Single large gall stone acceptable for Class 1?
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Single large gall stone acceptable for Class 1?
Wonder if anyone can help here?
The JAA Manual of Civil Aviation Medicine states the following :
"Billiary calculi : a single, large, assymptomatic gall stone wich has been discovered by chance may be acceptable".
I´m a PPL(A) who is going to have his first Class 1 medical very soon BTW (hoping to do a fATPL).
So, i have a single 7 mm gall stone, discovered by chance while checking for kidney stones, as i had a 2 mm kidney stone a year ago (very small, but still very unpleasant...). Checked back then, after that episode, and had no more kidney stones, and again this week, confirmed kidney stone free.
What i´m getting at, what are the odds i won´t be given an unrestricted Class 1 based on the single 7 mm gall stone?
I´m very likely gonna have the thing removed (depending on my medical insurance covering the procedure, wich they´ve said depends on the medical report..., and if it doen´t, how much it´ll set my highly stretched finances back...), but what do you think i can expect at the Class 1 exams when i show them the report for the kidneys and gallbladder?
Thanks in advance
The JAA Manual of Civil Aviation Medicine states the following :
"Billiary calculi : a single, large, assymptomatic gall stone wich has been discovered by chance may be acceptable".
I´m a PPL(A) who is going to have his first Class 1 medical very soon BTW (hoping to do a fATPL).
So, i have a single 7 mm gall stone, discovered by chance while checking for kidney stones, as i had a 2 mm kidney stone a year ago (very small, but still very unpleasant...). Checked back then, after that episode, and had no more kidney stones, and again this week, confirmed kidney stone free.
What i´m getting at, what are the odds i won´t be given an unrestricted Class 1 based on the single 7 mm gall stone?
I´m very likely gonna have the thing removed (depending on my medical insurance covering the procedure, wich they´ve said depends on the medical report..., and if it doen´t, how much it´ll set my highly stretched finances back...), but what do you think i can expect at the Class 1 exams when i show them the report for the kidneys and gallbladder?
Thanks in advance
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I can't speak to the issue of your flight status.
However, 7mm is not that big for a gallstone. It's small enough that it could get stuck in the plumbing leading out of the gallbladder. That would make a relatively simple condition more complicated, or even become an emergency.
Seek the advice of a surgeon.
_______
Graham MD
However, 7mm is not that big for a gallstone. It's small enough that it could get stuck in the plumbing leading out of the gallbladder. That would make a relatively simple condition more complicated, or even become an emergency.
Seek the advice of a surgeon.
_______
Graham MD
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I can't say what the CAA might make of granting you an unrestricted Class 1, knowing you have a 7mm stone, but if it helps, I have very recently had my gall bladder removed by laproscopy (keyhole surgery). After several bouts of severe abdominal pain (2 episodes in flight), I had an MRI scan which showed 3 stones, the largest was 9mm. The opinion of my consultant and the surgeon, was that removal was the best option. Recovery was quick - just a few days of feeling lethargic (the Olympics were on TV!) and some localised bruising. No restrictions on diet and I feel that if I was to reapply for a Class 1, the CAA would probably be agreeable, with a report from my own Doctor.
PM me for further if you want.
PM me for further if you want.
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Thank you for your replies.
I thought 7 mm was a large stone. Seems not. Hope it doesn´t move till i get the chance to have the whole thing taken out (since deciding to go for the fATPL i´ve been taking real good care of myself, so i hope that helps it stay assymptomatic).
I thought 7 mm was a large stone. Seems not. Hope it doesn´t move till i get the chance to have the whole thing taken out (since deciding to go for the fATPL i´ve been taking real good care of myself, so i hope that helps it stay assymptomatic).
Psychophysiological entity
I had a gall stone the size of a small chicken egg. They still managed to get it out through a minute hole...along with the bag. I was one of the first to have it done that way.
I can't tell you how ill I was with that, but imagine, having taken enough Pethidine to quiet a village, yet it still felt like someone was jumping on my chest and thrusting a spear under my rib cage and out my back. Blue light job, once they could agree on the cause. Don't miss the gall bag at all.
Search Loose rivets and 'gall stones' 'at any time'...I've said quite a bit about it in the past.
I can't tell you how ill I was with that, but imagine, having taken enough Pethidine to quiet a village, yet it still felt like someone was jumping on my chest and thrusting a spear under my rib cage and out my back. Blue light job, once they could agree on the cause. Don't miss the gall bag at all.
Search Loose rivets and 'gall stones' 'at any time'...I've said quite a bit about it in the past.
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Loose rivets, thank you. I had already read most of the stuff written here about gall stones, but since i understood in your case it was the gall bladder that became inflamed, not that the stone got stuck somewhere after exitting it, and since your stone was positively huge, i thought our problems weren´t exactly the same.
I was under the impression that my 7 mm stone could not get out of the gall bladder and get stuck somewhere where it could cause blockage. Neither did i think it was big enough to cause the gall bladder problems. Wishfull (and uninformed) thinking, i gess...
Anyway, as of today, i have never had any real problem with it, though i agree there´s no way you can take the risk of flying any passengers if there´s even a remote chance that you´ll have a crisis like that, and thus i´m definitely planning on having the op, though there´s still the small matter (made a big matter by approaching fATPL course fees...) of wether my medical insurance will cover it.
Funny thing, i´ve done some aerobatics this year (G forces ranging form +6.5 to -3) and the stone never made itself present, contrary to the 2 mm kidney one, wich got on it´s way the night after my first aerobatic flight, last year.
I was under the impression that my 7 mm stone could not get out of the gall bladder and get stuck somewhere where it could cause blockage. Neither did i think it was big enough to cause the gall bladder problems. Wishfull (and uninformed) thinking, i gess...
Anyway, as of today, i have never had any real problem with it, though i agree there´s no way you can take the risk of flying any passengers if there´s even a remote chance that you´ll have a crisis like that, and thus i´m definitely planning on having the op, though there´s still the small matter (made a big matter by approaching fATPL course fees...) of wether my medical insurance will cover it.
Funny thing, i´ve done some aerobatics this year (G forces ranging form +6.5 to -3) and the stone never made itself present, contrary to the 2 mm kidney one, wich got on it´s way the night after my first aerobatic flight, last year.
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Single large gall stone acceptable for Class1
Hello GSXR1K,
I´m a radiologist in Switzerland. 7 mm is not a big gallstone. Anyway, I would reccommend to wait and see, because we usually find a lot of gallstone when doing ultrasound. When it becomes symptomatic, in 1-80 years, even mild, for instance, getting pain after eating fatty things (like Swss chees fondue...) it´s time to call for the surgeon.
hope that helps
bravolim553
I´m a radiologist in Switzerland. 7 mm is not a big gallstone. Anyway, I would reccommend to wait and see, because we usually find a lot of gallstone when doing ultrasound. When it becomes symptomatic, in 1-80 years, even mild, for instance, getting pain after eating fatty things (like Swss chees fondue...) it´s time to call for the surgeon.
hope that helps
bravolim553
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Gallstones & frequent flying
Hi - I am not a pilot but i have to fly 50 + times a year .
Don't know if this might help you but i was diagnosed with having gallstones in 2002 after numerous bouts of gastro / chest pain .
I was due to have an operation to remove my gallbladder in august 2002 but because the Gallbladder was infected i was put on a course of Antibiotics and my operation was re-booked for late September .
I informed the registrar that i had a number of european flights booked and was travelling to New York mid September and i was concerned as this was a longer flight than normal if it could have any effect on my ability to fly . I was told No .
This was in fact incorrect advice and i was actually very ill during my 5 day business trip to New York and when i landed in the Uk had to be taken to my local accident & emergency . I had an emergency operation to remove my gall bladder .
My consultant was not a happy chap and the registrar was reprimanded .
Apparently under the pressure within the confines of an aircraft your organs can actually swell / enlarge and a small stone from my Gallbladder had actually blocked the bile duct after the entrance/exit had widened .
I was very lucky because after 5 days & 2 long haul flights my gall bladder was very badly infected and in my consultants words was " fit to burst " it was that big it had to be drained before they could operate .Had it have burst i would have been in deep trouble .
I was also told that as this was a pre-diagnosed illness my insurance would have been nil and void especially had i taken ill in the US . A frightening prospect .
Now my wife has a sneaky suspicion that my consultant had in effect been negligent anyway and that the flying issue's where over exagerated but i thought that my experience may help you make a descision about what to do .
As a pilot you are flying every week and even a small stone can become an issue .
hope you get sorted
Don't know if this might help you but i was diagnosed with having gallstones in 2002 after numerous bouts of gastro / chest pain .
I was due to have an operation to remove my gallbladder in august 2002 but because the Gallbladder was infected i was put on a course of Antibiotics and my operation was re-booked for late September .
I informed the registrar that i had a number of european flights booked and was travelling to New York mid September and i was concerned as this was a longer flight than normal if it could have any effect on my ability to fly . I was told No .
This was in fact incorrect advice and i was actually very ill during my 5 day business trip to New York and when i landed in the Uk had to be taken to my local accident & emergency . I had an emergency operation to remove my gall bladder .
My consultant was not a happy chap and the registrar was reprimanded .
Apparently under the pressure within the confines of an aircraft your organs can actually swell / enlarge and a small stone from my Gallbladder had actually blocked the bile duct after the entrance/exit had widened .
I was very lucky because after 5 days & 2 long haul flights my gall bladder was very badly infected and in my consultants words was " fit to burst " it was that big it had to be drained before they could operate .Had it have burst i would have been in deep trouble .
I was also told that as this was a pre-diagnosed illness my insurance would have been nil and void especially had i taken ill in the US . A frightening prospect .
Now my wife has a sneaky suspicion that my consultant had in effect been negligent anyway and that the flying issue's where over exagerated but i thought that my experience may help you make a descision about what to do .
As a pilot you are flying every week and even a small stone can become an issue .
hope you get sorted
Plastic PPRuNer
Gallstones are common (10-20% of population) and most are asymptomatic (and remain so).
The American College of Physicians (ACP) has issued guidelines for the treatment of gallstones.
ACP releases guidelines for the treatment of gallstones | American Family Physician | Find Articles at BNET
"Asymptomatic gallstones. Because of a benign history and a low risk for ever incurring a major complication, patients with asymptomatic gallstones should receive expectant management. This recommendation applies to men and women of all ages. The effort and minor risk of surgical and nonsurgical intervention still outweigh their corresponding benefits. Expectant management must suffice for asymptomatic gallstones until a safe, effective, convenient and inexpensive treatment is developed."
The American College of Physicians (ACP) has issued guidelines for the treatment of gallstones.
ACP releases guidelines for the treatment of gallstones | American Family Physician | Find Articles at BNET
"Asymptomatic gallstones. Because of a benign history and a low risk for ever incurring a major complication, patients with asymptomatic gallstones should receive expectant management. This recommendation applies to men and women of all ages. The effort and minor risk of surgical and nonsurgical intervention still outweigh their corresponding benefits. Expectant management must suffice for asymptomatic gallstones until a safe, effective, convenient and inexpensive treatment is developed."
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The CAA seem to follow the letter of the JAR law, or that was certainly the case with me. During an ultrasound the doc found three tiny gall bladder stones floating around inside me. I believe one of these little devils was the cause of a very uncomfortable bout of indigestion (as I thought it was at the time) and, small wonder, Gaviscon never did any good 
Anyway, I haven't had any repeat episodes of the 'indigestion' but, for obvious and good reasons, the CAA got a copy of my ultrasound report. They sent me a letter detailing JAR Ops blah, blah, blah; the long and the short of it being, more than one gall stone = a note from the teacher on one's medical certificate saying 'with or as a copilot' (or somesuch wording). It makes absolutely no difference to an everyday airline pilot but I can appreciate it may to someone who hasn't yet got to that position. And, just to clarify, that was only for Class 1 privileges. Flying around on the PPL makes no difference.
So, it sounds like, even with a 7mm stone, if it's by itself then there should be no restriction placed on your Class 1.
Small print: not written by an AME or someone purporting to be one!
Anyway, I haven't had any repeat episodes of the 'indigestion' but, for obvious and good reasons, the CAA got a copy of my ultrasound report. They sent me a letter detailing JAR Ops blah, blah, blah; the long and the short of it being, more than one gall stone = a note from the teacher on one's medical certificate saying 'with or as a copilot' (or somesuch wording). It makes absolutely no difference to an everyday airline pilot but I can appreciate it may to someone who hasn't yet got to that position. And, just to clarify, that was only for Class 1 privileges. Flying around on the PPL makes no difference.So, it sounds like, even with a 7mm stone, if it's by itself then there should be no restriction placed on your Class 1.
Small print: not written by an AME or someone purporting to be one!
