Wednesday, February 18, 2009
Today we'll start off with the good news....
Blake has been doing Great on his CPAP breathing settings. So well that Dr. Su will continue to wean him off even more. They'll both be on CPAP until around week 32, but they can reduce the settings to where the kids are pretty much breathing on their own.
He continues to do well on his feeding, and is growing growing.
Now onto the part that we dread. (this part edited to include more information after talking to Dr. Su)
Jenna has been doing pretty good since she went on the antibiotics and they raised her breathing settings. She only had one A&B last night and hasn't had any today. So that's great news.
The down side is that there can be some issues with the infection. If everything goes to plan, then the antibiotics will do their job and she'll recover quickly. The most severe complication is that if the infection gets into the blood stream, it can then get into the spinal fluid. That can cause big issues as then, it can be transferred to the brain (because the blood/brain barrier isn't very developed in premies). Because of her earlier issues with brain hemorrhage, this can cause some serious issues i.e. Meningitis. Meningitis would mean an increased risk of developmental issues later in life. The good news is that they would treat meningitis with the very same antibiotics that they put her on at the first sign of an issue. The positive is that there was no detection of bacteria in the blood culture after 24hrs. Hopefully we won't see one tonight at the 48hr mark. IF there is an infection, there is about an 80% chance it will be seen at the 24hr mark & a 95% change it'll present itself at the 48hr mark. Even if the blood culture is neg, there could still have been an infection, but the infection may not have entered the body, or was so weak that it just didn't grow well. Ahhhhhh the unknown.... welcome to our life. haha
But I digress. So far Jenna has been active and has responded so well, that they are happy with the way things are going. IF her culture comes back posative, then they'll do a lumbar puncture (spinal tap) to verify the strain of bacteria and how serious it is. They'll also do a head sonogram to determine if it's entered the brain. They would also continue the antibiotics for a longer period.
Another cause to her initial Apnea would be NEC (Necrotizing Endrocolitus [plz forgive the spelling or wrong med name]). This is where a bacteria is eating away at the intestines. Dr. Su doesn't think this is the cause as babies usually get Very sick if they have NEC and besides the Apnea and a small amount of blood in the stool, she's not behaving like she has NEC.
When all this started, they took xrays of her stomach and intestines because of the possibility of NEC, but everything looked perfect. When they did that, they did notice that her feeding tube had shifted back into her stomach. This in itself could have caused Everything from the blood in stool, to the apnea and lower platelet count. But... being the professionals that they are, they weren't going to wait around for more symptoms, they went ahead and treated things that could develop into bigger issues if left un treated.
Hopefully I don't bombard y'all with way too much information. Kim and I want to know every possible aspect of their health and treatment. It really helps us understand the situation and deal with things as they come. We are the kind of people that if we understand things, we are better able to make decisions and cope, where as the unknown really makes things difficult for us. Unfortunately, NICU life is full of unknowns.
So.... the short of it is that she's doing really good right now. The antibiotics seem to be working as she's acting normal and healthy and her breathing is good. If she continues to do good, Dr. Su would like to begin her feedings tomorrow. But, as with everything in their situation, things can change at a moments notice and there seems to always be the chance for serious problems. NICU life in general.