Sophie is improving a lot! When we got to the hospital this morning, Sophie was off oxygen, awake and alert, and crying because she lost her paci. Not fun seeing your daughter cry, but better than seeing her lethargic and knowing something is wrong!
Sophie's nurse told us this morning that the blood culture from yesterday did, in fact, grow group B strep. This is what we had all suspected, including the pediatric infectious disease specialist, who met with us at length today to explain everything and answer all of our questions. When I asked her about how rare this infection was, she said it actually wasn't that rare, so obviously wherever I read that it only occurred in 4 out of 10,000 infants was incorrect. :) Unfortunately for Sophie, she is one of the approximately 3% of infants who get the infection again after it has cleared. The obvious next question is whether a third occurrence of the infection would be likely. In her career, the infectious disease doctor has only seen one child get the infection a third time, which is reassuring.
Group B strep is an organism that can affect parts of the body other than the blood -- the most common and serious of these is meningitis. This is why Sophie had a spinal tap the first time she had this infection and another one last night. I'm happy to say that her spinal fluid this time looked completely clear! They are still going to culture it to make sure bacteria don't grow, but for right now, they are assuming she does not have meningitis. Thank you, God!
There are a few different places Sophie could have gotten this infection. Group B strep is common in infants, pregnant women, diabetics, and old people, so the obvious best guess is that it came from me, although it could have been through exposure to anyone who has this bacteria in their body. This bacteria can be a normal bacteria and not cause an infection, but it often becomes a serious infection in babies. When I was tested for group B strep during pregnancy, I was negative, but the doctor believes this test could have been incorrect. She recommends that I need to be treated for group B strep in all future pregnancies, regardless of what the test shows. All that entails is two doses of IV antibiotics before delivery... I can handle that. Another possibility is that Sophie got the infection from my breast milk. I had a case of mastitis which started a couple days before Sophie was diagnosed with group B strep the first time, and I was on antibiotics for ten days. The doctor is going to "think about" recommending that all my stored/frozen breast milk be thrown out from those ten days just in case it might be infected. I'm not thrilled about throwing out that much milk, but it will be totally worth it if it prevents another infection in my little one.
The plan to get rid of this nasty infection is 10 to 17 days of ampicillin. The doctor was going to decide whether to do 10, 17, or somewhere in between. We're hoping for closer to 10, but we want her to have the right amount to get rid of the infection. She is also on gentamicin until the spinal culture is negative for 48 hours, at which point the gentamicin would be stopped.
Because of Sophie's multiple episodes of feeding intolerance and another episode with her belly yesterday (which is most likely attributable to the infection, but just to be safe)... the doctors have been throwing around the idea of doing an upper GI study to look at her intestines and make sure nothing is twisted around and causing stoppages. The test is done by giving Sophie a dye through her feeding tube and/or through a bottle and taking multiple xrays to watch the dye move through the stomach and small intestine. The downside to doing this test is that it includes exposure to a lot of radiation. Today, the doctors decided it would probably be a good idea to do this test, just to be sure she had no anatomical problems that were causing all of the feeding intolerance. The test was done this afternoon, and it came back completely normal. Her feedings are likely to be restarted tonight or tomorrow... in fact, they may have already been restarted, I just haven't talked to the nurse yet tonight.
The girls both had their eye exams this morning. Thanks to Nate for staying with Evie and helping hold her while she had her exam so I could go to the waiting room and not watch. From the sounds of it (yes, I could hear it from the waiting room), she didn't like it very much. Evie's exam looked great, with no problems at all. According to Sophie's nurse, she just has stage 1 ROP in one of her eyes, which is nothing to be urgently concerned about and usually reverses itself. Yay! Both girls will have another eye exam in two weeks.
I know there were a lot of people praying for Sophie after my post last night; we really appreciate it. Our prayers are working -- the doctor commented today how impressed she was at the quick turnaround Sophie made after being started on her antibiotics. :)
Love!
The VPs
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