July 21 - Belated Info Update

The big happening over the weekend is that we discovered what was causing the fever. After some tests (including an unpleasant procedure called a "catheter culture"), it turns out that he has a UTI (urinary tract infection). The labs came back positive for e. coli. However, an e. coli infection of the urinary tract is apparently not on the same order as an infection of the upper GI tract from ingesting e. coli. Nonetheless, it is non-trivial and Max is back on antibiotics again. For this, he has another IV in his head. Intellectually, I know it's no different than one in his arm, but I always find it disturbing to see the needle and line connected to his scalp. Fortunately, his fever seems to have abated after only a couple of days. Though he'll still be on antibiotics for the rest of the week.

Max' physical therapy is coming along well. Melanie says that his head control in really improving. His overall muscle tone and strength are good for a newborn at 47 weeks gestational age.

Melanie had a conversation with Dr. R concerning Max' feeding regimen for coming home. All recent attempts to compress his feedings into shorter times have thus far resulted in him not keeping meals down well. Max seems to tolerate continuous feeding much better - where milk is introduced into his feeding tube so slowly that it's continuous throughout the day. Unfortunately, continuous feeding results in increased risk of aspiration (inhaling milk into the lungs if the tube position shifts enough) since the number of hours that the feeding pump runs per day is greatly increased. The way to avoid this is to insert a G-tube (gastric feeding tube) instead. Alas, not all of his doctors agree that another surgery is a good idea at this time. We were leaning toward the G-tube option, when Dr. R pointed out to us that the anesthesiology would involve intubating him again. Max' breathing has been steadily improving, but he's still having some respiratory problems. Including a slightly enlarged right heart ventricle - usually attributed to a cardiac response to pulmonary stress. We really don't want to see him on a respirator again. Especially, since it could trigger a regression in the respiratory progress he's made so far.

To sum up, no more talk right now of when he may be going home.