I just want to preface that this is going to be a lengthy entry as there is quite a bit of information and it always take longer to type out then it does to say verbally in person or over the phone, so bear with me here. I met with Dr. Aliabadi on Tuesday Jan 5th in the afternoon for a 30 minute consult. Wicked nice man and I felt very comfortable and confident with him. Jared was unable to make it to the appt due to work. He started out by having me explain in my own words what I thought was going on from what I have been told by the perinatologist and my OB dr. If you read my last blog entry about the posterior urethral valves and the kidney dilation then that will give you a good idea of how I explained it to him. He started off by saying that it was a good sign to him that I was not crying! I told him that what's the point of crying when there is nothing myself, or anyone can do right now as it is just a waiting game until delivery. Dr Aliabadi then went through everything again with me and told me what the different scenarios would be. Nothing can be done until this little guy is born. Once he is delivered the hospital staff will call/page him and let him know that I delivered. An ultrasound will be done 24 hours after he is born. The dr is in no rush to have this done as it is not hurting the little guy and he would rather have him learn how to regulate his temperature and get used to be on the outside world before they start doing anything on him. So on day 2 or 3 of life little baby Kuyper will have an ultrasound done on him to see more clearly what is going on b/c you can only see so much on him going through my body and as the end of the pregnancy gets closer (REALLY SCARY TO THINK THAT) ultrasounds get less and less accurate.
They will do the ultrasound to specifically find out what is going on with him. There are two different things that could be going on and until the do the ultrasound on him they will not know for sure. The first is that where the kidneys and ureters connect, there could be a blockage in which there is not enough urine passing down the ureters which is then collecting in the kidneys making them dilate. The second is that there could be a reflux happening. This would be from the posterior urethral valves not letting enough urine pass through the urethra so the urine is being pushed back up in the kidneys causing the kidneys to dilate. Think of acid reflux/heartburn being pushed up in your throat and that is like the urine being pushed up into his kidneys.
From the ultrasound they can determine if it is the blockage or the reflux. If it is the reflux then what they can do is go through the urethra and shave down the valves in order to let more urine pass. This is a simple same day procedure that would be done in order to fix the reflux. If it is the blockage then they would actually have to do surgery in which that would require him to be in the NICU for 2-4 days to recover. The dr did not say how soon after birth the surgery would be b/c as of right now we don't even know for sure if it is the reflux or blockage so why jump to conclusions when we could be wrong. I will still deliver at Methodist and the staff there will page him to let him know about delivery. The ultrasound will be done at Methodist but any procedure or surgery that would need to happen with be done at Children's Hospital. I'm sure a lot of you are wondering the size of the kidneys and he said that right now they are dilated to 13mm on the right side and 15mm on the left side. He also said that one side could be reflux and the other side could be blockage. Just because there is bilateral dilation doesn't mean that both sides are the same. In which if one was blockage then they would surgically correct that one side.
I still will be going for my weekly appts, NST/BPP's until delivery. The dr also said that there is no reason to take him early and he would like be to get as close to 40 weeks as I possibly can. If baby Kuyper does need surgery he wants him to be as big and healthy as possible. That is all that I can think of for now. If you have other questions or ones that I may not have answered don't hesitate to call or email. Hope everyone is enjoying this wonderful cold weather!
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