Infection Ups and Downs

After successful surgery on Friday, Madeleine has been fighting the ups and downs of infection. Its hard to understand how serious the infection is because, to a certain extent, the Doctors expected Madeleine to get worse after surgery. We knew going in that infection was an issue as Madeleine was fighting the infection for two days prior to surgery and the goal of the surgery was to reattach the ostomy, thereby eliminating the likely cause of infection. Since the surgeons disturbed the infected area around the ostomy, it makes sense that Madeleine got sicker following the surgery and that is exactly what has happened. On Saturday morning, Madeleine was very sick-- her white blood count was high (60), she was fighting an infection, and she was also struggling to maintain her blood pressure. To address the blood pressure, the doctors increased her level of dopamine to 20 (the highest level possible) and also administered epinephrine (pure adrenaline). The epinephrine was started at .1 and was increased to .23 (the highest level allowed is 1.0). In addition to the blood pressure, the doctors also used tylenol to decrease Madeleine's temperature.

Fortunately, beginning on Saturday evening, Madeleine began to stabilize allowing the nurses to wean the dopamine and epinephrine. Since early Sunday morning, Madeleine has been completely free of epinephrine and her levels of dopamine have been lowered and is hovering around 11-- she's been as low as 9 and had one spike on Sunday night. The spike occurred last night and the nurses increased her level to 20 and were prepared to administer epinephrine when Madeleine stabilized. Its not entirely clear what caused this drop in blood pressure but shortly beforehand, Madeleine had an episode with the ventilator where she couldn't breathe. The nurses immediately addressed the situation and realized that a piece of mucus was blocking the air tube. The nurses cleared the tube and Madeleine resumed normal breathing. We can't be certain, but it is possible that the trauma caused from the breathing incident led to the drop in blood pressure. In terms of the infection, labs on Madeleine's blood show that her white blood cell count is still elevated but it has decreased to a 39 today-- it was 40 on Sunday after being in the 60s on Saturday.

I guess I'm just rambling a bit, trying to provide a sense of what is going on so let me summarize where we stand. First, Madeleine is stable but is struggling with an infection post-surgery. The surgery itself was a success but given her struggles with infection, Madeleine is reliant on blood pressure medicine to keep her stable. In the next few days, the Doctors will continue to fight her infection while hoping to slowly wean her off the blood pressure medicine and from the ventilator. Kirsten and I are a little scared but mostly, frustrated with the ups and downs of the NICU. We know that progress in the NICU is typically followed by a few steps back... we're just hopeful that Madeleine gets over the infection sooner rather than later.

That's all for now. We'll provide further updates as they come in. Right now, we don't have a time frame for recovery-- the doctors are content to watch Madeleine and let her body tell them when she is ready to be weaned.

Brent and Kirsten

PS-- Thanks again for everyone's support. We've raised yet again our goal for the March-- we've now raised $2,475! We're amazed by everyone's generosity and look forward to walking this coming Sunday. Let us know if you're in the area and want to walk with us.