1st time for everything!

Alexandra had her first mess that warranted a walk straight to the bathtub!
I always thought is was a bit of a joke when my uncles talked about throwing kids into the tub fully clothed, apparently the joke was on me. Not only did she completely fill the diaper but she managed to shoot it up to between touch her shoulder blades.

It took about 30minutes of tub time to get her all cleaned up. During that time she helped me empty and draw clean water 3 times before we actually got her all covered in sudds. The beauty of it all was that when we got done Annellice also had a messy diaper.

I think I have hit my fill of the dirty diapers this week - it's dad's turn now. Weird part is that changing the dirties always seem a bit fun; the girls are usually smiling and we tend to have a good chance of a story coming out of the experience as well :)

No reason to be alarmed :)

During bathtime last week Annellice figured out how to hold her breath long enough to turn PURPLE! She almost looked like an Oompa-Loompa.

Why do kids do this exactly? After some bouncing, pulling of the arms and legs, gentle squeezing of the cheeks and na-da. In comes dad to the rescue! He pryed her mouth open then stuck his index finger in to pull her tongue down from the roof of her mouth. After about 30seconds the screaming began. YAHOO!
She is doing well now and has had no ill effects from her new-found trick. I have been checking on her a bit more when she is sleeping appears to be back to normal from what I can see.

Hearts are Good!

Totally forgot to tell you all... Alexandra had her post-hospital follow-up with the Cardiologist (Dr Albrecht from UVA) on the 17th. They started with taking her blood pressure which is not an easy task on such a small squerming body. After several attemptes by one nurse they pulled in another nurse for an extra set of hands, all the while Lexie sat there squerming and occasionally throwing out a smile. After the BP was taken they stuck about 10 sticky patches to her chest and abdomen to listen and document her heart rythms. From the patches with little plastic flaps that close-pin like things clipped onto. After the monitor printed out 3 tests the removal process started. We let the nurse be the bad guy on that one as Lexie didn't like getting the sticky pads taken off with warm water and soap much less just being yanked off without warning.

After much screaming and crying we were off to the ultrasound room with Dr Albrecht did his thing. He showed us on the monitor that there are still 2 small (less than 3mm) holes - VSD's and 1 hole that each baby has after birth that has yet to completely close. Now I know that sounds bad, but the Dr assured us that these holes are VERY common and that they DO NOT deter people from leading happy and productive lives.

So--- YEAH! No surgery needed! YIPPIE!!!

13" @ 6AM

HAPPY HOLIDAYS!!!!

So are they cute or what!!??!!??

Lexie is on the left and Annellice is on the right.

Who would have thought blowing air on the their faces would insite a riot of smiles?!? I am loving the trick so far though. Here is another one of them hamming it up.

Brrrr....

Wow time is flying by and I can hardly remember all the things that we have been doing since Thanksgiving! We now see what people say about this time just being a blur; I hope we can at least take enough pictures so we can at least look pack on it at some point and go "Oh yeah - thats when..." We shall see what happens though.

At any rate, the girls sported their snow suits for the first time about 1-2 weeks ago now. Even though they are sized for newborn and 0-3 months they are swimming in them. At least they are staying warm while we walk Titan - which is better than me some days! We are looking forward to our 1st snowfall of the year now. (Annellice is the the white suit and Lexie is in the pink one. )

The daily walks with Titan have been a good way to settle the girls in for the evening. If I plan everything correctly the afternoon stroll tires them out just enough so that I can get dinner made without to many runs to and from the pack-n-play/toys.

Recently, the girls started "talking" more. They now have "lights on" when they look at things, so we have started placing them on a play mat that has little objects dangling from it. Annellice enjoys talks to the pig and blue bird, while Lexie likes the cow and the red bird (each of the animals has a noise maker inside - either rattle, squeeker or bell sound). They are still not fans of Tummy-Time unfortunately. The trick may be to do it sometime when they are not hungry :)

Titan Loves His Girls

Return on Investment

Smiling is their latest trick...and no, not just gassy contortions of the face...real smiling. It makes me melt every time! Annellice is the bigger ham right now. She will smile for anything and anyone if she thinks attention is to be gained. Alexandra requires a bit of a better mood and is more selective in when and with whom she'll share her newest gift.

All Night Long!!!!!

For the first time the girls slept a full 8-hours last night. It was great not to have to get up in the middle of the night for the hour+ ritual of changing and feeding, though I don't expect this trend to be permenant yet. We have had single occurances of 6 and 7 hours in a night all of which were followed by a day of cranky babies, additional feedings, and sleepless nights. Here's to raising a glass of hope that we've crossed a threshold.!?

While the girls were sleeping soundly, I was cooking a turkey that had to be pulled from the oven around midnight. Long story short, when I awoke to remove the bird I started searching through the sheets for "the girl" and asking Gwynne where the baby was. Turns out I was having a dream that one of the girls was asleep on my chest and when I woke up I couldn't find her. Took a few moments of panic for me to regain a grip on reality...kind of funny now that I am awake enough to look back on it.

Returning Home

Tuesday's flight home was at a much more tolerable 8:15a compared to the 5:45a flight leaving Richmond. As it worked out, based on some advice from a local business traveler and the complexity of the Phoenix airport, we didn't get a whole lot more sleep despite the later departure time. We arrived to drop the luggage, Gwynne, and the girls at the terminal prior to 6a...another couple did the same and my parents were close behind. Gwynne and Tracy decided to take the babies through security while Tom and I returned the rental cars...here is the only place where we experienced a problem...

Going through security by yourself with two infants is a nightmare. You have to carry the infants through the metal detector and break down their car seats and stroller for screening. You also have to declare the breast milk and have that inspected on top of all of your own personal belongings. Alexandra was particularly squirmy as Gwynne walked through the detector and a TSA lady reached her arms out to help. Just as Alexandra was about to fall into the arms of the TSA official, she backed off and Alexandra took a header toward the floor. Luckily her car seat was there to catch her before hitting the hard floor. Boy was Gwynne peeved to the max!!!

The flights themselves were uneventful. Both girls were well behaved with minimal fussiness and all the flights were on time.

Wednesday we were off to Norfolk to pick up Titan. As we were tired from the race and travel, we were not looking forward to this trip. Traffic was light on the way down, though we could see the return trip was going to be a mess. Got to my parents' house, fed the girls, grabbed Titan, and then we were off. Thinking it would be smart to avoid I-64 we headed south to loop to Hampton via an alternate route. Approaching this tunnel was a 6-mile parking lot due to an accident at the tunnel opening. Gwynne hit reverse down the highway to the exit we had just passed and we were off on an adventure. We wound through the countryside to Smithfield and then Rt 10 all the way to I-95 south of Richmond. After stopping for dinner and to feed the girls, we were back on the road to home. The 1hr 45 min trip to Norfolk was followed by a 4hr return trip to Richmond.

Luckily Thanksgiving was spent in Richmond at Gwynne's Aunt and Uncle's house so we didn't have to travel far. Black Friday was experienced for the first time as a consumer by all four of us. We found a couple of good deals as we shopped around. We noticed that there weren't many folks out and most of the stores had a surplus of in-stock items; looked like a poor day for the retailers.

The girl's have been having a difficult time re-adjusting to life at home. They got awfully comfortable being held all week by everyone during the trip to AZ. We have had to let them cry it out a bit and get used to entertaining themselves again. Somehow their precious cries break us before we are able to break them. Hopefully they will be back on schedule by tomorrow for Gwynne's sake when I return to work! :)

Race Day!

This past Sunday was the big race day we had been planning for over a year now. It was an early start for us (4am) so we could get the babies ready and to race site at 5am (the house we had was 25 minutes away).

The girls took well to the 4am wake-up call. As usual they ate well and then slept often. It is starting to appear that Lexie is enjoying the her bottles more now. She is happily finishing 95-100% of her bottle and burping without significant regurges. We are caustiously optimistic and will be keeping a close eye on this to make sure we do not have any set backs. On another note - we will no longer be using Huggies diapers for a while. This trip has taught us that they leave the babies feeling wet (no wicking apparently) and therefore we have had very fussy critters while on our trip. I have heard that this brand of diaper is good at later stages, so we will try them again when the girls get older... until then it is back to pampers we go.

At any rate - race day weather started out very chilly (45F) so the girls and I cozied down into the car until just before the race started. At 630am we ventured out to meet Kevin at near the swim start area. It was a bit diffcult to find him b/c the tent we had used as our meeting point had been moved from the day prior and just about every athlete was decked out in black wetsuits and red swim caps. Kevin found us at 640am. After a quick update on his ankle (he severely injured it on 11/15 running and had not been able to put much pressue on it leading to the race) and a much love from me in the girls he was off to the swim start.

The gun sounded at 7am and the atheletes were off for the day. Kevin's anticipated time prior to his injury was around 9hrs 30minutes - with the injury just finishing was the goal. The girls and I camped out at the car with the heater running until the sun rose high enough to heat the air (it got to be 75F). Kevin did an amazing parking job that morning backing us into a parking garage spot that allowed us to sit in the tailgate and watch the atheltes on a portion of the bike course - it was a 3 loop course so we were able to cheer him and our other friends that were racing several times. In total we had 5 racers (Kevin, Bill, Tom, John and Ed) and 11 supporters (me, Lexie, annellice, Katie and John (kevin's parents), Meg (bill's wife), Tracy and Cadence (tom's wife and their 5/6month old girl), Sharon (John's wife), and finally Trey and Nicole (dear friends who shortened their trip to Sedona to cheer on the boys). The girls did amazingly well given the loud party atmosphere that was all around us (think lots of screaming/chering and cowbells rining). It probably helps that we had 4 professional mom's around us (Katie, Sharon, Meg and Nicole all have been moms for 3 to 30 years).

After the bike portion of the event was complete we packed up the girls and walked down to the race site to watch the run portion. The run was a 3 loop course (figure 8 shape) that totalled a marathon. The worst part of the endeavor here was that it was all on concrete walk ways (not good for a bum ankle) and not a shade tree in site where you could watch the course closely. As it so happened the run course looped under a bridge and we were able to take shelter there. The noise was a bit much at times but luckily it was just cheering and not the loud announcer speakers.
Kevin was able to hobble past us with a brave face. After the 1st lap he nearly pulled out of the event - each step was painful both walking and running, the compression sock was hot, and the swelling in his ankle was so bad that his foot had gone numb too. I personally have never seen him in that amount of pain before, but this was his race and to continue or not was a call to be made by him. He decided to head out for another loop and re-evaluate the pain at the intesection of the 2nd lap (approx 3.1 miles after I saw him). At the intersection he was jogging with a group of 6 other people, but rather than stop and evaluate the situation he kept going. Tough as nails! The girls were due for a feeding at this point so it was back to the car for us for some down time.

The parking area was quiet now that 95% of the athletes were out on the run course. Here I had my first experience being smeared with poop. Lexie had soiled her diaper and little did I know that some of it had escaped the diaper and found its way to her leg. After picking her up and changing her I noticed that there was poo on her foot - "where did that come from?". After a few moments "DOAH!" as I found the evidence planted squarely on the front of my shirt. Annellice sleeps thankfully sleeps through all of this commotion but then starts all of her own fussiness issues shortly there after while I am feeding her sister. Ahhh, to have another set of hands would be wonderful.

By the time we finished our feeding the sun had started to set and the air temp dropped about 10-15 degrees. We had packed layers for the girls so on they went. I had been getting updates via cell phone and Kevin was still on the course. Meg, Nicole and Trey arrived at the car just as I was locking up and we were off to the finish line to watch the boys finish. The crowd of people was insane. Luckily the lady with the double stroller was given wiggle room to get through when needed. We made it to within 25 yards of the finish line before I sent the others on... the announcer speaker was a bit to loud for the girls to be near (it was like being in front row seats at a rock concert). Kevin crossed the line in roughly 10 hours 30minutes, and met us down the line from the finish line shoot. After some manuevering the girls and I managed to help him pick up his bike and gear bags. We made it back to the house around 730pm after a quick trip to Jamba Juice (chocolate peanut butter banana smoothie for Kev) and Chipotle (salad for me).

The girls settled in for the evening extremely well! I was expecting far worse given the fact they were being overwhelmed with noises, light, and smells all day long. I managed to do the 2am feeding by myself as Lexie was awake and raring to go while Annellice was sawing logs (again). It was really a great ending to good day. I do not know how we have been so lucky to have such flexible kids; I just hope their tolerance for this sort of thing continues.

Arizona... mid week

Wow... there is a ton of dirt and sand here. Somehow, I have gotten allergies with hardly a plant or mold spore in sight; atleast I hope it is allergies.

Yesterday the girls and I ventured out to the Ironman race village. They got to meet Les, Taz and Lawrence for the first time. They are officially little bike monkeys in the making now; they will probably know the difference between 9 and 10-speed shimano parts before the alphabet :)

While Kevin and the rest of the race group waited in line to get their race packet for the event myself and supporting spouses jumped in to volunteer with packet pick-up. Needless to say... the organization for the packet pick-up was lack luster. Rather than trying to reinvent the wheel someone had created we did out best to keep it lubed and the line moving. After going horse from explaining the intricasies of the waivers that needed to be signed we moved ourselves to the actual packet distribution where someone called out the number and we scrambled to get the correct one. By 12pm we were cooked, especially the girls. Lesson learned - the girls will not be able to make it the entire day out in the open on Sunday so we are now trying to devise as plan of spectating and caring for premmies at the same time. We are crossing out fingers that the girls and Kevin will be able to make it to the finish line now.

First Plane Ride

On Tuesday the girls experienced their first ever plane ride! To bad it was to Atlanta...
The flight left out of Richmond at 545am. The people at security were uber helpful. They allowed the entire days worth of bottle feeds for the girls through the check point they just used a little swab test kit to verify that it wasn't explosive... not if only they could check to see if I had eaten anything that would make the girls explosive!

The first flight was about an hour long. The flight crew was so accommodating for our little ones. They even were kind enough to help us pack and un-pack strollers while boarding and deboarding the plane. They were also very funny for 545am, something they have fine tuned over the many commuter flights I am sure.

The sceond flight from Atlanta to Phoenix wasn't as good as the first. The girls were fantastic, the plane on the other hand was not! After waiting in line for take-off for approx 20-30minutes we then had to taxi back to the gate to have a fule gauge fixed (annouced as a 5-10 minute fix). Well the "fix" wouldn't take so they had to manually add more fuel to insure that the exact level of fuel was correct... 30minutes later we started to push back to wait in line for take off again. During this time the 18 month old and 2 yr old in the rows in front of us provided many scenarios was what to-do and what NOT t0-do with your child on a flight. The 18 month old was laying down on the floor of the plane and playing/rolling around. In her romp she located the ice pack that kevin had used on his foot and took off with it, before you knew it the bag was being licked like a pop-sicle... YUCK!!! The 2 year old was much better behaved. She loved asking "what's that?" to Kevin, to which he would kindly reply "It's a baby" or "That's her sister".

Our girls did fabulously! There was no fussing of crying. The only hard part was for us because they are little radiators sitting in our laps making the delay out of Atlanta very warm. Their feeding schedule was a little out of whacj b/c we allowed them to sleep as much as possible rather than waking them to keep them on a schedule that would change when we landed b/c of the time zone change. Thank goodness for the sleep of infants!!

The Gag Reflex...

Why are we born with that anyways? I wish Alexandra didn't figure out that reflex the way she has. Lately she has taken to gagging to get the binkie out of her mouth if she does not want it. The problem with that is inevitably she will wind up tossing her cookies about 10-20 seconds later. When this happens she usually sleeps very soundly afterwards as her little body is working hard with all that activity. We have been told that this is ok just so long as she keeps gaining weight. Visibly we can see that she is growing still so we are staying optimistic.

We have been lucky that Annellice does not partake in these gagging activities; however, she has started the typical baby spit-up phase (about the size of a quarter whenever the mood strikes her). The only time this creates a problem is if she gets twisted around in the crib while sleeping b/c then it winds up and weird places and we are left wondering whether it it spit-up of leaky diapers (either way we still have to change the bed linens).

We have a little graduate!

Annellice has up'd the ante! She is now wearing stage 1 diapers.
I know it is such a little thing to be excited about but is means so much to us considering how small she was when she was born. When I have time I will post a picture of the orginial premmie diapers that she was wearing when they were in NICU, its about the size of a cell phone.

They both recently went through some kind of spurt, one was eating any and everything available and the other was trying not to eat or would throw it all up afterwards. We are thinking it may have been keyed off by the stressor of the vaccine shots they had last week. Either way we are finally getting back to small sense of normalcy with them, as slow as it may be.

On another graduate note... both girls are now in newborn size clothing. I have been packing the premmie sizes away this week as they are being washed. It's crazy that we are already putting them away considering we just got them out. This is the way life will be for the next 18 years though :) Most of the clothes will be going back to the RAMOM group that I borrowed them from and the ones that we owned will be going to the NICU/PCN where the girls stayed for 4 weeks.

The girls are now 10 weeks old which is actually only 3 weeks old developmentally. They do not see shapes or faces yet. They do however, recognize out voices and will strain their little necks to follow the voice around the room. I have been told that around 6 weeks they will start to see faces and shortly there after their hands and feet. I'm looking forward to the little stages we have coming up!

Getting Ready for Travel

We're off to Arizona on the 17th for my ironman on the 22nd to return to Richmond on the 24th. We've been thinking all along about how we are going to get all that we need for the girls (not to mention all of my equipment) to AZ in the easiest way possible. Lots of thinking...a bit of research...a bit of arguing...and not much has been decided.

What a lot of crap...stuff...they have!!!

Aside from the car seats, strollers, breast pump, diapers, wipes, etc., etc., etc. we are trying to manage how much milk to pack in carry on, in checked luggage, and how much Gwynne can provide once we arrive. It is all a guessing game at this point.

The good news is that the stroller and car seats will be checked at the gate with no penalty to us and their diaper bag is allowed as a free extra bag. TSA has also eased their restrictions on the 3:1:1 liquids to exclude breast milk and formula. Getting through the gate will be interesting as they expect everything to be broken down and the girls in arms going through the detectors. Hopefully we are in front of some understanding folks.

We did find a place in Phoenix that will rent everything we need and deliver it to the rental house, that option is still a consideration. Their prices were remarkably reasonable for weekly rentals.

To add to the fun of the experience, we will be making a rushed trip to Norfolk on the 15th and 25th to drop off and pick up Titan from his sitter. My parents' neighbor is generously keeping him for the 10 days...and he really enjoys being there. We are going to ease our burden a bit on Tuesday morning by staying in a hotel next to the airport Monday night. Since our flight departs at 5:45a, it only made sense to save us the 45 minute drive to the airport in favor of spending that time prepping the girls and their stuff.

I will be sending two bike boxes to AZ; one with my bike and a second with all of the wheels (five in total). These have to be sent out this coming Tuesday (11/10) so that they arrive in time.

The final straw to all the fun we're having is that or flight has been re-routed from a layover in Cincinnati to Atlanta...I hate Atlanta's airport. I hate it especially much around the holiday season.

How Are They Doing?

Growing! At the two month check-up Annellice weighed in at 8lb 4oz while Alexandra weighed in at 6lb 8oz. Based off our last visit to the doctor approximately 2.5 weeks ago, that puts Alexandra 2.5 weeks behind (as she has been all along) as Annellice weighed 6.b 8oz at that visit.

Sleeping! Both girls are spending a bit more time awake during the day. At night we are able to let them sleep 4-5 hours at a time, which is making a huge difference in our energy level and overall affect. We usually feed them at 8:30, down to sleep by 9:15-9:30, then we feed them at 1:30 and 5:00-6:00 depending on my work schedule and how well they are sleeping that particular night.

Eating! Annellice is up to 100 ml per feeding, or about 3oz. That is a long way from the 1.5 oz we started with when she first came home. Annellice has also been taken off of all of the formula calorie booster; she is eating pure breast milk. We do still add a little bit of thickener to prevent any regurgitation, though that should end this coming week. Alexandra has also seen similar expansion in the amount she eats at each feeding now consuming 75-80 ml, or just under 3 oz. When Alexandra came home she was eating .8-1.1 oz. Because of the relational retardation in weight gain, Alexandra is still on the calorie booster. She also remains on the thickener as her reflux continues once or twice each day.

Pictures of the Twins... finally uploaded!

Below are links to Snapfish online photo albums of the girls. Unfortunately, I have not had the time to name the photos or to even weed out the bad ones that are all blurred. Hopefully, I will be able to do that by Christmas (HAHA!... am I being to optimistic on that one?).



Babies 1st Week

Babies 2nd Week

Babies 3rd Week

Babies 4th Week - Home coming!

Babies 5/6 Week

Babies 7th Week

Babies 8th Week

Just Cuz

Life on a Schedule

So all those years of scheduling our crazy training for different races and adapting to the elements come what may have started to pay off now. The girls were placed on an 8, 11, 2, 5 schedule while at the hospital. 11pm to 2am was a hard on for us seeing as how pre-babies we were in bed around 10pm and up at 5-5am. Now that they have been home for 2 weeks we have been able to successfully move the late night feedings to better match our own sleeping patterns. We have bumped the 11pm to 10pm and and the 5am to 6am. This gets us an extra hour in the overnight sessions.

The girls are adapting well to the schedule change. To them it is just about being fed the right amount to keep them asleep long enough. Many have asked us if we are waking them to feed them on the schedule. The answer to that is Yes. Reason being is that they still need to gain weight and missing a feeding just means calories lost to sleep. We are hoping that we will be able to start doing having them sleep closer to 5-6hours by Thanksgiving... the peditrician will probably have some say-so in that one once we go back on Nov 5th for the 2month checkup.

Speaking of the pediatrician, we really have lucked out with Dr Arkin. He has been willing to go to bat for us with the insurance company to get the girls the Synagis shot. Synagis is a medication that helps babies born prematurely have less severe RSV (aka: common baby colds) if they were to contract a viral strain of some kind. The reason premmies need something like this is because a common cold to them can become extremely severe brochialitis that could put them at greater risk for having to go to the hospital for treatment. Seeing as how we have had a trip to AZ on the books since last November the shot is high up on the priority list IF the insurance company will foot the bill for it.

Outside of the baby-bubble things are going well. Kevin and I are alternating days of tiredness. Kevin's training for Ironman is going accordingly with some minor tweeking to accommodate feeding schedules. I just started running with Titan on a leash and cycling indoors on my trainer this week. The only issue with that is that I do not remember by bike saddle being THAT small before... or maybe its just me being bigger than I remember. HAHA!

Eating...Growing...Sleeping...

Both girls are increasing the amount that they are eating at each feeding. Annellice has hit a new high of 80 ml, which is just short of 3 oz; Alexandra has taken 54 ml or approx 2.75 oz.

At the doctor's office on Wednesday Alexandra measured 5.0 lbs; Annellice 6.5 lbs

Beginning Wednesday night we tried to see if we could extend the period between feedings during the night from 3 hours to 3.5-4 hours. It has worked for 2 of the 3 nightime feedings each of the last two nights. We'll try to get the cocktail correct so that they can make it through all three feedings. It has made a world of difference in our sleep patterns, energy, etc.

Rookie Freak Out

Wednesday we experienced our first panic over the health of Alexandra. We were getting ready to feed her and Gwynne suggested that she looked awefully pale. After comparing her present status to some pictures from earlier in the week, I agreed. I took her temperature and it was approximately 1 degree below normal. She was also acting a bit lethargic for her "normal" state of being awake. Both of us worried we called the doctor to get her in for an emergency sick visit. By the time we got to the office Alexandra's color had returned and the doctor could find nothing wrong. Turns out...she was cold.

Despite being well dressed, she just needed a little more. Gwynne and I joked that when we arrived there would be nothing wrong and that we would have suffered from a new parent over-reaction. Turns out, thankfully, we were right. It is silly what lack of sleep and nerves will do to your common sense. Being outdoor people, we know what it looks like to be chilly and how to fix it. Perhaps if we had been outside, we would have been a touch more rational. Then again, maybe not.

Sisterly Bonding Time

YAHOO!!!

Both babies are home now!! Alexandra was released from the hospital yesterday afternoon. She had a smooth transition home and appears to feeding and sleeping well so far.

We will update more either tomorrow or this weekend when we have a little more time to download pictures.

Thank you everyone for you continued love and support as we navigate the world of premmies.

Deja vu....

Have you ever had the sense that you have been somewhere and done that before? Right now it feels like we are reliving the events of last week again only this time Alexandra is the prize that is staying just ever so sightly out of reach.

We have been hearing that the Alexandra would be ready for Wednesday discharge since Saturday/Sunday. Tonight was bath night and as typical we sported the daily weighing in festivities. Turns out that Alexandra has lost a bit of weight. If the doctors follow the "not losing weight the night before discharge" that they enforced with Annellice it looks like we are looking at yet another week of dashed hopes and likely that she will come home later rather than sooner. We are trying to stay positive despite the outcome fo the weigh-in but knoinw all to well how it affected us last week it is much like reopening a wound not yet healed.

Outside of the weigh-ins the girls are doing well over all. Annellice had her first well-baby visit with the pediatrician on Monday and she sported all the of a healthy baby. We will go back in 2 weeks to have blood work done to be sure that her iron levels are remaining in the desired ranges. Her feedings have already started to increase as well from max of 55mL to a max of 70mL if the mood strikes her. Alexandra had her feeding tube removed last week and has been on 100% bottle feeding. The theory behind this one is that its like teaching some kids how to swim you just have to throw them in the deep end to see how they respond... lucky for us she is responding well and has been maintaining her feedings well. The reflux for her is still an issue that we will likely have to monitor for some time until she grows out of it. On Monday Alexandra also has her Echocardiogram done to see if the small murmer detected at birth is still present. At this times the they estimate that the hole is now 2 different holes approximatley 2-3mm in size. One of the neonatologist docs feels that the reason for it being 2 small holes now is that the process of closing up entirely created a septum and that the murmur is likely going to go away as she gets bigger. Whenever she gets discharged we will be set up to meet with the cardio group approx 6weeks-3months out to measure the progress again.

We are almost there now, finish line in site... now if only it would quit moving on us things would be great!

Annellice Comes Home

When we went for our daily visit at 8a Friday morning, the nurses and doctors were sure that Annellice would be released that day. We didn't want them getting our hopes up again just to be let down for a third day in a row. Besides, I was heading to Lake Anna for a couple of races and Gwynne was off to Fairfax to look after her parents; her dad just had thyroid surgery.

Around mid-day the call came in that Annellice was ready to go...plans changed for Gwynne. She packed a few bags and headed off to the hospital to pick up Annellice. Knowing how excited I would be to see the baby outside of the hospital she headed up to Lake Anna to stay with me. That's right, one month old and one minute released from the hospital and Annellice is off to her first vacation/race/job site. It was great!

While at the hospital on Friday the doctor, only partially kidding we think, asked Gwynne how she would like to take two babies home? While we weren't prepared for both to be released, it was a nice way of him saying "I think she is close to being released...get ready for the double bubble..." The doctor did indicate that it would likely be early this week when Alexandra is released because she has been progressing steadily and will likely flourish once at home.

Through all of the excitement of not having to see the hospital again for a while, hopefully, we've heard the "she will be released" rumor before. We'll see what happens here over the next couple of days.

Rumor Giveth & Scale Taketh Away

All indications were that Annellice was to come home today. Unfortunately that didn't happen due to a slight decrease in her weight last night (10 grams) and a slowing in the quantity of food she is taking each feeding. The rules are that the baby must gain weight the night before being sent home...turns out it was a faulty reading because tonight she was 3 ounces heavier than she was on Monday night. The doctor said, "That sometimes happens". Maybe so, but what a bummer. We were looking forward to having a little one at home this evening.

Oh well! The new rumor is tomorrow. We'll just have to wait for tomorrow to find out.

In other news, Alexandra has been increased to bottle feedings for all 8 meals. She is given 30 minutes to take as much as she can and then any remaining is pushed down her feeding tube.

"Be Prepared..."

Ahh the trusty ole' Boy Scout motto. Turns out it applies perfectly in our situation these days. With the girls progressing each day we are often told to be ready for changes. Changes thus far have been the feeding regime to greater boost their growth and development. Everytime we turn around there is a new way of doing things; 50% of the time it is just bumping up their intake levels the other 50% is changing the schedule to allow greater amounts of bottle feeds, breat feeds or nuzzle time. We show up daily with open minds to accomodate the new systems. So far the changes have had a mostly positive influence on the girls. The only set back so far has been that Alexandra's reflux issue has caused a step down in her quantity of bottle feeds. She seems to be doing far better now and is pushing to catch up with her sister.

The girls had their hearing tested this week and came out with flying colors. Not sure what the test was really since we were not there when it took place. We also took in a car seat for them to have their car seat screening done. The car seat screening is when the baby is placed in the car seat for about 40-60 minutes and their respiratory and cardiac systems are monitored closely for negative deviations. Annellice did very well with her test on Monday afternoon. They are going to wait on testing Alexandra until later this week.

We are still waiting and always prepared that Annellice may come home on Wednesday. The doctors will make that call mid-morning and notify us via the telephone. If we do not hear from them by the afternoon we assume that she will be delayed a day or two then. We are crossing our fingers now and hoping there is a stroke of luck coming our way finally.

Moving Quickly

The last week has seen major strides at nearly every turn of the clock...

Annellice has progressed to exclusive bottle feeding and her feeding tube has been removed. They are working out a few kinks in her feeding schedule, to give formula or not, and whether to thicken her feedings or not, and then she'll be set to come home...may be as early as Wednesday this week.

Alexandra has progressed to taking half of her feedings through a bottle on every other feeding appointment. Her hold up is the reflux she has been suffering. She is likely 10 days or so behind in developmental maturity compared to her sister.

On Friday we were able to allow the girls to co-sleep. We had forgotten our camera, but the nurses took a couple of photos for us. When we get one scanned it'll be added to the post...very cute.

Last night we spent the night at the hospital doing what is called "rooming in". I am not sure what the purpose of this exercise is, but it is a sign that you are close to taking the child home. Basically we arrived at 8p and fed both girls. We then took Annellice to one of the hospital rooms and spent the night with her. We were to awake every 3 hours to feed and change her. If we stopped right there it may seem like a useful practice to what we may experience when she comes home. However, the nurse came in each time to deliver her bottle and check on us. Plus we had a faulty monitor that alarmed all night long. I don't think either of us slept but an hour or so. We were asked to leave by 8a so they could use the room for a surgical patient later in the day. We left immediately following the 5a feeding. Miserable experience! Luckily we won't have to do it again with Alexandra.

Bath Night!!! My Favorite!!!

Tonight was bath night. This is definitely my favorite time of the week...and how do the girls repay me? That's right, peed all over me. Annellice was gentle and hit my hand and her bath materials. Alexandra peed all over my arm which dripped onto my shirt and then onto my shoe. Suprisingly, never have I been happier.

Gwynne got both of the girls to finish their bottles this evening on their own. Annellice weighed in at 4 lbs 11.4 oz; Alexandra 3 lbs 8.8 oz.

One bottle down!

Yesterday was a milestone for us. We were able to get Annellice to take her bottle in full! She had one juicy burp in the middle of it and zero alarms on her heart/respiratory monitors. Alexandra toughed it out and did well on her bottle while battling a severe bout with gas. Her little body seems to be more sensitive to the gas than her sister which is seen as normal given her small size.

As of Saturday night the girls are weighing in at 4lb 8.2oz and 3lb 6.7oz. Typically babies at this gestational age will gain .5-1lb per week in the womb. Not sure if that transpires to premmies or not but we are hoping it will. Alexandra will need to hit the 4lb mark in good form before they will move her to an open-air crib. We are not quiet sure how she will take that though as she is so acutely aware of metal sounds when she is sleeping on us after a bottle feeding.

At the Sunday 11am feeding the last of the umbilical stumps fell off. Alexandra's had fallen off last week and has been loving life without the alcohol swab across her abdomen. Annellice was holding on to hers for dear life for some odd reason. Right now they have little outties which I am sure will change with time. It makes diapering them easier now without having to worry about getting them accidently caught on something.

Two Weeks Old Today

Today Annellice and Alexandra are two weeks old and are the talk of the Progressive Care Unit. All of the nurses think they "are so cute". We agree with extreme parental bias.

Gwynne has been going to the hospital twice a day to bottle feed the girls; I've been able to go once (they are on a bottle for 3 of their 8 daily feeds). We have been meeting with the feeding specialist each morning at 8a to learn the tricks of getting the girls to feed, as well as their bio-rhythms and signals that will alret us to when they are receptive to feeding, when they need burping, when they are tired, etc. It sure is different working with premies rather than full-term babies.

One of the best parts of the increase in bottle feedings is that we are able to hold the girls more often and for longer periods of time. We hold them for 30 minutes with the bottle and up to an hour afterward, and we can do that with each feeding we attend. We can also continue to kangaroo, though that has taken a bit of a back seat simply due to the restrictions of a 24-hour day.

This past Tuesday was the first day I didn't go to the hospital in the evening. Gwynne and I decided to take a selfish day to get some rest. We took solice in knowing the girls were in the hands of the best babysitters in Richmond and got some much needed R&R.

Catch-up Time #2

The weekend went by faster than the blink of an eye. I am not sure we were able to get anymore sleep that any other day during the past week.

Saturday, Sept 12 - We spent the morning hours down in Williamsburg watching Kevin race in the Half IM. Unfortuantely, it was not his day out on the course and the stress of the past few weeks burned up all the energy that he had. After missing a turn on the way back on the bik and going 2-4 miles out of his way and noted that the event would just be a long training day. After heading out on the run course though his body began to fall apart and the day came to an end early. Emotionally, this was probably the best thing as we were able to depart earlier to come home and see the girls.

Our stay on the 3rd floor was a bit longer today as it all starts off with BATH NIGHT! Kevin and I took turns watching each other perform the duties that were shown to us in NICU. It's amazing how different the process is from person to person. None the less we have clean babies - albeit not as happy as they were sleeping in the incubators moments before.

HUGE milestone was hit today though - Annellice is allowed to start feeding from a bottle 2x per day (alexandra will likely get the orders on Monday)! This seems so early to us now given the fact that they are still on feeding tubes. Jessica, our nurse, informed us that this is completely normal and that they are working on getting the girls to correctly use their suck/swallow/breath reflex. We will be allowed to start feeding her on Sunday. For the rest of the evening, we spent our time changing and the kangarooing the girls. Little Alexandra proved to be a little trouble maker as her heart would have fits of bradycardia (heart rate dips drastically and then take a while before coming back to normal). It was noted in her chart - and it is likely due to reflux as it happened after her feeding had ended. All will be addressed with the doctor comes in for rounds in the morning. Until them, we go home a bit apprehensive of what all that really means.

Sunday, Sept 13th - We arrive to find that Little Alexandra is being given Caffiene to counteract the fits of Bradycardia and Annellice is proving to be a pro at taking the bottle. The caffiene is not like the stimulant that we get from coffee and soda's but more of a neurological stimulant with get things firing the way they are supposed to. Dr Ross infomed us that this is normal for premmie babies and that she will likely be on it for the next 7-10days. She also stated that it is a long acting stimulant and that it wold take a couple days once it has stopped being given to see how she does on her own. This gave us a small window of seeing the days in the hospital expand past another 2 weeks.

Annellice is doing well on the bottle. She and her sister are unlike any babies we have ever bottle fed before. They do not aggressively suck on the bottle. Infact Alexandra just wanted it to sit in her mouth she didn't seem to know what to do with it from there. Annellice is having some issues with timing the suck/swallow/breath and then at times seemed to tired to go one. The nurse gave us 30 minutes to see what we could do and then tranisitioned whatever was not ingested to the feeding tube. This is probably the hardest task thus far as at this stage it is not about the amount we get into them but rather the quality of their eating pattern. I will meet with the Speech Pathologist in the morning to learn better feeding techinques and recoginizing signs of issues with the girls.

I am beginning to wish I had the energy from college where we could pull all-nighters studying again! This time is slightly different though as all of it will need to be applied to provide a better life for the little ones. God bless the staff at the hospital for all the patience that they provide while helping us learn the ropes of the prematurity and for recognizing parents that are hitting overload and just need to hold and love their children.

Catch-up time...

My the days have flownby since our last update! Between visits to the hospital, work, and trying to remember to eat and sleep time has gotten away from us.

Thursday, Sept 10 - The day started out like most of the others did. The update from the doctors and nurses was positive. Alexandra and Annellice's biliruben levels did elevate overnight but not to a degree by which they needed to return to being under the lights. Both seemed to be processing things well without the lights. I noticed an increase in sleeping for Alexandra. I am beginning to think she will be the one rising and setting by the sun while Annellice will be the one that can take a nap just about anywhere.

I met with a gentlman named Peter today. He works closely with families on behalf of the hospital as a patient advocate. Basically, he is going to help us menuever the fun world of insurance now that the girls are here. We were able to determine that Kevin and I just work too many jobs and save to much money to get assistance from the Medicaid plan that many other families with multiples qualify for. Had we only been paying alimony we may have made the cut - alimony is one of the only ways to bring your net worth down when calculating for medicaid (who knew!). Overall, it is nice to know that the hospital provides us with contacts that can help us through the inner workings of the system. So we now say bring on the paperwork!

In the hub-bub of meeting with Peter a new group entered the NICU. A set of high-risk triplets was born prematurely and came swooping in with neo-natal teams in tow. In light of the new patients the doctors made a qucik decision and decided to move our girls up to PCN (progressive care nursery). Yahoo for us!!! The decision to move them as a duo came down to the fact that they did not need assitance with their respiratory system and most of their biological functions are good... to quote th doctor "they just need to grow". Off we go to the 3rd floor... yippie!!!!

Friday, Sept 11 - This is one of those days that you wish you can wipe of the calendar for eternity b/c of the negative memories it brings. For us at the moment it has brought knew milestones and information galore. Our first day in PCN proved to be informative. One of our new nurses, Jessica, is a wealth of knowledge. She was able to provide us with milestones that were never mentioned before. She indicated that much of what she said was in the binder we received on our first day in NICU from the March of Dimes.... we haven't had the chance to digest all of the information yet. Hopefully, we will be able to start processing all of this better soon.

Overall the girls are still showing signs of improvement. We know have wonderfully stinky diapers of all various colors. The maconium is now passed and we are onto the less tar like stuff spouting from them. Speaking of spouting, each of the girls has successfully gotten both Kevin and I while we changed them. I was lucky in that I was able to containg the moisture to an already soiled diaper wheras Kevin had to completely change them over again... something to be said about moving slower I guess. The girls we happy with their little showers of joy we are awaiting the day when the figure out how to do number two while we change them as well.

Wednesday post - a day late.

The transition home for me was a bumpy one on Tuesday. At the HD Hospital they seperate the patients who do not have access to their kids to a seperate floor because it isn't very warming to see everyone elses kids go floating my in their cribs for bonding time. At any rate, apparently my doctor forgot that I was not on the regular post partum floor as the girls are in NICU. When he called to check my status in the morning for discharge purposes the nursing staff on that floor stated there wasn't anyone there by that name so he presumed I had been discharged the day before. At around 330pm I was discharged... only 8 hours after I had planned and having missed 3 changing/feeding sessions with the girls. All is good now, as we had amazing bonding sessions with the afterwards.

The bilirubin (sp?) lights were turned off this morning. The levels will continued to be monitored and should they rise again to unacceptable levels they will be placed under them again. Alexandra made the best of her new found time in the shade by sleeping through most everything going on around her. Annellice on the other hand decided to get a bit fussy b/c the temperature was a bit cooler without the warm glow of artificial light. The Neonatologist informed me that they would likely be removing Annellice from the incubator and to an open air crib. He warned that if she did not respond well b/c of the excess noise in NICU that she would be moved to the Progressive Care Nursery (PCN) without her sister. While we want nothing more that our girls to get healty quickly we also would like them to be together, so we are crossing our fingers that they will hit all the necessary milestones together.
On another note, the Alexandra's IV was placed on her head overnight. She had pulled it out of just about every other location and the head provided the next best available vein. At first glance it looks very scary but it is what is best for her and her little overactive body. The nurses informed me that should the IV come out on either one of them again they likely will not replace them as that are taking in enough breastmilk via the feeding tube that the do not really need the supplement of the IV.

The kangaroo session was different that normal this evening. Typcially we have been limited to 30-60minutes b/c the girls needed to be under the lights. With the lights now gone the sessions were elongated to nearly 2 hours and longer! Had I known is was going to be that long I would have gone to the bathroom first. It was fun none the less despite the tiredness we felt after getting home at nealry 11pm.

Time to go Home... for Mom

Well I'm at the end of my inpatient status here at the hospital today. It is just now hitting me that I will be leaving the little ones behind. They have each made great progress the past 4 days. Last night Annellice showed a small dip in weight to 4lbs 1oz but overall is a hapy little camper who enjoys wiggling as much as possible for the nurses. Her smaller sister is at 3lbs even; she has been a little terror pulling out IV's and taking off her little light-lamp sunglasses. If their weights get closer it could possibly increase the chances of them going into one crib together and/or graduating to PCN at the same time.

The nursing staff here at HDH has been amazing. Each of the ones I had care for me has had a child and many have even had their kids in NICU. I count my blessings that I was surrounded by such knowledgeable people who helped answer so many questions regardless of how late the hour. They also provided just the right amount of "that is totally normal" replies to insure that I am not going crazy as my own body seems like a foreign object of swollen joints and belly. They care of a very diverse group on the floor that I have resided on; those on bedrest for months at a time, to basic medical procedures, to moms of babies sent to NICU/PCN.

After I am discharged today we will be running the many errands that did not get done prior to the babies arriving. Kevin will likely be running them solo with exception of the obtaining the rental pump. The pump will wait for no one as the milk supply stored at the hospital is being used rather rapidly the past two days with the girls increasing their feed intake as much as 2 fold. We will be back at the hospital in short order though to provide the girls with their nightly touch therapy (kanagroo) and milk supply.

All Hail the Kangaroo

Last night was awesome!!! Gwynne allowed me to kangaroo (hold against the chest skin to skin) both of the girls last night. I was able to hold Annellice for an hour and Alexandra for 40 minutes. It was incredibly theraputic for me. I was having a hard time emotionally with not being able to hold them. Touching through the incubator is great, but feels a bit anticlimactic.

Beginning tonight Gwynne and I will each kangaroo one of the girls and then we'll switch which girl we hold each night.

Blessing and Curse

The Curse:
The hardest part about this process so far has been the inability to hold the girls. Due to their need for increased growth, physical maturation, and other metabolic processes we are advised not to touch or otherwise disturb them other than at their feeding times. They are both in incubators so we are able to look at them and watch them, but no physical contact. When they are fed (every 3 hours) we can touch them, change their diapers, feed them, etc. We will begin to kangaroo them (holding them against our chest skin to skin) later today, hopefully. If not, we will definitely try to coordinate our schedule to start tomorrow. We'll have to get further clarification, but initial indications are that this type of contact is only encouraged once a day at this point. As they get stronger we'll be able to increase the frequency of all types of contact.

The Blessing:
Henrico Doctors Hospital has the highest rated NICU in the entire metro Richmond area; the girls are receiving exceptional care. Several of the nurses work here part-time from other hospitals including UVA and VCU to gain the experience from a center of this level. Gwynne and I prepared ourselves for this possibility and have been delighted with the care all of the nurses have given our girls, and how attentive they have been to our needs and questions. All of this is for the better!

Another Milestone

Gwynne and I have been able to change the girls' diapers today. Beside the challenge of the tubes/wires and being really small, trying to change them inside the incubator is something that we'll have to get the knack of. Ah yes, and there was poop! Crazy to think that poop is so exciting, but it is a major step.

Both girls are increasing the quantity of milk/formula on a regular basis and tolerating each increase well. Last night I was able to feed Annellice and Gwynne was able to feed her today. We haven't yet been able to coordinate the schedule to feed Alexandra.

Alexandra has been diagnosed with a VSD (Ventricular Septum Deviation...think heart murmur) that is very minor. She is expected to "grow out of it", perhaps as soon as her discharge from the NICU. They'll do another echocardiogram on the day of her discharge to formulate a plan of care, if any further care is necessary.

Milestones in Baby Steps

Annellice was removed from the oxygen tube and is breathing on her own normally.

Both girls have begun receiving nutrition via the feeding tube. Their calories are a combination of breast milk and formula in the feeding tube; vitamins, electorlytes, and lipids in the IV.

Delivery Pictures

Below is the link for the full album of photos from yesterday's C-section. There are several pictures that are not for the squeemish so viewer beware...

You will be prompted to enter a password to enter Gwynne's account; use "exercise1".

http://www1.snapfish.com/thumbnailshare/AlbumID=1122176012/a=86984610_86984610/otsc=SHR/otsi=SALBlink/COBRAND_NAME=snapfish/

What Are All the Tubes and Probes?

Not to worry, everything is perfectly normal. Both girls are "equipped" with an IV into their right hand; heart rate, respiratory rate, and temperature monitors on their abdomine; and a pulse oximeter on their right foot.

Annellice has been equiped with a breathing tube to help push oxygen into her lungs (a move not unexpected). She has also had a feeding tube put in. This feeding tube is acting as an air release valve to prevent the stomach from bloating due to the forced flow of the breathing tube. Alexandra will also receive a feeding tube later today as both girls will receive their nutrition this way until such time as they are able to suckle a bottle or breast.

When I visited the girls late last night, both were doing really well. They were about to get a bath and be moved from the warming tables you see them in to incubators. This change in "living area" will allow a more consistent ambient temperature and a less stimulating environment in which they can concentrate on growing and getting stronger. Both girls had a blood gas test done to be sure that their breathing was efficient. Annellice returned strong numbers (Alexandra's numbers we expected to be good on account of her breathing on her own and having cosistently high pulse oximeter readings), as a result of which, they were able to reduce the amount of supplamental oxygen she is receiving. They hope to have her weened off the breathing tube in the next day or two.

Proud Daddy

Annellice Virginia

Alexandra Marie

What Happened to the 9th?

We went through our liteny of doctor appointments yesterday with things going smoothly right to the end. Then there was a deceleration...a what?...a deceleration. Annellice's heart rate showed a dramatic drop followed by a slow recovery. This made the perinatologists nervous; they admitted us right away.

We spent the night last night in the hospital being observed, though it felt more like a preparation for the inevitable delivery. We were both quite cranky as they weren't letting Gwynne eat and I hadn't eaten either as a consequence by proxy. Neither of us slept more than 10-15 minutes of each hour last night and so fatigue was certainly a complicating factor.

The doctor who was supposed to see us and send us home at 0630 never showed. Gwynne's OB showed at 0830 and said it would be up to the perinatologists to decide if we can be discharged. When we asked when we would get to see them, we were told some time later today perhaps as late as this evening. That chapped both our hides as they were the ones who admitted us and couldn't even make the time to follow-up in a reasonable manner!?!

Finally at 1100 we were wheeled up to the perinatologists, they conferenced with the OB and a specialilst in Utah, and delivery was decided. We were to be notified of the scheduling and sent back to our room. Suddenly there was a flurry of doctor and nurse traffic in our room, and in what felt like an instant Gwynne was wheeled off to surgery.

The surgery itself (C-section) was fantastic. I got to view the whole event from first cut to last stitch, and I have the pictures to prove it. Gwynne did fantastic as we both made humor the whole time. I'll post all of the pictures to a seperate site, which I'll link to the blog so that you can view them in their entirity if you are so inclined. Some aren't approved for the squeemish so I'll save the general public from that. I will be sure to post pictures of the girls to the blog once I get them downloaded.

Twin Arrival

Alexandra Marie (3 lbs 1 oz) and Annellice Virginia (4 lbs 5 oz) made their presence known to the world at large at 1348 and 1349 respectively.

Catch up time!

Things went well yesterday at the doctors. We had a new ultrasound technician that we have never had before. This is quite unusual as we have now had close to 30-35 ultrasounds with this pregnancy. As usual the girls are looking healthy - they were having fun playing catch me if you can with our technician. Thank goodness most everyone in healthcare it blessed with patience otherwise she might have been ready to shoot someone after trying to get the heart readings done.

Thursday we will meet with the Neonatologists at the NICU. We will have our little question and answer period about what we should expect to see with twins at a 34 week delivery time. For the most part things look and sound good, we just have the added pressure of them being small for their age. The smallness can lead them to have issues maintaining their body temps and/or insulin levels. We are praying the suck, swallow, breath reflex will be mature enough so that they can start regular feedings without tubes; from what I have heard from other parents with twins delivered at this stage if they do not have the reflex it may only be 2-3 days before it is fully functional.

On Thursday we will also have our final appt before surgery with the doctor that is delivering the babies. I think in some ways he is more excited about the day being 9/9 than anyone as he wants to try to push it to being 9am delivery time. I guess when they have routine procedures the doctors have to play a little game to have fun along the way. Now is only the MegaMillion would let you play all 9's!!

Riddle me this.... can you tell who dressed which bear below? The names of the bears are.... ohh wait, we can't tell you that yet as it matches the names for the girls :) We figure we have to keep something a secret along the way.

Pictures of the Nursery

So it has come to my attention that we have neglected to post nursery pictures. Yikes! Here they are now in all their glory. You will see that there is only 1 crib for now, we will be adding a second crib as they grow.

Here is picture of the other corner... many a nook and crany to store things.

Then there is my corner, or as so demonstated here the corner where Titan will live when everyone is sleeping soundly.

2-Weeks 2-Go - Yahoo!

Today's appointment announcement is that the girls will be arriving at 34 weeks. Given their growth restriction, this is their best chance for survival and healthy longevity. Barring any further development, we'll be delivering at 8:30a on Wednesday, Sept 9, 2009.

The vital stats haven't changed; hearts look good, lungs look good, blood flow is normal, and both girls are moving and breathing as expected for their gestational age/development. We are planning for a NICU stay of up to 2-4 weeks, though we are hoping for shorter. I am sure that this will provide additional challenges and emotional havoc as Gwynne is able to be discharged and return home sans babies 4 days post-delivery. Having a glass half-full attitude, Gwynne will be able to have her incision heal prior to the girls coming home and I will be able to focus more of my paternity leave around the girls' arrival home versus their stay in the hospital.

We're into crunch time...the nerves are peaking a bit...but we're just as excited as ever.

To Admit or Not to Admit

We're still looking for our easy button with this adventure...

Yesterday's visit to the doctor started smooth as silk. Everything looked status quo with the girls' heart rate and cardiac function. Measurements were taken and they are both growing...and the first reason for pause arises.

While they are both growing, the smaller baby has slipped a bit further behind again (dropping from the 13th %ile to just below the 10th). The larger baby is now weighing in at 3 lbs 13 oz, with her smaller sister weighing 2 lbs 8 oz. Knowing that these measurements are estimates with inherent error the doctor didn't appear overly concerned. The roughly 30% differential has been relatively consistent since we began tracking their measurements. It did spark a conversation as to when we will need to pull the smaller baby from the womb to increase its chances of survival. Growth restriction of this type in the womb often poses greater risk to the fetus in utero than a prolonged stay in the NICU; especially considering the health of the larger baby. We must remember that with this type of twin all of their blood supply is connected and what happens to one directly (even if sometimes inversely) effects the other.

Long story short, the conversation ended with an understanding that the decision to deliver is more strongly a day to day decision and that 34 weeks may be as long as we can let them gestate...though the jury is still out...many conversations between the perinatologist and the neonatologist to come.

After all of this we still had to do our fetal non-stress test. Heart rates look good; uteris monitor shows steady, gentle contractions. We're not too concerned as Gwynne's fetal fibronectin test came back negative and her uteris was still long and closed. The doctor had some concern. He wanted to manually check her uteris before he decided what he let us do next (i.e. leave for home or admit to the hospital).

Going to the new exam room, our third of this visit now nearly 3 hours old, I hear him on the phone with the neonatologist discussing our case. After a short wait he performs the test. After a brief pause that felt like forever, he lets us go home because Gwynne's uteris, is indeed, still long and closed. Those girls could be dropping hand grenades and they aren't coming out through the uteris at this point.

Thursday, and each subsiquent visit thereafter, will be a constant watch for hospital bed rest and/or C-section delivery. We will just never know when it is our day. Let the fun continue!

P.S. if anyone has that easy button, we'll take it.

Negative Test

The fetal fibronectin test is negative...smooth sailing continues...until Monday's visit. We'll see what's in store for us then.

Aug 20th Dr Visit

Today's visit was more of the same, which is to say that the girls are looking good. According to the ultrasound images things appear to be progressing as we should expect. As Gwynne elaborated on in the last post, we are now in a process of have fetal non-stress tests done on each visit. This means being hooked up to the monitor for Gwynne and a 20-minute nap on the couch for me.

Today's monitoring kept our attention as we were convinced the uterine contraction numbers couldn't possibly be correct. They were hovering in the 40s and 50s with spikes near 80. We were 5% worried and 95% sure the pad was placed in the wrong spot, especially since Gwynne couldn't feel anything contracting or otherwise. When our doctor came in she indicated that the numbers themselves didn't hold any meaning as pertaining to intensity, rather just the stability/volitility of the uteris.

Great! Smooth sailing we laughed and joked. As it turns out, it appears that Gwynne has an irritable uteris with one sustained contraction. So she was off to her OB, with whom she had an appointment anyway, for a fetal fibronectin test. Basically, if the test comes back positive, then there is a 1:5 chance that she will begin labor in the next 1-3 weeks. If it comes back negative, then there is a 1:50 chance of early labor; we'll repeat the test in a couple of weeks if we receive a negative result. Not really sure what will happen if we get a positive result.

August 14

Ahhh... So another week goes by! Things this week were a bit anti-climatic, which is probably the best thing we could ask for given our circumstances. We started a new process with our monitoring program/regime. Now in addition to doing ultrasounds to monitor heart, fluid, and fetal movements (including practice breaths) we are now also being hooked up to fetal heart monitors each visit. The heart monitors are these round discs that get placed on my abdomen (one above each baby) that are then held in place by velcro straps. In addition to those 2 discs they also place another disc on the remaining free space of skin to monitor contractions.

So far so good! The babies are always moving around so their heart rates go from 130 to 140's and then 000 because they have moved away somehow. The hardest thing about the whole process is breathing. This is because they have me in a reclined position each time. On Thursday I had Kevin move my chair more up-right and it was far more bearable. Kevin's enjoyment out of the fetal heart monitoring on Thursday was that he got to lay down on a couch and get a catnap for 20 minutes or so.... that is after he breezed through the interesting magazines in the room.

We asked our perinatologist this week if there was any indication of when the babies would arrive. He said that there was no way of knowing, but that doing the monitoring multiple times per week would improve our chances of both of them making it as far as possible. So right now we have little goals make is to 32 weeks. Tuesday will be the mark of 31 weeks... so we are looking like we will make it to our first goal ok, provided I can lay-low.

On another note, this weekend is my first real weekend away from the Tri races. I'm not use to being home when it comes to these summer weekends. So I feel a bit tense not being at race site even though I know the staff is doing a killer job without me there. Titan is kind of bummed too... he misses being race dog and snaking a few rogue bagels that the athletes tend to disgard on the ground. Atleast we have each other to keep company with... as well as some awesome neighbors and friends who have been so very kind in helping us out now that I am on lock-down.
That is all the news for this week :)

August 1-10

...after receiving the two steroid shots and further conversations with our physicians, Gwynne was released from the hospital on the 1st to go home to continue her bed rest. We were also leaving with a much more relaxed about the context within which the previous two days had transpired. It was true that the smaller baby was nervously small and low on the percentile growth standards. It is also true that the smaller baby was still growing and that all heart and lung function looked good. As it turns out the steroid shot was a precautionary measure should we get into the need to delivery earlier rather than later. All of our doctors were surprised that we hadn't been admitted to the hospital up to this point, let alone only for a precautionary series of injections and fetal monitoring. During today's appointment, one of our specialists indicated that the odds of Gwynne and the twins progressing to their current state given where we started is about 5%. In that sense I suppose we are very lucky.

We had another round of fetal growth measurements today, Aug 10. Both babies are still growing with the larger weighing in at 3.5 lbs and the smaller at 2.4 lbs. The smaller has moved up to the 13th percentile in the last 10 days. The doctors are increasingly optimistic compared to just ten days ago.

Now you must be wondering how Gwynne is coping with the bed rest issue.?. She is moderately misbehaving within the loose parameters of her imposed restrictions. She is still working feverishly on the computer preparing for the races each weekend. Though she broke the rules this past weekend, she will no longer be traveling to events on the weekends. She is rarely driving, really only to come into town for her doctor's appointments. Other than that she is pretty much on home confinement.

The term bed rest has also been loosely interpreted within our house. She does spend most of her timing sitting in a chair or on the couch. Some time is spent truely in bed, but more realistically laying on the couch has been her primary mode of bed rest. Though the doctor's orders were no cooking or cleaning, one shower a day, and one trip up and down the stairs per day they express their pleasure with her "compliance" thus far (only off the record, of course).

How have the twins been responding to the bed rest restrictions. Well, I've already indicated they have experienced strong growth over the last ten days. Her stomach has also grown exponentially. This has been attributed to the lack of physical stress she has been under lately, which has allowed her abdominals to relax enough to stretch to meet the added requirements for space. Her lower caloric expenditure also reduces her body's leaching of nutrients from the twins to allow them to better support themselves.

Thank you for reading thus far. Now that we are all caught up with this blog page, we'll try to keep updated after each visit each Monday and Thursday. Stay tuned.