Jac has been having problems with his phosphorous level. When they first measured it last week it was off the chart - it was less than 0.5 which is unmeasurable. None of the doctors had ever seen a level that low - including the endocrinologist. Since then they have been testing his phosphorous level every 12 - 24 hours and pushing potassium phosphate (his salt levels were also now so adding the potassium to the phosphorous makes sense - phosphorous cannot be given alone) pretty much continuously. For a while his phosphorous level would not budge while his calcium level was coming down. The doctors found this very mysterious but last night his phosphorous started moving up and as of 8 am this morning it had made it all the way to 3.3. They would like it to be at 4.4 - 4.7. As of 8 pm tonight it had made it to 4.2 - almost there.
Jac's phosphorous level is an indication of the health of his kidneys - and if he can maintain his phosphorous level on his own it will be a great sign. He is receiving another bolus of potassium phosphate tonight and his level will be measured again tomorrow morning at 6 am. If it has reached the target level - they will extubate him! This is very exciting as it means he will off of the respirator and will move back to the CPAP which is progress toward Jac being able to breath fully on his own!
The other thing that the doctors are hoping to do after his phosphorous level reaches its target is to try feeding him again. They will start with just a few drops of my milk (probably fresh from Mom) and see how his gut reacts to it. If he is able to hold that down they will continue upping the amount very slowly.
Both the possible feeding and the extubation would be great signs of Jac's progressing health.
We got another piece of good news tonight. They did an echocardiogram of his heart today (we all thought it was being done on Friday) and the PDA has closed quite a bit. It started out Large (on Monday) (they classify them as Large, Medium and Small) and it has progressed to being Small (Thursday). This means that the PDA is closing down on its own and will in all likelihood not need any intervention to finish closing. It also means that it is not causing any problems with the blood flow to his lungs or to the rest of his body (including his gut) which has been the concern when he threw up my milk a few days ago.
Tomorrow morning at 6 am will they will run labs on his electrolyte levels and if his phosphorous and calcium levels look good they will in all likelohood extubate him. Joseph and I are going to be at the hospital in time for that in the hopes that we can be there when they do it - and then really hope that they don't have to re-intubate him later - that he is now strong enough to breath on his own.
The really good thing about his extubation is that it should mean that very soon we will get to do Kangaroo care with him (only I have done it - and only for about 90 minutes) frequently. This will be very good for him and very good for Joseph and me.
Doing good Jac, almost there!!
ReplyDeleteI think you're right about kangaroo care being good for all three of you. :) Here's hoping that you'll be able to start that soon!
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