Saturday, January 29, 2011

Revisiting the Japanese medical system

Posted by kuri, ping, the pinglet, & mini-ping on 1/29/2011
So much for my New Year's resolution to post daily! Somehow January has gotten away from me, even though it isn't over yet. Mi madre will be coming for a visit at the end of February so I'm already in the future making plans about what we'll be doing. Hopefully, she won't mind working on putting together a few albums of about 1,000 photos that have yet to be "organized." Can't you just feel the excitement?

The Pinglet and Mini-Ping continue to keep me and Ping on our toes with the various ailments they come up with. I wonder if they have a children's version of the Merck Manual and go through it nightly so that they can present ever new and innovative symptoms to us in the morning.

Miraculously, the Pinglet has (knock on wood) escaped the flu outbreak that occured in her class. Her BFF, a certain K-chan who's name I hear daily, was out for about a week. Every time the Pinglet would come home on the bus, she would have to undergo questioning before being allowed to come near Mini-Ping, the only one of us to not receive his flu shot. So far, all is well on the home front.

Mini-Ping, on the other hand...*sigh* He is SUCH an easy baby. Sleeps well, eats well (except for the constant vomiting, of course, but such is my life), has a smile for everyone, and is just a really easygoing baby. It makes me nervous because I'm so used to the Pinglet who rails against the world when she perceives that she's been slighted in any way, such as when she is refused a second mug of hot chocolate, for example.

Mini-Ping had his 4-month check the other day (and just to interrupt myself here, I can't believe he's 4 months old already!), and they found a problem with one of his kidneys. We visited the pediatric urologist today and found out that he has hydronephrosis, a malformation of the kidney, which can affect the kidney function. Basically, the urine isn't flowing correctly and remains in the kidney, leaving him vulnerable to UTIs. The doctor isn't quite sure what the problem is yet, but it's one of two things: "vesicoureteral reflux," which is where the urine is pushed back up from the bladder into the kidneys, or "ureteropelvic junction obstruction," which happens when the ureter (pipe connecting the bladder and kidneys) is kinked or too narrow.

At the visit today, they did three tests (my poor baby!). The first was a blood test to see if his kidney function was OK. My little champ passed that with flying colors. The second test was a urine test to see if he had any infections. His white blood cell count was slightly high, but they didn't know if that was because it wasn't a clean sample, or if he has the beginnings of a UTI. For the forseeable future, every time he has a high white blood cell count, he'll have to take antibiotics to fend off any UTIs.

The third test was an ultrasound of his kidneys. His right kidney is fine, but his left kidney is engorged within the kidney itself, and also at the exit of the kidney. Hydronephrosis is graded on a scale of 1-4 (1 is mild, 4 is severe). Based on the ultrasound, the doctor has graded him as a borderline 3, since there is swelling both inside and at the exit of the kidney. A class 4 would require him to have surgery as soon as possible. Class 3 means Mini-Ping will have to undergo two more follow-up tests to determine the course of treatment.

One test is called the "voiding cystourethrogram (VCUG)," where they examine the urethra and bladder as it fills and empties to find out if there are abnormalities and if the flow is normal when the bladder empties. This tests for vesicoureteral reflux. The other test that he'll have done is called an "intravenous pyelogram." They'll inject a liquid that can be seen on xrays into a vein and will check out the entire urinary tract to see if they can determine if/where there is an obstruction.

Depending on the severity of either the obstruction or reflux, they'll either recommend surgery, or not. This condition can clear up on its own and may just require periodic monitoring. I'm hoping/leaning towards that.

So, that's where we stand...he's fine, looks like he wants to crawl all over the place (but can't of course!), is smiley, SLEEPS!, and isn't in any pain. He doesn't exhibit any symptoms (no fever, no distended abdomen, no pain), so had we not had a routine ultrasound for him at his 4 month check, we never would have known.

Ping and my track records for pediatric surgery is not good. The Pinglet has 2 surgeries under her belt already: once for an ovarian hernia at 4-months (seems to be the magic number) and the second time on her eye. I'm hoping that gives us our quota and we'll escape with minor monitoring of Mini-Ping's condition. Thoughts and prayers greatly appreciated!

4 of you feeling verklempt. Tawlk amongst yourselves:

gaijinwife said...

The tests, at any time, but especially when they are so young sucks. Tubes up their bits, being velcro-ed to the table :( Marina has had those tests and I think had to be put to sleep for both? - which actually,come to think of it, might have been more traumatic for both of us at her post-op 2 year check up:( I hope Ken can keep being his smily self and just monitored. You've definitely had your share of hospital time. Xxx

Violet said...

Hi there,
I think this is possibly the first time I've commented on your blog, but I am an avid reader (when you post that is - coming from a blogger who hasn't posted in nearly 6 mths...). Anyway, sorry to hear of the medical troubles. Great that they were picked up so soon and action is being taken though. Just wondering, how did you get the routine ultrasound? My boys (twins) are nearly 8 mths and we didn't have any routine or otherwise ultrasound at either the 3/4 mth or the 6/7 mth check ups. For all I know, they may have the same condition, just undetected....

kuri, ping & the pinglet said...

GW, tests anytime do suck, but even more so when they're so tiny. I remember both of the Pinglet's surgeries and how awful it was (more so for her, but she still doesn't even KNOW she had surgery. :) She doesn't like the sight of her own blood (other people's blood is OK apparently) so telling her that she had surgery will guarantee that the waterworks start. :) What did Marina have a problem with?

Violet, thank you so much for commenting! I'm sorry for being a bad blogger...I was SO not inspired to blog by being pregnant in the hottest summer on record! LOL I am not sure about the routine ultrasound, but both kids had them at their 4 month checks (and follow-up checks, I believe). Maybe it's part of this city's health check? Not really too sure about it...I don't know how they check for this condition since Mini-Ping has/had no symptoms and they just found it kind of by accident...same for the Pinglet and her hernia. Am off to check out your blog!

Anonymous said...

Happy you're back blogging! And I'll see you in less than 2 months!


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