Amazing Grace

Amazing grace, how sweet the sound

That saved a wretch like me!

I once was lost, but now am found

Was blind, but now I see.

Can I get an amen?

The above stanza is the introductory verse to “Amazing Grace” written by slaveholder turned minister John Newton in 1779 as a part of the Olney Hymns signifying his hometown. In most churches I have attended and/or visited over the years, we typically stop after the second verse (there are six in total); in black churches nationwide, “Praise God!” is harmonized ad lib as the speaker of the hour - normally the pastor – prepares to begin preaching his or her sermon.

Nearly two months ago, our daughter Caeli was transferred to ACH for retinopathy of prematurity from UAMS. ROP is a potentially blinding eye disorder that primarily affects premature babies weighing less than 2 ¾ lbs. or born before 31 weeks of gestation. In other words, the smaller the baby, the more likely she is to develop ROP. Caeli was a micro-preemie:  born at 24 ½ weeks, weighing 1 lb. 8 oz., and only twelve inches long. To put in perspective, she was slightly longer than a footlong sandwich at Subway, and depending on how your sub was made, she could weigh less than that Dagwood Bumstead monstrosity. With most babies, ROP improves and leaves no permanent damage in the milder cases. In fact, 90% of babies with ROP are in the milder categories and do not need treatment.

Below are five stages of ROP, ranging from mild (Stage I) to severe (Stage V).

Stage I — Mildly abnormal blood vessel growth. Many children who develop stage I improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.

Stage II — Moderately abnormal blood vessel growth. Many children who develop stage II improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.

Stage III — Severely abnormal blood vessel growth. The abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina. Some infants who develop stage III improve with no treatment and eventually develop normal vision. However, when infants have a certain degree of Stage III and “plus disease” develops, treatment is considered. “Plus disease” means that the blood vessels of the retina have become enlarged and twisted, indicating a worsening of the disease. Treatment at this point has a good chance of preventing retinal detachment.

Stage IV — Partially detached retina. Traction from the scar produced by bleeding, abnormal vessels pulls the retina away from the wall of the eye.

Stage V — Completely detached retina and the end stage of the disease. If the eye is left alone at this stage, the baby can have severe visual impairment and even blindness.

Most babies who develop ROP have stages I or II. However, in a small number of babies, ROP worsens, sometimes very rapidly. Untreated ROP threatens to destroy vision.

The Lord gives sight to the blind, the Lord lifts up those who are bowed down, the Lord loves the righteous. -Psalm 146:8

Throughout the journey from conception to an abbreviated pregnancy and the extended stay in the NICU, God’s grace has proven itself amazing. Even as a professional wordsmith, I sometimes cannot find the superlatives to describe God’s goodness through each of Caeli’s victories. A Tiger Woods fist pump and primitive yell would have to suffice – in the car, not in the hospital (ACH has over one hundred babies in the NICU, many of whom are still sensitive to sound). Through many dangers, toils, and snares we have overcome, it is grace that has carried us safely to this day and will surely lead us home.

I was blind. Now I see.