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Archive for March, 2012

Saturday was the peanuts 2 month birthday and we celebrated by attending a beautiful baby shower for them!  My wonderful friends and family put on a fantastic lunch at the East Bay Grille, where we were showered with love and gifts for the cutest two month olds ever.  It was wonderful to see everyone and even one of their NICU nurses came by and brought them each a beautiful outfit!  When I went to thank everyone for coming, I got really choked up.  People often ask us how we stay so strong and it’s really because of all the love and support we receive from so many people – even those who have never met us before but have heard our story!  It honestly is knowing we have such a huge support system behind us that makes us strong enough to get up every day and face the challenges.  I tell everyone that my children are the most love children in the world right now – it’s simply amazing.

The weekend for the peanuts was a good one – for the most part.  They were on 2.5L of flow on their high-flow nasal cannulas and Colton was at room air (21%) for a bulk of Saturday and Keltie was between 25-30%.  There was a lot of discussion around them being weaned on Monday and their caffeine was discontinued as well.  They also had their two month vaccines which covers a whole list of things such as polio, HepB, pertussis, and things I’ve never heard of before.  We visited with them on Sunday and they were still doing well and we even got to try non-nutritive breast feeding with Keltie!  This is where you put a baby to an empty breast to work on latching and learning to eat.  She’s shown a lot of signs of rooting and wanting to feed, so I pumped myself empty and we tried putting her to breast.  She wouldn’t open her mouth wide enough to truly latch, but she did make a good attempt.  We let her goof around with it a bit and then she fell asleep and we cuddled.  It was a nice experience for me – something other than a mechanical pump there so I felt less like a cow and more like a mom. 

Apparently late Sunday evening, overnight, and yesterday morning – things went a bit downhill.  Both of their oxygen needs were up (30-40%) and Colton was having a lot more spells.  So, instead of weaning their flow – both were brought back up to 3.0L and Colton had his caffeine restarted to try and help with his spells.  This was really disappointing news as most times they don’t allow you to start feedings by mouth if they are on more than 2.0L of flow.  Now that they’re 35 weeks, we really wanted to start teaching them to feed.  I visited with them after work and cuddled with Keltie for a while.  I stayed for their weighing and Colton was 3lbs, 14oz and Keltie was 3lbs, 10oz so they have both gained more than 2lbs since birth!  Right before I was about to leave, Colton had a pretty bad spell – probably the worst I’ve witnessed.  He turned a real dusky / blue color and it took quite a while and intervention from the nurse to get him to recover.  That scared the daylights out of me – I just stood there next to his isolette completely stunned.  Of course I couldn’t leave after that, so I hung around a bit longer until I felt better about leaving him. 

Just as I got home, my cell phone rang and it was the doctor.  That’s never a good thing.  She called to tell us that they were going to take some blood from him and look for infection and viruses to make sure that isn’t what is causing the increase in spells.  She said because of the one I saw and it being a pretty big one, she wanted to act on it now to rule things out.  When we called at around midnight, the bloodwork had been completed and he didn’t have any indication of an infection or virus, so that was a good thing. 

Today, according to the nurse and Chris who has been up there already, they’re both doing good.  Still on the 3.0L flow, but Colton has been lower on his oxygen and hasn’t had any real spells.  The speech pathologist (who I had no idea does eating readiness checks in the preemie world) came in for her consult at noon to see if they are ready to feed.  Shockingly, Colton did better with her tests which I guess include muscle tone of the mouth, sucking on the binky, etc…  They also fed him 17mL through a bottle and he did well – a few sips and then a few breaths.  He was much better “coordinated” was the term they used.  Keltie was a little more disjointed – she was forgetting the breathing part but she still managed to take down 13mL.  The speech pathologist will be back on Saturday, so we’re going to make sure we’re up there for that so we can meet her and learn more about everything.  I believe they’re hoping to start trying one bottle a day for them soon – which is super exciting!

Hopefully this week brings some advancement with their breathing – but I’m not holding my breath (pun intended).  I feel like we’ve reached a breathing plateau and it’s a bit frustrating.  I’d like to be able to put this behind us and start on the next challenge of feeding.  But, they’re the bosses (get used to it, right?) and they’ll let us know when they’re ready. 

I’ll end with their two month birthday pictures – they’ve grown so much since their one month pictures!

Colton at 2 months!

Keltie at 2 months!

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…and it has done wonders for lack of time and sleep!  On Tuesday I returned to my full-time job and it was bittersweet.  Monday was a hard day for me as it was the last day where all my time and attention could be devoted to the twins and the NICU.  Driving home that night, I sort of lost it.  Okay, I lost it big time.  It was more anger than saddness and I’m sure that returning to work was just a trigger – but it really comes down to one thing:  I’m over it.  I’m over this whole NICU thing, I’m over having to drive to see my precious babies, I’m over the whole experience.  I just want them home.  But of course the reality is – they are where they need to be and I have to swallow that fact and move forward.  So, that’s what I did. 

I did receive the warmest of welcomes back from my colleagues and peers and that helped make it better.  I do have to chuckle that my loving boss said that we’d ease me back into things.  That lasted about a day (and to no fault of hers – there’s just a lot to do!) and, in fact, I’ve been bringing along my laptop to the NICU and working on stuff in between cuddles with the kiddos.  But, truly, it has brought some normal back into my life and has also allowed me to experience different things at the NICU that happen in the evening hours such as weighing them. 

Both peanuts are doing well.  The doctors have been working to wean them on their flow of their cannulas and they’ve gone back and forth on that – down to 2L and back up to 3L and right now they’re hanging out at 2.5L and tolerating it well.  Colton’s oxygen has been primarily between room air (21%) and 25% and Keltie’s oxygen has been between 25% and 30%.  They’re going to try and wean them down to 2L on Monday and see how they tolerate it.  The goal is to get them to tolerate 2L and below so we can start trying to feed them by mouth!  I so look forward to that, but also recognize that brings a whole new set of obstacles and bumps in the road.  In order to help them, they started them each on diuretics to get rid of some of the adema (swelling) they have going on.  It’s not the most commonly known one, Lasix, but is a gentler one that doesn’t pose the same risks that Lasix does (the name is escaping me). 

Their growing has been wonderful!  As of last night, Colton weighed 3lbs, 11oz and Keltie weighed 3lbs, 7oz!!!  My big, strong peanuts!!!  They are off the Prolacta and are on what they call Hi-HMF to help boost the calories.  Due to the extreme cost of the Prolacta, once they reached a certain point they make the switch since the risks are very low now that Prolacta helped prevent. 

Keltie’s blood pressure has been captured and they actually expanded her dosing schedule from every 8 hours to every 12 hours, which is a sign that whatever is causing it is starting to break down.  It’s a relief to not see those high BPs on the monitors anymore.  We did have a slight scare with her earlier this week – there was blood in her urine once and so they did another renal u/s and everything looked clear.  They did a urinalysis and that didn’t show one drop of red blood cells.  So bizarre.  The doctor thinks it was a fluke or something – there’s nothing really there to say what it was but we know what it wasn’t.

Onto some not so good news – their second eye exam was on Monday and they do have Stage 2 ROP in Zone 2 of their eyes.  I don’t know if both Chris and I misunderstood or what, but when we assumed they were free and clear of it two weeks ago…we assumed wrong.  The “good” news is that this isn’t uncommon and they’ll have another exam in two weeks to check the progress.  Apparently it is not unlikely to get worse before it gets better, but 90% of the time it resolves on its own.  If not, they will need laser surgery to correct it.  Ugh – thoughts and prayers that everything resolves well on its own with no lasting effects on their vision. 

Other than that, we’ve been soaking up their absolute adorableness (is that even a word?) and loving every minute of it.  We’re starting to see them more and more awake and that’s really awesome, too.  Here’s an absolutely adorable video of Colton looking around:

Colton at 8 weeks!

Keltie at 8 weeks!

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I’ve been neglecting the blog – but I’ve been eating up these two as much as possible before going back to work next week.  I brought my laptop in today and so I’m officially blogging from the NICU, with Colton on my chest kangarooing!  How high tech and multi-tasking, eh?!

Let’s see – the end of last week and the weekend was pretty good.  The peanuts got new condos in a new location in the NICU – they’re in the “pod” which was a bit of a graduation for them, so we were excited!  They’re out of the Giraffe isolettes and into “regular” isolettes, so they’re mostly working on weaning off their high-flow nasal cannulas and oxygen support and trying to grow, grow, grow!  The new space is a bit smaller with no natural light – which we don’t like.  BUT, we were able to finally reunite the peanuts and hold them both at once!

We had some nice visitors over the weekend as well – both sets of grandparents, Auntie Lindsay, and some honorable Aunties all came to see the porkchop and lambchop.  Much to my surprise, Sunday night Daddy put together the cribs and I came home to find the nursery coming along nicely!

From a health perspective, both babies are doing well.  And the big news is – we have two 3 pounders!!  As of today, they are both 3lbs, 2oz!  What an awesome milestone for them each to reach – we are just so excited!  They are doing well with their breathing – both were weaned down on their flow, but today they were put back up to 3L as they were working really hard to maintain the lower flows.  Just a minor set-back, so they want them to just focus on their awesome growth and they’ll try to wean them again on Monday.  Keltie’s blood pressure is finally under control – they found the magic dose of her medicine and she’s had BPs within the normal range since Sunday.  It’s likely she’ll be on the BP meds for a while since the clots take some time to break down.  Keltie has been showing signs of wanting to feed by mouth – that is really exciting and I believe they’re planning to try that starting next week.  Colton hasn’t shown as many signs, but I’m sure he’ll learn quickly.  Clearly we have genius babies… 😉

And, in case you didn’t get enough of the amazing photos Candace took and previewed for us – you can see all 35 wonderful shots by clicking this link and using the password “allantwins”:
http://prints.candaceschwabphotography.com/Births/Allan-Twins

She completely captured the beauty of these precious miracles and gave us a gift no one else could.  For that I am forever grateful!!!

And I’ll end it with another FAQ –

Q:  When will they be able to go home? 

A:  We’ve had this asked quite a bit lately, probably because it’s been 7+weeks and they are doing pretty well growing and with their breathing.  Unfortunately, we still have quite a road ahead of us.  The doctors have always said to target around your due date, which for me was April 30th.  So, we expect them to be home with us by early May – which seems like forever away.  But, we’ve “survived” 50 days, so what’s another 50?  I believe I may have mentioned this in another entry but they have to meet at least the following milestones to be released:

– No spells (brady cardias / apnea)

– Take all feedings by mouth (and the entire amount)

– Consistent growth (not a specific weight)

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Monday was a huge day for the peanuts – they had their eye exam, Keltie had her kidney u/s, and Candace was coming for their photoshoot!  Good news there all around – their eye exam showed no ROP and “normal” premature retinas.  The doctor will return in two weeks and likely continue every two weeks until they’re released.  This was a huge milestone – I didn’t sleep much Sunday night because I was so nervous about it.  It doesn’t mean that ROP won’t show up, but it’s not likely if it wasn’t seen on Monday’s exam.  Keltie’s kidney u/s was clear as well – no major clots or issues.  Unfortunately, her BP continued to rise throughout the day and right before I left it was something crazy like 120/80, so the doctor made a plan to have a cardiology consult on Tuesday for her. 

Candace arrived and spent almost four hours with us at the NICU.  She was amazing – and so patient.  It was hard as I really wished that I could have had maternity pictures since the likelihood of me being pregnant again is…well, ZERO.  But, we decided to make lemonade from the lemons we were handed and these pictures will be so precious and important to us in the long run.  Well, last night she posted a preview of six pictures and I immediately burst into tears.  They’re amazing.  Gorgeous.  A true capture of the beauty of my children and the love I have for them.  I can’t even imagine with the rest will look like (I’ll have those in about a week or so).  I believe if you click this link, you should be able to see them.  Let me know what you think!  And anyone in the MD  / VA / DC area who is looking for a wonderful photographer, please consider Candace!

Tuesday Keltie’s BP continued to be very high – the cardiology consult basically agreed with what the neonatologist thought and that’s where Keltie likely has a small clot or clots not able to be seen on the u/s and this was likely caused by the arterial lines that were in her belly button which were removed a while back.  Their little bodies take a long time to break down these clots, so the cardiologist and neonatologist decided the best course of action would be to treat her high BP and allow the body to break down the clots.  The tricky part is getting the dosing right on the medicine – enough to lower her blood pressure and sustain the ideal blood pressure range but not too much that causes her to plummet (which is actually worse than it being high).  They’re still working through this – today it was lower about an hour after her dose of meds, but then it came right back up high a few hours later.  *sigh*  Luckily, this is something they can manage for her and they’ll eventually find what will do the trick. 

Keltie’s also behind in her weight gain – especially when compared to Colton who is now being called a “porkchop” by one of the neonatologists. 🙂  So, the nutritionist provided instructions for me to do this special pumping process for the next 1-2 weeks to get and separate out the hindmilk for Keltie.  So, I started that on Tuesday and she gained 30 grams from it just in one day!  As much as it’s a bit of a pain in the butt to do (you pump for 4 minutes, put that in a bottle and mark it F for “foremilk” and then continue pumping and put that in a bottle and mark it H for “hindmilk” and only bring in the H bottles to the NICU) and it kind of affected my supply for a bit (I think the stopping to pour the foremilk made my supply “confused” if that’s even possible…I could just be making this up, too), it’s totally worth it if it’s going to help her put on the necessary weight.

Speaking of weight…I had my 6 week postpartum visit today and all is good in the Krista hood.  I currently weigh only 4lbs more than I did on my wedding day.  I was shocked.  I never knew a good weight loss plan was to get pregnant with twins!!!  I am happy to finally be able to go to the gym again, though, and take advantage of the head start.  My body is absolutely different than it was before – I have fat in places I never did before and I’m skinnier in other areas.  So bizarre.  Of course I had to fill out some survey and they score it to see if I’m suffering from postpartum depression.  For any SHC people who read this – it reminded me of the PSE!  It had questions like “do you feel stressed?”, “are you having trouble sleeping?”, “are you sad?” – me being…well, me, answered it truthfully and so my “punishment” for that was to have a 30 minute conversation with my OB about how that stupid survey shouldn’t be given to moms with kid(s) in the NICU!  My answers were purely situational and I’m not suffering from postpartum…I’m suffering from stress and concern over my 26 week premature twins!  She agreed and was happy to know I see a therapist (I think everyone should!) and we finally were able to move on.  I got my return to work note and I’ll be back on March 20th – I’m looking forward to getting some “normal” back in my life but I’m a bit nervous as to how I’m going to manage it all.  I’m sure I’ll figure it out – I just wish I could work from the NICU…

Other than that, Chris and I have been alternating who we hold each day and getting in some serious cuddle time.  We both agree that we fall in love with them more and more each day.  It’s crazy – and it’s awesome.

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The remainder of last week was stable for Colton and Keltie.  Both Chris and I switched off kangarooing each of them and it was nice to have snuggle time.  They continued to do well with their feedings and their breathing was stable on the high-flow cannulas. 

On Friday, we had our first night out in the city with some friends who were in from out of town.  This was also Mommy’s first night with her long lost friend, wine, since July!  It was nice to enjoy a few adult beverages and socialize with some fantastic friends, but I must admit that coming home and pumping 4 ounces and pouring them down the drain was SO HARD.  It’s a lot of work pumping every 2-3 hours – it’s become like a part-time job!  So seeing that valuable milk go down the drain was tough, but worth it.  I just had to remind myself that 4 ounces is a very small drop in the bucket when we have a freezer full of milk.  And – I deserve a little me time, right?  Mmmmm, wine…it was good!

Saturday was another day of indulgence as we had a wedding to go to.  Chris and I went up to visit with the peanuts before the wedding ceremony – it was funny to walk into the NICU in a dress and heels!  Chris’s friends came to meet Colton and Keltie prior to the wedding – they have their own miracle baby who was a 25 weeker and she has been our inspiration throughout this journey.  It was so wonderful to have Stuch and Jen visit and meet them – they are truly a couple who know exactly what it is we are experiencing.  It meant a lot to me and was especially important to Chris, so I’m glad they wanted to see them as I’m sure it brought up a lot of memories from six years ago and that couldn’t be easy.

The wedding was great – again, another wonderful evening with friends we unfortunately don’t see as much as we’d like because of where everyone lives.  I think we’re running out of people left to get married which is what brings everyone together, so I’m hopeful they’ll start putting together an annual weekend away with our families again.  The last one a few years ago in Hershey was awesome  – and now Chris and I will actually fit in as we’ll have kids to bring along! 🙂

Chris had to fly out this morning for three days, so it was Mommy’s job to kangaroo both of them – especially since we didn’t get to kangaroo at all yesterday because of the wedding.  I ended up spending about two hours kangarooing each of them!  When I called to tell the nurse I was coming up, she said Colton was a little antsy and that she was glad I was coming up and she was hoping I was as she knew he’d be better if I held him.  That made me feel so good and I was happy to help!  I read Colton a book that my friend Lillie had bought them called Are You Awake? by Sophie Blackall – the dad in the story is a pilot!  We also talked about being a big boy and how strong he’s getting – he was 2lbs, 11oz today!  And we chatted about how he had to be nice for his nurses because they’re trying to help him be healthy enough to come home and meet Lucy and Cooper.  And we talked about going to the beach and playing in the sand.  It was a very nice one-way discussion!  Colton was much better after our snuggle session and before he went back into his isolette, my MIL and SIL came for a visit and they got to see him (and hear his very boastful cry!) and that was nice, too.  Lindsay hadn’t seen him yet without anything on his head / face – I think she fell in love all over again with my handsome boy…

Next up was Keltie and she was having a good day, except her blood pressure was high.  We snuggled for almost two hours as well – starting first with a visit with Grammy and Auntie Lindsay and then ending with the Are You Awake? story and some discussions about her being big and strong – she was 2lbs, 7oz today!  We also talked about what she wanted to be when she grew up and how she will not be allowed to wear short, tight skirts like the young girl I saw earlier in the week outside the hospital.  I figured I might as well start the conversation early…

The blood pressure thing has me really uneasy – before I left it was even higher, so I spoke with the doctor and they’re keeping a close watch on it.  I called the nurse tonight and she was working to get a good urine sample to send off to see if there was anything telling in her urine.  She just called back within the last half hour and there were some red blood cells, so they’re going to have a kidney u/s done tomorrow to see if there is a blockage or if they can determine what specifically is going on.  She is otherwise doing really well – eating, pooping, peeing, her breathing is good, heart rate is good, and she seems okay…  The doctor said it could be a sign of some slight damage to the kidneys from the chronic lung disease, it could just be prematurity, or it could be a blockage (with that being the least common).  It’s not a critical issue and it’s something that can be managed noninvasively if it is one of those things – so we’re just keeping our fingers crossed for Keltie and sending positive thoughts and prayers her way.

Tomorrow is a big day for two other reasons – one is their big eye exam to see if there are any issues at this point with their retina development (looking for retinopathy of prematurity or ROP).  I’m really hoping everything looks normal for both of them, but I know the risk is there.  The other big thing is that my friend Candace is in town and is coming to the NICU to take some pictures of the peanuts!  She does amazing work (check out her FB and website) and I’m hopeful she’ll be able to work her magic in between the constraints and challenges of the NICU. 

But, most importantly, I hope that Keltie’s blood pressure issues are easily resolved and that both babies continue to do well and have a good week.  I don’t so much like bumps in the road…

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