Overwhelmed

Just asked one of the residents to come in and give me a run down of where we're at with B...and wow, a lot to process.

So...one of the tests they did, Anti-HBs, did come back positive. This means that B has antibodies to Hepatitis B. More than likely, Brady received the antibodies (which anyone who has been vaccinated against or has had Hep B in the past would have) during an IVIG transfusion and does not have Heb B himself, but, there is a small chance (1 in 200,000 to be exact) that he could have contracted Hep B through one of his blood transfusions. The test that is coming up positive is the first one that would show up positive during a specific window of time after contracting the virus when others, Anti-HBc & HBsAg, would still be negative. They are sending out another test tomorrow morning that will provide the definitive answer. Hepatitis B is obviously THE worst case scenario but, it's also the least likely, so I'm trying not to panic unnecessarily. If the test comes back negative for Hep B then that leaves two other likely causes. He could have what they call a "Heme stone" in his liver, which is caused by iron build up from transfusions and/or hemolysis, and that is blocking one of his ducts. Or, he has hepatotoxicity from the chelation medication his takes. They've temporarily stopped that medication. If its determined that is what caused this then he would not be able to continue that and would need to try other chelation meds. The problem is that those medications are less effective and still have the possibility of being hepatotoxic, meaning toxic to the liver.

B's hemoglobin is 7.8 so its holding out nicely. His bilirubin is down to 1.7 and his liver enzymes are around 500 -- way down from over 2000 at admission -- but still a long way from normal, which would be below 35. The docs did say that they're low enough that if he wasn't scheduled for a hidascan and IVIG wednesday then he would be being discharged so that's awesome. At this point, they're fairly confident he can be discharged wednesday night.

I'm not sure if I mentioned that they changed his formula again, actually back the the Enfacare that he originally transitioned to when he ran out of my milk. The Nutramigen was running right through him causing diarhea and a horrible diaper rash. Also, the Enfacare has extra nutrients that boost babies who are preemie or "failure to thrive". They also upped the calories per ounce from 24 to 27. To put it in perspective, normal formula or breastmilk contains about 18 calories per ounce. Brady burns so many calories just to fight the anemia and lung disease that he needs to take in roughly 50% more calories than a healthy baby would.

Well, think that's it for now. Thank you for all of the prayers and support through this. Things were pretty scary for a day or two but B is tough little guy and things are looking up :)