Wednesday, March 28, 2012

Urologist Update

I realized today that I never really updated everyone on what happened after Evelyn's visit to Driscoll Children's Hospital in January.  We were referred by her pediatrician to a pediatric urologist, whom we saw about about two weeks ago.  Going into that appointment, we knew from follow-up labs ordered by her pediatrician that Evelyn has what is called vesicoureteral reflux (VU reflux for short).  What this means is that after her kidneys drain into her bladder, the small valve that is supposed to close off the bladder and keep the urine in the bladder to be eliminated is not closing so the urine is splashing back up into her kidneys.  At the pediatric urologist, we learned that normally this isn't much of a problem, but it is when infected urine is refluxing into the kidneys it can cause scarring and other kidney disorders.  She has a grade 1 reflux on one side and a grade 3 reflux on the other (the reflux is graded 1 to 5 with 1 being very minor and 5 being major).  They generally treat VU reflux in one of 3 ways.

  1. Surgery to repair the immature valve.  Fortunately, Evelyn is not a candidate for surgery at this point because her reflux is considered pretty minor.
  2. Consistent low-dose antibiotics to keep urine infections from coming, thus preventing damage to the kidneys.
  3. Do nothing and observe.  In most cases, young children outgrow VU reflux with time - so as long as the child is not getting recurrent urine infections, you can just wait it out.
Going into her appointment we were praying and believing for no surgery and no medications.  We really do not want her to be on antibiotics all the time until she outgrows this.  Fortunately, her urologist opted for treatment number 3!  We just have to monitor her and watch for urinary tract infections.  So long as she does not have what he referred to as, "recurrent UTIs," she just has to follow up with him annually to check how the reflux is doing.

Well...we made it another week :-(.  On Friday evening, she started acting fussy and was running a low-grade fever.  Once again we initially attributed it to teething (still no teeth - they've got to come soon, right?!).  However, when it continued through Saturday and spiked overnight on Saturday, we decided not to wait it out.  Our pediatrician's practice holds office hours on Sundays, so we called and got in to see another doctor in her practice.  We had to wait quite a while to actually see the doctor, but Evelyn kept us entertained...
She loves playing peek-a-boo and has started hiding herself to play!
It turns out she had an ear infection starting, and her urine sample looked pretty suspicious.  So he started her on antibiotics again and asked us to follow up with her pediatrician on Tuesday (it takes 48 hours for the urine culture to come back from the lab).  Her urine culture was positive - so we're glad we caught this one earlier than the last one.  I spoke with her pediatrician today, and as long as she doesn't have any more UTIs - we just have to continue waiting it out.  If she has another UTI before we go back next March, we have to see the pediatric urologist again and he will likely put her on the low-dose antibiotic. 

Please pray with us and believe that God will heal and mature her little valves!  No more UTIs in Jesus' Name!!! :-)

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