Kidney Stones

[Castorero]

There has been more than the odd discussion regarding kidney stones on this forum over time, which points to the sad reality that Kidney Stones are more common than we would like.
No point in reiterating what has already been discussed ad nauseam, usually re Stones and your ability to get back in the air.

I want to veer off in a slightly different direction here and dispel the common belief that once a Kidney Stone, always a kidney stone. In most cases, yes, but not always unfortunately.

What I am getting at is best illustrated by a very real story that took place a few years ago.

" One very hot Summer, a busy river fishing guide showed up with typical kidney stone pain, some microscopic blood in the urine etc. " Well, he was dehydrated most days , standing and walking in pristine clear water without ever getting his lips wet. After all, fish do their thing in that water, right?

This was in the day before the advent of an Ultrasound, or CT scan, but an Xray taken after an intravenous injection of a contrast dye was often useful in finding a stone somewhere in the urinary tract, if one was present.
Needless to say he did have a good sized stone stuck in a ureter, and off he went to see the urologist to have it removed.

A year later he showed up again, this time in the office, not the ER, with similar complaints as the year before. He was busy fish guiding and needed to get back to it, so all he wanted was some morphine to relieve the pain and help the stone to move along on its own without having to waste time to go to the hospital etc.
Having been a student of the Famed Peter Banks, who often praised the importance of looking at the urine under a microscope, in the office, Sure enough there was blood in the urine, and likely a stone somewhere in the urinary track.

Unfortunately for him, he did not get any morphine but was told he had blood in the urine, Ya, just like last year, he said.
Yes, but it was blood in the urine that needed all the investigation of blood in the urine, whether he liked it or not.
The usual tests failed to reveal the presence of stones anywhere, which is not that uncommon.

Off to the urologist, to undergo more invasive testing, which showed an early tumor in the upper kidney. He lost half of his kidney and then went on to die 25 yrs later of a ripe old age.

I am telling this story because most people will cling to the once a stone, always a stone dictum, including some doctors unfortunately. So my suggestion is that if you have a history of stones and a recurrence of symptoms like that of previous stones, but no stones are found, make sure you get investigated for other causes as well.

Sadly this happened to a young aquaintance of mine, with a similar history of stones etc not fully investigated, who died in his youthful forties from a kidney cancer that spread to his spine and was untreatable.

I know how much pilots, myself included, love going to the doctor and like to share their history ...