Apparently, Sam likes to act a fool and have his biggest troubles on Sundays. Shortly after posting Sunday's blog entry about his great progress, I headed to the hospital and was informed he was running a fever and had a spike in his heart and respiration rates. Also, his tummy girth had increased. There was concern he may have some kind of infection. An x-ray of his abdomen was ordered. It showed some dilation of the intestines and some soft markers for a condition called necrotizing entracolitis aka NEC. It's as scary as it sounds. This is when bacteria in the intestine attacks the walls, causing perforation, which could allow all that bacteria to enter the abdominal cavity. Also, parts of the intestine can start to die and those parts must be surgically removed. It is often fatal. I was on the verge of tears most of the day pondering all this.
Bloodwork later indicated a definite infection, though they could not determine where it originated. Sam was started on wide spectrum antibiotics and a follow up xray was ordered a few hours later. That xray looked a little better in that the markers for NEC were no longer there. Our nurse practitioner was pretty certain it wasn't NEC. We breathed a sigh of relief, but knew Sam wasn't out of the woods. Something was still definitely wrong. We'd noticed the previous day he was fussier. Sunday morning, I could tell he wasn't himself. I looked into his eyes and he seemed to be telling me he wasn't feeling well. It made my heart ache. Poor little guy.
In the evening, a nice nurse discovered Sam had a motherlode of boogers (clinical name-nasal discharge!) in his tiny nose. She softened them up with saline solution and suctioned them out. Sam was momentarily pissed, but the boogerectomy had him feeling much better afterwards and his breathing showed marked improvement. We finally left after our 15 hour stint feeling a little encouraged seeing him rest comfortably
He did even better yesterday. The nurses were alerted to be on booger watch and make sure he's clear. He was on 30% oxygen in the morning. By 2 pm, the pressure on the CPAP was lowered to 5 (the lowest it can go) and he was on 24% oxygen. Pretty kick ass!
The poor little guy has had 3 IVs put in since Sunday. They don't last very long due to his veins being so delicate. Sometimes multiple attempts to get them in properly are needed. He screamed bloody murder at the first attempt on Sunday. I gave him his pacifier for the 2nd and it definitely helped. The nurse also put a few drops of a sugary solution in his mouth with the binky and he did great. Just like a kid to be so easily distracted by candy. Anyhoo, his PIC line was reinserted last night. He will get all his meds and nutrition through this line and it lasts much longer than an IV.
Little dude had his 2nd lumbar puncture since his arrival to check for meningitis. Thankfully, that was negative too.
Perhaps the antibiotics are kicking in. He just looks better. When serious infections and the like strike, respiratory function is generally diminished. The fact that he's been so stable in that regard is fabulous. During this morning's check in with the night nurse, she advised he remained on 24% oxygen overnight and did really well. He may soon graduate to a nasal cannula. Yesterday's bloodwork looked great. Signs of infection have diminished, but antibiotics will be continued.
So, another crazy few days. Now, we watch and wait.
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