Lauren looks lots bigger tonight. She weighed in at 2 lbs 5.6 oz, but she is really swollen around the legs and groin tonight, so that is probably not a true weight. They took out the IV on her foot and put in a new one in her scalp vein. She got transfused with some platelets yesterday, and today she got a blood transfusion (THANK YOU!!!) since her red blood cells were down this morning. Daddy took a good look at Lauren's surgical wound and it is still open. It is pink and has a small amount of what is either drainage from the wound or drainage from the ileostomy stoma. The neonatologist looked at it and said that it actually looked better than the previous day. Daddy got to pick up Lauren so they could weigh her - she actually has some weight to her now. Both Mommy and Daddy took turns brushing Lauren's hair with the toothbrush. Grandma Nidia and Big Brother Preston visited tonight as well.
11/07/01 NOON:
Lauren looks more swollen today. Her face is starting to look a little puffy, mostly her eyelids. Her platelets were down again, so she got two more transfusions with platelets since last night. Her red blood cells are up but still on the low side, so she might need another blood transfusion soon. According to the neonatologist, it is all the extra fluids in the transfusions that might be making her so swollen. He says that the extra fluids are not hurting her, so he is not too concerned about it yet. If she gets too much more swollen, he says they can give her diuretics to get rid of some of the excess fluid. Also, he is somewhat concerned that her abdomen is still moderately distended and her platelets are down. He says that could be a sign that there is still some sort of inflammatory process in her bowels that is not related to the surgery. However, her signs and symptoms are so non-specific right now that no therapy other than observation is indicated. She starts getting some small amounts of Mommy's milk (trophic feedings) later today (1 cc every 6 hours) to see how well she tolerates them and to "prime" her gut. Her ventilator settings are now for moderate support. She had some A's and B's yesterday on the low settings and they had turned the vent up to full support again.
11/07/01 11:00PM:
Mommy is working tonight and got the opportunity to check in on Baby Lauren. She is even more swollen and weighed in at 2 lbs, 10 oz (over 2 1/2 lbs!!!) but that is certainly due to the excess fluids she is retaining. The neonatologist ordered some Lasix (a diuretic) for her so she should be putting out more urine soon. A side effect of the drug is that it causes potassium (an electrolyte) to be excreted in the urine, so she might need some potassium added to her IV fluids to prevent heart rhythm abnormalities. Since she is tolerating the trophic feedings well with no residual volumes, so they might increase the feedings in the next few days.
11/08/01 2:00AM:
In response to popular demand, Daddy stayed up and put some photos up on the web at another site. Please come back after viewing them. Click Here to see the photos.
11/08/01 11:00PM:
Lauren started having residual volumes after the feedings, so they stopped them to let her gut "rest" some more. She got some more platelets (more fluids) but she also got some more diuretics, and she weighed in at 2 lbs, 9.25 oz (3/4 of an once less than yesterday). That means that she urinated out all the extra fluid she got today plus a little more. Although she weighs about the same, she doesn't look as swollen. They took out the arterial line that was in her wrist. She was so active that she had to be lightly sedated. She kept grabbing the breathing tube and pulling on it, and since she already has extubated herself twice, the nurse took some gauze and taped it around her wrists and hands to make tiny mittens. Now she can't grab anything. The nurse said that her surgical wound looks a little better. The factor that concerns the neonatologists at this point is the repeatedly low platelet count.
11/09/01 5:30PM:
Lauren remains stable, with no significant changes today. They repeated the blood cultures to make sure that there is still no infection showing up. Mommy says Lauren looks less swollen. Her abdominal girth meassurement is slightly less today, so her belly is less distended. Her vent settings are still for moderate support, but the oxygen settings are low.