Monday, March 30, 2009

Sleep over!

Last night Rachel and I slept in at the hospital w/ our babies. It was awesome, we stayed up and talked about boys, did makeovers, had pillow fights stayed up all night! OK, so some of that is a stretch, but we did stay over night w/ our girls to get a taste of what its going to be like at home. We had our girls off the monitors all night and handled the 9:00pm, 12:00am, 3:00 and 6:00am feeds by ourselves, and everything went great. Did I say that they were off the monitors?

Also, babies make a lot of noise...

-tinny out

Sunday, March 29, 2009

What's Missing?

A Skyline dinner for the first person to comment correctly w/ what's missing from the girls in these pictures.
-tinny out

More faces of Ella

I think that Ella is trying to tell Rachel and I that she is ready to come home. The following series of pictures show her actively removing the leads that monitor her heart and breathing... so independent! Make sure to check out all the distinct faces that she is making...
lookie what I have!
look how hast I wave it in your face to flaunt it!
I am done w/ you now...
-tinny out

Thursday, March 26, 2009

The Twinslers' are Hulkamaniacs

When I was a kid, I used to love watching professional wrestling w/ my dad on Saturdays mornings. I loved watching all the classic stars like the Ultimate Warrior, Andre the Giant, the Iron Sheik, the Honkey Tonk Man, the Legion of Doom, and of course Hulk Hogan.

Hulk was the biggest star of his day even though he was like 60 years old at the time. The way that he worked the crowd was amazing. He entrance was sweet, he'd come into the ring and rip off his t-shirt and then do this really weird thing were he would flex with one arm and point off into crowd w/ the other like this...
So, I came into the NICU yesterday over lunch to find Ava w/ her arms out of her tucked swaddling towel like this...
Then after work, I found Ella looking like this...
They are thier father's daughters.

-tinny out

Wednesday, March 25, 2009

Update

Sorry for the shock value title to the last blog, I already got figuratively slapped for that. I guess I just wanted you all to share in the emotional ride that we're on. The girls continue to grow, each having their little issues and episodes. Ella just topped 5lbs the other day, so that was pretty exciting. Ava is taking most of here feeds and pulled out her tube (by herself). They will not reinsert unless they need to. She has been doing really well, but had an episode while I was feeding her last night at 6:00. She had taken almost all of here feeds over the past few days. Ella had her first episode in a really long time, so that will probably buy her a few more days. Will we have Ava home by this weekend? God only knows...

-Tinny out

Monday, March 23, 2009

Holy Cow, Ava is Coming Home*

That is what I was going to blog on Friday afternoon when I got to the hospital. As I was heading down to the hospital after my 35th trip to exchange baby items at Baby's 'R Us, I get a text from Rachel just after the 3:00 feeding that said "Ava is not ready to come home yet." We traded a few more texts, and I learned that Ava had another choking-stop breathing-turn blue episode on Friday and proceeded to have several more on Saturday. So, they put her feeding tube back in her nose and tried to let her rest. She is trying to tell us that she is not ready to go home. However. Ella is our little darkhorse, because she continues to steadily take more and more of her feeds. Ella is our slow and steady daughter, whereas Ava seems to soar, and then crash-and-burn... little drama queen. I had the week taken off work and was all ready to split time btw home and the hospital, but we'll have to wait and see how things go. There is a possibility that Ella could catch up to Ava and they could come home together. I am really praying for this option.
I know it sounds trite, but what an emotional roller coaster. Last weekend when they said that Ava could be coming home on Monday, I was a little freaked out b/c I didn't feel ready, but this past weekend when they said the same thing, I think that Rachel and I were now ready to take Ava home. It was so deflating to have to wait longer when we, in a matter of hours, had planned out the next days and weeks. These twins are really putting a damper on Rachel and I's planning tendencies:)

Oh well, keep our little Twinsler's in your prayers. I'd ask that you pray for Rachel and I that we can feel as confident as possible as we take these little ones home. Right now we are a little gun-shy when it come to feedings, so hopefully God will give us a couple steady days to help calm and pump up Rachel and I before we bring them home.

-tinny out

Thursday, March 19, 2009

Update

After a rough weekend, both girls are doing well and progressing. Ava is back to being a little piggy w/ her bottles, generally taking them in less than 10 minutes, who-hoo!. Ella is still showing lots of signs that she is ready for her bottle, but she still lacks the stamina to finish. It's tough because she almost always show that she wants a bottle, but is only finishing ~1 or 2 a day. So, we’ll keep following what the girls are telling us…

-tinny out

Sunday, March 15, 2009

Suck, Swallow & Breathe

This is harder than it appears for our girls. Little Ella has been progressing nicely, probably on par for how a normal 34 week preemie should do w/ the bottle. She is taken several full bottles, multiple partials (where she is fed the rest through her tube), and several times she has either choked, lost interest or just never started. She seems to get tired pretty easily, but this is understandable as they didn't have to work for their meals before this past Monday, so it can be expected that they are both very tired.
Ava, however, has been quite the little stinker. She had her episode (that Rachel blogged about) on Friday, and then had another while I was feeding her yesterday. Saturday's wasn't quite as bad, but she still stopped breathing, became very blue in her head, and was unable to finish her bottle. She (and her sister) are stressing their parents out! Just to play w/ us even more, today Ava took her 3:00pm bottle in 8 minutes-her fastest ever. Ugh, what a little drama queen! The up and down seems to be much more trying on the 'ol emotions as opposed to just being headed in a general direction, either up or down. Keep Rachel and I's sanity, as well as our girls in your prayers and thoughts.


On an unrelated note, tonight Rachel and I are headed to The Melting Pot to celebrate our 6 year wedding anniversary, woo-who!

-tinny out

Bath Time

In a few minutes, I am going to blog another not-so-happy post, so I thought that I would tell you all about one of Rachel and I's favorite things to do w/ the girls... bath time. The girls get baths twice a week, and Rachel and I have reached a new level of "wow, we feel really old" because we really looking forward to hanging out in the hospital on Saturday nights during bath time.

Rachel and I each take one of the girls and give them a bath, one at a time. I have had Ava for the past two times, but I am done w/ her for a while (I'll explain why later).
The actual bath is pretty short and simple. First we weigh the baby, which is not a big deal, but during bath time, we unhook all the monitors, which is both scary and liberating. Then we wrap the baby in a receiving blanket, and place them in the tub. The tub is literally a plastic storage container that you could buy at Target, w/ an angled mesh platform to elevate their head out of the water. They say that babies either love or hate the whole bath experience, and we are fortunate to have two girls that like the water. When you place the wrapped baby in the water, they immediately relax and their eyes roll back and you can almost hear them think "oh yeah baby".
You wash them one body part at a time, trying to keep them swaddled as much as possible to keep them warm. Start w/ the face and head and work your way down to their stinky feet and bottom. Because of one of their sensors on their foot, their feet smell horrible... like a rotten band-aid. Once you are done, you pick up the baby into your arms into a dry cloth. Its at this point that Ava, being oh-so-relaxed, has peed on me, twice.

-tinny out

Friday, March 13, 2009

Ava

Ava has decided that she is not ready to go home yet. Last night she decided to stop breathing and the nurse had to change the position she was sleeping in and stimulate her to get her oxygen sats back up. This bought her at least 5 more days in the NICU. Unfortunately she had another bad spell this afternoon. I was feeding her a bottle at noon today and she decided to choke, turn blue and her body became a wet noodle. Probably one of the scariest things I have ever experienced. She has been a champ with the bottle thus far, so we are not sure what is going on. We actually had to use oxygen to get her color to come back. I think this episode bought her 7 more days in the NICU. We are going to try another bottle now. Hopefully this one goes a little better...

Ava didn't take much of her 3:00 bottle either, and Ella only took 5 mls of her bottle, leading the nurse to think that both the girls are tired. It looks like they will rest tonight, and hopefully their parents can too.

-Rachel

Thursday, March 12, 2009

Slaves to the Monitor

One of the things that Rachel and I are trying to do right now that is providing to be quite a challenge is to ween ourselves from the monitors that the Twinsler's are hooked up to.

When you first walk into the NICU, most people are surprised at how not-hospital it looks. It feels more like a uber-corporate cubical farm w/ each baby having their own little area separated from the other babies by small dividers and rows of cabinets. The second thing that you notice are the sounds. There are all sorts of beeps, buzzes and chimes going off at any time, and then you start to coordinate those sounds w/ how people react. Some alarms trigger urgent responses from nurses, while others just seem to go on and on and on w/ no one seeming to care. It is the NICU's own language, and as a means of survival, you need to quickly get up to speed, or you'll drive yourself crazy worrying about your kids.
At the end of our first week in the NICU, we had one of the nurses walk us through every part of the monitor (screen seen above). The Right hand column shows the baby's statistics that the monitor is directly hooked up to. The left column is another baby of the nurses choice. The whole NICU is networked so that a nurse can keep an eye on another baby that is not w/i eye or earsight. The green row show's the baby's heartrate. Babies have (or should have) a higher heartrate than us old folks. We like to see btw 120 & 160 for this number. The yellow line is the babies breathing rate per minute. This fluctuates in a huge way, sometime dipping into the teens or single digest, the spiking up in the 100's. They sometimes forget to breath, and as I understand it, that is really the crux of SIDS, kids just forgetting to start breathing again. The blue row is the blood oxygen saturation level, and that number is a percentage of 100. We all "sat" 100 most all the time, but preemie babies vary btw dangerously low (<75) and the high 90's. The first two lines, heart rate & breathing rate, directly effect the oxygen saturation, and this saturation is what will affect the health of the baby later. Example, the babies breathing and heart rate can be really bad for a certain length of time, but as long as all the organs are still getting oxygen, we're OK.

The white line is the last blood pressure reading taken. This is taken twice a day. and the little red fine print is a log of all the most recent times that the baby gone out of their "zone". Apnea, brady cardias, low sats, all things we do not want to see here. So when you initially com into the NICU, you immediately look up to the monitor and look for the red... how has she been doing? Each baby has allowable range for each of these readings, and depending on how far out of the zone they are, an alarm sounds. One beep for this and two beeps for that. Every device has its own alarm and "voice".

So, for the last 5 weeks, Rachel and I have become slaves to the monitors. Now they are telling us to watch the baby, not the monitor. This is way easier said than done, but we are trying. Yesterday during baths, we had them completely disconnected. It felt like I was unplugging Neo from the Matrix! All went well, but it is quite a transition.

I'll post some pics of the baths soon, that was a good time.

-tinny out

Tuesday, March 10, 2009

New Pictures up on Flicker

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Ava's hitting the bottle!

Yesterday at noon was also Ava's first crack at a bottle. before I say how it went, I just need to say that Rachel and I are already struggling w/ comparing these twins to each other. I think that they are doomed for a life of this, though, so they should get ready for it! Here is Ava's feeding 40-something mls, ready to be had...
Here is Ava going to town in our primary nurse's hands. Good Sam NICU has some of the best nurses ever, by the way.
Ava took the whole bottle in 17 minutes! She was a machine! Here is a picture of the aftermath. I am going to have this picture blown up soon so that it is ready for her high school graduation party.The real kicker is that 3 hours later, Ava started showing all the signs that she was hungry again. She should be hungry, b/c they are on a 3 hour schedule, but she was rooting and biting on her hands (all signs that she is ready for a bottle). So, Rachel and the nurse decided to give a second bottle a try. This is very unusual b/c taking a bottle is a lot of work, so they usually start them out on one bottle every 12 hours. Ava took down here second bottle like it was nothing! What an over achiever.

Rachel and I are trying to not get too ahead of ourselves, but some things are really setting in on us. The first is that Ava could come home first, leaving Ella in the NICU. We really do not want this b/c of the craziness that it would cause. The second thing is that Ava could optimistically be coming home in less than a week. Very cool, but this creates quite a sense of urgency to get the house in order. Please pray that God works out all these details while gifting Rachel and I some sense of sanity. Thanks!

-tinny out

Ella's First Bottle

On the twin's 5 week birthday, both girls got their first shot at taking a bottle. This is a pretty big moment, b/c taking their feeds from a bottle is the final hurdle before these girls come home (assuming that they keep moving forward on all other fronts, breathing, growing etc). The nurses warned us that some babies take to it very quickly and others can struggle w/ it and take their time. At Noon on Monday, March 9, Ella attempted her first bottle, seen here, looks tasty, doesn't it?
Here is Ella trying to figure out what all the fuss is about w/ her developmental therapist. They allow 20 min for the feeding, and whatever is left, they feed through the gavage (feeding) tube. When it was all said and done, Ella took 13 mls on her first shot at the suck, swallow, breath routine. Afterwords, our nurse said they would have been happy w/ 10 mls... Ella you rock!We learned this AM that during one of her feedings during the night that Ella took here whole bottle from the nipple... She definitely gets her love for food from her Dad.

-tinny out

Sunday, March 8, 2009

Big Week Ahead!!

The girls continue to make steps forward. They have been off oxygen for a couple days now and each day have fewer drops in their heart rates/oxygen sats. Ava and Ella continue to grow at rapid pace (Ava-4lbs 8oz, Ella-4lbs 1oz), and have a big week ahead. On Monday they will be 34 weeks, which is the time they learn how to suck and swallow. We will be trying their first bottles on Monday!! This will lead us into the "feeder/grower" stage and if everything goes well we could be coming home soon!! The girls will start out with one bottle every 12 hours and increase as they tolerate them. Once the girls are able to take all of their bottles without droping their heart rates/oxygen sat for 48 hours they are able to come home. According to the nurses, this can take 2-4 weeks. We are praying that the girls will be able to suck, swallow and breathe all at the same time.

-Rachel

Friday, March 6, 2009

Just how big are they?

It has really set in recently just how much the girls have grown over the last month. In some ways they are still really small (both under 5lbs, but in other ways they look like normal babies. I set out to use a common object for reference in a highly scientific manner to show everyone out there in the blogosphere how big the Twinsler's are, and how far they have come. So, I've chosen an object that popped into my head the first time that I saw my babies in the NICU, a Chipotle Burrito. I thought wow, my babies are the size of a Chipotle burrito!

Here is an approximation of what how Ava compaired to a burrito during her first week of life.
Now in the second picture, we see Ella eying up her first real meal dirung thier 5th week of life.Rachel and I are both really luck to have such great twins and access to such great burritos.

Chipotle, you out there? How about a little corporate sponsorship for this blog, just think, it could be "the Twinsler's presented by Chipolte."

Seriously, looking over the pitures from a month ago really brings it all into perspective as to how far they come... God is good.

-tinny out

Wednesday, March 4, 2009

Steady

Today was an OK day. Ava continues to be a champ on room air w/ no breathing assistance, and Ella had a much better day than yesterday but decided to implode for 45 minutes in the late afternoon. She seems steady now, though.

We have great friends and family, and we are truly humbled by all the love and support that we are feeling from you all. Thanks

-tinny out

Tuesday, March 3, 2009

What A Day!!

Nick went in early this morning to find out that the girls had a good night. Which is always good news. He was there for the 9am feeding and had a hard time leaving because Ella kept dropping her oxygen sats. I show up around 10am and spent about 1 hour watching my beautiful Ella's oxygen sats continuously drop into the high 30's low 40's and her poor little face turn very pale with a tint of blue. Talk about stressful!! Today she was very unpredictable, one minute she sats in the 90's and the next minute she drops into the 50's. She knows what she is doing... just look at that evil grin...
Needless to say she is still requiring oxygen. By the end of the day thankfully she was doing much better. This behavior is a little unusual for her, so we are praying it doesn't continue.

On a happier note, our other beautiful daughter, Ava was taken off oxygen today and tolerating it so far. She spent some good time in mommy and daddy's arms. Here is picture of Ava receiving a boogerectomy. This is a pretty regular occurrence where they use a high powered suction device to clean out the nasal passages and mouth... It's pretty much like hooking a Dyson up to your nose, and it usually works.

-Rachel (w/ Nick's help for the boogerectomy)

Monday, March 2, 2009

Happy 1 Month Birthday!

We have some really great nurses in the NICU!! Last night our night nurse made this one month birthday card for the girls. Rachel and I were very impressed, first because she would take the time to make this beautiful card and second because of how nice a card it was for using supplies from around the office. The confetti are cut up post-it notes - brilliant!

Today, as the card implies, is the girls' one month birthday. In some aspects, this has been a realy long month, and in some ways, it has flown by. The girls are still dancing around w/ their oxygen, but they are continuing to grow and improve. Personally, I think they are becoming a lot more baby, and a lot less science experiement - Thank God for that!

-tiiny out

Sunday, March 1, 2009

Weekend Update

Things have been going pretty well as of late for the girls. They have both been up and down in terms of breathing. They are slowly being weened off oxygen and "flow", but the nurses are quick to remind us that the girls are the boss, and they let us know what they want to do (I really hope that doesn't come home w/ them) They continue to tolerate their feeds that keep being increased, and all their systems seem to be working well, because they are growing. I am not sure of their exact weights, but earlier this weekend, they were both 1lb over their birth weights, and Ava could go over 4lbs tonight. Late this past week was the first time that Rachel and I both really noticed that they are getting substantially bigger. They both have cheeks, chins, growing bellies and the start of fat rolls on their arms and legs (as much fat roll as a less-than-4lb baby can have).

The other night, I asked the girls "How much are foot-longs going for these days at Subway?" They both rolled their eyes as I snapped these pictures...
Finally, Mom and Dad are doing well too...

-tinny out