MRI Results

Dr. George called about 15 minutes ago to share his interpretation of Miller's MRI results. Here's what he found:

1. There is no sign of a structural abnormality.

2. There is no sign of a tumor.

3. He also said there was no sign of Hydrocephalus and the chance of him developing that condition was small.

It is still not clear what caused the bleed in the first place (probably just plain prematurity), but the significant news is that we've been able to rule out the issues that would require some form of intervention (spinal tap, shunt, surgery, etc).

For now, Dr. George says Miller will follow a normal clinical path for a baby his size. We'll continue the Friday ultrasounds (like many of the babies). There's currently no cause to prescribe another MRI. In Dr. George's words, "it looks like a one shot deal". There was a bleed, and of course, some level of injury. But we're hoping that Miller can put it behind him and go forward from here.

Should something unexpected develop, we should be able to see it on the ultrasound and Dr. George will address it at that time. But for now, Miller's job is to keep eating, growing, breathing, and kangarooing.

What the future holds for Miller is still uncertain, and will be for many, many months. As mentioned above, we cannot undo the fact that there was indeed a grade IV bleed and the possible challenges that are associated with it. What we do know is that much of Miller's progress depends on his care, and we have that covered. Much of it will depend on his will (all Peoples kids are stubborn as an ox) and we think we have that covered. The rest of it will depend on faith and prayer. With all of of your help, we believe we have that covered too.

Continued thanks to each and every one of you for keeping Miller in your daily prayers, adding him to your church prayer lists, and for checking in on his parents!

Love to you all,

Danny & Stephanie

Test Updates

Miller actually had 2 tests today. They didn't tell us until this morning that he'd have an eye test, but he did. When mom arrived this afternoon his eyes were dilated and he was a little restless and cranky. His eye test was performed around 2:30. It was a test for ROP which stands for Retinopathy of Prematurity (ROP occurs when abnormal blood vessels grow and spread throughout the retina, the tissue that lines the back of the eye. These abnormal blood vessels are fragile and can leak, scarring the retina and pulling it out of position. This causes a retinal detachment. Retinal detachment is the main cause of visual impairment and blindness in ROP). You can see a more detailed description of ROP & its causes and treatments here: http://www.nei.nih.gov/health/rop/index.asp#2 . Fortunately, Miller passed his test with flying colors. He will have another ROP test before he goes home which is standard procedure in the NICU.

He also had his MRI this afternoon around 5:30 pm. Apparently, he was a bit of a rascal so he ended up with a 2nd dose of the sedative, Chloral Hydrate. He did not need to be reintubated though, which is great. We should get the results from Dr. George sometime tomorrow (Saturday).

With all of the excitement, Miller was totally pooped. As a result, we did not kangaroo tonight so he could rest up. He should be bright-eyed and bushy-tailed tomorrow morning. We are hoping, praying, and crossing our fingers and toes that the results are positive.

We'll update the blog when we have our results. Hope you all have a nice weekend!

Love,

Danny & Stephanie

Fridays are test days and we have a new one this morning. The Neurosurgeon, Dr. George, requested an MRI on Miller's head. We discussed this a couple of weeks ago and Dr. George agreed to hold off on the MRI until Miller got a little bigger. As of today, he weighs a whopping 3lbs, 7oz! At this point, everyone seems to agree that the risks associated with the scan are minimal. Miller's bleed was very unique and Dr. George wants to know why.

Our biggest concern is how well Miller will tolerate all of the ancillary procedures that accompany an MRI on such a small child. It's not just the scan. First, they'll have to move him to the MRI facility (fortunately, there's one in Seton). He'll be given a mild sedative and will hopefully stay on his nasal cannula. Sometimes, these little guys need to be reintubated (breathing tube). We don't want that because it increases his risk for a respiratory infection. In fact, in our negotiations (that's what it felt like), we agreed to call off the scan if Miller had any adverse reactions to the sedative.

The other issue was risk vs benefit. What exactly do we hope to accomplish with this scan? Will it change his immediate treatment?
Dr. George hopes to learn the following:

1. What caused the bleed in the first place? Was it just prematurity or is there some structural abnormality?
2. Is there a chance it could happen again?
3. Is there any cause for immediate intervention?

The regular Friday ultrasounds have not indicated a situation where Miller needs a procedure. The ultrasounds can tell us what is there, but they can't tell us how it got there. This is what Dr. George hopes to learn so we know if we need to fix something.

The MRI will take place this morning but the results probably won't be available until tomorrow or Monday. It should be noted that every baby in the NICU gets an MRI before he goes home, so this is a very normal procedure.

As for Miller, he's doing great. He's very alert and active. He loves his Kangaroo time and the pacifier game he plays with his daddy when he's in the isolette. This might sound a bit surprising, but last night Miller nursed. It's the truth. Just before we gave him his normal feeding through the tube, Mom whipped out and let him have a go at it. We've been practicing with him for a few days and trying to encourage his "rooting" instinct with the pacifier. Last night Miller latched on for an appetizer. It was very brief, maybe a total of 20 minutes. When he finished, the nurse used a syringe to extract the milk he consumed from his tummy and measure it. He got about 2 cc's. 'Atta boy!

Please keep the prayers coming, and thank you all for the continuous support.

Love,
Danny & Stephanie

Miller had a great Memorial Day weekend!

We don't want to jinx anything, but it looks like he's turning a corner on this whole breathing thing. He's still on the CPAP, but has been doing great since they reduced his air pressure a couple of days ago. He's been maxing out on his oxygen saturation all weekend too. Basically this means that he's breathing, and he's breathing deeply.

We didn't spend Memorial Day at the lake this year. However, we did get to give the Miller Bear a bath (video posted above) and it was the perfect way to spend our afternoon. It was our first time, so we were a little nervous but as with all things, practice makes perfect.

Dad got to kangaroo twice this weekend, so momma played paparazzi. She caught Miller showing his team spirit for the home team. Must be because his uncle Nick came by to visit him today (Nick is a senior at UT and plays baseball for the Horns). Looks like we have a Little Longhorn!

Miller's weight gain seems to be back on track. As of yesterday he weighed 3lbs., 4oz. Or in Beth's (his day primary nurse) words, he's huge! To ensure that his gain is steady, his nurses have asked that momma bring in only hindmilk for now-which they are continuing to fortify with a few extra calories as well. Hindmilk has the highest concentration of fat and is released after several minutes of nursing/pumping.

We hope you all had a nice relaxing holiday weekend. Thanks for checking in on our little guy! We cannot thank you all enough for your ongoing support and prayers. Keep those prayers coming-they are so powerful!

Love,

Danny & Stephanie

Miller was big enough for his first chest x-ray today. A byproduct of the oxygen delivered by the CPAP and cannula is moisture. As we all know, moisture is a breeding ground for bacteria and we have to keep a close eye on Miller's lungs. Fortunately, his chest x-ray results gave no indication of abnormality and the doctors have reduced his air pressure. This means he will work a little harder to get his breaths and oxygenate his blood, but it's important for his development.

He also had his regular cranial ultrasound on Friday. We still haven't heard anything from the doctors all day and assume it is because there is nothing significant to report. We've left instructions with the NICU that all meaningful ultrasound results are to be delivered by Dr. George, the pediatric neurosurgeon. We have yet to speak to Dr. George, so the scan must not have revealed anything that we need to be immediately concerned about.

For right now, Miller is doing everything we are asking him to do. He's tolerating his meals, reacting to stimulation, kangarooing like a champ, and breathing normally for this stage of his development. There are a million things that could trip him up, but we're hopeful that he continues his progress.

There was one thing that caught our attention this morning. An article in the Statesman related a story about a nurse in the Seton mother-baby unit that possibly contracted whooping cough. She works on the 2nd floor ( the NICU is on 8 ) and the article identified the time period between May 5th and last Friday as the time when she could have interacted with newborns and their parents. She's not a NICU nurse, but it's possible she's been in contact with NICU nurses. As a result, there are about 7 second floor nurses on leave (and on antibiotics just in case). It's a little scary, but the NICU is confident that the 8th floor was not compromised.
It's something we'll continue to monitor.

Miller got some daddy time this morning. He had a relaxing snooze on his daddy's chest. Mom likes to sing, but Dad can't carry a tune in a bucket. So, Dad just likes to tell him stories about his great grampaw Lee (his namesake). Miller learned about all of the vegetables in his great grampaw's gardens today. Who knows...Miller may grow up with a green thumb, too!

As always, thanks so much for all of your thoughts and prayers.

Love,
Danny & Stephanie