She was started on breastmilk through the foley catheter that is holding the place of her g-tube (that popped out in the cath lab early on). It is going at 2 mL per hour right into the stomach. Remember there are roughly 30mLs in an ounce, so every 15 hours she is getting an ounce. Nothing has been digested and come out the colostomy yet. I am eager to see this happen.
Tomorrow she will be taken off the CRRT dialysis machine for 6-8 hours to see if they can stimulate her kidneys to make urine. Oh man, pray that they do- this would be a huge step.
During this break she will be taken down to the radiology lab to get a J-tube placed under fluoroscopy. This is something she has had before. It goes from her nose into her small intestines. I don't know what orders will follow, but I do know they want to mix the breastmilk with some kind of oil substance that binds bilirubin, assuming the bowels can still move food through. I am hopeful, as usual.
I also hope to hold her during this break. I am not allowed to when she is ventilated or on the CRRT machine. This will be the first time since November 3rd.
If we can get Ava back to taking regular food, we can get the TPN artificial nutrition off. TPN is really hard on the liver.
On the upside today, her platelet lab value was normal...all by itself, no infusion therapy. This was pretty cool. It was 290. Now we'd like to see the liver take care of the PT/INR and the bilirubin. With a normal platelet count she has better chances of clotting on her own if she bleeds. The PT/INR still need to get on board, but it helps.
Her hematocrit is still dropping every day...so some process is "chewing up" her red blood cells. I'd like to see her build up her hematocrit by herself and hold it there. The alternative is another blood transfusion.
Ativan was weaned from 0.7 to 0.6 yesterday and the fentanyl was weaned from 1 to 0.8 today. Hydrocortisone was also weaned and her blood pressure is still holding well. She is still on the vancomycin and other antibiotic. She is still on keppra for seizure prevention.
A sweet lady is going to take family photos tomorrow here at the Ronald McDonald house. So, we went and got the boys' hair cut and then wandered through the Ogden mall finding them some Christmas-y shirt. They will look nice and the rest of us will be kind of blan, but that's ok. Ivy's cute little Christmas dress is in Idaho Falls. I bought 2 during the after Christmas sales before the girls were even born. Don't have high expectations for Christmas cards. Heck, I will be proud if they get sent out. Don't tell me not to worry about it...because I am, and I always do.
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