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.
Wednesday, September 30, 2009
"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.
Monday, September 28, 2009
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.
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.
Tuesday, September 22, 2009
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.
Monday, September 21, 2009
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.
Friday, September 18, 2009
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.
Monday, September 14, 2009
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.
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.
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.
Thursday, September 10, 2009
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.
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.
Tuesday, September 8, 2009
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.
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.
Monday, September 7, 2009
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.
Beginning tonight Gwynne and I will each kangaroo one of the girls and then we'll switch which girl we hold each night.
Sunday, September 6, 2009
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!
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.
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.
Saturday, September 5, 2009
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.
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/
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.
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.
Friday, September 4, 2009
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.
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.
Tuesday, September 1, 2009
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.
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