Tuesday, Nov. 22 Evening

We went and saw Ezra this evening.  They had weaned some of the ventilator settings but had to make a slight increase in some of the settings again prior to us leaving.  They are still trying to figure out a good fluid balance for him so that they take enough off with dialysis but not too much that his blood pressure decreases and his heart rate increases.  Based on a lab draw they had done they decided to give a fluid bolus right before we left as well. The nephrologist and urologist are very happy with how the dialysis is going so far and we have been able to increase the amount of time the solution dwells (stays in the peritoneal cavity) up to 75 min and increase the amount to 25cc. When we first started it was at 20 min of 10cc each time.   They did a kidney and bladder u/s today and found that the bladder is more normal shape and there does not appear to be a rupture in the urinary tract system.  This is a miracle within itself.  For weeks leading up to the birth the ultrasounds showed that there was some form of rupture and many doctors that saw it all agreed. The left kidney has made itself pretty clear that it is what they call multi-cystic and will not be able to recover.  We are still praying and hoping that the right might have some function left.  Based on the u/s there is some kidney tissue there but it looks very echogenic on the u/s and therefore doesn't look like healthy tissue.  The nephrologist are hoping that it proves them wrong and that it will maybe start producing some urine in the next few weeks.  They took the tube that had drained the 400cc cyst last week out today since it didn't appear to be in the renal pelvis where they had hoped it was and is no longer draining anything. While doing the u/s they also found a clot at the end of the PICC line.  This is a  fairly big concern so we are praying for God's protecting hand on this situation.  They are doing an echocardiogram of the heart tomorrow to take a better look at it.  Dialysis makes everything a little more complicated so it's not quite as easy to start Ezra on a blood thinner to help with the clot so we continue to also pray for wisdom for the medical team. Ezra was running a low grade temp this afternoon so they did culture the peritoneal dialysis output and take blood to culture all of his lines just to check and make sure no infection is starting. We continue to pray that this is not the case. After  things became unstable last night they held the feedings down the orogastric tube going into his stomach. They then restarted it during the day but again had to stop since his GI tract doesn't seem to be moving things forward. It sounds silly but one of our prayers is that Ezra can have a bowel move to make sure everything is in well working order there.  We continue to be humbled and incredibly thankful for your continued support and prayers!

With love,
Jeff & Nicole