It's all so obvious in hindsight.
In hindsight, the ped ordered us to get an ambulance on Wednesday night not because Scotty's vitals were dropping, but because he was afraid of brain damage. Kernicterus moves quickly and goes through stages - early, middle, and late - and Scotty had one of the four in the first stage (lethargy). Hitting stage 2 would have met the brain damage was happening, and stage 3...well, stage 3 is either permanent damage and/or death.
In hindsight, we were sent to the NICU (a very odd decision, according to our nurse from yesterday, since babies that have been home are considered "dirty" and ususally not allowed in their germ-aphobic environment) not due to staffing issues, but because of the need for a possible exchange transfusion. An exchange transfusion is done on a baby who's bili levels are rising (or are already too high). It sounds like a blood transfusion, and the baby recieves cleaner blood. I asked the neonatologist point blank if an exchange transfusion (the last weapon in the fight against kernicterus) was on the table, and she said yes. She said that b/c his levels dropped so quickly (from 28 [or 29, depending on who you ask] to 21 within four hours, and down to 19 within 12 hours), it was canceled.
In hindsight, the neonatologist also said a blood test on Friday, August 21st, would have highlighted rising levels. Even a level of 10 or 12 would have warranted a recheck on Monday, in combination with supplementing with formula. Breast milk actually contains bilirubin (from me), which is why breast fed babies take longer to get over jaundice than formula fed babies. Scotty's levels most likely rose over the weekend, fueled by the dehydration, but since we didn't know about either, Monday, Tuesday, and Wednesday's feedings were just barely keeping the little guy stable. He never had a fighting chance.
And in the research I found last night, in the case studies of babies who did develop kernicterus, 81% of them were breast fed. 81%. And that ped on camera in that movie I watch said there are NO DANGERS to breast milk? How so? It seems as though if you plan to exclusively breast feed, you should be required to have additional monitoring for the first 7 days while at home, including blood tests and more frequent ped visits. And maybe even mandatory phototherapy as a preventive measure. Why are hospitals not talking to new moms about this? My child had three hearing tests while in the hospital - and deafness is not a life-threatening condition - but not one single person talked to us about the jaundice and the dangers of breast feedings. Why don't most people know and understand what happens after jaundice gets out of control? Considering the ramifications, you would think everyone in the free world would know and monitor jaundice babies like hawks.
In hindsight, it all makes sense. And moving forward, hopefully, hopefully, our little Scotty will make a full recovery and never have to hear the word "kernicterus" mentioned. Ever. I know I don't want to.
I just called the NICU for an update and he is up to 7lbs, 13oz - a huge jump from yesterday's 7lbs, 8oz. He is eating and eating, which means he is pooping and pooping. Thank god. Get all of that gunky bili out of your system, little man. It sounds very promising that he will be home later today, which means I won't have time to blog much anymore, but thanks for all of your thoughts and prayers over the last few nightmarish days.
And in other news (as Catheter-gate continues)...I think I might need to pee! I felt the urge last night. God bless the bladder. I'm not removing the foley until my mom is on the ground in Vegas, but maybe, just maybe, we can put this horrible week behind us. It's funny, since if you know me well, you know I despise the month of August. (I hate April, too...I don't know why. Months that start with the letter 'A' just have always bugged me.) Anyways, several months ago, I was telling my friend Sherri (who also is not a fan of August) that since it will most likely be Scotty's birth month, maybe it's a sign I need to get over my dislike of August. Well, after this week...I don't know. August 18th was by far the greatest day of my life to date - beyond anything else I've ever experienced - but August 26th was also the worst day of my life (with yesterday coming in a close second). I can't help but look at the calendar and breath a little easier knowing that September starts on Tuesday...wake me up when September comes.
In hindsight, the ped ordered us to get an ambulance on Wednesday night not because Scotty's vitals were dropping, but because he was afraid of brain damage. Kernicterus moves quickly and goes through stages - early, middle, and late - and Scotty had one of the four in the first stage (lethargy). Hitting stage 2 would have met the brain damage was happening, and stage 3...well, stage 3 is either permanent damage and/or death.
In hindsight, we were sent to the NICU (a very odd decision, according to our nurse from yesterday, since babies that have been home are considered "dirty" and ususally not allowed in their germ-aphobic environment) not due to staffing issues, but because of the need for a possible exchange transfusion. An exchange transfusion is done on a baby who's bili levels are rising (or are already too high). It sounds like a blood transfusion, and the baby recieves cleaner blood. I asked the neonatologist point blank if an exchange transfusion (the last weapon in the fight against kernicterus) was on the table, and she said yes. She said that b/c his levels dropped so quickly (from 28 [or 29, depending on who you ask] to 21 within four hours, and down to 19 within 12 hours), it was canceled.
In hindsight, the neonatologist also said a blood test on Friday, August 21st, would have highlighted rising levels. Even a level of 10 or 12 would have warranted a recheck on Monday, in combination with supplementing with formula. Breast milk actually contains bilirubin (from me), which is why breast fed babies take longer to get over jaundice than formula fed babies. Scotty's levels most likely rose over the weekend, fueled by the dehydration, but since we didn't know about either, Monday, Tuesday, and Wednesday's feedings were just barely keeping the little guy stable. He never had a fighting chance.
And in the research I found last night, in the case studies of babies who did develop kernicterus, 81% of them were breast fed. 81%. And that ped on camera in that movie I watch said there are NO DANGERS to breast milk? How so? It seems as though if you plan to exclusively breast feed, you should be required to have additional monitoring for the first 7 days while at home, including blood tests and more frequent ped visits. And maybe even mandatory phototherapy as a preventive measure. Why are hospitals not talking to new moms about this? My child had three hearing tests while in the hospital - and deafness is not a life-threatening condition - but not one single person talked to us about the jaundice and the dangers of breast feedings. Why don't most people know and understand what happens after jaundice gets out of control? Considering the ramifications, you would think everyone in the free world would know and monitor jaundice babies like hawks.
In hindsight, it all makes sense. And moving forward, hopefully, hopefully, our little Scotty will make a full recovery and never have to hear the word "kernicterus" mentioned. Ever. I know I don't want to.
I just called the NICU for an update and he is up to 7lbs, 13oz - a huge jump from yesterday's 7lbs, 8oz. He is eating and eating, which means he is pooping and pooping. Thank god. Get all of that gunky bili out of your system, little man. It sounds very promising that he will be home later today, which means I won't have time to blog much anymore, but thanks for all of your thoughts and prayers over the last few nightmarish days.
And in other news (as Catheter-gate continues)...I think I might need to pee! I felt the urge last night. God bless the bladder. I'm not removing the foley until my mom is on the ground in Vegas, but maybe, just maybe, we can put this horrible week behind us. It's funny, since if you know me well, you know I despise the month of August. (I hate April, too...I don't know why. Months that start with the letter 'A' just have always bugged me.) Anyways, several months ago, I was telling my friend Sherri (who also is not a fan of August) that since it will most likely be Scotty's birth month, maybe it's a sign I need to get over my dislike of August. Well, after this week...I don't know. August 18th was by far the greatest day of my life to date - beyond anything else I've ever experienced - but August 26th was also the worst day of my life (with yesterday coming in a close second). I can't help but look at the calendar and breath a little easier knowing that September starts on Tuesday...wake me up when September comes.
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