Today was Neviyah's appointment with the urologist. I woke up this morning with a sick feeling in my stomach. Up until today, I have done a good job pretending that she has nothing wrong with her. Even when coaxing her to take her antibiotic, I have not allowed myself to dwell on it.
We were running late. Traffic. Inability to find it. My blood sugar was off and I felt like indulging the rage that was building up inside of me. I didn't. I bit my tongue. Finally we found it and quite quickly we were ushered in to see the doctor. He is an older gentleman. Gentle looking.
Rob said, "It is you. You were my urologist when I had a cystoscope and cystogram. I remember you singing, 'I wish I was an Oscar Meyer Weiner' just as I was going under."
"Yes, that was me!" he said.
Then we dove into the x-rays. First the ultra sound. He showed us where and how he could tell that her kidney was slightly enlarged. He also told us that there is no damage.
We then viewed the voiding cystourethrogram. He showed us how both sides were not functioning properly. The left side proved to be worse than the right but the problem still exists on the right as well.
He discussed causes...insufficient length of ureter relative to diameter being affected by the muscle or lack thereof which then presses and opens the valve mechanism. Inflammation can cause it. Obstruction. The latter was ruled out. It could be either of the first two.
Next we discussed grading. He graded it a Grade III--mild/moderate dilation of the ureter, renal pelvis and calyces with minimal blunting of the fornices. The urologist who originally reviewed it at the hospital graded it a Grave IV--dilation of the renal pelvis and calyces with moderate ureteral tortosity. Grading is I through V with I being the lowest and V being the most severe.
There are three treatment options. He is going to treat her for six months with a new antibiotic. If inflammation is the cause, then this should fix it. She will be retested at 1 year of age (6 months from now) to determine if it is better/worse and to re-evaluate her kidneys for damage. There is a 45% chance that this will correct the problem.
If things are not better, there are two other options. One is an outpatient surgery that places a type of stuffing to help the valve not open up. This has an 80% chance of correcting. Lastly, there is a surgical solution that requires approximately 3 days in the hospital. This has a 99% chance of correcting the problem.
The antibiotic is important to make sure there is not a breakthrough infection. And that is our current treatment plan.
That's the news.