Urology Appointment Update

About a year and a half ago, Brooke was diagnosed with Vesicoureteral Reflux (VUR), or kidney reflux as it is more commonly called. After several UTIs and kidney infections, with the last landing her in the hospital for a week, we were happy to have a diagnosis and plan of action. We have been meeting with her urologist every 4-6 months, continually monitoring her condition and doing follow-up tests to ensure there is no more damage to Brooke's kidneys.

Yesterday was time for another check-up, starting with a VCUG scheduled around noon. Brooke and I left our house around 8, hoping to make it to Lubbock in time for an early lunch at Cracker Barrel (her favorite restaurant). As we were eating, she started getting nervous, and I can't say I blame her. It is an invasive test for a 5 year-old, involving a catheter and lots of x-rays...not fun at all. This is the third time she's had the procedure done, and she burst into tears as soon as the nurses entered the room. It took her a few minutes to calm down, but then she did an awesome job! She laid still throughout the procedure and even told me later that it didn't hurt too badly. I was so thankful for a kind nurse and an understanding x-ray tech. They really helped calm her fears and took excellent care of her (and she was thrilled with the stickers and suckers they gave her!). I watched the test on the screen, and was disappointed to see that her reflux had not improved, and actually appeared a bit worse.

We had an appointment scheduled with her urologist for that afternoon, and I was anxious to get Brooke's test results. We have been fortunate to have Dr. Smith as our doctor, she has been very supportive in exhausting every treatment option before requiring surgery. Our hope has been that she would simply outgrow the reflux (which is very common), and her doctor has said "as a surgeon, I love to operate, but not on kids that don't need to be cut open". When she pulled up the images from yesterday's VCUG I could tell we were getting bad news. Her face dropped a little, and she told me the reflux was definitely worse, and needed to be fixed. At this point, surgery is our only option.

During the procedure, the ureters will be reimplanted further into the bladder muscle, preventing urine from refluxing back up into the kidneys. If all goes well, the reflux will be gone and there should be no further damage to Brooke's kidneys (she currently has swelling and decreased function on one side). We have scheduled the surgery for June 11, with a pre-op ultrasound scheduled for June 10, and we expect Brooke to be in the hospital for 3 days afterwards. The post-op sounds similar to a c-section...she will have a small incision above the pubic bone, a catheter and ureter drain to keep pressure off her bladder, and most likely an epidural for pain management. Recovery time is typically 2-4 weeks, and Dr. Smith said that the biggest concern is bladder spasms that can be very painful.

While we were in the office, I noticed that Brooke's cheeks were flushed. The nurse took her temp and she was at 99.6, so a little warm. An hour later her temp had increased to 100.8 and her urine sample confirmed that she had a uti. Perfect timing, right? If we had any doubts about the surgery being necessary, they were gone at that point.

Brooke knows the basics about the surgery, and we've told her she can ask any questions or talk about it with us whenever she wants. She only had two questions yesterday, "will it hurt?" and "it's like I'm having a c-section, but I WILL NOT have a baby, right?". With the surgery being done early in the summer, she should be fully recovered before her birthday and still have plenty of time for hanging out at the pool before starting first grade-important stuff at her age!