Trying to resolve deferred medical Cert

[tradford]

Well, I passed my Class 2 physical, but I had a bout with a kidney stone earlier this year and didn't have sufficient evidence to prove that it was gone. My AME deferred my case, so I immediately went out and secured a CT scan and Urologist report that granted me a clean bill of health. Now I've got to get the report into my file that was deferred about a month ago. It doesn't look like MedExpress is going to be of any help and my AME says that they're out of the loop - that from here on out it's between me and the FAA. Any suggestions as to what my next move should be?

I'm guessing that I need to send a copy of my report to:

Federal Aviation Administration
Aerospace Medical Certification Division / AAM-331
CAMI, Building 13
P.O. Box 25082
Oklahoma City, OK 73125-9867

The FAX number is (405) 954-9326.

 

But that's only a guess.

[Discap]

I am surprised that your AME is not of more help. Ask him for a phone number and call the FAA before you send the reports. Be aware that when you do get your medical back, that it will probably be dated with the date of your AME visit, not the date that the FAA approved it. You will lose a couple of weeks/months.

 

I spent 2017 doing chemo and radiation. My AME handled everything I never spoke with the FAA.

 

Bill

[tradford]

Thanks. At this point, I'll just be glad to get it back. I too was a bit dismayed that they've washed their hands of the issue. My flying buddy just had his physical as well and his AME suggested that I give the paper work to my AME and that they would send it in as a addendum to the file they sent. No go. I'll vector myself in with the numbers listed online.

[avbug]

Several years ago I was in the middle of moving houses, and preparing for an early trip the next morning. Middle of the night, I began vomiting and shortly was in so much pain I couldn't remember my own name. My wife took me to the ER, and ended up with surgery for a kidney stone, and installation of a stent. I contacted the chief pilot who said "good luck, and let me know when you get your medical back."

 

Whaaaaat? It's just a kidney stone.

 

Not a chance. I ended up working through my own AME and a union AME, and it took about three months, three surgeries, and removal of the stent (which turned out to be the worst part).

 

Your AME should have helped you resolve this. Don't ever use that AME again, and make sure you let others know not to use him, too. AME's like that do not deserve the business and should be avoided. Dump him. Like a hot rock.

 

In 2015 the FAA authorized AME's to keep an airman in service even with retained kidney stones so long as the airman can be shown to not be expected to release any more stones. The simple breakdown is that if you had a kidney stone and can show that you it won't be a problem in the future, it's a matter of providing the FAA the documentation, and that should have been handled by your AME. If you have a recurrence of kidney stones, then it triggers a bigger problem; cross this bridge first, and that one when you come to it.

 

There are services that can help.

 

If you're an AOPA member, then member services helps in cases like this, and there's an assistance program for a few dollars a year that helps with medical, legal, and all kinds of things. Well worth it, even if you only use it once.

 

AMAS, Aviation Medical Advisory Service, may be able to help. https://www.aviationmedicine.com. Several pilot unions retain their service.

 

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

 

Pilot Medical Solutions (https://www.leftseat.com) specializes in assisting in cases like this, as well as special-issuance medicals and waivers. You might contact them and see how they can assist.

 

https://www.leftseat.com/faa-medical-certification-nephrology-kidney-function/

[tradford]

Thanks Avbug - and I agree. At first, he talked about scheduling an X-ray so that my certificate could be renewed before it expired in 10 days. He read my CT Scan report and it talked about unrelated issues with my kidney that he didn't understand. Everything was normal. That was a bit alarming in itself. I'll be switching to my buddy's AME.

 

My stone experience was beyond gut-wrenching, but I think it was tame compared to what you went through. I still count my lucky stars as I was holding a ticket for a departure the next morning to Singapore. I can't even imagine how bad that would have been.

 

Thanks,

 

Tony

[avbug]

I'd have never believed that a kidney stone could be so incapacitating. I was scheduled to be in Abuja, Nigeria the next day, and I can't imagine being treated there. A kidney stone is something one might think possible to work through, but looking back at it, I believe it would have been incapacitating in flight. I can see why the FAA takes the position that they do.

 

Several years ago as we preflighted, following a briefing one morning in Nevada, for an active fire, one of the pilots complained of shortness of breath and some pain. First thought was a heart issue, but after talking with him for a few minutes, I suspected kidney stones. We got him to the local clinic; that was their diagnosis. He was sent to Reno, where he passed a large stone.

 

Good chance they'd have had to divert on your flight to Singapore, or you'd have been stuck with that pain and possibly sepsis for the trip, then stuck being treated in a foreign country (which can be it's own adventure).

 

It's good motivation to drink a lot more water. The pilot mentioned above still carries lemon drops and puts them in all his water, and he goes through a lot. He never wants to experience that again, and I can't blame him.

[tradford]

I agree that it's debilitating. I did a mountain bike run earlier in the day and fell off (as I often do) and landed on my side. Minor pain. Later in the day, I was sitting in my home office when all of a sudden, it felt like someone came up behind me and shoved an ice pick in my kidney. I barely made it to the couch covered with sweat and in serious pain. My wife immediately started dialing 911, but I asked her not to - to drive me to the hospital that's not far away. By then, I was throwing up and peeing blood. Mine was a tiny stone of 2mm, but it felt like a sea urchin was ripping its way through my body. I can't even imagine what I would have done if I'd been sitting in a coach seat at 30,000 feet. Freaks me out just to think about it.

[avbug]

Interesting. I'd been to an aikido group with some kids earlier that day, and participated with them. there were several hard falls that I didn't think too much about that the time, but from which I felt off, the rest of the day. Just didn't feel right. In hindsight, I think that the perhaps the kidney stone was turned loose by the jarring, or something occurred to set off the chain of events. I've been a lot more careful about being slammed around since then. My particular stone was large, I forget the size, but big enough to completely block a ureter and cause sepsis.

 

I spoke to an associate a few days ago who had an experience along those lines while he was in Mongolia. He wasn't able to travel, and had to be treated there, with surgery. He didn't think he'd survive, and we had an email from the Chief Pilot to that effect. I ran into him in Miami at a hotel this last month and we chatted. His was the worst experience I'd heard, but I could empathize.

 

I was scheduled to operate the flight; commercial to San Juan, then operate to Cape Verde, then to Abuja. I'd have been unable to function, and aside from the obvious penalties of physical pain and hazard, there's an FAA cost as well; a pilot who is incapacitated in flight can face a long uphill battle that wouldn't be fought if the problem occurred elsewhere. Experiencing a problem that makes one unable to perform flight duties takes it to a new level, so far as the FAA is concerned. Somewhere I don't want to go.

 

For your issues, the FAA should just need the doctor's release, and x-rays. You may be asked to provide additional data such as a 24 hour urine sample, and an analysis of the kidney stone (there are several types and causes: calcium oxalate, uric acid, calcium phosphate, and systine).

 

There are also a number of foods to avoid, depending on the cause of the kidney stone. In my case oxalates. I was told to avoid dark sodas, dark green vegetables, nuts, salt, animal proteins, excess vitamin C, etc. The big thing is to drink a lot of water.

[tradford]

At least my follow-up scans made it into my deferred medical file at FAA. Unfortunately, the shut down has stopped processing activities, so everything is on hold until the feds come up with a compromise. I guess it's not as bad as missing paychecks, but it still sucks!

[tradford]

Still working on getting my medical back. After I sent in my follow up CT Scan results, I received a letter asking for several things that were already included in the original submission. I went back to the doctor this week and asked for a new letter and faxed it in today. It takes 10 days for a fax to make it into my file. When I call for a status update, I'm on hold for half an hour only to find out that very little progress has been made.

[nightsta1ker]

I passed one in 2013 and was on a Speciall Issuance for 3 years. Needed to get a 24 hour urine collection and x-rays as well as written diagnosis from a urologist prior to my annual class 2 physical. Finally after 3 years being stone free, they dropped it. Avbug gave me good advice then too and I appreciate it. I agree with him about that AME. Find another one. Another thing that helped me expedite the reinstatement of my medical was AOPA pilot protection. Worth every penny and literally a phone call away from getting immediate action taken on my file. I got an email with my special issuance 3 days after calling AOPA pilot protection.

[tradford]

That's great advice. I'll re-up my AOPA membership. Thanks.

[tradford]

Yaaaaa! Finally got my medical cert back, 3 1/2 months after being deferred. What a frustrating experience that was and I know it was benign compared to some of the horror stories I've heard. Still, it's great to be 'commercial' again.

[Nearly Retired]

Congratulations, T. That's really good news! Now get out there and fly that f'ing helicopter!