What is Gretchen's Problem?

That is a funny title, cause it has 2 meanings:) Today was awful. Gretchen sobbed & negotiated with everyone she thought could help her. We both cried. The radiologist even had to leave the room a couple of times.

I WILL NOT MAKE HE HAVE ANOTHER ONE OF THESE TESTS.

They ended up stopping the test before her bladder even emptied all of the way. I took her to breakfast & then to a movie. The test cost a lot, but then the negotiating isn't cheap either. After, we had to take a nap. In the future, this post will help me explain to Gretchen why she is so suspicious of doctors, nurses & hospitals.

A renal ultrasound examination may also be obtained to rule out obstructive uropathy in children. An ultrasound examination can detect gross renal scarring or marked asymmetry of renal size in patients with vesicoureteral reflux. A DMSA renal scan is the best method for detecting renal scarring.

Two types of cystogram are available. A standard voiding cystourethrogram (VCUG) is obtained by instilling radiopaque contrast medium into the bladder and imaging the bladder and renal fossae during filling and voiding (Figure 1). The severity of vesicoureteral reflux is graded on a scale of 1 to 5, depending on the degree of distention of the collecting system.

A nuclear cystogram can be obtained by instilling a radionuclide agent into the bladder and imaging with a gamma camera. Nuclear cystography is at least as sensitive for the detection of reflux as a standard VCUG and exposes the child to less radiation. However, grading of reflux is less precise, and associated bladder abnormalities cannot be detected with nuclear cystography. Therefore, a VCUG is preferred as the initial study in the evaluation of a child with a urinary tract infection. Nuclear cystography is used in follow-up of patients with vesicoureteral reflux who are on an observation protocol. Vesicoureteral reflux is present in one third of siblings of patients with reflux, and in two thirds of the children of patients with reflux. Nuclear cystography may be employed for screening these children as well.