additional hurdles

It's been a busy few days jumping through hoops trying to get baby discharged from the hospital. Enrique is looking stronger everyday, with no respiratory problems and stable blood sugar, but he's not eating quite as much on his own as his doctor would like so leftovers are still being fed to him through a feeding tube. For several days the plan has been to let him go 24 hours eating as much as he'd like while checking what happens with his blood sugar, but this experiment has gotten delayed by the addition of an endocrinologist on the case. This new doctor was brought on board to see if there might be a hormonal trigger for the low blood sugar. Checking hormones requires a tremendous amount of blood work -- so much that there's been concern that a transfusion would be necessary. When the labs showed all hormones to be in the normal range, rather than stopping the troubled hormone hunt this latest doctor began to look deeper. Enrique's primary physician did talk her colleague out of continuing the excessive blood draws but was unable to talk him out of an MRI of the brain to check the size and shape of the pituitary gland, which was determined to be normal.

Having ruled out every other trigger, consensus from all the doctors on his case is that immaturity was the cause of the hypoglycemia. Nonetheless, his endocrinologist ordered a test to check his cortisol levels. This stim test, as it's known, involves administering medicine designed to provoke a fear response, after which they measure to see if cortisol, the stress hormone, rises in response to the negative stimulus. Not only was the test sure to delay his discharge from the NICU, it also seemed perfectly gratuitous (and somewhat cruel), given that, when pushed, the doctor admitted that Enrique's cortisol levels were, in fact, normal. We spent the last 24 hours working through the chain of command before finally getting everyone to agree that the test was not necessary, so that has now been dropped. Whew!

Enrique is currently in the process of trying to prove that he can eat enough to maintain his blood sugar high enough to keep anything scary from happening. Once that's through he should be ready to come home. Our wonderful nurse today even made sure to check as many things off the discharge list as possible to avoid any further hold-ups. Through it all, Enrique has been a total trooper. He has a wonderful disposition and is full of smiles. He's also growing fast, having already put on half a pound in ten days! Not bad for a little guy who started out at less than 4.5 lbs! Our fingers are crossed that he'll be home by Tuesday.