We finally met with the pediatric urologist, and Jon and I really liked him. He was very tender, patient and intelligent – all good things. I have been doing a lot of my own research so I didn’t learn a ton of new information today, but reading about something on the internet is very different than hearing it from a doctor who will actually be performing these things. Here are the details of what we walked away with:
1) There are typically two main causes of kidney dilation: reflux or an obstruction. Because of the severity of this case of hydronephrosis he seems pretty positive that it is an obstruction and not reflux.
2) Here what my son’s first month of life will be like (besides lots of eating, sleeping, pooping and cuddling of course):
Day 1: start on antibiotics. This will be to help fight the urinary tract/kidney infections that are likely to occur given his condition.
Day 3 – Ultrasound to measure kidney size after birth, get a good look at his tissue, etc..
Day 3 – VCUG. This stands for Voiding Cystourethrogram. Basically a fluid will be inserted through his urethra and through x-ray technology they will check to see if the fluid shoots back up to the kidney. This test is done to determine if reflux is the cause, so although our doctor doesn’t think it is, he wants to be able to rule it out. This seems to be a very uncomfortable procedure that lasts a couple of hours. I’m glad he will be too young to remember it.
1 Month: Renal scan (mag 3). During this test a low-level radioactive material is inserted through an IV and then the doctors wait and see how his kidneys process it. This will determine how much Kidney function he has left at this point and also help determine more info. about the obstruction (which is most likely right where the ureter meets the kidney). This is about a two hour procedure during which he may have to be mildly sedated.
1 month: Surgery. If little boy has less than 15% kidney function (which is determined by the Mag 3) on the left side he will remove the kidney. If he has greater than 15% function, he will do surgery to correct the obstruction. This surgery of correcting the obstruction has a high success rate (90-95% success rate). He said a month is the very earliest he would prefer to do surgery, however given the severity of what he is seeing now he thinks that is the best idea.
How I’m feeling about all this: It feels good to meet the man who will be treating our son, to have an idea about a time line of events. It feels awful to know that our son, at the fragile age of one month, will be put under general anesthesia and with the way things are looking now, most likely say good-bye to a major organ.
I kept looking at the doctor’s hands, realizing that these were the hands that were going to be caring for our baby’s urological health, the hands that would eventually be cutting into his tiny body, removing his tiny kidney or re-attaching his tiny ureter.
He wore a wedding ring, and his hands seemed calm and steady. I feel good that this appointment is done with and that we are on the road to treatment with what appears to be a competent pediatric urologist, however I can’t trust him fully. His hands are human.
The only Hands I can really trust are our Fathers. I pray that His Hands will continue to be upon our boy, and that Dr. Ashley’s hands will really be God’s hands as he deals tenderly with our newborn.