Today's focus was mostly on keeping Lewis comfortable and safe, so he can get started healing. Once he got settled last night and got started on his medicines and fluids, he had a pretty calm evening. Getting him settled wasn't such a quick process though. He got a couple of transfusions, antibiotics, medicines for pain and sedation, a diuretic to help him get rid of some of the fluids from surgery and nutrition by IV. His ventilator is already down to room air (no added oxygen) but we've been warned they're likely to keep him intubated for a few days. Since this was a more invasive surgery, Lewis will need more pain meds than last time. In order provide those drugs to an infant safely, they have to keep him on the ventilator.
The surgeon came by during the day today. He thought things looked good so far - not too much swelling and the drains and incisions looked the way he wanted them to look. So far, Lewis' temperature is normal and his blood pressure appears to be under control.
The physician who heads up the NICU told us that, in his 35 years of practice, he's never seen a baby have as many bad breaks in a row as Lewis. Now that we hold the record, we figure our man should start to rest up and head in the other direction. Hopefully that journey starts today.
Showing posts with label Blood Transfusion. Show all posts
Showing posts with label Blood Transfusion. Show all posts
Friday, November 21, 2008
Wednesday, November 12, 2008
This is Lumbar Puncture
A couple more sonograms of Lewis' abdomen essentially confirmed the hypothesis from yesterday. Most of the post operative complications are caused by a big hematoma in the stomach wall. We're also working to solve high blood pressure and a potential infection. Here's a rundown on today's events.
Blood - when we arrived this morning, Lewis was receiving a red blood cell transfusion, which completely freaked us out. We had been warned that he might need the transfusion, if his hematocrit (red blood cell count, they carry oxygen) dropped below where it had been over the last day or so. The aggregation of blood in the hematoma sounds like it caused this. Lewis' platelet count is also low, for the same reason, but not low enough to require a transfusion at this point. (Platelets are responsible for clotting). We noted that medical professionals don't seem to see think transfusions are nearly as much of a cause for alarm as we did.
Kidneys/blood pressure - as we mentioned yesterday, they did a sonogram of the kidneys with a kidney specialist to try to determine why Lewis has high blood pressure. The specialist noted that there could be some kidney damage from the initial oxygen deficit at birth, but she didn't see any problems at this point. She thought that high BP is likely a result of the retention of fluid and sodium. The fluid retention isn't unusual after surgery (it was described to us as one of the body's reactions to stress) and is one of the things making Lewis so swollen. The doctors have put Lewis on Lasix to treat the fluid retention. If that doesn't solve the blood pressure issues, they'll move to a hypertension drug, but the Docs don't seem concerned. The first dose of Lasix was around 2, Lewis has been peeing like a fiend since then. His BP is down a little, but not too much so far.
Infection - still no direct evidence of an infection, but the Docs remain quite concerned. The blood and urine cultures from a couple of days ago are still negative and the more recent ones aren't ready yet. Lewis' fever was down to normal range all day today. There's still concern that Lewis could be brewing something. The NICU Docs got a consult from an infectious disease specialist to make sure they weren't missing anything. Based on that, Lewis got a lumbar puncture (spinal tap) to confirm there wasn't an infection of the spinal fluid. They also changed him to a different antibiotic. The good news is that they gave him his pain killer and sedatives right before the lumbar puncture and apparently it was done very well. Hopefully it didn't hurt him much.
Respiratory - Lewis is relying on the ventilator much less today. No firm word on when it can be removed, but they're not concerned about him breathing without it.
When I left tonight, Lewis was resting comfortably, alternating between dozing and looking around calmly. His color is good, his hands and feet are warm and his face is nice and rosy as a result of the new blood.
BTW - based on our observations today, "lumbar puncture" and "spinal tap" are synonomous, unless you're trying to keep addled parents calm. In that case, Spinal Tap is just a movie...
Blood - when we arrived this morning, Lewis was receiving a red blood cell transfusion, which completely freaked us out. We had been warned that he might need the transfusion, if his hematocrit (red blood cell count, they carry oxygen) dropped below where it had been over the last day or so. The aggregation of blood in the hematoma sounds like it caused this. Lewis' platelet count is also low, for the same reason, but not low enough to require a transfusion at this point. (Platelets are responsible for clotting). We noted that medical professionals don't seem to see think transfusions are nearly as much of a cause for alarm as we did.
Kidneys/blood pressure - as we mentioned yesterday, they did a sonogram of the kidneys with a kidney specialist to try to determine why Lewis has high blood pressure. The specialist noted that there could be some kidney damage from the initial oxygen deficit at birth, but she didn't see any problems at this point. She thought that high BP is likely a result of the retention of fluid and sodium. The fluid retention isn't unusual after surgery (it was described to us as one of the body's reactions to stress) and is one of the things making Lewis so swollen. The doctors have put Lewis on Lasix to treat the fluid retention. If that doesn't solve the blood pressure issues, they'll move to a hypertension drug, but the Docs don't seem concerned. The first dose of Lasix was around 2, Lewis has been peeing like a fiend since then. His BP is down a little, but not too much so far.
Infection - still no direct evidence of an infection, but the Docs remain quite concerned. The blood and urine cultures from a couple of days ago are still negative and the more recent ones aren't ready yet. Lewis' fever was down to normal range all day today. There's still concern that Lewis could be brewing something. The NICU Docs got a consult from an infectious disease specialist to make sure they weren't missing anything. Based on that, Lewis got a lumbar puncture (spinal tap) to confirm there wasn't an infection of the spinal fluid. They also changed him to a different antibiotic. The good news is that they gave him his pain killer and sedatives right before the lumbar puncture and apparently it was done very well. Hopefully it didn't hurt him much.
Respiratory - Lewis is relying on the ventilator much less today. No firm word on when it can be removed, but they're not concerned about him breathing without it.
When I left tonight, Lewis was resting comfortably, alternating between dozing and looking around calmly. His color is good, his hands and feet are warm and his face is nice and rosy as a result of the new blood.
BTW - based on our observations today, "lumbar puncture" and "spinal tap" are synonomous, unless you're trying to keep addled parents calm. In that case, Spinal Tap is just a movie...
Subscribe to:
Posts (Atom)