When I was 38 weeks pregnant, I took a tumble down some stairs and ended up needing “trauma monitoring” to ensure that all was still well with Lucas. Luckily things were still on track and there was no trauma to the placenta or the baby. During the exam however, the technician noticed that Lucas’ left kidney was enlarged. Through further review by the doctor they determined that Lucas had hydronephrosis. The doctor assured me that while it was considered to be a severe case, it wasn’t anything to be worried about, but that Lucas would require an ultrasound at two weeks to see if there was any change.
When his follow up
appointment showed that he did in fact still have a severe case, we were
scheduled for testing at Children’s Hospital on October 3rd. This
first round of testing was so the doctor could monitor the flow of his urine
through his kidneys. When we arrived we headed into radiology for the test. The
room was cold and dark with a huge CT scanning machine. The nurse came in and
explained the procedure to us. Lucas was then put into a johnny and laid on the
table. The nursing assistant held him down while the doctor inserted a
catheter. I couldn’t help but sob as I watched my baby squirm and cry in discomfort. There was nothing I could do.
For the next hour I held his hands and whispered in his ear that everything
would be okay. No matter how upset or scared I was, I needed to reassure my son
that all was ok.
After the test was over we met with Dr. Diamond, Lucas’
urologist who informed us that while the urine was traveling through his kidney
there appeared to be a blockage somewhere along the way. He told us that in
most cases these early blockages work themselves out in time with the growth of
the baby. Hydronephrosis is much more common in little boys as their penis can
become kinked in uetero causing a blockage, additionally he told us it could
very well be that he just has a “baggy” kidney and the urine was getting stuck
in the folds. In both cases he would be fine. He went on to tell us that there
could potentially be a large problem, if the blockage was severe enough, if
there was urine reflux back into the kidney or if he was losing functionality.
Given that Lucas was just a month old the doctor wanted to give it another four
weeks to see if any growth would help resolve the problem. We were given a
prescription for amoxicillin to prevent any sort of infection while we waited
for our next follow up.
On November 1st
we went back to Children’s Hospital for more extensive testing. The first test
they performed on him was called a MAG3 test. The inserted a radioactive
isotope into his blood stream through an IV. Watching the nurse try to find a
vein on my son’s tiny little hands was heartbreaking. I couldn’t even watch
when she finally found one and inserted the needle. The isotope can be seen on
a neuclear reading machine. During this fifteen minute portion they watch the
flow of the isotope to determine where the blockage is and how severe it might
be. The results of this determine whether or not his case warrants further
testing. We were assure by the nurse that roughly 95% of these tests come back
requiring more information. Sure enough Lucas needed the next portion. For the
next 45 minutes a substance known as Lasix travels through his system to
his kidneys and basically causes them to contract and force out any remaining
urine. How long it takes for this process to complete shows how severe his case
truly is. When this process was complete we were once again sent to meet with
Dr. Diamond to hear his results.
Dr. Diamond told us we
had good news and bad news. The good news being that so far Lucas’ kidneys are
functioning right near the 50/50 split they are supposed to. His right kidney
has 54% functionality and his left has 46% so at this point there is no worry
about kidney failure. The bad news is the ideal amount of time for a kidney to
empty on Lasix is between 5-10 minutes. Anything over 15 minutes is considered
abnormal and anything over 20 is serious. It took Lucas’ kidney 38 minutes to
empty. Given that result Dr. Diamond told us that more than likely he will need
surgery to remove whatever is causing the blockage. Because he is so little the
rest of his organs haven’t matured to where they should be to safely receive
anesthesia we need to wait another 6 months. During that time Lucas will continue
to be on an antibiotic. At the end of the six months, in May, we will go back
to Children’s again and re-do the
MAG3 and Lasix testing. If, at that time the results are the same, or God
forbid worse; or he’s lost more than
10% of his kidney function we will need to schedule him for surgery. While
there is still a chance he could outgrow it, Dr. Diamond did not seem hopeful
that would be the case. Brian asked him how serious of a surgery it is and we
were told that it’s a “pretty significant” surgery and that it would require an
incision (no lapriscopic option) and a fairly lengthy recovery. The last thing
any mother wants to hear or think about is her baby needing surgery.
While these visits and
tests were traumatic to me (I know to some that may seem over the top) I know
Lucas will never remember them. I also know it could be worse. I can’t tell you
how many families we saw that day with their far sicker children. I thank my
lucky stars that this is all we are dealing with. Over the next six months we
have been instructed to keep our eye on him, to watch for any signs of pain to
the stomach when touched, a fever over 100.4 and/or any other “unusual”
activity. So far, our little guy has been his happy, silly self and we couldn’t
ask for any more!! 
No comments:
Post a Comment