Margot is home and Happy Father's Day

We have had lots of firsts the past few days.  It was Bubba's first Father's Day!  They had an event at the NICU on Saturday to celebrate with pizza and BBQ.  We brought David and visited Margot.  The March of Dimes sponsored the event and had a Royals gift bag for each father - which included tickets to a Friday night game!  Lots of fun.  They also took pictures of the dads with their babies.  Bubba's picture was so cute that they want him to sign a release form to be able to use the picture on their site.  

The proud daddy:

With Da at the Father's Day event:

Monday was a big day.  David had his first pediatrician appointment.  His pediatrician Dr. Moylan was on vacation, so we saw Dr. Pecararo - who was my pediatrician.  Everything had come full circle as he met with David almost 32 years after meeting me for the first time!  Margot will have her appointment on Friday - with Dr. Moylan who will be back in town.

David getting weighed at the pediatrician's - he is 6 lbs, 14 oz now!

Dr. Pecararo:

After leaving the doctor's office, we went to pick up Margot who was ready to come home!  We wheeled the twins out on a wagon - they looked so cute.  Margot's homecoming was so wonderful.  It is really nice to have them both at home.  

Waiting to leave the NICU:

The cuties in the wagon:

David is home!

We brought David home yesterday afternoon at 4pm!  It was so wonderful.  He looked so tiny in his car seat and slept all the way home.  When we got there, aunt Martha was waiting!  What a wonderful homecoming.  I was excited to see the nursery that Martha, Denise, and my mom had finished while I was rooming in with David.  It looks incredible!  David looks so little in his huge crib.  It is set up with a bolster pillow under one end of the mattress to elevate his head.  He has a tucker sling to keep him from sliding down (like when he was strapped on to his wedge in the NICU).  He slept like a champ!  I think he really likes his bed and his room.  I can't wait until Margot gets to come share with him.  I talked to the doctor this morning, and she said we are still on track for Margot to come home on Monday!!!

We had aunt Martha, aunt Denise, Baba, and Da over for dinner.....and they were all such good helpers.  David loves them all.  Here are some pictures from his first evening home:

David in his car seat: 

Bubba holding his "little helper":

David in his little lamb swing:

David in a bouncy seat in the nursery:

Mommy and Daddy looking in on David in his crib:

Rooming in

We are rooming in with David starting today!!  That means, if all goes well, he will come home on Thursday!  Margot still has at least a week to go because she had two bradycardias that needed mild stimulation yesterday.

We meet with the home monitor company this afternoon to learn all about the monitors they both will (most likely) come home on.  These monitor for bradycardias and apneas.  

Bottles and Swing

David in the swing:David's first bottle (from nurse Christy):
Margot's first bottle:

David and Margot have come so far in the past few days!  They are both able to take a bottle now!  Hooray!  They are using the Dr. Brown's bottles because those are supposedly better for gas and reflux.  They took to them right away.  My mom (Baba) came to learn how to feed them a bottle today because she will be taking care of them when I go back to work.  It went really well.  AND over the weekend, David had his first ride in a swing.  He loves it!  He starts feeding (and finishes feeding) first, so we put him in the swing while I'm finishing with Margot.  

The really big news is that they think David is ready to go home.  Margot still has about a week because she keeps having random bradycardias and desats that need mild stimulation.  But David hasn't had a brady in 7 days, so we will room in with him starting tomorrow or Wednesday.  This is when we will stay with him in a hospital room and will completely care for him.  

Because we think he's ready to go home soon, he got circumcised today.  It was so hard to send him to that operation, the poor guy.  I walked him down to the operation room, and it was so hard to leave him there.  I felt like it's harder for him (since he's 7 weeks old today) to have this done now than a non-preemie baby who would have had it done right after birth.  He did really well, though.  

We have an appointment tomorrow with the company that makes the home monitors to learn how to use them.  Both David and Margot will go home on a monitor because they will go home sleeping on an elevated mattress on their tummies (prone) to help with their reflux.  This will be a pain, but will also be peace of mind.

They both will need to do carseat tests this week.  Bubba got their carseats installed in the Mountaineer with the help of our friends Dan and Alysha tonight.  We will have them inspected tomorrow and then will bring the seats (minus the bases) to the NICU for the test.  The test involves having David and Margot sit in their carseats for an hour while hooked up to the monitors to make sure they don't have bradycardias or apneas while in them.

Fun night-time update

I just got a call from the hospital.  I was a little panicked when I saw caller ID because it's 10 at night.  Usually, the doctor calls me each morning with an update, but I had never received a call at night.  The nurse called, though, because she had such exciting news.

She said that David was very awake when she went in for his 8:00 feeding.  She gave him some oral stimulation, though, and he went back to sleep.  Oral "stim" is when the nurses give them some breast milk orally.  They really like it.  They sometimes "demand" it and will fuss until they get some.  It is like a drug to them almost and really makes them happy.  Once David went back to sleep, she gave him his 52 ml of breast milk via his NG tube (through his nose into his stomach).  She had weighed him, and he gained 15 grams (1/2 ounce).  This is great!  I breast fed them for two feedings today, so it is good that he gained weight.  The first day I breast fed, they lost weight.  This is normal because they use so much energy to nurse (plus, I'm never too sure how much they are taking in).

Margot was also very awake when she went to give her feeding.  And oral stim didn't settle her down.  So the nurse decided to give her her first "cup feeding".  This is where they have a little cup out of which they let them lap up the milk.  They do this instead of bottle feeding while the babies are still getting used to breast feeding.  This is so that they don't stop wanting to breast feed because they get used to bottle nipples.  Margot did fantastically!  She took 40 ml of her 50 ml feeding (the rest went down her NG tube).  What a good girl!  And she gained 1.5 ounces!  Wonderful.  I will go to sleep happy tonight.

We had a good day today.  I only breast fed them two feedings (instead of the three that I usually fit in) because Martha and her boyfriend Chris came to visit and then took me out to lunch.  It was a fun time.  The babies loved seeing their aunt Martha.  Then they had another fun visitor - Baba (my mom).  Mom held Margot for about a half an hour, and she was in heaven.  Both of them were.  :)

Also, Bubba and I met with the occupational therapist today to go over developmental items for the babies once they come home.  She talked about how we should consider their adjusted ages when looking at milestones.  Which means if babies should be doing something at 6 months, for example, David and Margot should really be doing it at 8.5 months.  We are supposed to count for milestones from their due date instead of their actual birth day.  We went over different activities we can do with them and had a chance to get a lot of our questions answered.  It was really nice.  They will go to The Children's Spot by St. Luke's periodically to be checked out by physical, occupational, and speech therapists to make sure they are developing well.  This will be a very nice support for us!  Also, we found out that David and Margot will get hearing tests done next week - where there are little electrodes put on their heads while sounds are played to them.  They are asleep during this, but the electrodes are monitored to see how well they hear.  The nurses say that sometimes preemies take a while to get fully developed hearing due to excess fluid.

As far as coming home goes, the nurse we had today guessed at 2 weeks.  We think it will be between 1-2 weeks.  We are supposed to bring in our carseat sometime next week so they can do the carseat test.  This is where they sit in their carseats for an hour while hooked up to the monitors to make sure they can breathe, etc.  Sometimes it is hard for preemies to breathe correctly in carseats because they get scrunched down in them.  And we also found out that we will "room in" with them for 48 hours before they go home.  This is where we will stay in a hospital room taking care of them and feeding them for 48 hours to make sure there are no problems.  It will be reassuring to do that before we go home.

Tomorrow I will feed them twice before going home to get ready for my good friend Allison's wedding celebration.  It's funny because we didn't think I'd be able to go to the party (thinking I'd either be VERY pregnant or we'd have the babies at home).  But I get to go and am looking forward to it.  We are so happy for Allison and Brian.  Congratulations!

Freedom!

I promise to put up pictures soon but just wanted to update everyone.

Breast feeding is going well.  I am feeding them 3 times/day (11:00, 2:00, 5:00) right now.  The big, fun news is that they are off nasal cannula!  Hooray!  Now they only have one "tube" on their faces - their feeding tube.  They are still connected to monitors for their heart rates, respiration rates, and oxygen saturations.  They are still having lots of episodes, but they are all self-limiting (they come out of them on their own).  They haven't needed any stimulation in days.  This is so good!  

I met with a discharge nurse today to discuss all the things we need to know for discharge.  This includes their carseat test, rooming in (which we will do for 2 days and 2 nights where we will be completely caring for them/feeding them), and upcoming doctor's appointments.  This doesn't mean we are being discharged right away, but means that it is coming up some time in the near future, so we should be preparing.  It is most likely that David and Margot will come home on monitors - which means they will each have a "belt" that will monitor their heart rates and respiration rates.  This is attached to a monitor which is in a shoulder bag.  I saw one on a baby leaving yesterday, and it wasn't a big deal.  David and Margot will most likely have them when they go home because the will probably go home with the orders for an elevated mattress in their crib.  This means they will sleep on their tummies.  Since babies are supposed to sleep on their backs to minimize the risk of SIDS, our babies will have the monitors...it will be good for peace of mind.  Lots of babies go home on the monitors.

5 pounds, 6 pounds - and baths!

David:Margot:

It has been a busy week for the twins - full of activities and visitors.  Margot is now over 5 pounds!  She is 5 lbs, 2 oz, to be exact.  And David is 5 lbs, 15.8 oz.  If we were rounding, that would be 6 pounds! Hooray!  And since they are almost 36 weeks gestation - and 6 weeks old, they got new big-boy and big-girl pacifiers (as shown in the above photos).

The plan to move each of them down to 30-minute feeds and 1 liter of air on nasal cannula was a total success.  We marched on with our changes each day.  We also switched them from zantac to prilosec for their reflux.  They are still having lots of self-limiting desats (that they come out of on their own) which are causing alarms, but since they don't need stimulation or anything, we are not as concerned.  So we started trying to breast feed yesterday.  Both David and Margot are doing a really good job, but we still haven't fully mastered breast feeding.  It's not for lack of trying, though!

Dad (Da) got to hold the babies for the first time this week!  Here are some pictures from that momentous occasion:

Bubba's parents came to visit, too.  Here is a picture of Debbie holding David:

Sunday night was a fun night.  Bubba and I went to the hospital to help one of the nurses give David and Margot tub baths.  Bubba was the bather, and he did a great job!  Both Margot and David LOVED their baths.  They were both fussy until they hit that warm water, then they just melted.  David was his usual mellow self the entire time.  Margot was putty in her dad's hands once he massaged her eyebrows. 

We got lots of pictures from bath time!  The first ones are from David's bath, followed by Margot's.

Food and Social Security

Margot:

David:

In order for David and Margot to come home from the hospital, they need to meet three requirements:

1. They need to be able to breathe on their own.  

2. They need to be able to regulate their temperature.

3. They need to be able to eat on their own and sustain an appetite.

They have been progressing well against these three items.  They can breathe on their own.  They do have apnea spells every once in a while, but those are mainly due to their reflux.  They are on nasal cannula, but not really because they can't breathe - more to remind them to breathe.  They are masters at regulating their temperatures.  They are both in cribs (versus incubators that stay warm to help with this) and get their temperatures checked every 3 hours to make sure they are staying in the normal range.  They always are.  Good job, David and Margot!

Food.  That is the final hurdle.  We have been discussing that with the doctors and nurses over the past few days.  Both David and Margot had been getting their feeds over a 2 hour time period.  Today, we contracted that down to 1.5 hours.  In order to try feeding by mouth, we need to be down to 30 minutes.  We also need to have their nasal cannula flow down to 1 liter (or nothing).  They are currently on 2 liters.  

So, the plan is to see how they do with 1.5 hours feeding time today (so far, they have been doing fine).  Then, either tomorrow or the next day, we will turn down their nasal cannula flow to 1.5 liters.  We will keep making a change towards the goals of 30 minute feeds and 1 liter nasal cannula each day until we get there.  We don't want to make more than one change per day because then if they have a setback, we won't know what caused it.  The other change we might throw in the mix is changing their reflux medication.  Right now they are still on zantac, but there are other medications that we might try now that they are a little older.  

Currently, David is getting 42 ounces of fortified breast milk every 3 hours.  Margot is getting 40 ounces.  As far as growth goes, David and Margot are both thriving.  David is now 5 lbs, 5 oz, and Margot is 4 lbs, 10 oz.  Here is a picture of Margot getting weighed a few nights ago:

When I got home from the hospital this evening, I checked the mail and found a letter addressed to David and one to Margot.  They were their social security cards!!!  They got good numbers that are only away from one another.....I hope I don't lose the cards before they need them.  They say that they shouldn't be signed until the bearer turns 18 or has their first job, whichever is first.  Interesting!  It made me think of Bubba's social security card (which he still has) that he signed as "Bubba Fair" at the age of 5.  His dad then had him cross out Bubba and write "James David Fair" above it.  Ha!