Updates from overnight and this morning’s rounds:
- A good chest x-ray resulted in decreasing her respiratory rate to 40 (from 45), and since she’s had a couple of good days in a row they decreased one of her pressures 1. She is now at 20 over 6.
- She continued to give back mixed residuals of some milk and some mucus. If the residuals are mostly mucus the team discards them, if its mostly milk, they’ll re-feed it to her. They are keeping total volume to 1ML per hour for now, but we will start Reglan today (a medicine to help increase motility).
- Direct bilirubin came down just a tad overnight. It’s now at 12.2 from 12.8 yesterday. The team has recommended that we consider stopping Phenobarbitol completely. This is a decision they are currently leaving up to Luke and me as parents. The reason we would stop the medicine entirely is twofold:
- (1) It would allow us to see if her direct bilirubin continues to decrease over time, even without the medicine. If this were the case, it would point more towards Olivia’s liver suffering from the initial insult at birth, rather than an inherent inability to function as desired.
- (2) It may help us better understand Olivia’s “baseline” for alertness and activity. This is working under the assumption that the Phenobarbitol has had a sedative affect on her over the past week or so. The doctors are convinced this is the case given her low dosage, but it’s certainly a possibility and has been the observation of a number of nurses, OT, and us as parents.