Bombshell

The pediatrician sat me in exam room #2 with four week old M and began, "Well, there are some things that showed up on M's renal ultrasound."

We've been with this pediatric practice since Miss J had been born two years prior and had grown to love our pediatrician.  He was kind and gentle and always had a warm smile.  Playful and fun, Miss J had always been at ease with him.  Today the smile was replaced with a look of serious concern.  He got right to the point,

"M's right kidney is very small and underdeveloped.  Both kidneys are duplicated, so basically instead of one ureter leading from the kidney to the bladder, there are two ureters on each side.  Both kidneys have high-grade reflux and the urine from the bladder is flowing back up the ureters and into the kidneys.  His bladder is larger than it should be. You'll need to see a pediatric urologist."  

I sat, stunned, taking in all this new information.  Before I could respond, the pediatrician continued, "I am listening to him breathing and I don't like the sound. I want to to also see a pediatric ENT."  He took M and listened to him carefully.  

"Do you hear that?  He has tracheomalacia.  His airway is floppy.  It isn't uncommon and usually isn't serious, but I want you to get it checked out."

Within a few days, we were sitting in the Urologist's office.  He confirmed what M's pediatrician had told us about the kidneys.  We were scheduled for a battery of tests.  He would need regular ultrasounds to monitor growth of the right kidney and to make sure damage didn't progress.  M would start taking antibiotics every day to prevent any urinary infections.  He cautioned us that if M were to get a urinary tract infection and that infected urine back-flowed into the kidneys,  serious damage could occur. M would need monthly urine checks for bacteria.

The appointment with the ENT was for the following week, but M's breathing seemed to be getting worse.  I called to see if the appointment could be moved up and was told that babies with tracheomalacia do breathe very loudly and not to be concerned, but that they would move the appointment up for the next morning anyway.

I hung up the phone and looked in on sleeping M.  His breathing was loud and ragged and he looked more gray than pink.  I put M in the car and took him straight to the pediatrician. 

The doctor looked at him and said, "He's not safe to be at home.  He needs to go to Children's.  Now."

Tomorrow:  The Mothership