Bladder Up!

Many of you know that Ruby had surgery last week, though we thought we'd post this anyway for those that are interested.

Back in May Ruby was experiencing pain during urination, and there seemed to be a correlation between the fullness of her bladder and the level of discomfort she felt. Each time, when questioned about where it hurt, she pointed to both sides of her lower back (doctors call this "flank pain"). On Mother's Day night she went potty and actually cried out in pain, which prompted a call to the nurse line and then a trip to the ER (given her kidney history, the nurse felt it best not to take chances). The ER couldn't find anything wrong and told us to monitor her at home and go to the pediatrician if things persisted.

Things persisted and after an appointment with the doctor, a trip to the hospital for a bladder/kidney x-ray, Ruby was diagnosed with kidney reflux. This simply means that Ruby's urine was traveling back up the ureters (WRONG WAY!) into her kidneys, and the severity of Ruby's reflux meant she risked damage to the soft tissue of her kidneys if the problem wasn't corrected. Enter Doctor Shukla, pediatric urologist.

Doctor Shukla recommended surgery to correct the reflux, and that happened last Monday. Ruby was able to go home on Tuesday evening, though not without a Foley catheter because she was still having trouble completely emptying her bladder. I cannot overstate how much Ruby hated that catheter (can you blame her?) and she had to wait until Thursday to have it removed (shockingly, this was a job we had to perform at home). We told her we would take it out first thing on Thursday morning, so she woke us up promltly at 6AM, pee bag in hand, because she was ready to roll. And out it came.

She had a great day on Thursday, but by Thursday night she wasn't feeling well, and on Friday morning she had clearly had a setback. She had chills, was lethargic, whimpering, and couldn't get comfortable in any position. She wasn't running a fever and couldn't quite identify what was making her so uncomfortable, but her condition seemed to be worsening and while I was on the phone with Dr. Shukla's nurse, she started vomiting. I'm not sure I've ever driven down University Avenue so fast, but we made it to the ER in record time. After many tests and poking and prodding it appeared that she was simply dehydrated and a bag of IV fluids did wonders for her overall condition. We had the good fortune of being seen by Dr. Shukla who was at the hospital performing other surgeries, and he felt like she was going to be fine and we just really needed to push the fluids and peeing.

Since then Ruby's been great, continuing to improve by leaps and bounds. She lost some weight during the ordeal, and she didn't really have any extra weight to begin with, so that was visible on her tiny little body. She's eating well again and we've relaxed our food standards somewhat to get more calories/fat into her, something I think she's thoroughly enjoyed.

This experience has been a difficult one for us as parents and brought back some painful memories of her hospital experience of 2007. A child in the hospital - in pain - is frightening and awful and really makes a parent feel so helpless. And while I know the doctors and nurses are only doing their jobs, if putting a catheter in makes my daughter cry, my instinct as a parent is to leap over the bed and tackle you to the ground so that it stops her from hurting. Hospitals tend to frown on that sort of thing, so one has to suppress that urge and put on a brave face. Not easy.

I'm sure that in a few weeks much of this will seem like ancient history and Ruby will simply have another battle scar to show off to her friends when she's a teenager, but right now I still find myself hugging her hard, holding her tight, and marveling at her resilience and tenacity. Ruby is a bad-ass.

One final thought: If you have never stopped to give thanks for your healthy bladder, kidneys, and ureters, you might want to think about doing so. They really shouldn't be taken for granted.