Natalie's testing

Hi Everyone!I wanted to update you all on Natalie's tests she had done today. She went to Children's Hospital for 3 tests. An Ultrasound, Renal Mag3 lasiks scan, and VCUG. It was a very rough day for our little Natalie. She had to be catheterized twice and had to have 3 needle sticks. :( Poor girl.

The ultrasound was to determine the size of the kidney and compare to last month. The size is still very enlarged. Compared to last month, it's about the same degree of enlargement, almost 3cm larger than the left kidney. So even though it's still at a stage 4, it hasn't grown a great deal more than they expected to see. It's something they want to keep an eye on.

The Renal mag 3 lasiks scan was to determine how well the kidney is functioning and thankfully, it is functioning equally with the left kidney at this point. This means that it is making and filtering urine well. However, it took 54 minutes to drain as compared to the left kidney which took 17 minutes to drain. The concern with this is that b/c as it takes that long to drain, and she is eating in the meantime, it starts to fill again. So it's constantly holding urine, which is a concern with future functioning and risk of infection.

The final test was a VCUG, which looks for kidney reflux, or a backup of urine from the bladder back into the kidney. This test was negative, so she does not have kidney reflux. She also does not have a double ureter, which was something the original ultrasound listed as a possibility.

After the tests, we met with the doctor and he said that the renal scan showed that she has an obstruction in her ureter. It's called a UPJ obstruction (ureter pelvic junction). In utero, while the bladder and kidneys are forming, the ureters form from the bladder and grow upward to meet the kidneys. Sometimes the ureters fail to attach correctly causing a blockage, kink, or narrowing of the ureter. This is what happened in Natalie's case. Because this occurred, the urine does not move out of the kidney as quickly as it should.

The good news is that the kidney is functioning well. So at this point, the doctor doesn't want to do anything but watch it. We will go back each month for an ultrasound and doctor's visit. They will make sure the kidney doesn't get any larger. If it does, she will need surgery. If it stays the same, we will continue to watch it with monthly ultrasounds and do another renal scan at 6 months to see if the kidney is continuing to function well. He said that patients with stage 2, or even stage 3 hydronephrosis where there is a UPJ obstruction sometimes correct themselves. Stage 4 isn't as likely, but he's seen it happen so he wants to wait it out in the hopes that it will correct itself. He said several times, "I don't want you to think i'm dragging my feet, but I just feel that toddlers are stronger and can bounce back from surgery easier than an infant in the event she ends up needing surgery". So I really feel like he has Natalie's best interest at heart.

He said that he's had patients like Natalie present with the same condition, with the same level of kidney function, end up needing surgery at 6 months or a year. But he's also seen some that are fine until they are 3 or 4 and then present with flank pain or repeat infections and end up requiring surgery. Of course, all of us hope the next few ultrasounds will point to it correcting itself, which he has also seen happen. That would be the best case sinerio.
All in all, it was a very good appointment. I feel confident that she is in good hands. And I know that we've got a long road of testing ahead of us, but it needs to be done and we'll get through it. She is in God's hands and we just pray that he will continue to watch over her.

Her next ultrasound will be the end of February. I will keep you posted!

Thank you for all of your prayers!
Christy, Matt, Ally, Tommy, & Natalie