Thursday, August 03, 2006

Woody Reloaded

Now that it looks like that we have Woody's UTI in check, it's like we're just letting him recharge his batteries and get ready to make another run at extubation. He's getting a 'lab holiday' today (he was supposed to get one yesterday too, but they wound up poking him anyway to check his antibiotic levels), which in itself is a sign that no one is that worried about his day-to-day signs and that we're letting him grow and get stronger.

Speaking of, Woody's rate of growth is pretty phenomenal. He gained another 60 g or something yesterday, bringing him up to 2320, which is over four times his birth weight (565), about five and a half times his lowest weight (420), and for the first time, over five pounds (and two ounces). From the perspective of eating, digestion, and growth, Woody is doing amazingly well. He's also responsive, feisty, and a little ornery, which is very nice to see after how lethargic he seemed on Monday.

Our good friend Angie (Jack's mom) asks what the deal is with the trach and why he would need to be on it a year. It's a good question, because the trach itself does not require any time to be on it; it's only an access point to allow him to be artificially ventilated while being able to do the developmental stuff that the mouth allows. But the issue is that if he still requires ventilator support at the time he'd be coming home, he is not that likely to suddenly get off it anytime soon. While we don't know how long he'd be on it (yes, the year is pure speculation) we could be pretty sure that he'd be on it a while. At this point, he's pretty likely to be on some diuretics when he goes home, some oxygen, and who knows what else for care. We're also likely to not let him hang out with other kids much this winter, just because he'll be very susceptible to the narsty bugs that they can carry (my nephew Leo, whom I love very much, acquired the nickname 'the littlest disease vector' in our household this last winter).

Angie also asks what's up with possible surgery on the eyes. ROP is a disorder of the developing eyes; at birth, preemies have incomplete blood vessel growth between their retinas, at the back of the eyes, and the lens and cornea structures at the front. As they get older the blood vessels grow in from back to front, and a couple of things can go wrong in this process. These issues are lumped in under the term "retinopathy of prematurity." The most serious problem is that if the vessels form scar tissue, as the eye grows the scar tissue basically acts as a lever, popping the retina off the back of the eye, which would leave the kid blind. Laser surgery is useful because it can vaporize scar tissue and prevent this from happening, as well as getting rid of anomalous vessel structure, which can either allow good vessels to take their place or at least remove the bad vessels from obstructing or otherwise messing with the vision. ROP is awfully common in micropreemies, and the doctors are pretty used to treating it. I am confident that he'll be able to see, and if we need to get him some cute little glasses, so be it. We'll just have to suck it up!

In short, Woody is having a watch-and-wait day, and while I am tired of such days I am happier with them than with the days where it seems like lots of new, bad stuff is happening.


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