The specialists

     Today was the busiest day that we have had so far. We met with several doctors. The day started out with rounds, where Charlotte's neonatologist and nurse practitioner assess how she is doing, and then they make changes to her medical care. The neonatologist has started Charlotte back on her full feedings because her potassium and sodium have returned to normal. Since resuming her feedings, Charlotte's blood levels have been normal. They will continue to monitor her as she gets more feedings. Charlotte is much more calm now that she is allowed to eat again! She continues to do well with her breathing and is using the CPAP machine with low amounts of supplemental oxygen. Laura was able to hold Charlotte for 1 hour today, and it went very well!
     We met with the endocrinologist, and she is waiting for the blood labs to see if they show any problems with Charlotte's aldosterone. Aldosterone is a hormone produced by the adrenal gland. It regulates the balance of water and electrolytes in the body. She thinks this could be a reason for why Charlotte's sodium and potassium levels are abnormal. If so, they can use medication to treat the problem. However, Charlotte doesn't have the other symptoms you would typically see when there is a problem with aldosterone. So, we are waiting to get more answers. 

     Then, we met with the geneticist who did a physical exam of Charlotte to see if she had any dysmorphic features which is a difference of body structure. They can be related to a congenital disorder, a genetic syndrome, or a birth defect. She didn't see any dysmorphic features. She will also be looking at blood work that was sent out to a lab to rule out any underlying disorders or diagnoses. 

     The nephrologist did a renal ultrasound of Charlotte's kidneys this morning and found out that Charlotte has dual collecting ducts in her kidneys. Most people have one in each kidney. This will likely not cause any problems. Some people just have two sets of ducts instead of one. However, some people can develop an obstruction, reflux, or an infection. The nephrologist suspects that Charlotte may have had a urinary tract infection which caused her blood levels to become abnormal. They will closely monitor Charlotte to see if it happens again. Also, they will monitor how Charlotte's kidneys react to food. 

     The hematologist met with us about why Charlotte's platelet counts have been decreasing. He believes that Charlotte has a diagnosis called NAIT. Neonatal Alloimmune Thrombocytopenia is caused when the mother’s and baby’s platelets become incompatible, and so the baby's body attacks its own platelets to get rid of the mother's platelets. This can be treated with IVIG therapy. IVIG is given as a plasma protein replacement therapy for immune deficient patients who have decreased or abolished antibody production capabilities. We will wait to see if the neonatologist thinks that Charlotte needs this therapy. Otherwise, we can continue to give Charlotte platelet transfusions and wait for her body to start producing them on her own. David and I will have our blood drawn to see if we can find a definitive answer for whether Charlotte has NAIT or not. 
     Charlotte is continuing to grow and gain weight every day. She weighs 1 lbs 14 ounces now! All of the lines in her arms and legs have been removed because now she is back to eating by mouth. Her skin is looking great. Today is Dr. Seuss's birthday, and we found the perfect motto for Charlotte!