June 14 - One Person's "A+" is Another's "F"

21:46 - Of course... just as we're scooty-scoot-scooting along thinking "he's doing so well!" there's a dissenter waiting around the corner to say, "not so fast!" I get it, MAX IS SICK. When I say, "he's doing so well!" that's not saying he's doing as well as a dissimilarly situated baby born without CMV. I'm sayin' that given his situation, [insert positive comment here]. For some reason I think the doctors think that we think he's coming home next week. We know he's not, okay, so let's move on.

As I mentioned yesterday (I think), for this weekend only Dr. R. is Max' neonatologist, who we really, really like. It started out as and remained a fairly uneventful day, where I went to visit Max in the morning followed by Phoo in the afternoon -- that is, until 17:45. Phoo was picking up dinner on his way home from the hospital, and Meaghan and I were leaving my parents' house; as I'm juggling my purse, the diaper bag, and portable pump, my cell phone rings and although I missed the call I see that it's the NICU calling. I called back and Nurse S. said that Dr. R. wants to speak with me. Uh-oh. He said that Max' CO2 has been increasing steadily the past two weeks, which we knew, and that his lungs continue to sound wet. Dr. R. feels that Max' PDA is worsening and that Max may be beginning to experience mild heart failure. Scary words, but we kinda knew that already because they attempted the ligation surgery while he was so so sick with CMV. AND, Dr. R. feels like Max isn't doing well with his feedings. I said, "What?? He just started two days ago??" What happened to the OT's "A+?"

I'm losing steam as I type this, so I'll cut to the chase. Basically we need to buy time so that we can get with the cardiologists at another hospital to determine what's next for Max' PDA. Dr. R. proposed we immediately start Max on Lasix, a diuretic, to treat the fluid around his lungs and see if that would bring his PCO2 back down - oh yeah, forgot to mention that it was 76 mmHg(!!) after this morning's blood gas. Do the blood gas at 21:00 and if his PCO2 was still high, back to CPAP. If PCO2 is good, wait until tomorrow and revisit. So tonight, after the 19:00 Lasix, the nighttime neonatologist decided to do an arterial blood gas instead of the heel prick. She noticed that Max' extremities are very cold, which could affect the integrity of the blood gas results. (Max is a little hotbox and hates to be swaddled.) Sure enough -- they pulled blood from his artery instead of his heel and his PCO2 registered at 46 mmHg -- the best in over a week. Was it the Lasix, or was it the artery blood? That's the problem with changing more than one variable at a time. We can't know right now which one caused the good gas. We'll be talking with Dr. R. tomorrow. Phoo is at the hospital now but I doubt anything else will happen tonight....

Sorry to make this so short and choppy, but I hate to let the blog go more than a day without updating. More tomorrow, I'm sure.....