ok, news. he gained 1/2lb in 3 days. (now up to 3 3/4lb) this is too much fluid. several possible reasons why/contributing factors/vicious cycles.
he's not being fed by digesting milk since the intestinal infection on new year's, but getting his nutrition in an iv. this isn't optimal, and getting your electrolytes like that can cause fluid shifts and retention. then, if they change his electrolyte levels, that can make things worse, fluid-wise. sorta like eating an entire big bag of chips can make your ankles swell if you're susceptible to that.
so all this extra fluid is making his heart work harder, and it is enlarging according to an xray this evening. if his heart is left alone pushing against all that, his lungs can back up and fill up with more fluid - congestive heart failure. right now, something to closely watch.
*and* his heart working more against more pressure means his ductus arteriosus - a little vessel that links your lung vessels to your aorta when you're a fetus - is very likely open. is this the cause of the extra fluid, or a result? who knows. anyway, this is the murmur most newborns have that goes away over the first few days. being on a vent, being a preemie, the extra fluid - these are some risk factors.
SO - the plan is 1) an echocardiogram in the morning. this is a heart ultrasound. they will see if the ductus is indeed open.
if it is, 2) ligation (clipping it closed) of it in the next few days. this is a little surgery, not a big deal, not open heart or anything, except that it is *my teeny baby*! actually, i'm concerned, but not worried. it really isn't a big surgery or a big risk, but still... sometimes, though, fixing a pda (patent ductus arteriosis, for those playing along at home) makes a *huge* difference and babies can come off the vents almost like magic and start breathing on their own. sometimes that doesn't happen. ya pays yer money and takes yer chance.
if nothing shows up on the echo, then no surgery and we hope that 3) feeding him (which will start a week after his normal tummy xray, which will be about wednesday) and slowly getting him off the iv nutrition might be the key.
until then, they are increasing his lasix (fluid medicine, which makes him pee some of it off) to twice a day. he's slowly been needing more oxygen over the last week or so, and i think he's been retaining that long, just not showing it by being puffy, so i hope that will make a big difference in his needs.
so, in summary, he's having an obstacle that might need a little surgical procedure. at the least, it needs close watching.
you know i'll keep y'all informed!