Saturday, March 03, 2007

He's Red, He's Curly...

Thanks to Amy Toth for this delightful homage. = )

I am working on the burly part...

More about Fish Camp, the biggest, baddest and most successful student-led college orientation program there is.

Sunday, February 25, 2007

What's the deal with Hyberbilirubinemia?

[Please note, I am not a doctor and this is not intended to be medical advice.]

Several of you have asked for more information about the health issues that Noah has dealt with since his birth a week ago. Since his mom and I are first-class worriers, we've taken the time to study up on hyperbilirubinemia, the condition that Noah's doctors believe he has. Hyperbilirubinemia is a condition that is characterized by early jaundice in newborns, but is confirmed by blood test.

Many babies develop jaundice within a couple of days after birth. This is a result of their immature liver trying to recycle red blood cells. Bilirubin is part of the blood that if not flushed out of the body properly can cause jaundice (it also is responsible for that yellow color in bruises and the brown color of stool). In a very few number of cases, babies with very high bilirubin levels can end up with deposits in the brain that can cause mental deficits. Noah's doctors responded aggressively to an early high reading with phototherapy, which can help break down the bilirubin and get it to pass out of the body. In the first couple of days, while the baby's stool is transitioning from the meconium stool to the breastmilk (or formula, I suppose) stool, the color is dark green and looks like it has little black seeds in it. The appearance of these seeds in the diaper means the body is getting rid of the excess bilirubin.

Noah's levels have been coming down from a high of 16 at about two days after birth to just over 14 this afternoon. The older the baby gets, the higher the level they can tolerate, though eventually the levels settle somewhere around 1 for adults.

For those interested, a couple links to read up on hyperbilirubinemia and breastmilk jaundice:

American Association of Pediatrics - Mangement of Hyperbilirubinemia

Cost Consideration in Hyperbilirubinemia Treatment (requires registration)

Breastmilk Jaundice

A Very Merry-Unbirthday...

This particular unbirthday finds Noah at one week old (well later tonight it does). An unbirthday is not the same as a half-birthday, which Becca always manages to remember. Noah is continuing to adapt to home life despite daily visits to the doctor's office (and/or phlebotomist's office) for follow-up bilirubin tests.

This post will have a side-rant now to talk for a second about quality of healthcare. I am a supporter of Dennis Kucinich's Healthcare for All plan, and think that socialized medicine is the only way that we're going to correct the incredible disparity between rich and poor peaople's healthcare access in our nation. One issue that is being solved is the doctor shortage, and while med school enrollment is going up, we need to also address patient care expectations. In the last week we've had a doctor tell us that our baby is starving (he isn't and wasn't) and have had pescriptions for bilirubin management made without consulting--much less being familiar with--Noah's patient history. I explained to the healthcare worker that was relaying this recommendation that I understood that they talk to many patients every day with the same problem, but that this was our first time to deal with it. She agreed and thanked me for correcting her when I said that it was irresponsible to make reccomendations without knowing the context of our case. Our goals for building a sustainable, openly accessible healthcare system, I think, depends on training enough capable doctors to know their patients personally.

Oh, and we need an ethics examination prior to medical training. Our national "Burger King Mentality" has resulted in a generation of doctors (and I realize this is a broad brush; take some responsibility for the integrity of your profession...physician, heal thyself) that are more willing to do surgery than insist on lifestyle change.

[/end rant]

Poor bedside manner aside, we're doing well given where we are at with the jaundice. We had a wonderful consultant come out yesterday to talk to us about making sure that Noah is getting enough food. Why can't they all be like this?

So, now for some photos...

Our phototherapy has gone from Tron/Buckaroo Banzai sci-fi


Aeon Flux

Perspective...Grandparents for the first time...
grandparents for the eight time...

Thanks to all who have called, written, and visited. Hope to see you again soon!