UTI(s)

My daughter has had five recurrences of a urinary tract infection since March.   More than two in a six month period and typically doctors want to look into the situation in more detail to see if anything else is happening.   We had plans to see a pediatric urologist but messages got crossed, a referral didn’t get followed-up on and I lost track of time.   And then we thought things had cleared, so we didn’t pursue it.   But then my daughter got another UTI and it was time to get her checked.

Yesterday we went to see that pediatric urologist we had plans to see two months ago that got put off. My daughter had finished a ten-day course of antibiotics and was cleared again as infection-free while we were there.   We answered a host of questions on a questionnaire, something that was a challenge to do with a six-year-old who doesn’t want to discuss anything medical happening to her.   She was more forthcoming with the doctor who had twin two-year-olds and had just the right words to use with my daughter.

They did an ultrasound on her bladder, with me telling her this was what they did to me to see her when I was pregnant and she was inside me.   The ultrasound was fairly simple, testing only to see if there was any urine left in her bladder after she had gone to the bathroom (there wasn’t).   She has no issues at all with solids, which eliminated other concerns.

The doctor asked if she’d ever had pain in her lower back or fevers, which she hadn’t at all.   That eliminated kidney infections, something that can cause permanent damage.  Bladder infections aren’t as much of a concern because the linings of the bladder regenerate over time.   I asked about hygiene and found out that when I was a child, doctors thought hygiene could cause bladder infections but in recent years determined hygiene rarely causes UTIs.  

What the doctor said was that some bacteria has the ability to eat through the lining of the bladder closest to the urine.   This layer is thin and is non-stick, so the bladder can be emptied completely.   When the lining is compromised, the bacteria can hide behind it and lies in wait for the antibiotic to pass, only to return and reinfect the bladder.

The good news is the lining regenerates, but the infection needs to be completely wiped out.   We had two options: a low dose of one antibiotic for four months, once each day or a high dose of another antibiotic for ten days, two times per day.   Both options work well, it was up to me.   My daughter has so much medical going on I went for ten days.

We scheduled a three month revisit and shortly after we left the office I got a text message the prescription was ready.   When I was at the drive through to pick up the prescription, the pharmacist came over and asked over the mic, “does your daughter swallow pills?”  She’s never had to swallow pills and this medication isn’t available in a liquid version.    I said thanks and we’d do our best.

Last night we told my daughter she could have ice cream and we’d put the medicine on the top, crushed up.   That went well for about three bites and then she complained of the terrible taste, saying she thought she was going to vomit.   It took two glasses of milk to get the taste out of her mouth.  I tried a bit of the ice cream to see if it was that bad—it was—I couldn’t get the taste out of my mouth with the tiny bite for over half an hour.

This morning I talked to my daughter about swallowing pills without chewing.   She’s helped me put my vitamins in my little seven-day container so she knew I took “pills”.   I put them in her hand and said I swallowed all four every morning with one sip of water and I knew she’d be able to do so easily with one pill.

My husband broke the pill in two, got some yogurt and two bites later the pill was down.   It was a small victory, but it felt like a big one after the unpleasant experience from the night before.   I didn’t want her to be fiercely opposed to the medicine.   Hopefully the remaining nine days will go “down” just as easily.

The Big Boy Update:  We were leaving the Mini Milers youth running practice on Tuesday and my son was in the car with me.  He noticed someone on a bicycle.   And then he noticed another person running.   He asked me, “mom, is today ‘Physical Day’?   Everyone is exercising."

The Tiny Girl Chronicles:   My daughter acts like she’s not paying attention, but she listens to everything.   The doctor said it was important to drink seven cups of water each day.   She asked me when we got in the car how many water bottles full that would be and we figured out it was over five times.   She asked for water at lunch and has been trying to drink a lot, as well as go to the bathroom more.   She doesn’t complain about the bladder infections, but I think she wants to be done with them enough to try and help in whatever ways she can.