An uneventful night last night... and day 1 without ECMO

When we arrived this morning, we saw the surgeon walking into the NICU. He stopped and told us that Memphis did well last night. His oxygen numbers have been doing well, staying above the threshold they have set for him, and typically staying at the maximum. All of his blood gases have been excellent so far. They have been good enough that they have weaned his ventilator flow down slightly. Due to the threat of pulmonary hypertension reoccurring they will not wean his oxygen numbers down much until after he has recovered more completely. Dr. Anderson said that one of the more optimistic things that has come out of all of this is that after removing the dialysis machine, and fluids collecting (which is a typical response of being removed from dialysis), his lungs did very well and he was able to tolerate it very well.

They will place him back on dialysis later today. They will be taking a small amount of fluid from him, when they can. It is still important that he doesn't accrue a lot of fluid inside. They feel fairly confident that he will urinate on his own while on dialysis, if they allow his kidneys to rest a while longer.

We still have no word on when they will plan the repair survey for the hernia. We were told it can be done while on dialysis, but they probably will not do it until after he urinates on his own. The reason for this is that obviously the surgery will not fix his kidneys, and that is the bigger issue right now.

We will keep you updated.

Looking good without the pump

Here's a shot of Memphis modeling his new hair style (or lack of hair... he lost some when they took the tape off) without the pump in the background. You can see the dialysis access on his neck now rather than the big cannula. They had put him back on dialysis immediately after the procedure, but the machine has clotted up (which is normal) and he is off until the next morning.

Memphis is officially off of ECMO! He is doing fine, but they have him paralyzed at the moment. They say that the next few days can be tough.

Just a quick update to let everybody know.

Coming off of ECMO

Dr. Anderson stopped by this morning, and after looking at his numbers during the trial off, he has decided that he is stable enough to be taken off of ECMO. This will include takingnhim off of dialysis. When he removes the canulas, he will attempt to put a venous central line in the vein at that point. This may or may not work to give them access for dialysis. He will not be on dialysis for a couple of days in which we hope that he will urinate. If he does not, he will have to be put back on dialysis. In which, finding access is an issue. They can use a vein in his chest or groin, both of which are not quite as big as they would like them. Hopefully the venous central line will stick in there and they can use that if they do need to put him back on dialysis.

They are planning on pulling the canulas between eleven and two. It will be a couple of hour procedure.

Update from Dr. Anderson

Dr. Anderson, the surgeon involved mainly with Memphis' recovery, stopped by and gave us a little update about what they have planned with his trial off. They are all very hopeful due to his numbers being so low for the last day. He has ordered the ventilator to be turned up. All this means is that he would like Mempis to be supported by the ventilator rather than the ECMO pump. One major issue with all of this effort is the dialysis pump. When coming off of dialysis, they need the kidneys to take back over and start producing urine. The urologist is stating that she is not confident that his will start back. This is not to say that they will or will not, but they aren't that hopeful as of right now. The easy solution to this would normally be keep him on dialysis. Unfortunately, this is not that easy. The dialysis pump typically uses the right side jugular vein for access on babies. Due to being on ECMO, especially for the length of time he has been on it, this vein is inaccessible. They can put access on his left side, but then all of the main venous flow from his head would be blocked, which would cause issues with blood flow and hemorrhaging in the brain. Which all are not risks they seem to take lightly, I wouldn't either. The other solution on a healthy baby is to diurese through a port in the stomach. This would be acceptable if he didn't have the hernia. This increases fluid in the chest, so they can't do it. It really seems that if he doesn't start producing urine, they are at a stalemate between his body and the pump.

His pump as of right now is down to .18, gas is .3, and o2 is 80%. the ventilator setting has been set at a rate of 40(up from 20), the o2 concentration is 60% (up from 40%).

Let's hope for some great urine output!

New goals

Memphis' stats are all about the same that they have been for a few days now. Everything looks hopeful in the idea of getting him off of this machine. They started dopamine yesterday to bring up his blood pressure. Today they are starting two different medicines, steroids and lasixs. The steroids are to help him recover more and be stronger for the possible trial off. The lasixs are to help him urinate. They want him to have a little bit of urine output before they remove him from dialysis.

He gained 110 grams last night. So let's hope for some weight loss, and some pee.

Just a quick update

Memphis had a new PICC line put in today. It goes in at the base of his big toe on his left foot. Basically he has a tube that runs from his big toe into his heart now. That's crazy. Everything went fine and he is recovering now (which is basically no different than what he does the rest of the day.

He had his eyes (yep both of them) wide open when we got here after lunch. They were both so big and clear, compared to the usual fuzzy and sedated look he normally has. I think he may be trying to smile a little. It's hard to say with all of the tape around his mouth, but maybe he is.

That's it. Just a quick update.

A slight setback

Last evenings pump change has brought some repercussions with it. He has gained 530 grams. This may be from the difficulty they had yesterday at keeping the dialysis pump running. His blood pressure was floating around a mean in the twenties. They try to keep this number somewhere around a mean of fifty. This has been a long running issue with dialysis, and something that is expected, but I think they weren't expecting this much of an issue with it. They have increased his ECMO flow to .460 due to this. They can control his blood pressure somewhat through the pump, but this is counter productive. His x-ray has shown some more "whiting out", meaning that there is less oxygen in his lungs. This a typical response from the pump circuit change out. They are planning on starting him on steroids as of tomorrow. All of these things are the "tricks" that the doctor had ready for Memphis when he was taken off of ECMO.

With all of this, his co2 sweep is still at .3. This means that his body is ventilating the carbon dioxide somehow. Even if his lungs are less open.

This issues will be hopefully resolved within the day, and it will be just like taking a day off of recovery.

A new pump

His pump change went great. They didn't have to paralyze him for it, just gave him his normal pain medicine. They also changed out his dialysis machine. They turned up the oxygen on the ECMO pump, not because they had to, but because if he needed the extra support they wouldn't have to try and catch up with him.

A quick update

They are planning the pump changeout at around 2:00 pm. This is also the time that they close the NICU for shift change. Along with changing our circuit they are also changing our neighbor's circuit. Rarely do you see the NICU this congested with nurses.

Let's hope all goes well and I will keep you guys updated.

38 Days on ECMO

We haven't seen the doctor yet this morning, but he has come by the bedside we were told. He wants to make no changes as of yet concerning dialysis.

Dialysis is continuing to make Memphis' blood pressure drop. His blood pressure mean has been in the 20's and mid 30's last night and this morning. The nurse asked the doctor what he wanted to do to fix this and he said nothin for right now. There are several tricks such as giving Memphis steroids or dopamine to help the blood pressure go back up, but the doctor wants to save those tricks to help get him off of ECMO.

Memphis' x-ray is still showing air in the right lung. Yay!

The flow on the ECMO machine has been turned up to .270 to help bring the blood pressure up some. His gas number has been weaned to .27 and his %o2 is 50.4. These numbers along with all his good stats are all showing that Memphis is heading in the right direction. He lost 60 grams last night which puts him at 9 lbs 11 oz! He has come a long way from 14 pounds.

Still, even with all these good numbers there is alot the doctors are worried avout. Such as:

1. the ECMO pump being two weeks old. The machine has several blood clots in the tubes. If one of these clots gets loose and into the oxygenator it WILL shut the machine down. So why not just change the machine you might ask.

2. They are going to change his machine/curcuit but this runs the risk of loosing all of the great progress that he has made. It will definitely push him backwards 24 hours or so. He could loose the oxygen and all his numbers could go back up.

3. The canula in his artery is not stable any longer and is backing out. This is very serious and everyone is watching it very closely. Even if they change the machine and everything goes great, if the calula comes out the machine is useless.

4. He needs a central access once off ECMO so the nurses can give him the fluids he needs. He has a picc line but it has moved and is no longer in the greatest position. They can give him a new picc line somewhere else, but it's tricky to stick a patient that is on heparin.

So, what all this boils down to is we HAVE to come off the ECMO machine soon.

So Memphis is down 285 grams from last night. All of his numbers are pretty much the same this morning, but his blood pressure has been going down. This usually means that he is getting too dry. They have changed his dialysis machine not to take any extra fluids off. A pretty uneventful day as so far.

His afternoon and evening yesterday was very eventful. The svo2 number which indicates how much oxygen is in his blood after it flows throughout his body, has been going down. It needs to stay around 65 and last night it was only around 55. They had to increase his pump flow. It was around 250, they had to turn it up to around 400. His heart rate had been up around 170. These are all signs of being too dry. Hopefully they will decide to take him off of the dialysis pump within the next few days and start the weaning process. His numbers are better now, and we hope they will stay that way.

Still waiting on dialysis

Today is much like yesterday, we are still playing the dialysis waiting game. Memphis lost 45 grams last night. Because of the dialysis affecting Memphis' blood pressure yesterday, they had decided to take fluids for 2 hours at a time then let him have a 4 hour break. Today, Memphis seems to be tolerating everything better so they have gone back to taking 10ccs every hour. This is the equivalent of taking two teaspoons of fluid from him every hour.

The ECMO pump has been weaned down to .23 which is about as low as the nurses will go until he gets off of dialysis and is peeing on his own again. Memphis' gas (co2) numbers are the same as yesterday .67 and his %O2 is at 54.4. These two numbers also need to be at .2 eventually if we are to get off of ECMO.

All of Memphis' other numbers such as saturation numbers, blood pressure, heart rate, and breaths are looking great!

Yesterday, we stared playing classical music for Memphis to listen to when he is awake. We think he likes this. It' so hard to tell. But with his daddy being a musician and mommy a dancer we figure their has to be a love for music in him somewhere.

Memphis is doing about the same, or so it seems today. He has lost another 305 grams, which gets him down to 4790 grams. Dr. Anderson came in and talked to us this morning. He stated there really isn't any specific weight that we are trying to get him down to, rather we are trying to get as much weight off as possible. He definitely looks better than he did a few days ago. The dialysis has been going slow and testy. The more fluid that they remove the less efficiently his pump works. His blood pressure has been dropping, which is typical. The usual response to that is either to turn the pump up or give him fluids, both which are counter productive to what we are trying to do. He got some plasma last night, which seemed to help, but it is still running low. They also turned down one of his pain medicines today, which they hope will increase the pressures. With all of these problems, he is still running smoothly in the direction they would like him to.

The biggest issue we are dealing with now is the arterial canula. The tube that is going into the arterial side of the blood system. It is backing out. This very moment, it is ok, but it is an issue. The reason for this is just the amount of time that he has been on ECMO. The tissue around the canula has started eroding and deteriorating, and therefore letting go of the tubing. There is nothing they can do for this, so it makes this weaning even more important. This truly has turned into our last effort to get him off of ECMO.

We want to thank everybody for their support, and keep Memphis, Levi, and all the others in your thoughts.

Memphis seems to be having another successful morning. The dialysis machine is doing it's job, Memphis lost 500 grams last night! This morning, the nurses have just begun to turn the dialysis machine back up to taking 10cc every other hour. He is still very dry and the nurses don't want to take too much fluid to fast.
Since Memphis has been on dialysis and losing fluid, he lungs have opened back up and we once again see air in his lungs. The nurse we have this morning said that his x-ray looks better than it ever has.

As was posted yesterday, the doctor does not want to wean the ECMO machine down to low until all the extra fluid has been taken out. This is to continue to let Memphis rest while the fluid is being removed. But, a few days ago the machine was giving Memphis 160 percent support now it is only giving him 80 percent and Memphis is doing the rest. His gases have also been weaned down from 1.6 to 1.0.

Let's keep letting Memphis know that we want him here with us and to keep working hard. Our neighbor baby, Levi, is working hard to come home also, keep him in your thoughts as well.

Such an eventful day

So today was Memphis' first full day back on dialysis. He has shown improvements, but the doctor doesn't want to push him into a idle standpoint on the ECMO pump as of yet, he wants to get the weight off first. They had started him at 10cc of extra fluid off every hour. He tolerated that well, so they increased that to 20. At around seven pm, he started feeling the effects of having too much fluid taken off. His pump started acting up and the pressure monitors would set off and pause the pump, which would in turn aggravate Memphis. His upper saturation number which is typically between 95 and 100 was briefly dropping into the 70's. This was all said to be the product of having too much intravenous fluids pulled off. The dialysis pump has been turned back down now, to zero, and they are waiting for the intracellular fluids to seep into his bloodstream.It shouldn't take long, but on the other hand it could happen faster. The day was slow to pass by and it was filled with the sounds of alarms going off all around us. Every time one would go off it seemed to wake Memphis up. He was very restless and then would "sleep" with his eyes wide open. His eyes would drift around until they found a satisfactory spot and then they would drift apart from each other. It was a pitiful sight. Not often do I wish they would give him more sedation, but today was one of those days.

Just to remind everyone, Memphis needs all the thoughts and prayers he can get but he isn't the only baby up there. Our neighbors need it also, please send some their way. The family right next to us is dealing with a diaphragmatic hernia as well, they need all the thoughts and prayers they can get. Thanks.

Back on the right path

5595 grams today, he has lost 65 grams over night due to the dialysis. Something that we have been trying to do now for a while. Everything is heading towards a more positive direction again just as it did last time we were on dialysis. His ECMO pump has been weaned down to 0.33 from 0.6 just yesterday. The co2 sweep numbers are down, as are his blood gas numbers, all good things. His x-ray showed some improvements also, the right side is opened more, not completely, but more.

All in all another day on ECMO, but a much better start to the day at least.

Just Another Picture

 

So it seems that dialysis is again a certainty. They really need to get him down in weight to try and get his lungs to open up. He gained 160 grams last night, which is most definitely unneeded. The nurse practitioner has said that she wants to get another heart echogram to see how much pulmonary hypertension is truly there. She feels like this is still an issue due to the amount of shunting he has been doing. This will have to wait until he has lost more weight and he has opened up. If the pphn(persistent pulmonary hypertension) is still a major issue, they will start him on nitric oxide and Viagra to dilate this artery and try to relieve some of the pressures. All of this is so dependent on him losing weight and opening his lungs. One goal at a time.

I will let everyone know more when I know it.

Updated: as of about 1230 Memphis is now officially on dialysis. Let's hope this helps him progress.

His Little Eyes!

 

 

An update from Dr. Chuck

The doctor finally came by after a long wait. I only had a few questions for him to answer. He is very concise and friendly. I will try my best to explain the long and short of it.

First Question: When is he planning on starting the steroids?
Answer: He wants to get some more weight off first.

Second Question: Do you think taking him off of dialysis made him regress?
Answer: No.

Third Question: When will he be taken off of the phenobarbital?
Answer: Probably not until the surgery is over and he has recovered.

His explanation, as I understood it, went as follows. The steroids are to help him push harder at the very end. He would like for him to lose most of the weight and start being weaned off of the ECMO. This is getting more important the farther we go along. The dialysis is something that he is going to suggest again tomorrow, and we will more than likely be seeing that machine again sometime tomorrow. We all kind of agree that this is for the better in that he needs to get the weight off. He stated that he would like to get the weight off and try to wean him off the pump again, if he allows it, before they decide if anything is going to be possible in the long run. He also stated that due to the difficulty we are having getting back to just a ventilator, that he feels that the hernia is a severe one, and that the lungs are severely underdeveloped. On the brighter side of the conversation, he stated that since he was able to be weaned down so low here recently, he is optimistic about the entire process.

It has been a long day, and Memphis' numbers have been only adequate. Lets hope for a much better day tomorrow and success at losing the weight.

Good night all.

Just another day

Memphis is doing about the same as he has been for the last few days. He gained 20 grams last night, which isn't necessarily good or bad. It's better than how much he had gained night before last. His x-rays look a little worse than they have, they are more "whited" out, which means that there is little to no air in his lungs. We are waiting on the doctors to come by and talk with us about what needs to be done to make his lungs open up more if there is anything. Just another day, with the same explanations. It definitely feels that we are at a stalemate at the moment. What a toll this waiting can take. We are trying our best to be strong and let him do his thing.

The nurses swaddled his arms downs hopefully this wil keep him from flailing about as he has been doing.

When we here from the doctors I will post again and let everybody know the news.

Just a simple thought

You never know what it's like. I sit here with his eyes open and actually looking at me. It hurts me to the core to look at him and see him crying, you can see it in his eyes, even though you never hear a sound. You never think that you would ever want your baby to cry, until the one you have can't.

You know this is just his life, everyday. When he is able to fight through the sedation enough to open his eyes, you know he is still looking through the medicine, all blurry and such.

If he could just smile, laugh, or even cry it would trump all of the bad stuff we have seen up until now. Just one minute to hold him, would means much.

Just some thoughts,
Hope everyone out there is having a good one

Chris

Chris went to the ER last night

Chris (Memphis's daddy) has been having some severe back pain the past two weeks. This past Friday he went to the doctor in Huntsville and they said that it is muscle pain. We think from the stress of memphis being in the hospital, not being able to be in B'ham with Michelle, and taking care of Rowan and Braden by humself back home. The doctors gave him a muscle relaxer and prednisone.
Last night, Chris woke up at 3am in so much pain he was unable to get out of bed. He went to the emergency room at that time and was finally released and back home by 8:30 this morning. After 5 hours and much more pain he was told that it was just muscles. He was given a Toradol shot, Codine, and lorazepam.

Memphis gained 260 grams last night putting him at 5480 grams. Not the direction that we hoped we would be going today. His ECMO machine is still turned way up giving him 100 percent assistance. His gases (co2) are also still very high. His saturation numbers are ok but not the best. All in all we are doing about the same as yesterday.

X-rays did not look good today, Memphis is almost completely whited out again. Meaning, that all the air that we did have is gone. This is probably due to the fact that his ECMO machine is on resting settings and Memphis is not having to breath.

We believe we will be starting steroids today but we are not positive on that. If this happens, he will hopefully be able to function a little better.

Thank you for keeping us in your thoughts.

4 weeks today

5215 grams today, that's down 165 grams from yesterday. This is important again due to him being taken off of the dialysis machine. He still isnt back on dialysis but it may still be in the near future. He has had some urine output last night, which is great!

All of his saturation numbers are still lower than what they need to be, but the nurses tell us that this is not atypical. They are still going up on his sweep numbers (co2) but once again this is normal. The doctors are now talking about steroids to try and help him along. Hopefully this will get him working a little better by himself and allow them to turn the pump numbers down. We havent talked to anyone about the risks involved with steroids and such, but hopefully the risks will be minimal.

His X-rays look about the same, we are told. Haven't had a chance to look at them yet though.

The nurse told us today that he was awake all last night. Awake and aggravated, even through the sedation. She feels like that maybe he has his sleep pattern backwards. This is gonna be wonderful when he is finally able to get home, always something to look forward to. Mommy is going to have to change her sleep pattern too. :)

Mom and dad both are feeling the long hours of stress. Between pimples, back aches, head aches, and everything else between, it's been a bumpy ride.

Emotional Rollercoaster

As you all know, we went on dialysis this past Wednesday. Well yesterday, Memphis was doing so good using his lungs to breath that the ECMO machine was only having to support him 65 percent. His flow numbers had gotten down to .205 which is the magic number and the nurses were able to wheen our gasses so much that the doctors thought that we had a window of opportunity to get off of the ECMO machine altogether. This would have meant we were getting close to surgery.
Because of all of Memphis' great progress yesterday the doctors decided to take him back off of dialysis. This happened between 2pm and 4pm. Memphis had to be off dialysis and peeing on his own again as well as using his lungs to process oxygen in order for us to move to the next step.

But alas,today is another day and we missed our window. The ECMO machine has been turned all the way back up and Memphis is resting his lungs once again. The doctors are talking about putting him back on dialysis and of course to put icing on the cake he will have to get his third circuit change.

Let's hope that Memphis was showing us that he will be able to do this he just isn't quite ready yet.

Finally positive news two days in a row!

Memphis has been waking up more yesterday and today. He opened his eyes for a couple hours yesterday and woke up to see his mom and grandma this morning.

We started dialysis yesterday at 6:30pm. Memphis took getting hooked up to the dialysis machine like a champ. It didn't seem to effect him at all. Mommy was very proud of him. We were told that once getting hooked up to dialysis the kidneys may shut down. This morning, Memphis had a wet diaper so as of right now his kidneys are still working. He lost 75 grams last night.

His x-rays looked better today than they did yesterday which means that he has more air in his lungs than yesterday. His flow on the ECMO machine continued to be wheend over night. His current flow is at .243 which means the machine is only supporting him 65 percent. The nurses are also wheening his gasses. Both of his saturation numbers are still in the upper 90s.

Thank you to everybody that is praying for and sending positive energy to our baby Memphis Warren Tipton. Just like our nurses, all of you have helped him and encouraged him to stay with us. It means so much.

Good news and bad news

Gained 355 grams last night.

The doctors came by last night and informed us that due to the length of time he has been on ECMO and his kidney numbers, they are planning on putting him on dialysis today. The kidney doctors will come by soon and check his levels and discuss it with the surgeons. If they feel that it would be beneficial, then they will start it. Dr. Anderson says that the machine will run continuously which is better for the kidneysn and hopefully it will only last a few days.

His numbers are good though. The pump has been weened way down at the moment and his saturation numbers have been riding around the upper 90s. So that is great.

One month at Children's Hospital

9/13/2011
Memphis has slept for two days straight. This is from all of his medications. One of the effects of the siezure medication phenobarb is sedation. We only lost 20grams last night which isn't enough to mention, But better than nothing at all. That puts Memphis at 11 pounds 1 ounce. Still two pounds to lose before we can start making tremendous progress.

His sodium is slightly on the high side, but still within his range. The nurses are using some plain d5 (whatever that is) whenever they flush him to help with this.

Nurses are still hearing very slight breath sounds. They say the breaths sound squeaky. On a good note, Whenever the nurses try to wheen Memphis from the ECMO machine (lower his flow) his stats seem to get better. A nurse said today she can not explain why that is. Technically the higher the flow on the machine the better his stats should be. Let's hope this trend continues.

Chest x-ray still looks the same.
We will continue to keep you posted.

An uneventful day, at last.

I am reporting all of this from home, through Michelle's info. He lost 385 grams last night, which we didn't expect. Dr. Anderson came by and said that his x ray was looking about the same. He mentioned that he looked better though. He is not as swollen as he was and we are moving toward the right place.
His numbers haven't really changed that much, they have been trying to ween him off the pump. So his numbers have been up and down. His medicines are the same, and his seizures are the same. Hopefully this will start getting better if he loses weight.

I will keep you guys updated

Still having some seizures

9/11/2011 He is still having issues with seizures. They are more controlled for sure, but they are still there. The phenobarbital seems to have finally evened out. Now you can hardly see them unless you know he is doing it, his eyes open and shut and then his right arm starts twitching. The only difference between this and just twitching seems to be the fact that touching him doesn't stop them. The nurses all say that this is something typical for children that have been sick for a period of time, and they feel its more environmentally stimulated than brain related.
His lung x-ray show some oxygen in the right lung, although it is just a small bit. This is a good start, and if he keeps on losing weight he should continue on this trend. He lost 5 grams last night, which is not even hardly enough to mention though.
It is hard watching him laying there twitching, so helplessly, but it is equally as hard looking at him lay there so out of it. He is on three different things to keep him relaxed (phenobarbital, fentanyl. lorazepam), so even when he opens his eyes, there is little behind them. Friday, he was so coherent seeming. He had his eyes open looking at us, switching between Michelle and I. Responding to us talking and showing us books, being so calm and interested. These last two days, there's been nothing. His eyes seem so sad. I will keep everybody updated the best i can.

9/10/2011 Talk about an eventful day today. This morning around 7:00 am we receive a call from Dr. Chuck (one of the surgical fellows), he tells me that he has been having seizures through the night. They are not obvious, but they aren't always that obvious in children. He tells me that it may be a result of them changing out the circuit yesterday (which went great by the way). They have already given him a brain ultrasound to check for bleeding and there wasnt any evident, and they would call the neurologist up as soon as they could. Being as i was leaving at 8:00 to go to huntsville to see rowans soccer game, we went up to the hospital to see if they would let us in a few minutes early. Sure enough, they did and what we saw was him very drugged up, on phenobarbitol and ativan to keep him from seizing. We sat there until we saw memphis start shaking. It was just a subtle movement in his right arm that was very rhythmic.

I left from there and came to watch the game, which was entertaining. Michelle let me know that the neurologist had came in and stated that he thought it was something called myoclonus, a nerve irritability. After the EEG, it showed up to be a seizure, but it inst in the cortical area of his brain (whatever that means) that they were concerned about. At this point they have taken him off of the extra ativan, but left him on the phenobarbital.

On a better note, he only gained around 400 grams, which is better than what we thought. The surgeon said that his xrays and ultrasounds look much better

I will keep posting as i know.

A picture of Memphis doing what he does best today. You can really see how purple he is right now.

9/9/2011. 5060 grams. Memphis lost 585 grams last night! This was not expected since he received some extra blood products last night, but it happened. This is good since he will probably gain some weight when he gets the circuit changed out. He still needs to lose down to about 3700 grams(his birth weight), but this a leap in the right direction.

The surgeon came back up to look at his incision which was still bleeding. The x-ray had shown that his arterial cannula had backed out probably due to him moving around so much. Since the site was already somewhat open, the surgeon was able to push the cannula back to where it should have been. His numbers seem to have benefited from this.

Due to the varying of his coagulation factors (platelets, plasma, and cryoprecipitate) and the blood thinners, his skin has developed an issue called Petechiae. It's nothing more than popping of small capillaries in his skin. We are told that it is nothing to worry about, but it looks bad. His skin is very purple around his face, and his little chest is very red and speckled.

The nurse also tacked a roll of gauze inside his hand. He was reaching up and trying to pull the tubes out of his throat. Hopefully this will stop him from doing that.

Some further complications...

The site where the surgeon cut him to put the two cannulas in has started oozing blood, probably due to Memphis' coagulants being too low or his blood thinners being too high(he is on heparin while he is on ECMO. It keeps the machine from clogging too quickly). The doctors haven't been by yet to correct this, and hopefully it will be as simple as just putting clotting powders on it, but until then this definitely doesn't help with the gaining weight due to getting blood as it drains out of him constantly.

UPDATE: the surgeon came and put some surgicel on the incision. It's a collagen based clotting sheet.

Memphis Warren Tipton

This is a picture of Memphis right after he went into the NICU, about an hour after he was born

9/8/2012. Memphis weighed 12 pounds 7 ounces today. He only lost around 45 grams last night. Not a lot compared to previous nights. They are planning on changing out his ECMO circuit soon due to having to give him coagulants multiple times a day(platelets, plasma and cryo). Hopefully this won't set him back too awfully far and push us into dialysis sooner than we absolutely have to.

They also went up on his pain medicine. He was acting like he was becoming used to it. So... He's been knocked out all day

First post

Hey we are gonna try this blog thing out for a while just to give some updates. I'm gonna try to post a little most days and let you guys know what's going on.