Thursday, October 14, 2010

Liver lesson and more!

First of all... update!

The kids had an appointment with Dr. Escobar today. He is a neonatologist that now sees preemies until they are 3. A few things. Owen needs to go back on Neosure (preemie formula). Not for the calories... oh no, not for the calories, but for the DHA that has proven to improve IQ and memory of the preemie population. Owen will be mowing the yard by next week!!! No more hunting for Similac Advance. They are ahead of their adjusted age (6 weeks old.. because they were 10 weeks early), but a little behind of their real age. This was ahead of what he expected for them. They tend to turn their head to the right a lot.... they always have. We are to try to feed them, change them, and play with them on the left side more so they will develop those muscles more. He changed the kids from Zantac to Prilosec. He is going to go over to the NICU to familiarize himself with Grey, and we will see him with Grey, and then again in Feb for Lilly and Owen. Oh, they can also stop their STUPID vitamin that is hellacious to give to them! YAY! They both have umbilical hernias... but this should get better on their own as their muscles grow together more.

On too Grey and the liver lesson.

Grey had a liver ultrasound today. It again was normal. They were able to visualize more of what they wanted to today. All of that was very positive. TPN (iv nutrition) is now OFF!!!! YAY!!!! He is on 100% formula, and 5 cc every 3 hours away from his goal feeds which he will be on tomorrow! He can also start to try bottle feeding if he is rooting, and wanting his pacifier! THANK YOU GOD!!!!!!

The liver is a complex organ, that has over 500 functions! (having to pull out of my brain my transplant education information)

Main functions of the liver

-makes and stores protein

-"cleans" blood

-drains bile to intestine(bile breaks down fats in the small intestine so it can be absorbed there)

-controls a lot of clotting factors

-breaks down fats

-stores cholesterol

So, when the liver fails..... all of that fails as well.

One main function of the liver is draining the bile. Biliary Atresia is usually the lack of common bile duct, or the blunting of the common bile duct which does not allow it to drain the bile from the liver into the small intestine. The bile then backs up into the liver and scars the liver, a lot of times it is an irreversable scarring that causes cirrhosis. Cirrhosis of the liver is end stage fibrosis (scarring at its worse). There are 4 stages of scarring in the liver F1-F4. Fibrosis 1 thru fibrosis 4. Fibrosis 4 is cirrhosis. Anything less than Fibrosis 4 or cirrhosis will heal. The liver is very good at healing itself if given the chance, and if the circumstances that are causing the fibrosis changes. Just a tid bit of information: If you transplant a half liver into someone (which some centers do), it will be the size and functionality of a whole liver in 2 months after transplantation. It's an amazing organ.

Grey's ultrasound today showed that his common bile duct was visualized, and was not dialated... which is super. It looked normal. The hida scan will show more of the bile ducts IN the liver, or intrahepatic duct structure. So again, going through the lack of symptoms of Grey...
Clotting fine, no fluid in his abdomen (ascites) from the lack of production and storage of protein, spleen (usually large in people with liver failure because of the overload of fluid from the liver), platelets good.

I am happy with where we are right now. He still has a ways to go with his liver, it will take a while for his color to return, and the complete function of his liver to return. All of which will just take time and healing. Still praying for normal testing on Monday!

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