an odd ultrasound

Ricky having his ultrasound
Originally uploaded by Beckerbuns

For quite a while now, Ricky's gastroenterologist has wanted him to have an abdominal ultrasound to rule out other issues that might be causing the pain he's been having for a couple of years now. We've always figured it was bowel issues, common in CF, since he had such a hard time with bowel obstructions during his last two hospitalizations.

In recent months, CCS and Medi-Cal have decided that the gastroenterologist, who has seen Ricky since he was a neonate in the NICU, is no longer someone for whom they will pay for services rendered. So I had to turn to the CF doc (lung doctor) to get Ricky's ultrasound ordered. Today he had it, at Packard.

First off... The tech asked if anyone had ever mentioned Ricky having situs inversus. I said no, I didn't think so -- what was that? He said it was where the organs are reversed. He said that Ricky's liver seemed to be in a different place. I quickly Googled the term on my phone and puzzled over it.

Then the tech asked if anyone had ever told me anything about Ricky having issues with his pancreas. I said that other than pancreatic insufficiency, no.

I was asked about whether he'd had surgeries. I mentioned the several centimeters of small bowel that were removed when he was a few hours old. I said as far as I know, nothing else had been removed then.

Then things got really weird. He couldn't find Ricky's gallbladder. He had him turn this way and that, hold his breath. No gallbladder. And as it turns out... No right kidney either. What. The. Heck?

He called in another ultrasound technician. She couldn't find either organ either, after a lot of looking. Then the two of them brought in a radiologist. Even with his help they couldn't find the right kidney or the gallbladder. Curiouser and curiouser.

The exam was wrapped up with ultrasound tech #1 saying that the report would be completed soon. He mentioned that other imaging studies would probably be ordered.

When we got home I left a message on the CF nurse's voicemail. I talked about the weird ultrasound and asked that she call me as soon as the results were received, since I figured it would be pretty soon with how weird things were. I got a call back shortly thereafter from the patient care coordinator. He let me know that they felt Ricky needed to be referred to a gastroenterologist, I'm assuming one there at LPCH. So... results of the ultrasound? We don't have them yet.

How does someone lose their kidney? And gallbladder? He's had so many x-rays and at least one other ultrasound and CTs and... No one noticed this before? Or the strange liver placement or pancreatic issue? I'm so confused.

Hopefully more answers are forthcoming this week.

UPDATE:  I heard back from the gastroenterologist eventually.  She said that, in fact, both kidneys were visible, but the right kidney was obscured by bowel gas (which was odd, since he hadn't eaten since dinner the night before).  The gallbladder was there, but greatly compressed.  The gastroenterologist said this could be indicative of a number of problems, and suggested that Ricky have an abdominal MRI.  This will have to wait til we see the new gastroenterologist at LPCH.  We're waiting for that to happen... Hopefully soon.

Update

I got a call from the supervisor at Medi-Cal late in the afternoon yesterday. She said that I should ask the pharmacist to try the prescription again. I called, and the pharmacist, in between sympathizing with me about all of the issues we've been dealing with, ran the prescriptions again and got them to work! Hooray! I am going to go pick them up tonight, and just in the nick of time. Meanwhile I've submitted some of Ricky's other meds for refills; we've now gone over the six per month (ridiculous, if you ask me) that Medi-Cal likes to refill, so we'll see what kind of battle we'll have to fight.

And now, before I go, I want to congratulate Nate and Tricia of CF Husband on their Blogger's Choice Awards. I'm hoping for some good news for Tricia and family SOON!

Medi-Cal update

Yesterday morning I decided I'd had it with the idiotic Medi-Cal people, and I wrote an email to my contact at the County Supervisor's office detailing the situation.

I got an email yesterday early afternoon from my contact. She said she had called her contact at Medi-Cal and that I might be getting a call.

When I got home (much later in the day, since I worked til 5, and then went to get Misty followed by the boys) I had an answering machine message from the supervisor I spoke with on Friday. She said she was putting something in the computer to have the HMO thing taken out, but if it wasn’t possible to do it on her end, she’d have to call the Sacramento office. At this rate it might not be taken care of before the boys get Healthy Families anyway! And the boys will both be needing meds soon! But at least something is happening. And it turns out that it was not her with whom the pharmacist spoke on Friday, supposedly.

I spoke with my contact from the Supervisor’s office today and gave her status. I promised to let her know what happens, and she said she’d follow up if need be.

So, yay!

Meanwhile, Ricky is doing great all around. He missed soccer this past Sunday because I had to work, but we're going back this Sunday.