22:20 – So Max had some baby steps backward today. His LFT came back with some factors higher and some lower than last week. This is an indicator of his hepatitis, and ultimately, of the status of his CMV infection. After the scare last week with the very high spike in values, we had hoped for more encouraging results in all areas, but we'll take what we can get.
His platelet count went down to 19k, so he was transfused with more platelets again this morning. His spleen is again destroying platelets (or "chewing up" as Dr. D is wont to say) faster than his body can produce them. His count had been hovering in the low 30k's this last week without additional help, that is he hadn't been transfused for 5 days. For reference, a normal count is 150k-400k. They did tell us that his need for blood products would not suddenly go away - the frequency of transfusing platelets and FFP (fresh frozen plasma) would slowly become less and less frequent. To get some perspective, Max had 14 transfusions during the first 72 hours of his life.
One good sign today is that Max is taking his pacifier enthusiastically. Even though he's either been on IV nutrition (TPN) or feeding tube his whole life, he still does have an instinct for feeding normally. This is a good sign that he'll eventually be able to move to bottle feeding. Some babies that spend many weeks on a feeding tube develop an aversion to swallowing due to the soreness and discomfort in their throat caused by the tube. This apparently hasn't happened yet with Max.
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