Through the Wringer and Back

Wow. Have you ever seen one of those old-fashioned washing machines with parallel rollers for wringing water out of freshly washed clothing? They look kind of like a printing press with a wash basin attached. It feels like we've been put through one of them in the last five days. Tate has had elevated levels of bilirubin for three weeks, but a week ago we also learned that he had elevated levels of two important liver enzymes. A week ago yesterday, we had been told that Tate's bilirubin level had dropped from 17 mg/dl to 0.1 mg/dl (yes, one tenth of one deciliter) in three days, and that as a result we could take him off the biliblanket. As it turns out, that test was wrong, but that's a longer story. To make the long story short, last Tuesday, May 8, our pediatrician saw in this test that Tate's bilirubin had dropped precipitously. The doctor was amazed (we now understand his skepticism was justified). At the time, Tate already had elevated levels of these two liver enzymes, called AST and ALT, but the pediatrician's sense was that they were elevated largely because his liver had finally kicked in to get rid of the bilirubin. So we began celebrating a bit, believing that Tate, in effect, had a clean bill of health. The doctor wanted us to have Tate's blood checked for the presence of the enzymes one more time later that week to see that the levels had dropped, which would indicate that his liver was returning to normal after working very hard to purge all of his bilirubin. So on Thursday last week, May 10, I took Tate to the lab, and had his blood tested. We had relished for those two days the freedom from the biliblanket, and enjoyed doing some slightly more normal, medically unnecessary things with our boy, but on Thursday night, the pediatrician called, and told us the levels had not only not gone down, but in fact had risen alarmingly, to the point that the doctor wanted us to get Tate to the hospital right away for observation and tests to figure out what the deal was. You can imagine our initial panic and fall from the happiness of the two days of relative freedom from medical procedures.
For the next four days nothing much happened, really, aside from regular daily blood tests, discussions with the pediatric unit staff and a pediatric gastroenterologist, and an ultrasound of Tate's liver. This was at times emotionally exhausting, frustrating, frightening, and overwhelming, as you can imagine. As each day passed, however, the likelihood of something extraordinary and seriously wrong with Tate's liver diminished because the enzymes were trending downward (thankfully), but their cause remained (and as of today, remains) a mystery. The best news came with the ultrasound, which indicated that Tate's liver structure was normal and healthy, and showed no signs of a missing or malformed gall bladder, spleen, or bile ducts, any one of which would have certainly required immediate surgery. Because the liver's structure appeared healthy, the next most likely scenario was that Tate had somehow contracted a liver infection (literally a hepatitis) of some sort, which was causing the elevated enzymes. This remains the notion under which we are currently operating. I'll find out Thursday morning if Tate's enzyme levels have dropped on their own, which will essentially confirm the diagnosis of an infective, and that Tate's body is taking care of it for him. As with any virus, there's little to be done, really--it just has to run its course. So the likelihood that we'll ever know what Tate has had is increasingly remote. This is just fine with me.
A week or more ago I was talking with my dad about how Tate's bilirubin levels were still elevated, and how we were feeling grateful but frustrated by the constant necessity of the biliblanket that we had been using to reduce his bilirubin levels. We were talking about how people frequently gripe and complain about "how stressed out they are" with everyday circumstances--I certainly have been one of these people on more than one occasion--when real stress in fact lies in the concerns regarding the health of a new baby. It's certainly given me a few grey hairs recently.
Tate is 25 days old today, which hardly seems possible. 7.5 of those 25 days have been spent in the hospital--at his birth and for his most recent liver concern. Half of these days he's been connected to the biliblanket, which effectively kept us tied to the house. On 20 or so of his 25 days, he's had blood drawn from his feet, his arm, or his groin. We are extraordinarily grateful that Tate's liver ultrasound indicated it was healthy; it means that the scariest of the possible diagnoses is increasingly remote. We're also really grateful for all of the good thoughts and prayers of friends and family as these days have transpired. They have helped buoy our spirits and make us feel encouraged during it all. Thank you.
Here's a recent picture of the boy, tough guy that he is.