We are eating again! Kinda…
It has been seven days since Evan’s cardiac episode (NEC scare) and the surgeons are slowly starting to feed the little guy again. This morning they started him out at 3 mL per hour for 24 hours. It’s being pumped directly into his stomach through an NG tube continuously. If there are no bad signs by tomorrow morning then they will slowly start increasing his feeds back up to the point where he was. Tomorrow they will increase the continuous feed by 3 mL per hour every hour until he’s up to 22 mL per hour. Once he’s there they will stop the slow continuous feed and him on a more normal ‘all at once’ type dose, (this is called a bolus dose) of 22 mL. The following day 44 mL every 2 hours, the day after that 65 mL every 3 hours. This will put him back up to what he was eating before. Once he’s okay with that then they will start increasing the calories of the breast milk from 20 calories per ounce to 22 calories, and then to 24 calories. If you’ve been doing the math that’s about another week of us being here.
The nurse came in to give him blood today, this was news to us. She said his hematocrit (the percentage of red blood cells in blood) was low. We’re not sure why this happens, I think it’s just due to blood loss during surgery and such. We’ll confirm with the doctors when we see them next. It was not dangerously low by any means and in an adult they likely would not have done anything but they have found that in infants it’s best to have them at the high end of the normal range after surgery.
Evan is still on Milrinone for cardiac function and we’ll likely go home on a similar oral drug called Captopril. Until his feeds are back up he’s also still on IV nutrition consisting of TPN and lipids (fat emulsion). With food back in his stomach, he’s getting Reglan to help digestion and of course he’s still on Lasix to get rid of extra fluids. As far as tubes and wires, he had the NG tube put back in his nose this morning, a catheter in his leg for blood pressure monitoring and blood draws (which may come out tomorrow!), the dual lumen intracardiac Broviac catheter going through his chest and into his heart for medication, nutrition, etc, the pulse oximeter (red LED thing), and the 4 sticky pads on his chest to measure breathing and pulse.
Students are starting to show up here in Ann Arbor for the fall term. The streets are getting pretty busy. Get me out of here!
Here’s some photos of the last couple days.
