Friday, August 31, 2007

Good News

No, no - not the long-awaited for and hoped for going home news, but still really good news.

The girls had their eyes checked again and they had great reports. Natalie's eyes are still good, and Abby's eyes are looking much better. Both exams also show that their eyes are in Zone 3 out of 3 as far as growth. In other words, the blood vessels in the eyes are nearly finished growing.

The girls were quite cute today. I was holding Natalie while she sucked on her paci. The paci´s are hollow and both girls like it when you put her finger in it. It´s kind'of neat because you can feel them sucking. Anyway, I was holding her and had my pointy finger in her paci. She was holding on to my thumb with one hand and another finger with her other hand. It was so very cute.

Abigail and I had some nice quality time as well. We had our final Kangaroo Care video session today. She did great. At the very end though, she started grunting and moving around. Then a heard a big toot! After that, she settled right back down:-) They've actually been very gassy lately and are quite the little tooters. Daddy is very proud.

Thursday, August 30, 2007

Honestly - how hard is it to learn to eat?

Apparently, it's pretty hard. Since I keep talking about their feeds, I thought I'd vent a bit.

Learning to eat from a bottle is of utmost importance - obviously. It's their ticket home. So far, it's not going well. As you can tell from my little columns and lists, their success is completely random.

So, you might ask, what exactly is the problem? Hmmm. Good question. The current theory is reflux. It's pretty much like reflux in adults, and as the adults can tell you - it really sucks. The symptoms the girls have shown have mostly been in terms of their apparent discomfort. They arch their backs, move their mouths around and occasionally cry a little. In the last few days however, I've noticed them licking their lips and swallowing a lot. They've also started spitting up a little.

It actually just breaks my heart that they might be in pain. Poor little things. They are receiving reflux meds that are supposed to help. They probably are. It's one of those things where even though they still have problems you never know just how bad it would be without them.

Theory two is a combination of the reflux theory and simple prematurity. They simply may not be ready yet. Some babies just take longer. I'm told that one day the light bulb will just go off, and they'll "get it". I want to know if Babies R US sells those light bulbs. I need two.

It's so frustrating when they are getting so big and still can't come home. Our stress level is rising every day. It's getting harder and harder. We just thought they'd be home by now. We are even getting a little snippy so we've decided to take a few days together this weekend and just chill out. It will be our last chance before the girls come home.

Please continue to pray that there's a sale soon on light bulbs.

Wednesday, August 29, 2007

Abby - world traveler

Well, at least a cross-town traveler. She has made her way back to DRH AGAIN. She arrived about 7:30 Tuesday evening. Obviously, her eye exam went really well. Her eye showed improvement and no surgery was required. The doctor thinks her eye will continue to improve and be just fine. Yeah!!! Thanks God!

Since time continues to fly, I'll catch up on the week.

While Abby was in their care, Duke took care of a few housekeeping duties. Sunday evening she had a VCUG - voiding cystourethrogram. Radioactive fluid is squirted into the bladder to see where it goes. It's trying to detect if any urine is flowing backwards into the bladder. If it does, it can cause an infection. She has been on amoxicilin just in case that happened. But, the VCUG showed that the bladder was functioning normally and there was no sign of urine reflux. This is great and means she can stop the antibiotic.

Tuesday before she left, she also had an Upper GI to see if there were any physiological reasons for her eating issues. Again, everything looked good. It did show some mild reflux.

Speech and OT continued to work on her bottle feeds. I was told she took a whole bottle right after she arrived on Sunday afternoon. On Monday at 2pm, she also took another full bottle. I think that's all they tired at Duke. Today (wednesday), she had a bottle at 6am, but only took 12ml. At 2pm, she took 25ml. At 8pm she took 35ml. Her weights at Duke were 2610g on Sunday and 2630g on Monday. When they checked her back in to DRH she weighed in at 2640g - 5lbs 13.12oz. Wednesday, she weighed in at 3695 - almost 2 more ounces - 5lbs 15.06oz! She may hit 6lbs tomorrow! She's going to outgrow some of her clothes before she ever gets home! And never mind those preemie diapers I bought. She'll be in Size 1 any day now. Oh - another little first today - I clipped Abby's nails for the first time. They are the tiniest things you have ever seen. But, I manage to avoid drawing blood.

On to Natalie...

Natalie managed fine while her sister was away. OT and Speech worked with her a lot between Sunday and today.
Sun - 11am - 44ml
Mon - 12am - 13ml
9am - 20ml
6pm - 24ml
Tues 9am - 36ml
9pm - 15ml
Wed - 3am - 24ml
9am - 11ml
3pm - 9ml
9pm - 40ml

She also continues to grow.
Sun - 2165g
Mon - 2225g
Tues - 2230g
Wed - 2270g - 5lbs!!!! and .07oz. Go Natalie!!!

Monday was a big day for Natalie as she also had her nails clipped for the first time. As it was my first time, I have to say, it was one of the scariest things I've ever done. Luckily - we both survived - with all 10 fingers - and my sanity in tact.

Sunday, August 26, 2007

Back at Duke

Well, as of about 2pm, Abby is back at Duke. She settled in nicely and the nurse said she seemed quite happy. Almost as soon as she arrived, they fed her by bottle and she took the whole thing. Go figure. They will check her eyes Monday morning. Oh, today while still at DRH, they put Abby in the swing for the first time. They said she seemed to like it. I hate I missed it.

Back at DRH, Natalie is doing well. She also took her full bottle at 11am. Our girls are so weird. Natalie also gained another ounce and is at 2165g - 4.12lbs. If she continues to take her bottles, maybe she can come home next week! I guess I shouldn't get my hopes up, but I hope, hope, hope.

Clear plastic containers, label makers, and color coded closets...

No, no, no - not that kind of organization! I promised an explanation of the oft-used term, "organization" in relation to the girls. This may be a little technical, so hang with me.

If a person says the term, "fetal position", most people can visualize what that means. We imagine a person curled up in a ball with their head to their chest, arms pulled in and legs tucked to their chest. There's a reason this position is termed in this way. As the womb shrinks to an ever-growing baby, the baby is forced to assume this curled up position. There are practical reasons for this - space being the most obvious one. However, there are also physiological reasons as well - leading to the concept of organization and sensory integration.

The skin is the body's largest organ and the largest receptor of sensory information. It feels hot, cold, soft, and firm and takes all manners of information from the world and transmitting that information to the central nervous system and then to the brain. In most babies the central nervous system is developed enough to accept and process the information it receives. If the information is too much, the baby can "curl" to protect itself. Think about what happens when you get cold. You immediately pull your arms in to your body to minimize your skin's exposure to the cold. If you are really cold, you sit and pull your legs in and drop your head to your chest, aka the fetal position. It's also a protective position for emotional pain. When we are hurting emotionally, we crawl into bed and curl up. It's our body's way of saying it can not handle any more stimuli, and it's a way of the body calming itself. And herein lies the key to "organization".

Full-term babies are better able to recognize when they receive stimuli and can pull their hands and arms in to minimize stimulation and calm themselves. Their abilities to bring their hands to their mouths and suck on their fingers are also calming and organizational behaviors. Pre-term babies especially, are not automatically geared to do this. Perhaps because their living spaces never became cramped enough and they never had to spend time in the fetus position, it simply is not instinctive. Also, since they did not have time to finish developing their nervous systems, they simply don't know how to respond to excess stimuli. The result is disorganization.

There are many cues the babies give to indicate their disorganization and stress: Flailing arms and legs; open hands (opposed to fists); straight and locked arms and legs; and scared, wide-eyed looks on their faces among others. Organized cues include clenched fists, arms drawn into center of chest, hands at mouth and bent knees. For babies who are not organized, they have to be taught and encouraged how to do it.

Teaching Natalie and Abigail how to organize themselves involves a few different methods. They are usually kept wrapped up with their hands snuggled tightly at their faces so they can suck on them. Wrapping, called swaddling, also keeps their arms and hands centered in their chest. They are also swaddled with their legs in a "flexed" position. The babies also prefer firm, deep touches to light touches - think massage versus tickling. They also prefer quieter voices to loud, sudden ones. All of this is partly to re-create the conditions of the womb - quiet, cramped, and comfy.

For those who are still reading, congratulations. You've made it through Baby Organization 101. All this is important because the inability to organize can lead to future issues, like sensory-integration problems. That's exactly what it sounds like, the inability to process or integrate all the sensory information that the body receives. It mostly occurs in the areas of touch and sound. For instance, I have a few sensory issues myself. I hate for rough things to touch me. I also hate tight things. I've been like this since I was a child. It has and continues to do considerable damage to my wardrobe. I hate most fashionable clothes since I find them too tight or made of some weird yucky fabric. I'm a loose cotton t-shirt, elastic waistband type of girl. So, we are trying to prevent such weirdness in our girls.

Well, now you know what I'm talking about when I throw around big words like "organization" and "sensory integration". If you are completely lost and actually care, give me a call:-)

Saturday, August 25, 2007

On the road...again

Well, Abby's eyes were checked again on Friday. (I must say I've been very pleased with how they are keeping on top of it.) Her left eye was still fine, but her right eye showed more advancement into stage 3 ROP. So - back to Duke. This time Dr. Tang (at DRH) wants them to stay until they go home. She is also very concerned about their lack of oral feeding. She wants Natalie to go to Duke as well for her feeding issues, and since it may be two more weeks, to make life easier on us.

They've been trying various things at DRH with the feeds: breast milk with progestimil (which supposedly tastes yucky); then breast milk with Elecare (supposedly no taste). Today they are trying just breast milk trying to determine if there's something about the taste they don't like. They are also adding "simply thick", a Vaseline-like substance that thickens the milk so they don't choke so much. We are also holding off on breastfeeding this weekend in case that's causing them confusion. In any case, they are about out of ideas. Their best guess is that the girls suffer from reflux - very common in preemies. They don't spit up often, but it can still enter their throats causing burning and irritation. There is a doctor at Duke that does research in reflux and Dr. Tang think he may have some ideas. That's why she wants them to go - and stay - at Duke.

Do, they will move over Sunday or Monday morning. Probably Sunday. Hopefully they will take Natalie too. Although parking is a pain at Duke, we are looking forward to going "home". I'm looking forward to the cotton (and not nylon) short-sleeved gowns and the comfy recliner chairs for holding and breastfeeding. Ahhhh.

In other news...
Weights
Abby
Fri - 2515g
Sat - 2530g (5.9lbs)

Natalie
Fri - 2080g
Sat - 2130g (4.11lb- shortening the gap!)

Just a run down of their sporadic feeds...
Natalie
fri
2am - 8ml
11am - 6ml
8pm - 25ml
Sat
5:30am - 6ml
11am - 11ml
5pm - 30ml

Abby
fri
12am - 5ml
9am - 6ml
9pm - 21ml
sat
6:30am - 12ml
11am - 20ml
6 pm - 17ml

As you can see there's no pattern or progression. It's completely random. Hopefully Duke will have some eyes, or as Dr. Tang said, maybe they don't like Durham Hospital and will like it better at Duke.

Friday, August 24, 2007

It costs HOW MUCH???

So, we received an Explanation of Benefits from our insurance company today for Abigail's charges. Anybody want to guess???


Wait for it............$377,862.06. Once again. $377,862.06. The best part is the plan liability part - $0. Total Patient Responsibility - $377,862.06. Obviously this isn't correct. Oh, and the best I can tell, that's only through July 11. Interestingly, one of the largest charges is $45,470.00 for drugs. I've been trying to talk to Abby about that crack habit.

We haven't seen all the bills from Duke yet. I'm wondering if this is even correct. I guess we'll see. All I can say, regardless of its issues, is thank God for health insurance.

New Pictures

I've posted new pictures for weeks 13 and 14. I also updated the "Watch Me Grow Week by Week". That's really worth checking out. To see how they've grown and changed from birth to now is amazing. Enjoy.

Thursday, August 23, 2007

A reminder...

Please don't forget to sign your name on the posts you leave. We love reading them, but we can't tell who they are from if you don't sign your name! Thanks!

The days fly by...

Is it Thursday already?? I get so easily behind. How does that happen? Well, here's the news...

Tuesday Abigail had her eyes checked again. I was very pleased they went ahead and checked them as I had asked. Her left eye showed even more improvement. The right eye, the troubled one, was "stable". I guess that's good. They will check them again in 4-6 days.

Tuesday morning the girls did well with their feedings. Speech fed them at 11am and Natalie took her whole bottle! Abby took 40ml of her 55ml feed. Later that evening at 8 and 9pm, Poppy and Nanny took turns feeding the girls and did quite well. Natalie again took a full feed. Abby only took 22ml, but she was half asleep the whole time.

Obviously, Poppy and Nanny were visiting on Tuesday. Our dear friend, Laura, also visited on Tuesday. I was able to sneak her in by saying she was from our church, which is true. She was able to hold Natalie and it was darling.

Wednesday
Wednesday was frustrating for Mommy. I tried to breastfeed both girls and neither would have anything to do with it. I was very frustrated. I have great milk production, but the equipment to transfer it falls a bit "flat". Later that evening, Ben and I had a little talk. Ben was wonderful and very supportive. I just have to remember to stay calm and realize that they will eventually get it - when they are ready.

Wednesday evening also saw a visit from Aunt Kimmy. Ben has two bracelets, so Kimberly put one on and they never even blinked about letting her in. It's been over a month since she's seen them and they are a lot bigger now. The visit was short, but we are so glad she could see them. I know the girls were thrilled.

Today - Thursday - was a nice day. I was at the hospital from about 2 to 7:30. They moved the babies around in the room so we have the whole back corner. There's also no one on the opposite side of the room, so really we have the whole back half of the room, which is quite nice.

I tried breastfeeding Natalie at 2pm with the help of Speech and Cathy, the lactation consultant. It didn't work. I did manage to stay much more calm this time. I ended up kangarooing Natalie while Speech bottle feed Abby. They tried putting some thickening stuff in the milk to see if it helped her any. It didn't. She only took 15ml and worked hard for that. So, no more thickening stuff and better luck next time. I also took some time to kangaroo Abby. I really enjoyed just holding and enjoying my little girls.

Here are their recent weights:
Abby
Mon - 2310
Tues - 2365
Wed - 2425
Thurs - 2425 (5lb 5.53oz)

Natalie
Mon - 1899
Tues - 1968
Wed - 2040
Thurs - 2045 (4lb 8.135oz)

As a side:
You may have been wondering why my dad, step-mom, and sister were visiting in the middle of the week. Unfortunately, we had a tragedy in our family this week. My cousin, Dustin, was killed in a motorcycle accident in Burlington on Saturday night. He was only 21. They were all here for the funeral on Wednesday. It was a very sad for all of us, especially Dusty's father and brother. Unfortunately, Dustin had a tough life during his short time here. He had bi-polar disorder and had struggled with the disease most of his life. Although his passing is tragic, we have all been comforted that his suffering in this world is now over, and he is finally at peace.

Monday, August 20, 2007

Mommy's OWLS - Divination - T

For all you Harry Potter fans, you know that Divination is the art of predictions. A T stands for Troll - the lowest grade you can get. A review of the predictions I made several weeks ago reveals Mommy will NOT be pursuing a NEWT in this subject. For those non-Harry Potter fans who are desperately confused, my predictions were wrong, and oh, read the books:-)

Abby
* Abby is steadily gaining weight. At this rate I think she will hit 4lbs by August 8 - in one week. THIS IS THE ONLY ONE I GOT RIGHT - SHE MADE 4 LBS SUNDAY, AUG 5.
* She is now receiving at least 3 of her 8 feedings a day by bottle and taking all or nearly all of each feeding. I think she will take all of them within the next two weeks - by August 15 - her 3 month birthday. WRONG
* With all her progress, I really feel that Abigail will make it home by her due date - August 20 (a Monday). I think she'll come home at about 4 lbs 9 oz. VERY WRONG - SHE'S NOT HOME YET, AND SHE IS ALREADY AT 5 LBS

Natalie
* Natalie is doing really well, but is still almost 11 ounces behind Abby. She had some setbacks in growing, but she seems to be taking off now. I predict that she will hit 4 lbs by August 15. NOPE - SHE HIT 4 LBS AUG 17
* Natalie is also doing well with her bottles, but again, started almost two weeks behind Abby. She is trying 3 bottles a day as well, but not eating them as completely as often as Abby. I think she will need an extra week or two and may come home around August 31. UNKNOWN - THIS HASN'T BEEN PROVEN WRONG YET, BUT IT'S NOT LOOKING GOOD

And with that - Mommy's out of the prediction business.

A few days in review...

I need to catch up the last few days, so here goes...

Friday - The girls has their eyes checked again for ROP. Natalie's eyes look great. They are now between Stage 1 and 2. Abby's left eye also still looks better - Stage 2. However, now her right eye is showing some Stage 3. It wasn't concerning enough to send her back to Duke, but they will check them again in 5-7 days. I actually requested today that they check them sooner rather than later. Hopefully, they will look at them on Wednesday.

I can't remember if I posted that the girls failed their cortisone tests last week. It's not a really big deal; it just means they will continue to receive hydrocortisone in very small doses.

As of today, they have switched them from Progestimil to EleCare preemie formula. They are both pre-digested, hypoallergenic, yada, yada, formulas. The EleCare is supposed to be easier on the stomach. It also tastes better. Apparently the Progestimil is icky and changes the taste of the breast milk when mixed in. The idea is that if they like the taste better, they will take more from the bottle.

They measured the girls today. Abigail is 18 inches long now. Natalie is a bit behind at 16 1/4 inches.

Here's the run down of their weights:
Abby
Wed 2150
Thurs 2120
Fri 2205
Sat 2225
Sun 2300
Mon 2310g (5 lb 1.48oz)

Natalie
Wed 1739
Thurs 1779
Fri 1829
Sat 1872
Sun 1894
Mon 1899g (4lb 2.985oz)

40 weeks! Their Due Date has Arrived!

Well, as of today, the girls are officially here. From hence forth, if you ask their age, you will get two answers: their "real age" (time since birth) and their "corrected age" (time since due date). For instance, today they are 3 months old or 0 days old. The corrected date is important in terms of evaluating developmental milestones. If their actual age is used, they'll appear delayed in everything, like rolling over, sitting up, etc. Using the corrected age shows more accurately if they are on schedule or having delays that may need intervention.

Also, as of today, my patience has officially expired. I have suddenly developed a desperate longing for the girls to come home - NOW. I found myself very frustrated today with their lack of progress in the eating department. I was especially jealous when the baby next to us, a 29 weeker, now only 33 weeks, was chomping down her bottle like a pro. It's very frustrating. They are doing so well in every way, and the ONLY thing holding their ability to take their feeds from bottle and/or breast. We are told that one day they'll just "get it". I think it's time.

Here I come to save the day!


So Mommy has been out of town at a wedding on Friday and Saturday and then yesterday a family emergency on her side cropped up. So that explains the lack of posting.

But never fear, Daddy is here! Just a quick update before I get my second cup of coffee and start working. Last night Johelen and I bottle-fed Abby and Natalie and both did extremely well. This is the second time I've done a feeding and it's pretty cool. I also changed a couple diapers on Saturday while my Dad was here and it was pretty messy. I'm getting the hang of it though, and can tell with about 95% accuracy if they pooped or not. Natalie also farted on my hand which had me laughing for a while. Hey, I'm a guy and bathroom humor is still funny to me!

Natalie is at 4lbs 1oz.
Abby is just a smidge over 5lbs!

I'm sure once Johelen wakes up this morning, she'll update ya'll some more.

mmmmm...coffee....

Thursday, August 16, 2007

3 months old - August 15

I'm sorry for not updating more often. Life gets so busy and when things are going well, there are fewer things to report. I've been spending 4-6 hours in the afternoon at the hospital with the girls and by the time I get home the time just flies. I'll try to do better:-)

Okay - here we go.
Tuesday
Yesterday, the girls were 13 weeks old. They are just growing and growing. Abby gained nearly 2 ox in one night. She went from 2035g Monday to 2110g (4lb 10.5oz) on Tuesday! Wow! Natalie's doing pretty well yourself - she was 1702g (3lb 12oz) on Tuesday. They have had a little reflux with their feedings. I think they are going to start Natalie on Zantax to help. They haven't been doing very well with their bottle feedings, but hopefully they will get better.

Natalie also had a cortizone test to see how well she's doing without receiving the hydrocortizone. We haven't heard what the results were yet. Abby will have the test Wednesday.

Wednesday

Wednesday morning the doctor called and said Abby's hemocrit (red blood cell production) was at 21. That's pretty low. I wasn't too surprised since it had been at 24 a few days ago. So, little Abby needed a blood transfusion. They do it over two days so she'll get more on Thursday. She did great though and by the end was just as pink as could be!

Once again, neither did well with nippling in the morning. However, they each did better with breastfeeding in the afternoon. At her 5pm feeding, Natalie took 14ml. At 8pm, Abby did 24ml. She did great! They seem to do better with breastfeeding which is perfect if you ask me!

At lunch we had a visit from a case worker from the state Infant-Child Development Coordinator to explain some of the services available to the girls. She will help coordinate OT, PT, Speech and whatever else to help get the girls up to date with development. The best part is it's all free! Most of the people will come to our house to do the therapies which is wonderful. Just as a note - my mom actually used to do this job. She actually did evaluations and provided the therapies. Needless to say, Natalie and Abigail will definately have people on top of things when it comes to development!

There's still no discussion on coming home. Obviously, they aren't eating very well so until they catch on, mum's the word.

Here's a quick recap of weight:
Abby
Mon - 2035g
Tues - 2110g
Wed - 2150g (4lb 11.8oz) - can you believe this! She'll be 5 lbs before coming home!

Natalie
Mon - 1655g
Tues - 1702g
Wed - 1739g (3lb 13.3oz)

Monday, August 13, 2007

What a Wonderful World...

We have had a great weekend. Thursday and Friday Poppy visited. Then Nana and Mema arrived Friday night and have visited for several hours on Saturday and Sunday (and will again on Monday). Grandpa and Ya-Yai also came on Saturday. It's been a grandparents weekend! Mommy and Daddy have barely held the girls:-)

Everything continues to go well. They raised the volume of their feeds a little. Abby is receiving 42cc and Natalie 34cc. We are also still working on breastfeeding which is going quite well. Today Abby took 20cc and Natalie a whooping 26cc! It's actually somewhat unusual for preemies to learn to breastfeed, especially 26 week old preemies. But, I think my girls are going to figure it out! Mommy is getting the hang of it either. Note to men: it's not as easy as it looks! But, we are figuring it out. One of the Lactation Consultants, Cathy, also comes to DRH, and she's wonderful. I'm quite happy it's working out as bottle feeding and pumping would be a chore.

Their weights the past few days...
Abby
thurs 1857
fri 1912
Sat 1967
Sun 2000 4.54lb

Natalie
thurs 1488
fri 1523
sat 1585
sun 1628 3.942lbs

I have posted some new pictures, so be sure to check them out.

Also, thanks to Tamara and Carolina for visiting the babies and bringing such lovely gifts. As always, Tamara has great taste and brought a Peter Rabbit plate, cup and bank. Little did she know my mom had already started collecting Peter Rabbit for the girls!

Friday, August 10, 2007

NICU Day 87

Wow - 87 days! Sounds like forever, but the end is near.

Last night and this morning Poppy was here for a visit. We had a great time holding the girls and talking. Nana and Mema will be here this weekend and I know Natalie and Abigail are very excited.

Today we had some good reports. Abby had her repeat eye exam for ROP. Good news!! Her eyes still look better. There is only one place on her left eye that is of concern, but the doctor didn't seem concerned. She feels it will continue to improve. We also had a breastfeeding session with Abby. We tried a breast shield this time and it worked much better. Abby did great! She sucked about 10 minutes or so. We didn't weigh her before, so we didn't know how much she ate, but we thought about 10 ml. She ultimately got tired and sleepy, but considering they had just performed the eye exam (which isn't very fun), she was very agreeable. I feel much better about it now. I had really begun to think they'd never figure it out and I'd be stuck pumping and bottle feeding the breast milk. Today was very encouraging. We will try again at least once a day.

Natalie also had some good reports. PT came in about 1pm and did a little work with her. She said Natalie is getting much better at organizing herself and pulling in her legs and arms. (more on "organizing" in another post) Today she was so cute all wrapped up in her bed. She was sucking on her little thumb knuckle. Just darling:-)
Natalie also stopped receiving the microlipids today. She will continue to receive the progestimil at 3/4 teaspoon.

Their recent weights:
Natalie:
Thurs - 1488g
Fri - 1523 (3 lb 5.7oz)
Abigail
Thurs - 1857g
Fri - 1912g (4lb 3.4oz)

Wednesday, August 8, 2007

On the Road Again...

Abby is on the move - she is being returned to DRH this afternoon. We are very sad to leave Duke - again. We just love it there. It was so great to see some of the nurses again. We will definately visit again with both girls. We are happy that Natalie and Abigail will be together again. Two hospitals was a chore.

Natalie is doing well this morning as well. She will receive the other half of her blood transfusion this afternoon. I am going to try to breastfed her later tonight. I'll also give Abby a try as well. She did very well with her bottle this morning.


A note: I've mentioned little Buddy from Caswell County before. He is having a hard time right now. Please pray for him and his family.

Update:
Abby arrived happily at DRH about 5:30pm. She did very well with the transport. It was very nice to have them back together, even though we miss Duke. They aren't in the same bed right now because the beds DRH are too small. We may put them together for naps, but they will still have their own beds.

The girls continue to do well. I gave Natalie a bottle and she took 22cc. Abby had a bottle in the morning at Duke and took 34cc. Feed and grow...feed and grow...

Tuesday, August 7, 2007

Great News! - 12 week birthday

Abby had her repeat eye exam and the news was great! The ROP in her left eye had improved and was back in Stage 2. She will not need to have the surgery at this time. We are so thankful it looks like her vision will be okay. Of course, the ROP could take a turn for the worse and she could end up needing surgery after all, but for now, the news is very good. She will be checked again in a week. She is headed back to DRH as soon as they have a bed open.

Both girls had really good days. Yesterday, they were each a little fussy. Maybe they were missing each other. They still apparently are able to channel and copy each other even at different hospitals!

Monday, Abby tried a new, bigger nipple to help with her feeding. This nipple has three holes, but is a little harder to suck. So, even thought there are more holes, the milk comes out slower. I worked with Speech/OT to give her the 3pm bottle Monday and she took 20 of 39ml. Her night nurse, Mandy, reported that she too 15ml at her 9pm bottle. She was also given a bigger paci to go along with the bigger nipple so she can get used to the size. Today (Tuesday) she didn't do as well with her 3pm bottle, but she may have been tired out after her eye exam. Hopefully, she'll do better tomorrow. She is at the point where she has to eat her way out of the NICU. Her weight for the past few days:
Fri - 1780g
Sat - 1780g
Sun - 1820g
Mon - 1830g (just over 4 pounds!)

Natalie was also a little fussy yesterday, but was doing better today. Yesterday, she received her first big girl bed! It's a very small plastic-isolette like bed. (Abby actually has a crib-type bed.) They don't have the crib bed's at DRH because they take up so much room. In any case, she looks so cute in her little bed. She stays bundled up, but she seems to be holding her temperature well. Her weight was up and down a little. It's possible that trying to stay warm affected her. Also, she tested a little anemic Tuesday morning, so she received a transfusion this afternoon. Her weight:
Sat - 1371g
Sun - 1399g
Mon - 1445g
Tues - 1424g (3.23lbs.)

She has also been finicky about her bottles. The nurse hoped that the transfusion would help with her alertness and interest.

I'll try to post some more pictures soon. We have some adorable ones of Natalie in a little pink sundress:-)


**Mommy was a little ahead of the game and had originally posted that the girls were 13 weeks old. They are actually 12 weeks old. Mommy can't count. That's why Daddy is in charge of math homework:-)

Saturday, August 4, 2007

Good News and the Not-as-bad-as-we-thought News

Friday turned out to be an interesting day. I was able to go to the hospital and spend time with the girls for the first time in nearly a week. It was so great to be with them. They are getting so big and are just so cute.

Early Friday afternoon, just before I arrived, the girls had their check-up eye exams to check the progression of ROP (retinothopy of prematurity). It's complicated to explain. If you really want to know, I suggest you google it. Otherwise, just know it has to do with the blood vessels growing correctly from the eye and attaching in the right places. If they don't, it can cause various degrees of vision problems including blindness.

I'd been there a little while when the doctor had news about the results of the exam. Natalie's eyes looked very good. What little ROP she had shown on her last exam actually appeared to be correcting itself and looked better than before. Abigail had a similar report for her right eye. Her left eye was a different story. It showed increased ROP to Stage 3 (of 5). The DR doctor felt that she may need corrective laser surgery. So, (this is the good news part) - they transferred Abby back to Duke to be seen by the doctor there. Apparently they only do the surgery at Duke. Therefore, to our great delight, Abby arrived back at Duke at about 8:30pm Friday evening. It was like coming home. The familiar waiting room, the friendly front desk staff, the short sleeved gowns and cushy chairs...It was wonderful. Ben accused me of being downright giddy. (and I was!)

When we walked in the room to see Abby, I'm proud to say I recognized her right away. But, we almost didn't believe it and double checked her tag because she was in a "big girl bed"! She was no longer in an isolette, but an open bed with a heater lamp about 2.5 feet above her. She was just so beautiful. She was actually just lying there without any blankets, and although her temp was good, I thought she looked cold, so we covered her with her special pink blanket and placed her little froggy at the head of her bed. I just can't say how adorable she looked.

The doctor came in about 9:15pm and checked her eyes. It's not a really fun exam and the babies don't care much for it. I don't think it hurts really; it's just uncomfortable. Of course, to Abby it was all the same and she cried and cried. Her darling daddy couldn't take it. He had to leave the room. It was really just too sweet and it was immediately clear who would be taking the kids for their vaccinations and any shots in the future.

In the end - the news was much better than we expected. The Duke doctor said she did NOT have Stage 3 ROP. There were a few spots that were stage 3, but overall it was still stage 2 and she felt it may correct itself as the other eye had. Also, for now, Abby does not need any corrective surgery. They will continue to monitor it and check her again in about a week. There's a chance it could worsen and she could need the surgery after all, but there's also a chance it will get better and she won't. We just have to wait and see.

For those who were paying attention - yes, Abby's trip back to Duke was a solo one. They didn't have enough room for Natalie too. So, poor Natalie is still stuck back at Durham Regional. We aren't sure how long Abby will stay at Duke. They may send her back to DR, then bring her back for her check-up. Or, they may keep her until the check-up. It probably depends on how much room they have and if they need the beds for children who are more critical. I'm going to ask about Natalie being transferred to Duke as well, especially if they are going to keep Abby for at least a week. Honestly, I'd be surprised if they agree to it. There's really no medical reason. I just don't like them being apart, and it does make it harder on us to go between two hospitals. However, if Abby can stay at Duke another week, I'll gratefully hospital-hop for as long as necessary.

Please pray that Abby's eye will heal and there will be no damage to her eye sight. As always, thanks for your prayers.

Friday, August 3, 2007

Still growing...

The girls continue to feed and grow. They have both been a little disinterested in their bottles for the last day or so. OT (Occupational Therapy) and Speech have been working with them each once a day. As soon as I am well enough to see and hold the girls again (hopefully tomorrow - Friday), I am going to start trying to breastfeed and give their bottles. Maybe they will respond better for their Mommy.

Review and Update:
starting Tuesday, July 24
Abigail
Tues -1427g (3.2lb)
Wed - 1440g
Thurs - 1457g
Fri -
Sat - 1553g
Sun - 1584g
Mon - 1624g
Tues - 1652g
Wed -
Thurs - 1687g
Fri - 1735g (3.13lb)

Natalie
Tues - 1162g (2.8lb)
Wed - 1186g
Thurs - 1207g
Fri -
Sat - 1247g
Sun - 1281g
Mon - 1302g
Tues - 1322g
Wed -
Thurs - 1342g (2.15lb)
Fri -

On Wednesday, I spoke with the doctor about how the girls are doing and what the plan is for the next few weeks. I also got a run down of what kind of drugs they are still on and why.

They will have another eye exam on Friday to check the progression (or hopefully non-progression) of the ROP.

Right now, they are both still receiving hydrocortizone for an adrenal insufficiency. The adrenal glands produce cortisal which is one of the hormones involved in stress situations. Sometimes preemies don't make enough. They are tapering it off and it will end on Aug 6. On August 13 they will have a stimulation test that involves introducing a different hormone that prompts the adrenal glands to produce cortisal so they can measure how much is produced and see if the glands are working properly.

They are also each receiving elemental iron to help maintain their red blood count. There's still a chance one or both may need another blood transfusion before they are discharged.

They also receive calitril - a calcium-type supplement for their bones. It also helps prevent a baby form of rickets.

Because of the possibility of a bladder infection that could be caused by the back flow of urine into the bladder, they are receiving a prophylactic dose of amoxicilin. Before they leave the hospital, they will have a VCUG test. I have no idea what that stands for, but basically they will insert a catheter into the bladder and inject a radioactive dye to allow them to see where the urine is going. If it's backing up, they will go home with antibiotics.

To help add additional vitamins and minerals and nutrition, they receive a special boost of pregestimil powder, a special preemie formula.

Natalie is also receiving a boost of microlipids to her feeds. It's to give her extra calories so she can grow faster.

We talked about the forecast for their homecoming. As expected, the doctor was non-committal. They have to meet the criteria I've mentioned before - 4lbs, maintain their temps, and take all their feeds orally.

The doctor did not indicate that they are having any major problems or areas of concern which is really great. They continue to do very well.

The main concern right now is their inconsistently in taking their bottles. Please pray for them to develop a sudden liking for bottle feeding.