He's up to 5lbs 6.4oz as of last night. Getting bigger. But he's still so small with really long legs, arms, (fingers) and feet. Geez! I can only imagine what size he's going to be in when he's like 5! He has developed a PDA (Patent Ductus Arteriosus) It's basically a hole between the aorta and pulmonary valve that has either not closed or was closed initially closed but opened back up. They have done an echocardiogram Monday and another one today to see if it's getting better, worse and no change. They aren't sure what they are going to do about it. Do they risk surgery and put him on the vent and pray he comes off of it easily? Do they leave it alone and pray it goes away on it's own? We just don't know. They are gathering as much info as they can but it's too hard to say. So worse case scenario, he could be looking at surgery. If he does have that surgery, they would probably do the other stuff as well (hernia and circumcision).
Here is an overview of what PDA is:
Normal ductus arteriosus closure
In the developing fetus, the ductus arteriosus (DA) is the vascular connection between the pulmonary artery and the aortic arch that allows most of the blood from the right ventricle to bypass the fetus' fluid-filled compressed lungs. During fetal development, this shunt protects the right ventricle from pumping against the high resistance in the lungs, which can lead to right ventricular failure if the DA closes in-utero.
When the newborn takes its first breath, the lungs open and pulmonary vascular resistance decreases. After birth, the lungs release bradykinin to constrict the smooth muscle wall of the DA and reduce bloodflow through the DA as it narrows and completely closes, usually within the first few weeks of life. In most newborn infants with a patent ductus arteriosus the blood flow is reversed from that of in utero flow, ie. the blood flow is from the higher pressure aorta to the now lower pressure pulmonary arteries.
In normal newborns, the DA is substantially closed within 12-24 hours after birth, and is completely sealed after three weeks. The fall in circulating maternal prostaglandins contributes to this. The residual scar tissue from the fibrotic remnants of DA, called the ligamentum arteriosum, remains in the normal adult heart.
Patent ductus arteriosus
Patent ductus arteriosus, or PDA, is a heart condition that is normal but reverses soon after birth. In a persistent PDA, there is an irregular transmission of blood between two of the most important arteries in close proximity to the heart. Although the ductus arteriosus normally seals off within a few days, in PDA, the newborn's ductus arteriosus does not close, but remains patent. PDA is common in infants with persistent respiratory problems such as hypoxia, and has a high occurrence in premature children. In hypoxic newborns, too little oxygen reaches the lungs to produce sufficient levels of bradykinin and subsequent closing of the DA. Premature children are more likely to be hypoxic and thus have PDA because of their underdeveloped heart and lungs.
A patent ductus arteriosus allows that portion of the oxygenated blood from the left heart to flow back to the lungs (following the pressure gradient from the higher pressure aorta to the pulmonary arteries). If this shunt amount is substantial, the infant becomes short of breath because there is not only the normal amount of unoxygenated blood that has returned from the body to go to the lungs but in addition there is the amount shunted through the PDA. The infant's work of breathing is increased, using up more calories and often interfering with feeding in infancy. This condition as a constellation of findings is called congestive heart failure.
In some cases, such as in transposition of the great vessels (the pulmonary artery and the aorta), a PDA may need to remain open. In this cardiovascular condition, the PDA is the only way that oxygenated blood can mix with deoxygenated blood. In these cases, prostaglandins are used to keep the patent ductus arteriosus open.
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Micah has his Belt Ceremony at Karate on Saturday. He tested for the next level and passed. So he's now......ummmmm.....well he's the next level. So he gets a patch for his belt and a headband. I'm so proud of him. He likes karate most of the time, but Antwan and I may not re-enroll him again right now because it's a fight to get him to go. I think he would probably go if he had a friend with him. With going back and forth to the hospital, it gets a little crazy but we are trying to make his life as normal as possible.
He is getting excited about moving. We just have to get the stuff moved in. The official "real move date" is next Saturday 1/31/09. But we will be moving stuff in between now and then. We officially have until the end of February to be out of the apt. No rush, but I would like my first night in the house to be Thursday, but I know that won't happen since Antwan doesn't plan on moving the beds until Saturday when the fellas come over to move.
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