some new things

Dane had a very stressful day yesterday. First he had his second head ultrasound. We were told these were just a formality and they didn't expect to see anything. As it turned out, there was a "little abnormal something" seen on the first ultrasound that they wanted to recheck. There was a small abnormal spot that "may or may not be a small intracranial bleed" from the first scan that is still present. The radiologist wouldn't commit to a definitive answer but the NICU doctor said that he doesn't think it is anything problematic. He said that it is either not a bleed or is a Grade I (the lowest grade) bleed. It is also difficult to tell exactly what is going on because the ultrasound was done through his anterior fontanelle (the small soft spot at the front of his skull, which doesn't provide a large window to view his brain with the ultrasound). These bleeds aren't surprising in preemies, we were told, and they are frequently due to trauma at birth. They were a bit surprised that it wasn't resolved by now, 4 weeks after delivery, but they said that it isn't worse and there aren't any new abnormal spots so the physician isn't too concerned. Even if it is the Grade I bleed, most preemies with this grade intracranial bleed do fine. As of right now, it will be up to the physician if he wants to get a better look at the spot with a MRI of his brain (which would be done at 40 weeks, ~3 weeks from now) or just follow Dane's progress clinically. They don't think there is much reason to get the MRI right now because even if he had the Grade I bleed, it wouldn't change his medical management at this time.

The second big event from yesterday was Dane's eye exam. The pediatric ophthalmologist said that the blood vessels in his eyes look very well developed. The only concern was that he has several retinal hemorrhages. Again, these are somewhat common as birth trauma but usually are completely healed within 2 weeks and are less commonly seen 4 weeks after delivery. They said these hemorrhages could also be due to trauma since birth, which is also extremely unlikely since he hasn't left the NICU yet. Because of the possible intracranial bleed and the retinal hemorrhages, the doctors got another blood draw on Dane. It showed that he is still anemic (not surprising after less than a week since the last blood test) but, the good news, is that his PT/PTT (measures of his platelet function and how well he clots from both internal and external stimuli) and platelet count was also normal. So for now, they don't believe that Dane has a bleeding disorder and are assuming that the possible intracranial bleed and the retinal hemorrhages are due to birth trauma. We will be following up with the pediatric ophthalmologist in ~2 weeks to see if things are resolved.

Finally, Dane is still doing well (but not doing perfect) with his feedings. He is continuing to gain weight and hasn't needed many feedings through his nasogastric tube. Today, he was increased from 40cc / 3 hours to 45cc / 3 hours. We were with him for 2 feedings and he did very well. He took his entire bottle on the first feed and for the second he breastfed really well. We weren't expecting him to breast feed well on the second feed, so we hadn't weighed him prior to the feeding and therefore had no idea how much he drank. But he did latch and feed well for almost 40 minutes. We assumed that he got about half of his feeding from that and then successfully took ~25cc of milk from the bottle.

We are getting very excited for Dane to come home! Because of this, we finished washing all of his preemie clothes and blankets/sheets tonight. All of his clothes are so small and cute! Pretty much everything is ready for him to come home (we think).