Nicu Days 6 and 7

Day 6: Wednesday, April 10, 2013

What a busy day! Today was the first day that I was home from the hospital and Emmeline was not at preschool. Emmeline's last music class was this morning, so Alex dropped me off at the nicu before taking her to that. My mom stayed at the house because we were having granite counter tops delivered. We had obviously made this kitchen remodeling decision before we knew that the twins would be arriving early. We contemplated changing it, but than quickly came to the conclusion that it will always be a bad time. They look fantastic, btw.

Busy, busy morning at the nicu. First was milk management. This nicu has an amazing milk bank. You just label and drop off your milk, and then they coordinate with the nurses and handle everything else. My milk production has been out the roof (which is surprising because I really was a low producer with Emmeline), which has been great. But it meant the I had a lot of unlabeled bottles from the night that I had to separate and organize and take to the bank. Pump then kangaroo with Evan then pump...then meet with lactation consultant to fix the pump. Then chat with the social worker. Oh, and do our children want to be part of the blah, blah, blah research study? I finally made it to triage to get my staples out. Yay! Wow, does that ever feel better. Ordered some lunch, took a breather and then Alex and Emmeline came up around 1:30PM.

It was cute...I have stocked one of the nicu rooms with some of her favorite snacks. She asked for one as soon as she came in and I think got a big kick out of it. After saying hi to her brothers, we went to the play area down the hall. Yes, according to Emmeline, the nicu is a "fun place". I'm glad she sees it that way. I know if the boys were sicker, she may have a different impression.

Left the nicu, a short stint at home, then off to her swim class. Then back to the hospital for a fun dinner at the hospital cafeteria. Seriously, she got a kick out it. Back to see the boys. Special times as Emmeline got to see Oliver out of his "crib", help put on his hat and sing to him. She also got Oliver's stuffed tiger all situated for the night and asked the nurse to watch over him too. So many nurses commented how nice, calm and sweet she was. I was proud. Came home and crashed.

Day 6 Evan "no more pictures please":


Day 6 Emmeline, dad and Oliver:


Day 6 Emmeline, taking it all in:


Day 6 Emmeline before swim class:


Day 7: Wednesday, April 11, 2013

After dropping Emmeline off at preschool, we both headed to the nicu. Pump, kangaroo, pump, rounds, eat, milk management. These are our mornings. After 7 days, we are settling into a routine. Rounds went well. Probably the best news is that Oliver had taken 58% of his feeds by mouth. Evan took some by mouth, but less. But really, just the fact that they are taking any by mouth is impressive. Auntie Lauren came for a morning visit and even got to feed Oliver a bottle. Tonight, after we pick Emmeline up from preschool, we are going to this indoor jungle gym area with her. We've decided that we wouldn't go back in the evenings on her preschool days (as long as they are doing well).

Day 7 Mom and Oliver:


Day 7 Dad and Evan:


Day 7 Evan eating:

Nicu Days 4 and 5

Day 4: Monday, April 8, 2013

Same schedule, different day. Morning rounding went well. The doc who saved Evan immediately upon delivery was there. I was kangarooing Evan at the time and admittedly half paying attention. All I heard him say was "Evan holds a Mott nicu record...". Not fully understanding what he meant, I laughed. The whole nicu team looked at me as if I had two heads. I then asked for clarification. The record he holds is not a good one. He had the lowest hemocrit ever recorded at birth. Translation? He had the worst case of anemia at birth. Essentially, we had hours. My ob at the time made an amazing call. See, I was on NST monitoring all night before the c-section, and there really wasn't anything to indicate that they couldn't wait one more day while the lungs matured. However, this ob just felt something in his gut that said "deliver now". I've been looking for him everyday because I want to say thank you.

My mom spent the morning in the nicu with me, while Alex took Emmeline on a playdate. She is doing so well. Then, in the evening, Alex and I had the opportunity to hang out with the boys by ourselves while my mom watched Emmeline. They were just about ready to put the lights on Oliver (for jaundice) when we arrived, so we couldn't hold him - I was glad I had the chance to spend kangaroo time with both in the morning. Even though we couldn't hold Oliver, it was still very nice for both of us to be able to be there and spend time with the boys. Alex had a chance to hang with Evan.

Day 4 Evan:


Day 4 Oliver (morning):


Day 4 Oliver (evening with lights):



Day 5: Tuesday, April 9, 2013
After taking Emmeline to preschool (with pics of her new brothers), Alex and I spent the morning with the boys. I was so happy to see that the lights were already off Oliver...unexpected! We both got some kangaroo time with the boys...me with Oliver, Alex with Evan. Good reports at turnover. Not much to report...which is a very good thing. After picking Emmeline up from preschool, we decided to take an evening off from the nicu and we went out to dinner with my mom. Another good day.

Day 5 Evan:


Day 5 Oliver:


Day 5 Mom with Oliver:

Nicu Days 1, 2 and 3

So I am going to try to document our nicu journey. Try is the key word. Life is busy.

Day 1: Friday, April 5, 2013
Evan was born at 9:35AM. Oliver was born at 9:38AM. After they got Evan out, Oliver flipped and my uterus started clamping down on Oliver. They gave me a shot of nitro to relax my uterus and after 3 minutes of dramatic tugging, Oliver was born. Both boys were immediately taken away next door to a place called "the nest" where they were resuscitated and stabilized. They were is rough shape. Evan's initial APGAR score was 1. Oliver's was higher, but still not great. I heard Oliver give a weak cry, but not Evan. After I was sewn up, the delivering doc asked if I wanted to see the "remarkable" placenta. I did. Even as a non-medical person, I could see why it was remarkable. One half was pale, pale pink (Evan's half) and the other half was deep purple.

I was then pushed to recovery to wait for a room and Alex stayed in the nest with the babies for awhile. I recovered well - just the usual exhaustion and post surgery nausea. Eventually, the nurses wheeled my bed down to the nest so I could get a peak. I think I missed the big drama, because although I knew they were sick, I expected them to look worse.

I finally got a room and continued to recover. I tried to get up on several occasions to go to the nicu, but just felt too woozy. Auntie Lauren, Alex and Emmeline went down and Emmeline got to meet her little brothers. Later that evening, I made it down as well. They were doing so well. By the time I went down, Evan was already off his ventilator and Oliver was about to come off.

Day 1 pics:



Day 2: Saturday, April 6, 2013
Woke up, feeling well and headed to the nicu. Both boys were now off the ventilator and Evan was even on room air. They had a good night. Alex and I experienced our first nicu rounds, and figured out that it will be good to be there in the mornings...rounding usually happens between 9-11AM. Emmeline came to the hospital, had lunch with me and got to see her brothers again. In the afternoon, I continued to rest and recover. We headed back in the evening and we both got to hold both boys for the first time. By evening, Oliver was also on room air only.

A Day 2 pic of mom holding Evan:


Day 3: Sunday, April 7, 2013
Discharge day! Took my first shower and headed to the nicu with Alex for rounds. Another good night for the boys. They got to start food today and I was lucky enough to give Evan a bottle. He took most of it, but the nurse warned that as he gets bigger and requires more volume, he may not be able to keep up with the bottle. Still, it was a promising sign that he was practicing sucking. Oliver did the same. We got to hold the babes again. Then, around 12PM, I was discharged. We went home - so good to be home - then headed back in the evening for a short visit.

Day 3 Evan:


Day 3 Oliver:


Day 3 Dad feeding Evan:


Day 3 Grandma visiting Evan:

They are here!

Around 9:30amish Friday morning our boys came into the world after 32 weeks 4 days of hanging out in a cozy uterus. Oliver Charles Wall weighed 4lbs 9 ounces and Evan Alexander Wall weighed 3lbs 11 ounces.

It started Thursday morning with a "routine" appointment that quickly became non-routine. Baby Evan was showing signs of stress which was eventually diagnosed as anemia. Originally, the decision was just to do a little more monitoring, but then quickly the plans changed into admitting me directly into labor and delivery...and informing me that I wouldn't be allowed to go home until the babes were out. My best friend and I had plans to have lunch and a pedi after the doc appointment...so like boys not to understand the value of lunch and a pedi with good friends. ;-).

They gave a couple steroid shots to help mature the lungs quickly and had hoped to have pushed delivery until Saturday morning. But after a night of monitoring and Baby Evan continuing to show signs of stress, they decided to do a c-section this morning. And what a wise choice that was...

Identical twins that share a placenta are at risk for something called twin-to-twin transfusion...basically one twin starts robbing the other twin of blood, causing one twin to have too little blood and the other twin to have too much blood. This was the cause of Evan's anemia. The somewhat unusual thing is that it usually starts to develop before 26 weeks. So to have develop so suddenly at 32 weeks was kind of rare. And, to boot, it was a "dramatic case" per the delivery team - so dramatic that they asked if we would sign consent forms so that they could use pictures of the boys/placenta in future lectures/studies. We've explained to Evan that this was probably not going to be the last time that his younger brother Oliver would be stealing something from him....

So they were pretty sick when they first came out (Evan worse off than Oliver). But the great news is that now, almost 48 hours later, they are both very stable and off their ventilators. Alex and I both got to hold both of them last night. What a strange feeling to not be able to hold your baby(ies) right away. It will be a long haul as they will probably be in the nicu anywhere from 5-7 weeks, but we are just grateful that we made it to the 32 week mark.

Emmeline is doing fantastic and got to meet her brothers the day that they were born. I'm doing well - my biggest challenge will be slowing it down and realizing that this is going to be a marathon, not a sprint. I should be discharged today. Alex is well and is trying to establish the balance of helping care for Emmeline and being up here at the hospital. My best friend Lauren and my parents have been very valuable these past 72 hours. Now to figure out the challenges of life with two babes that don't get to come home right away.

In the pics, Evan is on his side and Oliver is holding my hand.


More to come...

32 weeks tomorrow

Wow - we have arrived. Obviously, it would be great if they cook a little longer, but if they decide otherwise, the outcome is now looking very good. 5 weeks left...at the latest??? I can't believe it and start to breath a little too fast when I let that sink in.

Sleeping has moved into the miserable realm. I dread nighttime. Dread it. It goes something like this...fall asleep at 10ish, wake up at midnight for about 30 minutes, fall asleep until 2ish, awake from 2-5ish (but not awake enough to do anything productive...just awake enough to watch endless episodes of The Office or Friends), fall back asleep around 5ish, sleep on and off until about 7:30am. This is standard. This is not enough sleep. The problem is my back and my belly. There is just no good way to support either. Even sleeping reclined offers minimal relief. I belong to a twin group and someone even made the bold statement that because sleeping is so miserable with the babes inside, that I actually may feel more rested once they arrive. I can see where this may be true. Sure, I will be awaking up every 2 hours to have 2 babes on my boobs, but at least I will be able to sleep in the short periods in between. We'll see.

We had a very nice Easter - spent with my mom and a dad and some friends down the street. Emmeline had fun. We are both pooped. I'll leave you with a 31 week and 2 day belly pic as well as a pic of E and her pregnant momma enjoying a beautiful Easter day on the swings...

Other gifts...

So, although I'm not on bed rest, and it appears that I may not be through the rest of this pregnancy, I am definitely slowing - both physically and mentally. As a result, I have asked my parents to come on the weekends when my husband works (he's a commercial pilot...should be interesting when the twins come, eh), This has been so helpful. They sometimes say that they feel bad that they don't do enough and that it still seems like I run around like a Tazmanian Devil even if they are here, but what they don't understand is them giving their undivided attention to Emmeline is the biggest help they could possibly be. It is such a relief to do the little things around the house without my 3-year literally pulling on my leg much of the time.

And because they come so much, there are definite traditions. Emmeline always sleeps with my mom. Within minutes of my mom coming in the door, Emmeline politely asks "Can I sleep with you?". Of course! And it works perfectly. She sleeps the whole night and loves cuddling with her grandma. Although she usually sleeps through the night anyway, the benefit to me is that I don't have to do bedtime. At 8:15ish, they head upstairs and I have the evening to myself. Total treat for everyone, I think. And Emmeline and my mom have special things they do - My mom introduced her to puzzles, which is perhaps one of her favorite past times. So she knows that grandma loves to do puzzles with her...and snow flakes. And then there is bath time. Grandma has a reputation for being able to blow monster-sized bubbles with her soap. Emmeline will tell her "Mommy can't blow bubbles as good as you, Grandma.". It's true. My dad has his own relationship with her. He brings her a milkshake when he comes...chocolate. And messes with her about her imaginary friend, V-nick, saying that V-nick actually hangs out with him at his house. Last night, Emmeline decided to run a music school, and he faithfully followed Emmeline around the house while she sang "we're marching, we're marching" and banging some play instrument. And then, as bedtime was winding down, Emmeline asked for him to come up to say goodnight to her...a true sign of her affection.

You don't think you do enough, mom and dad? Trust me - you do more than enough.



Just one of the many gifts these boys are already giving us as a family.

This weekend I had the great opportunity to visit with Alex's aunts and cousin. It was a nice treat as we don't get to see much of them. They came with fun gifts, including this - as you can see from the above pic, I think it was a hit and a testament that no matter how far away they live, they understand my who my daughter is.

30.5 week appointment

It went great. Could not have gone better. Both babes weighing around 3.5 pounds. Same fluid. Super long cervix. Despite dropping, no signs of them coming anytime soon. Baby B is head down. Baby A is butt down, as in his butt is resting on my cervix. The CCAM hasn't grown and remains a very minimal risk. I want to be off work by end of next week, but things went so well that my doc said that she can't write a "bed rest" order because there is no medical reason. She will write an "off work" order based on it being a twin pregnancy and the fact that I'm measuring "full-term". Last work day: April 1st.

Other appointment stats: I've gained a total of 28 pounds. My blood pressure yesterday was 133/87. I was concerned, but the doc was pleased. So I'll just go with that.

Also, we have a concrete plan for the birth. If I go into labor on my own, I'm progressing and the first baby is head down, we'll give a vaginal birth a shot. If I make it to 37 weeks with no signs of labor, we'll go direct to a c-section and skip the induction phase. Ahh, feels good to have a plan and I'm comfortable with these choices.

Funny story about my high-risk ob. So basically, she's become my high-risk ob because I have connections in the system. My best friend is a pediatrician in the system and is friends with a wonderful ob, who initially became my ob for this pregnancy. Then, when we found out about the twins, she worked some magic and transferred me to her connection...one of the best, most experienced ob's in the high risk practice. Apparently, my high risk rarely takes her own patients anymore as she is busy doing other high-risk things (not sure exactly what). Bottom line - I'm pretty much her only patient right now. I have figured this out because of the utter confusion at my ultrasound appointments when I'm asked and "do you have an ob appointment soon?" and I respond with "yes, today, with Dr. T". Then always the look of confusion and shock.

So when I did in fact see Dr. T yesterday, I told her how I've come to realize that I am very special that I am getting to see her as a patient. She just smiled and winked and said nothing. Then, as we were checking out, we ran into her and she put her hand on my shoulder and said, "By the way, your not special because I'm your doctor. You're just special.". I choose to take it as a compliment. :-).

So ultrasound pictures are getting harder, but she managed to get a profile of Baby A. That bubble near his mouth? His umbilical cord. I'm grateful he doesn't have teeth yet! lol.



The other big thing yesterday was that we made our stroller purchase. The City Select Double. Love it. In this pic, it is set up for an older configurations (once they can sit up), but those red seats come off and there are adapters for their infant car seats. Note the fun platform for Emmeline...although last night she enjoyed playing baby and sitting in the red seats. Yes, I drove that stroller all around the house for a couple of hours.



Next appointment in 2 weeks, followed by weekly appointments till the end (for NST monitoring). We are truly in the home stretch.