Friday, May 29, 2009

Ella and her Kidneys

Ella had her kidney tests done this past week.

She still has Vesicoureteral Reflux (VUR) in both kidneys, but things look a little better than last year (her right kidney is now a grade 1-2 and her left kidney is a grade 2-3).

Her kidneys themselves look good though.  They are growing appropriately, are equal in size and show no signs of swelling or scarring -- which is really great news.

We now have some decisions to make, and they're not easy ones.  The pediatric urologist we see gave us a few options and we've talked with our pediatrician as well.

Our choices are:
1.  Continue with daily medicine, keep a close eye on her (for urinary tract and kidney infections -- kids with VUR can get really sick really quickly) and retest next summer.  However, long-term treatment with antibiotics may cause the bacteria to become resistant leading to more infections.  But it may not.
2.  Do a minimally invasive procedure called Deflux, which is an endoscopic treatment with a chance of being a single, daytime hospital visit.  Then keep her on a precautionary antibiotic treatment for at least 3 months and retest her in a year to make sure things look okay.  However, during the procedure the child is put under general anesthesia and some children may need more injection procedures over the years or may eventually need to have the full kidney surgery anyways if the Deflux doesn't work.
3.  Do the full abdominal surgery on both kidneys (which has a 98% success rate) but has a longer hospital stay and is, well, major SURGERY.

There still a small chance she could outgrow it, although this doesn't look too likely based on the reflux grade and her age.  Our pediatrician does recommend surgery by age five, if needed, which is also a consideration.  

Tom and I have been talking this weekend, have a few more questions for the urologist and will hopefully make a decision within the next few days.

As for the procedure itself, we had to be at the hospital by 8:15 am, so it was up and out the door earlier than normal.  Grama Dianne hung out with Zoe, which was a HUGE help!!  Zoe and Grama actually came in for the ultrasound part of the appointment and Ella did a super job keeping still while Zoe was very wide-eyed during it all.  Afterwards (and into the next day) she asked Ella numerous times to show her her tummy (even though there wasn't anything to see).  I thought that was kind of funny.

Ella was a trooper, like she always is with medical stuff.  She was also really sweet and thoughtful -- anything she got (chapstick for the gas mask, stickers, little treats and Teddy Grahams) she asked for another to give to her sister. 

Ella before the procedure, smelling the chapstick in her gas mask.

She also really enjoyed the 'Giggling Gas'.  During the procedure she did really well, got laughing so hard at one point the nurses and tech person were laughing too, and even fell asleep for a bit.  Afterwards, the combination of being really tired and not feeling great (it hurt to go to the bathroom because of the catheter and dye) made for a fussy girl and she cried on and off.  The worst part really was how much it hurt for her to go potty for the rest of the day.  

I have to say, I am so impressed with our awesome Children's Hospital.  They sure know their stuff and they know how to make things not as scary for little ones.

We had big naps that afternoon and since then the girls have been playing in the mud, literally.


Joe and Jane said...

Glad the procedure went well and good luck making those tough decisions! Talk to you soon!

~jd said...

i've heard really really amazing things about Children' glad Ella has a great place for wonderful care :) Both girls really are troupers for all they've gone through in 3 years. Keep us posted on Ella!