We had a busy day today -
Ryder had a good night, still with more out than in; each day looking more like a baby and less like a linebacker as his nurses say :) His blood pressures still look great, chest xrays still look stable. He has been more and more awake so his sedation was actually increased just a bit to this morning to keep him comfortable. He started "trophic feeds" today which basically means putting just enough milk in his gut to stimulate it. That is great news! He also had a brand new chest bandage placed and since his kidney function has been stable his lasix drip was increased so hopefully the fluid will come off a little faster.
Another ECHO was done this morning and unfortunately Ryder now has a clot in his right atrium. There was a question of it being there Friday but today's study confirmed this. He has still been on a small amount of heparin since he has been off ECMO and the bleed seen on head ultrasound has been stable in size, and over the weekend the comparison images do not show the clot has increased in size or moved, so those are all good things. So, his heparin was increased again and now he will need to be monitored closely for any bleeding - mostly at the site of the intraventricular hemorrhage. Another head ultrasound was done today to get a new baseline, and will be repeated daily for now. The clot probably started because he has an IV line going in near the atrium (a known risk) but for now the line will stay in and his left arm/neck will also be examined w/ultrasound today to see if the clot extends. That will help decide if the line should be moved in the next couple days or can stay put.
Bummer, for lack of better word, but despite risks and implications of this clot the I was dwelling on the fact that he has to stay on lovenox for a few months at least. That is an injection. I know, clearly there are a lot of things in life worse than injections, but still. I cried for an hour the first time I cut Addy's finger with a nail clipper, and I know I'm not the only mommy that cried for baby's first shots. So, under a binding verbal agreement witnessed by Ryder's new hematologist I will keep cutting the fingernails despite the blood thinner but Ross has to inject it. Now it's on the internet too, so no take-backs!!
Just another bump in the road, but please pray Ryder's clot stays put and that he tolerates his heparin well, because otherwise he is having a great Monday :)
Prayers said - you got it. Happy Monday!
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