Little Elise's PDA is still moderate; unchanged by the 2nd round of medicine. We just thought for sure that since it went from large to moderate with NO medicine, that with a little medicine, it would go from moderate to small, or even closed in no time. Unfortunately, we didn't get what we had wished for. I know all of you were wishing for it as well.
After speaking with Dr. Whitman, Elise's neonatologist, and hearing that she was really on the fence as to how to move forward, G and I had a private talk between the two of us. As much as we hate to send our 27 1/2 week baby into surgery, we decided there were too many risks if we wait it out. (i.e. Elise cannot get my milk until this PDA is resolved and we absolutely want to move forward with nutrition. Did she move back to the oscillator from the conv. ventilator partly due to the PDA? No one knows for sure, but one can assume so. She is at higher risks for more pulmonary issues down the road if we leave this PDA and "hope" it closes). After we came to the conclusion that we needed the surgery, we ask Dr. Whitman to come back and see us again. She listened to everything G had to say and couldn't agree more. (G spoke so wonderfully as I sat with big Momma tears in my eyes. Glad I don't have to do the talking!) Dr. Whitman said she talked to other neonatologists on staff while G and I talked privately and all the neonatologists leaned towards the surgery in Elise's case.
Dr. Whitman was telling us that a year ago PDAs were cut and dry...all preemies with PDAs went for surgery. In the last year, literature has come out to say a doctor can go either way with a moderate PDA. The large PDAs you automatically go to surgery and the small PDAs you usually sit on until the preemie is older, if not one year old (wow!- I actually wouldn't want one year of worry). Of course the moderate sized PDAs are the fence-riders.
Here are the pros to surgery:
1). The PDA is closed for good and we can move forward (weaning off vents, feedings, holdings, etc).
2). Feedings will begin as soon as she is stable from the surgery
3). The surgery is done bed-side and usually takes 15 minutes...a small cut on her side and the PDA takes 1-2 stitches. Tiny!
4). The surgeon has done a thousand of these surgeries and many times on much sicker and smaller babies
5). Elise is in great condition right now...no BP meds, on room air for oxygen, never drops her sats when she is being changed, etc.
Of course with any surgery, there are risks. However, we are confident that our little tiger can sail through. Some kiddos come out and need a little boost with BP meds and higher oscillator settings. This is just for a few days. Some kiddos don't need anything. We are hoping our tiger is one of those "sail through" kiddos. However, if she isn't...she can go back on BP meds (remember when she was maxed out on 2 meds and weaned herself completely off?) She is currently on the lowest settings for the oscillator, so she certainly can be "turned up" if need be.
We will hear from Dr. Abraham, the surgeon, tomorrow as to when he can fit Elise into his schedule. The nurses think Tuesday or Wednesday morning. He likes to do his surgeries first thing of a morning and always meets one-on-one with the family beforehand. Dr. Abraham is on a commercial that is aired in Indianapolis about St. Vincent's critical team of doctors. In a weird way, I feel like I already know him!
Now for the best news of the day?? Elise's nurse yesterday caught her with her eyes opened AND had the camera ready. Even though she was squinting, we LOVED seeing her beautiful eyes when we got to the NICU today! Daddy caught one eye open during 2:00 hands on time today, but she is a quickie and sure doesn't like the paparazzi :)
Have fun with this: comment to this blog what you think Elise thought when she first opened her eyes...
Here's our little tiger on her new frog fleece! Mommy was putting her temperature probe back in to make sure little lady doesn't get too cold in her jungle. It also looks like Daddy didn't get the diaper quite all the way up..she's a low-rider :)
We thank you for all your prayers...especially as we head into our first (and hopefully last) surgery this week.
Always worried, but confident in our tiger...
G & J & E