"I'll have one of everything, thanks!"

After Andrew was born, we bought a book about premature babies to give us some idea what we were in for.  It's been helpful for us both to have something to reference as doctors and nurses throw out acronyms galore...IVH, ART, PAL, TPN, etc.  In the book's introduction, the author warns not to read the whole thing, but to reference various sections as they apply to your baby.  Those that know me, understand that I read the entire thing, cover to cover, in the first week.

One of the chapters covers top heath concerns for preemies of different gestational ages.  Remember, Andrew was born at 23week, 5 days so he's one of the smallest, right on the edge of viability.  I was reading back through the list for 23 - 25 weekers the other day and mentally checking off what he has been through already.  Wouldn't you know, that he's hit almost all of them?

• RDS - Respiratory distress syndrome; needed ventilator support at birth (almost all at his age need this)  CHECK!
• BPD - Bronchopulmonary dysplasia (also called Chronic Lung disease); damage to the lungs, usually resolves by age 2 (65% of babies his age have this.) CHECK!  His is mild, yet still causing breathing issues.
• Apnea - forgetting to breathe, should resolve by 38 weeks.  CHECK!
• PDA - pulmonary ductus arteriousus valve does not close on own after birth, causes too much blood flow to lungs (40 -50%.) CHECK!  Andrew had PDA ligation surgery at 10 days old to clamp the valve.
• IVH - interventricular hemorrhages; bleeding on the brain caused by small blood vessels rupturing (50 - 60%.)  CHECK!  He had a level 2 bleed, which is resolving on it's own and shouldn't cause any long-term damage, thankfully. 
• ROP - retinopathy of prematurity; abnormal blood vessel development in his eyes (almost all at his age.)  CHECK!  Right now his is at stage 1 (out of 5) but could progress or resolve.  Long-term effects TBD.
• Hernia - loop of intestines slides into the groin from the abdomen (15%, mostly males) CHECK!  He'll need surgery at some point to correct this, it's not an issue now unless it gets trapped.
• NEC - necrotizing enterocolitis; inflammation of intestinal tract (5 - 10%.)  He's avoided this one so far, luckily, but still could occur later in his stay.  It sounds pretty harmless, but can be very serious, requiring surgery and removing part of the intestines.
• Infection (50%).  He's also avoided this!  Infections can be very serious, so we are hoping to land on the good side of the odds on this one.

So, we've been lucky to avoid some of the more serious complications (like more serious brain bleeds, NEC, and infection) but he's managed to hit on most of the concerns.  After his eye exam the other day, which showed Stage 1 ROP, his nurse commented that he didn't have to hit on every complication known to preemies!  We agree!! 

After his eye exam - chilling out

As for the newest development (ROP), he will continue to be monitored to see if the eye blood vessels stop developing abnormally.  Ironically, extra oxygen is one of the factors that causes this issue (which of course he needs to breathe!)  Sometimes, it will get worse before it gets better, so we'll wait for next week's exam to see.  In the worse case scenario, the retina could detach from the eye and cause blindness (FACT OF THE DAY: This caused Stevie Wonder's blindness!)  Of course, this is why they monitor closely (he'll get eye exams every week or two until it is resolved) and if the level of disease gets bad, they would do laser surgery on his eyes before the retina detaches.  About 5 - 10% need the surgery, so the odds are low his would progress to that stage. 

Visiting with Daddy the night of his exam

While we are joking that Andrew is struggling with all the complications of prematurity, it really is amazing to look at that list, and realize all he's been through in his seven week life.  Clearly, our little boy is pretty strong and resilient.  And, what a testimony to technology, medicine, and the caring hands of his doctors and nurses that he is doing so well!  While we wish we had a time machine, to fast forward to when he is home with us, we are so very thankful for the home is in right now.  They are really miracle workers, and Andrew is one lucky boy.  We know he will overcome what ever is thrown at him next.

Awake for part of our visit last night!