Tuesday, May 7, 2013

Kidney

When Madeline was a year old we learned she had kidney reflux, Grade IV. Which means..

Vesicoureteral (ves-ih-koe-yoo-REE-ter-ul) reflux is the abnormal flow of urine from your bladder back up the tubes (ureters) that connect your kidneys to your bladder. Normally, urine flows only down from your kidneys to your bladder.

  • Grade I – reflux into non-dilated ureter
  • Grade II – reflux into the renal pelvis and calyces without dilatation
  • Grade III – mild/moderate dilatation of the ureter, renal pelvis and calyces with minimal blunting of the fornices
  • Grade IV – dilation of the renal pelvis and calyces with moderate ureteral tortuosity
  • Grade V – gross dilatation of the ureter, pelvis and calyces; ureteral tortuosity; loss of papillary impressions

The younger the age of the patient and the lower the grade at presentation the higher the chance of spontaneous resolution. Most (approx. 85%) of grade I & II cases of VUR will resolve spontaneously. Approximately 50% of grade III cases and a lower percentage of higher grades will also resolve spontaneously.

So when she turned we 3 we went St. Louis Children’s had a test and learned that her reflux had gotten better on one side-grade 2 but the other side was still a grade 3.  They told us to come back in 2 years.

So we this week we headed to children’s for another …

Voiding cystourethrogram (VCUG). This test uses X-rays of the bladder when it's full and when it's emptying to detect abnormalities. A thin, flexible tube (catheter) is inserted through the urethra and into the bladder while your child lies on his or her back on an X-ray table. After contrast dye is injected into the bladder through the catheter, your child's bladder is X-rayed in various positions. Then the catheter is removed so that your child can urinate, and more X-rays are taken of the bladder and urethra during urination to see whether the urinary tract is functioning correctly.

 

This time she got the laughing gas. Made it much better!

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They even had a child life specialist there to hold an ipad and let her pick her favorite shows.

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We are blessed and praising God to report that Madeline has healed to a Grade 1!  The dr. seems to think we will not have to have anymore of these crazy tests! It is so nice to see Nick’s and my prayers for the past 4 years answered. We also learned that yes she still has a large bladder for her size and age. No wonder she is the best car trip child!

Monday, May 6, 2013