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the eric update - day 71: another transfusion. reduced reflux. reglan questions.

pooh decided to put one of the yellow "live strong" wristbands to good use after eric finished getting his latest transfusion. as regular readers are quite aware, we've known for awhile that he's needed a transfusion, so it was nothing suprising and it will go a long ways towards giving eric the energy he needs to bust out of the nicu.

interestingly, they did a special blood test to see specifically how many new red bloods cells he was making and it seemed like he wsa doing a great job creating new ones, but just not making them quite fast enough to keep his hemoglobin levels from slowly dropping.

otherwise, eric had a quiet day. he gained a little weight, but most of that was due to the transfusion and fluid retension. his reflux problems were greatly reduced, presumably due to his new meds, but i've been given some reasonable information that reglan can often some with some nasty side effects. i specifically asked about it today and the nurse, who is very normally very responsive, sort-of dismissed the question and said that it's just part of the normal nicu course of treatment for reflux and they never see any problems. we'll definately be following up a bit more rigorously tommorrow to see what the thinking is, considering that his reflux is fairly mild ( although, it must be stressed that reflux in a micropreemie is nothing to play around with as it can quickly spiral into a host of other issues ).

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9/13/2004 11:50:00 PM 7 comments

7 Comments:

Oh - the great Reglan/Zantac debate... What a wonderful thing - let's give 2 potentially damaging drugs to a child for reflux vs. one drug that comes with so little side effects and is very effective!

I assume by now you're picking up on my sarcasm. Well, it's because Reglan is NOT a drug to be messed with, specifically in infants (more so in preemies). To begin with, the drug was not approved by the FDA for use with infants. You can view the exact usage label for Reglan Syrup here:
http://www.fda.gov/cder/foi/label/2001/18821s20lbl.pdf
Please note that it's indicated for Short term use only (4-12 weeks) in adults.

In addition, Reglan can cause a neurological disorder, Tardive Dyskinesia, which has no known cure.
http://www.ninds.nih.gov/health_and_medical/disorders/tardive_doc.htm

Now, I will reiterate that these studies are done on adults - so just imagine the impact on a child.

On a final note - Reglan is only effective in 1/3 of those that use it. 1/3 experience no change - and the remaining 1/3 - even with effectiveness experience minor to major side effects. It is the practice of the Loyola Medical staff to remove all children entering their clinics and NICU immediatly until a GI study can be performed to ensure that reglan is the necessary course of treatment. Thier first medication of choice... Prevacid, followed by prilosec.

Here is a bit more of my rantings on the use of Reglan & Zantac in neonates - if you care to read :)
http://forums.twinstore.com/eve/ubb.x?a=tpc&s=36960974&f=91360919&m=69010543611&r=71910353611#71910353611

By Blogger Katra, at 1:26 AM  

P.S.... Could he be any cuter in that hat! What a doll :)

By Blogger Katra, at 1:27 AM  

aha! source of reasonable information revealed! thanks for posting the information, katra. we ended up calling the hospital late last night and having his reglan course stopped until we had a chance to talk with the neonatologist directly. of course, the nurse was shocked, shocked that it was approved for use in children ( although, as you know, many of drugs that are used in the nicu are not, so it's not super surprising that it's not, but it is surprising that nobody seems to know that it's not ).

thanks for telling us about loyola's screening program, as that will give us a bit more ammo, versus the "well, read it on the internet" response.

thanks again.

By Blogger e3, at 5:54 AM  

and i don't think he could be any cuter in the hat, but i might be biased :-)

it's funny to see how big a stock preemie hat is on him still.

By Blogger e3, at 5:56 AM  

Wow, Katra - you're a library of info! I wish I had known more about the drug before desparately putting Ethan on it, but sometimes you just assume that nurses/doctors know best and you forget to double check. I am relieved that Ethan was only on it for a short time. And I applaud Eric and Kris for "questioning authority" in this case. It is sometimes hard to go against recommendations of a trained professional, especially when those professionals are just so damn good at their jobs. But, I think it was important enough in this case.

I was noticing how big Odin looks in Kris' arms now! He really almost looks the length of a full term baby. In fact, my mom (Sondra) was a full term twin and weighed just under 4 lbs I think (aunt Sonja apparently hoarded all the nutrients and came out at 6lbs something. LOL.)

Do they have a specific "target date" now in mind as to when he will be released or is it just a "wait and see" right now?

Oh, and post pics of his bedroom when you have it finished and ready for his arrival. A couple moms were curious of what "theme" you were going with, but I don't think you necessarily have to choose a theme... but I could imagine you'd want to honor Pooh and Piglet after they have been so good with their vigils :)

C

By Anonymous Anonymous, at 8:17 AM  

all will be revealed regarding the nursery, very soon. on friday a bunch of kris' family are coming over to help us get everything done. we don't have much of a theme, per se, since it would have taken us forever to decide on one. and obviously time is something we don't have a lot of. so we just went with color coordination ( well, hopefully everything is color coordinated ) and will probably work in a theme as we go along.

By Blogger e3, at 12:03 PM  

"Do they have a specific "target date" now in mind as to when he will be released or is it just a "wait and see" right now?" |

it's just wait and see. everyone seems to be still alluding to the "two weeks to a month", even though a week has passed since the initial whispers that he might possibly be out in two weeks. to manage my own expectations, i'm imagining that it'll be 3 to 4 weeks, but maybe he'll do his best to prove me wrong.

By Blogger e3, at 12:16 PM  

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