Wednesday, March 21, 2012

Scarlett's Kidney Workup

Yesterday was Scarlett's scheduled kidney workup at Methodist Hospital. Cody and I were SO nervous for her knowing what we were about to put her through.  I feel like God planned the timing of my last clinical rotation at Urology San Antonio so that I knew exactly what was happening with Scarlett. I mean what are the odds that I just observed these same procedures last quarter and then had to observe my own daughter go through it?!

We checked into the pediatric radiology unit and were thankful to not have to wait very long. First she had to do the VCUG where they insert a catheter and then inject contrast into her bladder to watch the flow of urine with a series of x-rays. The radiologist and RN were wonderful and said they would tell us immediately if something was wrong and then call our pediatrician so we could discuss it. 

They made her wear a hospital gown

She explained to us that they would do the procedure twice because sometimes kids don't reflux on the 1st attempt but will on the 2nd. And that is exactly what happened to Scarlett. She did not reflux on the 1st attempt but did on the 2nd. 

Vesicoureteral Reflux

You can see the bladder full of contrast (the big dark circle) and then the urine "refluxing" back up to the kidney. Scarlett did this on both sides. The right side had very minimal reflux and the left side was much more dramatic. The radiologist stated it was grade 2 and that less than 5% of children with grade 2 or less require surgery. However, when I spoke with our pediatrician she said that based on the written report (she hasn't seen the images yet) that is sounded like at least a grade 3. We will see what she says once she sees the images.

Then Scarlett had her renal ultrasound to make sure she had 2 kidneys that were the right size. This part was less invasive but she still cried because she didn't want to be touched at that point. I ended up nursing her while they did the ultrasound to calm her down. The results from the ultrasound were perfect.

The radiologist called my pediatrician with us standing right there and gave her the results. Our pediatrician asked to speak to me and discussed the next steps. Scarlett has to begin prophylactic antibiotic (Bactrim) daily to prevent UTIs. She will have to have this test repeated in 6 months. The hope is that she "outgrows" it as her body gets longer and stretches out the ureters. If there is ever a sign that it is getting worse, we will have to discuss surgery. 

We were also informed by the radiologist that siblings under the age of 5 should be tested as well. This really bothers Cody and I because we can't imagine putting two more girls through this procedure and how do you even explain it to a 3 year old who comprehends?! Our pediatrician agrees and is ok with our decision to wait until one of them gets a UTI before testing them. She said we could begin with the ultrasound to be less invasive and would be able to see any kind of kidney damage at their age. Cody and I think the girls are fine as they have not had any past UTIs.

Praying she outgrows this and that our other girls don't have the reflux as well!

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