Monday, December 15, 2014

Day 12 Update

Poor Sam. He had a low grade fever off and on yesterday, but Tylenol took care of it.  This morning around 8:00, his fever spiked to 103.7, so the nurse and nurse practitioner started thinking he had an infection somewhere. Scary!  They took a urine sample, blood sample from the picc line, and regular blood draw to see if it's a urinary tract infection, line infection, or something else. Those cultures take 48 hours to get results. 

This morning, they started the same antibiotics that he got as a precautionary measure last Tuesday post-op. He got a chest x ray, which came back clear, so no problems with his lungs or heart. Hallelujah!  Temp was normal again by 10:00 A.M.

Last night, his tummy looked swollen, and the nurse didn't seem concerned. I asked the NP about his stomach again this morning, so they did an abdominal x ray to see if they could see anything.  In the meantime, they stopped the feeding tube. Breastmilk is naturally 20 calories/ounce. They started his feeding tube with unfortified BM a few days ago, increased to fortified 24 cal (which is what he got at home), and then increased again to fortified 27 cal yesterday. The NP thought maybe his bowels weren't responding well to the high cal milk. Well, the abdominal x ray showed that his bowel loops are dilated. This could be because of air pockets in his bowels or stool that's backed up. They're going to do an x ray every 6 hours to check progress. Dr. Kao (my hero) came by and explained that babies with low oxygen saturation (which Sam was before surgery) sometimes have low profusion to the bowels, which basically means that his bowels work more slowly than normal. So before the surgery he was in charge of his feeds--when he ate and how quickly. Once they started using the ND tube, they just pumped a steady stream into his bowels, plus they went up to 27 calories, and his bowels couldn't manage. So the worry was that a bowel loop could rupture; however, the NP spoke with a peds surgeon, and he thinks antibiotics and holding off his feeds for 24 hours will take care of the problem. 

They also did a blood gas, and it came back normal. That test checks for lactate, which shows if there has been any tissue damage, so we're good there. 

Sam is acting uncomfortable, so they're going to give IV tylenol. The nurse said he might be feeling hungry, so it might be a rough 24 hours for both of us. And, unfortunately, there's not really anything I can do to make him feel better!  Dr. Kao did say his heart and all his heart-related stats looks great!

So! Prayer requests:
1.  the issue with his bowels gets resolved
2. if there is an infection, let there be clear results and that it responds to antibiotics 
3.  Sam's discomfort is manageable so he can rest

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