Finding comfort and hydronephrosis care close to home

AJ Arria was diagnosed and treated at Boston Children’s for hydronephrosis – a urological condition where urine backs up into the kidneys.

Every child has a favorite thing. Some find comfort in the softness of a blanket, while others prefer snuggling a stuffed animal. Whatever the soothing item is, every parent cringes at the thought of misplacing it.

Michelle Arria remembers the day her 18-month-old son Anthony James (AJ) visited Boston Children’s Hospital for testing. It was the day his favorite blanket was lost.

“Testing was about to begin, and I went to get AJ’s blanket, and it was nowhere to be found. He was screaming crying, and I became hysterical,” Michelle recalls.

A staff member stepped into action.

“[The nurse] left the room and was gone for a period of time,” Michelle recalls. “She left the hospital, retraced my steps, and traveled to the sixth floor of the garage across the street before finding his blanket on the floor outside of the cardiology department.”

With his favorite blanket in sight, AJ quickly calmed down. Mom was extremely appreciative.

“No amount of gratitude is enough for this staff member who had done everything she could to track down a blanket — my son’s most prized possession. Thank you from the bottom of my heart.”

AJ enjoying his favorite blanket.

Treating hydronephrosis

AJ’s journey medical journey began well before his 18-month visit to Boston Children’s. It began in utero.

During a routine prenatal ultrasound, AJ’s mom Michelle was told her unborn child had bilateral hydronephrosisDr. Richard Yu, from Boston Children’s Department of Urology and director of the Robotic Surgery program, was called upon for care.

“I was first introduced to Anthony when he was in utero at 24-weeks gestation,” recalls Yu. “He had extra fluid in his kidneys, so I monitored him and Michelle in our Advanced Fetal Care Center (AFCC) and have followed AJ’s condition since birth.” According to Yu, hydronephrosis affects about one in 100 pregnancies and is the most common kidney condition he treats.

Though the prenatal diagnosis was unsettling, Michelle knew she was in the best hands. “When I was told something was wrong with [my baby’s] kidneys, I freaked out. But after meeting with Dr. Yu, I felt more at ease,” says Michelle, who lives north of Boston.

Welcome AJ!

On Dec. 8, 2014, AJ was born at Boston’s Brigham & Women’s Hospital at 37 weeks gestation weighing a delicate 4 lbs. 14 oz. Although AJ was tiny, doctors said he was a healthy baby boy and didn’t need to receive care in the neonatal intensive-care unit (NICU.)

“All the Boston Children’s doctors were outside the room, and I was glad they were there in case something went wrong,” Michelle says.

Soon after AJ was born, Yu began treating his tiny patient. He prescribed an antibiotic regimen to decrease the risk of Urinary Tract Infections (UTI) and kidney infections — common risks of hydronephrosis. Unfortunately, AJ developed an allergic reaction to the antibiotic, prompting Yu to discontinue use.

“Dr. Yu was great. When I had questions or concerns, he answered them no problem,” Michelle adds.

Time for minimally invasive surgery

20160115_PeabodyAnthony-16When AJ was 22 months, test results showed a sudden worsening of his kidney function and an increase of hydronephrosis of his left kidney. It was time for surgical intervention.

One month later, AJ underwent a robot-assisted pyeloplasty — a minimally invasive laparoscopic procedure that repairs the blockage causing hydronephrosis.

“Anthony needed surgery because the kidney dilation increased significantly. When this happens, there is concern that kidney function is at risk of declining,” Yu says.

With the use of a tiny camera and thin instruments, the obstructed section of the ureter was removed, and the healthy portion of the kidney’s drainage system was reattached.

“Anthony’s long-term prognosis is excellent,” Yu adds. “His kidney function started out at a level close to normal, and the surgical repair should last for his entire life.”

AJ recently visited with Yu during a follow-up visit at Boston Children’s Peabody location. The sweet-natured two-year-old is thriving and has returned to normal toddler activities.

“My greatest joy is taking care of pediatric patients like AJ, so they can live their lives as if their medical condition didn’t exist,” Yu says. “It has been a pleasure to watch him develop over the years into an inquisitive, outgoing and engaging toddler.”

Watch Dr. Richard Yu’s caregiver video.

Learn more about Boston Children’s Department of Urology and our locations of care.