Sam had his original doctor today, the one who got him through his first three weeks of life. He said that Sam’s liver is very enlarged (he knew this without the ultrasound and I that’s why he started changes immediately). Sam’s current doctor wanted to continue antibiotics and not resume feeds yet. This could be one of those times that experience matters, not following textbook protocol.
He thinks and hopes that the enlargement is due to a mix of the NEC infection and TPN. He hopes because if this is true then it is more easily treated.
So the MOST important thing for Sam, right now, is to get him feeding asap in order to help the liver get healthy.
In support of this they removed the replogle, which he seems to have tolerated. Next a feeding tube goes in and tomorrow they will begin breast milk.
Separately, he had an echo and nothing has changed from last time. Still has pulmonary hypertension but they’re not going to do anything about it for now.
He looks better overall because a lot of his edema is gone but now his swollen belly is even more pronounced.
Lots of pictures coming later of both boys!