Friday, May 2, 2008

Renal Ultrasound

Today the NP came in to let us know they are going to give Jacob a renal ultrasound. His bloodwork from this week and last week showed increased levels of Direct Bilirubin which is different from the bilirubin Jacob had when he was born that caused his jaundice. Direct Bilirubin is caused by the TPN that was administered through his IV (the fluids he received until he was ready to digest breastmilk). TPN, over time, can damage the liver. Roughly a third of newborns on TPN for more than a few weeks develop some liver complications, but the good news is that damage from TPN is almost always reversible. Once Jacob came off the TPN, his liver slowly started to recover, moving the bilirubin better into the intestines, from which it is excreted. The doctors may prescribe a medication to speed the process along which is why they are doing the ultrasound first. Once they are certain that this is what they are dealing with they will probably get started on the meds. Fortunately, the NP informed us that his levels have not increased from last week to this week so that is a good sign.

They are also concerned about his weight gain. The average weight gain now should be between 20-30 grams a day. The hospital looks at this weight gain over a week (from Monday to Monday) and his gain last week was 54 grams total. He is moving up (or on some days staying the same) so at least he is not losing weight, but they would like him to pack on the pounds a bit quicker than he has been. They have added more calories to his breastmilk to achieve this, so hopefully that will do the trick. He is still 2 lbs 9 oz, but 2 lbs and 9 oz is anywhere from 1,162 grams to 1,191 grams so as you can see he can still gain weight, but stay the same as far as lbs and oz goes.

I was able to hold Jacob today cradle style (check out the pic) and that was nice because I was able to look at him while I was holding him. Unfortunately, the nurse swaddled him with his arms outside the blanket so Ian and I had to fight him off of that CPAP mask which he was trying to yank off with all his strength.

That is all for today! Hopefully I will have the results of his renal ultrasound tomorrow and can post an update!

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