Shots and Stones

The Barr grandparents hit the road early this morning. We were sad to see them go! (They were here for two weeks, but it seemed like no time at all.)

This afternoon Matthew had his four-month checkup at the doctor, which included some shots (which made more than one of us cry). He is doing fine, and for his developmental milestones, he's achieved some of the two-month ones and some of the four-month ones. It sounds like that's about what they'd expect for a preemie of his adjusted age, so they weren't concerned about anything.

James was also doing fine when we visited him. We heard he'd gotten a lot of cuddling in the morning. :) He's up to 63 ml on his feeds (which translates to 21 ml/hour). He's getting closer and closer to their goal! He did have a bit of spit-up when we were there, but it's hard to tell whether it's just normal baby spit up, or whether he's telling them that they need to slow down a little to let him get used to the higher volumes of food. (If he has more of it, they'll likely assume it's the latter.)

He took a 20 ml bottle early in the day (yay!), but then didn't quite finish his later bottle. But, it's still progress.

They did a liver ultrasound on James the other day, since his bilirubin and liver enzymes were elevated. I found out about this when I called at 5 AM a couple days ago for an update. The nurse wasn't quite sure why they were doing the ultrasound, so -- even though I knew better -- I Googled "liver ultrasound", which of course led to "cirrhosis of the liver," which of course is a rather grim diagnosis. And some of the symptoms of cirrhosis are edema (fluid retention), which he has, and hypertension (high blood pressure), which he has. The doctors have told us that while being on long-term IV fluids does put the liver under stress, the liver also has excellent healing capabilities, and bounces back after the fluid is stopped, unless it's completely damaged. "Oh no," I thought, "they're worried that his liver has turned the corner and won't be able to recover!" Well, later in the afternoon we found out that the liver ultrasound came back normal; his liver is fine. The doc mentioned that they thought the jump in his bilirubin levels was probably a delayed reaction to being off feedings for surgery, but that they just wanted to rule out any other problems, which they were able to do with the ultrasound. So, that was a relief. And his bilirubin levels today had started to come down (to 9-something from 11, which is at least in the right direction.) The moral of the story is, Step Away From the Google.

The ultrasound did show that he has some kidney stones, though. Being on Lasix and gentomyacin (an antibiotic) are risk factors for developing them, and he's had both of those. The blood pressure medicine they have him on now (hydroclorathyazide, or something like that -- I can never keep the name in my head) is actually the recommended treatment for dissolving the stones, so it's doing double duty. And they're not particularly worried about them at this point.

Our "educational" activity for today was emptying the ostomy bag, which was neither as disgusting as we expected, nor as easy to get everything out. But it's definitely in the "not a big deal" category.

The doc warned us that Matthew might be a little more fussy tonight after his shots, and alas, it seems she was correct. (The middle picture is Mattie at the doctor's office, and the bottom one is James.)