It’s been a long one. Between the two of us (and mostly Abigail), we’ve been at the hospital non-stop since 7:30am this morning. Abby is still there to do evening hands-on, so I’ve got the job of writing the update.
After several days back of having Teddy back on the ventilator, we still didn’t have any concrete answers for his continuing and worsening desatting episodes (intermittent drops in blood oxygen saturation from the low 90’s where it should be to as low as the 60’s or 70’s) and occasional bradys (spells where his heart rate dips below 100bpm). We also had a new symptom last night, as he vomited a couple times.
The vomiting was a particularly worrisome development, as it can be an indication of necrotizing enterocolitis (NEC), which is basically cell death of intestinal tract tissue that can lead to perforation and eventually sepsis.
I am incredibly proud of my wife and grateful that our little boy has such a strong mom; she refused to let the staff off the hook with non-answers during rounds this morning, which resulted in a bunch of action all day long.
First they stopped his formula feed and returned him to IV-only nutrition to give his digestive tract a break and prevent or forestall any developing NEC.
Next, they did a chest x-ray, which showed clear lungs but a misplaced ventilator tube. The initial hope was that fixing that would end the cardio-respiratory episodes and perhaps even allow them to extubate Teddy within the day.
Unfortunately, he continued to desat and brady even after his tube was re-placed, so they followed that up with blood and urine tests, which meant placing an IV line and a catheter – not an easy task on a 1lb 8oz, 33cm baby, or a fun time for anyone involved.
The blood and urine cultures will take some time to grow, so they put him on preventative antibiotics in case there’s an infection of some sort. That doesn’t seem to be the working theory of doctors or nurses, but it’s good that they’re checking.
The CBC blood test did reveal low “H&H” levels (hemoglobin and hematocrit), which provided a strongly plausible explanation for the bradys and desatting. As a result, Teddy got his third blood transfusion a few hours ago, and Abigail’s last report is that he seems to be responding well, though they still have his ventilator settings up a bit to let him rest from what was a lot of poking and prodding over the course of the day.
Anemia is apparently relatively common in premature babies, and something that they eventually tend to outgrow on their own, but right now the effects can be pretty devastating. Low oxygenation can lead to NEC, as an oxygen-deprived body will shunt blood from the digestive tract to protect more vital organs. Fortunately, the transfusion should make a pretty drastic difference in his body’s oxygen-carrying capacity.
So that’s where we are tonight – waiting to see if anemia has been the main cause of his recent challenges, worrying about the possibility of NEC, and hoping that the blood transfusion does what it’s supposed to do. We’ll be sure to keep everyone updated tomorrow – in the meantime, please pull for that blood to do its thing!
One sidenote – I know I am extremely grateful that there is plentiful blood available for Teddy’s transfusions. My mom even donated last week in Teddy’s honor. (I tried but unfortunately, like my son apparently, I am too anemic). If you have the ability and the opportunity to give blood, please think of our little guy and the help he’s receiving from goodhearted people like you.