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