Where did all the electrolytes go?

Sometimes even the doctors can't fix things on the first try. After giving Dane indomethacin yesterday, an echocardiogram today showed no change in his PDA. They said that they will hopefully try again sometime soon-ish with a repeat trial of the indomethacin dosing to see if it will close the PDA. If that doesn't work, Dane may require surgery to close the PDA. We'll deal with that if it becomes necessary. I read that sometimes you can get the PDA closed via cardiac catheterization instead of surgery, but it sounds like they don't do that on such small kids.

In addition, Dane is having some problems with his electrolytes. It seems that some of his cortisol level and electrolytes are low today (and the electrolytes are continuing to drop on on the afternoon labs). The doctors believe that he has adrenal insufficiency. The adrenal glands are located on the kidneys and produce enough steroid hormones - primarily cortisol and aldosterone. Cortisol is called the "stress hormone" and helps regulate body blood pressure and blood sugar. Aldosterone acts on the kidneys to conserve body water and sodium, increasing blood pressure. The neonatologist said that this isn't an uncommon problem in preemies and that, hopefully, as Dane's adrenal glands mature he will go back to normal. But, for now, he needs some cortisol supplementation. We're still waiting to figure out all the specifics.

On a good note, Dane was completely off of the high-flow room air via nasal cannula again. He was breathing well today. When we got to the NICU, he was crying and the nurses said he was just having an unhappy day. After snuggling with his mom for about 2 hours, he was in a much better mood when we left. Due to the indomethacin, he was still not being fed today and was instead still receiving all his nutrition through his IV. He had very good weight gain yesterday (while also not eating), and has now regained almost half of the weight he lost after delivery - that is encouraging to us.

For those of you reading all of this, thanks for your prayers. Some days are harder than others...I know that we are still catching up on sleep and still processing everything that has happened over the past week. The stress of simply not knowing all of the answers is hard. Hopefully we'll know more tomorrow than we did today and that what we find out is good news.