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My toddler is 23 months. At about 19 months, she had a really, really bad UTI. Her bacterial count was over 200,000, she was running 106 fevers for about 4 days. She was almost hospitalized, thank God for breastmilk. Her pediatrition wanted to do a VCUG and an IVP. I declined as I was pretty certain where she got the UTI (she pooped in the bathtub in the 30 seconds it took me to run to the bedroom and get her baby sister). I resisted tons of pressure to do the procedures. Then she got another UTI. Not a bad one this time, but still...Then I was talking to dh's natural grandmother, and his natural mother (raised by stepmom and dad) had tons of UTI and Kidney infections as a toddler/child/preteen. Was finally diagnosed with Stage Three reflux. Under these circumstances, I reevaluated our decision not to proceed with the VCUG and IVP. I talked and talked with her pediatrition. We decided to do the procedures, but we have to travel to another pediatric Urologist because the one in our town won't do sedated ones and I refuse to put her through it unsedated. We called and scheduled an appt, it's on the 1st of July. The thing that really upset me about this whole thing is that she has to be on a low dose of antibiotics every day until the appt. If she has any bacteria in her bladder, it will be forced up into her kidneys when they put in the dye and can cause bad kidney infections, etc, etc, etc....About two weeks ago, I ran out of her meds. In the chaos of trying to get everything ready for dh to come home, etc, I didn't get to the clinic to get a refill. I got over there last week, but then we went out of town for a few days and I forgot the meds in the fridge. So she's been without her meds for about 1 week 5 days. I started back the other day. Yesterday, she woke up with a fever. It wasn't high, nothing I even got the thermometer out for, but last night, it got higher. It got up to 103. Not a high fever, but now I"m scared. If she's got another UTI, it's going to mean surgery for her. Of course, she's almost two, let's see teething? Springtime, roseola? Ear infection? If I call the clinic, they will immediately want to put a cathedar in her, I don't want that. But I also don't want to miss anything. She's got NO other symptoms, no runny nose, nothing....she is wanting to nurse all the time, and is pretty grumpy. When I ask her what hurts, it's different every time, but nothing to indicate she's in pain when she urinates.<br><br>
ANyone have any thoughts? Ideas? Suggestions? Thanks so much.
 

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Sorry I don't know what a VCUG and an IVP are. I'm assuming some sort of invasive tests in the urinary tract maybe a vaginal something?<br><br>
Do you have soemthing equivalent to the nurse on call? or is that your clinic. We have a nurse we can call for advice on what to do -- kind of a check in on whether we should go to the ER or can it wait till morning, etc.<br><br>
You also don't mention what her normal fevers are like -- meaning some kids regularly when they get a fever it is super high and others, well, it doesn't go as high.<br><br>
fire alarm going off here gotta run outta my office.I'll try to come back...
 

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She doesn't usually run fevers, that's the thing. I mean, she got several ear infections between 6 and 12 months, and she wouldn't run a fever until it was really bad. She ruptured her eardrum three times because she'd be fussing, and I'd think "teething" since there was no fever, no pulling at her ears, nothing like that. And then 3-4 days later, she'd start running a fever of 101-102 and then she'd have all the blood and pus running out of her ears and we'd know she ruptured her eardrum...you know? She isn't one to get high fevers, she isn't one to get sick, so I guess that's why this freaks me out so much. I do have the 24 hour nurse line, but under these circumstances, they would tell me to take her in. I have a call in to our nurse right now (she's very supportive of our anti mainstream choices) and am going to request a specimen cup for her urine. She's potty training herself, so I'm pretty sure I can get a sterile sample that way, but if not.....<br><br>
And a VCUG and IVP. The VCUG is a cathedar inserted into her bladder and then dye forced up into her bladder and kidneys to make sure they are functions properly with no reflux. The IVP is a dye injected through an IV to get a more detailed picture of her kidneys. Obviously, the VCUG is more invasive, and I'm pretty anti medical model anyway, but then with the family history, there *is* a chance she has reflux and kidney damage is nothing to fool around with, you know? It's just so hard, balancing what you *want* for them, and what you think is right, and the dangers of what *might* happen if you miss something....<br><br>
Thanks so much for the thoughts. Baby awake..gotta go.
 

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My nephew had kidney reflux, and luckily he grew out of it. BUT, medical model subscriptions aside, you said it your self, kidney damage is NOTHING to mess around with. If a child with this condition repeatedly has infections which are untreated, permanant kidney damage can occur. PLEASE have the procedures done -- quickly. They only need to do them once a year, and if there is a potential problem, better to find out sooner than later. The antibiotics are to prevent further infection, which can prevent damage.<br><br>
I am sure I have said nothing you did not already know, but since we went through this with my nephew, I know how serious it can become.<br><br>
(((HUGS)))<br>
Stacie
 

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I'm not really clear on why there would have to be surgery if she gets another UTI.<br><br>
I was born with bilateral kidney reflux.<br><br>
Most kids outgrow it...the body just adapts. I did.<br><br>
When I was a kid, the surgery had a very low <i>survival</i> rate let alone a decent success rate. So, there wasn't much discussion about that.<br><br>
Yeah, I had a lot of UTIs. And I had the VCUG e-v-e-r-y y-e-a-r for several years. I have a latex allergy and they used latex catheters. I screamed everytime I peed for a week after the procedure. And, as we weren't going to go forward with any surgery, this "just checking to see what is going on" procedure was for the birds.<br><br>
If my kid ever gets diagnosed with it, I'll just give him plenty of dandelion and other kidney support herbs. And cranberry juice.<br><br>
edited to add: I got involved in a thread about this that exposed all the raw emotions that remain from my experiences with kidney reflux. With a knot in my stomach and with a caution about reading it, I'm adding this here: <a href="http://www.mothering.com/discussions/showthread.php?p=804551&highlight=kidney#post804551" target="_blank">http://www.mothering.com/discussions...ney#post804551</a> I'm not pleased with how I melted down in this thread, but it is still up, so I guess someone somewhere thinks it is useful. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/bag.gif" style="border:0px solid;" title="Bag">:
 

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My daughter had stage three reflux, had the procedures you have scheduled for your child. Like Sohj, my daughter in fact grew out of it, but did need yearly evaluations to check. She was also on low dose antibiotic therapy.<br><br>
I would get her urine checked. Frequent UTI's arent good for the kidneys, and the subsequent antibiotics arent so terrific either (although needed). You could go to the ER where they will do a urine, but it might be just as good to call your pediatrician who can send out her urine also. (in the ER you'll get the results asap, but your wait might be awful). With my daughter, her UTI led to Urosepsis, basically she had the infection in her blood as well, and was in the PICU for 8 days.<br><br><br>
With her history, and her not being on her medication, my hunch would be she has a UTI.<br><br>
Good luck. I hope she is feeling better soon. Please keep us posted.
 

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ok I'm back.<br>
i forgot to come back initially, sorry about that.<br><br>
I guess, I'd do some kinda medical intervention. If it stretches into doing it every year and finding nothing...then I might skip it. But doing it once to see if they find anything, I'd figure out a way to check her out. Also because she's not really complaining, I'd guess she has a high pain tolerance, which could mean if there is something there it would get worse before you find it.<br><br>
That said, it is a hard question.
 

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I had those procedures as a young child (starting before two) and they were not traumatizing for me. My mother is rock solid and I think her attitude was #1 in keeping it that way.<br><br>
My problem? The infections were completely asymptomatic. I had a tendancy towards them due to anatomy, and then to not show any symptoms was a double whammy. I did outgrow the reflux, but I am still prone to them.<br><br>
The solution when I was a child? Prophylatic antibiotics during some years :)roll, but it worked) and every two weeks urine tests. Why not get test strips yourself? You can do it at home. She can even help out and start taking control for herself since she is starting a lifetime of self care.
 

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How much antibiotic has she had?<br><br>
Antibiotics themselves will cause bacteria to go erratic, so ultimately they are probably the cause of her infections.<br><br>
Is she vaccinated?<br><br>
The first UTI started at 19 month, why? I doubt that it was because of poop in the tub. That happened often with my kids. Unless you let them soak in it, I very much doubt that it was the original cause. Her immune system was weakened by something to let her come down with UTI.<br><br>
I would go along with sohj - plenty of dandelion and other kidney support herbs and cranberry juice.<br><br>
And avoid antibiotics. Gosh, I don't know what to tell you now since she is on them, but I would more than likely switch to probiotics and look at everything natural before I would subject her to such invasive procedures.<br><br>
Did you read the Thread Sohj provided?
 

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My son was diagnosed w/bilateral VUR (uretheral reflux) at 2 months, with his first UTI. He had the VCUG at that time, and again at one year, when he was found to have outgrown it already. From 2 months until one year we put him on prophylactic antibiotics--which is a very low dose, and as far as I could see did him NO harm--no yeast, nothing. It is definitely good to counter the antibiotics with some probiotics to prevent yeast, but I definitely would NOT forgo the antibiotics. As you said, UTIs in a child with reflux can cause permanent and serious kidney damage which has far more serious consequences than low-dose antibiotics. IMO, it is not enough to give child "kidney support herbs" and cranberry juice, etc. because while they may prevent infections, they won't kill the infection if it does come, which antibiotics (abx) will do, thus preventing the damage to the kidneys. Also, whoever said abx will cause bacteria to go erratic, that's not true. Abx promote yeast growth, but yeast is NOT bacteria. Abx will kill bacteria, but not cause it go "go erratic" (other than the possibility of abx resistance). So, I guess I'd put your dd back on abx, wait until this UTI/fever has cleared and then get the VCUG to find out for sure what's going on. They should also do an ultrasound of her kidneys if they find VUR, to see if there's been any damage already.<br><br>
As for sedation during the VCUG, my son def. didn't have it at 2 months, and after reading some stuff here at mothering from other moms, I was going to ask for Versed for him at age 1, but I talked to my boss first, who's a doc, and she said she wouldn't give versed to her children at that age. I don't know what age she would consider it safe however. My son, at age 1, had almost no problems with the VCUG--cried a bit when the cath went in, but once it was in, stopped crying, and happily listened to us read to him etc. during the approx. 15-20 mins it took. HOwever, 2 is older and def. a different story, so I'd def. consider the Versed, but I'd ask around a little more first if I were you.<br><br>
I'm also not clear why she'd automatically need surgery if this is another UTI. I can't imagine them doing the surgery without first finding out a) if she has VUR and b) if so, what grade. Because even if she has it, it's not common to do the surgery unless prophylaxis isn't working (they have "breakthru" UTIs) and/or they've reached the age of ~5 without outgrowing it. So, while IMO you should refuse any talk of surgery without tests, you should def. do the VCUG, and if she does truly have reflux, then I believe in doing the prophylactic abx for her until she outgrows it. I really think it's the safest course to prevent long-term problems.<br><br>
And finally, I'm pretty sure that the surgery for reflux is now quite safe, and also usually successful, though I could be wrong about that. Of course, I understand, SOHJ, that it was quite different when you were younger. Now, off to read that thread you linked to.
 
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