More Time

This is going to be another quick update since I'm not going to the hospital tonight and need to use this time to catch up some sleep! Its Dave's turn to be sick so he's been out of commission with a flu since Friday. I'm trying to hold up the fort, take care of Dylan and the boys and somehow manage to take care of myself....

This week started off pretty well for the boys. Feeding was moving along and we were kind of on a roll at 4 out of 8 nipple feeds so the doc increased them to 6 out of 8 nipple feeds. But then they started to have consistent choking episodes along with their desats and general fatigue for several days. I think it was just a little too much for them. We want feeding to be a positive and pleasurable experience for everyone so today the doc reduced them back to 4 out of 8 nipple feeds. They just need more time to mature their suck/swallow/breathe coordination and pacing especially during letdowns.

Jared was given a blood transfusion (his 2nd in the NICU) on Friday night. He also got a dose of lasic for fluid retention today.

Both are having another eye exam tomorrow to check for ROP.
Blake weighed 4lbs, 11oz on Sat.
Jared weighed 4lbs, 8oz on Sat.

Blake's also been off the nasal canula for about 3-4 days now. Seems like this time its for good. This is the 4th try.

Storytime

Just got back from another late night at the hospital with the boys. They were both wide awake when I arrived and breastfed well but still had desats. Both are so hungry and suck well so sometimes they don't even stop themselves. I have to pull them off and stimulate them to remember to breathe.

Blake's taking 39cc and Jared's taking 37cc per feed.
Current weight is: Blake 4lbs, 5oz and Jared 4lbs.

They are both being given epigen (sp?) to increase the growth of red blood cells (shot MWF) and a diuretic (daily oral).

Our guesstimate discharge date is another 10 days? We'll see how far off we are or if we've guessed right! The docs and ourselves are taking their cues and watching them closely. They will let us know when they are ready. At the moment, they just need more time to coordinate suck, swallow and breathing with their feeds and are still weaning off the oxygen although the assistance is minimal at this point. In the meantime, we are getting their room ready and trying to tie up any other loose ends around the house. Lots of things to do and very little time!

Tonight just before I left, I had a short storytime session with them. I read 2 books Do You Love Me Mama and Going to Bed. Both guys were attentive and seemed to enjoy it. I gave them each a binky and wished them SWEET DREAMS. Good night Jared, good night Blake!

Back to the NICU

I've been going back to the NICU to see the kids again. My first day back was Saturday. Blake and Jared are in the open plastic cribs that you see typical newborns in. They have a lot less wires attached and their color seems better in general. They've been sleeping like angels...


Today the doctor said they may be coming home as soon as two weeks from now (i'm convinced it'll be more like 3wks)! Truth be told,we were a bit taken aback. Of course we're excited too, but the twins are tiny and are still getting half of their feeds through a tube. They seem so fragile...Jen and I both said "Can't we all stay here longer?". It's funny because that's how we both felt when we had Dylan - on the day we were discharged we asked, "Can we stay another day?". They laughed at us.

Today when Jen was feeding Blake, he had a desat episode. His blood oxygen level gets low because he forgets to breathe or he does shallow breathing. The alarm goes on and if the level gets in the low 80 / 70's you have to pull him off and rub his back and wake him up so he starts to breathe again. He also turns bluish. I finished his feed with the bottle and it happened again. It's not uncommon for preemies to desat, but it is unnerving to see your baby turn blue. Thankfully it doesn't happen too often. Jen just got back from the NICU this very moment and said the night feeds went great!


We should feel more confident and we will by the time they come home - we've taken care of a newborn before. But this will be different and require more attention, care and of course worry. The nurse said, "(when you take them home) these aren't babies you can feed while talking on the phone. You have to watch them, pay attention to make sure they're doing okay." Jen and I will have to refresh our CPR and learn the techniques for bottle feeding these little guys. Over the next few weeks we'll be in preemie care bootcamp! Exciting.

The nurses took some pix of the twins after their bath w/ their fuzzy hair dos. Enjoy.

A Quick Update

What's the latest and greatest with the twins?

These days the boys have just been busy feeding and growing!  They have 1 feed every 3 hrs (8 total) each day.  Beginning today, we will up their breastfeeds from 1 to 2 times a day.  In addition to the breast, they are getting 1 bottle a night and the other 5 feeds are still through the feeding tube.  This means I am now going to the hospital twice a day and spending lots of quality time(4 hours a day) with them.

Jared weighs 3lbs, 11oz and Blake weighs 3lbs, 13oz as of yesterday!  They also had baths the other day and their hair was nice, clean and fluffy like little chicks!  The nurses were nice enough to take pics, so cute.... I'll have to post them later tonight.

The boys will have eye exams on Monday.

I took my mom for a quick visit yesterday before her flight home around 5pm.  When I returned at 10pm for their feeds, Jared's nurse informed me that Jared woke up shortly after I left at 5:30pm and hadn't gone back to sleep.  It was quite a long time for a preemie to be awake.  She said he's a smartie.... he knew what he wanted which was to be held and rocked and figured out how to get it!  Uh-oh.  

Two Peas in a Pod

The twins are finally back together....last night they were moved into an open-air bed and are now co-bedding. All their official cribs are being used so they put us in a makeshift crib and we will wait for the next available one. They look so cute together!! I know they will encourage each other and keep each other company for the rest of their time in the NICU.

We weighed Jared for the first time today before and after his recreational breastfeeding session. He's usually the bigger eater so we wanted to see how much he is actually getting. Today he drank 7ml from me. They said that was a great job!! Go Jared!!

Last night they also took out both of the twins' nasal canulas. Blake is doing great without but Jared still needed just a bit so they put his back in this morning.

Steady Now

Time is flying by these days..... the twins are technically 3 wks and 2 days old! We hope they will come home around 38 wks so I'm still counting by adjusted age which means they beginning their 35th week tomorrow!

We seem to be "last weeks news" now that they are completely stable and moving on a normal preemie track. A couple ways to tell your babies are getting better: 1) less nursing attention. Jared and Blake use to each have their personal 1 on 1 nurse 24/7 but are now sharing a nurse, sometimes even with another baby. I was also getting used to the nursing attention and now I find I'm having to help myself to footstools and nursing pillows. boo-hoo! I'm often wondering, Hello! Where is everyone? They must have gone on break? 2) less wires and equipment. Blake has been moved to a smaller, less complex isolette bed and Jared will be moving shortly. Both have nasal canulas for minimum oxygen and feeding tubes through the nose for breast milk and fortifier. Both had their PICC (IV) lines taken out as well.

I'm spending about 2hrs a day at the NICU. I recreational breastfeed each and spend time cradling them and inspecting them (trying to differentiate the two). The past couple days I'm also cuddling them chest to chest so they can hear my heartbeat. This is the closest reminder of being in the womb. I'm also changing diapers (poopy ones too) and taking their temperatures.

Breastfeeding is coming along slowly. They both latch, suck for a bit and draw out some milk but they just don't have the capacity to swallow. It then results in them pulling off and sometimes desaturating (a dip in their oxygen level or heart rate). The nipple shield has helped quite a bit and in due time, they'll get the hang of it. They are starting to gain weight now that they are on full feeds every 3hrs. As of today, Blake is 3lbs 11oz and Jared is 3lbs 8oz!!

First Feeds

It's Thursday, March 5th. The boys are doing well, just coasting this week! Jared is still on his nasal canula with minimum oxygen and caffeine. Blake is still doing great with open air.

This week's focus is on feedings! Both boys are at full feeds beginning last night which means 28ml every 3 hours through a gavage feeding tube. One of the nurses told me that we would start recreational breastfeeding in a few days. But to my surprise, when i walked in on Tuesday they said," Want to try now?"
Basically, we are just introducing them to idea of breastfeeding, familiarizing them with the nipple and trying to stimulate them. Full term babies have this capacity but preemies need to be taught the process of latching, sucking and swallowing. It uses a great deal of their energy.

Blake was first up to bat! At first, he looked around. Still groggy from waking up and probably wondering what is this thing 1 inch from my face. He heard my voice and smelled my scent and was able to look at me with open eyes. He did a good job! He latched a few times with a little direction and was even able to take a few sucks. Then he did what he always does which is pass out and sleep peacefully for as long as you are willing to hold him.

Now Jared's turn. This little guy has a lot of fight in him. He was also able to latch and he actually sucked out some milk but then pulled back realizing it was going to be a bit much energy to swallow which he can't quite do on his own. The nurses were impressed with his intuitive decision to stop.

So this is what I've been doing the last couple days. My mom has been coming with me. We take turns cuddling the little guys and watching them make facial expressions, hiccuping, opening their eyes, and just sleeping. We've decided they are identical but Jared is slightly smaller and Blake has a dimple on his right cheek! Check out the pics!

Dave is banned from the NICU because he tried to take the babies home in his back pack. Just kidding... he has the cold that has been going around the Valley - he got it the first day he went back to work.

Milk

Blake and Jared are both continuing to improve. Jared is on the nasal cannula and Blake is breathing on his own completely. Blake has some spurts where he tends to breathe really fast, but so far it's nothing to worry about. The twins are moving on to become "feeders and growers" say the nurses. We are ecstatic about that.

Jen will start offering the boob, oops I mean recreational breast feeding tomorrow. She has to pump first and then offer the breast as to not douse them with the fire hose of milk she's producing. We have an entire freezer full of frozen milk for these little guys. If you have extra freezer space and live in Mountain View let us know!

Right now, the nurses feed Blake 8ml every 3 hours and Jared 6ml every 3 hours through a gavage (nasal tube). They are increasing the feeds by 2ml every 12 hours. Afterwards they draw some of the milk back up the tube to check if there are any digestion problems. So far so good.

Yesterday my mom, brother and dad visited the twins (my dad sat outside cuz he has a cough). Today Jen's mom visited. I took Blake's temperature, changed his diaper and held him during my lunch hour (the hospital is 7 minutes away from work). Blake was alert and awake for the first 15 minutes, looking at me and checking stuff out - I'm sure he just sees fuzzy shapes for right now (they're only 34 weeks tomorrow). Every time there was a loud noise he would jump and make the cutest grimace. The nurse asked me to kiss his head before he went back in the crib. Jared's been really fussy lately when we visit. The nurses flip him in all sorts of positions to make him happy and we use our hands to sort of swaddle and comfort him. Today he was sleeping so angelically I didn't want to disturb him.