Midday update (Wednesday 11/26)

Let's start with news from the southern front. Max had his barium study this morning. Final results won't be in for a while, but Carolyn was able to get some early returns off the record. Broadly speaking, the results looked normal. In addition to testing for Hirschsprung's Disease, the study could also detect other abnormalities of the colon. Early indications are that, at worst, only a small part of Max's colon isn't working right. Interestingly, although the radiologists were able to see some stools in his colon, they didn't see a static mass blocking the system up. Perhaps his constipation is some combination of normal baby variation plus the fact that preemies have a hard time with their intestinal function? Could the southern front resolve on its own without growing into a major disaster requiring surgical intervention? Don't get your hopes up, but stay tuned.

On the northern front, disagreements rage about how much, exactly, Max's head circumference grew last night. The choices are: a lot, or much more than a lot. They'll measure again to break the deadlock. I'm assuming that the doctors have heard of the Law of Large Numbers and thus the underlying issue is too complicated to be fixed by some guy with a tape measure and the ability to average n readings. They may or may not tap Max again today. At his next tap, the neurologists are considering taking more than the standard 10 cc amount of CSF. The doctors don't want to take too much for reasons that are too terrifying to discuss here, but "too much" is usually thought of as being in the 50 cc range, so they could take some more without entering the danger zone.

Not to compound the bad news, but Max's doctors seem to think that he's retaining fluid. If this turns into a big deal, we'll name a new front, but for right now it's just something to watch. Max's eyelids and other sensitive tissues appear swollen. He's gained nearly 250 grams over the past two days. The medical team have brought in Max's dietitian to consult on the nature of the fortification he's getting in his milk. In addition, Max is getting supplemental sodium to make up from sodium loss from lumbar taps: perhaps he's retaining water. The good news is that his kidneys continue to make urine: his output has been, we're told, consistent and, perhaps, appropriate.

In addition to being a collection of symptoms and martial metaphors, Max is also a baby, and a darn cute one. Carolyn forwent skin-to-skin contact because Max had had a big day already. She held him from 9:45 to 11:15 and then again later; he snoozed the whole time. But when Carolyn got to the hospital, Max's eyes were wide open; he was checking out the situation in the radiology lab where his barium study was conducted. Max continues to tolerate his feeds well, and he isn't having apnea, brady, or desat episodes.

Also, Max gave us a Thanksgiving card today (we're told his nurses might have helped although he maintains that this is a base canard). It's too cute for words and we'll try to get some kind of picture asap. Nurse Kiera took his footprints and made a turkey out of them (the more common handprint turkey was ruled out because "Max wouldn't cooperate"). This inscription reads "To Mom, Dad and big brother Felix/From Max aka turkey toes."