As you can see from the pictures posted earlier today, Granmommy got to hold Isabella. Goodness was she excited! During her holding time, the GI doctors came by to observe Bella and what might be causing her bilirubin levels to be elevated. First he said that he felt, based on all prior tests and screeenings, that the level is high because of the TPN fluids she was on for an extended amount of time due to her bowel and PDA surgeries. He went on to mention that the reason why the bilirubin level may be moving down slowly is the way the liver accumulates small particles while on TPN. With not being fed for so long, once she started feeding there is a good chance she flushed out a large portion of the tiny particles at one time. Thus causing the bili to flow out of the body at a slower rate. The GI doctor also mentioned, saying it was a slim chance, that there could be biliaratresian (I know I spelt that wrong). In this case, the duct connecting the liver, gallbladder and small intestine becomes lined with scar tissue, cannot filter bilirubin properly and would require surgery. An ultrasound was done mid-morning, but the results have yet to come back. Susan, Bella's primary NP, spent quite a bit of time explaining everything to me and reassured me that Bella most likely does not have the latter problem.
Later in the afternoon, Bella had another eye exam. This was also not charted by bedtime tonight...so another waiting game. All I do know is that they will repeat another eye exam next week. That doesn't give me much confidence.
Dr. McGahren also stopped in for a visit this evening. Overall he feels that she looks good and that her recovery has been nice, although Bella was not a "normal" baby from the beginning (as he put it). Her hole next to the mucous fistula has closed; however, the fistula is now very prolapsed. Dr. M said this is uncommon but not a problem. If the fistula starts to turn blue, then there would be concern. As of right now the fistula is pink and healthy. I mentioned the ultrasound done on the liver, he said that he would take a look at it as soon as he got the chance. But he did say that it is good that the stool is yellow, indicating that bile is coming out.
So we will have to see what information we get this evening...Peace and God Bless!!!