Where do I begin?? Caleb's second week started off with three extremely difficult days with many ups and downs. His status deteriorated quickly starting Sunday, July 27, 2014. He started trying to breathe over the oscillator vent, which was concerning because the machine is supposed to do all of the work. For most of the day, the doctors tried to stop him from breathing on his own by changing some of the respiratory settings on the oscillator and finally decided that they would increase his morphine to help sedate him and make him more comfortable. This seemed to make a significant difference.
Monday and Tuesday brought Caleb a new set of challenges. His kidneys had shutdown and he stopped excreting urine for the 2nd time. They performed an X-ray and he began being followed closely by the renal team. The X-ray did not show any cysts and they believed that he had acute kidney failure, which is the rapid loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your body. They inserted another Foley catheter to monitor his urine output, began giving him a renal dosage of dopamine, and started administering Lasix; a diuretic to help remove the excess fluid that had built up in Caleb's body and to help increase his production of urine. During that afternoon, he also had a severe drop in blood pressure and some additional complications when the team of doctors removed his umbilical venous catheter. This catheter was fed through Caleb's umbilical cord to just outside his chamber of the heart and could only remain in place for up to ten days after birth. It provided access to the arteries and was used to draw blood and monitor his blood pressure. He began to desat, but after a little intervention from the respiratory therapist, he recovered quickly and they were able to successfully replace his umbilical venous catheter with a peripherally inserted central venous catheter (PICC line) in his arm.
Finally, we got some very devastating news. We learned that Caleb has a grade 2 intraventricular hemorrhage (IVH), which is bleeding into the ventricles of the brain. Prematurity is the greatest cause of an intraventricular hemorrhage and doctors think that several things combine to make preemies susceptible to IVH. First, the blood vessels in a preemie’s brain are more fragile than those in a term baby and premature babies may suffer from repeated episodes of low blood-oxygen levels, and are exposed to greater fluctuations in blood pressure. The doctors believe that this may have been caused by his extremely low blood pressures on Monday. Thankfully, grade 1 and 2 hemorrhages are usually considered mild bleeds and most of the time, they can resolve on there own and there are no long term problems resulting from the bleeding. However, grade 3 and 4 bleeds are more severe, with more serious initial symptoms and more long-term complications. Since there is no way to stop the bleeding associated with IVH, our greatest hope is that his grade 2 bleed does not progress further. The doctors will try to keep Caleb as stable as possible and he will be followed closely with a weekly head ultrasound.
So, as the emotional roller coaster continues for us, Caleb continues to fight everyday. We must take one day at a time and have learned that although we are grateful for each minute Caleb is stable, his status can change instantaneously.
Monday and Tuesday brought Caleb a new set of challenges. His kidneys had shutdown and he stopped excreting urine for the 2nd time. They performed an X-ray and he began being followed closely by the renal team. The X-ray did not show any cysts and they believed that he had acute kidney failure, which is the rapid loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your body. They inserted another Foley catheter to monitor his urine output, began giving him a renal dosage of dopamine, and started administering Lasix; a diuretic to help remove the excess fluid that had built up in Caleb's body and to help increase his production of urine. During that afternoon, he also had a severe drop in blood pressure and some additional complications when the team of doctors removed his umbilical venous catheter. This catheter was fed through Caleb's umbilical cord to just outside his chamber of the heart and could only remain in place for up to ten days after birth. It provided access to the arteries and was used to draw blood and monitor his blood pressure. He began to desat, but after a little intervention from the respiratory therapist, he recovered quickly and they were able to successfully replace his umbilical venous catheter with a peripherally inserted central venous catheter (PICC line) in his arm.
Finally, we got some very devastating news. We learned that Caleb has a grade 2 intraventricular hemorrhage (IVH), which is bleeding into the ventricles of the brain. Prematurity is the greatest cause of an intraventricular hemorrhage and doctors think that several things combine to make preemies susceptible to IVH. First, the blood vessels in a preemie’s brain are more fragile than those in a term baby and premature babies may suffer from repeated episodes of low blood-oxygen levels, and are exposed to greater fluctuations in blood pressure. The doctors believe that this may have been caused by his extremely low blood pressures on Monday. Thankfully, grade 1 and 2 hemorrhages are usually considered mild bleeds and most of the time, they can resolve on there own and there are no long term problems resulting from the bleeding. However, grade 3 and 4 bleeds are more severe, with more serious initial symptoms and more long-term complications. Since there is no way to stop the bleeding associated with IVH, our greatest hope is that his grade 2 bleed does not progress further. The doctors will try to keep Caleb as stable as possible and he will be followed closely with a weekly head ultrasound.
So, as the emotional roller coaster continues for us, Caleb continues to fight everyday. We must take one day at a time and have learned that although we are grateful for each minute Caleb is stable, his status can change instantaneously.
