VCUG
The doctor's office just called, and AJ's urine sample was positive for a UTI. As much pain as she had yesterday when urinating, I was sure it would be.
The doctor is giving her a prescription for some kind of sulfa drug and is referring her for a cystogram (VCUG--voiding cystourethrogram). Since the doctor didn't mention the possibility of this test yesterday, and since it's her first UTI, I am a bit confused. She's never had a diagnosed UTI before, although she has had several incidences of anxiety and discomfort associated with urination--most recently over 6 months ago after Baby E was born. She doesn't have a fever, which is usually a determining factor in recommending a VCUG, and she doesn't have any abdominal pain or symptoms other than yesterday's pain while urinating.
From what I've been reading, a cystogram is generally only used in children with recurrent bladder or urinary tract infections. It's used to diagnose urinary tract reflux or incomplete voiding. The test is expensive and invasive, involving catheterization and fairly large amounts of radiation in multiple doses. It apparently should never be done while a child has an active UTI.
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Considering that AJ has had severe diarrhea and just finished 10 days of not-all-that-great sanitary conditions, complete with ocean, pool, and contaminated tap water, it seems logical that this, her first UTI, would be the result of introduced bacteria rather than some long-standing problem. Also, the urine sample was collected in a non-sterile way (a little "hat" on the toilet instead of a midstream void). She is already improving, even before medication, and was no longer in pain when urinating this morning.
The nurse I talked to had no clue what the test involved, why the doctor was recommending it, or anything about it other than the name.
Do most people just take without question a prescription and an order for more testing phoned in by a nurse, without ever discussing it with a doctor?
Is it too much to ask to be able to get answers to questions like, "What types of organisms was the test positive for? Why are we treating this with sulfa drugs instead of the standard antibiotics? What is this test for, and why are you recommending it? Is it really necessary? Could we get a second opinion?"
I tried to ask some of those questions of the nurse, but she was no help. Talking to the doctor on the phone is apparently not an option. I'd probably have to make another appointment with the doctor to be able to ask those questions, pay all over again (on top of paying to have the doctor take AJ's temperature and poke her tummy yesterday). I guess I'm a "difficult patient," but I want to know what's going on!
The doctor is giving her a prescription for some kind of sulfa drug and is referring her for a cystogram (VCUG--voiding cystourethrogram). Since the doctor didn't mention the possibility of this test yesterday, and since it's her first UTI, I am a bit confused. She's never had a diagnosed UTI before, although she has had several incidences of anxiety and discomfort associated with urination--most recently over 6 months ago after Baby E was born. She doesn't have a fever, which is usually a determining factor in recommending a VCUG, and she doesn't have any abdominal pain or symptoms other than yesterday's pain while urinating.
From what I've been reading, a cystogram is generally only used in children with recurrent bladder or urinary tract infections. It's used to diagnose urinary tract reflux or incomplete voiding. The test is expensive and invasive, involving catheterization and fairly large amounts of radiation in multiple doses. It apparently should never be done while a child has an active UTI.
############
Considering that AJ has had severe diarrhea and just finished 10 days of not-all-that-great sanitary conditions, complete with ocean, pool, and contaminated tap water, it seems logical that this, her first UTI, would be the result of introduced bacteria rather than some long-standing problem. Also, the urine sample was collected in a non-sterile way (a little "hat" on the toilet instead of a midstream void). She is already improving, even before medication, and was no longer in pain when urinating this morning.
The nurse I talked to had no clue what the test involved, why the doctor was recommending it, or anything about it other than the name.
Do most people just take without question a prescription and an order for more testing phoned in by a nurse, without ever discussing it with a doctor?
Is it too much to ask to be able to get answers to questions like, "What types of organisms was the test positive for? Why are we treating this with sulfa drugs instead of the standard antibiotics? What is this test for, and why are you recommending it? Is it really necessary? Could we get a second opinion?"
I tried to ask some of those questions of the nurse, but she was no help. Talking to the doctor on the phone is apparently not an option. I'd probably have to make another appointment with the doctor to be able to ask those questions, pay all over again (on top of paying to have the doctor take AJ's temperature and poke her tummy yesterday). I guess I'm a "difficult patient," but I want to know what's going on!
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Posted by purple_kangaroo at 12:28 PM[Permanent link]
7 Comments:
PK- You're not being difficult at all, just a justifiably concerned parent. It seems that lately you have to be your own doctor just to make sure that things are being taken care of properly. Best of luck with the situation, and hopefully the kiddo will be back to her perfect self ASAP.
You should have been able to ask your questions of the nurse, and she should at least have asked the doctor and called you back. Or the doctor could have called you back. Much easier on THEM than the extra visit as well!
But VCUG looks like one of those comment verification thingies.
Yes, most people truly do just take the pills or get the tests done.
I am always amazed when some of my friends or anyone in my husband's family go to the doctor. They do not question or doubt.
I don't think you are a difficult patient. Why can't you talk to the doctor?
It's your right and responsibility to find answers for the questions you have and you are right to expect the Doctor to inform you of any tests called for and why. (Or medical treatment) If there is one thing I have learned it is to keep yourself informed and in the know. :-)
Thanks, everyone. I did call to try to talk to the doctor, but he wasn't in. The nurse did ask one of the other doctors for me if AJ still needed to take the medication since she was no longer experiencing symptoms (yes).
I'll have to call next week to try to ask some questions about the test.
One of my friend's children was subjected to this also, and it turned out to be a simple wiping from back to front instead of front to back issue. It was giving her repeat UTIs, and it certainly wasn't scheduled after 1. I think it is great of you to research and get to the bottom of it.
I think your Doctor wants to rule out Bilateral Vesicoureteral Reflux. Only a VCUG can do this. My daughter had reoccurring UTI’s starting at 1 year old. It was misdiagnosed until she was three years old. We've had to go thru a lot of doctor's appointments, two surgeries, and she was even on antibiotics for over 1 1/2 year. I think if the Bilateral Vesicoureteral Reflux was diagnosed when she was 1 year old. things would of turned out differently. My daughter is now 9 years old and just about a month ago she had another UTI. She will be having for 4th VCUG tomorrow. I think you have a good Doctor that knows what to look for.
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