Yesterday David started a new round of a medicine called indomethacin. He was treated with indomethacin immediately after birth. It’s used for neural protection. It’s also used to help with something called PDA (patent ductus arteriosus, (not public display of affection)), which is a common heart problem in premature babies. A valve is open in his heart that shouldn’t be open anymore. If he were still in the womb it would and should be open, but since he’s out it needs to be closed. When full term babies are born the first deep breath they take in has enough force to close this valve. David did not come out taking deep breaths of air and therefore this valve never closed.
His treatment ends this morning at 11am. He has been NPO the whole time (no idea what NPO stands for) but I do know what it means: no food during treatment. That means he hasn’t eaten since Wednesday night. He looks hungry to me. They will do another echo (heart ultrasound) this afternoon to determine whether the indomethacin worked.
They detected David’s open PDA by first hearing a murmur on Wednesday. As of yesterday, David’s murmur was significantly louder. At first I thought this was a bad thing. Doctor Suresh, who uses analogies to explain medical terms and procedures, said that if the murmur gets louder then the open PDA is most likely closing. He used the analogy of a wide river and a small brook. You do not hear the Connecticut river flowing because there is such a large passageway through which the water flows. You do, however, hear the babbling brook in your backyard, because the passage is small and therefore more turbulant. A louder murmur is potentially a result of a smaller passageway, a closing PDA.
His PDA could also have been the reason he started to struggle to breathe well on his own. As of last night he had been weaned off the pressure on his ventilator settings. If he can stay stable at room air (the oxygen level we breathe) with low breaths-per-minute he will come off the ventilator and be put back on his CPAP. We will find out all these results today.
J & G & D