Sunday, July 7, 2013

Urology pre- transplant

On Tuesday of last week we spent the day at our "favorite place". (Insert sarcasm here) Yes, you guessed it. we were at Children's Hospital AGAIN! That is what took me so long to post this. Two days there wiped me out emotionally and physically. Now that i have rejuvenated, I can get you up to speed. Parker had a VCUG done at 8 a.m and then we met with Dr. Roth in urology at 10. In the VCUG, the radiologist inserted a catheter and pumped saline into Parker's bladder. The point of this was to determine how much "urine" his bladder can hold. Remember, Parker's bladder has never had ANY fluid in it and he has NEVER peed. So, before we went into the procedure my mind started to wonder about everything, and I thought, "Well if they put something in then it has to come out somehow, doesn't it?". But I kept my questions to myself in fear that they were common sense and I would look like a complete idiot. So when we entered the radiology room, the team asked the reasonings we were doing the procedure, and I told them. Low and behold, they were just as baffled as me! One of the tech's looked at the radiologist and said, "Well, he has no kidney's and has never used his bladder. This is a first. Think he will pee it out?". The radiologists response.. "Well we are about to find out!"

When we met with Dr. Roth afterwards he told us that Parker can hold about 40ml's in his bladder, but that the pressure started to back up into his kidneys, also called reflux. He said that his reflux was low grade,and that it usually resolves on its own. He also said that it could have been caused by too much pressure pumping in at once. The problem that he noticed was that Parker can only hold 40 ml's and that the average two year old hold about 150 ml's. I, however, think that it's impossible to expect his bladder to hold the same amount as an average two year old. After all, they have the advantage of USING their bladder for two extra years. 

There are two options that they may take. One is that they will take a wait and see approach. Usually the bladder will stretch on its own post transplant. As it fills and expands it stretches. The con with this that high grade reflux can cause damage to the new kidney, so he would have to be monitored closely to make sure his doesn't get worse. The second option is to do bladder cycling before transplant. Bladder cycling basically means that they will put a catheter into his belly and to his bladder and we will flush saline into it every day to stretch it before surgery. I've talked to several "kidney moms" and none have done the cycling, so we are hoping that Parker won't have to either. 

We have another fun-filled day at Children's Hospital Thursday with the GI team. Hopefully by then someone can give us answers on what's going on. 

Aren't they so cute?!

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