Monday, August 16, 2010

Smooth sailing in nephrology (so far)

Today's nephrology appointment went well, with the understanding that not all required tests are complete, but everything so far was fine.

The appointment was at 3:30. We left the house at 3, even though it takes 10 minutes to get there, leaving us extra time to find a parking spot and such. I made sure to bring The Boy's urine sample, which I had collected from him at a time when I knew he had to go because he'd been without pants for hours and hadn't gone in nearly two hours. I figured that to ask him to pee in the cup while at the office would have been too stressful, and the timing would have been too difficult, so I'd get it in advance. It was either that or have him wear a pee bag and I'm glad to say that he is potty-trained enough that he can avoid the pee bag for the foreseeable future. The pee bag, if you will recall, is stuck around the appropriate part to collect a urine sample from a non-potty-trained child. The Boy was never a big fan, and who could blame him? So I'm very glad that the pee bag is a thing of the past.

My mother told me that The Boy's diaper that he had on was coming undone but I didn't do anything about it. When I got him out of the car and took the diaper off, it was dry, so I asked him if he could wait to go until we got upstairs.

So, armed with The Boy's urine sample, we proceeded into the hospital. The Boy was amazingly cooperative. He held my hand when he was supposed to and ran in whatever direction he was told. The first place we went, of course, was the bathroom. They have cute bathrooms in that waiting area, with a normal-sized toilet and a little tiny one! The Boy was excited to use the tiny toilet and he actually went! I wished I had some underpants to put on him, but I didn't, so he wore his sea-green diaper with the snaps.

We went to the second waiting area, registered, and then waited some more. The Boy played with one of the little kiddie computers that they have in the area and even shared with a smaller boy.

Then to the actual nephrology area, where the med-tech (I think that's what he was, unless he was a nurse) asked if The Boy was potty trained and could pee in a cup. He was glad when I produced the sample and told him that I had collected it in advance, knowing that I'd need it. We did The Boy's vitals. He hasn't grown since last month, when he was at the pediatrician for something. His blood pressure was okay but not great, since he was making a fuss about it.

We got to wait. And wait and wait. I even had a post ready about waiting for over an hour to see the doctor but I forgot to post it because she arrived. But, before she did, The Boy wanted to use the little toilet again (it was my idea but he still did it).

First she told us that The Boy's basic urinalysis looked fine. No significant protein, no blood, no albumin, no leukocytes, nothing was there that shouldn't be there. That, combined with his blood pressure both there and what I reported from home, made her think that his kidney function is better. She said that she wanted to run a protein/creatinine test on the urine, and she had some bloodwork that could be done next week when he goes to hem/onc.

The medication that The Boy takes is good for his kidney, so she wants him to stay on it, but since his blood pressures have been good and he sometimes didn't need it under the parameters she had set for it, she reduced the dose so that he would get it every day. For now, 1 mg of Enalapril, and we are to monitor his blood pressures. If it gets over a systolic of 105 consistently, we call her and adjust the dose.

It's still so amazing to me that the ONLY medication he takes now is the Enalapril. He used to be on such a cocktail.

As for his diet, the doctor said that we should keep him away from TOO much sodium. As he gets older, if he continues to have kidney problems, we may need to restrict his protein. The potassium doesn't seem to be much of an issue these days (although next week's bloodwork will confirm that). I might even start making potatoes again.

Oncology next week; "well-child" visit the week after. And then we avoid the doctors for a little while, we hope.


Sarah R said...

I'm glad all is well! :) I am jealous of a sea green snap diaper (it's my favorite color) -- what brand is it?

Heather said...

SO glad to hear that it went well so far. Way to go David for going potty a lot yesterday.

(I LOVE the little potties and wish that it was a practical idea to put one in our house.)

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