Day 58

Ava's CO2 blood gas was 37 this morning, which is good. They had an eye doctor come in and check her. They found that she has stage two retinopathy of prematurity, which is typically. Retinopathy of prematurity (ROP) is abnormal blood vessel development in the retina of the eye in a premature infant.

There are 5 stages of ROP.
Stage I: There is mildly abnormal blood vessel growth.
Stage II: Blood vessel growth is moderately abnormal.
Stage III: Blood vessel growth is severely abnormal.
Stage IV: Blood vessel growth is severely abnormal and there is a partially detached retina.
Stage V: There is a total retinal detachment.
An infant with ROP may be classified as having “plus disease” if the dilation and twisting of the blood vessels matches or exceeds a standard photograph.
Symptoms of severe ROP include:
Abnormal eye movements
Crossed eyes
Severe nearsightedness
White-looking pupils (leukocoria)

Thankfully she can see and her retina hasn't detached. The doctor told me that steroids and eyes don't really go well together. The steroids could be causing the problems or it could be the high percent of 02.

Ava got a brand new ET tube this evening. One of her nurses brought a new blanket for her. So they changed her to fresh bedding and it seems her O2 saturation is in the 90s.

Her CO2 was 44 this evening. Amplitude went down to 13.

Her liver enzymes were high, but they feel that lab results were wrong and that the liver is functionally well. They are going to retest on Friday and if the results are the same they will scan her liver. They say her urine is yellow and not white so there shouldn't be a problem.

I spoke to the doctor tonight and he talked to me in detail about her lungs and his outlook. He told me that the day she was born her CO2 blood gas was 138 and that was extremely bad. If you notice now, good blood gasses are in the 40s. But he said you can't account for the will to live, and that Ava has. A strong will to live (nor can you account for our great and wonderful God). He told me that since we had heard all the negative stuff about Ava, that he was going to concentrate on the positive. He still feels that nutrition is so important and he is going to push that. Dr Riley is on next and if he has to let him have the glory on getting her off the oscillator/ventillator, he will let him. He is going to start weaning her more on the steroids since her blood sugar has been so high. We are hoping that her lungs will stay strong, and grow because she can't stay on steroids forever. They put an IV in for her to get the insulin.

Praying for her eyes to get stronger, her lungs to grow and get rid of the lung disease and her liver enzymes to be normal.