HELP/sick child

[bunny]

My friend's four year old daughter keeps complaing of burning and pain right over her bladder but the urinalysis come up normal.

The doctor has suggested a VCUG to rule out reflux into the kidney. The mother asked the doctor's office if it was going to hurt with crying and screaming and such and the nurse said, "yeah, but we are used to it."

Does the child have to be totally alert for this test?

What does the mother do to prepare the child? The DR. office said to do nothing. I strongly disagree but what do I know?

Any help would be appreciated.

nancy

[johnnarees]

How about a second opinion?

[Dixiefireball]

I agree get a second op. my mother had to switch me from uro to uro from the time i was born up until i was 12 before she died i was born with bladder and kidney problems.
if there is anyway they can check this child without causing her pain then they should it shouldn't be up to the Rn or the doctor it should be up to the mother.
i do believe a second op. is in order.
I did the same thing for my son when one doctor was wanting to send him to the o.r i switched doctor and the other doctor fixed him right up and said there was no way he would made my child go threw that and for the surgery that other uro wanted to do on my son was an old fashion surgery and most uro dont even do that anymore it would had caused him more harm then good.

[Betsie]

I guess I don't know what that procedure is. If it is clearly going to be painful, I guess for a four year old, I would really want to know what the options are, as in any other non invasive/pain inducing procedure for the same answers. I am not disagreeing with the Dr, as I am not sure about the procedure...but I would want to be real sure it was worth the emotional pain it will cause. some kids are real resistant, others aren't...at only four, I guess the parents have to search their souls and their options.

[ICNDonna]

I also don't understand what is going to be done. However, if it's going to be painful, my suggestion would be to specifically ask the doctor to order something for the little girl to help her relax for the procedure.

Donna

[bunny]

Thanks to all who responded. I appreciate it. I am going to talk with my friend tomorrow, so I can get more details. I do know that she has seen several doctors looking for an answer as to why she is having this pain.

A VCUG requires catheterization. I just don't know how a preschooler would handle that if she is already sore.

I think seeing your child in pain is worse than experiencing it yourself.

Anyway, thanks.

Nancy

[Betsie]

Boy, I am with Donna. I cringe at the thought of this, though I do understand it might be the only way. I too hope they can make this child very comfortable, I personally am terrified of instills and catheterization...I can't imagine a child holding still for this...though I am sure (I hope) the Dr would not perform a proedure to knowingly torture this poor kid. I feel for your friend, this must be an awful dilemna - is she pursuing pediatric uro specialists?

[radstudent]

VCUG is short for Voiding CystoUrethroGram. It is a procedure that is done in radiology. I have assisted with tons of them. It starts with having the child catheterized. Then the bladder is filled with a contrast (looks like water) that will show up on the xray machine. (There is no need to worry about being allergic to this because it is not entering the blood stream.) The radiologist will take xrays of the bladder while it is filling. This allows them to see the size and shape of the bladder as well as any filling defects. The doctor will also take a few pictures of the kidneys and ureters (with most children this can be done at the same time as the picture of the bladder) to see if any of the contrast is going up into the kidneys. This is what they call reflux. It is not supposed to happen and can be the source of many infections. Once the doctor gets the information he needs to make an informed decision they will ask the child to void while still on the table (this is sometimes the hardest part for the child next to being catheterized, because they have been trained to only go on the potty). They will take pictures of the kidneys and ureters during this time also because this is when reflux is most likely to happen. Once the child has emptied the bladder (they will be able to tell by the pictures) then they will remove the catheter and the test is finished.

I will tell you that some kids cry the entire time and others don't cry at all. The best thing is distraction. When I have assisted during this procedure I always like to ask the child about brothers and sisters, pets, school, their favorite color, anything to get thier minds off what is going on. I don't know how it is at all places but at our hospital we have a monitor in the room and it sometimes helps to tell the child that they are going to be on TV. The bladder filling looks like a balloon blowing up. When it comes time for the child to void, I tell them that if they pee then it will make the balloon go down and it becomes like a game. Again, this doesn't work with all kids. I wish your friend the best of luck if she goes this route.

[MelissaJ]

Hey, I just thought I'd put in my two cents worth. I've had dozens of these things done, since it took so long for the dr's to find out I had IC. It was a little scary. I'm not sure about being catheterized, since my urologist always did the procedure after doing a cystoscopy, so I'd always been catheterized while asleep. But I always had my mom with me. And if I absolutely could not pee on the table, I was allowed to go to the toilet, which happened several times.
Also, I think it is important to be very honesty with your child. I had my first cystoscopy when I was about five years old. Another girl from my kindergarten class was there. I knew what was going to happen, but the other little girl would not. When she woke up with a cathetor between her legs she freaked out and started yelling that they had touched her in a private place. I think it's important to remember even if someone is a child, it's their body and they deserve to understand. My mom always used plain language with me and if the nurse started to speak to her, she always told the nurse to speak to me instead and tell me what was going on. SO in a sense, I felt that I had some sort of control.
I hope this helps.
Melissa