Hypospadias

Yesterday I took Jude to the pediatric urologist up at A.I. DuPont Children's Hospital.

Let me start by saying I've never been to A.I. but Ryan had been there quite a bit when he was a child. He was treated for hip problems and asthma there and had told me before how great of a hospital it was. In addition my younger brother Chad had been there previously for thrush. Again, my parents had told me how great the hospital was. Just pulling in the parking lot I could see why!

Out front is a HUGE fenced in play ground and signs for "free valet parking" (I didn't use the parking service, but nice to know it's there!). The surprises only got better as I walked in the door. They had a corral of baby wagons waiting in the lobby so you could load all the kiddies up and wheel them around.

When I went to meet the front desk to find out where I was supposed to go, so told me I needed to follow the signs for the "sunshine module". All of the areas were color coded in bright primary colors; it was precious.

Once I found the sunshine module I did a very brief check in - they had gotten most of my information over the phone when I called in to make the appointment. This was convenient compared to other offices because obviously with a baby in your arms, the last thing you want to do is juggle 10 pages of paperwork and a fussy child.

Not to mention everyone I talked to seemed to really enjoy what they do. They were all super friendly and eager to help in any way they could.

But now on to the reason for this blog: hypospadias.

Hypospadias is basically a fancy word for "off center pee-pee hole". Instead of the hole being at the tip it's off center and usually somewhere else along the shaft of the penis. Sometimes this can be as bad as all the way down towards the testicles, other times it can be as simple as being just slightly off center. Jude's is just slightly off center. It's so slight that the person doing the circumcision didn't notice it until she started the incision. Because she started the incision she had to stitch him back up. Basically the doctor performing the correction will need to use the foreskin to correct the problem and so continuing the circumcision would cause more problems.

The biggest problems associated with a hypospadias from what I gathered are the following:

1. Possible reproductive issues.

2. Instead of peeing a nice straight stream he'll do more of a 'spray'. Typically if you don't correct the problem the child can sit down to pee, but generally that causes developmental issues. For example a first grader not understanding why all his friends stand up. He could think something's wrong with himself - or worse people could make fun of him.

As of right now though, it's fine because he's in a diaper.

When I went in for the appointment the doctor insisted he see Jude pee (makes sense). I stripped him down and he stimulated him enough to get a stream. He said at this point with the stitches still healing, he couldn't really see the hypospadias, so needed to have him come back in 4 weeks.

In the mean time he told us to frequently try to get him to pee without a diaper on so that we can see it (don't most parents try to AVOID this?). Basically he said we want to make sure the stitches and foreskin are healing fine and not constricting the penis. He said it's not uncommon for the opening to close up a little making peeing painful and causing a "ballooning" of the foreskin (great!). He said he doesn't see this happening with Jude as the stitches are already almost healed and he seems to be peeing fine.

In addition he said that we need to rub A&D ointment on the little guy to help avoid the problem above. I told Ryan this was his job - as all things penis should be.

So, we'll be going back in a few weeks for a follow up. He said that typically what will happen once he confirms the hypospadias is that he'll need to go in for surgery around 6 months of age. he will need to be put under and they will correct the problem then. Correcting the problem includes basically poking a new hole in his penis and sealing up the old one. In my opinion it sounds super painful. I feel terrible for the little man.

But in the end, it was reassuring knowing that everything is healing fine and that we really won't have to worry about it again until November.

Hospital Adventures

Our stay at the Christiana Hospital was exceptional. Ryan (who has been nothing short of an amazing father from the second Jude was born - helping me in any way he can, and just glowing from excitement) just kept commenting that if you were to have a child, CCHS is THE place to do it.

All of the recovery rooms are single patient rooms. Fathers have their own bed for rooming in and your child stays with you the entire time (no nursery - except for infant ICU). The nurses for the most part were all AMAZING and extremely attentive as well (there was one in particular who I wasn't too fond of, but even she wasn't terrible).

The First Night:

After being ushered to our room somewhere around 9 or 9:30pm it was a pretty big adjustment. We had come from the delivery room where everything was pretty much taken care of and routine to our room where it was up to us to care for Jude and call the nurses when necessary.

We needed to rest after a long day, but of course we were still wide awake from all the excitement. Even though it was past visiting hours Barbie and Meghan got to come up to visit for a little bit and it was nice to be able to sit down and talk and just mellow out a little. After they left we of course tried to get some sleep but every little noise or sound Jude made had us wide awake - even though for the most part he was sound asleep.

In addition to his little noises, around 1:00 in the morning it was time for Jude's 6 hour check up. At 1:00am we were being shown how to care for Jude - from taking care of his little cord to giving him a bath. He and I both had our vitals checked and I had some blood work done. Not too long after it was time for my Rogham shot (ugh! again!). We got a little sleep but before we knew it the sun was on it's way up and the nurses were bustling again.

Full Day #1:

Early the next morning it was time to get things rolling with all the procedures for Jude. He needed his first pediatric check up and his circumcision. In addition I had my morning visit from my doctor making sure I was getting by OK. The pediatrician ended up coming while I was in the shower, so Ryan got to take care of that. He was told that Jude was good to go but that they were going to test him for jaundice because of my/his blood type mix.

When Jude was taken away for his circumcision I felt terrible for the poor little man. Come to find out when he was brought back, the poor little guy wasn't even done. He has a hypospadias which basically is an irregular urethra opening which needs extra attention in the next few months. As a result they started the incision, saw the problem and had to stitch him back up. I felt terrible. But he seems fine and the stitches should heal without a problem. Unfortunately we'll have to take him to a pediatric urologist later on to get it treated further.

In addition, the jaundice test came back that he had slightly elevated levels of bilirubin which meant extra monitoring for jaundice. We were off to a great start!

All in all though he's a healthy adorable, amazing baby boy!

He and I spend the rest of the day sitting around the hospital room, taking visitors and Ryan ran a couple of errands and went home to shower and tend to Buddy.

Later when it came time to sleep, Jude had been sleeping all day so we were afraid he'd be up the whole night. We weren't too far off base. For the most part he was asleep, but wouldn't stay asleep in his bassinet very well. Which means that I was up most of the night holding him close to my chest to keep him content.

Day #2 - Getting Ready to Go Home:

First this Thursday morning I was very ready to get out of the hospital. I woke up bright and early and got showered and dressed to leave. Unfortunately we found out that his bilirubin levels came back higher than they should be and he would need to be sent home with a biliblanket. This meant we had to wait around a few hours for the delivery man to bring it through. We hung out around the room trying to keep ourselves occupied. Ryan carried all of our gifts and belongings outside and we were just waiting for the blanket. Once it came on home we went!