Visits to the doctor’s clinic in the hospital were always boring affairs interspersed with long waits and depressing sights. Wuan, who had been here since last Saturday, offered to accompany me to see the urologist who first saw me for my bladder condition back in 1991 for another assessment. Her company made it more bearable.

An ultrasound scan of my kidneys was taken in the doctor’s clinic. The diagnosis: shrunken left kidney. However, there were no signs of swelling in both kidneys, which is good news in the midst of bad. A creatinine clearance test was also done to ascertain the extent of my kidney function. It was a simple test where a blood sample was taken, the serum creatinine quantified and the figure for the estimated creatinine clearance arrived at with a straightforward formula.

My estimated creatinine clearance is 47 ml/min which is categorised as moderate renal impairment. The urologist stated that I have about 60% renal function. I am to continue with my intermittent catheterisation. I was also prescribed Detrusitol for my overactive bladder.

I was previously taking Ditropan for the same problem but the side effects were interfering with my daily routine. They included drying of the eyes, mouth and skin which was further aggravated by my body’s impaired ability to regulate body temperature. That made me very uncomfortable when the weather is hot.

Eating the correct food may also help and I have to make an appointment to see the dietician for this purpose. I am scheduled for another blood test in six months. I am keeping my fingers crossed that there will be no further damage to the kidneys when I return for the follow-up appointment.

Peter took me to see the urologist this morning. This is the follow-up to my previous consultation with the doctor and to receive the results of the x-ray and ultrasound of my abdomen.

The diagnosis: I am suffering from hydronephrosis and atrophy of my left kidney. The flow of urine begins in the collection system of the kidneys. It then flows down the ureters to the bladder. Hydronephrosis is the dilation of the kidneys. This could be due to the collection system being obstructed, or when vesicoureteral reflux occurs.

Vesicoureteral reflux is the backflow of urine from the bladder into the kidneys, caused by a neurogenic bladder. I have a neurogenic bladder because of my spinal cord injury. The abnormal pressure in the kidney caused by the reflux and the stagnation of urine will damage and eventually cause the kidneys to fail.

The treatment: Continue with intermittent catheterisation. My bladder does not empty completely. I use a catheter to drain it to prevent a reflux. This I perform every three to four hours throughout the day. I am to take bladder antispasmodic medication to relax the bladder and to prevent it from involuntarily contracting. The bladder antispasmodic I was taking produced uncomfortable side effects such as drying of the eyes and mouth, blurred vision, decreased sweating and nausea.

I was also advised to prevent bladder infections by taking potassium citrate (pot cit) which will make my urine alkaline. Now, pot cit is the most awful tasting liquid I have ever taken, but that is a little discomfort I have to endure to continue maintaining my urinary system?s health.

A man went to see the doctor.

“What is ailing you?” the doctor asked.

“Doctor, I am not feeling too good.”

After a thorough examination, the doctor said, “I have bad news and I have good news. Which do you want to hear first?”

“Give me the bad news first,” said the man.

“One of your kidneys is atrophied and probably not functioning.”

“What is the good news then?”

“Well, you can still live with one kidney.”

That pretty well sums up the situation after the ultrasound of my abdomen. My right kidney is 10cm, which is a normal size, while the left is 7cm. The atrophy could be due to the reflux of the urine from my bladder back into the kidneys. This is a preliminary diagnosis by the radiologist. I still need to go back to see the urologist for further assessment and treatment. This checkup is pursuant to the blood test which showed an abnormally high serum creatinine and uric acid levels.