Whew....all done for now!

We just left the nephrologist where Cintia's blood pressure was 135/98....yes that's high. It came down a bit before we left but we need to watch it in the coming year. Her blood creatine is a bit high for her age. That is also an indication of renal disease. It wasn't horrible but not perfect. Her ultrasound obviously indicated renal disease. She has a urological problem called reflux that causes the urine in her bladder to go backwards when she pees before finally draining out....which can damage the kidneys causing kidney damage. This was the cause of Kenny's kidney failure in childhood. He ended up with a transplant at age 16. His kidney was given by one of my favorite people on the planet...his daddy. We all know that Cintia was abandoned and will not have access to a family member so we pray she will never get there. Anyway, back to the reflux. Treatment for most is prophylactic antibiotics. The nephrologist feels like we can skip that until she has her first UTI at which point it is an immediate necessity. Any fever at all....antibiotics, check her urine, and culture it. She is suppose to limit sodium, drink alot, pee alot, take no ibuprofen, and stay completely decompressed in her intestines. Thanks to our stay in Cincinnati she is good now since she is on total bowel management...prior to Cincinnati, it was just about as bad as you can get and unfortunately had been for the first 3 3/4 years of her life....which is not so good. We can't look back and have to look forward. Anatomically, she has bad intestines (words can't describe what her contrast studies look like). She is still not perfect in that arena but she is as good as she can get. Apparently, constipation causes physical obstruction to the kidneys which is added on top of the reflux she already has compounding the problem. I am sure that is a huge part of this picture.

What do we do now? We were given the go to leave for Guatemala. The sooner she is adopted the better. Everything we have done in the last few weeks is to be repeated if possible in Guatemala in 6 months and for sure next summer here (prayerfully with insurance to cover it). With insurance, the hypertension will be worked up unless resolved before then. Apparently....that is super involved and super expensive for the uninsured...but what isn't, right? If her reflux is still there, she will probably need surgery to correct it. If her blood values look worse, well.....it will be a lifetime of watching kidneys and decreasing damage the best we can. If her blood sugar truly is high and not just a fluke....well, let's just say her daddy said that it will not be a pretty picture for her to have kidney disease and diabetes.

All of this to say that everything is pointing towards renal disease of some sort. It doesn't mean she will lose all kidney function and need a transplant. It just means that we need to watch it. As my Granny would say, "It is what it is." Burying our heads in the sand will not help Cintia but adopting her and giving her full access to the best medical care in the world will. It also is a good indicator that she needs to take care of her body if it is going to take care of her. All of her medical problems traveling into adulthood will not paint a pretty picture....with early intervention, her life will be as good as it can be. None of us have perfect bodies. Kids with congenital birth defects have their own variety of "not perfect." They tend to have "syndromes" meaning that normally if one thing is drastically wrong that other things tend to go along for the ride. For Cintia that is what is happening. All of her problems are related to her time in her mom's tummy between 5 & 7 weeks gestation. Something went wrong and produced abnormal anatomy in several areas. Even her spinal cord lipoma developed during that time....which is the first thing we need to take care of when her adoption completes. It not only impacts her balance and motor development but has massive potential to produce urological problems. One step at a time.....and we will get her to where she needs to be.

Next blog should be from Guatemala on Wednesday!

Blessings to you all!
April