36 weeks pregnant: My OB detects that Murphy has a dilated left kidney on a routine weekly ultrasound. The pediatrician comes in and explains that this is fairly normal and that 50% of the cases fix themselves prior to birth...so not to worry, we'll re-evaluate the situation after his birth and go from there.
Monday, May 11, 2009: Murphy (4 days old) has his follow-up ultrasound at Wittlich (it's a standard procedure for all newborns in Germany) and it is determined that he still has a dilated kidney. The pediatrician explains that Murphy could be prone to kidney infections because of this. He said that Murphy may never get a fever, or he could get one every two weeks -- we'd just have to wait and see. However, he did say, that if Murphy is to get a fever, we need to come to the hospital immediately in order to prevent permanent damage to Murphy's kidney.
Sunday, May 17, 2009: I couldn't get Murphy to nurse to save my life...he went about 9 hours without eating that morning. Later in the morning, I feel that Murphy is starting to get warm. I took his temperature and it was 100.2 -- higher than normal, but not high enough to rush him to the hospital. By noon, his temperature was 101.6 (the doctor had said to come in at 101) -- so Matt and I packed our bags, put a "pee catcher bag" on Murphy with the hope of collecting a urine sample on the way to the hospital -- and headed back to Wittlich.
The pediatrician on call says that Murphy is pretty sick (at this point, his temp was over 102) and immediately draws blood, tests his urine (it tests positive for bacteria), inserts an IV (luckily in his hand and not his head), and starts administering 2 different antibiotics.
Monday, May 18, 2009: Murphy has another ultrasound -- we learn that nothing has really changed -- and we are told that the antibiotic treatment is a 7 day treatment...in other words, Murphy and I would be staying at the hospital for 7-10 days until the treatment has been completed. Luckily, Murphy had responded very well to the antibiotics -- his fever had broken and everything was looking good -- now it was just a matter of putting in the time.
The rest of the week: Murphy and I were visited by Nana, Papa, Matt and JP tons... The doctors allowed us to go out for walks, so Murphy and I took many hikes along the same trails that I hiked when I was in labor with him, and Mommy read MANY books! It was a long week...however, it's all worth it if we can get this situation under wraps sooner rather than later. The silver lining to this long week was all the one-on-one time I had with Murphy. How often does a child (other than the firstborn) get so much quality time alone with Mommy??? We had a great time together...learning each other's quirks, we just wish it had been at home with the company of Nana, Papa, Daddy and JP!
THANKFULLY, my mom was able to extend her trip to help us out with JP. Between Nana and Matt, one was always able to be with JP while the other was visiting Murphy and me at the hospital. JP loved all the one-on-one attention from Nana and Papa, and I sure appreciated the company as well! We could not have done it without her help! Thanks Mom --- you are a life-saver!
Monday, May 25, 2009: Murphy and I are finally given the green light that we can go home! The doctor sits with Matt and me for nearly 30 minutes explaining what they know for sure, what the doctors' concerns are and the course of action from here on out.
What they know for sure: Murphy's kidney and ureter are dilated (bigger than they should be) most likely caused by a reflux of his urine back up the ureter to the kidney.
Their concerns: what is causing this dilation? Most likely, the doctor thinks that it is due to Murphy not having a properly functioning valve where the ureter enters the bladder. He explained that this valve's purpose is to close when the bladder is being emptied in order to prevent the backflow of urine into the ureter and the kidney. Due to the fact that Murphy had a fever/infection so quickly, he seems to think this is the most likely scenario. The other possibility is that the muscles are too tight which is therefore obstructing the flow of urine from the ureter into the bladder.
Course of action: Murphy is on a daily antibiotic to help prevent the occurrence of additional kidney infections. He will have a follow-up ultrasound June 15th to determine if this dilation is getting worse, better or staying the same. Then, on July 2nd, he will then have a "Centigraphy" (that might be a German word for the procedure) where they will infuse his body with a trace amount of radioactivity to determine how efficiently his kidney is functioning. At this time, they will also infuse a solution via a catheter into his bladder to see if it also makes its way up the ureter to the kidney. This procedure is not going to be very comfortable for Murphy, however, the doctor said he will be given a drug that will cause him to have "No remembrance" of this procedure taking place (I wonder if Mommy and Daddy can also take this drug???) After this has been completed, we should have a much better idea of his exact situation.
Best-case scenario: The antibiotics that Murphy is taking will work and we will not need to return to the hospital again. At that point, the doctor will most likely recommend surgery for Murphy next May after he turns 1. (The older he is...the easier the surgery is for both him and the surgeon.)
Worst-case scenario: Murphy and I become fast friends with the pediatricians and nurses at Wittlich -- going back frequently over the next few months due to him getting repetitive fevers/infections. If this is the case...Matt and I will consider having Murphy undergo surgery prior to turning 1 to prevent him from thinking that the hospital is his home :-)
We promise to keep you posted on his situation as we learn more about it! Who knew we would become such experts on the kidneys and urinary tract :-)
Here are some pictures from our week's "vacation" in Wittlich...the first is a diagram of his situation and there are also some pictures of the trails that we hiked.
If you want to read the medical explanation of his situation...you can read up on this website:
http://www.uroinfo.ca/brochures_pediatric/vesicouretericReflux.html
4 comments:
Megan, he is one of the most beautiful babies that I've ever seen. I am so sorry that you are having to go through this. I am glad that your mom has been there to help with JP...what a blessing. I hope you get to stay home and that the antibiotics work for him. Surgery at 1 sure is better than frequent hospital visits and early surgery. I'll keep reading the updates. Thanks for the email!
Mark had told me about all of this, and we have people praying for all you! Glad to hear the updates are looking positive~I'm sure just knowing "something" is a relief. Big hugs to you and all your boys!
Megan, so sorry you have to go through this! Many prayers for Murphy. There is a pediatric nephrologist back in the states at Walter Reed...I can give you the contact of a guy here who took his kid there for the same issue (they just PCS'd from here). You have my email!
I'm praying for you, Matt, JP and Murphy of course. I'm so sorry you're going through this, but you certainly have the right attitude. You have to stay positive! I'll be checking in with you and wish you a year out of the hospital! Love you guys!
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