Spirit

Archer prepared for his laser eye procedures today by missing feedings, receiving an IV line in his arm, and taking some eye drops. He still seemed pretty tired from yesterday's swallow study and eye doctor visit. He did take in all of a couple of feedings, but mostly drank just half of his other feedings since yesterday morning. Mom and Dad cuddled with him and gave him a good luck kiss when he was settled into the room across the hall, readied with the medical equipment and medical team. They waited in the family lounge for just over an hour until they were notified that the procedure was over and they could come back to the NICU.
The ophthalmologist said Archer did great throughout the entire procedure. He was content with sucking on drops of sugar water and didn't fuss very much. Archer only required a small bump in oxygen, from 24% to 28%. After the procedure was done he said that he opened his eyes and looked very content. He said he is a very spirited baby. Most babies would close their eyes and make a fuss when the procedure was completed. Archer's eyes were just slightly swollen. He does not require any temporary eye patches. The ophthalmologist was very optimistic that he caught the abnormal vessels very early and redirected them to grow normally. The results will begin to be noticed in a few weeks. If the procedure didn't fully work then Archer may have to have more procedures. He will have weekly checkups and will be taking drops for the next five days. Archer's IV line was taken out and is back to his normal feeding schedule.

Good News, Bad News

Good News: Archer began the day with a swallow study to see if he had milk going into his lungs during feedings. Archer took 30 ml of a bottle mixed with barium. The barium was detected by an x-ray video that was zoomed in on his head and neck. The milk could be seen going into the correct pipe without any flaws! G-tubes and G-buttons are hopefully now out of the picture. Archer just needs more time to build up his endurance during feedings. When he is taking 100% of his feeds by bottle, and is having little to zero bradys, he should be on his way home, unless other factors appear. His minimum feeding requirement was raised from 54 ml to 57 ml.
Bad News: The eye doctor felt a need to come in early and check on Archer's ROP status again. The checkup showed that both eyes had worsened and are in stage 3 ROP. Archer will undergo dual laser eye surgery tomorrow afternoon. The doctor feels that he is catching the abnormal vessel growth early. He said the success rate of the surgery is 80 to 90 percent of having semi-normal vision in at least one eye.  It will take 2 to 4 weeks to find out how successful it was. Archer will not be transferred. He will be the first preemie to have the surgery at Dupont Hospital, though the doctor has years of experience, just in other hospitals. Each eye will take about 45 minutes to complete. Archer will be sedated and will be able to take oxygen from the Vapotherm and cannula. The entire NICU will be closed to all visitors and parents during this time, even Mom and Dad.
Other News: Archer received his third and final vaccine, Pneumococcal. He received a Kate's Kart book: Chicka Chicka ABC.

Easter Sunday

Archer laid some rotten eggs and Mom and Dad found them. He managed to spew up on Dad once and pee on him twice. He was fighting gas in his tummy throughout the day which has become routine. Archer's weight is up to 5 pounds 13 ounces. His oxygen level made it back down to 24% and has not required a regular bump up in his oxygen during feedings or throughout the day for quite some time. He is still on 1.0 liter flow.

Archer fed by bottle really well for Mom and Dad today. Of five bottles he finished one, drank more than required for two, and had just a smidge left on two. It takes work and patience, but Archer is showing us that he is able to feed by bottle. Mom and Dad will find out more about any feeding problems he may have via a swallow study tomorrow morning.

Seventeen Weeks Old

Archer received his second vaccine, the Hib vaccine. He has taken his two vaccinations really well. Just one more to go.

Archer seems to be pacing much better during his feedings. Mom and Dad do not have to pull the bottle down or away from him as much to help him pace. He needs to work on keeping up his stamina so he can one day drink all the milk he needs to stay healthy.

Archer had another visit by his eye doctor. The prognosis was that his left eye is still in stage 2 ROP and a part of his right eye has entered stage 3 ROP. The eye doctor will come back in a week to see if his eye has worsened or if corrective laser surgery may be necessary. He has vessels growing abnormally in the back of his right eye and laser surgery can get the vessels growing back on the right track.

Archer's weight is up to 5 pounds 11 ounces.

Backed Up

Archer had three out of five good feedings today where he drank the whole bottle. He paced himself well. He was pretty tired through the other two feedings and he was trying to get out some poops during the entire day. He was still unsuccessful when Mom and Dad left for the evening.
A swallow study is scheduled for Monday. This test looks for any milk that is leaking into the lungs during feedings. If there is a small amount of leakage then it is possible for milk thickeners to help with the situation. If there is a large leak then surgery may be required to help him take feedings. Mom and Dad are trying to find out if there are any physical reasons why Archer cannot take full feeds yet, other than having premature lungs.

Little Pookie

Archer's bottle feeds haven't progressed much in the last 24 hours. He has taken all of some bottles and more than half of others. He still paces himself about half the time. Mom and Dad spoke with a surgical nurse today who observed Archer's hernia and talked about surgeries for his hernia, G-tubes, G-buttons, and a Nissen surgery in case he is having bad reflux. He will definitely need to have a hernia surgery. It's a matter of having it done soon, along with possible other surgeries, or having it done in a few months if other surgeries can be avoided. When he has surgery he will need to be transferred to a different hospital and will have to be re-intubated (put on a ventilator). Mom and Dad are weighing their options and are still hoping that Archer pulls through the tough time he is having with bottle feeding.
Archer received his first vaccination today, Pediarix. This is the first of three vaccines he will receive before going home.
Archer received a new Kate's Kart book: Night-Night, Little Pookie.

Adjusting

Archer did not drink as much volume from a bottle as he did yesterday, but Mom said he paced himself much better. He was very sleepy through a few feedings. His volume per feeding increased from 51 ml to 54 ml. It will be a challenge for Archer to keep up with the amount of milk he needs to drink based on his weight gain. His medications were also weight adjusted.