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the eric update - day 57: a nice, quiet day. but liver problems looming?

today was a relatively quiet day, with nary an alarm and only the occasional, normal "desat" ( lowering of the percentage his blood oxygen, which is associated with bradycardia and apnea ) that he seemed to be able to pull out of all by himself. he put on about an ounce and tipped the scales at 3 pounds, 4.7 ounces or 1495 grams; also, he's an astonishing 41.5 centimeters or about 16.33 inches, which means he's added over an inch to his length since the last time they measured him, and he's over 4 inches longer than his birth length!

unfortunately, we discovered that eric's conjugated or "direct" bilirubin levels are rising, which is cause for some concern and eric will get increasingly jaundiced, if the cause is not discovered. it might sound like eric is just having another bout of the physiologic jaundice that all babies can get which can be fixed by phototherapy, but unfortunately things are not that simple.

the two types of jaundice have different causes and different treatments. the good news is that we're probably seeing the result of eric's liver getting "sludgy" ( the neonatal nurse practitioner's term, i swear ), which is not too uncommon after switching back and forth between intravenous feeds and breastmilk ( which is what has happened to eric ); if the cause really is eric's sludgy liver then we can expect the issue to resolve itself after he gets back on full feeds. but there are also many other less fun things that can cause higher levels of conjugated bilirubin and they are currently trying to rule those out. he'll have an ultrasound of his liver sometime during the night and they drew a bunch of blood for a panel of liver function tests, but we won't know the results of those tests for a couple of days.

if it's not one thing, it's surely another in the nicu.

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8/30/2004 11:00:00 PM 2 comments


Wow, I'm sorry to hear about this.

But as always - a big show of support... Kyle was also diagnosed with Direct Hyperbillirubinemia. It became evident about 3 or 4 weeks after he started breastmilk feeds. It peeked 4 weeks later, then rapidly declined over the following 2 weeks. We were of course on pins and needles, constantly watching that number. He was given Phenabarbatol, in a small maintenance dose (now were near the high levels given to seisure patients), to assist with stablizing it, and helping with the decline.

At one point we were given the option to discontinue BM, but with the warning that it's benefits far out-weighed the negatives... There wasn't a question in our minds, we kept with BM - and we're glad we did. In the course of the next month, 2 other babies in our NICU developed NEC. We know in 1 case specifically, it was due to immature bowels and problems in processing the harsher "formula". Fortunatly the babies survived - but that wasn't a shoe we wanted to wear!

E4 is quite the fighter, as with all the challenges that he has faced so far... He will see this through in record time, I'm sure! Besides, with Pooh & Piglet at his side - what could go wrong? I mean really, he has a great little cheering section!

By Blogger Katra, at 12:34 PM  

thanks once again katra. it's nice to know that kyle was able to (relatively) quickly get things back to normal without and serious intervention required. based on the latest test results it looks like there's no major obstructions or other conditions causing the rise in direct bilirubin, so hopefully ( and quite probably ) things will clear up just as quickly for eric.

By Blogger e3, at 8:58 AM  

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