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...