Weight: 2.96kg

Met with the doctor at Bunda this morning at 6.30. Hearing test that was done yesterday at RSCM came back normal. Abdomen ultrasound result from April 1st was as stated in the last update (all is well except for liver which shows enlargement). Today she is scheduled for her eye test at the Jakarta Eye Center.

Altogether the main issues now are:

1. Congenital CMV infection - which can be treated with Ganciclovir. First we need to complete the round of tests, and we are now close to the end. After the eye test today, one more liver test tomorrow and doctors should be able to determine how extensive the treatment will be. https://www.drugs.com/cdi/ganciclovir.html

Due to the high volume of patients and different location of each test, the nurses haven't been able to schedule more than one test per day.

2. Laringomalacia - (literally, "soft larynx") is the most common cause of stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction. It can also be seen in older patients, especially those with neuromuscular conditions resulting in weakness of the muscles of the throat. However, the infantile form is much more common. Laryngomalacia is one of the most common laryngeal congenital disease in infancy and public education about the signs and symptoms of the disease is lacking. (https://en.wikipedia.org/wiki/Laryngomalacia)

Arlene has weak respiratory muscles that is affecting her food intake. As previously mentioned she struggles with sucking and swallowing milk. Growth and Development doctor has switched the feeding tube to come in through her nose, so the mouth is free for Arlene to train the muscles with a pacifier. We hope as her weight improves, her feeding and swallow mechanism can develop as well. In the meantime feeding tube and daily oral/respiratory physiotherapy are required.

Thank you all and have a great day.