Jaelyn's Big Week

Jaelyn had a very big week this week. Tuesday, went to Thunderbird Hospital for her Voiding Cystourethrogram (VCUG). A procedure we have been planning for almost a year. Last year on July 31st, 2010 she was diagnosed with a Grade II Vesicoureteral Reflux or VUR. In layman's terms, this means that her urine travels back up from her bladder to kidney's in the reverse direction that it is supposed to travel. Since July 31st, she has visited a urologist who placed her on a very low dose of prophylactic antibiotics. She takes the antibiotics every evening at bedtime, has ultrasounds every six months to check on the growth of her kidneys and bladder, and finally, as long as she has VUR, she will have the VCUG procedure once a year. Her second VCUG took place on August 16, 2011, Tuesday. The results came back with no change from the previous year. Our hopes were that in the last year she would have outgrown it on her own, but unfortunately that did not happen.

Thursday we met with the Urologist again. He did an ultrasound on her kidneys and they are growing well and normal. He also reviewed the pictures taken during the VCUG. This a picture that was taken. It shows her bladder filled with the dye. It also shows her Ureters which would typically not show up on this type of x-ray. You can see both of her ureters clearly on her x-ray because the dye they inserted into the bladder is able to travel up into the ureters and to the kidneys. This is how they they determine that she has it and also the severeness of the reflux.
The Jaelyn's Urologist discussed three options with us. None in which I really want to choose, but I know we have to. The first option is for Jaelyn to have surgery. It is a medium surgery where she would be put under general anesthesia and they would make an incision in her lower abdomen. It is called Ureteral Reimplantation surgery. The surgery is about 98-99% effective and will correct the VUR.

The second option we were given is called Deflux. Deflux is an endoscopic injection in which they enter through that bladder to insert a gel-like material to fix the valve that is not working properly. This is an outpatient surgery, we would only be at the hospital for a few hours and she would be up walking around the next day, if not the same day. Unfortunately with this option there is only about an 80% success rate. She would remain on antibiotics for 6 weeks after the deflux and then have another VCUG to test for the Reflux.

The last and final option is to continue doing what we have been doing. She would continue to take antibiotics every day for another year, the dosage would increase slightly. She would have an ultrasound in 6 months to check her bladder and kidneys and then a VCUG and ultrasound in one year. There is a 50% chance that she will outgrow it at this point or we would revisit these options once more.

As of right now, Josh and I are leaning more towards keeping her on the antibiotics for another year. As much as I hate that she is on them, she does not seem to have any side effects of the ones that she is taking and they are working to prevent any further infections. Surgery is a sure thing, but at this point we agree with the dr. that it may be a little on the extreme side. The Deflux, as noninvasive as it is, I am not really OK with. I do not like the idea that it is only effective 80% of the time.

We are praying that this time next year she will have outgrown the reflux and we will not have to choose from these choices again.