Post-Glenn

It seems like life has been more hectic than ever in the past couple of weeks, what with being back at work and having out of town visitors and taxes coming up and our car conking out and requiring expensive repairs. But I am having a momentary lull at work and so wanted to post an update!

Magnus had his follow-up cardiology appointment last Monday. They did an echocardiogram (not so fun, he was very wiggly, but it went pretty fast) and everything looked good. His cardiologist told us that her goal is to transition him completely off diuretics, which means that eventually, his only medications will be aspirin and maybe zantac if he still needs it! This was surprising to me and very exciting! And she went ahead and told us to reduce his diuretic dosage from 3 times a day to 2 times a day. It's not a huge change, and yet this makes things tremendously easier for us. For one thing, I don't have to remember to pack his medication for him when he goes to the nanny's. For another, twice daily medication means that we can give his meds at the civilized hours of 7 a.m. and 7 p.m. when he's usually awake anyway, as opposed to before when we had to give him medication at 11 p.m., which was not terribly conducive to getting him to sleep soundly at night.

In addition to the meds being easier, Magnus's weight gain has really taken off since the Glenn, and especially in the last week or so. His post-Glenn physiology gives him a slower metabolic rate, making it easier to gain weight, and his cardiologist also mentioned to us that his diuretic, Lasix, tends to dull the appetite, and we did notice that his eating really improved after we switched to twice-daily meds. The last time we weighed him, we found that he had gained 200g in a 3 day period...that's almost half a pound! He's still tiny for his age, but if he can keep this up, he'll actually be on the growth curve for weight in a couple of months, for pretty much the first time since he was born. He's a bit closer to the curve in his length and head circumference, so maybe he'll catch up on those even sooner.

Magnus's next scheduled cardiology appointment is not until the end of next month. We may end up having to come in sooner if there are any problems, but if not, that will be the longest he's ever gone without seeing a cardiologist in his entire life!

Life at home

This week has really flown by since we got out of the hospital. We went home early on Saturday, and Magnus continued to be pretty fussy for his first few days at home, which made life kind of difficult because we had to go back to our regular work routines. We had a few really bad nights where he would wake up every hour or so. But I would say that as of around Thursday, Magnus was pretty much back to his old self. We posted a couple new videos showing that our happy guy is back.

On Monday, Magnus had his 4-month pediatrician's appointment. We see two pediatricians: a pediatrics resident and the doctor who supervises her. I like this arrangement because it's kind of nice to have two different perspectives on what's going on, and I like both of our doctors individually. Anyway, I think their expectations for Magnus were fairly low given what he's gone through, but we spent much of the appointment assessing his achievement of various developmental milestones, and impressively, he's more or less on track when it comes to most things. The one thing he's definitely lagging on is doing a push-up (but we're not even letting him try to do one right now because he's not supposed to strain his chest muscles until his incision is fully healed). Unsurprisingly, he also hasn't rolled over yet, but again, we don't want him to right now anyway.

So, things are pretty much back to normal around here. In a way, it's hard to believe that Magnus had open heart surgery less than 3 weeks ago.

And then tomorrow, it's our good friend Julianne's turn. Julianne has a different heart defect from Magnus, Ebstein's Anomaly, but her doctors are treating it with the same 3-stage surgical sequence. Julianne's a tough girl, and I feel confident that she'll do great tomorrow, but I'm sure her mom Clare and the rest of her family would appreciate if you stopped by her blog to offer your support, as well as sending your prayers, positive thoughts, good vibrations or whatever ethereal support you have to offer their way!

Going home!

We got the all-clear a little after 8! He's had his dressing changed and an EKG done, and now we're just waiting for cardiology to "come take a look at him" and then we're out of here!

Bloodwork looks good!

His bloodwork looks good, so I'm pretty sure we're set to go home!

Waiting to hear

Magnus had a good day and a good night. He's been off oxygen and on all oral meds and looks good. The nurse practitioner came by yesterday to check him out and said that she thought that was the first day he looked like he had turned a corner.

They sent me over to the pharmacy last night to pick up all his discharge medications, because the special pharmacy we have to go to is closed on the weekends.

So basically, everything so far looks good, and it all comes down to his final bloodwork. They took the sample around 6:30 a.m. (this time it took FOUR sticks to get a sample) and they say it takes about an hour for the results, but there's usually a little lag, so I'm hoping to know maybe around 8?

I hope we can get out of here in a timely fashion, then. Even though the hospital operates 24-7, things happen more slowly on the weekends and at night, so I'm bracing myself for some frustration.

So far, so good

I am pleased to report that Magnus has continued to not do anything that would extend his hospital stay. They're transitioning him back to all oral medications today (and he gets to ditch that yucky scalp IV, yay!) and weaning him off oxygen at some point, and he just has to do OK with all of that, NOT spike a fever, have his cultures from yesterday continue to turn up negative, and have a normal white blood cell count tomorrow. And then we're free! I'm trying not to get my hopes up too high, though, since that's quite a few things that all have to go our way.

48 hours

So the good news is that Magnus's white blood cell count this morning was back to normal and his temperature has also been normal. But the bad news is that since he "spiked a temp" earlier, they need to let the cultures they took this morning grow for 48 hours to rule out infection.

So, the earliest we could go home is Saturday. However, there are a few things that could stymie this plan: he could get another fever, the cultures could turn up positive at some point, or the doctors could just decide that he needs a 7-day course of IV antibiotics (he is now on day 3). But we're keeping our fingers crossed that none of that happens and we get out of here Saturday.

Testing, testing

So, the doctors came to look at Magnus this morning, and given his elevated white blood cell count of the last two days, they were concerned about the fact that he had "spiked a fever," despite the fact that 38 degrees is not much of a fever. They ordered a few tests, and also put him back on oxygen, "just in case," which is kind of silly, but whatever,I'm confident that he can come back off it easily.

They just took some more blood to check his WBCs again (it took 3 sticks to get a blood sample), and they did another urine catheter sample, so the poor guy really went through the wringer this morning, yet again.

But then just now, the nurse checked his vitals again, and his fever is gone. So who knows what's going on? Oh, and in the meantime, those IV antibiotics he's been on for the past 2 days have given him thrush, diarrhea, and a fungal diaper rash.

Oh, I also forgot to mention that I almost ripped the dietician's head off this morning when he came over to discuss the fact that Magnus was not meeting his weight gain goals while in the hospital and that they might want to keep him here longer because of that. Um, yeah, he's not eating well because he feels lousy, and he's burning a ton of calories because he's getting poked and prodded and stabbed at all hours of the day, and you think keeping him in the hospital LONGER is going to help? He seemed to back down when I showed him my excel spreadsheet containing Magnus's weight measurements at least twice a week ever since he was discharged from the hospital on December 17th, and he realized that we are on top of things.

Anyway, I was pretty upset this morning. It just seemed like everything about the hospital was making him sicker and sicker and the doctors just wanted to keep him here longer and do more invasive testing, and it just never felt like it was going to end. But actually right now I feel OK...I think it's because Magnus has been showing that those smiles this morning were no fluke. Even though he was feverish, Magnus was really back to his old self this morning, and just seemed much more comfortable than he has for the past week. Somehow it all doesn't seem so bad as long as he seems to feel OK.

Morning update

Magnus has a new nurse this morning, one he hasn't had before, and she was concerned that he seemed fussy and felt a bit hot. She asked me if I thought he could be teething, and I guess it's possible, although he is about a week shy of 4 months, which is a little early. His axillary temperatures had been normal, but she took his rectal temperature, which is more accurate, and it came back as 38 degrees C, or a little over 100 degrees F. Obviously not great news since we are worried about infection issues. However, the nurse said she thought that the low grade fever and elevated white blood cell count could be due to teething...if she can convince the docs that this is the case, I think maybe we could still get out of here tomorrow. But, I kind of have a sneaking suspicion that they will want to keep him...

In more positive news, we finally got a smile out of him this morning!

Progress report

I spent last night at the hospital with Magnus, and while it was a better night than the one before, it is definitely taking a toll on both Iggy and myself to see our little guy so unhappy. I don't know if it's because he is in chronic low-level pain, or just because he's freaked out from everything he's been through, but every time he has his diaper changed or his temperature taken (axillary, not rectal!), he SCREAMS. And then his sats go down and the monitor beeps, and it's just a very stressful situation.

So anyway, I spoke to the nurse practitioner again this afternoon and we went over what he still has to do to get out of here. For one thing, he has to get off of oxygen. He's actually had his oxygen turned off for the last hour or so, and the cannula is still in his nose, which actually makes it a little harder to breathe than not having the cannula at all, and he's been doing fine. The one exception to this is the aforementioned screaming whenever anything is done to him, but he is usually able to recover his sats pretty quickly. I don't think getting off oxygen will be a problem.

The next thing he has to do is to transition from IV to oral diuretics. That's going to happen tomorrow, and again, I am pretty optimistic.

The third thing is the one I am most worried about, which is that he has to show that his infection issues are under control. They're still not sure about the source of his infection, his temperature has been normal, and his white blood cell count was down from yesterday...but still elevated. Basically, they're going to test him again tomorrow, and his white blood cell count has to be normal in order for him to go home. This is the one that makes me the most nervous, because his WBCs were still elevated this morning despite having had 24 hours of IV antibiotics. Tomorrow he will have another 24 hours' worth on board, and hopefully that will do the trick, but who knows.

The upshot is, I think that if his WBCs look good tomorrow morning, we should be able to go home Friday. And I really, really, really hope we can go home Friday.

In happy news, Magnus's grandpa Eddie and grandma Debbie arrived in town this afternoon, and got to meet Magnus for the first time! I wish he were a little more himself right now but hopefully, they'll get to experience Magnus in all his glory before they go home next week!

Up and down

Magnus has continued to have a much better day. His temperature, which they check every couple of hours, has been normal, which indicates that the infection issue seems to be under control.

His sats were really good this morning, so his nurse turned his oxygen down by half a liter. He seemed to do fine for several hours, but then this afternoon, he started to get fussy and his sats went down again. We tried several things to remedy the situation, including suctioning a bunch of gunk out of his nasal passages and thumping on his back to loosen the mucus in his lungs, but this actually seemed to make the situation worse, so we had to turn his oxygen back up to where it was this morning. But then around 5 p.m., he finally calmed down and fell asleep, and since then his sats have been great...so good that they turned the oxygen back down again, and as of this moment he's still doing really well. But my optimism is somewhat guarded given the events of today. I discussed things with the nurse practitioner and she talked about the possibility of sending him home on oxygen, which I'm really, really, really hoping doesn't happen, and I don't think it will.

One other good thing about today is that we have had some great nurses helping us out. Hoi, his heroic nurse from last night, is back with us tonight, and greatly relieved to see that he seems poised to have a much better night.

One other funny thing...when I came to the hospital this morning, Iggy told me that the mom of the patient in one of the adjoining bays told him that she had read this blog and had sent me an e-mail a while back. And then it all clicked into place...we were right next door to the Truhes. I had actually spoken briefly to Jackie last night when she kindly gave us one of their chairs, and it occurred to me at the time that she looked kind of familiar (because I'd seen her photo on her blog) but somehow my brain didn't put it all together at the time. Anyway, I know that Magnus made her night pretty miserable last night with his screaming, but she was very polite about it! They got discharged today, but have to come back in a few weeks so that Grace can get her pacemaker fixed.

Exit strategy, take two

I got to speak to the nurse practitioner this morning, and we're definitely not going home tomorrow.

In addition to his sat problem, his last bloodwork came back this morning showing a slightly elevated white blood cell count, and he's developed a very low-grade fever (37.6 degrees celsius, or about 100 degrees F), so they're worried about infection. They're starting him on a course of antibiotics, but they're not sure what's infected. One of his chest tube wounds was very red and angry looking, but the nurse practitioner didn't think that would cause the elevated WBC. In order to figure out what kind of antibiotic to use, they wanted to rule out a urinary tract infection, which meant another unpleasant test: they had to stick a catheter into his penis to get a clean urine sample to culture.

Anyway, they're going to start the antibiotics soon, and recheck his bloodwork tomorrow. In the meantime, he's going to continue to get IV diuretics all day today, and then hopefully transition back to all oral ones tomorrow. And he also has to get weaned off his oxygen...his sats are still looking good, but despite my friendly encouragement, nobody has made a move yet to wean him off it.

So, with all that still has to be done, the nurse practitioner told me that MAYBE we could go home Thursday, but more likely Friday.

Low sats

Magnus had a pretty rough night, as did Iggy, who stayed over with him in the hospital. I mentioned that Magnus was having a fussy day yesterday, and it only got worse...basically, he woke up crying at 5 a.m. and only slept for about 20 minutes between then and the time I went home around 9 p.m.

I had also been noticing that his oxygen saturations (or "sats") were pretty low. I had mentioned it to one of the nurses earlier, but she thought it was just because he was fussing so much. But then last night, they started to get concerned about it.

I wasn't here overnight, but according to Iggy, Magnus continued to be fussy, and his sats were really low, even with his oxygen cannula turned up all the way. And as if he wasn't fussy enough already, he had to have blood drawn several times and have a new IV put in (this one is in his scalp, yuck).

Anyway, I could go into great detail about the trials and tribulations of the last 24 hours, but the upshot is that they have increased his diuretics to get rid of some of the fluid around his lungs, and it seems to be working. Keep your fingers crossed that it continues to work. I think the increased fluid might also have been part of the reason why he's been so uncomfortable. After the Glenn surgery, babies tend to get headaches because after this surgery, blood from the upper part of the body flows back to the heart passively by gravity, and while the body is adjusting to this change, the fluid buildup in the head can cause significant pain. So it makes sense that if he had high fluid volume, that could exacerbate the pain. Of course, I just mentioned this to the nurse and she said she thought he was just fussy because he felt like he couldn't breathe because of the fluid around his lungs. At any rate, his sats are good now, and he is much more restful.

I have a feeling this is going to push back Magnus's discharge by at least a day, but I'm going to do what I can to talk them into letting him go tomorrow. He's still got his oxygen cannula turned up high, so he needs to be weaned off that, and they need to make sure he's doing OK with oral diuretics (he got both oral and IV diuretics last night).

Update

Good news: Magnus got moved to the step-down unit, and he's on all oral meds now (as opposed to IV meds).

Bad news: The nurse practitioner said he's definitely not getting out tomorrow because he still has to be weaned off his oxygen cannula. Not sure when they're going to try to do that. Today has been sort of rough...I don't know if it's because he's in pain or just because he's sick of the hospital but Magnus has been extremely fussy since last night and hasn't slept much. I feel pretty certain that he'll do better at home, so I'm really anxious to get out of here.

Also, I got a jury duty summons.

Exit strategy

Just got a chance to talk to one of the docs, and it looks like Magnus is on track to go home Tuesday or Wednesday! Basically he just needs to continue to do OK and to show them that he can eat well. He said the only two things that might slow him down at this point were a fever or collecting fluid around the lungs, and he said that both of these are unlikely.

Tubes are out!

They pulled his intracardiac line about 2 hours ago, and his chest tubes and pacer wires just now. He was pretty unhappy during the procedure, but should be a lot more comfortable now (he's asleep at the moment...they gave him a morphine dose right before they pulled the tubes).

So now he's just got an oxygen cannula, 1 IV, and his heart rate and oxygen monitors. Next time I get to talk to the docs I'm going to try to find out what else he still has to do to get out of here.

The plan

At morning rounds today, the doctors confirmed that Magnus is on schedule to get his cardiac line, his pacer wires, and his chest tubes removed tomorrow! I asked the nurse if this meant that he would be eligible to move from the ICU to the step-down unit, and she said that since he's so stable, he's actually eligible to move there now, except that there's no space over there. That's fine with us, since the ICU is a lot nicer than the step-down unit. Here he's got a big private room with a beautiful view of the park, the Golden Gate Bridge, and the Marin Headlands. Over there, he'd be sharing a bay with two other kiddos and none of the rooms have such nice views (if your bay even has a window at all).

I think I forgot to mention that Magnus had an NG tube placed yesterday...the original plan was to just feed him by bottle after he came off the vent, but because his lungs were kind of congested, they decided to start him with tube feeding instead just so they didn't have to worry about his breathing, I guess. But today we're going to bottle feed him, so hopefully, the NG tube will go soon, too.

Destroyer of lines

We learned from Magnus's last stint in the hospital that he is a great destroyer of lines. This has not changed. When he went in for his surgery, they sedated him with gas and then placed two IVs (on in his hand and one in his foot) and an arterial line. The arterial line died later that same day, and they had to place a new one in his foot. On Thursday, they said that his foot IV was going bad, so I suggested that they try to put in a new one while he was still heavily sedated. They tried but the vein wasn't good. Then last night, even though he was swaddled, he managed to pull out the IV in his hand, and now they're saying the one in his foot is totally shot. He's due for a 6 a.m. dose of Lasix, so I guess he's going to have to get a new IV really soon. Poor guy.

Other than that, things are going slowly, but fine. His urine catheter was removed yesterday, and he's not puffy at all anymore. One of the nurses told me yesterday that the soonest his chest tubes can come out would be tomorrow (Sunday) because they need to be in while he has an intracardiac line, and that line can't come out until 4 days post-op? Except other people have said different things, so who knows. I haven't gotten to talk to any of his doctors since yesterday morning, which in a way is a good sign, because the less attention you get from doctors, the better you're doing!

I spent last night in the hospital and actually did manage to get some sleep. Magnus did wake up and fuss a few times, but when he did they'd give him some morphine and he'd drift back off to sleep in a few minutes.

So anyway, I'm really not looking forward to him getting this IV, and I really hope this one will last a few days! Oh yeah, his arterial line is almost shot, too, but they decided they're just going to use it as long as they can, but they're not going to replace it when it goes.

UPDATE: The nurse tried flushing the foot IV and it still worked OK, so looks like he's gotten a reprieve for now! But she says she doesn't think it'll make it through the day.

Extubated!

Magnus has been off the vent for about an hour now and seems to be doing fine! They reduced his sedation for the extubation, so he's been pretty fussy, and he's very hoarse from being on the vent for 2 days. Next step is chest tubes, so hopefully he'll be a little happier after that.

Still moving slowly

When I got to the hospital around 6 a.m., they had started the spontaneous breathing trial and he was doing fine, but then the attending physician showed up and I guess she was mad because they had started the trial without her being here. So, even though he was doing fine, they turned the vent back on. They just turned it down again a little while ago, but it's still on, just at a lower setting. Magnus is sleeping and seems pretty comfortable, so I'm just sitting here catching up on some work and waiting, waiting, waiting...

Still on

I called in to the hospital about a half hour ago, and they said that Magnus had a good night, and that the plan is still to do a spontaneous breathing trial around 6 or 6:30, and if that goes well, to extubate around 7.

6 a.m.

...is the new ETA for Magnus's extubation. He's still doing fine and making progress, they just want to get a little more fluid off him before they extubate. I'm spending the night at home, and plan to be back at the hospital for 6.

Still waiting

Magnus is making progress with de-puffifying. Since 7 a.m. he has lost 100ccs, or a little less than half a cup, of fluid. I'd say he probably has another 50 or so to lose before he's back to normal, though.

They've been slowly weaning him off the ventilator today, and will hopefully try to extubate him sometime tonight. His chest tubes have been looking really good today, and his nurse was saying that she thought they might be able to remove them tomorrow. Getting off the vent and getting his chest tubes out are really the two biggest steps in his recovery, so if all that is done by tomorrow, he'll be well on his way.

Today has been a little bit frustrating, just because everything feels like it's moving so slowly, but frustrating is better than scary, and today has not been very scary.

More of the same

We're still waiting for Magnus to be extubated. Overnight he developed some swelling (his face is very puffy) and they're giving him diuretics right now because they want to wait for his fluid to go down before they try to extubate him again. Nobody seems particularly worried or anything, we just have to be patient and wait until he pees some of this fluid out.

Roadbump Number One

I'm completely exhausted right now (got less than 4 hours sleep last night), but didn't want to go to bed without posting an update. We finally got in to see Magnus around 3 p.m., and he looked much better than after his first surgery. He wasn't swollen at all, and his chest was closed. Of course, it was still definitely hard to see him completely sedated with tubes coming out of his chest.

The original plan was to try to wean him off the ventilator today, but as Magnus started coming out from the sedation and wiggling around, his chest tubes started collecting blood. Too much blood. The nurses tried to reassure me that it wasn't that big of a deal, but suddenly, the room started to fill up with people.

There's a scene in one of the Indiana Jones movies where the ophidophobic protagonist goes into some ancient temple or something and it's protected by hundreds of poisonous snakes. "Why'd it have to be snakes?" he says. And today I wondered, "why'd it have to be bleeding?" You may remember back in January, I posted about our fellow HLHS comrade Gabe, who passed away after developing bleeding problems following his stage 2 hybrid surgery. So even though everyone was trying to be reassuring, Gabe's story was looming large in my mind.

So, there were a few hours of excitement with trying to get the bleeding under control, which they eventually did, but because of that excitement, they decided to keep him sedated and paralyzed overnight to make sure he's fine and then take him off the ventilator tomorrow. It's not a huge setback, but it's not exactly where we wanted to be right now, either.

Our original plan had been for one or the other of us to stay with Magnus all the time throughout this hospital stay, but because he's going to be completely sedated, they encouraged us to just go home and get some sleep, and that's what we are doing.

They're done!

We just got the call: they're done and everything went well! They were able to do it without putting him on the bypass machine, too (more on that later). Gotta run...

Good omens

At around 8:20 a.m., the anesthesiologist carried Magnus off for his surgery. Just like before, we won't hear anything from them until they're done, which will probably be sometime around 1 p.m. or later.

Iggy is a very superstitious person, and I am not superstitious at all. I am a scientist! Except in something like this, where you have something so important happening and really no control over it, I think it's impossible not to be superstitious. And so far, everything seems to be going very smoothly.

Fasting Magnus was much easier than it was for the cath. Our instructions were that we could give him breastmilk until 3:30 a.m. and Pedialyte until 5:30. He had a big meal around 3 a.m., and then woke briefly at 4:30 and 5:30 to drink Pedialyte (the first non-breastmilk thing he's ever had to drink...he didn't seem to love it, but didn't seem to hate it, either). He mostly stayed asleep throughout the drive and the wait, and only really started waking up and seriously fussing around 8.

Iggy and I were both very happy that we have the same anesthesiologist we had last time. We really love her, and after Magnus's first surgery she would come by and check on him just about every day when he was in the hospital, which was for more than 3 weeks after his surgery. She's also from Massachusetts, like we are, and her strong accent reminds us of home! We also happened to bump into the surgeon, Dr. Azakie, when he was walking in the main hospital entrance.

After Magnus went in for his surgery, we were both hungry, so we decided to go out to breakfast, and I got the idea to go to Dottie's. We both love Dottie's, but the crowds there on the weekends are insane, so the last time we'd been there was the morning after our wedding night in September 2008. So, we ate a huge and delicious breakfast, and when we got in the car to go home, "Spirit in the Sky" was playing on the radio. Iggy has always said that that song puts him in a good mood, and we both remembered that it had been playing on the radio on the day of Magnus's first surgery.

So while rationally, I realize that none of these things could possibly have any bearing on the outcome of Magnus's surgery, so far, we're feeling pretty positive.

It's on!

Well, it looks like surgery tomorrow is a go!

We started the day with blood work (which was pretty horrible...it took 3 tries to get a blood sample), then a chest x-ray, then an ECG, and then we met with the nurse practitioner and anesthesiologist, and we were home by around 1:30, thankfully.

The nurse practitioner was a little concerned about his skin, but she said that she was pretty sure it wouldn't be an issue tomorrow. Nobody from the surgical team actually checked him out, so I suppose we could still have an unpleasant surprise tomorrow morning, but I doubt it.

So he'll probably get started around 8 a.m. tomorrow, and they say it will probably take 3 or 4 hours. I'll post updates here as I have them.

Appointment day

Today we bring Magnus in for his all-day "pre-operative appointment." The letter they sent us said that it will include "lab work, chest x-ray, echocardiogram, meet with the nurse practitioner, anesthesiologist and surgeon." It doesn't seem like that stuff should really take all day, but I can believe that it will!

Our biggest fear today is that they will find some reason why they don't want to go ahead with the surgery on Wednesday. Funnily enough, my biggest worry has actually been his skin. In addition to the cradle cap (which is much better, but something we still have to be vigilant about), Magnus has very sensitive skin, and is prone to rashes and acne flare-ups...including on his chest. I don't think I wrote about this before, but when we brought him in for his cath, one of the residents got worried because he had a bit of a rash in the area of his groin where the catheter is inserted. She thought it might be a fungal diaper rash, so we had to wait for the cath doctor to come by and check it out...did I mention that this was after Magnus had already been fasted for nearly 8 hours, screaming all the while? Thankfully, the cath doctor said that it wasn't a fungal diaper rash and it wasn't a problem for the procedure.

Anyway, Magnus's skin had been looking pretty good, but a few days ago, the cradle cap and rashes started flaring up again. We've been aggressively treating him with dandruff shampoo, Aveeno oatmeal bath, mineral oil, and every other baby skin remedy that's been suggested to us. And he looks OK this morning, but that could change in a few hours!

So, our hopes for today are that he gets a clean bill of health for the surgery, and of course, that the blood draw and other tests aren't too painful and go quickly. Wish us luck!