For many of you, this will be the first known knowledge of Ava's current kidney condition. Around mid-October of last year, Ava developed a high-grade fever above 102. After a visit to the pediatrician, the results of the exam revealed a UTI (urinary tract infection). She was prescribed an antibiotic and was soon back to her normal self. However, at that time our pediatrician recommended further testing secondary to the results of the UTI and referred us to a pediatric urologist at Ruby Memorial Hospital. Following our urology exam, we then scheduled (per the urologist's recommendation) a renal ultrasound (this was around February of this year). The results of the exam revealed Stage II Hydronephrosis, which is basically a condition in which urine trapped in the kidney causes it to swell. The cause of the trapped urine was unknown at this point, therefore, yet again, further testing was required. It wasn't until yesterday, September 20, 2011, that we were able to complete the next step of the process. The test Ava was required to undergo was a Renal MAG3 (Mercaptuacetyltriglycine) Scan. This test would allow us to understand more about Ava's hydronephrosis, determine kidney function, and detect an obstruction if present. Before I begin explaining the results of the exam, let me share with you, from a mother's point of view what yesterday was like for us, specifically for our precious little girl.
We arrived at the hospital just before 8:30am and were registered in the Nuclear Medicine department. The four of us (yes, we brought Audrey along - we prefer to have the whole family together as often as we can and especially during trying times) were escorted back to the examination room for the pre-exam procedures. Typically this test does not require anesthesia, but because Ava is under the age of 5, and unable to sit still for the required 45-60 minutes with an IV placement, she was required to be put under. After family history questions were completed and parental permission was given, she was then placed on the exam table for IV administration. This part was so hard for all of us. The nurse attempted placement in her right arm with no success. She then attempted placement in her right hand with no success. Then she called in another nurse, who choose a larger needle to attempt placement in her left arm - finally success. But, we were all in tears at that point. My poor little baby had to be pricked three times before the IV would successfully enter her vein, and during the whole process, she was begging me to help her. Talk about pure torture! And just when I didn't think it could take any more out of us, this next part of the procedure was probably the most emotionally-trying part. When the anesthesiologist began administering the anesthesia, Ava started acting funny and began looking at me as if she didn't recognize me or even know me just before she feel into a deep sleep. My heart literally broke into a million pieces. I understand the effects of the drug. I've even been put under a couple times myself, but seeing my daughter have to go through that right in front of my eyes, is something you can never emotionally prepare yourself for. I was scared for her. So many fears arose inside of me. "What if she never wakes up?" "What if she's never really herself again?" After the one hundredth kiss on her cheek, a consoling hug from the nurse, and a supportive "We'll take good care of her" from the medical team, we were asked to leave. The exam lasted well over an hour. We could only wait and pray.
Once the exam was completed, we were allowed to see her. She was still waking up. The effects of the anesthesia lasted a good while after she awoke. She appeared to be dizzy and clumsy. We were careful to make sure she didn't fall over when she insisted on walking. After the exam, we headed over to the Physicians Office Center for a follow-up appt with her urologist. Our appt was scheduled for 11am... we didn't see him until 1pm! You can imagine how exhausted we were at this point (especially trying to keep a 7 month old baby happy all the while!), but once he began discussing the results, we were thankful to have had the opportunity to see him. According to the doctor, the results of the scan revealed that both kidneys were functioning perfectly. The scan also revealed, however, that while the left kidney is filtering normally, the right is filtering little or nothing at all because it is obstructed. He said that he would have to refer us to a doctor in Pittsburgh, who will have to surgically remove the obstruction.
Everything is starting to make a little more sense now. This obstruction explains why there was very little amniotic fluid in my womb when I was pregnant with Ava. Her body wasn't filtering or possibly creating enough urine. This ultimately led to her being breech and to her Cesarean delivery.
Once we were finally back at home yesterday, and the girls were fed and bathed, they played together as if nothing had changed. I was so thankful to have both our daughters at home safe and sound with their daddy and mommy. Here they are playing so cute together in Audrey's crib.
I know that the Lord is always in control.
I praise God that she had the UTI back in October last year. Without that infection, we would have never known something was structurally and functionally wrong with Ava's kidney. I praise God that there are modern advanced technologies, such as the MAG3, that allow us to discover abnormalities within the body before permanent damage occurs. I praise God that before my little girl was even created, He had a plan for her, and I know that we can only trust in Him to continue to guide us in making the best decisions for our daughter. We can only place our faith in Him to hope for a safe and healthy outcome for her.
Please keep her in your prayers throughout the rest of this journey. She will be scheduled to see the pediatric surgeon in 3 to 4 weeks from now. We'll be required to stay in Pittsburgh for a couple days during this time. At that point, we'll know from there what's next. But from what the doctor here at RMH and from what I've researched on my own, the prognosis from this type of surgery is excellent. They should be able to remove the obstruction and regain normal kidney filtration. We sure are hoping and praying that this will be the case.
I know most of you will agree, that I would gladly give either of my daughters one or both of my kidneys if I could. Our daughters are so very precious to both of us. Being a mother can be so very challenging. It can be so very trying. It can even be heart-breaking. But I wouldn't give up being the mother of these two precious angels for anything in the world!
I'll be sure to post an update on Ava's kidneys when the time comes. Until then, your thoughts and prayers are gladly welcomed.