Yesterday's trip really put Nanette out for awhile. She was not to the point of going to the hospital, but she was getting close before things started to turn around in the late afternoon.
Gabe's hydrocephalus is an interesting case. Yesterday and today different doctors and nurse practitioners tried to convince us that putting in a reservoir was necessary. Nanette and I expressed some concern and skepticism, but after viewing the most recent head ultrasound and CT scan images, I was fully persuaded and proceeded to bring Nanette to the same conclusion. I checked the OR schedule before I left the hospital and Gabe is on for 10:15am. However, I still have not signed the consent, not given a verbal to the neurosurgeon. Well, tonight the neurosurgeon called and left a message to the effect that he is not convinced that Gabe should get the reservoir due to the how his head feels (Gabe's, not the Dr.'s). Gabe's fontanel is still somewhat soft. If there were significant pressure build up in the ventricles we would expect the fontanel to bulge out more and be harder to the touch. This was one of the symptoms that had Nanette and I less convinced. But the other doctors pointed out that the size of the head (Gabe's is not increasing too abnormally) and the fontanel are only parts of the whole picture and that they particularly use the size measurements taken from the ultrasounds to determine whether the hydrocephalus needs active management.
Clinically, Gabe is doing OK. He is on CPAP with a rate to help him breathe. His hematocrit has been on the low side, around 28%. His skin is bit more mottled in the last day. He is, still, cute as a button---which reminds me: the nurse told me that she can see a lot of me in him. ;)
Zeke is back on CPAP, but does not have a rate. He is up to 14mL of milk at every feed. He had his eyes checked out for the first time today. The doctor said he has immature vessels in zone 3. This is a very normal and not worrisome result for Zeke's situation. He will continue to get eye exams every week or two.
The highlight of the day: My brother Wade and I gave each boy a blessing.
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