today, 77 days or 11 weeks after little odin was born, we had our baby shower. thanks to the hard work of kris' sister, gina, and her partner, diane, many people came and had lots of good food to eat. we had a great time and received many, many great gifts, but of course, given the circumstances we had a tough time not dwelling in his eric's impending transfer to the new nicu for eye surgery.

i might have some of the details incorrect because i haven't had a chance to talk at length with eric's opthamologist, but my understanding is that eric is "pre-threshold" and "8 hours" into ROP which is technically stage 3+ and primarily developing in zone 2. if you think of the eye as a dartboard, the optic nerve is the bullseye and is zone 1 and there's a ring around the the optic nerve which is known as zone 2. there are 4 stages of the disease and stages 3+ and 4 can lead to the formation of scar tissue on the retina, vitreous hemorrhage, and retinal detachment. by saying that eric is "8 hours" into stage 3+ disease, his opthamologist is not telling us that he's been at that stage for a third of a day, but rather if he's giving us an indication of hos quickly the disease had progressed. if you were divide the retina into 12 hours, he's telling us that 8 "continuous" hours show signs of being in stage 3+ of the disease. he only needs to show signs of disease in "3 hours" to be considered "prethreshold" in zone 2 ( as the disease progresses, you move from being "prethreshold" to "threshold" which means you need surgery within 72 hours ), so it doesn't appear that they are making a marginal call and transferring him unecessarily.

or does it.

after spending much of the day trying to come to grips with how his disease could have progressed so quickly, eric's neonatologist paid us a special visit late in the evening ( on his time off, no less ). we've come to expect the going to get weird whenever we see him at odd hours ( he's a great guy, but as you can imagine he's A Very Busy Man ) and this visit was no expection.

after stating the appropriate amount of caveats , we found ourself listening to him explain that they could never not do what they were doing because they can't ignore the results of his latest eye exam - but that fact didn't stop him from holding out hope that eric's ROP was not nearly as bad as the evidence would lead his opthamologist to believe. sounding much like a zen master he stated plainly, "you see, it's apparent, but it might not be real." in medicine in general and neonatology specifically, sometimes a test will show something to be very apparent, but all one's instincts tell one that it's really not real, and in this case, his instincts are telling him that eric's ROP might not be real.

normally, ROP progresses relatively slowly and it's fairly unusual to have severe disease appear so quickly when they were monitoring it so closely. in fact, it's so uncommon that he's only seen it a handful of times in his many years of practicing neonatology. and every single time it's happened, the diagnosis was preceeded by a recent blood transfusion, which is exactly what eric received just six days ago. but in his experience, micropreemies that present the disease as eric is presenting who have also received a recent blood transfusion often have the disease disappear or at least significatly regress. his theory is that for whatever reason the blood tranfusion engorges the eye's blood vessels in a way that makes the ROP apparent, but not real. he stated quite frankly that eric's opthamologist would not agree with his theory and that it didn't change the fact that they needed to treat eric as if he were going to need surgery soon, so the discussion has an academic flavor to it. but it's a bit of hope and i guess in a week we'll have the benefit of hindsight to know whether or not his theory is true or if it's just a kooky prognostication by a neonatologist who likes to second guess the opthamologists ( i mean that in the best possible way, if he's reading this :-) ).

amidst everything else, eric continued to do what he's been doing so well on his 11 week birthday - eating and gaining weight. he's still guzzling bottles at breakneck speed and he tipped the scales tonight at exactly 2 kilos or about 4 pounds 6.5 ounces.

we said teary goodbyes to some of the night nurses, as they won't see his again after the transfer tommorrow early in the day. unlike some nicus, eric has had many of the same nurses for his 77 day stay at "saints" and they gave up not getting attached to him a long time ago.

we won't soon forget his nurses and i suspect they won't forget him either.