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Five Weeks and a Day - A NICU Story - Day 7

Day 7 - August 20, 2014


Today is a big medical update day. The doctors round in the morning, and if parents aren’t present, they call you with an update. We receive several pieces of news.


1) LoLa is taken off CPAP and put on oxygen via a nasal cannula. So this means she is doing more of the work of breathing on her own and relying less on the machines!


2) LoLa’s bilirubin levels are decreasing so they are holding phototherapy, however she continues to have lazy bowels. It is really important that she start to go regularly to excrete the bilirubin. One of the nurses explained to us that LoLa has a different blood type than me. When babies are in utero, their blood does not mix with the mom’s, but via the placenta, it interacts and exchanges oxygen and nutrients and antibodies. When mom has O blood type, and baby has A or B, mom makes antibodies that can pass to baby and cause destruction of baby’s red blood cells (RBC). When RBCs break down, the byproduct of that is bilirubin. The excess bili causes jaundice. Bilirubin is excreted in the stool. So if the baby is not excreting it or it is not treated, it accumulates in the blood, which can cause neurological damage to the central nervous system. So little girl needs to go! She lost very little weight over the last 2 days, “a teaspoon” the doctor joked, and she continues to tolerate increasing feeds.

I am the type of person who feels knowledge is power and I like to fully understand the condition, the causes, the consequences, the best and worst case scenarios…

3) LoLa is receiving a few tests: a head ultrasound and an echocardiogram (pictured). The head ultrasound will tell us if she has any bleeding in her brain. Preemies are susceptible to breakage of the small, fragile and underdeveloped blood vessels of their brains. That is a very scary possibility. Fortunately we are informed this test is negative, however, it will be repeated before discharge. The echo is performed because LoLa’s doctors detect a heart murmur. They feel it is likely due to the two holes in her heart, the patent foramen ovale (PFO) and patent ductus areteriosus (PDA) – one which

is between the atria (PFO), and one that is making an abnormal bridge between the vessels that carry blood to and from the body, thereby bypassing the lungs (PDA). In utero, the baby isn’t breathing air, so blood does not need to go to the lungs to get oxygenated. The ductus arteriosus is a hole that allows the blood to skip the circulation to the lungs. However, when the baby is born, these holes are supposed to close, so if open, less blood is getting to the lungs and deoxygenated blood is being recirculated. The echo will be repeated before discharge as well.


We are really grateful that the doctors keep us involved and informed (in the pic, it looks like LoLa is taking in the test results, too!). We also take it upon ourselves to ask a ton of questions and seek information on our own. I know I am the type of person who feels knowledge is power and I like to fully understand the condition, the causes, the consequences, the best and worst case scenarios…for some this may be too much to handle. We’re doing our best to take it all in and accepting prayers and positive vibes from anyone who is offering them!

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