Category Archive: Kidney Reflux

We have just received feedback / second opinion from 2 nephrologists from London on Baby C’s condition. One of the surgeons said to go ahead with the partial nephrectomy surgery. The second surgeon’s advise is to get another scan done on the right kidney before deciding to remove the upper pole of the right kidney (20% of the kidney). The scan (which uses dye and radiation again) will see the activities and the functions of the kidney. It will determine which part of the right kidney is the problematic one, i.e. the upper pole or the lower pole. Maybe Baby C doesn’t have to have a partial nephrectomy afterall if it shows that the kidney is perfectly fine. Maybe another type of surgery will be needed… and that’s just what I am hoping for. We will wait for more information from the nephrologist in London (from hubby’s uncle who is a surgeon in London) before we get this scan done on Baby C this week.

Baby C’s pee started to smell foul again yesterday.  I had expected this to happen coz her UTI attacks is a monthly affair.  Today being a Sunday, we had to pay the lab staff of a private hospital double the charges for a urine FEME test to be carried out on baby’s pee.  The WBC (white blood cells) reading is 15-26 and RBC (red blood cells) reading is 5-10.  This usually signifies that there’s bacteria in the urine, though the readings are not exceptionally high.  But I know the WBC and RBC will slowly and surely accelerate over the days.  That’s the reason why at the onset of foul smelling pee, it’s best to get the pee tested right away and treat baby with the appropriate antibiotics immediately.  If the WBC and RBC are uncountable, baby would need hospitalization and heavy doses of antibiotics given through intravenous (IV).   Finding a vein on baby’s hand and feet is my worst nightmare.  She normally has to be poked and pricked many times before a vein is successfully found and line inserted.

I can’t do much now but to wait until Tuesday next week to see what bacteria is in the pee before our doctor decides how to treat baby.  Looks like the surgery would have to be postponed again (from 24 Feb to 3 March 09 to 10 March 09 perhaps) coz a surgery is not advisable when there is an infection in the body. 

The urine culture results (for urine collected on Thursday last week) came out today.  There is a mixed growth of bacteria in the pee and the colony count reading is <5,000.   Whenever I get this kind of reading, our doctors would normally tell me that this reading means that the pee was most likely contaminated when it was collected.  The colony count reading of <5,000 is insignificant.  A repeat urine culture should be done to see if there’s anymore bacteria in the pee.  But I know deep down that there is indeed bacteria in Baby C’s pee and the bacteria is beginning to grow and multiply.  I am all too familiar with the trend of the urine test results for the past 8 months.   Anyway, I will send Baby C’s urine to be tested again on Friday.

Today I collected Baby C’s pee for tests again.  The last test done was about 2 weeks ago.  The WBC today is 3-4.  I know this isn’t a good sign, though the reading is insignificant.  The fashion in Baby C’s UTI occurance is that it will come about 4-6 weeks after the last attack.  Her last attack was on 17 January 09.  As the days are drawing close to 17 Feb 09, I’m feeling the jitters now.  The WBC can accelerate real fast as the bacteria proliferates.  Though there’s no bacteria in her pee today, it could be there the next day.  Oh gawd, I just hope Baby C doesn’t get another UTI attack coz if she does, the surgery that’s scheduled to be carried out late this month would have to be postponed. 

Hubby and I have decided that the surgery takes place later this month.  My main concern of not wanting the surgery to take place so soon is because Baby C is having a mild runny nose now.  I think it’s always good to go for a surgery when your immune system is strong.  Moreover, I am also having a mild cold and am not feeling too good.  I will call our surgeon tomorrow to find out from him when he will be back from his leave.  Will also ask him if it’s going to be an open surgery or a laproscopic surgery.

We met our pediatric surgeon today.  After looking at the MCUG and IVP films, our surgeon concludes that a surgery is definite.  The surgery is called a partial nephrectomy. 

Our surgeon explained to us that Baby C has 2 problems. The first problem – Baby C has a Duplex System on her right kidney. There is a single kidney on the right side but the kidney is separated into 2 portions as she has 2 ureters. The upper portion of the kidney is swollen caused by one of the ureters that is most likely blocked. In this surgery, our surgeon will remove the upper portion of the kidney, which makes up to about 20% of the entire kidney. The lower portion of the kidney will not be removed.  The good news is that her left kidney is perfect and with 1 3/4 kidney, she can still lead a normal life.  In fact, we can even live with just 1 kidney.  Our surgeon also informed us that though this is a major surgery, it is nevertheless a safe surgery.  He doesn’t even need to prepare blood bags.  Loss of blood and mortality rate are low.

The second problem – the other right ureter is refluxing the urine back to the right kidney. Hopefully after the partial nephrectomy surgery, Baby C will have lesser or no more UTIs. As for the reflux problem, our surgeon told us that most kids will outgrow the problem. If however Baby C still has the reflux problem in 2-3 years’ time, another surgery called a Uretal Reimplantation surgery will be considered to fix the reflux problem. Baby C still needs to take the oral antibiotics after the surgery for another 2 years or until she outgrows the kidney reflux.

Our surgeon suggested that the surgery be carried out soonest possible to prevent further damage to the right kidney, especially to the lower portion. He suggested that the surgery be carried out this Thursday as he will be away from the 16th onwards. This decision to operate immediately came as a surprise to us and I’m still not 100% ready for Baby C to go for the surgery so soon. I know it’s best for her, well hopefully. There will be more discussions with hubby and his uncle who is a surgeon in London today. We will have to come up with a decision by tomorrow. If the surgery takes place on Thursday, Baby C and I would have to admit ourselves to the hospital on Wednesday night.

Please pray for us everyone….

Today is the day that Baby C did the IVP and MCUG procedures at the hospital. We spent almost the whole day at the hospital and it was a day of non-stop yelling, wailing and bawling for poor baby. After feeding her the sedation meds the moment we reached the hospital, I nursed her and spent almost 30 minutes to put her to sleep. I just had a nagging feeling that she would be wide awake throughout all the procedures and true enough, the moment she was placed on the hospital bed, my baby who has developed a phobia of hospital beds woke up! Before anything was done to her, she was already yelling her heart out. Can you imagine the hours that passed from 10am – 3pm? It was a nightmare for both baby and me…. and truly torturous for baby.

As I had expected, our doctor had a difficult time finding a vein to insert the IV line. Poor baby was poked a total of 3 times. After all the crying, baby dozed off in my arms and I brought her down to the Imaging Department for the big thing. I was ordered out of the Imaging Room. The doctor first inserted the catheter into her urethra. The MCUG procedure followed. Poor baby’s screams and cries really crushed my heart to pieces.  I wanted to cry out loud but tried hard not to…. there was a HUGE lump in my throat throughout my time at the hospital today.   After half an hour which seemed like forever, the door of the Imaging Room opened and I saw one of the nurses cradling her. Poor baby’s eyes were swollen from all the crying.

As the doctor could not find a vein on her hands, the IV line had to be affixed on her foot. She was poked once on her hand and twice on her feet.

Baby all groggy from the sedation meds…. waiting for the Radiologist to arrive to perform the MCUG on her.

After the MCUG, I had to make baby wee wee to empty her bladder before the last picture is taken on her empty bladder.
Waiting for baby to pee was the hardest and took up a lot of time. We had to make her pee several times until the bladder was empty before a picture could be taken.
In this pic, I was waiting for baby to pee. She wasn’t wearing any diaper and there was a waterproof paper beneath her bum.

The IVP procedure was less traumatic for baby as I could carry her when the dye (iodin) was injected through the IV line. What traumatized her (though not painful) was placing her on the metal bed with a huge X-ray equipment above her. Baby had to be placed on the bed several times, in different positions for pictures to be taken. Each time she was placed on the bed, she bawled and struggled. Though she was darn tired, sleepy and groggy, she was still crying big time the moment she was placed on the bed.

Long story cut short, we did not manage to see our pediatric nephrologist today as it was already 3ish pm by the time the 2 reports for the IVP and MCUG were ready. I only ate my lunch at 3pm outside the Imaging Room… which hubby packed for me from a nearby Japanese restaurant….and poor baby had to starve and only ate her lunch (porridge) at 5pm.  I was merely swallowing down my grilled Mackeral fish and didn’t have any appetite. I was suffering from a tummy ache, resulting from STRESS! 

We will be going to the hospital again tomorrow to meet our doctor for her to interpret the report to us. But one thing is confirmed. Both of baby’s right ureters (she has a Duplex or Duplicated collecting system, which means double ureters), are blocked…. thus, she will most likely need a surgery to fix the problem.

Everything seemed to go wrong today…
1) baby woke up unusually early today at 6:30am (her normal wake up time is 8:30am) and I couldn’t do much work in the morning but nurse her and entertain her. Consequently, we arrived slightly late at the hospital,
2) baby had to be poked thrice for the IV line (brandula) to be inserted as the doctor could not locate a vein,
3) the sedation meds didn’t work – though she had taken sedation meds and she was sleepy, her mind was wide awake and she cried and screamed the whole day,
4) blood was oozing out from the IV line on her foot and the line had to be taken out prematurely. Consequently, the antibiotics jab (to prevent infection resulting from the procedures) couldn’t be given through the IV line and had to be given via intra-muscular on her bum and caused baby more pain and trauma.
Damn the Murphy’s Law!

The damage to the hubs’ pocket today is over RM1k and all medical expenses related to baby’s kidney reflux will not be covered by her insurance.

….. to be continued.