One at home, one in the NICU

It really is a blessing to have twin A home.  We are all transitioning well.  His older brother is thrilled to have him here.  The difficulty, having twin B still in the NICU.  It is no longer the emotional toll, but it is also starting to take a physical toll on me.  Before when they were both together I could spend all afternoon at the NICU.  Because I do have a 3 year old at home, spending all day never worked.  Now I'm lucky if I get to be there for one feeding.  Don't get me wrong.  I am THRILLED to have A home, but maintaing the balance is not easy.  Hopefully we are in for only more week.  Twin B is on the finally week of medication treatment for his infection.  He will have a test midweek to ensure that everything looks good. Assuming that comes back good we will be able to take him home next weekend.  Keep those finger crossed for us.

1 Month Old

It's hard to believe the twins were born just one month ago.  I honestly thought they would be home by now.  The good news is that both are continuing to do well and should be home in the next 1 1/2 weeks.  I'm trying hard not to get my hopes up, but I am so looking forward to having both of them home.  It is looking more and more like Twin A will come home before B.  While it is not ideal, because they cannot cobed in the NICU I will take one home if he is ready before the other.  

It is amazing to think back to how much progress they have made over the month, while at the same time each and every day by itself is so hard to stomach being away from them.  

Today however, we celebrate that we have two beautiful and healthy baby boys.

Breastfeeding in the NICU

It is so amazing.  One of my major concerns about having preemies was their ability to breastfeed.  Amazingly, it is the one thing they had no problems with.  *knock on wood*

14 hours after birth I started pumping with a hospital grade breast pump.  I got very little at first, but I wanted to condition my body to be prepared to feed 2 newborns.  I pumped every 2 hours consistentantly  It was a pretty easy schedule to keep up in the hospital, but once I got home and was traveling back and forth it became more difficult. I occasionally pumped there, but also used the opportunity to stretch my pumping session when necessary to 3 hours.  

The day I was discharge, 5 days after birth, my milk came in.  I continued with the every 2 hours, with the occasional 3 hour stretch.  I was startled to pump 12 oz in one sitting, so I started measuring to figure out how much I pumped in a 24 hour period.  23 days after birth I pumped around 55 -60 oz a day.  That's ALOT!.  I was very concerned about the amount because I read that you needed to pump 24 - 32 ounces for a singleton.  I thought there is no way I can do that.  I was thrilled to learn I was doing that x2!  

So, since my babies have been able to feed they have received my breastmilk, whether in a bottle or by breast.  

Now, for the latching onto the breast.  I was actually very concerned about the boys receiving a bottle or pacifier.  Everything I read said those are big no-nos if you want to have a successful breastfeeding relationship.  The NICU was not willing to let them feed solely on the breast.  I was initially very upset and then I realized I would do what it takes to get them out of the NICU and would work on feeding at the breast once they got home.  

Little did I know how few problems we would encounter.  As for the actual "latch on" I wish I had suggestions.  I used what I learned as a previous breastfeeding momma and doula training to position and offer the breast properly.  That was really key for the boys.  

Then I wanted to make it as easy as possible.  I initially pumped through a let down and then offered the breast.  After the appeared to get the hang of that I would do a little hand expression because they would initially get frustrated that they were working so hard and not getting anything so the expression allowed a little instant gratification.  Now, occasionally they get frustrated when I don't but they latch on perfectly.

I did have one problem that could have been a major one.  I had a clogged duct that quickly turned into mastitis.  I had a fever, the chills, the whole nine yards.  It came on suddenly.  I took a hot shower and massaged the affected breast.  I continued to pump, drink water, rest, and put warm compresses on the breast.  After 10 hours my fever went down dramatically so I decided to not go to the doctor and continue to rest, by 20 hours I was back to normal.  The problem was I tried to stretch my pumping out to 4 hours.  Not such a good idea.  I immediately returned back to the 2-3 hour routine.  

There is lots of great info on the web about exclusively pumping.  Here is a link to the site I found most helpful  http://www.ameda.com/breastpumping/moms/.  I'll also post additional links on the side of the blog that I use regularly.

Finally, I am so proud of my freezer full of milk that I had to share.  Thank goodness we don't freeze a lot of food.

37 Week Update

It's nice to have the internet back up and running and my computer working.  I feel connected again!

The twins are both doing well in the NICU.  Today they are 37 weeks in gestational age, 23 days old.  One is completely off oxygen and breathing on his own and the other has limited assistance.  It is a long way from 3 weeks ago.  Of course it doesn't feel like that on a daily basis, but when I have a chance to step back the boys have really come along way.

Twin B developed an infection and is on day 6 of a 21 day medication regiment.  SIGH!  He is eating beautifully, gaining weight perfectly, but has to remain in the hospital because of the infection.  He is fine, but it just sucks that this is the reason why he remains in the NICU.

Twin A is eating really well as well.  He took a bit longer to get with the program, but will no be shown up by his brother.  Once he is weaned off his oxygen and can breathe well on his own for 24 hours he can come home.  It could be any day, but it is all up to him.

So we continue to wait...

The Roller Coaster Ride of the NICU

It has been an up and down ride the last few days in the NICU. Twin A has gone from a ventilator to an oscillator. He was not doing so well on the ventialor. It is a different breathing assistance apparatus. It is kind of scary at first because it makes the baby vibrate. It is a sight to get used to. They have to be sedated and can't be touched as often. Ok, I said it was scary at first, I still get a chill when I first walk in.

While the oscillator is a little off putting, A has responded very well to it. In the last 24 hours the doctors and nurses have been very impressed with how well he is doing and have already started adjusting the settings to wean him off.

B is also doing good. He is still on the ventilator, but is now breathing what is considered "room air." The settings on the ventialor are comparable to what we breathe normally. Today they will give him a tiny bit of breastmilk through his tubes to see how he digests. This was a very exciting development and you can imagine how happy I was to hear this. It is only a tiny bit, but it is a start.

It is already after 3:30 and I have managed to only cry twice, which is far different from the constant sobbing I was doing before. I know part of it is just hormones, but leaving them in the NICU is still the most difficult thing I have ever done. Remind me of this when I hand them keys to go driving alone for the first time.

We are working on a good system to spend time with the boys at the hospital, our oldest son, and still make sure I am resting and eating so I can keep producing breastmilk. It so far has been a carefully crafted balance, but my husband is incredibly supportive and helpful in making sure we strike the right balance.



The Next Journey - NICU Stay

We have turned the page and started our next journey this time into the NICU. After 47 days in the hosptial, I am being discharged tomorrow and will have to leave my tiny, sweet babies here. It is the moment I have dreaded. Is a rare occasion that I can walk into the NICU without shedding a tear. I have gotten past completely crying when I walk in the door. It is incredibly hard to see your little ones fighting to mature and grow, with lines and tubes coming out of them. You feel so helpless. I know they will be ok. I know in my head that this is the best place for them, but it doesn't make it any easier. I want to hold them. I want to hug them and I can't. Not for now at least.

The NICU is one big roller coaster ride. For every two steps forward you move, you then take two steps back. I try to keep this in mind as I gather information about how they are doing.

Both boys currently need assistance breathing. Shortly after they were born the needed only brief assistance, but after this "honeymood" period was over, the have needed additional assistance. The amount of assistance has flunctated as their lungs continue to mature and they learn to breathe a bit more on their own. As of an hour ago they were both breathing mostly on their own.

Today they had their hearts examined as a result of the work their lungs are doing. They didn't think anything was wrong, but mostly examined them as a precautionary measure. Both of their hearts look strong and healthy for their gestational age. The cardiologist didn't have any concerns.

We are not sure how long this road will be, but we will continue to keep you updated.

Birth Day

The twins birthday started with contractions. I wasn't really feeling them, but I was feeling something different. This is the 2nd time I was having consistent contractions. The first time was earlier in the week and we were able to stop them. This time the contractions were spaced closer together. The doctor thought to check my cervix and see if the contractions were "productive." As it turns out, it was. I was 4cm dilated and completely effaced! Mind you these were contractions I wasn't feeling, but I was officially in labor.

Being that far along required immediate intervention to slow/stop the contractions so that I did not go into full fledged active labor. The potential for cord compression and complications increased if I went into active labor.

The nurses and doctor's began to prepare for the c-section. Remember all that anxiety I had about having a c-section? It was GONE...completely gone. Things went very smoothly. My favorite nurses were there in attendance and things weren't emergent, but were relaxed and steadily flowing.

The twins were born within the same minute (7:30pm), 20 seconds apart. They weighed the exact same grams, translating into 4 1/2 lbs and were 1 inch apart at 18 & 19 inches.

Being born at 33 weeks they are in the NICU. They are doing well, but it is definitely a roller coaster. I'm recovering, but it is hard. I've never had major surgery so this is a whole new experience for me and of course not being able to have them with me is very hard.

All and all, things could not have gone better. My body had enough and I went into labor. If I were not in the hospital I would have never known and things could have gotten much more complicated. Having had my contractions monitored we were able to do things in a controlled manor on my boy's and my body's time table, not an arbitrary date. There were no deccels, no babies in distress, but instead a very smooth process.

My nurses and the doctor's were phenomenal and I am so happy to have my babies here.

Thankful

As the days and weeks have gone by I've worried about my babies surviving, delivering by c-section, having premature twins, and a NICU stay.  While these are all very valid concerns, I'm realizing more and more how lucky I am.  I can say this now being just over 31 weeks.  I had the time to thoroughly process all of these fears, to weigh the pros and cons, and to come to grips with the possible outcomes.  How lucky is that?  I mean many women don't get the chance to think about these things.  They are just thrown into these situations and while they have the same fears, only get to process them later under much more difficult circumstances.  

My journey is by now means over and I'm still aiming for a 36 week delivery, but I feel prepared to handle what comes my way.  I'm not saying it will be easy or that I won't shed tears if things don't go as I would like, but I've had the time to think about and process all of the possibilities.

I've always thought I was carrying March babies (baby, when I thought there was just one).  I've long been at peace with that fact and never flinched about it changing.  I will continue to hold onto this and hope for a little more than 4.5 weeks of happy babies remaining in the womb.

*knock on wood*

Passing Time

On one hand my days to have some flow and on the other hand they don't.  Yesterday I woke up ridiculously early excited about the inauguration.  I had a steady flow of visitors which was really nice, but by last night I was exhausted.  Wouldn't you know, the one night I'm completely exhausted the babies stayed on the monitors perfectly, not a problem even when I got up to go to the bathroom.  I got to sleep peacefully without interruption.  My nurse actually came in this morning to say bye because she hadn't seen me all night.  

My daily walk is throughout labor & delivery and the postpartum area.  I try to stop in and wave to the NICU staff and occasionally I see babies in the regular nursery.  That is really the highlight of trip.  

Tools & Processing the NICU

I'm so thrilled to be approaching the next phase in our journey, on to 24 weeks and home monitoring, but I am still struggling with a potential stay in the NICU.  I am working every day to try to mentally prepare myself.  

I having been searching for the tools to help me put things in perspective, to understand that this is just a potential step in our journey and it is what is best for the babies.  Since I wasn't able to see babies up close during our NICU tour I found this video that was very helpful.  

The NICU is just everything that is not me.  It is sterile.  It is medical.  It is impersonal.  It is invasive.  It is cold.  I know in my head that those are not the intentions.  I know the NICU is the best environment for preemies to thrive, but it seems so opposite of what comes natural to me.  Natural would be holding, nurturing, breastfeeding, cuddling, smelling, and touching.  

I can't say the NICU is everything that is not me, because I was in the NICU.  I know some of my fears come from how difficult it was for my parents, but also on a subconsious level, how difficult it was for me as a baby.  I recently had an eye opening conversation with an amazing woman who encouraged me to explore these fears and where they stem from, because it is not until I face them that I will truly be able to deal with them.  She explained and I understand that the twins chose my husband and I to be their parents and me to be the vessel in which they arrive.  That they can help guide me through facing my fears.  I believe that and I am working and processing, but it is not easy.

 

Hospital & NICU tour

On Friday we toured the hospital where I will give birth and the NICU where the twins may stay.  It is very nice facility and the 1st thing I noticed was how incredibly friendly the staff was.  I'm not in all hospitals all that often, but I don't ever recall being greeted so warmly by the staff that weren't sitting at the information desk.  That was really nice.  

The hardest part was walking down the hall to the NICU.  There is a beautiful wall of framed photos and gifts expressing thanks to the wonderful staff at the NICU from families whose babies spent time there.  Beautiful stories and beautiful babies.  I couldn't help but cry.  I have a lot of time to get used to the idea that my babies may (and I do say may, because while the odds are in favor of the NICU it is NOT a for sure thing) spend time there.  Tubes coming out of their tiny little bodies, IVs in their arms, oxygen...I'm just not ready for that.  I do need to come to grips that it might happen.  I am trying.  I am trying to get to a point where I understand that this is apart of the process to bring home to healthy bouncing baby boys, but I am not there yet.

I was a preemie.  While I was able to come home initially, I had to go back to the hospital for several weeks.  My parents tell me this story all the time sharing how much they love me and why they are so thankful for me.  But the other side of the story is how heartbroken my mom was leaving her tiny baby at the hospital.  I've been told this story at least once a year for the past 30+ years.  It is apart of who I am.  Now to think I may have to go throw what my mom went through.......just hurts.

During my tour I did get to talk to the director of the NICU and she was amazing.  I know if they have to spend time there that they will be in good hands.  We talked about breastfeeding, visiting, and to my delight kangaroo care.  She was supportive and informative and offered to be available for any questions that may come up before and after the babies are here.