Tuesday, April 28, 2009

Collaboration

We knew at some point that we wanted to talk to Dr. Hasselman, Adam's cardiologist, prior to them being released from the hospital. It's helpful to get informaton firsthand and learn about any follow up that might be necessary. The nurse asked this morning if she would like for us to call him and he was available to come down for a visit. He drew a diagram of the heart and explained how the heart typically sends firing to beat. Adam's SVT (rapid heart rate that was triggered when his PIC line was inserted) was probably caused by an extra firing node. It is highly likely that this will resolve itself as he grows and develops more. His initial thought was to keep Adam on Digoxin for 6 months and we would monitor him at home and keep tabs on his heart rate. As he gained weight, his dose would remain the same and it would act as weaning him off the medication. However, we were fortunate enough that Dr. Hasselman arrived at the same time as Dr. Macwan, Adam's neonatologist. They collaborated about Adam's total care and decided it would be better to take Adam off the Digoxin now for a few reasons. First, if there are any side effects from being off the medication, the hospital staff will be better equipped to monitor any issues. Second, a side effect of Digoxin is gastrointestinal issues...which Adam is having. They also attached his feeding syringe to a machine that will administer it slowly through his feeding tube over an hour, rather than quickly by gravity. We are hopeful that we are narrowing down the issues causing Adam's recurring tummy episodes. He had quite a few bradycardias yesterday, as well. Once the Digoxin is out of his system, the doctor will consider increasing his caffeine slightly to stimulate him.

Sara plugs right along. I fed her from a bottle again today and she took 6mL of her 23mL feeding - approximately 25%. Still a good accomplishment for her. It really does sap her energy to put forth that effort. Hopefully this evening will go well and Shannon will take his turn with Adam tonight. By the time we discussed options with the doctors this morning, Adam had fallen back asleep and that certainly isn't an opportune time to be challenged with eating from a bottle!

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