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The Sunday Somethings, 14aug11

Sunday, August 14th, 2011

Something happening around the house: This week, we have an inspector coming to look at the air conditioning installation and someone else to check on the efficiency. We are also getting the house appraised this week for our refinance. We’re keeping our fingers crossed for the appraisal as it can affect our rate quite a bit.

Something I’m reading: I finished A Clash of Kings and started both SuperFreakonomics and A Storm of Swords. I need to finish SuperFreakonomics for this month’s book club before getting much further into A Storm of Swords. At this rate, George R. R. Martin may finish the 6th book by the time I get through the first 5.

Something Gabe is reading: A Dance with Dragons.

Something I’m watching: I think I just watched one episode of Alphas, and that was about it.

Something Maddie is doing (41 months old): She was stung by a bee this week at school, poor girl. She did not seem to have a major reaction, so that is good news. She claims it was a yellow jacket. Yesterday, we were practicing drawing letters. She’s been writing her name constantly on her papers at work in addition to practicing at home. She wants to know how to spell other people’s names, and she’s been pretty good at writing letters not in her name. Yesterday, I had her write the entire alphabet. I was impressed! She made it through R without issues, but then I think she was a little tired of the exercise by the time we got to S. Maddie calls Cullen “baby,” “my baby,” “baby brother,” and “Cullen” (of course). We told her months ago that Cullen is no longer a baby, but he will always be her baby brother. I haven’t mentioned this in a while, but Maddie still uses her belly button as a security blanket. She lifts her shirt and puts her finger in her belly button when she’s nervous or needs extra comfort. I try to remind her to “put her shirt down” when we are in public. She had another t-ball lesson this week and seems to enjoy it. I don’t think that she’s going to be ready for the major leagues anytime soon. She’s having fun, so that’s what is important. I’m thinking we should get a t-ball set for her to play with in our yard.

Something Cullen is doing (18 months old): Cullen had his VCUG test, and as I reported we are thrilled about the results. The tests showed no visible kidney damage and only Grade 1 reflux on one side and NO reflux on the other. This was fabulous news. Cullen is repeating more and more of what we are saying, in addition to adding new words to his vocabulary daily. Two more teeth cut through the gums. The ones I was worried about in the front have FINALLY cut through. I’m relieved! They have been trying to come through the gums for months, I swear. Cullen’s grand total of teeth is now up to 12. Since he’s such an awful teether, I’m not sad that big bunches of teeth seem to come in at the same time. Cullen sometimes says, “please” when asking for something and “thank you” when appropriate. Sometimes when you ask him a question, he’ll start his answer with “ummmmm…” He does this a lot when we’re looking at books and I ask him to find something specific. “Cullen, where’s the bunny?” “ummmmm….” Cullen went through a short phase where he asked, “why?” when we said things to him. I know he picked that up from his big sister! He has been amazingly sleeping through the night. As soon as I type this, I’m sure the streak will be over. He’s had more nights that he sleeps through the night than not. I think in this past week, he had only one restless night (and it was before one of the days we discovered new teeth). I’ve been putting him to bed most nights. He is excited to have his teeth brushed (while I sing the ABC song). Then we go up to his room for several “stories.” He has a great attention span for most of his board books now (at least right before bed). After reading several books, we turn out the light and I put him in the crib. He finds his paci. He then curls up with his bum up in the air and his feet folded, and I put the blanket over his body. We rarely hear much from him now until 6:30am or 7am. I probably shouldn’t jinx things by writing about it here! Apparently, we had a short period around 18 months where we declared Maddie was “sleeping through the night” (and then she regressed until she was at least 2 and a half). Note: I wrote this section just before going to bed last night, and sure enough last night was one of Cullen’s worst nights in a while. He was very restless and woke up often, screaming. He does seem to have some congestion this morning, so I’m thinking he’s probably not feeling well.

Something I’m doing towards my goals: I am not caught up on photos, but I did make a little progress and I have scheduled a bunch of blog posts about our trip over Memorial Day week. Stay tuned for those!

Something I’m looking forward to: I’m looking forward to dinner and games with friends, hopefully some poker, and the last t-ball class.

Something random: It’s much easier to go through sets of photos with Gabe helping me! I try to keep to the rule of keeping only 25% or less of any particular event (exceptions are made for smaller sets). Of course, I still keep too many photos, but this rule makes it much more manageable.

Something captured: Maddie, fielding 3rd base. The t-ball lessons are in a gym (thankfully, it’s too hot outside!). She was more interested in fiddling with her belly button and twirling around in her skirt than she was keeping her eye on the ball.

Others writing The Sunday Somethings: Audrey

Great News for Cullen!

Saturday, August 13th, 2011

Wednesday, we had Cullen’s follow up VCUG, exactly one year after his first one. After the first test, he was diagnosed with kidney reflux. The course of action was for Cullen to take a daily maintenance antibiotic and to retest periodically to see if he would outgrow it. He had Grade 3 kidney reflux on one side and Grade 2 on the other.

I am extremely happy to report that Wednesday’s testing showed amazing improvements (at least as far as this Mommy is concerned). The renal ultrasound showed no visible scarring or damage with normal kidney growth. The Voiding Cystourethrogram study (VCUG) showed no reflux on the side that was previously Grade 2 and only Grade 1 reflux on the side that was Grade 3. I’m thrilled!!! We have a followup with the doctor in a few weeks. I hope that we will be able to put VCUGs and maintenance antibiotics behind us with the improvements that we saw today! I have no idea what his recommendations will be, but unless he strongly urges us to retest, I’m pretty sure we are DONE WITH THAT.

We had to get up bright and early to have Cullen at the hospital by 7:45am. Gabe and I drove separately so that Gabe could take Maddie to school during early care hours. Cullen and I arrived at the hospital, and he had breakfast/snack while we checked in. The check in process went quite smoothly, and Cullen was a happy boy. He didn’t even beg to be out of the stroller.

They called us back to the ultrasound not long after we arrived at the waiting room. Cullen did great in the ultrasound! He got a little wiggly at times and didn’t like sitting still, but overall he did better than expected. He even giggled a little bit as we told him that the technician was going to “tickle” him a little with the wand. This test didn’t take very long. We were given a CD of the images after all the tests were over. You decide… kidney or baby?

We went back out into the waiting room where we thought we had over an hour and a half between tests. We waited for Daddy to arrive. They then told me that they would try to take us back for the next test in a few minutes. I hoped that Daddy would get there before we started! Fortunately, he arrived shortly before we were called. Cullen had fun climbing in the chairs. We read a few of the books we brought, too.

For the VCUG, we knew we were going to have to put him in a hospital gown (which is a good thing considering that the point of the test is to get him to pee all over the table…it’s a messy test!).

He did not want to sit on the table while we were waiting for them to get ready for the test. I debated between my child’s happiness and what I’m sure is not the cleanest floor. I chose my child’s happiness. He tried to escape.

When they were ready to insert the catheter, we got him on the table and into the Papoose Board. This is the first time that we had encountered it. I was worried that he wasn’t going to like being strapped onto the table, but he wasn’t unhappy with the chest straps. He could still move his arms freely, and we distracted him with Tigger. I also tried reading him a book, hoping that would help get his mind off of things.

Once they inserted the catheter and started to put fluid into his bladder, he started crying and did not stop until the test was over and he was off the table again. It was awful. I held his little hands and “hugged” and kissed him as well as I could for 99% of the time (pretty much the whole time, except when a couple photos were taken). I felt awful for the little guy. Once again, I’m not sure how long the test lasted, but it was at least 20 minutes.

The table moved him into the x-ray machine. I was able to continue to hold his hands and talk to him and kiss him throughout the test. The worst part was that he kept trying to undo the wide velcro straps and he was saying, “Help me. Help me. Help me.” It was heartbreaking.

The test this year uses a different kind of fluid and less radiation. I was thinking the images would look similar to last year’s, but they were much different. I couldn’t tell if the results were good or not. The technician did not give us information about the results right away, but at one point I was convinced he had NO reflux since I didn’t see any obvious lines from the bladder leading up to the kidneys. This set of images represents when they were filling the bladder (the first 3-4), and then when he was voiding (you can see that the fluid exited the bladder and some of it was in a pool on the table).

I didn’t see this at first, but once you look very carefully at the 2nd to last image, the technician spotted a slight whisper of reflux. I think it is minor, even for Grade 1.

All in all, we are thankful that the test is over. We are hopeful that we will never have to put Cullen (or Maddie) through it again. We are THRILLED that the results were so positive.

Cullen is 13 months!

Monday, March 7th, 2011

I can’t believe that in a couple months, I’ll only be doing Cullen’s letters every three months! I think that will make it easier since then Cullen and Maddie’s letters won’t fall during the same month anymore! Cullen’s letter this time is a couple weeks late…hopefully, I will be more on time next month. (more…)

Cullen’s (quite overdue) 10-month letter

Friday, December 17th, 2010

It’s getting harder and harder to keep up with these letters! I knew I had no chance over the holiday week since we were going to be out of town for more than a week and I had to write TWO letters. Whew! I finally finished Cullen’s latest letter. I had it written a few days after he turned 10 months, but it took me a while to get it organized and add the photos. Now, I’ll have to write another letter in just a few days. It’s crazy how time flies. (more…)

Cullen’s overdue 7-month letter

Wednesday, September 1st, 2010

The months where I have to write a letter to Maddie and a letter to Cullen are a little rough! It’s challenging to get them both done on time, and this time I missed the “deadlines.” Oh well, as long as I write the letter on or around the date, then I’m happy. Here’s the latest letter to Cullen. I wrote it on the day after his 7-month “birthday,” but I’ve been struggling to keep up with the photos. (more…)

Kidney Reflux

Tuesday, August 17th, 2010

A couple weeks ago, Cullen had his first high fever and some vomiting. He also had a cough and a little congestion, so we were pretty sure that he had some sort of cold. I now think that the congestion was unrelated, and he had learned how to make a new noise with the coughing. The fever got worse over the next couple days. This time period coincided with his regular 6-month check up, so they decided to go ahead and test his blood and urine for signs of infection. The doctor wasn’t overly concerned, but we all figured that we could save another trip to the doctor since they would want to test everything by the next day anyway.

His white blood cells were elevated, so now the doctor was a little more concerned. Once we got the urine sample. it looked a little abnormal at first. They prescribed him with antibiotics and said they would contact us about the culture. She did not want to diagnose him with a bladder infection since that would mean we needed to get additional testing done at the hospital.

Meanwhile, Cullen improved greatly after just 12 hours of the antibiotic. I didn’t think that this was a coincidence! They wanted us to complete the course of antibiotics and then scheduled us for an ultrasound of the kidneys and a VCUG (Voiding Cystourethrogram) study. We had these done about a week ago.

Poor little Cullen has been subjected to at least 5 or 6 catheters now. He has had this done at least twice in the doctor’s office (testing for infection), twice in the ER (two separate trips), and now the VCUG study. The ultrasound of his kidneys was the easy part. The hardest part of that was keeping a wiggly baby from wiggling off the exam table. It didn’t hurt, and he didn’t seem to care about the slippery gel all over his belly.

The VCUG was NOT fun. He hates being catheterized (can you blame him?), and this particular test takes much longer than it does to get a urine sample. After they collected a urine sample, they injected a dye into Cullen’s bladder. For infants of his age, they like to do this twice. Once the dye fills the bladder, they wait for him to urinate and watch the x-rays to determine whether urine is refluxing into the kidneys. Unfortunately, we did not need to do it twice as the reflux was immediately obvious with the first void.

Cullen screamed through out the whole test. I am not sure how long it took, but it felt like FOREVER (not to mention the tube that I swear they were threading all the way up to his brain). It was so difficult as a parent to subject him to such torture. Poor little guy looked at me as I held his hands. His questioning eyes demanded to know why I was doing this to him and why wasn’t I picking him up?? I felt so bad for him.

I thought it was very interesting that the radiologist told us the results of the test and the severity right away. I thought that it was quite unusual that they did not send the results to the pediatrician first. She explained that he has Grade 2 reflux on one side and Grade 3 on the other.

From what I had been told (and the research that I have done online), it is common for many kids to outgrow the condition. The ureters are not properly attached to the bladder, allowing urine to back flow to the kidneys. This is a condition that was present at birth. For many kids, the problem corrects itself presumably as they grow and the “valve” gets bigger and stronger (the connection isn’t exactly a valve, but it acts like one, I think?). Many kids require surgery, especially those with more severe reflux. The severity is on a scale of Grade 1 through 5.

These are all the facts that we know. We now have an appointment with the specialist next week, and I hate to have to wait so long to get more answers. Based on the experiences of others and Dr. Google, I’m guessing that they are going to want Cullen to take a maintenance dose of antibiotics. He would have to take the antibiotics daily until he grows out of it or has surgery. From what I have gathered, it is very common for kids to out grow Grades 1 and 2. Grade 3 can be outgrown as well, but it sounded like it was maybe just as likely to have surgery? I’m not sure. I have also heard that it is very common in siblings, something like 30% of siblings also have it. Given Maddie’s history of unexplained fevers, I would be very surprised if they did not want to do the same VCUG test and ultrasound on her. If they do not feel that surgery is necessary at this time (seems unlikely), then I think that he needs to be retested every year or maybe twice a year. Again, everything in this paragraph is a guess.

It’s my understanding that undiagnosed kidney reflux can be very serious. The earlier the diagnosis, the better. Cullen is very young, so we are lucky that his doctors did not wait for infection after infection to find out about the reflux. It sounds like it is manageable upon diagnosis with careful monitoring (periodic VCUG tests/ultrasounds, diligent testing of urine with fevers, etc) and regular, low dose antibiotics. Repeated bladder/kidney infections can be bad, but we would hope to prevent them, if possible.

I am looking forward to getting our questions answered at next week’s appointment. Until then, I’m trying not to worry too much about my sweet little boy. He is getting extra hugs and kisses from me in the meanwhile.