Thursday, February 26, 2009

Evening update (Thursday 2/26)

The pediatric neurosurgeon, Dr. K., examined Max this morning, reviewed his most recent CT scan as well as his past scans of all sorts (ultrasounds, MRIs, and CTs) and his head growth trajectory. Dr. K's assessment is that Max does not currently need a shunt, but that he is a "borderline" case and should continue to be monitored. Essentially, this means closely watching his head growth as well as his fontanel. Dr. K.'s assessment thus matches that of the NICU team and the other neurosurgeon who has been seeing Max. We know that a shunt may ultimately be the best thing for Max. But for the time being we are glad that he is managing to avoid it, because once the surgery takes place he would have it (or a revised version of it) for the rest of his life.

Max took about 10 cc by mouth at two separate bottle feedings today. At the first one around 10:30, he promptly spit it all back up. That feeding time was about an hour delayed (the NICU is a crazy place these days) and I think he was hungry and just gulping it down too quickly. The second effort at 4 p.m. went better, with him keeping it all down, at least by the time I left at 5:30.

The NICU attending, Dr. R., spoke with me today about the next steps for Max. Most likely, he will be discharged to the halfway house of the HSC where he will receive intensive speech, physical, and occupational therapy. The goal of HSC to to transition kids to home, not to keep them there long-term. The developmental pediatrician, therapists, and doctors at GUH seem to think this step would really benefit Max. While we are eager to have him home, we also realize that he will need a high level of care. We think that both Max and we can learn from a stop at the HSC. Andreas and I are going to visit HSC on Friday afternoon to get a feel for the place. If Max continues on his current course, and if a bed is available at HSC, my guess is that he may be going there next week.