Sunday, January 23, 2011

Take Two

One of the main concerns for Daxton when we got home was his weight gain.  He had lost about 1 1/2 pounds since birth and he was pretty weak from his ordeal.  When we went for weight checks, he still wasn't gaining.  The doctor suspected that Daxton was too weak to breastfeed efficiently, so I was told to pump and feed him with a bottle.  That way we could measure exactly how much he was getting.  Well, it turns out he wasn't eating near enough.  I was producing much more than he was taking, but he just wasn't interested in eating very much.  The pediatrician called a pediatric gastroenterologist who decided to admit Daxton back to the hospital for observation and consultation.  So, back we went.

Thankfully, we now had a great relationship with the doctors and a lot of the nurses so that offered a certain semblance of comfort.  Unfortunately, Daxton had to get another NG tube when we got to the hospital.  This one was quite a bit bigger and he gagged and threw up when he ate.  In fact, in the first 12 hours we were at the hospital, he had only one feeding which he threw up.  I was a little more than frustrated.  We had come to help him gain weight, and he was starving!!  (OK, I got that out!)  But, we had some needed tests done which helped give us some answers.

Daxton had his third MRI which determined that he had a LOT of fluid built up in his head.  Just a bit of medical background:  When there is bleeding in the brain, the blood breaks down and is absorbed by the body, but it leaves behind a different kind of fluid.  Ideally, the fluid drains out of the brain through the ports where normal cerebral spinal fluid drains.  However, the proteins from the blood can gum up the ports which is exactly what had happened with Daxton.  And he had a lot of fluid because of the size of the bleed.  His poor little brain was swelling and probably giving him a terrible headache and nausea too.  No wonder he didn't want to eat!  It was pretty obvious that Daxton needed a brain shunt to help drain off the excess fluid.  The neurosurgeon was fairly certain that if we could relieve the pressure in his head, Daxton would start eating better.  Surgery was scheduled for the next day!

Thinking about our baby having brain surgery was really not cool, but there really was no choice.  The surgery only took about 1 1/2 hours which is pretty amazing considering what was done.Craniotomy for cerebral shunt

"During a cerebral shunt procedure a flap is cut in the scalp and a small hole is drilled in the skull. A small catheter is passed into a ventricle of the brain. A pump (valve which controls flow of fluid) is attached to the catheter to keep the fluid away from the brain."  (Thanks to the howstuffworks website for the image and explanation.)  Because Daxton is still a new baby, his fontanelles are open and he didn't have to have the hole in his skull.  Everything is under the skin and the catheter that drains the fluid is snaked behind his ear, down his neck and chest, and then into his abdominal cavity.  A small incision is made in his abdomen to pull down the tubing and make sure it is in the right place.  Crazy stuff!!

I do not have pictures of Daxton right after surgery - way too painful.  His poor little face was so swollen and he was in pain.  Me no like.  As we were sitting in recovery with him, I wondered out loud to Trent about who our post-op/night nurse would be (since surgery happened during shift change.)  I hoped it was Bret with his pockets full of meds.  We got back up to PICU and sure enough, Bret was there waiting for us!  Tender mercies!!  Daxton was kept as comfortable as possible and was actually cleared by the neurosurgeon to go home the next day!!!  But, he still had feeding issues to deal with.  He was given a smaller NG tube that wasn't quite so gaggy, and we settled in to see how he would respond to the shunt.

Adorable and so peaceful!
LOVE this picture - about one day post op.  (And yes, that is my Nothing-Bundt birthday cake in the background!)

This picture is about two weeks post-op, but you can see the incision and the shunt pretty well.

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