Of boys & UTI / Part 2

unexpected arrival

unexpected arrival

QT arrived unexpectedly. He was due on 15 March, but came 6 weeks earlier at 34 weeks. But he was good, arrived at a good weight so he didn’t need to be in the NICU. Just the Special Care Nursery (SCN) was good enough. They kept him in till he was 35 weeks and he would have been discharged on time except that his oxygen levels dipped once and they extended his stay just to be safe. And then it got further extended cos his jaundice levels spiked one day and he had to be on phototherapy.

WTH. He stayed at the hospital until he was about 9 days old before he was discharged.

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He came home, nursing fine, breezed through another 4 weeks, with multiple jaundice checks at the polyclinic. It just wasn’t coming down enough. It got to the point where the polyclinic referred us back to KKH because it was still relatively high. We did suspect that it could be breastfeeding jaundice. However, as it was too high, we had to go back.

The PD that saw us decided that just to be on the safe side, it would be better for QT to take a urine test, to see if something was acting up. I wasn’t too worried at that point, considering there wasn’t any fever at all and he was feeding well. I mean, no fever means no UTI right?

So..so wrong. We went for the appointment in the morning, and then was called back in the evening to admit QT cos there were traces of white blood cells in his urine, which could possibly mean there was an infection. My heart sank. Not again? I hurriedly packed the essentials (so good at that now, considering how unexpected QT’s arrival was, I hadn’t even packed my hospital bag then), called my FIL to watch Ollie, and rushed back to the hospital.

They did a blood test and took another urine culture, and according to the preliminary results, QT’s cell count was off the charts. Argh. Hey, time to pack my bags for the guilt trip. Was it something I did? Was it something I ate? (cos I was breastfeeding) Why were my kids getting UTI?? Was it cause QT was born prematurely? The only thing I was thankful for was that QT did not have a fever, so he was in his normal mood. But it was also a bad thing. If the doctor hadn’t asked for a urine test, we would not have known QT had UTI. His pee didn’t smell funky either. I…shudder to think if the UTI had gone undetected.

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the stay was shorter this time round, the usual round of antibiotics given (ampicillin & gentamycin). I was familiar with the routine already, we took home the ridiculous amount of cefaLEXin, and was discharged with the usual follow up, with an ultrasound plus DMSA when he turns 6 mths.

As with Ollie, we managed to keep QT awake until the time for the DMSA. I nursed QT to sleep, and we managed to get him to sleep through the entire process. Phew. We were pretty hopeful that the results would be good, like Ollie, that way he could be off antibiotics. I guess we were too hopeful. We sorta pooh-poohed the thought of QT ever needing to go back for anything else.

Second time we were wrong. The DMSA results showed no scarring. Technically speaking, there wasn’t a need to continue with the antibiotics. I pushed for a discontinuation of the antibiotics also on the basis that there were no further episodes of UTI, and the doctor agreed. However, she did point out that part of the left kidney appeared swollen (focal dilatation in the upper pole calyx of left kidney). Wasn’t too major at this point in time, but she would like us to keep going back for ultrasounds every quarterly to monitor the swelling, and to go back to her post ultrasounds for follow-ups.

Fair enough. I still wasn’t too worried. Could be a one-off thing right? Hahaha I am that eternal optimist. I wanted to close the chapter and move on with my life, our lives. But ah..that wasn’t meant to be. That was July 2014.

September 2014: Ultrasound showed that the left kidney had grown in size, from 5.6cm to 5.8cm. Still slight fullnesst of the upper pole calyx PLUS left renal pelvis at 4mm.

February 2015: Ultrasound showed that left kidney is now 6.4cm in length, mild left pelviectasia is noted, more prominent in lower pole calyces, left renal pelvis still measuring at 4mm

July 2015: Ultrasound showed left kidney is now 6.7cm, prominent calyx at upper pole of left kidney, left renal pelvis still 4mm. Left hydroureter noted, mid ureter: 12mm, distal ureter 5mm. 

When we saw the PD in July this year after the ultrasound, she said she had to refer us to the nephrologist. Before we saw her in July, the PD had been happy to accommodate with the left renal pelvis being at 4mm, cos she said it was still within the normal range. I have to say she had been pushing for the Micturating Cystourethrography (MCUG) so that we could eliminate reflux (urine going backwards) being one of the reasons for the dilated ureter. However, both Donald and I were against it as we felt it was a very invasive procedure. And the problem didn’t seem too serious. We asked questions like if it appeared that the dilated ureter was a result of reflux, or under what other circumstances could the ureter be dilated?

However, when it went up to 12mm, it was something that was out of range, and she highly recommended the MCUG. We were still hesitant, and we agreed that we could listen to what the nephrologist said before making the next decision.

what if the choices you made, which you strongly believe are made in the best interest of your child, is actually wrong? 

Gaah..again, packed my bags for another guilt trip. Did delaying the MCUG cause the ureter to be dilated? What if it was because of my decision to just observe and monitor was worsening the problem? Donald had to assure me that the decisions we had been making were educated decisions, and it was after discussion with the doctor that we agreed to proceed with our decisions. Still..you know, I couldn’t help but feel responsible for the state that QT was in. It was our decision afterall.

next part: meeting the nephrologist and beyond

Category: Daily

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