Zac's fourth ultrasound and its result for his Hydronephrosis

We all woke up early morning yesterday for Zac's 9:30AM kidney ultrasound at Riley Children's Hospital. We were called right away after we were registered and the ultrasound probably lasted for only 10- 15 minutes. Zac was very cooperative and he didn't gave the sonographer a hard time. They checked for the size and the amount of fluid found in his kidney, took a picture of them and submitted them to his Urologist. i guess another reason why Zac didn't give a fist is because of the TV his watching hehe.

We were called again for the result, but before the urologist came, a nurse took a sample of Zac's urine. She made Zac lay down in the bed and sticked a plastic bag on his private organ and hope that he will pee. i gave Zac a bottle of milk because I am sure that drinking milk will make him pee and he did pee after 5 minutes of drinking. My husband called the nurse and the nurse took the urine sample. Another doctor went in  the room and check Zac's belly if there is any lump but good thing that he found nothing. At last the urologist came, he brought the cd and ran it in the computer. He showed to us the previous pictures of Zac's kidney and the latest one. He showed us the comparison and told us that his right kidney is NEGATIVE to hydronephrosis and his left kidney has still the same amount of fluid found on his last ultrasound (June 2010).

We saw on the pictures there were no changes in his left kidney. The good thing about it is that at least it didn't get worse. His urologist categorized Zac's hydronep in stage 2 (There are 4 stages of hydronep and 4 is the worst). He said again the same thing, that he don't need to go under any medication because his condition is MODERATE and 80% of this resolve by itself. For now all we can do is to monitor him and regular ultrasound for his kidney. His Urologist wants to see him again after 9 months.

Renal Ultrasound result

Ok, this post should be posted before the VCUG result but I just got the Renal Ultrasound result that is why this is late. This is the result of the kidney ultrasound:

INDICATIONS: Congenital Hydronephrosis

COMPARISON: 1/18/10

REPORT: Renal ultrasound was performed. The kidneys appear to be a of normal size. The right kidney measures 6.4 cm in length and the left kidney measures 6.6 cm. There is moderate left sided pelvocaliectasis has developed since 1/18/10. There is no evidence of right sided hydronephrosis. No renal masses are identified. Renal cortical echogenicity is normal.

A single of the urinary bladder was obtained which was unremarkable. The patient did immediately void and we were unable to asses for bilateral ureteral jets which can be an indicator of ureteral patency.

IMPRESSION: Moderate sided pelvocaliectasis which has developed since the prior study. Normal apperance of the right kidney. We were unable to asses for ureteral jets as described. One might consider a follow up intravenous pyelogram if there is a need to further evaluate a possible left sided obstruction.

So that was the result. You can't actually notice that Zac has a kidney problem because he acts like a normal kid. Yes, it says it was congenital which means he inherited it. I didn't had any kidney problem and so in my family so I asked my hubby, and according to him, kidney problem runs in his family. From his mom, to him and his two sisters. I just hope that his kidney problem will get solved so that he will be done with this ordeal.

I love him so much that sometimes it scare me on what will happen next.

Zac and the VCUG

Zac had his VCUG last July 22nd at Riley's Hospital. I think I will just let Wikipedia explain what VCUG means:

In urology, a voiding cystourethrogram (VCUG), also micturating cystourethrogram (MCUG), is a technique for watching a person's urethra and urinary bladder while the person urinates (voids). The technique consists of catheterizing the person in order to fill the bladder with a radiopaque liquid (a "contrast" or "contrast agent", typically cystografin). Under fluoroscopy (real time x-rays) the radiologist watches the contrast enter the bladder and looks at the anatomy of the patient. If the contrast moves into the ureters and back into the kidneys, the radiologist makes the diagnosis of vesicoureteral reflux, and gives the degree of severity a score. The exam ends when the person voids on the table while the radiologist is watching under fluoroscopy. Consumption of fluid promotes exertion of contrast media after the procedure. It is important to watch the contrast during voiding, because this is when the bladder has the most pressure, and it is most likely this is when reflux will occur.

Kidney Reflux (vesicoureteral reflux) is diagnosed with an ultrasound and VCUG. Children who have chronic Urinary Tract Infections are given this test to determine the level of damage to the kidney.

Yes, they inserted catheter to Zac which made me almost cry. I held his arms and hubby held his legs because he was trying to fight while they were putting the catheter on. He cried in pain which made me and hubby upset. But we can't do anything because he needs to have this test to check his bladder :(

After waiting for almost an hour for the Urologist. He finally came and talked to me (hubby was outside the hospital getting coffee) in the room. He gave us a good news that Zac's bladder is clear, which means there was no reflux and his bladder is normal. But he wants to see the ultrasound pictures (which I already requested in the hospital today) of his kidneys to see on why his left kidney is enlarged. He said that according to the ultrasound impression of the radiologist. According to the urologist, there "might" be a blockage in the ureter which causes the enlargement of his left kidney. And again, his urologist said that as of now, we don't have to do anything because his hydronephrosis is in moderate condition which there is a possibility that it might resolve by itself when he gets a little bit bigger.

Tomorrow, I have to go to the hospital to sign up a release form for them to forward the ultrasound pics in CD to his urologist.

I am really praying hard that it will resolve by itself and I know that God is with us in this journey.

NOTE: The pic above is Zac wearing laboratory gown. That pic was taken before the VCUG.

2nd KUB result

So I got the result of his 2nd ultrasound in the mail today. It says:

Findings: The right kidney measures approximately 5.23cm, increased from 5.15cm on the previous study.The left kidney measures approximately 5.22cm, increased from 4.95cm in the previous study. A small amount of fluid is seen within each renal pelvis. There is no dilation of the calices. The proximal ureters are not visualized. Color Doppler blood flow is present within both kidneys. No perinephric collections are seen. Bilateral ureteral jets are identified. There is only small amount of urine within urinary bladder.

Impression:
1. Interval renal growth, as above.
2. Trace fluid within the renal pelvis,bilaterally. No caliceal dilation is identified. The kidneys are not grossly hydronephrotic and this could be related to normal urinary excretion.
3. Bilateral ureteral jets exclude ureteral obstruction.

If I remember it right, the urologist said that if the fluid increased more than .10mm then his kidneys needs to be monitored and there is tendency that he needs to take antibiotic. Based on the result above, his right kidney increased .08mm, his left increased .27mm. His left kidney increased alot of amount :( But the urologist said that he don't need to take any medicine as usually, this kind of case resolves on its own. Oh God! I really hope so.

No amount???

It's been a week and a day now since Zac's 2nd ultrasound and I finally got the result of it (yeah, just now!). I called them last Wednesday for the result but as usual, its their voicemail who answered my call so I just left a message to call me back. Unfortunately, no call from them on that day. I waited til Thursday,., still no call from them so I decided to call the next day. Friday came and stiiiiiill no call from them. I was so frustrated the whole weekend as I wanted to know the condition of my baby. I called them Monday morning and I was happy that I got a call from them on the afternoon. A nurse called me and informed me that he (Urologist) wants to see Zac before they give the result. I asked her "Is there any problem with my son?Why does he needs to see him? " she answered "Because that is how we do it" I replied "Is that the best answer that you can give to me? That is how you (hospital/doctor) do it?". I mean, why not tell me the result? if the result is negative then that's good BUT if there is any problem in his kidneys then let me know so I could bring my son to him but I want to know the result first (which i deserve to know) before I bring my son there. I didn't want to be rude or mean to her but giving me crappy answer like "Because that is how we do it" made me more confused and scared about the result. I mean, common! I waited days for their call and that is the answer I will get from them???

Today, I spoke to his doctor's secretary and she said that there is fluid that was found in his renal area. Urologist also said he has mild hydrophrosis and it usually resolves on its on so he doesn't need to take any antibiotics. My son also needs to have another ultrasound 6 months from now to check if the fluid is still there. I asked for the amount of fluid they found in his kidney but the secretary wasn't able to give it to me because it wasn't noted in his record. Anyways, I just asked her to send me my son's medical record.

I am thankful that my son is one of those lucky kid who only has mild hydronep. I am also hoping and praying that the fluid will be gone soon.

2nd KUB

Nine o' clock this morning is his appointment. When we arrived in the hospital, I was like "Oh my! waiting time again." I was glad though because we were called on time this time because I waited for one hour on the last time I had my pregnancy ultrasound there.

Zac started crying when the technician slightly opened his clothes to put on that gel thing for his ultrasound. Hubby gave him milk and that made him stopped from crying hehe. During the ultrasound, I saw his kidney on the monitor but of course i don't understand what's going on. I just saw that the size of his right kidney is 5.34mm and his left is 5.18mm. I don't know if his kidneys are considered enlarged with those sizes. I keep on searching on the net on what is the normal size of kidneys on babies but I couldn't find any site :(

They told me that the result will be forwarded to his Urologist this Wednesday. I will call his Urologist maybe Thursday? I hope that he already read the ultrasound by then.

We are just being positive that the result will turn out negative like the result of his first ultrasound. Oh God! Please help my son. I hope nothing is serious in his kidney condition. Please bless him.

First appointment to his Pediatrician

This morning was Zac's first appointment to his pedia. The 3 of us (me, hubby & Zac) was up early to go to the clinic. Jeez! it was freaking 10F outside and we all need to hurry in getting inside the car or else we might turn into popsicle sticks lol!

Inside the clinic, after hubby filled out some papers, the nurse checked Zac's weight. He weighs 7.52 lbs. when he was born and weighs 6.10 lbs after a couple of days. The nurse told me that it is normal to an infant to lose 7 % of its weight after few days the baby was born. I found this site which explains on why. Zac's weight went 6.18 lbs. on the 5th day which was a good sign because infant shouldn't continue losing weight. Anyway, his weight now is *drum roll* 8.10 lbs. woohooo! He gained almost 2 lbs. in 15 days :D The pedia told us everything looks fine with Zac and his jaundice was gone :)

We then went home and finally, I received the call I have been waiting for. It is the call from his urologist. Actually, it was his secretary who called me.The secretary told me that Zac's urologist already reviewed his record of ultrasound from the hospital where he was born. She said that his urologist wants him to have another KUB. Why? the urologist said that usually, babies are born dehydrated til their second day which makes the KUB result inaccurate if it is done within the day that he is born til his 2nd day. Sooo now, Zac is scheduled to have his 2nd KUB on Jan 18th.

I hope that everything will be fine. I love my son and I always pray for his safety and health.