Hurrying up to wait

We are currently in a holding pattern on Jack Henry's PDA.

That's right - we're hanging with the acronyms still like we work for the hospital. When reading our observations on various medical activities, please keep in mind that we're not doctors... we just play them on TV.

So to recap, Jack Henry's PDA is not this or that, but instead it's the heart murmur.

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The present info on the heart murmur is that the doctor decided to end the treatment of indomethacin early after two of the three doses in the first round. This decision was due to watching Jack Henry's urine output decrease precipitously, but fortunately it did not stop all together. Additionally, his creatinine levels (related to the adrenal glands and kidney function) were in the elevated range of 1.5 to 1.8. The neonatalogists and nurses have been patiently watching these levels every 12 hours to see if there remained an opportunity to administer the final dosage of medicine in this first round, but it appears best to wait for his levels (urine and creatinine) to improve and normalize.

The next step is to have an updated echocardiogram to determine the size of the open ductus relative to the original ECG.

We're sitting on a balance of extremes. While the doctors have noticed that the murmur sounds quieter over the last day, this is not a clear predictor of success or failure as the lesser turbulence over the ductus could mean that it is more open or almost closed.

If the ductus remains open, the doctors may determine that the best course of action is "wait and see" on whether the ductus will close on its own rather than jumping right into surgery.

UPDATE: The ECG has taken place, but we are now waiting for a cardiologist to read the report. While the tech took multiple snapshots of the ductus, the cardiologist will need to review the entire session of scans as there are multiple measurement points related to blood flow through and around the ductus. (On the ECG, the ductus looks like it is flaring blood through it, but then again, I'm not certain what I'm reading.) This means that the doctor will also review a dynamic file on the scans rather than limited points in time.