top of page

Five Weeks and a Day - A NICU Story - Day 28

Writer: Dr. Megan Powers, PTDr. Megan Powers, PT

Day 28 - September 10, 2014


I am at work when I get the daily update call from the doctor. He gives me the latest stats: weight: 4 lbs 9.5 oz, feeds up to 41 ml. He remarks that she seems to be coming around since earlier this week. She's less irritated by touching and he feels she's pretty much back to herself. I agree...except for one thing. Her eyelids are puffy. I disclaim my concern by saying, "I don't even know if this is a thing, like a symptom, or whatever...but..." But her doctor completely validates my observation. He'll take a second look. He knows by now that I want the complete picture. He walks me through differential diagnosis.

Eyelid puffiness in infants can be caused by: 1) edema (fluid retention/accumulation), 2) conjunctivitis (pink eye), 3) tear duct obstruction. He immediately rules out the last two conditions and explains why edema is most likely the culprit. In newborns, he clarifies, edema sometimes presents different places: eyelids, outer part of the ear, or nape of the neck, whereas adults collect fluid in the extremities. He explains that this type of edema is usually related to nutrition, caused by a lack of protein intake. He assures me he'll keep watching it, but reminds me she'll be having her eye exam this afternoon, which will likely worsen the puffiness. I am nervous that I won't be there for this test. I will be anxiously awaiting the results.

Comments


bottom of page