Sunday, 10 May 2009

MacGyver Moments

Rory's personal plumbing can best be described as unorthodox. He passes urine through a little slit in his abdomen. For a lad that never peed until way past his 4th birthday, we consider it a major achievement - it could come out of worse places!

Management of this uber alternative u-bend, is pretty straight forward, but it does require a certain level of inventiveness. During the day, we slip a pad into his nappy to collect the constant drip. This pad is a classic of the maternal necessity, school of invention. Pad's, of the like required by our lad, are not what you would call, an over the counter item. They are the product of much discussion, trial and error. Thanks to the bright sparks in Temple St., we happened on our current model; a new born nappy cut in half with a strip of Mepore tape stuck across the top.

I tend to make them in dozen batches, usually while watching telly in the evening. It's a real Blue Peter experience, scissors, sticky tape - the whole kit. I have it off to a fine art now and can rustle up a batch before the tea is even drawn! The pad usually lasts just shy of about two hours before the telltale wet patch becomes visible on his shirt.

At night we attach a bag with a 2 litre capacity, although a late starter, he now pees like a pro.There is no road map for urine routes such as his. He's a one off. A bit like speeding up the M1 before the official opening, without a sat nav. Each new stage, has us scratching our collective heads.

We've arrived at an un-signposted cross roads. The tube, his almost new ureter, which conveys the urine from his reconditioned second hand kidney, is also a miracle of recycling. This ureter came with the kidney and, well, although it came from one former, carefulish owner, it has been around a couple of decades longer than it's current owner. In short, and really no pun intended here, it is not going to grow with our bolting boy. Here's where the law's of physics are very visible, as he grows the ureter is stretched, and as this tube stretches, the hole at the end gets narrower.

We've been monitoring this for a while, we even had the opening surgically dilated in Crumlin back in February. After this procedure, I was granted yet another unenviable medical task; that of stretching it daily. Now, I've learned some procedures, since Rory was born, many were not pleasant; injecting EPO into a 3 month old thigh, passing NG tubes, but I did them as they were keeping my boy wonder alive. But, I have to fess up here and admit that stretching a urostomy with, what looks, for all the world, like a stainless steel crochet hook; is, put mildly, my least favourite procedure to date! I often wonder, if years from now, he'll fill expensive hours of therapy with memories of his mother plunging stainless steel hooks into his stomach! Well at least it'll give him something colourful to recount!

I noticed last week that my daily stretchings were becoming a much more difficult affair. The opening was getting visibly smaller. Now as you can imagine, I watch urine flow down his plastic bag at night, in the same way that a new mother neurotically checks that her new born is still breathing. An interruption of flow is just too horrifying to even contemplate, so it was with a heavy heart that I contacted the hospital on Friday morning.

I had prepared myself to leg it to Dublin. Luckily, the other kidney was not away on one of his very frequent 3 week work trips abroad. So on the face of it, a Friday dash to Dublin was completely manageable. Jess could stay with her Dad, while boy wonder and myself crossed the country. The phone calls back and forth were promising, maybe we could hold off on the dash. A variety of surgeons and ologists were consulted, and finally arrived at the solution of getting a smaller crochet hook! Simple yet brilliant. For the sake of expediency, it was suggested that I try to borrow one from Galway hospital.

I phoned the always helpful Paeds dept. I was greeted with the usual warmth, concern and large doses of common sense. The nurse who answered, gave me all the relevant contact details, but just as we were winding down the conversation, she asked if the implement in question was available in Temple St. When I confirmed that was the case, she suggested I get them to put one on a train to Galway immediately as it would be a lot quicker than trying to track one down this side of the Shannon. I was instantly struck by the genius of the suggestion.

So, our sainted consultant in Temple St procured the implement, and I called our former dialysis taxi driver to pick it up and deliver to Heuston station. Fortunately, these two links in the chain are made of solid gold. The consultant personally packed up his two preferred options, and the taxi driver charged through lunch time traffic to meet the 14h35 to Galway.

She arrived on time, only to find a sign proclaiming that Fastrack had ceased trading! Now, way back in the days when I had a career, Irish Rail's courier service, Fastrack was my very flexible friend. I could practically recite the timetable by heart. How had this bastion of Irish communication, the purveyor of all things provincial, been closed without my knowledge? I was dumbfounded; now what?

The taxi driver said she would investigate further. The next phone call, was a hoot! I have no idea what she said, threatened or promised, but all I know, is that the package was thrust into the hands of the train driver who personally guaranteed to deliver it into the hands of the other kidney in Galway station! I love it when the old Ireland shines through all the shallow gloss of progress!

By 17h22 the new smaller medical thingamagiggy was in my hands. All it took was a further call to the consultant to compare size with our current incumbent and the job was oxo!

MacGyver would have been proud.




steph said...

You had me enthralled with that story. So glad it had a happy ending!

My ever-so-logical mind tells me that if the ureter opening is narrowing, then two things are for certain...

1. Wonder boy is growing taller by the week and ...

2. More surgery is looming!

My daughter had a ureter 're-implanted' (with stent insertion) when she was eight and Temple Street were the bees knees!

Rock on, Ann

AnnB said...

Your ever-so-logical mind is ever so right Steph. I'm also very fascinated by your daughter's story - sounds pretty amazing. The question now is how looming is Rory's surgery - the jury is out on that one, but more on that anon!

Anonymous said...

Well you can't beat that for a good story. The train driver had no hope against the fab mammy/taxi driver brandishing medical accoutrements around the platform muttering about urostomys and consultants and a plaque on him if he failed in the task... Yes I love the way we get things done too- I don't think it can happen anywhere else but this country. Mayve the HSE should take note !

Xbox4NappyRash said...

Brilliant, the solution at least.

Old Ireland is rare now.

AnnB said...

Thanks Rosie and welcome Xbox, - it's a sure sign I'm getting old when I find myself nostalgic for the days when you could threaten someone by suggesting you were going to tell their Mammy on them! I may never know what our mighty Taxi driver said to the train driver, but I have a feeling she may have used the 'M' word!

Sharon said...

Glad to hear the happy ending to that story. Isn't it fascinating, the things we end up doing when there's no other way. If you'd been told all that you'd face now when you were younger, you might have said, no way could I cope with all that. But then it happens and you just deal with it. I know that's how I feel.

Good on the taxi driver and good on the train driver for doing the decent thing.

AnnB said...

That's so true Sharon, it's amazing what is possible when you have no choice!