update from ICU

So we had the cat scan. The doctor looked at it and said that no blood showed in the scan, and that things looked “good” to her. She is just the floor doctor though, so we need to talk to the neurologist tomorrow to see what the Cat scan results mean in conjunction with the MRI results. I don’t know if puss would show on the cat scan or not. Basically worst case at this point sounds like an infection in the brain, which could mean puss pockets that have to be surgically removed. Best case is still that it is just some inflammation from seizures that may all ready be healing on their own.
The good news out of the cat scan is that there is no fresh blood, so currently he is not bleeding in his brain, which is a good sign.

They finally took him off the ventilator. He is breathing just fine on his own when awake, but is not breathing as deep as he needs to when he falls asleep. This is a normal side effect of being on the vent, and so tonight he is on a low level of O2 through a tube hooked up to his nose in order to help him get enough air in the night. We should be able to wean him off the tube tomorrow.

They are starting to turn down the pain and sedation meds. He’s been on them for a week, and they are narcotic based, so he’s probably low level addicted to them. The pain specialist stopped by and prescribed methadone as part of the weaning process. He’s on a five day plan to wean him, so hopefully thanksgiving he will be weaned off of them at some point. This means we will not be home in time for thanksgiving. My ICU nurse today predicted another week, maybe 10 days more in the hospital. Ollie is showing something already that they consider a symptom of withdrawal, it has something to do with his mouth movements. The plan is to give him a dose of methadone now (well, as soon as the nurse gets it from the pharmacy) and then in 12 hours to give him another dose and cut the pain meds in half. Assuming he stands that, then 12 hours later we will repeat, and hopefully he’ll be off the pain meds in 3 days, and then 2 more of the methadone as needed.

They are working to wean the Milrinone next. Hopefully we will be able to start liquids by mouth in at some point tonight. We are going to try and feed him an ounce of breast milk in about an hour, and see how that goes. He’s got to stay on the antibiotics through Weds.

Then there is still the anti-seizure meds to deal with, I haven’t heard the plan of attack on that. That’s really the biggest question at this point. He seems to be doing okay other than that one issue, making steady progress.

Tonight, I finally got to hold him. It had been an entire week (almost half of Ollie’s life) since anyone had been able to hold him. It was pretty awkward, and it took two people to get us situated, but it was totally worth it. He’s still got a lot of tubes. The nurse said once he is off the Milrinone, the catheter can come out, so that will be nice.

Ollie is acting better. He’s having more periods of wakefulness. He now opens both eyes and he does track movement, both eyes together, so that is a good sign to me. They are watching him to see if he acts “normal” but since he was only home with us for a week, normal isn’t well established at this point. Normal for a newborn seems to be a lot of sleeping and eating, so we just need to wait and see. He seemed normal to me while I was holding him, but I’m not the best judge.

11/21/09

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