Surgery went well and Toby is recovering nicely. The overnight stay at the hospital was a precaution because of his lungs; he had no problems during his stay, so he was released Wednesday. Yesterday, he visited his pediatrician who was quite pleased with how he'd come through the surgery. He gained a modest two ounces this week. (For those of you keeping score, that's 8 lbs 13 ounces.) The surgery and hospital stay interrupted his supplements, so hopefully his growth rate will improve again. The main thing he needs to do now is GROW and get some healthy new lung tissue.

Toby endured his surgery today. We are told that all went well. However, he has been admitted to the hospital for a twenty-four hour observation period. He and Mom are settled in and are reacquainting themselves with the familiar hospital routine of waiting.

Late breaking . . .

The doctor's office just called to say there's been a conflict. Surgery has been rescheduled for Tuesday morning at 10 o'clock. Otherwise, everything's the same- just 24 hours and 45 minutes later.

Weight Check

It has been a busy week with the increased breathing treatments and supplementing feedings.

The good news:

The tests done Friday at the U of M were all negative for infection and nothing grew in the cultures. The nurse said they had ruled out the most unpleasant possibilities. I think this means the weight loss is attributable to an imbalance between his caloric intake and needs.

He weighed in today at the pediatrician's as 8 lbs 11 ounces- up 4 ounces from Friday. The extra calories seem to be doing their job and he was pronounced to be quite healthy.

So at this point we are planning to go ahead with the hernia surgery Monday morning in Toledo. We need to arrive early as it is scheduled for 9:15. It will be outpatient unless the anesthesiologist decides to keep him overnight. (I've been told this is a possibility because of his reduced lung function.)

God is good; we are thanking Him for His mercies so far.

Hung up!

Aaaarrgh!



Yesterday was another visit to the pulmonologist at the U of M. 7 hours of fun, as you can see by the above photos of Toby having a chest x-ray. This was his second visit to include this experience, and he looked so funny the first time that I smuggled in a camera and managed a few shots.



The news is not as entertaining. Toby weighed in at 8lb 7 ounces, a loss of half a pound from his visit 3 1/2 weeks earlier. He has also been breathing faster and working a little more at it. The download from his O2 monitor showed a good baseline, but also a few periods of lower oxygen level. He was tested off the oxygen for 5 minutes and made a poor showing. He gave samples of about everything he had- blood, urine, stool.



The x-ray showed that his lungs do not have excess fluid, so the diuretics he started last month are doing their job. The other initial results show no signs of infection, but we are waiting for cultures. It is possible that there is an infection in the bowels which could be interfering with the nutritional absorption, and that could be responsible for the weight loss. Or it may just be that he is not taking in enough calories for the energy needs which accompany his bpd. (broncho-pulmonary dysplasia, the fancy name for the problems he has with his lungs as a result of the time on the ventilator.)


So the doctor has made some changes in his treatment. He has increased from 1 breathing treatment a day of one drug (Pulmicort) to a total of 6 breathing treatments each day: 2 of the one and 4 more of an old friend from his nicu days (Albuterol). The nutritionist wants half of his feedings to be by bottle so we can enrich the milk to a high calorie load, also like his nicu days. We tried a bottle this morning without success; the little we managed to get in him, he promptly spit up. Hopefully, we will be more successful before his next weigh-in on Thursday.



Otherwise, he continues to delight us daily with smiles and snuggles- and the occasional strong opinion.

Toby saw the eye doctor on Thursday. She was absolutely thrilled that he watched her walk across the room. She says he is doing great and the only reason he has to go back at all is because he is on the oxygen, so she still has to watch his eyes.
His pediatrician is equally pleased with his progress. Though, we're not sure if this is because of scale differences, but Toby continues to weigh in at only about nine pounds.
The surgery is officially scheduled for September 22.

He has made good progress in the past couple of weeks, and has recently started reaching for and playing with his toys.

Toby and his ball wrestle.

Toby in a contemplative mood.

Bemusedly looking at the people trying to make him smile for the camera.

We finally coaxed a smile from him - not his cutest, but the best we were going to get.

Toby smirking at our frustration. He knows who has the power.