So Rachael was surprised late last night when she called the NICU to hear that an order had been written for Jimmie to have an MRI today. She went in this morning and tried to get answers as to why. No one could tell her- the NP and the nurses didn’t know and the Doctor who wrote the order wasn’t there. All preemies get an MRI before they go home, but Jimmie is not even close to taking all of his feeds by mouth- which has to happen before he goes home. Rachael had asked if he could receive an MRI early and they had told her- no it is better to have one closer to 40 weeks gestation. At that time they can better visualize everything they need to. So hopefully tomorrow she’ll talk to the Doctor that ordered it and find out why he ordered it so early. She was a bit “put out” about it. We thought he was supposed to have his repeat eye exam today, but no one had written an order for that. When Rachael asked about it they put him on the schedule for that next Wednesday.
The good news is his MRI showed a healthy brain! Those CPC’s (Choroids Plexus Cysts) they saw with his last head ultrasound were gone and he shows no signs of PVL- (Periventricular leukomalacia). This is the most common type of brain injury in premature babies. It is often the cause of cerebral palsy (CP), intellectual impairment, or visual disturbances.
I read a study of which babies are most likely to have PVL. Here is what I read, “Periventricular leukomalacia (PVL) occurs most commonly in premature infants born at less than 32 weeks' gestation (Jimmie was born in the 24th week.) who have a birth weight of less than 1500 g. (Jimmie was 690 grams) Many of these infants have a history of maternal chorioamnionitis. (That’s the infection that Rach had that he fought off after his birth.) So yeah-- Jimmie was faced with all three of those risk factors! And praise God he has overcome them! Go Jimmie go! (-:
The only thing noted was there was a very small amount of dried blood on the left side of his brain. The tech asked if maybe he had a grade 1 brain bleed, but Jimmie hasn’t. So the tech and the NP that talked to Rachael said this was not of any significance at all and was absolutely nothing to worry about. Jimmie had not had an ultrasound on his head since before his “crash and bleed” week. Believe me it crossed our minds that week that maybe he could be bleeding elsewhere as well. I still think that fiasco was connected to his blood transfusion. Anyway-- Rachael didn’t think it was enough to even classify it , but she will be talking to the Doctor tomorrow about it. We have been assured that it’s nothing to be concerned about.
They also visualized his nasal passages and did not see anything abnormal which is great news as well. There was uncertainty (during his crash and bleed) or worries (at least by me) that he may have had a tumor or cyst that bled, or a congenital abnormality of some sort. So hearing that everything looks healthy and normal is a relief.
Jimmie did not have to be sedated for the MRI. They fed him and then put this special vest on him that helped hold him really still and then they hoped he'd just fall asleep. It went well . . .
He couldn’t have his oxygen hood in the MRI so they cut the prongs of a nasal cannula and put that on him for oxygen.
And he took his first ride out of the NICU. He went down the elevator and through a connecting hallway to the medical building next to the hospital. So his first big ride. (-:
After Rachael talks to the Doctor tomorrow and asks all of the questions she has regarding this whole thing I’ll update you on those details.
Rachael is taking matters into her own hands and going to try to come up with a solution to try and help Jimmie’s feeding tube from slipping out of place. The tape the NICU is using does not work well when it gets wet. With Jimmie trying to feed by mouth he dribbles milk on to that tape on his chin and that causes his feeding tube to come loose. At this point most babies have an NG tube. (a feeding tube that goes in the nose and down into the stomach) Rachael is still very leery about putting anything in his nose, so she has a few ideas for different kinds of tape etc.. that may help this problem.
Over all just pray for Rachael that she would continue to have wisdom and grace advocating for Jimmie. It’s not always easy, often quite challenging and frustrating.
And keep praying for Jimmie! For his health, his safety and that he would get big and strong enough to eat by mouth.