Crystal Clear

Archer has been very busy the last few weeks. Along the way he has been laughing and learning new talents. He is constantly putting his hands in his mouth, along with other things. This is supposed to help him make new sounds as he learns about how his mouth works. Archer has also started seeing new occupational, physical, and speech therapists at a local hospital. They help him with exercises and feeding techniques to help get him caught up with other babies his age. They are all very impressed with his progress. Dad practices exercises with him everyday to help him do things like touch his toes, roll onto his sides, develop good trunk muscles, and sit up. When Archer plays on his own he mimics these movements quite well. He also talks to his toys and is getting better at propping himself up during tummy time. Archer also had his first experience in a large swimming pool. He is picky about the water temperature, just like his parents. He enjoyed kicking and splashing water at Grandpa Long as Dad held him. He has also significantly increased his milk intake and has finally hit the double-digits! Archer was 10 lbs. 6 oz. at his weigh-in today!
Archer had an overnight oximetry study at home a couple of weeks ago to see if he still required oxygen. Shortly after he had a follow up appointment with his pulmonologist. After this appointment, Mom and Dad decided they were uncomfortable with this particular doctor. A couple of days after this appointment Mom received a phone message to increase Archer's oxygen intake during sleep times because it might help him with weight gain. Mom and Dad were frustrated with not getting many answers regarding Archer's health and felt that his needs weren't being met. They quickly decided to change pulmonologists with the help of the pediatrician's office.
Today, Archer met his new pulmonologist, who had several good reviews and was also highly recommended by a case manager. The new doctor's initial thoughts were that Archer physically seemed very healthy. His lungs sounded very clear, and he did not react poorly to any quick tests by increasing respirations or work of breathing. He mentioned that Archer's vocal chords sounded very good after being on a ventilator for over 60 days in the NICU. The doctor was a little perplexed about some previous decisions that had been made regarding Archer's lungs and oxygen requirements. He reviewed the most recent overnight oximetry results but said there is not enough information to determine if the data is accurate and whether Archer can come off or requires a higher flow of oxygen. He then sent Archer to receive a chest x-ray as Archer has not had one since he left the NICU. After the x-ray the doctor seemed very pleased. He said that by the x-ray you would never be able to tell that Archer was a micro-preemie with Chronic Lung Disease. Archer's previous chest x-rays always looked hazy or fuzzy, but Mom and Dad observed that this x-ray was crystal clear! The pulmonologist spoke with Mom and Dad a little longer, along with a respiratory therapist. Mom and Dad agreed to a different type of overnight study that is more complex than just setting up a pulse oximeter at home. In two days they will stay overnight at a hospital with Archer while he undergoes a pneumogram from 4:00 pm until the next morning. Archer will go about his normal evening and nighttime routine with Mom and Dad. Without oxygen, he will be hooked up to a pulse oximeter and a monitor on his leg to see if his leg movements affect the oxygen reading on the pulse oximeter, as this can throw off actual numbers. His heart rate and respirations will be monitored to see if they correlate with drops in his oxygen saturation levels. He will also have a special cannula in his nose to measure the amount of air intake. If his saturation levels stay consistently above 88% without any major events, then there is a good chance that Archer can come off oxygen altogether. If it appears that he still requires oxygen, then his flow may have to be increased because as he and his nostrils get bigger there is more room for the oxygen to escape. If Archer were to come off oxygen, then he will still require an apnea monitor at home for at least another month to make sure that he is through with having any real events (he hasn't seemed to have any, almost all alarms during the night have appeared to be false, although Mom and Dad are still awaiting the results of an apnea monitor download). Then his medications will most likely be reevaluated and hopefully he will not require them, as this doctor prefers to wean babies off oxygen and medications quickly after being released from the NICU. Mom and Dad were very pleased with Archer's new pulmonologist and feel like a plan is now in place to meet Archer's needs.