Prayers needed

[HouseofWool]

My sister (a SAHM) had her 4th child at 11:40 pm on Good Friday. Tate is beautiful, but Saturday afternoon he was having trouble nursing. When the ped came through for his routine exam, they discovered that Tate has a membrane closing off his left nostril (the membrane is up in the pharynx (sp)). In the early afternoon he was admitted to the NICU so his O2 sat could be monitored. They discovered that anytime his head fell forward, it dropped. It also dropped if he was laying looking to his right.

They told my sister that he couldn't be discharged until she and her husband (a pharmacist at the hospital where he was born) learned infant CPR. My mom told my sister to insist that she won't take him home unless Tate has a pulse-ox monitor.

At first they were saying that they would surgically remove the membrane, but now they are saying that any surgery would be too rough on the little guy (he was full term, 7lbs 6oz and 20-1/2").

Any insight from either ENT or peds would be greatly appreciated. Of course when I told DH about it last night, he said that they should insist on taking the baby to the Children's Hospital where he is doing medical school. It is a great hospital, but it is nearly 4 hours away.

I know nothing about that specific issue, but I do know that if I had a newborn with anything unusual, I'd get him to the closest teaching hospital ASAP.

Best wishes for little Tate.

[Deebs]

Are there any hospitals in the area that see a greater number of peds and at a higher acuity? There are some great hospitals that see tons of peds without being children's hospitals, but short of that, I would want him transfered to a peds hospital.

[GreyhoundsRUs]

I'll be keeping everyone in my prayers.

[Michele]

You all will be in my thoughts. FWIW our NICU gave an infant CPR class that they recommended all preemie moms take. It was kind of a joke. Basically chest compressions are the most important and in infants you should attempt CPR before calling 911 (unless a second person is available to call while you resuscitate). At least that's what they taught me 2 years ago. The rest was all common sense. I'd also ask for a monitor. There is a regular babymonitor by AngelCare that has a plate for under the mattress with an apnea alarm. We have it and used it with Daegan. More often though I'd forget tobturn it off when I pulled him into our bed and the alarm would go off.

[HouseofWool]

My family is about an hour from Mayo which is affiliated with their local hospital, but Mayo itself does not have a neonatology department. As for other local hospitals, there are 2 hospitals in my hometown. The hospital where he was born does have a NICU with one neonatologist, but it is Easter and I am sure he is not in today. The other does appear to have several neonatologists on staff.

The closest children's hospital (or teaching hospital that emphasises in peds) is in the Twin Cities.

I know my sister and BIL are both exhausted and worried to death so I doubt either of them are thinking clearly. I don't know what to suggest to them.

[DCJenn]

Sending positive vibes to you and yours.

I'm sure that that the neonatologist has been at the minimum consulted. That said, I'd see how they felt about the bigger children's hospital- it may be that they'll end up there anyway but it can't hurt to ask.

Good luck.

Jenn

My MIL was in a Mayo-affiliated hospital in Wisc for a while and they seem to rely almost entirely on their own staff (she ended up transferring to Mayo because the surgeon she needed was on vacation). That is only one instance and not peds, of course.

Your sister and her family are in our thoughts. Please let us know what happens.

[GrayMatterWife]

I will pray for the family. My thoughts are with all of you.

[Phoebe]

Are there any hospitals in the area that see a greater number of peds and at a higher acuity? There are some great hospitals that see tons of peds without being children's hospitals, but short of that, I would want him transfered to a peds hospital.

ITA... My husband agreed with a children's hospital and said they operate on children much smaller all the time. A children's hospital would have people who could do the surgery.

[Meenah]

Definitely the closest Children's Hospital.

[v-girl]

I'll be praying for him. I agree with the others on getting him to the peds hospital.

[Deebs]

Kris,
Is there any update? I can't imagine having three other kids at home and trying to figure out what is the best thing to do. I'm hoping for your family's sake that now that it's Monday they may get more of the help they're looking for!

[HouseofWool]

Thanks for everyone's input.

The docs put the little guy on a nasal spray (I keep thinking nasonex, but that is not the right name) because they were thinking that it wasn't a membrane after all, but excessive swelling. Apparently, he was suctioned pretty vigorously because he had passed meconium before birth.

Yesterday he was taking a bottle well and his sats were staying up! They will be doing an EKG and something else to rule out an aortic fling (essentially the aorta passing too close to the trachea and constricting it).

If he hadn't been showing such strong signs of improvement, I would have pushed much harder to have him moved to Minneapolis.

[peggyfromwastate]

My sister (a SAHM) had her 4th child at 11:40 pm on Good Friday. Tate is beautiful, but Saturday afternoon he was having trouble nursing. When the ped came through for his routine exam, they discovered that Tate has a membrane closing off his left nostril (the membrane is up in the pharynx (sp)). In the early afternoon he was admitted to the NICU so his O2 sat could be monitored. They discovered that anytime his head fell forward, it dropped. It also dropped if he was laying looking to his right.

They told my sister that he couldn't be discharged until she and her husband (a pharmacist at the hospital where he was born) learned infant CPR. My mom told my sister to insist that she won't take him home unless Tate has a pulse-ox monitor.

At first they were saying that they would surgically remove the membrane, but now they are saying that any surgery would be too rough on the little guy (he was full term, 7lbs 6oz and 20-1/2").

Any insight from either ENT or peds would be greatly appreciated. Of course when I told DH about it last night, he said that they should insist on taking the baby to the Children's Hospital where he is doing medical school. It is a great hospital, but it is nearly 4 hours away.

Scary... I'll ask DH when he gets home, but I *definitely* wouldn't bring home the baby without the monitor at least. I would also go to the Children't hospital. He should get treated for that, and if he has no other health problems I know ENTs have worked on babies smaller than he is...

4 hours is really worth it, IMO. Even if he's not *authorized* for care at the Children's hospital, I'm betting that he could go into the ER, the parents could explain the problem, and at least they'd get a referral to the ped. ENT. Make sure to ask to consult with the 2nd tier ENT-- so not just the resident, but the fellow or attending, too.