Tuesday, December 21, 2010

Urology Update

So, this is last weeks news on urology...

Ruth had her DMSA (kidney scan) scheduled at Children's in Dallas. At 7:30 AM. Not sure why I get so lucky to get all these early appointments, but hey - at least it doesn't take my entire day! Traffic is not so friendly that time of day, however.

It was just me and Ruth for this adventure. We parked in the same parking garage we had for the fetal MRI last May. I soon discovered it was not the best place for the Children's hospital, and we ventured across the other Hospitals to find the right one in cold. Ruth was happy and bundled in her car seat, so not a big deal.

We checked in at Admitting, and after paying our copay and getting a bracelet (although I got to wear it, since Ruth still had her casts on), we headed back to radiology. A short wait later, we were brought into the back, where they placed an IV to give Ruth the radioactive dye needed for the scan. (I was assured it was harmless). The nurse did a great job placing the IV, Ruth was more annoyed than upset. They immediately removed the IV. We then got to wait 2 hours for the dye to make it's way to her kidneys, so off to the cafeteria we went. I ate a small breakfast while Ruth napped on my chest. Once our time was up, we headed back for the scan. She was well rested and full, so she was happy when it was her turn on the table. They strapped her down from the chest down (leaving her arms free, thank goodness).

The machine had children's stickers all over it, so the whole 20 minutes or so it took to get the images, she just tried to get at the stickers. It kept her very entertained, no crying.

Tuesday morning, Ruth suddenly started running a high fever, so I took her in to her pediatrician to check for a UTI. The quick dip came back clear, so they also drew blood to see if anything else was going on. She was pretty pitiful, but I was glad it didn't look like another UTI.

Her appointment with her urologist was that afternoon at Scottish Rite. She had a renal ultrasound first, and Ruth wasn't real crazy about this one. Her bladder was VERY FULL for the entire scan, so at the end they had me cath her to empty her bladder so they could get pictures of her bladder empty. (For a child with a supposed OPEN bladder neck.... interesting..)

The appointment with the urologist went well. We got the results from the DMSA scan - which were GREAT!! Her kidneys showed no scarring, and great function. The doctor said that is the money test - if she does good on that test, she is doing good! So that was wonderful news! Although her renal ultrasound from earlier showed some swelling of her right kidney (the same kidney she has grade 4 reflux on). That was somewhat concerning, although the urologist said it may have been because her bladder was so full. So right now, no change in plan for her care. He wants to see her back in 1 month to recheck the swelling on her right kidney.

So, we talked a little about the concern her old urology nurse practitioner from San Francisco had about her care. (They feel she should be on medications and cathing.) He basically said that she can't prove her methods are better, and he can't prove his are better.... yet. But he feels most babies don't need cathing unless they start getting infections that risk damaging the kidneys. He said reflux alone won't damage her kidneys. He said the UTI's she have had so far are not concerning because her fever never got over 101. He said not to worry about low grade fevers. I'm not sure how I feel about all this. All the information I was given when I was pregnant talked about the importance of protecting the kidneys. I worry about regreting this later after damage has been done. However, I do feel confident that this urologist is closely monitoring her. The DMSA looked great. He is closely watching her UTI's (or hopefully lack of them), and frequent renal ultrasounds as well. He did say that if the next renal ultrasound still showed swelling, he would like to repeat the VCUG (the initial test done in SF after she was discharged), to see if something was going on with her bladder.

So, for now, still no cathing or medications. Follow up in 1 month. Please continue to pray for her health.

1 comment:

  1. Glad that things are looking good so far, and I hope they stil are in a month!