Friday, November 7, 2014

We had our first family meeting today with the doctor and social worker. We received an overwhelming amount of information today. Overnight, the doctors and nurses had tried to place a PICC line (peripheral inserted central catheter) in Connor's arm so that they could remove the umbilical artery line that is currently giving him fluids and nutrition. They were unsuccessful so far but will try again tonight. The PICC line is a more permanent IV catheter and will result in less blood draws. He has a little gauze bandage above his left elbow where they attempted the procedure. 

Connor's PDA (patent ductus arteriosis) that he received medication for earlier in the week, has shrunk significantly and will hopefully close on its own. :)

Connor is on a caffeine IV drip for about 10 minutes every day at noon to help his brain develop faster. The nurses don't know how he can last until noon without his coffee! :)

He is not showing any signs of infection and is not on any antibiotics at the moment. As his feeds progress, they expect him to gain weight over the next couple of weeks. They will also be fortifying his feeds and he may be participating in a research study on feed fortification.

While our meeting wasn't all great news, we are still optimistic that Connor will be ok. Our biggest concern is that he has some bleeding in his brain, called an intraventricular hemorrhage or IVH. This is very common in micro preemies. Three brain ultrasounds have been done since he was born five days ago. A mild stage 2 bleed was found within the fluid space of the left lateral ventricle on the first ultrasound. Some possible bleeding was also found in the right ventricle but could not be confirmed by ultrasound. The areas surrounding it show no bleeding. As the blood is in the fluid spaces and wouldn't normally be there, the blood needs to be filtered out. As the blood is broken down, it can leave strands of fibrin. Sometimes the fibrin can block the filters and this MAY cause the fluid space to enlarge and become damaged, however, this is only in a small number of cases and only time will tell if there are implications from this. As a result, it is something they will continue to monitor closely in subsequent ultrasounds.

The goal over the weekend is to take Connor's endotracheal tube out (extubate) and move him onto a CPAP (continuous positive airway pressure) ventilator. This will provide gentle pressure plus oxygen to keep the tiny alveoli in his lungs open. He may have to be intubated again, but this is normal for babies this premature to go back and forth on different types of ventilators.

Definitely feeling overwhelmed with information and emotions today but other than the unsuccessful PICC line attempt and the IVH, everything else we heard today was relatively good news. :)

For more info, check out these RELIABLE sources directly from McMaster Children's Hospital:

http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/PICCLineBaby-lw.pdf

http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/PatentDuct-lw.pdf

http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/IVH-lw.pdf

http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/BabyBreathingLA-lw.pdf