Wednesday, April 11, 2012

New and Exciting Maladies

I'm interrupting my labor/delivery/NICU narrative to give some fairly dreadful news. Elijah has necrotizing enterocolitis. The nurses are calling it nec for short, so that's what I will call it. This evil-sounding condition is common in preemies, but being common does not make it less dangerous. Right now, the doctors are treating it with antibiotics and keeping a close watch on his bowels with x-rays. Worst case scenario, his bowels could perforate or sections of them could die - hence the x-rays. In the event that this happens, immediate surgery will be necessary, and this particular operation has about a 25% death rate. Basically, they would remove the damaged/dead tissue, and later on, when he is bigger and stronger, they would reattach the intestines. That's if only a section of the intestines were damaged. There are rarer cases where the entire intestine is damaged, but I don't want to think about that. Best case scenario, the antibiotics kill the infection, and there is no permanent damage.

I overheard the doctor explain to the nurses that the first 48-72 hours is the most dangerous window for perforation, but he wouldn't say that to me. To me, he said that it could happen at any time the infection is still alive in Elijah's gut. That didn't stop me from marking time, though. We are almost out of the 72 hours today. He came down with it very suddenly around 11 AM on Easter Sunday, so 11 AM today will be 72 hours. Unfortunately, this could happen again, even if the antibiotics kill it and we can start feeding him again. As disheartening as that was, I'm glad they told me, so I won't be surprised if we face this again a month from now.

Even if everything is fine and infection is killed, this is a considerable set-back on when he can come home. He will be on bowel rest (no food) for at least 2 weeks, which means we have to start over with all the progress we made since he was born 15 days ago. I can't get to far ahead of myself, though; at this point we really are just fighting for his life - we'll worry about homecoming once he gets better.

He has been fighting pretty hard. They had to intubate him yesterday (I should get an honorary nursing degree after all of this is over - I think I'll know everything). That means he has a tube going into his trachea that breathes for him. They are also going to implant a picc line so that he has a stable, more permanent IV instead of getting poked every time one of his IVs goes bad. They couldn't get a vein on him yesterday - they tried 3 times and none of them were in the right spot (the line kept coiling up before reaching his heart). They wanted to put it on his head, but I hope they put it somewhere else. He likes it when we stroke his head.

He's on morphine, so he's pretty out of it, but at least he isn't hurting. We are taking this thing a day at a time; any more than that would make me lose my mind.

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