Micah’s surgery is done. Friday felt like the longest day of my life. He went into the OR for surgery around 3:30 in the afternoon at LA Children’s Hospital, and he was on the operating table for over 3 hours. Under the careful hands of a highly trained Urologist, the 3 hour process of redemption unfolded. Micah had a narrowed portion of his left ureter removed, extensive tapering applied to the urater, a stint added, ending in reimplanting the urater into the bladder. He was intubated, given an IV, a foley, a spinal tap, and an c-section incision across his lower abdomen.
After surgery, in the consult room with the Urologist, Brent and I learned a lot. It was in that tiny room lined with uncomfortable chairs that my understanding of kidneys grew. The doctor described his profession as one attempting to insure that each person’s kidneys outlive them. He said that if we each lived to be 150 years old, our kidneys would inevitably fail us. Those unfortunate people who have both kidneys give out early in life, gain a little extra time because of dialysis, or a transplant, but the human body simply does not thrive in either of these situations. Dr Paul Kokoroski has made it his life’s mission to prevent people from getting to that difficult place in life.
Micah’s left kidney was born to fail; most likely, sooner than we would hope. We all want to know “when?” But we do not have that answer. In most cases, a single kidney failing later in life causes no immediate threat. The healthy kidney kicks into high gear, and the person continues with urinary function via their surviving kidney. But we were not designed to function very long on one kidney. The surviving kidney often wears out sooner because of the added strain of working alone. Thus, we understand the significance of a child’s kidneys failing early in life. Friday’s surgery was an attempt to prolong Micah’s left kidney’s function, and it appears to have been a success.
What this means. Micah’s left kidney will always be in question. The blockage that was causing the flow of urine to pool in the left kidney is gone now, but the amount of redundant tissue removed from the left ureter seem to indicate a mutation in the formation of Micah’s entire left side of his renal track (as seen by the enlarged size of his kidney detected in utero). Even with the correction made to his urater, the kidney is not expected to recover entirely, if at all. Micah will routinely be evaluated for further complications and continued kidney function. The doctor assumes that the blocked urine flow has damaged his kidney, but to what extent is indeterminable.
The doctor said that the year ahead of us is critical for determining the success of Micah’s renal system. The next four weeks are vital for his incision recovery and the mending of the tissue that makes up his left ureter. In 4-6 weeks we will see how his tapered urater holds up without the assistance from the stint. But the long-term function of his kidney will still be in question long after the surgery wounds have healed.
It may always be in question.
For some, a surgery like this solves all kidney problems for the duration of the patient’s life. For others, this is just the beginning of a long road of complications.
It is still uncertain where Micah’s story will take him.
Today I am facing 6 different prescription medications, a lot of blood, and a little boy who is scared to go to the potty alone. He is playful one moment and exhausted the next. One moment I am trying to remind him he cannot jump on the couch, and another minute he’s curled up in indiscriminate pain. It is unclear what tomorrow will bring.
Tonight as Micah prayed, he asked for God to make the cut on his belly better and to help him be able to jump and climb again. He fully believes God can and will make him whole. I see in Micah a trust in God and a simplicity of perspective that I crave. He moves with a limp, and yet he’s not complaining about the process. He told me that God used a doctor to be His hands to fix his broken insides. He is so right.
A sovereign protector I have,
Unseen, yet forever at hand;
Unchangeably faithful to save,
Almighty to rule and command.
He smiles, and my comforts abound;
His grace as the dew shall descend,
And walls of salvation surround
the soul He delighted to defend.