Prior to this morning’s rounds, we had two visits.
Dr. C’s (neuromuscular) team members came in to assess Olivia. This seems to be the normal process when working with any consulting specialist: a team of residents and/or med students will visit with a patient and complete a brief clinical assessment before the specialist comes in. Unfortunately Olivia was completely conked out while the team assessed her. Hopefully she’ll be more awake this afternoon when Dr. C arrives.
Dr. F (genetics) came by to check in on Olivia and speak to us. He is waiting for Dr. C to complete her initial assessment. The two of them will then consult with one another, and confirm next steps in terms of testing. He did share that he thinks the recommendation will be to move forward with a full gene sequencing. While this type of test doesn’t guarantee a diagnosis, he said it’s the best option we have at this point.
The plan for today, from morning rounds:
Direct bilirubin level is up slightly from yesterday; it is now 12. Regardless, we plan to keep the Phenobarbital dose at 3 as mentioned yesterday to see if she begins to look and act less sedated.
Feeds didn’t go well last night. High residuals continued throughout the night, so we’ve decreased the total volume of breastmilk to 1 ML per hour.
Respiratory remains at 22 over 7 with pressure support of 10. A good gas overnight (or early this morning) allowed them to turn rate down to 40. She is handling these numbers well, and has started occasionally breathing over the vent again, so we’ll leave her where she is today.