Fever Update

I spent a fitful night waiting for the doctor to call back. She didn't have test results until 3AM and decided not to wake us.

The CBC shows no signs of infection. Her CRP is only 2, which is the lowest it has been in her entire life. Nothing has come back yet from the cultures.

Her temp returned to normal fairly quickly (although she did have some Tylenol to help out. Imagine that-Tylenol. It is funny to think of her having such a normal medication). She did not have any other signs of sickness-her perfusion was good and she seemed comfortable.

I had asked when they called if she was still bundled up. When I visited she was wrapped in a flannel swaddler. I had mentioned to the nurse that she probably would not tolerate it long because she gets warm easily. She was still swaddled when her temp first went up, but they unwrapped her for 15 minutes and took it again. The doctor assured me that the temp was too high to be just from bundling.

The neonatologist thinks maybe there were some localized bacteria that were released when the PCS line was removed and her body had an dramatic response to them.

Whatever the cause, her temp has remained normal today. The CBC and CRP will be repeated tomorrow. If they are still normal then the antibiotics will be discontinued.

Her O2 requirements are a little better than yesterday, but still not as good as they had been. She is high 40's to low 50's. Yesterday she spent a long time in the low 60's, so this is better.

The doctor lowered her MAP to 15 yesterday, so in a way it is remarkable that her oxygen requirements have not gone up.

Her CO2 has been climbing for 3 days now. If things do not improve soon we may be looking at steroids to try to give her a boost. We were hoping to avoid them due to our previous experience, but it may be the way things are.

Edited to add: Steve was visiting Natalie this afternoon and her stomach looked distended. They can't rule out strictures forming from the NEC, but they think it is highly unlikely. Her bowels are probably slowing down in response to an infection. Her feeds are being held overnight and they will do a repeat X-Ray in the morning. They are also doing stool cultures just in case. He says she looks a little pale and her perfusion is a little slow. Amazing how quickly things change. Steve also said when she woke up she was very alert and waving her arms and legs. That used to require a big increase in her O2 needs but today she held her own.