Friday, December 23, 2011


The phone rang the next day with the results of M's tests.  I was summoned to the hospital to discuss the results. Good news, I know, can be delivered over the phone.  The doctor calls, tells you that everything looks great, and to have a nice life.  Simple.  I knew that if I was being asked to come to the hospital, this wasn't going to be a simple answer.

M's infection was clearing, which was good.  The not-so-good news was that M did need surgery.

We learned that M's enlarged bladder was of concern.  It held three times more fluid than it should.  This sounds convenient, but it is not good.  A large bladder that holds more urine increases the likelihood of bacteria growth.  Excess fluid in the bladder means more to backflow into the kidneys and more pressure on the kidneys, thus causing more damage.  It means that the stretching of the bladder damages nerves.  Other tests showed that M wasn't fully emptying his bladder, which could be a sign of existing nerve damage.

For this we would have to have M empty his bladder every two hours in an attempt to shrink it.  Imagine a stomach...the more food you put in it, the more it stretches.  Put less food in it and it shrinks.  It is the same with the bladder.  If less urine stayed in the bladder, it may shrink.  If this did not work, we would have to catheterized M several times a day at home.

The enlarged bladder explained why M had been so easy to toilet train.  His huge bladder and damaged nerves allowed him to hold his urine for hours on end.  Once his bladder filled up, urine back flowed to the kidneys, which became a reservoir of sorts.

Additionally, we learned that M was not concentrating his urine. Whenever he peed, his urine was the palest yellow, almost clear.  The scar tissue in M's kidneys had made them inefficient at filtering.  We were warned that this put M at a higher risk for dehydration.  If M were to have diarrhea or vomiting, we were to take him to the ER for IV fluids.

The tests had showed that M's right kidney had not grown at all.  It was underdeveloped, atrophied and flat.  It was believed to be non-functioning. The left kidney, working overtime to do the work of two, was swollen and larger than normal.  The lower pole was scarred.  Of M's kidneys, only the upper pole of the left kidney was functional.

He was functioning on one half of one kidney.

The good news was that the one half of the one kidney was doing enough work to keep M out of renal failure.  The little bit of kidney was chugging along and doing its job. This was a huge relief.

The doctor did say that he could possibly lose the kidney function he had.  When M had the adolescent growth spurt at puberty, the kidney may or may not be able to keep up.  It is entirely possible that M will require a kidney transplant.

Surgery was discussed. The ureters would be trimmed and reimplanted into M's bladder.  If necessary, the right kidney would be removed.

A date for surgery was set.

No comments:

Post a Comment