>> I'm a dancer and a swimmer.
I've been dancing since I was out like four and swimming since I was five.
>> I'm Chloe's mom.
We thought she had a urinary tract infection, but urine culture came back negative.
The interesting thing was Chloe was never in any pain.
So it was a little confounding.
She referred us to CHOP and said get an ultrasound.
Dr. Tasian's reaction was, "Wow.
Yeah, that's a really big kidney stone for a seven year old."
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>> One may not know they have stones in the kidney, even a very large stone, but the
times where it comes to light is where that stone, for many different reasons, may move, it may grow and cause changes.
And some of those symptoms that you typically see, it could be anything from blood in
urine, to pain, to nausea/vomiting, to fever.
It's absolutely essential to have an experienced, comprehensive and integrated team for stone care.
And I think it really starts in that conversation before surgery is decided upon.
And the reason for that is there are different approaches, different procedures, that one might use for a given stone.
At CHOP we really believe in shared decision making.
Where I, as a urologist, can present those options and then work with the patient and their family and their caregivers
to decide about the surgery that works best for them, and really include patients and their families in that process.
The three most typically used surgeries to treat stones are shockwave lithotripsy,
ureteroscopy and percutaneous nephrolithotomy.
>> Options were very well explained.
We knew what to expect.
Dr. Tasian is excellent at answering questions, addressing concerns and not just mine, but Chloe's
also, which as a parent, it's important for me to empower Chloe to be able to make her own decisions.
If this is going to be a lifelong issue, ultimately she's going to be able to stand on her own two feet and
advocate for herself, which is important to me and Dr.
Tasian his team are great at that.
>> He was really nice.
I loved him.
He was like, he made me comfortable.
>> Chloe, I first met a few years ago and at that time she had a
urethral stone as well as the stone in her kidney.
>> So pretty quickly we wound up having her first surgery.
>> She had ureteroscopy.
>> They were within a year of each other, the first two.
And then we went another full year before she developed another stone, large enough that we were concerned.
>> After that stone was recognized, when she reflected on the
experience that she had in the past about requiring urgent surgery to remove the ureteral stone, what
she decided to do with her family members was to do a surgery to prevent that stone from becoming
symptomatic and removing it before it became a problem.
>> When we had the option of lithotripsy, which I think was your third surgery, we jumped at that.
>> So at that time she elected to have shockwave lithotripsy, which was
effective in eliminating and removing that stone.
So shockwave lithotripsy is a non-invasive procedure to remove kidney stones.
It is done under a general anesthetic.
It's an outpatient procedure, meaning that once the procedure is performed, then the child would go home
after recovering for about an hour or two after surgery.
In this procedure, the stone is visualized through either fluoroscopy, which is a type of x-ray or with ultrasound.
At CHOP, we use ultrasound to visualize that stone thus eliminating any radiation when that procedure's performed.
And then in targeting that stone, or stones, in the kidney, you're able to focus those shockwaves noninvasively so
that each of those shockwaves hits the stone, and then at the end of the procedure, that stone is turned into
fine particles that then pass spontaneously in the urine.
>> They call you the night before and say, here's your arrival window.
So I think we arrived around seven -- it's an early morning.
It's an outpatient procedure, but it's the whole day.
I was able to walk back to you, the operating suite.
And then I waited maybe an hour and a half.
It's not a whole long time.
And they do get you right back to your child.
It's been our experience that there's zero complications in recovery.
I think the dedicated team makes all the difference.
The fact that you continue to work with the same providers who then know you and know your child and know your
circumstances, makes a huge difference in comfort level.
The ongoing research, not just for Chloe, but for other patients too, I think we're now in the third
study that we've participated in with them and knowing that you have the opportunity to make a difference,
not just for your child, but for other children.
As you can see, this is sometimes a difficult and traumatic experience for a younger child.
>> In the Kidney Stone Center, we focus our energies on understanding what's
driving, what's determining this disease, why it's happening earlier in life, and then being able to turn that
knowledge into new treatments or more effective treatments.
We know that individuals with kidney stones have a greater sense of anxiety than those without living with stones.
And that's in between those acute symptomatic events.
So being able to partner with the patient from beginning of the planning of surgery, to the execution of surgery,
and then most importantly, seeing them in followup six weeks later is tremendously satisfying and to be able
to share what it's like for them to know that event is behind them and then focusing in the future on prevention.
>> They really helped me through it.
And I couldn't be any more happier for them to help me get back to life.
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