Brief Explanation of BUN

A blood urea nitrogen (BUN) test measures the amount of nitrogen in you blood that come from the waste product urea. Urea is formed when protein is broken down in your body. It is produced in your liver and eliminated from your body in urine.

This is a daily blood test that is run on Ashley. It gives us an estimate of how well her kidneys are working. If her kidneys are not removing the urea from her blood normally then she shows a high BUN number in her labs. Dehydration is one reason that causes the kidneys to not be able to remove this urea. This seems to be the reason for Ashley's struggles. Her FK (anti-rejection) medication can also cause her kidneys to slow down this process as well.

Once again it is the balance of Ashley's fluid status that seems to be the cause of her problems. We go from one side to the other very quickly. Just yesterday it was determined she was too overloaded with fluids so we backed down on her TPN. Obviously we backed down too much because by morning she was battling another round of dehydration. This fluid balance along with her feeding issues are the two things that keep us here in the hospital. Once these two things are figured out (barring any infections or virus or rejection) then Ash and I will be on our way to our apartment. Unfortunately we are a very long way from that day. Ashley has not been successfully fed in 17 weeks, and no one knows why she is not able to tolerate food. This is one area that David and I are working on. We would like to feed Ash breast milk rather than formula. The team has agreed to give it a try. They have never done this with one of their small bowel transplanted patient. We tried this with Ashley before her transplant in an attempt to get her short bowel to absorb but we were unsuccessful. We do not know if she will grow on it this time, but we believe it is worth a shot. After her new feeding tube is placed later this week we hope to begin feeding her. Our prayer is that it will be successful and that she might tolerate the milk better than the formula. It is a long shot. Ashley's issue is not really related to what we feed her, but to the shape of her anatomy post transplant. Dave feels led to try so I am going to follow his lead.

Now that Ashley is being re-hydrated her urine output is picking up. The concern with the increase in her fluids is that she may keep too much fluid on board causing her lungs to struggle. It seems as though one thing affects another and another and another. It is hard for us to think about being in this position more than four months post transplant. We definitely would have never imagined that our little one would not be able to eat or breathe. I try to keep my mind focused on the thought that God has plans to use us in some way in this hospital. There has to be a reason for us to still be here.

Once again your prayers and your faithfulness to our Ashley's story touches us deep in our hearts. We know how difficult it must be to follow the ups and downs that she goes through. We realize that many have drifted away from her journal because it is too emotional, but we pray that they were somehow touched by His hand as they learned of our Ashley. Thank you for loving her and for loving us. We hope to meet you all someday if not here then in Heaven. May God bless you. Trish