Seek and find

Ryder, Ryder, Ryder...

This weekend G.G. and Grandpa Jim came to visit (not to be confused with Grandma Linda and Grandma Linda's Grandpa--sorry Dad, apparently Addy has decided that Mom owns you)!  G.G. spent the morning/afternoon on Saturday sitting up here with Ryder so Mommy and Addy could go to the zoo and visit Nikita (the po-dar bear) and Daddy could work on the deck.  We have to have a nice place to hang out when Ryder comes home after all!  Yesterday he had a quiet day, still just working on fluid balance and adjusting some electrolytes in his TPN.  A follow-up ultrasound showed he still has a lot of ascites (ascites = extra fluid in the belly, probably starting from when he was so swollen early on).

Ryder on and off has been having belly concerns - he had a couple of ultrasounds that showed ascites but no other problems, though it's not really clear why he thinned out everywhere but within the belly.  He has been having poopy diapers and no belly pain, but it seemed that his little buddha belly has gotten bigger and bigger this week.  Today he had a CT scan to see if there was anything going on within his bowel.  Seek and ye shall find...not the answer to that (bowels looked fine) but there was a wedge of tissue in his liver that looked like it hadn't gotten enough blood and was breaking down.  We aren't sure why yet, but maybe a piece of his heart clot made its way down there.  This doesn't really explain the swollen belly but nonetheless, it was there.  The surgery team saw him today (worst case scenario this tissue since it isn't alive could make him sick and would need to be taken out) but they thought he didn't need any interventions for now.  It doesn't really look like an abscess but since he had the bloodstream infection, he had fluid taken off his belly with a paracentesis today (fluid removed with a needle while he was asleep) to check it for infection, etc.  He is still asleep right now but has a great-looking little belly now that the fluid was drawn off!  We will be watching the cultures of this fluid (hoping negative) and his abdominal circumferences (hoping he doesn't reaccumulate this fluid right away).  He is starting an antifungal medicine for a short time too, just in case.

It's good to have found this issue, but always disappointing to find something you weren't seeking (when it's something you don't want).  I told Ross several times this week that it would be nice to just do a therapeutic paracentesis because he should do better on ventilator weaning without so much pressure pushing up on his diaphram and because the increased abdominal girth is why his team is hesitant to bump up his feeds...so I guess I got what I was seeking--the lesson being sometimes our prayers are answered, just not exactly as we were anticipating (and sometimes not so simply).  Usually we will find, though, that what we get is much better than we even knew to ask for...right, Ryder?

We are thankful that so far this area of liver ischemia doesn't seem to be causing Ryder any distress or further complications and hoping that it stays that way!  Addy really wants to take her baby Ryder home soon!!