Today we will start with the good news. Although Sam was a little listless on Thursday and his blood tests were showing some minor variations, he had held steady and not become acidotic. It appears that he can tolerate the simple fat he is getting which means that we can move a step forward at the beginning of next week. He lost a little more weight on Thursday and had dropped back below 5 pounds, but when he was weighed on Friday night he had bounced back and weighed 5 lbs 1 oz again. They have also begun to save all of his bowel movements. They plan to have these analyzed if he becomes acidotic. This way they have samples of every day for him and they can compare them from each date to see what has changed.
The plan is to replace the simple fat he has been getting with a complex fat that is less broken down and then monitor him again for any changes. If that goes well then they will actually replace his Pedialyte and fat with a formula that contains the same type of fat that he will be getting with an amino acid. If all goes well with that formula then Sam will be coming home and be treated on an outpatient basis. Although that is the plan, chances are that he will react at some point to one of the ingredients they are adding.
This morning Sam developed a fever of 103.3. For someone so small a fever that high can be very dangerous. He is not showing any other signs of having any type of cold or flu, so he is having a full blood work up this morning along with another spinal tap so that they can determine if there is an infection somewhere in his body. Due to the various lines that he has had in over the course of his stay here, we have been told that this would not be uncommon. So for now we have another round of wait and see on our hands to try to determine what is causing his fever.