initiate a flight when either seems imminent, I have little doubt about my ability to safely land under the influence of a stone.
Click to expand...

An excellent example of why the FAA's standard for judging likelihood of sudden incapacitation is ridiculous. Any pilot on any given day is about as likely to have a sudden "incapacitating" bout of sickness from food poisoning as I'd be to have a sudden "incapacitating" pain from kidney stones.

It's quite simple, I don't fly when I'm not at 100%.

Jeff
 
I had a kidney stone (required lithotripsy) before I started flying (about 1980). When I went to get my first medical, I told my AME and he had me jump through some hoops. When it was all said and done I had to wait 6 months for a letter from Oklahoma City and all it said was that I was not allowed to fly under the affects of a kidney stone. Every medical now, I report that I have had a history of kidney stones, but it has never stopped me from flying.

Yes it was painful, I spent 4 days in a small country hospital with constant pain, pumped full of the maximum amount of pain killers as they said they could legally give me, and it didn't help. Finally they transfered me to a large hospital in Omaha. A doctor gave me a ride in his SUV, all 40 miles, and I remember every crack in the road.

I promised myself that while I was in that small country hospital that I would learn how to fly if I ever recovered. I kept the promise!
 
Not sure about the rest of you but in reading this thread I downed 20 oz of water and am headed for a refill. Hope you are better soon Nick!
 
I am currently waiting on the FAA to send me a letter concerning my kidneystones. I am a student pilot with 15 hours and was looking forward to my first solo. From the sounds of things that may have been put on hold for awhile. I had a ct scan and blood work and a small stone was discovered. It's been 3 weeks since my AME sent the information to the FAA and I have been checking the mail with anticipation everyday. I called them and the lady said my medical is up for review which I take it that really doesn't mean much. Guess my solo will have to wait
 
Keep calling - a couple of times a week. It's about the only way to move it up in the pile.
 
Thank you, I will call everyday if I have to... It's very frustrating but after finding this forum I see I'm not alone with this kidney stone issue
 
N6958H said:
Thank you, I will call everyday if I have to... It's very frustrating but after finding this forum I see I'm not alone with this kidney stone issue
Click to expand...
I think non-consecutive days works best, don't want to get on their bad side.

There is an AME here, one of the good guys, who might chime in to explain what's happening with the system.

PS - I had a kidney stone attack, the day after my PP checkride.
 
N6958H said:
I am currently waiting on the FAA to send me a letter concerning my kidneystones. I am a student pilot with 15 hours and was looking forward to my first solo. From the sounds of things that may have been put on hold for awhile. I had a ct scan and blood work and a small stone was discovered. It's been 3 weeks since my AME sent the information to the FAA and I have been checking the mail with anticipation everyday. I called them and the lady said my medical is up for review which I take it that really doesn't mean much. Guess my solo will have to wait
Click to expand...

So the stone is still in there? What were the scans for? Were you looking for stones? If the stone has been passed (and you're confirmed stone free) you can fly all you want.
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top