Tuesday, October 6, 2009

My Eyes! My EYES!!!

It's been a while since we had a pedantic and yet overly-simplistic anatomy lesson around here.  Time to remedy that.  Whee!

As you've all caught on to by now, Jane, by virtue of her early arrival and small size, has been particularly susceptible to most of the exciting issues that preemies CAN be susceptible to.  The latest: ROP, or retinopathy of prematurity.  I believe I've mentioned it here before, but haven't really talked about it much.

When Jane was born, her eyes weren't fully developed yet.  Not by a long shot.  Her eyes were still fused shut, and more importantly, the blood vessels hadn't finished growing.  What happens with ROP is that the blood vessels in the eyes begin to grow abnormally.  If this doesn't stop on its own, it can get so bad that the retinas detach and the baby is left blind.  Yeurgh.  High levels of oxygen support are a contributing factor to developing ROP.  (Remember those days of Jane on 100% oxygen?  Yeah, there were LOTS of reasons not to like that 100%.)

As with everything, there are different levels of severity of the disease, five stages in this case.  The first two can resolve themselves without intervention.  The others?  Well, that's when things get scary.  And we're not going to talk about them (it's true!) because Jane, if you can believe it, does NOT have scary levels of ROP OR something called "plus disease", which is when the arteries get thick and twisty ("dilation and tortuosity" would be the terms for impressing your friends and opticians).  Way not to get every complication on the menu, Jane!

During her second eye exam (the one I first ghoulishly watched) the nice opthamologist saw Stage 1 in a half-hour of one eye.  (They think of the eye as a clock face, and describe ROP in terms of the number of clock hours affected -- if that makes sense.)  I don't know what happened in her third exam -- Tom was there for that one but didn't stick around to watch -- but by the fourth it had progressed to Stage 2 in both eyes.  Dr. Brusque (favorite of approximately NO ONE in the entire ICN) isn't the chattiest man, and so I didn't have much chance to ask him anything and I can hardly read -- or understand -- the notes on his exam reports.  However, after yesterday's exam he said "no change" but his notes indicated Stage 1 in both eyes, and no plus disease.  So I'm taking that as the start of the ROP resolving on its own.

So there.  A confusing and incomplete lesson in something we aren't currently having to worry about.  Aren't you glad you checked in?  Oh, Stevie Wonder had ROP.  There's your trivia for the day.

In ventilator news, they did give Jane a break from any changes yesterday to let her catch up with what they'd done for her over the previous three days.  As of today at 3:30, her pressure setting was down to 15.5 (nicely on the way to 12) and the amplitude was at 37.  I think?  Eh, something around there.  Her oxygen level was pretty much in the 50s all day.  She's really coming along pretty nicely, although I'm dying to see the oxygen back down in the 40s and even (dare I say it) 30s.  Something to look forward to, I suppose.

Enough.  I'm taking a bath and going to bed early.  And I might even take tomorrow off, so if there's nothing to post about, you can all blame Tom.

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