When will these doctors learn? Jesus.
So I show up this morning and... 100%. WHAT ARE THESE PEOPLE TRYING TO DO TO ME? Ugh. As usual, the doctors got all giddy about how well Jane was doing and messed with the ventilator's pressure settings and pushed her too far and... swoop! Back to 100%.
Have I told you all how weird Jane is? That's the nurses' term, not just mine. I swear. Anyway, most preemies don't want to be messed with. They hate being moved around a lot, being manipulated for x-rays and ultrasounds are always bummers, etc. Not our girl. So today Jane has an eye exam, which, naturally, I watched. Because I am a ghoul. It's the most uncomfortable and yet fascinating thing I've ever watched (oh, don't you worry, details to come). The opthalmologist is POKING IN HER EYE SOCKET, and Jane's satting goes through the roof. Her oxygen had been in the high 80s before the exam. It slowly starts to climb halfway through and by the end she was at 100% saturation. THIS IS WEIRD. Truly, deeply weird.
So Awesome and Hilarious Respiratory Therapist Eileen bumps her pressure setting back up to 21 (they'd tried to get her down to 17 overnight, which is where it all went south), and immediately gets her oxygen back down to 80%. Not as good as before this latest fiasco, but an improvement. And her CO2 went down to 52 from the 70s (it should be in the 35-45 range, but 50's okay for a kid with chronic lung disease).
Now, here's why the nurses are so damn awesome. Awesome Nurse Karen, who was on today and yesterday, took Awesome Nurse Donna (on tonight) aside during the shift change and said "We all have got to team up and make sure the doctors do NOT mess with Jane's pressure for a while." I'm sorry, but that's just too cool. The nurses are advocating on our behalf, and I couldn't be happier or more grateful.
Okay. So, the eye exam. SKIP THIS PART IF YOU'RE SQUEAMISH. They have to put drops in Jane's eyes to dilate the pupils, which babies just LOVE. Yeah, no. Then, the opthalmologist comes and uses a tool that looks like a warped binder clip to force the eyelids open. It's very Clockwork Orange. Then she takes a tool that looks like a teeny tiny spatula which she slips into the eye socket so she can push the sides of the eyeball where she can see them through the pupil (scleral depression is the term, for those looking to impress their eye doctors). Anyone nauseated yet? What they're checking for is a condition called retinopathy of prematurity, which is when the blood vessels in the eye grow abnormally. (The Wikipedia entry is actually quite good on this, for the curious). There are many stages and degrees of ROP, but at the severest end, if left untreated, it will lead to blindness. Fun, eh? Oh, supplemental oxygen use is a risk factor for ROP, along with prematurity and low birth weight. GREAT. Let's get her off the damn oxygen then, eh? Honestly, people.
So our girl Jane has the teensiest bit of stage 1 of ROP in one eye. 90% of the time it resolves on its own, I learned. So they'll continue to check her eyes weekly to monitor the sitch, but the opthalmologist was confident that it would take care of itself. So, I guess that's sort of goodish news.
Now a cute story as a reward for making it through that discussion:
While Jane's pupils were dilated and we were waiting for the eye doc to arrive, Awesome Nurse Karen tented a lovey (a flannel square I wear next to my skin to "charge" it, and then put in the isolette so J can bond with me via pheromones or something) over Jane's eyes to shade them. I went off to the pumping room, and when I came back, the lovey was entirely over Jane's face. "Karen, are you messing with my kid?" "What are you talking about?" Karen looked baffled, swore she hadn't touched her. So she repositioned the fabric and Jane immediately pulled it back down over her face. She was playing peekaboo! Okay, she was only trying to move her arm, which was stuck under the lovey, but it was really cute and funny, and Karen and I totally cracked up.
Maybe you had to be there.