nil per os

Poor Benjamin has been NPO, or nil per os, since Saturday. For those of you not living in a NICU (or not Latin scholars), that means they took him off of food. On Saturday night his sodium levels dropped significantly. Not that he gave any clinical indication of low sodium (His O2 levels were staying steady at 21%, he was satting in the high 90s, his BP was good and he was active), but they decided to give him some sodium through his picc line to bring it up. As luck would have it, his picc line was occluding so they had to take it out and give him a new picc line. Several hours and several x-rays later he was all set for sodium BUT (isn’t there always a “but”?) someone noticed some suspicious looping in his belly from the picc placement x-rays. The low sodium, they explained, could be due to the diuretics they have been giving him, but it could also be a symptom of an infection, especially when combined with a suspicious x-ray.

So NPO. Clinically he was (still) fine. Still active. Still no changes to his O2 needs. Soft belly. Nothing unusual. But if anything looks like an infection, it gets treated like an infection – everyone wants to avoid NEC (necrotizing enterocolitis- it’s bad, trust me). So on Sunday (still NPO) he had a whole battery of x-rays done to see if there were any changes. Everything still looked mostly the same, so they kept him on antibiotics and stayed the course, doing some blood cultures. The first round from Saturday came back clear, but they have to be clear for 72 hours before it’s decided he’s infection free.

Today, Benjamin has stayed NPO, but he’s moving back off the TPN and back onto feeds tonight. His 2nd day of cultures has come back clear. His CRP (C-reactive protein) was a 1 (3+ shows an inflammation). The doctor has ruled out NEC, and after a blood transfusion, our little vampire Benjamin will return to his feeds- probably by 11pm (instead of using a diuretic after blood transfusions here they limit fluid for a bit). However, he’s going to alternate breast milk with formula for a while to help build his bone density (breast milk does not have a lot of Vitamin D, and Benjamin doesn’t get sunlight) and regulate his blood sugar a little better.

Hopefully by this time next week he’ll have been PO (Is that a thing? Probably not.) for a full week and busy gaining some weight. We need to fatten this kid up!

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9 thoughts on “nil per os

  1. Even the bad days aren’t as bad as they used to be. Every day he gets stronger and so do you guys. Just a little bump in the road and he’s back on track.

  2. Bumps in the road make the good days mile-strides ahead. Everyone is rooting for you Benjamin – a little louder each day. You’re doin’ great little man and so are you mommy and daddy!!! Keep your sites high and be calmed by knowing how loved you all are.

  3. We are all going to qualify to take the medical exams by the time this is over. It’s wonderful that the hospital staff are so on top of his condition and proactive. He is in good hands. Here’s looking at a future of many PO days! 🙂

  4. It’s a thing Amy:

    Per os (P.O., pronounced /ˌpɜrˈoʊs/) is an adverbial phrase meaning literally from Latin “by mouth” or “by way of the mouth.” The expression is used in medicine to describe a treatment that is taken orally.

    The nil means nothing.

    Tell Benjamin I said hi!!! See you soon.

    -Latin Scholar

  5. Another roller coaster ride….let’s hope we are on the upswing and stay there! On Sun, I showed Dr Kaur the pictures of Benjamin and she says to say a big Hi to all of you!!

  6. Wishing for Ben to get some good eats, very soon.

  7. Hi my name is Cinthia and I happen to see this post by accident. I have been in the hospital in picu with my newborn since march and we recently got discharged but are awaiting a phone call to return for a bone marrow transplant. My baby also has a picc line and is in tpn. I wish Benjamin a quick recovery. My prayers are with you all. It’s hard living out of a bag in icu, but its harder to see your baby be poked and checked and poked again, just hang in there. I wish u knew who u were, this is hard and its nice to be able to talk to people going thru it.

    • Cinthia,
      Thanks for your note. Sending positive thoughts out there for your baby too. It is really hard – Does your hospital have a parents group? It definitely does help to talk to others who know what you are feeling. Hoping only the best for a quick recovery for your child.

      • I don’t know but it’s simply something that it’s needed in every hospital. One can survive a week or two in the hospital but once you reach one month with no end in sight it gets hard to deal with. We were on the Oncology/Hematology ward which means that the parents there basically live there! They seem to know who the “new diganosis parents” are and usually rally around stoping by the room to show their support and leaving notes on the bedside table 🙂 Those become your family and pillars.
        I too have been thinking about your precisous Benjamin and sending positive thoughts and prayers to you all. You are amazing parents!
        Cinthia

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