Gall Stones
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Gall Stones
Hi, Can someone could help and provide advice. Thanks in advance.
I went to my GPs recently, and to cut a long story short the GP requested an Ultra sound. The results were no problems found but they have found a number of small kidney stones. The specialist yesterday recommended keyhole surgery to remove my gall bladder.
I have looked at the medical section on the CAA but Il a bit confused. Can anyone tell me what I need to do and how I recover my Class 1 medical after (if i can) as I want to continue flying as a flying instructor and eventually join an airline.
Will this operation stop all my flying?
I went to my GPs recently, and to cut a long story short the GP requested an Ultra sound. The results were no problems found but they have found a number of small kidney stones. The specialist yesterday recommended keyhole surgery to remove my gall bladder.
I have looked at the medical section on the CAA but Il a bit confused. Can anyone tell me what I need to do and how I recover my Class 1 medical after (if i can) as I want to continue flying as a flying instructor and eventually join an airline.
Will this operation stop all my flying?
Psychophysiological entity
I had one of the early keyhole operations for gall stone. They removed a stone the size of a small chicken egg and the bag out of a hole under my belly-button. There were three more holes for camera, tubes and- at a guess- inflation gas.
I was walking around in the foyer of the Oaks at Colchester within 36 hours. BUT - and yes, I'm shouting - I'd let it get bad before doing anything, and a couple of weeks before the op I was rushed to hospital as a blue light job. I felt like I'd got a spear in my belly that was coming out between my shoulder blades. I didn't know pain could reach those levels. I was stabilized with nothing but a drip and morphine for 3 days then sent home to wait for the surgery.
So, yes, get the bladder out of the way, you're so much better off without it.
Flying? No problem for me. Sensibly, about a month to make sure everything has settled down, but you'll have to see what the folks in the grey cube think. I had a class one for 15 years after that.
I was walking around in the foyer of the Oaks at Colchester within 36 hours. BUT - and yes, I'm shouting - I'd let it get bad before doing anything, and a couple of weeks before the op I was rushed to hospital as a blue light job. I felt like I'd got a spear in my belly that was coming out between my shoulder blades. I didn't know pain could reach those levels. I was stabilized with nothing but a drip and morphine for 3 days then sent home to wait for the surgery.
So, yes, get the bladder out of the way, you're so much better off without it.
Flying? No problem for me. Sensibly, about a month to make sure everything has settled down, but you'll have to see what the folks in the grey cube think. I had a class one for 15 years after that.
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20% of the population have gallstones and they don't even know they have them. A symptomatic g/s are recommended to stay in situ. AMO may put a multi crew only stamp on your Licence.
If they are acting up, get them whipped out....8 weeks off I think
If they are acting up, get them whipped out....8 weeks off I think
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Even if you've never had an attack of gallbladder trouble, a bunch of small gallstones is more of a problem than one or two big ones. They can lodge in the duct running from gallbladder to intestine (common bile duct), and then you have an acute problem, and treatment and/or surgery is more complicated. Could potentially incapacitate you while flying.
Big stones, not so much -- more time to discuss and decide.
So current advice for multiple small stones, even if no symptoms, is laparoscopic cholecystectomy (that keyhole bit). It's a pretty routine procedure nowadays, and I doubt that it would affect flying, once recovered. (I am not, however, an AME!)
Big stones, not so much -- more time to discuss and decide.
So current advice for multiple small stones, even if no symptoms, is laparoscopic cholecystectomy (that keyhole bit). It's a pretty routine procedure nowadays, and I doubt that it would affect flying, once recovered. (I am not, however, an AME!)
Psychophysiological entity
I smashed things in my bedroom as I reeled around with the pain. I'd taken 6 pethidine tablets during the night, given to me by a doctor who came to the house twice. He diagnosed a spasm of my sphincter. 
in fact, double
I was in a temporary okay state as I walked to the ambulance, but got bad on the 20 mile drive. They gave me some gas which made me drowsy.
I can remember being put on a gurney - for some reason in a kneeling position - must have done that myself - and then saying I felt sick. Someone bought a little cardboard hat-shaped thing, capacity, one tea cup at most. I emptied what looked like a gallon of bile onto the gurney and then slumped into it blissfully free of pain.
After thee days I was okay to go home. I'd lost 20 lbs. I was told 8 weeks for the operation.
I was commuting to Texas month-about-month then, and a surgeon phoned me from his car and said he was worried about me traveling. He'd do it privately in the Oaks in a week or so. I agreed. Twice they moved it forward, until I found myself packing for the next day. He'd got a team organized for a Saturday.
The anesthetist came in wearing a Canadian style shirt and everyone looked kind of relaxed. When the gall bag was removed, they told me it was covered in black patches. (that'll teach me not to act on early symptoms) I gather he had a lot to say to the night doctor and my GP. They were both kind of sheepish about it all. My GP blaming the 50 year in practice visiting GP cos of his experience. I made no criticism at all.
There was one big stone, and it undoubtedly blocked the duct or even the whole area near the outlet. What is significant is that it probably could have been coaxed out of the way by manipulation.
What is certain, anyone with an inflamed gall bag and a stone would have to be restrained on an aircraft, given the amount of the strong drug I'd taken still left me reeling about.
Slightest hint, get it diagnosed with absolute certainty. Multi-crewing? sheesh, they're working from books, no one who's really known that pain would want them on an airfield, let alone an aircraft.
Oh, BTW. I was an otherwise very fit 50 year old. Aggressive sports where I got a fair share of pain. Different league.
Another BTW. When I cut the stone in two, it was like rust on the outer layer, but inside, large white crystals were all pointing towards the centre. I felt disinclined to keep it for long.
in fact, double I was in a temporary okay state as I walked to the ambulance, but got bad on the 20 mile drive. They gave me some gas which made me drowsy.
I can remember being put on a gurney - for some reason in a kneeling position - must have done that myself - and then saying I felt sick. Someone bought a little cardboard hat-shaped thing, capacity, one tea cup at most. I emptied what looked like a gallon of bile onto the gurney and then slumped into it blissfully free of pain.
After thee days I was okay to go home. I'd lost 20 lbs. I was told 8 weeks for the operation.
I was commuting to Texas month-about-month then, and a surgeon phoned me from his car and said he was worried about me traveling. He'd do it privately in the Oaks in a week or so. I agreed. Twice they moved it forward, until I found myself packing for the next day. He'd got a team organized for a Saturday.
The anesthetist came in wearing a Canadian style shirt and everyone looked kind of relaxed. When the gall bag was removed, they told me it was covered in black patches. (that'll teach me not to act on early symptoms) I gather he had a lot to say to the night doctor and my GP. They were both kind of sheepish about it all. My GP blaming the 50 year in practice visiting GP cos of his experience. I made no criticism at all.
There was one big stone, and it undoubtedly blocked the duct or even the whole area near the outlet. What is significant is that it probably could have been coaxed out of the way by manipulation.
What is certain, anyone with an inflamed gall bag and a stone would have to be restrained on an aircraft, given the amount of the strong drug I'd taken still left me reeling about.
Slightest hint, get it diagnosed with absolute certainty. Multi-crewing? sheesh, they're working from books, no one who's really known that pain would want them on an airfield, let alone an aircraft.
Oh, BTW. I was an otherwise very fit 50 year old. Aggressive sports where I got a fair share of pain. Different league.
Another BTW. When I cut the stone in two, it was like rust on the outer layer, but inside, large white crystals were all pointing towards the centre. I felt disinclined to keep it for long.
Even if you've never had an attack of gallbladder trouble, a bunch of small gallstones is more of a problem than one or two big ones. They can lodge in the duct running from gallbladder to intestine (common bile duct),
However, it all went wrong as the stone was too hard and damaged the 'crusher'. SWMBO received a call to get to the hospital immediately to sign the approval for me to have an op to remove the stones as they were now life-threatening. I finished up with a large scar under the ribs, a drain in my stomach and severe jaundice. Several weeks of antibiotics while in hospital, and a few more weeks at home with the drain saw me feeling pretty good. Went to the surgeon (not the one who went on holidays, the one who actually did the job) to have the drain removed, and collapsed in agony as soon as he did so. Back to hospital by ambulance - removing the drain had released a large infection - for another 3 weeks. By the end of this I felt well, and have never had any problems or limitation on diet. However, SWMBO and D2 have both also had gallstones, and now cannot face rich foods. Both their ops were keyhole surgery as described by LR, without any problems.
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Hi. Thanks for the replies and stories! No pain from them and the original reason for ultra sound was looking into what was thought to be an infection or more serious in the kidney/ bladder area which has long gone with some pills.
Just leaving the question about the gall stones. It seems sensible to get the key hole surgery done and seems doable to get medical back after(?). But it would hopefully still give me single crew to retain sep instruction.
Just leaving the question about the gall stones. It seems sensible to get the key hole surgery done and seems doable to get medical back after(?). But it would hopefully still give me single crew to retain sep instruction.
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Chinese Medicine: This Works!
There are many Chinese in this world. Having worked in Asia for a number of years, I've known a number of colleagues who have succumb to Gall Stones.
So, one of my friends went to the friendly Chinese herbalist and put him on an apple/apple juice diet.
I've known two people who have used this treatment. They are STONE FREE...no surgery...no drugs. Here is a link to a remedy. There are several and they are all basically the same. Good luck!
Apple Juice Remedy for Gallstones | eHow.co.uk
So, one of my friends went to the friendly Chinese herbalist and put him on an apple/apple juice diet.
I've known two people who have used this treatment. They are STONE FREE...no surgery...no drugs. Here is a link to a remedy. There are several and they are all basically the same. Good luck!
Apple Juice Remedy for Gallstones | eHow.co.uk
Psychophysiological entity
Keep your cholesterol under control. Excess cholesterol clumps together to form gallstones.
I presume your two friends have a picture of the stone on ultrasound before and a picture with no stone on ultrasound after
Unfortunately some stones get passed diet or no diet. Put 1000 patients on this diet and I doubt the surgeons will be out of a job
If the NHS could avoid such a common operation which costs such a relatively large amount of money by a bottle of apple juice........
Never mind
Unfortunately some stones get passed diet or no diet. Put 1000 patients on this diet and I doubt the surgeons will be out of a job
If the NHS could avoid such a common operation which costs such a relatively large amount of money by a bottle of apple juice........
Never mind
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Agree with bearcat - 10-20% of population at any one time will have gall stones.
But, even if you are asymptomatic JAA will require you to have the key hole operation (as they are small and thus pose a risk to in flight incapacitation). WRT how much time off - I'm unfamiliar with the CAA, but JAA say up-to 3 months - although this can be at the discretion of the medical examiner. If they are open to negotiation - point out: key hole surgery & they will have used CO2 for the surgery and thus would probably be fit to fly in reality within a month .... but whether the CAA will see it that way or not .. who knows.
We clear pax to fly within 10 days!
But, even if you are asymptomatic JAA will require you to have the key hole operation (as they are small and thus pose a risk to in flight incapacitation). WRT how much time off - I'm unfamiliar with the CAA, but JAA say up-to 3 months - although this can be at the discretion of the medical examiner. If they are open to negotiation - point out: key hole surgery & they will have used CO2 for the surgery and thus would probably be fit to fly in reality within a month .... but whether the CAA will see it that way or not .. who knows.
We clear pax to fly within 10 days!
UK CAA.
Back in 1995 I was diagnosed as having numerous "small" gallstones. My symptoms had been incredible pain under my ribcage lasting almost exactly 4 hours.
Before I went for keyhole surgery the company doctor secured me 4 weeks leave in case I was one of the minority of people out there with a prolapsed gallbladder in which case major surgery would have been required. I had the surgery (keyhole) as an outpatient, walked out of the hospital that evening, and could have been back at work within a week. As it was i took the 4 weeks as it was over Christmas!
Post op. the most painful thing was an incredible ache in my right shoulder, apparently a by product of having your abdomen extended by CO2 gas, which presses on a nerve when you are subsequently deflated.
Small gall stones are the problem as they can pass done the bile duct, causing the pain. Large stones are to big to fit into the bile duct and will just remain in your gall bladder, and you may never know that they are there.
As ever seek professional advice.
Back in 1995 I was diagnosed as having numerous "small" gallstones. My symptoms had been incredible pain under my ribcage lasting almost exactly 4 hours.
Before I went for keyhole surgery the company doctor secured me 4 weeks leave in case I was one of the minority of people out there with a prolapsed gallbladder in which case major surgery would have been required. I had the surgery (keyhole) as an outpatient, walked out of the hospital that evening, and could have been back at work within a week. As it was i took the 4 weeks as it was over Christmas!
Post op. the most painful thing was an incredible ache in my right shoulder, apparently a by product of having your abdomen extended by CO2 gas, which presses on a nerve when you are subsequently deflated.
Small gall stones are the problem as they can pass done the bile duct, causing the pain. Large stones are to big to fit into the bile duct and will just remain in your gall bladder, and you may never know that they are there.
As ever seek professional advice.
But, even if you are asymptomatic JAA will require you to have the key hole operation (as they are small and thus pose a risk to in flight incapacitation).
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yes - sounds ridiculous! Who makes up these rules anyway?!
Thought I'd just check the stats though:
In the UK it has been estimated from autopsy studies that approximately 12% of men and 24% of women of all ages have gallstones present.(1) The prevalence in North America is comparable to that in the UK, and it is believed that 10–30% of gallstones become symptomatic.
(1) Garden, O. James. Hepatobiliary and Pancreatic Surgery: A Companion to Specialist Surgical Practice, 4th Edition. W.B. Saunders Company, 112009. <vbk:978-0-7020-3014-7#outline(10.1)>.
Thought I'd just check the stats though:
In the UK it has been estimated from autopsy studies that approximately 12% of men and 24% of women of all ages have gallstones present.(1) The prevalence in North America is comparable to that in the UK, and it is believed that 10–30% of gallstones become symptomatic.
(1) Garden, O. James. Hepatobiliary and Pancreatic Surgery: A Companion to Specialist Surgical Practice, 4th Edition. W.B. Saunders Company, 112009. <vbk:978-0-7020-3014-7#outline(10.1)>.
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Passed......
The stones are passed through the colon and into the stool. In these cases, small with a green hue. Want any more details. These people were told to have surgery and in one case, the doctor was quite adamant that she appear for the surgery.
A year later, both of these people are 'stone free'.
Believe the Chinese and their medicine....it works.
A year later, both of these people are 'stone free'.
Believe the Chinese and their medicine....it works.
80-87
You have just blown your argument
It is normal for small stones to pass into the guts and be eliminated. Nothing to do with apple juice, just a simple mechanical matter. Every time you eat the gall bladder 'contracts' and excretes bile - that is what it is for. And if the stone is small enough and in the right position and free out it goes.
The problem is when the stone gets stuck blocking the duct from the gall bladder to the gut. The gall bladder still contracts, the pressure goes up, and you get pain.
So what does the apple jouce do - scientific answers with evidence please, not anecdotal response.
Interestingly I can't find a single case of a pilot being forced to have surgery by a regulator. That doesn't mean the odd person didn't have surgery and I am sure there are some surgeons out there who are a bit knife happy and desperate to operate on anyone, but the operation is not risk free. Anthony Eden almost died from it albeit the non keyhole method. We not infrequently get patients with complications who have to go through years of corrective surgery and couldn't possibly fly.
So if you have asymptomatic gall stones, the usual advice applies: ensure you see a surgeon who does lots of these operations. See a surgeon your GP says is an expert ( as opposed to the surgeon saying it himself!!!), and if necessary get two opinions.
Neither of them from Pprune
You have just blown your argument
It is normal for small stones to pass into the guts and be eliminated. Nothing to do with apple juice, just a simple mechanical matter. Every time you eat the gall bladder 'contracts' and excretes bile - that is what it is for. And if the stone is small enough and in the right position and free out it goes.
The problem is when the stone gets stuck blocking the duct from the gall bladder to the gut. The gall bladder still contracts, the pressure goes up, and you get pain.
So what does the apple jouce do - scientific answers with evidence please, not anecdotal response.
Interestingly I can't find a single case of a pilot being forced to have surgery by a regulator. That doesn't mean the odd person didn't have surgery and I am sure there are some surgeons out there who are a bit knife happy and desperate to operate on anyone, but the operation is not risk free. Anthony Eden almost died from it albeit the non keyhole method. We not infrequently get patients with complications who have to go through years of corrective surgery and couldn't possibly fly.
So if you have asymptomatic gall stones, the usual advice applies: ensure you see a surgeon who does lots of these operations. See a surgeon your GP says is an expert ( as opposed to the surgeon saying it himself!!!), and if necessary get two opinions.
Neither of them from Pprune