Okay, well, Sunday nights. Jenn and I went to visit Lewis after Nate went to bed last night. When we arrived, he was in the process of getting all kinds of uncomfy tests, up to and including a catheter and "lumbar puncture" (spinal tap). Before we got there, Lewis' temperature went up from normal (37 C) to 38.2 C (about 100.75). The change led the NICU staff to do a blood test (CBC) to check for potential signs of infection. Since his white cell count on the CBC was elevated, they were working on a full battery of tests. Most of these will take a couple of days to come back with conclusive results.
On the bright side, Lewis wasn't behaving any differently (he didn't appear to be sick). They put him back on antibiotics right away, and his fever immediately came down. This morning, he was active and awake and Jenn and I each got to hold him for a good long while. The preliminary results of x-rays and observation look positive (not likely to be pneumonia or meningitis) but Lewis will be even more closely watched than usual, until they can explain the blood count and fever.
Respiratory - still having problems with secretions, but overall respiratory strength continues to look a bit better. They are moving the nasal cannula down to 3 liters today (meaning that Lewis will do more of the work of breathing on his own)
Feeding - decreasing to 3 hour interval, still 30 Ml per feeding through the tube, they are pushing to get him off IV nutrition as soon as they can
Physical Therapy - Lewis had his first visit with a physical therapist (PT) today. She was pleased with the tone in his limbs. His 'trunk' (neck, shoulders, lower part of face) is still a little behind. The PT says that that is not unusual following the full body cooling, and that it may be exacerbated by the phenobarb. Lewis will be having PT 3x a week, for now.
The speech therapist is visiting with Lewis now, to evaluate him and work on sucking and other important baby skills. Oh, one more thing - apparently Lewis let out a pretty good war cry when they did the spinal tap. This is a great sign, since he doesn't cry and hasn't made much, if any noise, so far...
Showing posts with label Full Body Cooling. Show all posts
Showing posts with label Full Body Cooling. Show all posts
Monday, October 20, 2008
Friday, October 17, 2008
the background
Friday, October 17, 2008
This blog has been created in order to help all our friends and family keep up with what's going on with Josh and Jenn's new baby. Lewis Jack was born on Friday afternoon, October 10th. Unfortunately, after a pretty long labor, Jenn suffered a uterine rupture as she was being brought to the operating room at Arlington Hospital. Lewis was delivered by emergency c-section. He was 9 lbs 1 oz and 22 inches long.
Jenn was very lucky; she is all sewn up and has an incision just as one would from a c-section but is doing fine. She was at Arlington Hospital until Tuesday morning recovering. Since Tuesday, she's been recovering at home, with frequent trips to see Lewis at the hospital.
When Lewis was born, he wasn’t breathing. Though his heart was beating, it isn’t clear how long his brain was without oxygen. He was initially treated in the neo-natal intensive care unit (NICU) at Arlington. After a couple of hours, he was rushed to Georgetown Hospital's NICU. Georgetown has a special fully body cooling machine which is used in the treatment of brain insults to infants. This is a very new treatment that is not widely available. (After the fact, we learned that much of the pioneering work on this type of treatment occurred at Georgetown). Lewis also suffered seizures and was immediately put on anti-seizure medication (a sedative).
The full body cooling began Friday afternoon, within 4 hours of birth. The cooling process is designed to slow the brain’s metabolism, preventing secondary injuries which are caused by the loss of oxygen to the brain. The doctors brought Lewis’ body temperature down to 33.5 centigrade (about 92.3 degrees F) and held it there through Monday afternoon. During this time, Lewis was breathing with the aid of a ventilator. Multiple tests were performed to assess the function of his heart, kidneys, liver and lungs. In general they showed that those systems were getting stronger, moving towards normal. He did continue to shudder or twitch occasionally, it looked like he was just cold, but it also might have been what the doctors call ‘subtle seizures’.
On Monday, October 13th, the NICU team warmed Lewis back to normal body temperature, over a period of about 6 hours. He came through the process well, with no additional issues surfacing, but he continued to have occasional subtle seizures.
Since then, Lewis has had a short hour long EEG which seem to be fine and a longer one which has yet to be read. He went back on forth on breathing support – on and off ventilation twice, but by Thursday, he was breathing room air (no additional oxygen) with just a nasal tube providing some added pressure. He was still having a lot of trouble with what the doctors call “secretions” (saliva and mucus) that have to be suctioned pretty frequently. Lewis is still being medicated for seizures but moves his arms and legs, clasp onto fingers, responds to light appropriately.
The NICU is pretty strict about visiting. Only two visitors at any one time, and one of them must be a parent. Jenn and Josh have visited daily and since Thursday have been able to hold Lewis. Grandparents Didi and Bop (Judy and Hank) and Babu and Nanny (Raymond and Susan) have spent time with Lewis too.
Nate, Lewis' big brother, is doing ok, with lots of attention from grandparents, his Uncle Danny and Aunt Anne, and his regular nursery school and babysitting routines.
Updates to this blog will be done regularly while Lewis is still at the hospital. Joanne, Josh's older sister, (that's Auntie Joanne to Nate and Lewis!) will help with this. Please feel free to leave comments, positive thoughts, prayers, good vibes, and anything else you want to say to Jenn and Josh here.
Thank you for all the love, support, and care you've sent to Lewis and family this week. We are very grateful.
This blog has been created in order to help all our friends and family keep up with what's going on with Josh and Jenn's new baby. Lewis Jack was born on Friday afternoon, October 10th. Unfortunately, after a pretty long labor, Jenn suffered a uterine rupture as she was being brought to the operating room at Arlington Hospital. Lewis was delivered by emergency c-section. He was 9 lbs 1 oz and 22 inches long.
Jenn was very lucky; she is all sewn up and has an incision just as one would from a c-section but is doing fine. She was at Arlington Hospital until Tuesday morning recovering. Since Tuesday, she's been recovering at home, with frequent trips to see Lewis at the hospital.
When Lewis was born, he wasn’t breathing. Though his heart was beating, it isn’t clear how long his brain was without oxygen. He was initially treated in the neo-natal intensive care unit (NICU) at Arlington. After a couple of hours, he was rushed to Georgetown Hospital's NICU. Georgetown has a special fully body cooling machine which is used in the treatment of brain insults to infants. This is a very new treatment that is not widely available. (After the fact, we learned that much of the pioneering work on this type of treatment occurred at Georgetown). Lewis also suffered seizures and was immediately put on anti-seizure medication (a sedative).
The full body cooling began Friday afternoon, within 4 hours of birth. The cooling process is designed to slow the brain’s metabolism, preventing secondary injuries which are caused by the loss of oxygen to the brain. The doctors brought Lewis’ body temperature down to 33.5 centigrade (about 92.3 degrees F) and held it there through Monday afternoon. During this time, Lewis was breathing with the aid of a ventilator. Multiple tests were performed to assess the function of his heart, kidneys, liver and lungs. In general they showed that those systems were getting stronger, moving towards normal. He did continue to shudder or twitch occasionally, it looked like he was just cold, but it also might have been what the doctors call ‘subtle seizures’.
On Monday, October 13th, the NICU team warmed Lewis back to normal body temperature, over a period of about 6 hours. He came through the process well, with no additional issues surfacing, but he continued to have occasional subtle seizures.
Since then, Lewis has had a short hour long EEG which seem to be fine and a longer one which has yet to be read. He went back on forth on breathing support – on and off ventilation twice, but by Thursday, he was breathing room air (no additional oxygen) with just a nasal tube providing some added pressure. He was still having a lot of trouble with what the doctors call “secretions” (saliva and mucus) that have to be suctioned pretty frequently. Lewis is still being medicated for seizures but moves his arms and legs, clasp onto fingers, responds to light appropriately.
The NICU is pretty strict about visiting. Only two visitors at any one time, and one of them must be a parent. Jenn and Josh have visited daily and since Thursday have been able to hold Lewis. Grandparents Didi and Bop (Judy and Hank) and Babu and Nanny (Raymond and Susan) have spent time with Lewis too.
Nate, Lewis' big brother, is doing ok, with lots of attention from grandparents, his Uncle Danny and Aunt Anne, and his regular nursery school and babysitting routines.
Updates to this blog will be done regularly while Lewis is still at the hospital. Joanne, Josh's older sister, (that's Auntie Joanne to Nate and Lewis!) will help with this. Please feel free to leave comments, positive thoughts, prayers, good vibes, and anything else you want to say to Jenn and Josh here.
Thank you for all the love, support, and care you've sent to Lewis and family this week. We are very grateful.
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