Saturday, December 10, 2011

Cold Air

Yesterday Kai met with a Pulmonologist at Stanford. He was referred by his pediatrician because Adam and I had noticed a little wheeze when he breaths. The doctor determined he does have a slight wheeze when he exhales which is most likely due to this cold air. Although he is not sick the doctor still wants to treat him with two different medications which he had while he was in the NICU. He prescribed him Pulmicort and Albuterol to inhale through a nebulizer. He wants Kai to start with Pulmicort 2 times a day for the next two months until the doctor sees him again.

He said because Kai was born with RDS (Respiratory Distress Syndrome) and also experienced extremely low amounts of amniotic fluid while in utereo, he will be at risk for Pulmonary Hypoplasia.Pulmonary Hypoplasia (P-Hyp) is the failure for lungs to develop in-utero. This often afflicts only one lung. Basically, the lungs do not have sufficient tissue and blood flow to adequately perform the oxygen/carbon dioxide exchange that the body requires to function. While in utero, Kai experienced prolonged oligohydramnios, where there has been long-term deficiency of amniotic fluid, the lack of development of kidneys, and premature rupture of the membranes. (The doctor also asked about his kidneys because that was a concern as well. A few days after Kai was discharged from the hospital we went back for a kidney ultrasound and never heard results from it. Well the doctor yesterday looked up the results since all of Kai's info is in Stanford's database and it said he had an "unremarkable" ultrasound with no areas of concern! Wow that's awesome! No wonder we never got a phone call.) 

Anyways, a definitive diagnosis of Pulmonary Hypoplasia can only be made through an autopsy, so diagnosis is really a strong suspicion and based on clinical presentation along with historical factors. Either way he still has Chronic Lung Disease which I was told is not so "chronic" but more acute meaning short lasting through his "baby years". It's sort of hard to explain. There are many malformations that can happen with lungs when born so premature simply because they were nowhere near fully developed. In closing the doctor basically told me to be aware of any other symptoms noticed that are respiratory related. Kai's lungs are the most important factor in his health as of right now. 

Additionally everything else is checking out great for Kai! This doctor whom we've never met before was just as impressed with his progress as all the other doctors have been since he's been home. His current weight is 14 lbs 10oz and 25 in at 7 months old. He falls into the 50th percentile for height and weight for a baby at his corrected age (almost 4 months) but of course below 5th percentile for his actual age. 

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