Rattle

Archer has been doing well at home in recent weeks, though he has caught a cough/cold as well as a small case of thrush (small blistering of lips and bad diaper rash). He has not needed emergency trips to the hospital or pediatrician, which is always good news.

Archer had his last appointment with his ophthalmologist yesterday. The doctor was extremely pleased with Archer's progression since his eye procedures. Archer will now see a pediatric ophthalmologist for follow-up appointments, then he will graduate to a local ophthalmologist to check for lazy eye, crossed eyes, cataracts, and other eye ailments that could come sooner or later in life. He will require regular eye appointments for the rest of his life to check for such ailments. Though for now, his eyes seem to be perfect.

Archer had a sleep study last week to see how his breathing levels were at night time. The results came back as Archer having less than tolerable levels just 13% of the time. This was not convincing enough to take him off oxygen just yet. He will undergo another study in a few weeks. He is still on 1/16 liter flow of oxygen during the night time. 

Archer has also started to consistently gain weight, averaging about 1/2 pound a week. He is now up to 8 pounds! He is taking in breast milk mixed with formula to make it about 25 Calories to help gain weight.

Archer has been smiling much more in the last week or so. He often smiles when playing with Mom and Dad or when he is playing with his toys. He is also learning to grasp his toys, as he will hold a rattle for a few seconds and shake it up and down. He is still working on crawling and rolling over. He enjoys tummy time (when he doesn't fall asleep) and working on keeping his head up and making crawling motions. He is verbalizing more, trying to tell Mom and Dad what he wants (Mom thinks he is saying "Ma!").

Smiles

Archer paid a visit to see a neurologist a few days ago. After Archer was born, a small brain bleed was detected and a nurse observed him having seizure-like movements. The same neurologist also paid a visit to the NICU and put Archer on anti-seizure medication for a couple of months. This time around the neurologist was very optimistic about Archer's health and brain activity. She saw a very healthy baby that did not seem to have any cause for worry. She gave Mom and Dad the option of having Archer undergo an EEG to look for abnormal brain activity. An appointment was made a few months from now with the option of canceling the EEG if there is a consensus that it is not needed. Archer also had some lab tests done on this day to see if some of his medications could be reduced or cancelled. It will be a few more weeks until there is a decision on this.
Archer's fussiness at home seems to be reducing. The pulmonologist would like Archer to be taking in 27 calorie feedings. Mom and Dad have worked Archer up to about 25 calorie feedings. Any more than this and Archer gets super fussy and backed up. He has started to gain weight at a normal pace. He is up to an unofficial weight of 7 pounds 8 ounces.
Mom and Dad are trying to teach Archer to smile on cue. He does not smile often, though more than weeks prior.

Calories, Calories, Calories

Archer had his second appointment with the pulmonologist yesterday. During his first visit the doctor said that she would like to see him gain about 8 ounces per week, and be on 27 calorie fortifier mixed with milk. She said Archer was not on the growth chart and her goal was for him to gain weight in order for him to wean off oxygen sooner. A week after that appointment Archer became very fussy and did not handle the calories well. Some phone calls were made and Archer's reflux medication was doubled and then changed, and a new brand of fortifier was tried. Since this change Archer has been less fussy, and he has gained a few ounces, whereas he was really struggling to gain weight during the first two weeks at home.
During this appointment the doctor was pleased with his overall health. She said his lungs sounded much better, he was not congested, and he was just more healthy than two weeks ago. She was not pleased with his weight gain, as he now weighs six pounds 10 ounces. She again doubled his reflux medication, and Mom and Dad will attempt to slowly add more calories to Archer's milk in order to get him up to 27 calories per feeding. A nurse mentioned that it usually takes about six weeks for most babies to really start gaining weight with a growth spurt and hopes this is the case for Archer.
Archer also had a ten-minute test without the aide of additional oxygen. The respiratory therapist was pleased with Archer's breathing levels. He is now allowed to be off oxygen during awake times. In two weeks he will undergo a night study to see how he does during sleep times, and if he will be well enough to be off oxygen altogether. Archer will see the pulmonologist again in four weeks.
Archer's fussiness has decreased some since being home. He will have a "crazy time" in the evening that lasts a few hours, where he will eat off and on, fuss, and requires constant attention. According to the doctor this is normal baby fussiness that occurs during a busy time in the household, like cooking dinner and cleaning up from the day.
Mom and Dad are pleased with Archer's progress. He seems healthy even though his fussiness can be overwhelming at times. He is starting to smile more often, his feedings are getting better, and he is really enjoying playing with his toys. He sleeps well at night and wakes himself up about every three hours to eat, then falls back asleep.  The Kumfer family is surviving the stressful times and having fun along the way!