Pediatric Urology

[ecobian]

Hi! i am new to the site. Here is my story.

My daughter is 3 years old and was just diagnosed with a UTI after 1 week of dealing with her doctor and a high fever that would not go away. When she first started with the fever on a Saturday morning, it was about 104 to 105. I gave her motrin and tylenol. She continued to have this fever all weekend and i got worried and took her to her doctor on monday morning. He checked her ears, her throat and saw nothing that would signal she had any kind of infection. He said it was virus and it would go away, but it did not. on Tuesday i took her to see him again and he sent me to a lab to get a blood test and a urine test, but could only do the blood since she was really fussy and not cooperative. I was able to get a urine test at night, but not knowing, i did not refrigerate it! Anyways i went back the next day and was able to get a tiny bit of urine out of her, but not enough to send to the lab. He did a dip stick test and said he was able to detect some blood and white blood cells in her urine, but that her blood work came back okay!! by that time i kind of suspected a urine infection and was giving her cranberry juice since that monday. She was fine until the following Sunday when she woke up with fever of 104 again. I took her the ER and there they just took her temp, gave her tylenol and sent me home and said it was a virus again. I was not satisfied with that answer and took her to her doctor again on Monday. This time we have 2 blood tests and i was able to get a good Urine sample. He told me he did not want to give her Antibiotics until he knew for sure what it was. He had been saying this since the first day i took her in. He said it would mask something that would probably be of greater concern. I left again not pleased! He called me that evening and told me that her urine test was consistant with the first urine test and he was able to perscribe me the antibiotics and i was to start giving it to her that evening. I started her on it right away. This was on a Tuesday. On thursday he called me to schedule a follow up with her on friday. I again took her and he said her blood work did show an infection now, well duh!!! He also said that he wanted her to get VCUG and he explained it to me and what it was. I got really scared because it sounded so awful to make my daughter have that done!! what i want to know is if she really needs to have this done with just this one and only UTI she has had in her whole 3 years of life??? Also, i am changing doctors! i am really disappointed with this doctor and how he handled this situation! i mean i know that now a days, docs don't want to perscribe antibiotics for just anything, but my daughter had 105 fevers for like a week! Even i know this is a signal of an infection!!!!! Can anyone please advise????

[LindaP]

Honestly it sounds right to me. We got a VCUG after my daughters first UTI. UTI's aren't normal in kids (especially one with a fever that high!! That means she probably had a kidney infection which is even more serious) and they want to check for an underlying reason. You really should have it and get it checked b/c if not she could be at risk for kidney damage. (If she has something and they don't do the test and find it).

It's not a fun test but a lot of kids have them and they survive. It's awful, but nothing a trip to the hospital gift shop afterwards and a good nights sleep doesn't fix. I think it's MUCH worse for the parent than the kids actually.

Linda

[ecobian]

Linda,

Thanks for the advice. Did your daughter get a sedative? How old was she? Does she remember any of it? I would appreciate if you tell me about your daughter's test?

[LindaP]

Hi,

My daughter was only 9 1/2 months old when she had the test. I think getting it done at 3 years old would be very different! But here is how it went. We went in and Emma got in a gown and just walked around for awhile (she was an early walker, LOL) then they came in and layed her on the table. This was THE absolute worst for her - having to lay there, then she calmed down and they catherized her. Honestly that was not nearly as bad as I thought, she calmed down fairly quickly after that. Then they fill a bag full of some sort of fluid in her bladder. That didn't bother her either. But then they moved the xray machine around and over her and she FREAKED out and screamed for the rest of the test. That really scared her. By then the test was practically over, they pull the catheter out, your child pees (now at age 3, I'm not sure if she'll do it on her own or she'll have to pee consciously, KWIM?) they take the pictures and it's over. All in all it's a very short test. Maybe 10 minutes or less. I won't lie, it was NOT fun and I felt so bad for my daughter, but I'm glad we did it.

What they're checking for is the kidney reflux. My daughter didn't have it but they found a bladder abnormality so she takes prophylactic antibiotics every day, just like someone with kidney reflux.

I hope that helps, let me know if you have any more questions!

Linda

[ecobian]

Linda,

Did she have any pain afterwards when she peed? Also have you noticed a reaction to the medication? I just started her on it. She hates anything to do with a doctor and she doesn't even want me to clean her private area when i need to see if its clean enough, cause you know you can't get it that clean when you bathe them sometimes. I think she will have a difficult time with this and so i think it will be a good idea to sedate her. Plus, i am pregnant and i don't think i will be able to be with her. I will have my mother be there with her. Her father will mostly not like to see it either, it would really break his heart... Thanks for all the information, i greatly appreciate it...

[katie2you]

Hey...just wanted to add my two cents. My daughter has had two vcugs. The first one she had was at one year and the second was at two. It was very traumatic for her and although she did not react in obvious ways immediately she developed a severe apprehension of doctors and now reacts as though she has been sexually abused.
I am now faced with my son having the test done and have been trying to find some way of sedating him or somthing to make it easier and less traumatic. I have been meeting with much resistance and have pretty much been told that kids have it done all the time and are ok. That is not good enough for me nor do I think should it be for any child. Mine was not ok.
Today My efforts have been rewarded and I finally have peace of mind..or at least as much as I can. My doctor is going to give my son somthing that is referred to as "giggle juice". I will have it's true name when she calls me back today or on friday and will post it. It relaxes the child as well as makes them forget what has happened. That is what I suggest you look for for your daughter, the test is very important and must be done since reflux can damage or destroy the kidneys, but shouldn't we try to make it as easy for our children as possible?
So many people just trust, and accept, and go along with what they are told is the way things are. Myself included the first time around. we need to trust ourselves more.
good luck

[chiyaki-chan]

Wow, this sounds like it's been quite a bumpy ride for you. I really hope that this info helps you to understand a bit more about what's going on, and more importantly, helps you to make her well again.

i kind of suspected a urine infection and was giving her cranberry juice since that monday.
OK, this is very important. Try to avoid her drinking or eating anything that will make her urine acidic, 95% of the bacteria that cause UTIs can multiply at double their normal rate in an acidic environment so I can't stress quite enough how much this part matters. This means ensuring that she's NOT drinking Cranberry juice & Orange juice. Ensure that she isn't using any acidic/non-buffered Vitamin C tablets. Try to keep her off all Meats (especially red meats), and any fatty foods as all of these will cause the urine to be acidic.
She was fine until the following Sunday when she woke up with fever of 104 again.
This would most likely have been due to the fact that whilst the Cranberry does indeed hinder the attachment mechanism of the bacteria, it's also fed the bacteria that did get chance to grab onto her body.
He told me he did not want to give her Antibiotics until he knew for sure what it was.
Well, I'm actually quite shocked about this, usually they throw whatever random anti-biotic is nearest to hand so I actually admire this decision. You see, many of the anti-biotics that are given out only work against 40%(ish) of the bacteria, so whilst she's on them, it's true that they can't really build up a very large colony size with nearly half of them being killed off all the time by the anti-biotic, but they also will never really go away since those that are not killed actually adapt to the anti-biotics and become stronger. One of the anti-biotics that's far too commonly prescribed for UTIs is called Ciprofloxacin, it has some horrid side effects that are very nasty to joints and bones, along with a known side effect of possible "death upon first dose"! This in mind it's easier to understand why the doctor would have been trying to hold back with such prescriptions.
He also said that he wanted her to get VCUG and he explained it to me and what it was.
Here's where I get lost... That's a very radical move... I suspect that a better idea here would have been to prescribe/recommend a product to prevent re-infection. I've been using a product called 'Waterfall D-Mannose' which is a natural, completely harmless, glyco-nutrient that interferes with the bacteria's attachment mechanism and causes them to be flushed from the body when I need to urinate. I've been UTI free since I started using it, and I'd strongly recommend that you give it a try so you can have her free of the anti-biotics, which could only be a good thing.

I really hope that you have her well very soon,

Chiyaki x.

[wifenmom]

Our 3yo daughter just had her first VCUG done last week. She did an AMAZING job! The nurse was surprised that she handled it as well as she did, but she does have a very high pain tolerance. Her VCUG was scheduled after her 4th UTI!! I wish it would have been done sooner - it came back that she doesn't have VUR, so we still don't know what's going on!