Savannah, her kidneys and upcoming surgeries

(This post is taken from an email I wrote to friends and family on Monday with new updated information)

Monday, the quads and I drove to Fort Worth for Savannah's appointment with her pediatric urologist, Dr. Pinto.

Ethan, Drew, Ben (Sav on the table)


Ethan


Andrew


Ben (who by the way--looked SO grown up to us when we returned from Chicago! Something about his face looks more mature)

We received the results from Sav's VCUG and RENAL SCAN that were performed on June 1, 2009. Not so good--pretty much worst case scenario for the poor gal. She has two very distinct and different situations going on with her kidneys/ureters and will require 2 different, big surgeries. I will do my best to explain.

Sweet silly Savi


SAV'S RIGHT KIDNEY (the worst problem):

She has almost a complete UPJ obstruction and lots of scarring, causing her kidney to swell.
The kidney is functioning around a 10% or lower capacity right now. (scary) Here is some info I found on the web to explain the surgery:

The classic treatment of UPJ obstruction is an open operation to remove the UPJ
and to reattach the ureter to the pelvis of the kidney, creating a wide junction
between the two. This operation, called a pyeloplasty, allows rapid and easy
drainage of urine produced by the kidney and relieves symptoms and the risk of
infection. The procedure usually takes a few hours and has a success rate in
excess of 95 percent with one operation. Hospitalization after surgery depends
on age of the patient. A variety of drainage tubes can be used to promote
healing, and the choice of which one to use is dependent on the surgeon's
preference. The incision usually is just below the ribs and just behind a line
that would pass from the patient's arm to the leg on the affected side. The
incision usually is two to three inches long.

The doctor told me that the surgery will last 3 hours and she will be required to recover in the hospital for 48 hours. They will also place a ureteral stint during surgery that will be taken out several weeks later in the office. Dr. Pinto was booked up until August, but managed to move the schedule around (including giving up a vacation day) for little Sav to get in sooner. She is now scheduled for next Friday, June 26th @ 2pm. Joe and I will spend the weekend with her in the hospital and she is expected to be discharged sometime on Sunday, the 28th.

SAV'S LEFT KIDNEY:

She continues to have vesicoureteral reflux at the highest grade (IV/V)---to the degree where her poor little kidney is completely swollen and full of urine. (not good) The good news is that the ureter is at least draining (unlike the right ureter), POORLY, but draining nonetheless. Here is some information about the surgery involved with this condition:

Open Surgery
The most frequently performed operation for the correction of
reflux is the Cohen cross-trigonal reimplantation. This is done through an
incision in the bladder and the ureters are relocated into the bladder to
prevent reflux. This procedure can be done with a 1-2 day hospital stay and has
a very high success rate – approaching 98% at most institutions. Due to the high
success rates of this procedure, some surgeons will forego follow-up VCUG. You
can read more about it here:
http://urology.jhu.edu/pediatric/diseases/reflux.php

HOWEVER, Sav's little body would not be able to endure both procedures in one day (it would be a 4+ hour operation)...not to mention that BOTH of her kidneys/ureters would be compromised at the same time (which is scary). So, we will wait a while for her body to heal from the first RIGHT kidney surgery, and then we will proceed with the Cohen cross-trigonal reimplantation for her LEFT kidney. (I'm guessing within a couple of months) Same scenario, 3 hr procedure with a 48 hr hospital stay.



Poor little girl does not act sick at all. You would have NO idea! Although we are relieved to finally take care of her renal issues, I am getting more and more anxious about the actual day of surgery. Please, please, pleeeeeeeease be praying for precious Savannah, our family, and all of the personnel who will be taking care of my sweet little angel.

After Sav's appointment, we headed upstairs to love on Dr. Tabor for a quick second. I just LOOOOVE all of his staff. Such sweet, caring people! I miss seeing their smiling faces every week!

The genius and his quads---its almost been 2 years!


Then we strolled across the parking lot to visit our buddies in the Harris Methodist FW NICU. You might recognize NURSE ASHLIE there in the middle! LOVE HER! MISS HER!


We also took a trip upstairs to visit the nurses on Jones 3rd floor where I lived in the hospital 2 summers ago. MY my my....just amazing to think about. (Forgot to take a pic, Jones 3! Much love)

And there you have it...a pretty intense little Monday afternoon for our family. I will keep you updated on Sav and her surgery. It is incredible to imagine how much your life is going to change once you have a child. One of my best friends once told me, that it is like having your heart walking around outside of your body. SO TRUE. Taking your baby in for surgery is one of the hardest things I have ever had to do (Ethan and Andrew had inguinal hernia repairs when they were just a few months old)---and it is getting more and more difficult the older they get. Praying for peace of mind and a successful, minimally traumatic surgery for the little girl.