Saturday, April 4, 2009

The training table

It was another one of those very rare days when Max didn't see either of his parents. (I was trapped in a conference and Carolyn spent the day with Felix.) The reports from his nurses at HSC continue to be encouraging, although they now notice Max's mystery cough. Carolyn has heard Max coughing for several days, but he always brightens up when a nurse or doctor comes into view. The HSC weekend attending examined Max, who stopped coughing the instant a new grownup came into view, of course. She declared that Max's lungs sounded clear. Thus, it's not likely pneumonia or new lung damage related to aspiration. Google tells us it could be RSV, despite Max's monthly vaccinations (each month's RSV shot costs more than $1,000--seriously). If it is RSV, those shots produced a pretty poor return on investment but still better than the stock market of course.

We're watching Max's bottle feedings carefully. On Monday he begins his gastric feeding test. The HSC team will pull his feeding tube back out of his jejunum and into his stomach. If he doesn't start vomiting up a significant amount, they will try to compress the feeds into a reasonable amount of time---normal babies can take in a decent amount in 20 minutes or less. In the past, Max never really tolerated anything faster than an hour. If he passes his gastric test, he comes home with an ng tube. If he fails, he comes home with a less good option, probably an nj tube. Max took 20+ ccs at each of his oral feedings today, and vomited none of it back up. It's a long way from handling that to tolerating 650+ ccs, but it's a straw in the wind that maybe he'll do okay.