Went to see the AME on Fri for an initial issuance, or hope there of, of a Class II and student pilot certificate. All went pretty well except the part of my having had a couple of kidney stones back in the spring of 09'. The treatment for the kidney stones I received was the norm, a lithotripsy, a non-invasive acoustic shock wave treatment to break up said stones. The blockage was a couple of stones stuck in the tube that goes from the kidney to the bladder. The procedure and recovery was uneventful. They did tell me I had a small stone still in one kidney that was not causing any problems and that it was better to leave it undisturbed for fear of causing any problems by messing with it.

Back to the AME. He said he'd have to defer to the AMCD or Region for initial approval. Ok, I said to myself, so I then went by Virginia Urology Center and signed a release for the AME to get the ball rolling; ie, procedure records and a letter stating my condition of no blockage of problems since then.

Is this something I will be disqualified for or am I fretting for nothing?

Thanks in advance for all comments and most opinions.
Kenny

Might ask over at Supercub.org aero medical forum thread.

> He said he'd have to defer to the AMCD or Region for initial approval. ...
> Is this something I will be disqualified for or am I fretting for nothing?

Deferring to region is better than deferring to AMCD in Oklahoma City. A friend with sleep apnea (retired airline pilot, well treated, no issues) got his special issuance after only waiting a month for Los Angeles to "review" his paperwork.

The initial issuance can't be done by the AME. I've been told that after the initial special issuance, the review process can shift from Oklahoma City to regional to local AME depending on the review and that after some rounds of special issuance, the process may revert back to the standard exam process.

I've been waiting since the first week of January for my special issuance, (in remission, no drugs, no detectable symptoms ...) after my AME told me it would be 2 to 4 weeks. (AOPA said more like 2 to 4 months.) Three people I have talked to have received theirs in 6 months (heart), 10 (brain injury with multiple rounds of misfiled paperwork) and 11 (heart with paperwork erroneous doctor notes) months.

So, yes, you will eventually get it. Supposedly only 0.2% get permanently denied but a much higher percentage get disgusted at the wait and give up (suspect statistics from a web site that supposedly makes sure you don't make mistakes on the application).

rjb,

Thank you for some useful and encouraging info. The waiting process may be a little more bearable now with a positive outcome on the horizon.

Best wishes in your issuance and good health.

Thanks again,

Kenny

Kenny,
With kidney stones, one episode is not a show stopper if you have normal lab studies related to kidney function and you have no retained stones. If someone has a history of a single stone, they will need to demonstrate normal labs and at least an x-ray to prove they have no further stones. An x-ray may be your preference as it will only show stones of clinical significance, whereas a CT will show even minute particles of calcification in the kidneys which will still be called "stones".

If you have more than one episode or have a retained stone, your first medical will be deferred for a special issuance. The good news is that subsequent exams will likely fall under AME assisted special issuance. Meaning if you meet the criteria on your next go around, the AME can reissue the certification on the spot. Much easier than most cardiac issues. Below is the section from the AME Guide pertaining to kidney stones. Note the "FAA physician" is not your local AME.

Special Issuances
AME Assisted - All Classes - Renal Calculi
AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations
(14 CFR) part 67.

An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the above disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.

Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
An Authorization granted by the FAA;
A statement from your treating physician regarding the location of the retained stone(s), estimation as to size of stone, and likelihood of becoming symptomatic; and
A current report of appropriate imaging study (IVP, KUB, Ultrasound, or Spiral CT Scan) and provide a metabolic work-up, both performed within last 90 days.

The Examiner must defer to the AMCD or Region if:
If the treating physician comments that the current stone has a likelihood of becoming symptomatic;
If the retained stone(s) has moved when compared to previous evaluations; or
If the stone(s) has become larger when compared to previous evaluations.

A pilot friend of mine read all of this and said: "This is a gigantic waste of time, energy and taxpayer money. " He is a good friend but he is rather critical.

I have spoken to a few urolgists that have dealt with kidney stones and pilot medicals. They emphasize x-ray and not MRI or CT scans for diagnosis. If you are told you need to be checked for stones insist on dye study, unless you are allergic to iodine dyes. I was told of one airline pilot who couldn't fly for almost a year because his initial study was a CT scan and that had to show up completely clear before the FAA would renew his medical.
Mark