Sunday, July 19, 2009

Hospital update #3 (or so....)

We just spoke with a nephrologist fellow and have some more news. Summary: Loki's kidney is probably blocked at the same place (the ureteropelvic junction, or UPJ) as in January, although the severity of this problem remains unclear. And he is still not eating enough, and runs a risk of dehydration, although it remains unclear if this is related to the kidney. Either way, a surgery is pretty likely.

Details: Loki is eating a bit more, like 20 mL every 2 hours. This is still about one-third of what he needs. Everything points to esophagus irritation from reflux as the cause. His reflux medications were increased a few days ago, and these can take several weeks to take effect. Thus, unless he becomes dehydrated, we should just wait.

Several things may point to kidney failure. Loki's urine output is low, and it is dark. His kidney is moderately enlarged. His ureter is not enlarged, implying that any blockage is at the UPJ. His creatanine (a protein that the kidney should be removing from the blood) is slightly elevated, although this could be caused (at least partially) by the kidney blockage. His potassium (which should also be cleaned from the blood by the kidney) was high. However, his 1:00 AM blood sample was a bit clotted (dried), which would have falsely increased potassium. Loki has his blood drawn about two hours ago.

Thus, we are facing two problems, none of which require action immediately as of yet. The irritated esophagus should improve on its own with the medication kicking in. The kidney probably won't improve on its own. Instead, it will likely need a surgery or two.

I'll sleep in the hospital tonight, and Mom may get her first full night's sleep in nine months at a nearby friend/nurse's house.


Sarah Marcus said...

Lijn and Jess- Just reading all the news now. Wish we could be there for you guys and Loki-man. Miss you and sending positive thoughts your way.

Mascha said...

This is not good news, but as long as they can figure out what Loki needs and can do something about it, I guess, it's a reason for a positive attitude toward it all.

Mom, I really wish you are not too worried to actually sleep through for a few hours.

Lots of love,

marieke said...

We do cross our fingers all day. What to do with this constantly coming up reflux? And again a surgery on this little man. He is in good hands but I can imagine you are both with mixed feelings.
Hold on!! Big hug, marieke en martin XX

Richard en Maaike said...

Zet hem op jullie drietjes! Dit is weer een hobbel die genomen moet worden, maar wel een hobbel waar je vroeg bij bent. Hopelijk is ie daardoor wat platter. We denken aan jullie!

Kyra said...

lieve lijn en jess,

tjee wat een onaangename verrassing van jullie troublemaker. we hopen op een even veerkrachtig antwoord na dit gebeuren, het lijkt of loki het wel aan kan, maar voor jullie is het K.. en K....

sterkte, kussen en kusjes.


Anonymous said...

I'm sending lots of good thoughts and love your way. Loki's a strong little dude. Love, Courtney

Unknown said...

thank you for keeping us all up to date during all this. I truly hope that Kathalijn was able to actually SLEEP all night. And that Jesse and Loki got a few winks too!

About Loki Sky

Loki Sky is a special little man. He was a very early micropreemie, weighing only 610 grams (1 lb, 5 oz) after 24 weeks, 3 days gestation, born to an American Father and a Dutch Mother in Berkeley, California on October 18, 2008.

On January 11, 2009, while still in the hospital NICU, his one kidney stopped working. It was repaired after three surgeries. After spending time in three hospitals in three cities, Loki came home on February 17. He struggled with eating, and then stopped in July, leading to 8 days in the hospital, a failure-to-thrive diagnosis, and a NG feeding tube. On October 10, a minor surgery installed a G feeding tube. Another procedure replaced it with a new one, and then again with a Mic-Key button in Jan. 2010.

In August 2010, he and his parents moved to the Netherlands.

Read about his first name.
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