Teeny Tiny Truman

This page is all about Truman, born Aug. 8, 2006 to Kara and Ben.

Saturday, September 30, 2006

Off TPN!


As of Saturday, Truman is sustained by breast milk alone!! He's up to 21 CCs per feed or 5.25 ounces per day. He's off the TPN, and the PLL (the line that was used for IV-nutrition) is gone. That means he has no IVs, lines, or anything needle-like in him, and all his limbs are free to wriggle and grab.

He still has some leads on monitoring his vital signs and the prongs in his nose for the C-PAP machine. He is doing very well with respiration. The C-PAP is on a back-up support of 10 breaths per minute, and he has been on mostly room air for several days now.

He slowed down some on growth this week and even lost weight a couple of days, but he's regained what he lost. He did not grow in length this week. We're hoping he picks back up to his prior pace of an ounce or so a day or we are in for a very long stay in NICU.

Truman had his first eye exam this weekend. Both eyes are on track and developing normally. One is even a little ahead. And, he does not have the eye disease caused by oxygen exposure! The next eye exam is in two weeks.

He has his voice back completely now. He likes to grunt a lot when wriggling, and he can definitely cry when he's mad. Last night, he decided to get mad when we put him back in after holding, and he let us know. But all it took to calm him down was a pacifier and some touch from Mom and Dad. His nurse said we were good with him. That was really nice to hear.

We are doing a lot more with him these days. Last night, we both took him out and put him back for the holding. I also aspirated his nose (or at least I tried). I guess we realize he's not so fragile anymore, and we've got to start learning sometime. Becoming comfortable in NICU is definitely a mixed blessing.


Friday, September 29, 2006

Update: Friday, Sept. 29

CURRENT WEIGHT: 2 lbs, 7 ounces

Truman gave me a present when I got the hospital today. He let me hold him all swaddled up like a regular baby. It was the first time I've held him and been able to see his face at the same time. I know I'm biased, but he's the cutest baby there ever was all wrapped up like that.

We talked and read for more than an hour. He was quite cozy and his oxygen levels were beautiful (that is after we got all the snot cleaned out of his nose from the sneezing he did just before I held him). Nurse Bev said that he had been alert a lot today and she just thought he needed extra attention. I also got to lift him back into the isolette when we were done. It reminded of just how little he still is.

He is up to 14 CCs (3.5 ounces a day) on his feeds and is tolerating them wonderfully. Nurse Bev said his PLL line (the central line that the IV nutrition goes in) is near the end of its life. There's talk that when it has to be pulled in the next few days that it might not be replaced. We've just got to get enough milk volume to take its place before then.


Thursday, September 28, 2006

Free of the ventilator again!!


Truman is very happily free of the tube down his throat this afternoon. He has returned to C-PAP. Within just a few minutes of the change, he was back down to room air, sneezing about the prongs in his nose, and trying to squeak out some noise. I'm sure within a couple of days, he'll be able to scream as loud as ever when he wants attention (or food). And boy does he start grousing about being hungry when it gets close to meal time.

Speaking of food, Truman is up to 13 CCs (3.25 ounces per day) and is tolerating feeds quite well. Human milk fortifier has been added to give him additional calories.

His arterial line is coming out today. Although it was still in, they allowed us to resume kangaroo care on Tuesday night figuring that if the line came out, it would be a mess, but he'd be fine without it. His IV was removed yesterday. Once the arterial line is out, Truman will be down to one line only. And once he gets up to full feeds and TPN can be stopped, his PLL will be removed and he'll be line free.

We got preliminary results of his Wednesday morning neural scan last night. The swelling in both ventricles has decreased, and the bleed has decreased as well. We don't yet have details as to how much improvement there was, but it was improvement nonetheless!

In fun details, Truman is growing more hair. It's getting thicker and a little darker. It's still very blonde, though. It's also getting long and is growing down onto his neck and over the tops of his ears. I think he'll need a haircut before he comes home.


Tuesday, September 26, 2006

Truman Update: Tuesday, Sept. 26


It appears that Truman is all better. He looks good, his vital signs are good, and the infection appears to be gone. His ventilator settings have been turned down to pressure support only, and there's a rumor he'll be extubated straight to C-PAP today.

We haven't gotten to resume kangaroo care because he has an arterial line in. Once that's out, we'll be back to holding our little one. The line might be pulled today, but they may wait until after a round of lab work scheduled for tomorrow morning.

His bilirubin levels are back up a little. Dr. Nama thinks it's from use of TPN which can cause liver damage over time. So, he added an IV medication to help with that called phenobarbitol. Truman is currently on 10 CCs of breast milk, which Dr. Nama said is about half way to full feeds. Once he reaches "full" feeds, the TPN will be stopped. Dr. Nama thought that would be within the next 10 days or so.

Truman gave us a big show on Sunday night. He was wide awake for about an hour and 45 minutes while we were there. His eyes were wide open. He was looking all around, wriggling around on his bed, and waving his arms. He even smiled a few times. Yes, we know it was probably involuntary, but it was adorable none the less.

--Ben & Kara

Saturday, September 23, 2006

Afternoon Update: Saturday, Sept. 23

Truman graduated back to the conventional ventilator this afternoon. His blood gas a few hours after the change looked great. He is also much less swollen today and is starting to look like himself again. Below are a few pictures taken on 9/23.

Although Truman has been intubated again, he has been resting peacefully for the last couple of days. You can see his Kara's hand here, letting him know that she's there.

An afternoon visit from Truman's aunt.

Spot the Cow looks in on Truman.

--Ben & Kara

Progress Report: Saturday, Sept. 23

Truman is getting better. His blood count, specifically his CRP (C-reactive protein) count appears that the antibiotics are working and lessening the infection. There is still is no word on what the infection was, and I doubt we will ever now. Dr. Khattak said that about 10 percent of bacteria simply do not grow on the cultures. His vital signs all look great, and he is more active and starting to act more like his normal, feisty self. He was very lethargic for several days, so it's good to see him opening his eyes and responding to us again.

Nurse Bev said earlier today that if his blood gases continue to look good today that he might graduate back to the conventional ventilator today. He's been on room air for a couple of days, and his settings keep getting lower on the vent.

Feeds were started back on Friday. He's back to 6 CCs at each feeding, or 1 1/2 ounces per day. He's handling those really well.

He continues to gain weight. He is at 2 lbs, 6.5 ounces. However, some of that is fluid retention. Between the extra fluid he's been given to fight the infection and the fluid retention caused by the infection and the antibiotics, he looks like the stay-puff marshmallow man right now. He has no chin. Even his ears are puffy. Dr. Khattak and Nurse Lisa said that will probably decrease over the next week or so once he's off the antibiotics. I think he finishes those on Monday.


Thursday, September 21, 2006

Thursday, Sept. 21 update and Neural Scan Results

Truman's nurse said this morning that his blood count looks like the antibiotics are starting to work. Most of these antibiotics are used over a 10-day course, so we're hoping to see marked improvement by Monday, September 25th. We still don't know what he has, and the cultures are still negative, but it looks like he's making some progress toward getting better. His heart rate was lower yesterday, and his blood pressure was higher -- both positive signs. He also started stooling into his bag yesterday after several days of not doing so. Dr. Khattak said that is a positive sign that he's getting better as well.

Dr. Khattak also reported the latest head scan results, showed us the images, and talked with both of us about the results again. The swelling in the ventricles has increased. He will now be given weekly neural scans to watch for increased swelling. If it continues to increase, they will consider a shunt or a type of reservoir placed into his head to drain the fluid and relieve the pressure on his brain. While the ventricles themselves are not brain tissue, if they continue to swell they can place pressure on the surrounding brain tissue and cause damage. Because Truman's skull is still soft, he probably still has some room to go with swelling before the pressure causes serious problems. Both of his ventricles are currently classified as having Grade III bleeds.

Regarding the bleed that is in another area in Truman's brain, Dr. Khattak said it is starting to "organize," forming a pit or cyst in the area that the bleed occurred. In the scan two weeks ago, there was some resolution on the bleed, but the bleed has not decreased in size during the last two weeks. Because it is organizing, Dr. Khattak said that the radiologists and neonatologists believe that it will not resolve any further and that area will be permanently damaged. However, he stated that it is a very small area of his brain and that it is a good thing that the blood is not surrounding the ventricles. For the first time, we talked about what goes on in that portion of the brain. He said that the damaged portion of the basal ganglia controls some motor functions and thinks that the results of the size and location of Truman's brain bleed leaves him with about a 30 to 50 percent chance of cerebral palsy. He said we should be hopeful that this would not be the typical type of cerebral palsy that one generally thinks of, but more likely something like a twitch or involuntary movement of limb that won't render it unusable like most palsy does. Of course, all of this is simply an educated guess. Only time will tell the true results of Truman's brain bleed.

Truman's weight is still at 2 lbs, 5 ounces. The plan is to start feeds again tomorrow. He is still on the high-speed ventilator and will probably be there for another week or more.

--Kara & Ben

Wednesday, September 20, 2006

Morning Update: Wednesday, Sept. 20

Truman continues to remain stable. However, his illness continues to remain a mystery.

He now weighs 2 lb, 5 ounces, but the staff believes the large gain is due to fluid given to him to fight the symptoms of his illness.

Tuesday, September 19, 2006

Update: September 19

WEIGHT: 2 lbs, 3 ounces
LENGTH: 13 1/2 inches

Dr. Khattak said that Truman is doing better today. His heart rate is lower and his ventilator settings are lower. They were able to wean him from blood pressure medication overnight, but he was back on it by mid-day. He has also had to go up a little on his oxygen settings since the night.

All of the blood cultures are still negative, including the fungal culture. They still can't figure out what he's got, but he appears to be slowly getting better. Truman is still very sick though.

He's sedated so that he doesn't breathe over the ventilator. It will be a few more days before the breast milk feeds are started again.

Dr. Khattak estimated yesterday that Truman would be on the high-speed ventilator for another 10 days to two weeks. As long as he is on this ventilator, there will be no kangaroo care.


Monday, September 18, 2006

Another step back

As of about an hour ago, Truman is back on the high-speed oscillating ventilator. He wasn't blowing off enough CO2 on the conventional ventilator. I guess it's back to the beginning on ventilation.

We still don't have any results on the blood cultures.


Sick and Back on the Ventilator

Truman has had a tough weekend. He is clearly sick. His blood count yesterday shows that he's fighting something, so more blood cultures were ordered. On Friday, his blood count was only slightly "shifted," and those blood cultures haven't grown anything.

After doing fairly well on Sunday, he had a big Brady/Apnea episode during the early afternoon and was clearly struggling to breathe during our afternoon visit. We arrived right after the episode, and spent the whole visit rubbing his back or annoying him in other ways to make him breathe.

During the dinner break, we got one of the dreaded calls from the NICU. He had had his worst Brady yet and had to receive chest compressions to get his heart rate back up this time. His lungs were also bagged during this episode, which lasted a few minutes, to keep him breathing. Knowing that adults don't receive CPR unless their hearts have stopped altogether, I assumed this is what happened, but we later learned that preemies get chest compressions when their heart rates drop below 60. Truman got into the 30s during this episode. Thinking his heart had stopped was a very scary time. He also got a shot of epinephren during this episode, so his heart rate was very high when we arrived at the hospital soon after.

He was re-intubated during this episode. He's back on the conventional ventilator and was completely "riding the vent" (letting it do all the work) last night, which is actually a good thing because he is so exhausted from trying to fight this infection and breathe at the same time that he really needs to rest. Preemies just don't have the energy reserves that the rest of us do. During the episode his O2 saturation dropped to the 30-percent range as well, and he had been fighting low oxygen saturation and episodes of stopped breathing all day.

The docs and nurses think he just got too tired trying to fight an infection and breathe. He was awfully small to be on the C-PAP anyway, and we had been told most preemies fail the first time they are extubated. He just took a long time to do so. We still wonder whether he could have continued doing well on it if he had not gotten sick.

During the night, he's had trouble with low blood pressure, so he's back on Dopamine this morning. He also had a blood transfusion this morning. They ordered more blood cultures because they think the infection is bacterial, but neither of the first two cultures have grown anything. He's been put on three broad-spectrum antibiotics in the hopes that one will do something. They were doing some blood tests this morning to see the "peaks and troughs" on the antibiotics to tell whether they are at the right amount and whether they are doing anything for him.

Before yesterday's episode he was down to one IV, but overnight last night he had another IV put back in as well as an arterial line, so he has only one free limb now.

Breast milk feeds were also stopped yesterday while he recovers from this illness. They don't want him to start rejecting milk just because he's sick, and Dopamine makes it hard to digest things.

I guess there's a reason they call it the NICU roller coaster.


Saturday, September 16, 2006

Illness Update: September 16

As of 2 p.m., Truman's blood cultures haven't grown anything yet (after about 17 hours), but they won't declare him negative for infection until 48 hours have passed. He's got a lot of yellow mucus build-up in his nose and throat, so it looks like there probably is an infection or at least he was starting to get one that may have been caught early. His chest x-ray today also shows fluid around his lungs, so they gave him a diruetic to help him urinate off the excess fluid.

He also looks a little pale. He had a big apnea/Brady episode while we were there, but after they suctioned his nose, he did a lot better and pinked up a little more. We're hoping that the 48-hour antibiotic course will be enough of a boost to fight past this infection.

His feeds are still going well. He's up to 10 CCs, which is 2 1/4 ounces a day. He actually lost about 5 grams yesterday, but still comes in at 2 lbs, 1 ounce.


Friday, September 15, 2006

Small Setback

It looks like Truman may be battling an infection. He had four big apnea spells this afternoon, and his blood count has "shifted" slightly. He also is less active and is acting like he doesn't feel well. So, they put him on two antibiotics, and put him back on nasal prong ventilation. He's getting 15 back-up breaths a minute.

We expect to get preliminary results from his blood culture in the morning.


Progress Update: September 15

Truman is now 2 lbs, 1 ounces and up to 8CCs per feeding, which is 2 ounces per day. He's continuing to get bigger every day!

Some of you have asked based on these pictures if he's back on the ventilator. Nope, he's still doing well on C-PAP. The white strap is holding the C-PAP prongs in his nose. It just looks awfully big on such a little face.

Thursday, September 14, 2006

Two Pounds!

Truman has reached two pounds, and he finally has two sets of cheeks -- one on top and one on bottom! Otherwise, no real updates. He continues to do really well. His primary nurse said if he continues on this pace, we might have him home by Thanksgiving.

Wednesday, September 13, 2006

Progress Update: Wednesday, Sept. 13

Truman continues to do well. He's handling the C-PAP quite well and is lowering his oxygen requirements on it. I think he was at 30 % most of yesterday. (Room air is 21%).

He's still doing well with feedings. He increased his intake today to 3 CCs every three hours, making for a total of 3/4 ounce a day. We're told volume will increase for a while, and then fortifiers will be added to my breast milk to increase its caloric content.

He is also getting more comfortable with kangaroo care every day. The first couple of times, it took him 10 minutes or more to settle in, and he was fussy from time to time. Now, he settles in within a couple of minutes and goes to sleep and tends to only get fussy when we adjust him or move our arms.

He's also learned how to manipulate Mom and Dad. Today, when I tried to leave the hospital after his mid-day visit, he started crying when I moved my hands away. I put them back and talked to him. He calmed down, and then as soon as I moved my hands away, he starting crying again. We went through the whole process three times before I could leave.

He looks fatter every day. His hands are getting bigger and his diapers are actually starting to fit. His cheeks are so chubby now that he has jowls -- there's actually a visible crease. He was 1 lb, 15 ounces last night, so keep your fingers crossed for crossing the two-pound mark today or tomorrow.


Monday, September 11, 2006

He breathes ...

Truman is quite the amazing baby! Yesterday, he was promoted to C-PAP only. That means that the machine offers constant pressure to keep his alveoli from completely closing when he exhales, but he is doing all the inhaling and exhaling himself. That means he's doing the breathing. Nurse Julie likened it inflating a balloon. It's a lot harder to inflate a new balloon with no air in it than it is to inflate a balloon with a little bit of air in it. That's what C-PAP does. It keeps a little bit of air in the alveoli to make the job of breathing a little easier for Truman. There is still a good possibility that he will tire out and have to be re-intubated, but for now, he's impressing everyone. All the nursing staff is amazed at his progress.

He still has a couple of big de-sats a day (his blood oxygen level drops really low). Sometimes these are now accompanied by episodes of bradycardia, which means his heart rate drops really low as well. The staff said these are to be expected with the C-PAP machine.

We got two more rounds of kangaroo care this weekend. Both Mom and Dad each got a two-hour session. It was great. He's also recovered from his hoarseness and can truly cry. Granted, it's a cry that volume-wise fits him, but it's a real cry and doesn't sound quite as cat-like or bird-like as some preemies do. He is easily soothed by his tiny pacifier (called a "Wee Thumbie") and tends to fuss when you take your hands off of him. His tiny hiccups are quite adorable.

He also continues to do well with feeds and should finish up gut-priming today. That means the volume of breast milk will likely increase. He's grown to 1 lb, 14 ounces and 13 1/4 inches long.


Saturday, September 09, 2006

He eats and speaks ...

CURRENT WEIGHT -- 1 lb, 12 ounces
CURRENT HEIGHT -- 12 5/8 inches

Truman had outgrown the tube on his ventilator and needed a bigger one. Since they had to extubate him to do that, they decided to try him on nasal prong ventilaton (basically C-PAP with 20 reminder breaths every minute). So, he now has two prongs in his nose and no air tube down his throat. He's doing a lot of the work breathing, with the machine assisting. Without a tube hindering his vocal chords, he can now make noise. He's hoarse from a month of having a tube in his throat, so he can only squeak at the moment. The picture above is his attempt to scream. Although he was mad, the sounds were quite cute. It was so wonderful to hear his voice for the first time since he was born.

What is also great about being off a conventional ventilator is that we have gotten to see his full face for the first time without ventilation tubes. Although the prongs have a little strap that obscures the middle of his face, unlike the tube down his throat, his nose tubes are removed periodically for suctioning his nose and other tasks. He can handle some short periods with no ventilation assistance.

Truman will most likely have to go back on the conventional ventilator at some point over the next few days to a week. He is still a little small to be on nasal prong ventilation, but the physicians thought that since he had to be extubated anyway, they'd give it a shot. Also, a lot of preemies get pretty tired from all the work that breathing takes and just get worn out the first time off the ventilator. So far, he's doing well with it.

Ben got to change his first dirty diaper last night. Some of the remaining the meconium finally passed on its own, and Ben had the pleasure of getting that sticky stuff out and off of Truman. It was a great initiation to many more stinky diapers in our future.

Ben did not get to try kangaroo care last night. With the change in ventilation, we needed to give Truman a break before we stressed him out by taking him out of his cozy isolette again.

Truman also started breast milk feeds again yesterday. He processed the first one, and we haven't heard on the subsequent ones, so keep your fingers crossed. At latest count, Truman gained another ounce to 1 lb, 12 ounces and he has grown an inch to make him 12 5/8 inches long.


Friday, September 08, 2006

Truman is one month old today!

My, how much life changed one month ago today. The three of us got to share an early birthday present last night when we were allowed to hold him. Ben let me take last night's turn. If Truman behaves today, Ben will hold him tonight.

The kangaroo care went very well. He appeared comfortable and kept his temperature up really well. It was 99 something when we were done. He was mostly pretty still, but Ben said he had his eyes open a lot at the beginning before he settled in to sleep. Before we were done, he was up to his usual squirming, including trying to turn his head. He's a strong little guy!

It was a wonderful visit and a very big moment to get to hold our little boy for the first time.

In other news, he was fully weaned from his pain medication and blood pressure medication yesterday. His arm IV was also exchanged for a scalp IV. Although a little scary looking, the scalp IV is reportedly a more comfortable IV for the little guy than ones in his limbs.


Thursday, September 07, 2006

Progress Update: Thursday, September 6

Truman has had a couple of very good days. His fiestiness is back as strong as ever -- so much so that the nurses asked for orders for a higher dosage of Ativan, a drug which is designed to help calm him down. When I was changing his diaper at noon on Wednesday, he was so agitated about it that he pulled out his feeding tube and pulled the guaze off his stoma (the wound where his intestines come to the surface from surgery). I tried to pry his little fingers from the tube before he got it all the way out, but he's a strong little fellow. I couldn't get them loose.

We received results from the follow-up head ultrasound. There appears to be some improvement! The right ventricle has not increased in swelling, and the blood in the left ventricle appears to be resolving some. The biggest news is that because the bleed in the left is slowly resolving, they think it was not an infarction as they reported last week. An infarction is like a stroke. It means that blood was cut off to a portion of the body, causing the tissue to die. If he did have an infarction in his brain, that would mean that portion of brain tissue had died and was permanently damaged. Since they now believe it was only a hemorrhage rather than an infarction, his brain is still damaged, but he could recover from the damage or create new pathways around it as the blood re-absorbs.

He is down to a very low dosage of both the blood pressure medication and the pain drip from surgery. They plan to wean the pain medication entirely today and hope to do so with the blood pressure medication, but they are not too hopeful about getting off of the blood pressure medication just yet because his blood pressure keeps staying pretty low. They made give him a cortizone shot to speed the blood pressure improvement up.

He is doing really well with the new ventilator. They say he may attempt to come off of it completely and move to C-PAP (a machine that delivers pressure to the lungs rather than breathing for him) in two or three weeks. He will likely fail the first time off the ventilator and have to go back on, but the fact that they are thinking two to three weeks is a positive sign.

The ostomy bag was put on last night, mostly to keep his hands out of the stoma (the fiestiness again). He will likely start feeds in the next couple of days. He needs to be off the pain medication, and preferably the blood pressure medication, first.

The nurses said that kangaroo care could start any day now. That means we'll get to start holding our little guy soon. Other than me lifting him up on the bed linens to change the bottom linens and Ben lifting him up once to weigh him, we haven't held him yet. Kangaroo care means that we would sit in a comfy chair with our shirts off or open. Truman would be placed on our chests, skin to skin. By placing directly on our skin, our skin helps to maintain his body temperature without him using so many calories to do so. Because his ear will be placed against our chests, he will be able to use our heartbeats and respiration to help regulate his own. Of course, he will still be on the ventilator. Kangaroo care has also been shown to help babies grow faster. The benefits for us are pretty obvious. We are both really excited about it!

Nurse Callie talked to us last night more about his stay overall. She said that because his lungs have done so well and because his ventilator support has been low pretty much all along, he probably won't be in acute care section of NICU as long as other tiny babies. But, because his intestional issue means he only has 2/3 of his small intestine to absorb nutrients, he's probably going to have a longer stay in the "feeder grower" section of NICU than other babies. They are talking about trying some creative options to use a catheter to re-insert the contents of his ostomy bag into the other opening on his stoma so that he can try to continue absorbing the nutrients in the lower third of his small intestine and keep his large intestine running. If they can get that to work, he will able to grow better than if his bag were just emptied.

He's getting fatter everyday. He's up to 1 pound, 11 ounces.

As always, thanks for all of the support and prayers,

Tuesday, September 05, 2006

Progress Update: Tuesday, Sept. 5

Truman is four weeks old today! He continues to recover well from surgery. Although still heavily sedated with pain medication, he appears to be acting like his normal self again.

Apparently, the distention in his stomach and bowel was causing more pressure on his lungs that anyone realized. We wrote in our last post that his ventilator settings decreased immediately upon surgery. By that evening, Truman had graduated from the high-frequency oscillating ventilator to the conventional ventilator. The prior ventilator sort of vibrated his lungs; this one operates like a standard ventilator. It was set at 30 breaths per minute on Saturday night and by last night was weaned to 25 breaths per minute. Sometimes Truman lets the ventilator do all the work, called "riding the vent," we've also seen him take as many as 60 breaths per minute other times, which means he took 30 breaths above the machine. Although these aren't necessarily productive breaths, he's learning!

He continues to struggle with getting off the blood pressure medication. His dosage has decreased since surgery, but he still struggles with low blood pressure and may do so until he gets bigger and stronger.

He already looks bigger to us and to his grandparents. He now weighs 1 lb, 10 ounces, but some of that is due to fluid retention from surgery. Ben's parents visited this weekend and had not seen him in about two-and-a-half weeks. They said he had changed dramatically in terms of color, size, skin, and general cuteness. It's amazing the difference that short time has made.

We still continue to be very worried about his brain bleed and what long-term effect it has on our little boy. He appears to behave the same as he did before the bleed, and it does not appear to have affected his personality. Hopefully, that's a positive sign.


Saturday, September 02, 2006

The Surgery Went Well

Just a quick update:

Today's surgery went well. An incision about 1.5 cm long was made just to the right of his stomach, and from there Dr. Roden was able to gain access to his entire abdominal cavity. As it turns out, the meconium blockage is actually in the lower third of the small intestine, which is why the enemas were unable to produce much of a result (there is a sort of valve in between the small and large intestines which is designed to only permit flow in one direction). A slit was made in his small intestine just above the blockage, and within moments the distention above the blockage had been relieved. His ventilator settings were able to be turned down soon afterwards, so it's clear that the distention was indeed placing extra pressure on his lungs, and it's a good thing that it's now gone.

It's uncommon for a meconium blockage to form in a baby's small intestine, but it's not completely unheard of. If it happens in full-term babies, it can be an indicator of cystic fibrosis, but Truman has already been screened for that and it came back negative, so we're not too concerned about that issue. The physicians will now be able to try to move the blockage from both above and below, and hopefully the bowel will be cleared out over the next couple of weeks. In the meantime, we've been told to expect some water retention in his upper body over the next few days as a standard side effect of this surgery. Once that inflation subsides and he has begun to heal, we hope to start giving him some breast milk, possibly in the next 5 to 7 days.

Overall, the procedure went well and the physicians and nurses are encourgaged by the way he has responded to it thus far. Truman is still under heavy sedation and will most likely be unresponsive more the remainder of the day. We'll keep you all updated as we get the chance.

--Ben & Kara

Truman Headed to Surgery Again

Truman had another bad day yesterday. He went up to his highest dosage on the blood pressure medication and had to up on the ventilator settings. The bowel distention was also quite a bit worse. They think it's interfering with his breathing by pushing on the lungs.

We just got a call from the hospital. They are planning to do the bowel surgery around 11:30 a.m. We are on our way to the hospital. We will not be able to update for a while today.

Thanks for the prayers,
Ben & Kara