Will must have gotten the mistaken impression that people weren't paying attention to him while he was doing so well, because he acted up tonight. We received our first phone call from the NICU to let us know about his condition, which was a little scary, to say the least. We headed down to find his oxygen and ventilator needs back up and his blood pressure low. After a couple of days off most of his medicine, he's back on quite a bit of it -- the dopamine returned, as did some surfactant, and he is also on three different antibiotics.
They have two possible scenarios to explain the downturn: Either he dropped off more than expected after a few days of benefit from the course of steroids he received over the weekend, or he picked up an infection after they stopped his antibiotics. If it's the former, they'll need to continue tweaking his oxygen and ventilator settings and give him more surfactant as he recovers. If it's the latter, the antibiotics should do the trick. They gave him three to make sure that they would knock out whatever it may be that he has, and will be able to more specifically target it in a couple of days when blood cultures come back. Why, you might ask, do they not just leave these tiny fellas on antibiotics all the time? Well, when I asked that, the doctor said that too much antibiotic might leave him susceptible to fungus, which isn't fazed by the drugs. If they keep him off antibiotics when he doesn't need them, the thinking goes, he'll be better able to fight that off. As with everything, they must weigh the good and bad of each possible course, and select the things where the good outweighs the bad. That always seems to leave us fighting the bad for a while after the medicine has done its good, but so far that has left him making slow progress in a two-steps-up, one-and-three-quarter steps back sort of way.
By the time we left tonight, the doctors were saying they were pleased with the way he had recovered, and hoped the worst was over. We hope so. These wild ups and downs can't be easy for Will to take, so we'd really prefer some more of those quiet days.
They have two possible scenarios to explain the downturn: Either he dropped off more than expected after a few days of benefit from the course of steroids he received over the weekend, or he picked up an infection after they stopped his antibiotics. If it's the former, they'll need to continue tweaking his oxygen and ventilator settings and give him more surfactant as he recovers. If it's the latter, the antibiotics should do the trick. They gave him three to make sure that they would knock out whatever it may be that he has, and will be able to more specifically target it in a couple of days when blood cultures come back. Why, you might ask, do they not just leave these tiny fellas on antibiotics all the time? Well, when I asked that, the doctor said that too much antibiotic might leave him susceptible to fungus, which isn't fazed by the drugs. If they keep him off antibiotics when he doesn't need them, the thinking goes, he'll be better able to fight that off. As with everything, they must weigh the good and bad of each possible course, and select the things where the good outweighs the bad. That always seems to leave us fighting the bad for a while after the medicine has done its good, but so far that has left him making slow progress in a two-steps-up, one-and-three-quarter steps back sort of way.
By the time we left tonight, the doctors were saying they were pleased with the way he had recovered, and hoped the worst was over. We hope so. These wild ups and downs can't be easy for Will to take, so we'd really prefer some more of those quiet days.
posted by John Kenyon at 10:46 PM
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