Wednesday, February 11, 2009
Baby Bella Day 68
Today was a fact filled day. So where do I begin...
LIVER - There are no detectable gallstones. There is no biliaratresian. There appears to be minor liver damage. Just as they said before, this is the result of being on the TPN fluids for too long. It was easier to detect with yesterdays ultrasound compared to the prior ultrasound and the difference in discoloration. The decent thing about the minor damage is that with growth the tissue will correct itself and not cause long term affects. Of course they will continue to monitor her bilirubin levels, give her the actigal, and follow-up with any x-ray/scans that may be necessary going forward.
EYES - Isabella's eyes have gotten worse since the last exam. They are now at zone 2 stage 3 (there are 3 zones and 5 stages, the further out you get the worse it is). Daniele (today's NP) said that she is moving towards the laser surgery. This surgery is fairly effective and works to tack down the retina before it detaches. The surgery would need to be done before the bowel reattachment. I asked if they could be done at the same time so that they don't have to intubate and sedate her twice. They are going to look at lining up the doctors schedules and the likelihood of doing them at the same time. We asked about the effects of having her sedated for too long at one time and Daniele said that it shouldn't be a problem.
MUCOUS FISTULA - The fistula is even more prolapsed today. Dr. McGahren has continued to look at it closely. They are trying to keep it from getting too irritated and causing damage they don't want before the surgery in two weeks.
KIDNEY - This is a new development that was only spotted because of the ultrasound. It appears that Bella is having a bout of hydronephrosis, or kidney reflux. The duct between the right kidney and bladder is dilated. This is the result of urine going back up toward the kidney instead of flushing out through the bladder (she is not emptying all the way). This can be the result of lasix, which she was given frequently while intubated. This too is minor and is being treated with amoxycillin. They may do a VCUG, a type of x-ray and dye scan, to evaluate the level of reflux.
WEIGHT GAIN - Isabella is up to 1850, which is great! They increased her feeds to 27 calories and so far she has tolerated them well. BUT, as the result of her prior weight gain and slightly chubby legs, she developed chaffing and thus a yeast infection around her thigh area. This is being treated with a topical antibiotic called nysatin.
BREATHING - As the most encouraging news of the day...she did the high flow nasal cannula for 11 hours tonight. They now have her rotating from 11 hours of cannula to 1 hour of CPAP. They want the 1 hour of CPAP for a couple of days just to make sure her lungs have some time of constant pressure to limit the risk of minor lung collapsing.
So I think that about covers it! I have been pretty stressed out since Sunday and have to thank everyone who has been patient with me and listened to me. Mom and Chris have been wonderful. But there are also the "usual suspects" who have been there for me...you know who you are ladies!!!
Chris reminded me today to read Isaiah 41:10, so I want to post that one again:
So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.
Much Love & God Bless!