Lily's Kimneys

We were very fortunate to get an appointment this afternoon with the Head of Pediatric Surgery/Urology at the University of Maryland. To be honest, as much as I wanted Lily to see the very best doctor I was also a little intimidated by the idea. I didn't need to worry. Dr. V was absolutely WONDERFUL! He was kind, patient, and gentle with our sweet Lily...and with me and Tony, too.

When we told Lily this morning we were going to the doctor this afternoon she told us repeatedly she did not like Dr. V and she did not want him to check her "kimneys". Turns out Dr. V won Lily over in a matter of minutes. Perhaps Mommy's not the only one with a soft spot for men with salt and pepper hair (and a New Zealand accent)!

Here's what we learned today:

Lily has one kidney stone in each kidney. The stone in her right kidney is 3 millimeters. The stone in her left kidney is 4 millimeters. They are small stones...but Lily's ureters are smaller.

According to the doctor there are 3 probable outcomes. First, and the most unlikely, is that the stones will dissolve on their own. Second, the stones will get bigger and need to be "dealt with". Third, the stones will dislodge and "pass."

Obviously, we are hoping and praying for the first (and most unlikely) outcome...that the stones will dissolve!

We did not delve too deeply into what it means to have the stones "dealt with". There was discussion about placing stents in Lily's ureters and using a Ureteroscopy to retrieve the stones should the need arise. At this point my eyes were welling up and my ears were shutting down. I was so glad that Tony was able to come to the appointment so we had two sets of ears to take everything in.

While I was already in shut down mode we discussed what would happen should a stone (or stones) dislodge. Dr. V told us that the symptoms would come on suddenly and that Lily would be "doubled over and writhing in pain." To say the very least I never want Lily to endure that! Dr. V asked that if this should happen we bypass our local emergency room and bring Lily directly to the University of Maryland ER so he can manage her care. Of course, we agreed.

Dr. V was quite honest with us about his lack of knowledge regarding Melamine exposure. He told us that he is trying to educate himself as data becomes available. We are also trying to do the same thing. Dr. V also told us that Lily is his first patient that has had probable Melamine exposure.

As an aside, Dr. V told us that in recent years there has been a steep increase in the rate of kidney stones in US children. I believe the words he used is there has been an "explosion". I thought that was really interesting.

Right now, we are waiting for the results of Lily's urinalysis. Unless the results show something significant, the plan is to monitor the stones by having a renal ultrasound and follow-up with the doctor every 6 months.

Dr. V requested that we check with our insurance company to see if they will cover Lily having ultrasounds performed at the hospital. While he was pleased with the quality of Lily's ultrasound films he is concerned that each time she returns to American Radiology a different radiologist will review her films. Dr. V said that there is a pediatric radiologist at the University of Maryland who is "the very best" and he wants that doctor to review Lily's films each time. I'll be calling our insurance company first thing Monday morning.

One of the things that the doctor stressed is that we make sure that Lily stays well hydrated and drinks plenty of water. The doctor told us he knows how challenging it is to get kids to drink water. Obviously, he doesn't know Lily drinks up water like a sponge!

To be honest, I was hoping to hear that there were no stones and that the initial radiologist's reading was wrong. However, since that's apparently not the case I'm glad we found a doctor that we all feel comfortable with. I will let you know if we learn anything more.