*there's an 8 weeker

His pinkie fingernail on mine

When Will was first born he was often referred to as a "29 weeker" by hospital staff. They still use his supposed gestational age as a guide and right now he is at 37 weeks. But by our count, Will turned 8 weeks old yesterday! He weighs 4 lbs, 8 oz.

The biggest thing going on right now is that Will is being weaned off the Vapotherm machine. I looked for a simple link to describe what it does but didn't have much luck. Vapotherm is a step down from the Cpap and the step after Vapotherm is just getting oxygen from the hospital room wall through the nasal cannula. For you medical people, he is currently at 2 liters and 21% oxygen, but that percentage gets turned up as needed to help with spells. For the rest of us, the liters are the amount of flow which can go down to one. 21% oxygen is the same as room air that we breathe so we want that to stay the same.

The Vapotherm, just like the ventilator, is necessary but can cause damage at the same time. In brief, exposure to too much oxygen before they are ready can cause their retinas to detach. Yesterday Will had an eye exam that looked okay but they plan to follow up in 2 weeks. I asked if that means they are concerned and our nurse says that follow up of some kind is expected and some babies get followed every 2 or 3 days. So I think that means we've got good news for now about his eyes.

Vapotherm

So you can see where Will falls, here are the criteria for leaving the NICU:
1. Maintain body temperature - CHECK!

2. Outgrow apnea of prematurity and bradycardia

3. Take all feedings by mouth on an ad lib schedule and steadily gain weight

4. Breathe without oxygen

There are exceptions to these - some babies are sent home with oxygen, an apnea monitor, or a feeding tube. It's possible that one or more of those could happen for Will, but for now he is expected to accomplish all of these successfully.

The last 3 that Will has to work on are connected quite a bit. He stays on oxygen (4) to help with the apnea or brady spells (2). [I'll take another shot at explaining Will's spells. We have called most of them apnea but if you read the link above it explains that apnea & brady spells often happen together. And remember those Tet spells? At first we thought there were some, then they said he's never had one...basically it's hard to tell. Now maybe you can see why I'm not a fan of that monitor that alarms when there is a spell. It's confusing. Also I think I'm now hearing those beeps in my sleep.] Also most babies can begin to coordinate sucking and swallowing by 34-36 weeks, but they won't try to feed Will by mouth (3) until he's off the Vapotherm machine which is what is giving him the oxygen (4). It's harder to get the sucking and swallowing down with air coming into your nose with so much force.

The MRI and sleep study that were suggested recently have been discarded for now. The attending doctor schedule changes quite a bit around the holidays. The new attending doctor that came in the next day prefers the wait-and-see approach and wants Will to have more time before exploring those options. They are still looking at the possibility of reflux but we haven't seen proof that keeping it in check is helping. The only other news I have today is that Will had another echo. We're looking forward to an update on his little ticker.

Grumpy face

~Jody