Light at the end of the Tunnel

Wow how time flies, I didn't realize it had been so long since I posted an update. Lots of good news and progress to report. Adam is taking all of his feedings by bottle/breast and since yesterday was the 24hr mark of doing such he had his feeding tube removed. He was also able to spend 5hr without his oxygen yesterday before it had to be put back on. When he is on oxygen the flow was decreased to .25L flow of 50-100% oxygen. We were told that they will allow babies to come home on oxygen which places him very close to coming home. Mia is still using her feeding tube but was able to feed 4-5X consecutively before needing her feeding via tube. They are progressing her to 100% bottle/breast feedings and when she does that for 24hr like Adam she can get rid of her tube. This is really the only thing keeping her in the NICU as her body temperature has been variable but within the 97.5 to 99.0 deg they like it to stay in. Their weights as of yesterday were 5lb 5oz for Adam and 4lb 10oz for Mia. Last weekend one of the NICU contract nurses told Mia that she was eating so well she may go home by Mon/Tue. Well Mia and Adam didn't like that so she slowed down on her eating. Maybe they are trying to coordinate their improvement so they can come home together.

Update 1/23-24 (Sorry no catchy title, I'm too tired)

Both Adam and Mia's weight continue to increase and their feedings are doing much better. They tried to progress Mia to bottle/breast at every feeding today and she is exhausted. She couldn't finish her the bottle her last two feedings, apparently she is just not ready for that yet. Adam is still on every other feeding with a bottle/breast and is doing well. I bottle fed him earlier today and he went longer before his oxygen had to be turned up. Milina's parents were in town today from East Texas to see the twins again. They have not seen them since the weekend after their births. It was a treat for them because they have some such a long way in a week and a half since they saw them last. We decided to skip the 8:30/9 feeding to give the twins a chance to rest from their long and tiring day.

Fighting Weight/Kryptonite

Both Mia and Adam are over their birth weight!! Adam weighs 4lb14oz (5lb is just around the corner) and Mia weighs 4lb3oz (5lb is around several corners). Both are breast feeding 1-2X/day and bottle feeding every other feeding. They sometimes finish their bottle and sometimes don't and get the rest through their feeding tubes. Each has their individual Kryptonite - Mia's is body temperature, despite putting on more weight her temperature hangs around 97.5 (lowest acceptable threshold) and 98.0. Adam's is still his breathing, he fluctuates greatly between 21% O2 (room air concentration) and 30% O2 with a flow setting of 0.1 to 1.0. Especially during feeding times or other times of stimulus he struggles. These are the main factors besides the full bottle/nursing feed factors that are keeping them in the NICU. They continue to make progress but it is honestly discouraging that they continue to struggle greatly with their individual obstacles.

The Weight is Over for Adam but not for Mia

Adam has not only met his birth weight but has added an extra 2 oz for good measure. Mia and I are obviously going to have another talk as she has not added any weight. In her defense she is working hard to maintain her body temperature and still requires extra swaddling to help her. They are both up to 3 bottle feedings/day and finishing their bottle in under 30min. They also both had a try at breastfeeding today and did well. They don't measure how much they are able to eat by breastfeeding yet just trying to get the technique down. Adam's oxygen is up and down and will continue to be so.
Sorry there is not much more to report some days are just not as eventful as others.

Paroled for Good Behavior (1-19)

Mia has finally joined her brother in enjoying how beautiful life can be outside an incubator. Much longer in there and we would have to call her "Bubble Girl". She is VERY wrapped up and swaddled in blankets though. Adam's oxygen will continue to go off and on over the next few days as he weans. Feeding times are his most difficult challenges in maintaining appropriate oxygen levels. The twins go back and forth with their feeding as far as who is better. Mia was better this morning and finished her bottle first and Adam had his turn this evening. Adam is officially the first to reach birth weight of 4lb9oz, Mia is still 1-2oz below hers (4lb2oz). Mia and I have had a very lengthy discussed on gaining weight. We discussed the media's degradation of the female persona in TV/print/radio and such. I think she now understands she does not have to look like all the other babies in the magazines and commercials. I told her the Gerber baby was airbrushed and she has nothing to be self-conscious about by putting on a few ounces. We will see if she will start a life of trusting her Father's advice or brush it off as an insane and sleep deprived Father's babbling.

First Time Together

Today was promising as well but we also realized they will not be ready to come home as soon as we hoped. We were hoping they would be ready to come home by the end of the week but that is not very realistic. They will be in the NICU into next week at least which makes it at lease 3 weeks total. They were a few more firsts yesterday which always excites us. They both finished their bottle feeding in the morning within about 15-20min, Mia also finished her evening bottle but Adam left about 4-5ml out of 40ml before he was exhausted and finished on the feeding tube. They do not feed as well with Milina and I, I guess they are too entertained by us and less focused on eating. Adam was able to wean from his oxygen completely last night for a few hours and then needed some after eating because it makes him so tired. They will probably turn the oxygen on and off throughout the day. They are leaving the nasal cannula in place to trick him into thinking the oxygen is still on. Both have gained a little weight but have a little bit yet to go to get back to birth weight. We were able to place them together for a picture last night as well for the first time. Milina will try breastfeeding some time this week to see how they do as well.

2 Days in 1 (1/16-1/17)

We had a very busy day yesterday and didn't post the day's events in time. So rather than type 2 different posts for yesterday and today I am just combining then. As time goes on the changes seem to be more gradual or at least less visible. Adam is doing well in his bassinet and maintaining his body temperature well with just swaddling. Mia is still in her isolator and has more difficulty maintaining her body temp but is also the lighter of the two so she has less protective fat to help her. She will be in her isolator for a few more days. Adam's breathing continues to be his greatest challenge so far. His flow was turned down to .10 with an oxygen concentration level fluctuating between 21% (room air concentration of oxygen) and 25%. He needs a a higher O2 concentration when he is feeding or being held. Adam is better at bottle feeding than Mia is both in the amount he is able to eat and the whole coordination of sucking/swallowing/breathing. We are hoping that next week Milina will be able to try breastfeeding. Dad was finally able to come home and meet his newest grandchildren this weekend. Milina and I decided to have a date night tonight to relax and get away for a few hours, nothing big just a movie or something.

Bottle Feeding Fun

The big first for today was both Adam and Mia are feeding from a bottle 2X/day. For the bottle feeding they are only able to do a partial feeding of no more than 30min and the rest via feeding tube. Milina bottle fed Mia and I fed Adam. Adam is still not ready to give up his nasal cannula even though it is only on 0.2L which is virtually nothing when they turn it down or off he doesn't respond as good as he should. His nasal cannula is his security blanket right now. Mia wouldn't let Adam try and pass her up so she graduated from her IV today. They are doing well in the step down unit and we are able to help out more with feeding, dressing, bathing, etc. Their weight hasn't changed since yesterday but we are also told that it takes more effort to bottle feed so they are burning more calories.

1/14 Update

Today was another great day in the NICU! Most of the changes lately have been with regards to Adam as he has farther to go to catch up with Mia. Adam no longer has his IV because his feeds have increased enough that he no longer requires it. Today was the first day we saw his head without something sticking out of it. He was also able to further decrease his oxygen level to .2, they tried to turn it off completely but he is not ready to give it up quite yet. Adam was also fed via a bottle for one of his feedings this afternoon. Mia's feeds have also increased enough that she will probably be able to get rid of her IV as well. We were able to help with Mia's bath today and Grandma was able to hold Mia for the first time during her feeding. This will leave then with only a feeding tube and heart rate/BP/respiration/O2 sat monitors which sounds like a lot but is really only a few very thin wires. They still get to wear whatever clothes we bring up for them. Biggest news though is they have been moved from the main NICU room to a step down room. They are still in their isolators/incubators but in an area where they require less supervision. They will no longer have their own RN to look after them which we will miss but that also brings them much closer to coming home. They still tell us 2-4weeks but we are optimistic that by the end of next week we will be able to bring them home

Everybody Needs Velcro on Their Head (1/13 Update)

Best news for today is that Adam’s oxygen on his nasal cannula was cut in half today. He was at 2.0L yesterday. 2.0L is a pretty good amount, it sounded like he had a leaf blower up his nose. In between breathes the intensity of the oxygen would inflate his cheeks out and make him puff air out like he had a leak and would deflate if they turned it off. They turned it down from 2.0 progressively to 0.5, he didn’t like to 0.5 and compromised at 1.0 which is still a big improvement. Milina was able to put some clothes on them today and they look very cute in their little preemie outfits. We almost got to move them from the warmers to a basinet but they had some difficulty maintaining their body temperature. Therefore, they have been placed in the incubators temporarily. It is harder to see them in the incubators when we were so used to just having them under the warmers. We are told they should only be in the incubators for 1-2 days then they will hopefully be moved to the basinets. We were able to hold both of them for several hours total today which is the highlight of our day.

Now for the fun part of the blog, the title of this posting is based on the fact that Adam has two small circle patches of Velcro on the side of his head. It is multipurpose, to hold the protective eye shades on when he is under the lamps and also was used to hold his CPAP on. So, in honor of Adam I am listing the many possible benefits of having Velcro on the side of your head. Please feel free to leave your ideas in the comments section and I will add them to the list.

1) In school you can attach your pencil/pen to your head
2) To hold your sunglasses on
3) Your hat would never fall off, even in a hurricane
4) Keep your kids in bed. You can velcro their heads to the bed and they won’t fall out and even more importantly they can’t get out once you put them to bed
5) Keep your snoring husband lying on his side and not his back (a personal favorite of Milina’s)
6) As a way to attach hair accessories
7) It would help breastfeeding mothers, you can breast feed “hands free”
8) A new Bluetooth attachment method, or for those who can’t afford a Bluetooth you can just velcro your phone to your head (poor man’s Bluetooth)
Submitted Ideas
9) Time out enforcement, velcro them to the corner
10) Road ID alternative (Road ID is a personal identification wrist or ankle band so they can identify you when you're hit by a car)

1/12 Update

I went back to work today and Milina will come home from the hospital tomorrow. As time goes on the changes in Adam and Mia are not as visibly noticeable as they were in the first 48-72hr. They are almost to their original birth weight and hopefully should be by tomorrow or the next day. They are not on the lamps today but that does not mean they won't be back on them off and on in the future. Their feeding amounts continue to increase as they are tolerating feedings well with little GI problems. You can definitely see personalities develop more as time goes on. Adam is still on the nasal cannula with 2liters oxygen. They tried again to lower it and he did not respond well. In fact he gave Milina quite the scare, she held him today for the first time and he stopped breathing for what probably felt like an eternity for Milina. They had to startle him by rubbing his back to get him to start breathing. We gave both of them a blessing last night and look forward to lots of improvements in the future.

Just Another Day at the Beach

Milina is still deciding whether she wants to continue to” room in” at the hospital or go back home. She likes to be close to the twins naturally but also misses home. I will return to work next week with a slightly lighter schedule that will allow me to spend an extended lunch time at the hospital. We have been able to get a little milk for the twins. It has to be stored and delivered to the NICU and is then given to the twins and supplemented with formula.
Both twins are up on their feeding amount to help them put back on weight lost after birth. They will be on light therapy most of the day today and probably off it tomorrow depending on bilirubin levels which have dropped significantly but are still high enough to benefit from the light therapy. When they are on the light therapy we can’t hold them as much, just 30min each 2X/day. Mia hasn’t had as many changes as she did the first 2 days but is still doing great. Adam tried 1.5L on his nasal cannula which is down from 2.0L which he did not like. He started to struggle too much to breathe so he was put back on 2.0L. They will continue to try lowering the level to test him until he can be taken off completely.

The Difference 48hrs Can Make

We continue to have wonderful changes everyday. We are constantly impressed at the loving care the NICU staff provides. This whole parent thing is pretty easy; every parent needs a NICU nurse for at least the first 1-2 weeks as parents. They are putting the twins on a schedule of feeding/changing every 3 hours, sometimes more on the changing. Hopefully by time the twins come home they will be pretty well trained. I am considering asking them to go ahead and potty train them while they are at it.

Mia – She has quickly become accustomed to the noises (beeps, dings, other babies crying, talking, etc) of the NICU. That does not mean that she hasn’t found her voice though. She has a cry that surely reaches pitches only dogs can hear which I am sure Polar and Cooper will adore. Her Granddad, Milina’s father, held her for the first time which he and I am sure she absolutely loved. She was working on her tan this evening. They use light lamps whenever their blood work shows increased bilirubin levels. You can see in the pictures that they have a great pair of sunglasses/shades to protect their eyes. They turn them to make sure their tan is even. She will have some great tan lines.

Adam – He graduated from his CPAP this afternoon and just uses a nasal cannula as a precaution. He tolerates the nasal cannula far better than the huge CPAP. They tried to move his IV to his foot but he is still to squirmy and it had to be moved back to his head. With the removal of his CPAP we can finally see his face as well for the first time and he is quite handsome. Another wonderful first for the day is that with his CPAP removed we can hold him finally. Jonathan was the first to be able to hold Adam and they enjoyed an hour or so of bonding over a syringe of preemie formula. He is also enjoying the same day at the beach light therapy as Mia and enjoying it as you can see from his pictures.

1/9 Update

Today was a GREAT day with lots of advancements in the twins status. Milina was officially discharged from the hospital this afternoon but they are allowing her to "room in". She basically gets to stay in one of the rooms on the maternity floor for free as long as the pt census is low and the room is not needed. She also gets to rest more since she is not under the hospitals care and the nurses do not need to check on her at all. We are hoping she is allowed to do this until Sunday evening at which point we will return home and just commute back and forth to the hospital every day.
Mia - Mia's CPAP was removed this afternoon around lunch time. That leaves her with only an IV and a feeding tube. The IV may be removed in a few days, they leave it in just in case they have to deliver medicine and it is easier to just leave it in than to take it out only to put it back in later if necessary. The best part about her CPAP being removed is we can for the first time really see her face, I saw her face immediately after she was born but Milina had never seen her face unobstructed until this afternoon. Needless to say it was an emotional experience.
Adam - Adam still has his CPAP but with a different set up that he tolerates a little better. He still gives the NICU nurses and respiratory therapists a headache by constantly pulling on the straps that hold it on. The new set-up though is more Adam resistant and he has yet to pull it out of his nose despite his best efforts. This is really the only obstacle keeping us from holding him so far. Since it takes the staff so much time to get his CPAP one and secure they will not let us hold him because that would mess up their set-up. Hopefully he will have his CPAP removed either later this evening or tomorrow. The IV situation is the same as Mia's.

Both love time with Mom and Dad. We are in the NICU at least 4-5X/day or every 2-3 hours right now for at least 1 hour at a time then breaks in between for us and the twins to rest. They each love to hold our hands and seem to calm down faster when we place their hands across their chest and then rest our hands over them, especially Adam.

1/8 Baby Update

The babies are doing great and mom is as well. Milina will probably be released tomorrow. The delivery was natural and Milina is recovering quickly.
Adam was downgraded from use of a breathing tube to a CPAP. Mia is still using a CPAP. Both are on room air O2 concentrations and have been the entire day. The results from the blood work should be back tomorrow to determine if either have any infections. Both have mild Respiratory Distress Disease/Syndrome which happens to practically all preemies. Hopefully they will be off any respiratory assistance in the next several days to 1 week.
Mia has quite the high pitched girly cry and lets you know immediately when there is something she doesn't like. She is not irritable though, does tolerate alot, and sleeps very well in between feedings and changings. We were able to hold Mia for the first time and help with her feeding which consists of holding a tube and allowing gravity to help the formula flow through the feeding tube. She is beautiful and strong willed with a great grip. She loves to hold hands.
Adam does not quite protest as loud as Mia does but he does voice his disapproval especially with the CPAP nasal prongs. They have to use a scalp line for his IV because they had a hard time getting an IV in his wrist. Because of the scalp line he cannot use the normal velcro strap system to hold the CPAP on and use a less secure method of attachment. He hates the CPAP nasal prongs and often pulls it out only to have the staff put it back in. He is patient and enjoys his conversations with mom and dad.

Mia and Adam Have Arrived

Adam Jonathan and Mia Nicole Stoddard were born on 1/7 at 10:43pm and 10:52pm
Adam is 4lb9oz
Mia is 4lb2oz
Both are in the NICU and will be for 2-4 weeks depending on how they do. Both are healthy and doing well. They are up to date with 32wk gestation as far as development. Both need a little help with breathing Mia is on CPAP machine and Adam is using a breathing tube and required surfactant to decrease the stress of breathing. They will decrease the breathing assistance over the next few days to test them and proceed as they respond. They are under the warmers but not in the incubators. Both are receiving antibiotics and will be tube fed until they breathe better and can start to try light feedings. All the news right now is positive. We will get the blood work results in 24-48 hours to determine presence of infection.

If you would like to visit the twins or Mom please call first. We can only bring in 1 person each to see the twins but it is look and not touch right now and visits have to be short to decrease the stress/stimulus on the twins.

I will take and post pictures over the next 1-2 days.

The Waiting Game

What to do while waiting for your wife to deliver.

While waiting for Milina to have the twins I was stuck with the challenge of trying to stay busy/entertained and for the most part out of the way of the nurses and doctors. Here is a list I came up with on how to pass the time on the Maternity Ward, some will also work for any MD visit/appointment. Not that I did all of these but just thinking about them made me smile.

1) Go through all the drawers - And I do mean ALL the drawers. You know you have done it while waiting for your Primary Care doctor. In the maternity rooms though there are a lot more to go through and far more exciting finds.
2) Push Buttons – Now with this one you have to be careful. For all you who have to push buttons in your friend’s car or push all the buttons in a new car the maternity ward is heaven on earth. There are countless buttons on the bed, TV/DVD/CD remotes, infant warmer (just like the food warmers at a Chinese Buffet and with a similar purpose), walls, IV poles ( I would not recommend this one), and bathrooms. If you are very brave you can even push your wife's buttons, just make sure you have the other hand on the emergency button.
3) Walk the hallways – Now this may not sound fun on it’s own but you can play a few games to make it more entertaining. You can eavesdrop in on the nurses station, people watch in the delivery waiting room (not as fun as people watching at the Yamboree but what is), Look at the names on the other delivery room doorways and think of funny first names to go along with the last names.
4) Watch TV – yes this is a boring and uncreative one but still an option. The trick is to find an entertaining station without snow
5) Pretend to be a relative – Walk into any room and strike up a conversation with the patient that would make them think you know them.

Coming Soon!! Sooner than expected!!

Milina went into labor 1/7 early in the morning. Of course as first time parents we didn't realize it. We called the doctor office Wed morning because she thought her water broke, it had. A short drive later in morning traffic and we were admitted to the hospital. We though originally she would just be placed on bed rest in the hospital for as long as possible. We were wrong! The twins are 1 day over 32 weeks and weigh appx 4.5lb to 5lb from the sonogram estimate which has the doctors encouraged. Mia is head down and ready to go Adam is still transverse but may turn as he has more room once Mia is evicted for non-payment of rent. 32 weeks is appx 3weeks early for a normal twin due date. They will more than likely spend about 2-3weeks in the NICU depending on weight and lung development. We will post more after they are born hopefully with pictures. If you plan on visiting the hospital please call us first as visitor hours vary, that way we can make sure no one is turned away.