Decisions, Decisions

Clara is still having trouble breathing. She is not back on the ventilator but is working harder to breathe than the doctors would like. Early Tuesday morning the doctors increased the amount of pressure in her nasal cannula (commonly referred to as "flow") from 3.5 liters to 4 liters. Tuesday afternoon the doctors ordered a dose of lasix be administered to Clara over three days. Lasix is a diuretic which helps rid the body of excess fluid and will hopefully relieve some of the pressure around Clara's belly and lungs. She has been on it before, but only in conjunction with a blood transfusion, and only for one day. If the lasix doesn't work, we will have some serious decisions to make.

Clara is most likely suffering from some form of bronchopulmonary dysplasia ("BPD"). This is a severe type of chronic lung disease affecting babies who were on a ventilator for a long time or were born very prematurely. Clara was only on the ventilator for about 36 hours, but certainly qualifies as a preemie. Another possible cause of BPD is if a baby received an infection in utero. This is also likely in our circumstance considering Chris' water broke as a result of an infection, her c-section was infected internally, and Clara was born with a high white blood cell count. Other characteristics of BPD include a bluish skin color and shortness of breath, both of which (especially when compared to Wilson) could be used to describe Clara.

If the lasix doesn't increase her lung capacity, the doctors will probably want to give Clara a dose of steroids to reduce the inflammation in her lungs. This doesn't seem like such a big deal, but there are numerous studies detailing the developmental risks of giving postnatal steroids ("PNS") to babies. In one study, 40% of the babies who received PNS had major disabilities (including cerebral palsy and mental retardation). In another study, doctors warned against using steroids at any point after birth but recognized some instances where it was necessary.

We always try to stay upbeat but this is hard. We should be having a baby shower this Sunday, not consulting with doctors to decide the best way to let Clara live. While we believe we are given what we can handle, we are quickly becoming disenfranchised by the infiniteness of that proposition. Hopefully Clara will pull through on her own. If she needs help, we will use all available resources to make the best decision for her.

Oh yeah, Wilson would probably want us to mention that he is doing wonderfully.  He now has nurses requesting him and trading with other nurses to take care of him. And no, we're not kidding.