Schedule

A friend of mine recently asked about my schedule, making the assumption that it was probably unpredictable. He's right, of course, mostly (though, contrary to my personal nature and instincts, we feed the boys on a pretty tight schedule. It seems to be the only way not to have an unraveling free-for-all of chaos). Rather than just tell him that, I had to go and make a snide response and detailed the essence of my schedule:

My schedule is probably more predictable than you might think. It goes like this: 7am: get bottles ready, 7:05am, change babies' diapers, 7:15am figure out a way to feed two babies simultaneously, 7:35am: take bottles out of mouths so you can burp the baby that is about to spit up all over everything, say uselessly soothing words to the other baby who is screaming because you took his bottle out of his mouth, 7:36am: put bottle back in screaming baby's mouth, try to jiggle one half of body to burp one baby without choking/drowning the other, 7:37am: give up on this, put other baby back down and put bottle back in its mouth, 7:39am: pick up other baby to burp, catch remaining baby before accidentally dumping him on the floor during unsuccessful one-handed pick up maneuver, 7:40am: try to reposition babies using only one hand each, try not to damage heads or other floppy appendages in the process. 7:41am, put bottles back in mouths, 7:45am: frantically reach for burp-cloth to wipe up the first half of baby's breakfast which he just spat up all over pants, 7:45am: abort! abort burp-cloth grab to rescue falling babies who were dumped off your lap in hurried maneuver, 7:46am: pick up bottles from wherever they landed, without dumping babies on the floor this time, 7:47am: take a deep breath, chant to self, "it's ok to have baby vomit all over my pants, it's ok to have baby vomit all over my pants," 7:48am: notice spit-up all over expensive couch, take another deep breath, chant to self, "babies' safety is more important than couch, babies' safety is more important than couch," 7:50am: finish first bottle, pick up crying baby to bounce, pat, and burp with one half of body while miraculously holding the other half of body motionless. 7:52am: ignore warm sticky stream of spit-up trickling down the inside of shirt. 7:55am: finish second bottle, pick up second baby and do the double-baby-bouncing-burping routine. 8:00am: pick up and hold babies like a litter of puppies and find a way to rock self into standing position, go to nursery and put litter of babies on changing table. 8:01am: begin changing first baby's diaper, 8:02am: try to keep other baby from kicking first baby in the face, reposition babies and continue to wipe up poop, 8:04am: wipe face and front of body of projectile pee, also wipe down baby's brother. 8:06am: untangle babies' appendages and reposition again, begin changing second baby's diaper, 8:07am: sooth baby whose face got bonked by other baby's head. Remove everyone's wet, pee-soaked clothes and dress in something dry and hopefully "cute," 8:15am: swaddle babies and try to settle them into sleeping or other satisfied state, 8:20am: continue bouncing and swaying and shhhing, 8:30am: continue pacing house and trading babies back and forth to get them settled, 8:40am continue efforts, 9:00am continue efforts, 9:30am: babies are sleeping. go to bathroom, change out of milk and pee soaked shirt, put bagel in toaster for nutritious breakfast, start pumping milk for next feeding, look at facebook and enjoy moment of respite, 9:35am: moment over. listen in despair as babies fuss while you are hooked up to pump and unable to respond to cries. 9:40am: have a good cry yourself, 9:50am finish pumping, go put pacifiers in babies' mouths, notice that one of them is poopy, 9:55am: change poopy baby's diaper, lament that I'm still wearing pajama pants, 9:58am: look longingly at bagel in toaster, start preparing bottles for 10am feeding, 9:59am, take single bite of cold, dry, toasted bagel, take bottles to feeding station and retrieve babies, 10:00am: repeat. 1:00pm: repeat, 3:00pm: repeat, 7:00pm repeat, 10:00pm repeat, 1:00am repeat, 4:00am: repeat, ...

This, of course, represents the easy days, when Seville is not around...

As the author of "Juggling Twins" noted, you have to have the "whack-a-mole" mentality 24/7 (you know, that arcade game you can play at Chuck E Cheese and other places, where different moles pop up out of a bunch of holes and you have a mallet and you're trying to whack as many as you can by just staying on your toes all the time? that one). One of the most astounding parts of twin-momdom is just how constantly repetitive everything is. As soon as you finish any task, you have another one to do, and you can't put your guard down for a second. Certainly you can't expect down time, because if you do you'll be frustrated to tears by its absence.  But it's all kinds of fun, too (I can only say that because I'm well rested, thanks to our shift-sleeping plan. Heaven help parents of twins who don't get sleep at night, which is the other 99% of them).


In other news, we had a photoshoot done recently. Here are some pictures captured with much effort and photoshopping to deceive you into thinking that twins do things like... say... sleep peacefully simultaneously (ha!). They're cute, though, ain't they?

Happy Birthday Babes

So these guys finally reached their birthday. The day there were SUPPOSED to be born, that is. Yesterday. Every time I get frustrated with their lack of eating skills or lack of pooping skills or lack of head-maneuvering skills, I get all kinds of attitude and say things like, "why can't you figure out how to eat you nitwit! It's not like you were born yesterd.... oh, wait, it IS like you were born yesterday. nevermind." A close variation on this sentence has come out of my mouth several times today. Okay, minus the "nitwit" part. What do you think I am, verbally abusive?

Anyway, as such their lives really should start counting from now. Pretend I had a coupla babies yesterday, and they will start moving and laughing and batting at objects all in due time. And unfortunately sleeping more than 2 hours in a row at night will take that much longer too.

Speaking of which, Jared and I have this brilliant shift-sleeping plan that is making all this quite do-able. He goes to bed around 10pm, but I stay up until 2 or 3am. I handle the feedings/burpings/cryings/poopings during that time, and after that I get to go to bed. Jared wakes for the 4am-ish feeding, but goes back to bed for a couple of hours before he gets up for the day (he doesn't have to do things like nurse and pump when he feeds them, so it's pretty quick. Nothing like the 2 hours I spend at every feeding, only to eat a snack, put on some clothes, go to the bathroom and figure out how I get to spend the next 15 minutes before it's time to start over.). Anyway, I sleep until about 10am (a million thanks to the folks who are coming over in the morning to let me do that!). And so far there are some great things about this. Mostly I find that as long as I get sleep I can deal with just about anything else. I may have 3 people screeching bloody-murder at me during the day, but if I'm well rested, I can tell myself that, in fact, no one is dying and we're all going to be fine. eventually. And furthermore, I'm not fighting my natural night-owl nature, and there's something soul-recharging about that. I just go ahead and stay awake during my creative time (late at night) instead of squashing it trying to force myself to fall asleep at a decent hour. Even though I have little time for actually DOING anything creative, just being awake for it and having creative thoughts is more than I've had in ages (you wouldn't believe all the really great blog posts you've been missing. I've thought them though! Does that count?). Jared even claims that he gets more sleep now than he did before because I'm not keeping him up with my tossing and turning and reading and fiddling with tea cups and chapstick and iPhones and magazines next to him in bed. If this new plan didn't mean that we spend virtually zero time together we'd probably keep it forever. That and the fact that we need to have someone over here in the morning so I can sleep, which works while people are taking pity on us, but probably won't last for long.

By the way, if you'd like to be one of those great folks that helps us out, you can sign up! We have this "Care Calendar" thing, where you can sign up for meals and baby shifts and things like that: www.CareCalendar.org. Our calendar ID is 36494 and our password is "engstrom." We are SO grateful to all the generous people are making sure we are fed and rested, which makes this twin experience actually enjoyable, instead of harrowing. Thank you!

Here are some pictures from our at-home adventures:

Seville meets her brothers for the first time.

Checkin' out Brickley

Now that they're home, we can snuggle them up like this.

....aaaaaaand the excitement starts to wear off. :)

Actually, Seville is being quite sweet with them, holding them all the time, shoving pacifiers into their little mouths every time they whine. She's had a tough adjustment, and she's being a doll, all things considered (at least she takes out her anger at being de-throned on people like Grandma. And Daddy. Not her brothers. so far).

And Now, to Really Gross You Out...

Brickley and Oswell will be 6 weeks old tomorrow, and will have been home for 2 weeks.  Last time I brought a baby home (Seville, obviously), 2 weeks into it was getting pretty difficult for me personally. I struggled mightily with deep postpartum depression and had an extremely difficult recovery from a C-Section to boot. Since I had another unavoidable C-Section this time, and since I was warned that pregnancy and post-pregnancy hormones are twice as severe with twins, we wanted to do everything we could to avoid the dark days of last time. We were better prepared in lots of ways, but there's one thing I really honestly think made a huge difference.

It's like this... every mammal on the planet eats its own placenta after birth - except humans, for obvious reasons (like, the fact that we would barf all over ourselves even attempting such a feat, completely defeating the purpose, for example).  But there are rumors about eating the placenta and what it does for you. Like that it eases and speeds your recovery. And that it stabilizes your hormones keeping postpartum depression in check.

I had heard these things, but since the babies were born 2 months early - at least a month before we expected to have to think of any immediate post-birth needs - I hadn't had time to look into what is called "placenta encapsulation," - where they put your placenta in capsules for you to take, like any other benign, un-disgusting supplement, with your daily vitamins.

In the recovery room, one of the doctors brought my placenta for me to see. Its rupturing was the cause of the emergent C-Section. She knew I was extremely disappointed at not having a vaginal birth, and came to show me the signs of rupture so I could see, with my own eyes, why my baby needed to come out asap and why he might not have survived a vaginal birth). You could see the signs of distress and hemorhagging on the one placenta. The whole "eating your own placenta" thing came up then, and I mentioned to Jared that it was a bummer we hadn't had time to look into it.

The nurse looked at us and told us it was easy to do yourself.  "What?" She was from Russia or something, and I don't know whether this is more common in Easter Europe or she was just a hippie at heart, but she walked us through how to do it yourself. And bless Jared's heart, he actually did this for me (that is serious dedication!).

Step 1: Wash thoroughly (there's a video at the bottom of this post of Jared washing the placentas. There were two of them, in my case.)

Step 2: Freeze until you have time to do something with it (and/or so you can slice it later) (you could skip this step, actually, if you had time to work with it right away and planned the "blender" method).

Step 3: Slice thinly and/or puree' (Here is where it gets a little confusing. Russian Hippie Nurse told us to freeze it and then slice it very very thin, and then dry on a dehydrator, not unlike jerky. Jared tried this and it just wasn't drying fast enough and he was afraid it would go rancid, so he looked up how to do it on our "friend," the Internet. The folks he Googled were putting it right in the blender and drying it like fruit leather, so he switched methods and went with that.

Step 4: Spread blended placenta on a fruit dehydrator and dry.

Step 5: pull or chip dried placenta off the dryer, and pulverize it into a powder (blender, magic bullet, mortar & pestle. whatever works. I think Jared used our magic bullet).

Step 6: borrow capsule-making thingy from brother in law (Thanks Bryce!) (or get one at local Natures/Wild Oats/New Seasons/hippie food store), and put powder in capsules.

Voila! Placenta Pills.

These have been my friends these last 6 weeks, and oh what a difference they've made. Unless it's all in my head, which is ok too. Whatever works.

(WARNING:)If you're a glutton for punishment, and you have a strong stomach, here's a video of Jared getting the placenta out and washing it...

Homeward Bound

They never want to tell you, in the NICU, when your babies are coming home. Nobody wants to make a projection because nobody wants to be wrong, and because everything just "depends" on the babies and what they do or don't do and when. So when they come home it's really sudden. We've known for the last week that they were getting close, but it looked like the end of the week, then the middle, then the beginning, and then we got the call yesterday that they are coming home TODAY!

Brickley managed to suddenly fast-track everything by yanking his own feeding tube out a few days ago. He'd been eating well enough that his nurse decided to take mercy on him and not put it back in, unless he needed it. He proved himself able to eat all his food by mouth for a few days, and so the staff tried to get his brother up to speed. Since they're taking everything by mouth (from a bottle - nursing is a different story), and meeting the other criteria like not having temperature regulation issues or apnea that requires intervention, they get to come home.

We're super excited. It's like having babies all over again - all the excitement and adrenaline and joy of babies. And we're also frantically trying to get our house ready. We've spent the last day doing things we thought we had a little longer to do - cleaning out the nursery-to-be, moving furniture, buying diapers. We even had to buy Seville a bed off craigslist so we can put her convertible toddler bed/crib in the boys' room. I tried to buy homecoming outfits, but couldn't get to a store that sells preemie clothes yesterday, so they'll have to come home in whatever we have (the same thing happened with Seville, and I always wished I'd managed to buy her something. I guess we'll live.)

The babies are both over 5lbs now, so they almost look like regular babies. Almost. Here are a couple final pics of us holding babies in the NICU.

In other news, Jared came in this morning and announced that he had sunk to a new low. Seville, who has eaten nothing but goldfish crackers for a few days, was being inflexible about breakfast (surprise). Jared actually made her "goldfish pancakes," complete with goldfish crackers embedded therein. Gross.

Casualties of Daddy-Time

Seville has had a lot of "Daddy-Time" lately. Daddies don't do as much coloring or crafty stuff, like mommies do...
Daddies are more likely to do something like... say... play with remote controlled helicopters...

...indoors...

...and near their daughters' heads.

(If a brother did this, not only would he be chastised by mom but Seville would no doubt be upset about it. But since Daddy did it, it's all funny and adventurous. sigh.)

Super Short Update

I noticed that it's been over a week since we've posted any updates. In short, here's a bullet list of recent progress:

1) The boys are out of the isolettes and have moved to regular bassinets;
2) They're taking the full recommended volume of breast milk for their age/size;
3) They're receiving a little extra calorie fortification in their milk;
4) Both boys started bottle feeding and nursing on Sunday! they're actually a little ahead of the game on developing their suck/swallow/breath reflex. Oswell drank 20mL (out of 38mL) on his first bottle attempt; Trajan drank 33mL (of 38); and apparently, Oswell did some real nursing last night. Good work, boys!
5) Skye is certainly not 100% yet, but she's making good progress on her own recovery;
6) Seville has her moments, but continues to be a really sweet girl in the midst of all this madness; she's also started talking with excitement about taking care of HER baby brothers when they get home from the hospital;
6) Me - I'm good.

What's in a Name

Frequently Asked Question #1:

Q: Where did you get their names?

A: Yes, there is a rhyme and reason to their names. Brickley and Oswell are both maternal family names: Brickley is Jared's grandmother's maiden name, and Oswell is my mother's maiden name - both of these names had no male heirs to carry them on, so the boys each got one in honor of those ancestors.

Magnus is Jared's paternal great great grandfather's first name, and a name that has been used in his Swedish heritage quite a bit. We figured it would be nice for one of them to have a Swedish given name to match our last name. Trajan is a name that Jared just really really likes a lot. And has the potential for really cool nicknames down the road.

Brickley Trajan
Born on the first day of Spring, March 21st, at 7:34pm, weighing 4 lbs 4 oz.

Oswell Magnus
Born the first day of Spring, March 21st at 7:35pm, weighing 4 lbs 2 oz.

Speaking of their size, we were all thrilled that they topped 4 pounds at birth (ultrasounds and doctor estimates were under 3.5 lbs). Still, it's hard to fathom what a 4 pound baby is like until you see one. Everyone who has visited says they are so much smaller in person than you imagine from pictures. Tiffany (Jared's sister) suggested we take pictures of them next to something so you get a sense of how big they really are. I get her point - these pictures look even to me as if I'm holding my hand closer to the camera than the baby is to makes him look small. But no - my hand is resting on the pillow right next to his head. They're really just that little. And, by the way, since babies lose weight at first, they are both in the 3's now. But they'll climb back up over 4 soon enough.

Introducing Seville

Since Seville is not allowed into the NICU, we have a challenge including her in our new family and introducing her to her new baby brothers. It broke my heart to learn they wouldn't allow her in - she had been so excited to meet them.  In any case, we decided we'd have a challenge either way, because it would be difficult to explain to her where they are and why they have tubes and things, even if she was allowed in. None of this is what a 3 year old might expect. Thankfully, she doesn't really know any different, and so when we explained that the babies came out a little bit too soon and they're in a place where they are still pretending to be inside a tummy, she took it at face value.

We introduced her to them for the first time with pictures, in my hospital room, and I caught a little of it on my iPhone. It's cute, you can see her little mind churning, trying to process what's going on in the pictures.

Happy Moments

Brickley holding Daddy's Finger. Though they sleep almost all the time, the boys always tend to wake up when Daddy comes around. When Mommy comes around they just continue sleeping - which is, I suppose, typical of Mommy/Daddy relationships in general. Daddies are for playtime and Mommies are for snuggling.

Oswell's Feet (that's an Oxygen Saturation Monitor strapped to his foot. It somehow tells The Machine how much Oxygen is in his bloodstream. It's one of the things that determines whether or not he needs breathing support of some kind or not. If the saturation gets a little low, The Machine starts beeping)

Brickley holding Mommy's finger. This is the arm with the PICC line - an IV- type line that runs a catheter all the way up his arm toward his heart (his veins were too fragile to tolerate regular IVs) - and thus all the tape holding things together.

 Me and Brickley doing "Kangaroo Care" - a widely adopted NICU practice where the Mommy and Baby spend time skin to skin. It has been shown to help babies stabilize, grow, and develop faster, and to help Mom's establish better breastmilk supplies sooner.

This picture makes my heart want to explode :)

1/3 Home

I was discharged from the hospital today. It's amazingly difficult to leave a hospital when your babies are still there. As much as I hate being in the hospital, I kept trying to think of ways to get them to keep me. And actually, my pain level increased a lot overnight (perhaps my psychosomatic attempt to manipulate the system). I think I almost had my doctor convinced at one point, but he was concerned that insurance might not pay for it if there's no REALLY obvious reason to keep me, and he'd hate for me to get stuck with that hefty bill. Anyway, I couldn't delay it forever, so here I am now in my own bed.

As for the boys, they are obviously staying for a while. A lot of people have asked how long they will be there. No one knows the answer really - it just depends on how they do - but babies born this early are typically ready to go home around 36 or 37 weeks' gestational age. So about a month, give or take.

The last few days have been quite a roller coaster. I think that is likely to be the nature of things. As with just about every child's development, the babies make progress and then seem to backslide, and then make more progress and then seem to backslide.

A few people are interested in lots of details about the ups and downs of the boys' progress, so here are those:

Yesterday was a particularly stressful day. Both babies had some issues that were causing them a fair amount of distress, if only because the nurses kept having to poke them with needles. Poor Brickley's little veins have not been tolerating IVs very well. They try to do them as few and far between as possible, but a preemie's veins are so fragile that sometimes they just don't work well. Brickley had been getting at least one IV per day (they try to keep it to no more than 2 per week normally). Yesterday he had to have 4 put in, which just broke my heart beyond belief. The doctor came and talked to us about putting in a picc line, which is a more robust IV-type line, but instead of a tiny spot in your arm, they thread a catheter up your vein all the way to your heart. It is much more complicated than an IV and has some additional risks, but apparently is not more painful than getting an IV (the initial poke is the same) and is much more stable. I'll spare you more details about it, but we decided to go ahead to spare him getting IVs over and over, which would probably stress him out too much. The picc line took just about all day to do (it's a sterile procedure done in phases with Xrays inbetween to monitor things and place the line correctly). They started around noon, and were finished by about 11pm.

Oswell also lost his IV and had to get another. The nurse told me how difficult it had been for him (why did she tell me that? Why? Seriously, I didn't need a description of them having to hold him down and how much he fought and hated it). By evening he was also stressed out and needed to go back on oxygen (he had been completely off not only oxygen, but even air flow before that).

I spent a long long time holding Brickley last night. Oswell was too fragile at the time.

Today they are both doing fine. Brickley's picc line is doing well so he's much happier. Oswell is still on oxygen a little since yesterday I held each one for about an hour. Jared even got to hold Oswell. Bless his heart - the babies can only be held so much right now, and Jared tries to let me have most of that time.

My mom has Seville for the night, so we are planning to return later. Can't wait!

NICU photos

Here's some photos I took of the boys today (the picture of Seville is from last night):

Trajan and Oswell Pictures

Here are a few pictures from last night - taken through the plastic pods they're in, so they're not all that great. My camera battery was dead this morning, so I haven't had a chance to take any good photos yet. The first two (on top) are of Oswell and the last two are of Trajan. As you can see, Trajan was awake for one of the pictures. The second one of Trajan shows him after they removed the CPAP breathing apparatus (he still has little tubes in his nose for air flow but not for oxygen):

The Twins are Here!

Some of this will be repetitive for some of you. I hope, going forward, to consolidate the updates and steer everyone to this blog...

So, Brickley Trajan (4 lbs. 4 oz.) and Oswell Magnus (4 lbs. 2 oz.) were born on March 21, 2010 (first day of spring!) at 7:34 and 7:35pm, respectively. Brickley and Oswell are both family names (Oswell is Skye's Mom's maiden name and Brickley is my maternal grandmother's maiden name). Though Brickley is the "elder" son's given name, we expect to call him Trajan (pronounced TRAY-jun).

Though it did not end up being an emergency, it became necessary to perform a c-section last night. Skye's water broke last Monday (at 31 weeks pregnant) and she fought hard to keep the babies inside her for another 6 days, which proved to be very beneficial to the boys. Both boys came out crying and breathing on their own. And they were both much bigger than anyone expected.

Both boys needed breathing assistance (via CPAP) and required help to stabilize for the first few hours. But by this morning, Trajan was doing well enough that they removed the CPAP. Oswell still needs a little breathing assistance, but they expect he'll be off CPAP within the next day or two. They'll both need tube feeding for a couple of weeks until their natural suck/swallow/breath reflex kicks in. They will be eating Skye's breast milk pretty much right away. They also have IVs and little probes to monitor their heart rates.

Both boys are in isolettes (clear plastic shells that are temperature regulated), but they decided Trajan was doing well enough to pull him out this morning and let Skye hold him (skin to skin) against her chest for almost an hour. The boys may be able to stay in regular bassinets within a week or so.

Skye is recuperating well and overall, everything seems to be very good with everyone. Thanks for all the well wishes. We'll keep you posted here on the blog with any updates...

Saturday Afternoon update

So, I'm not into posting lots and lots of updates every day, but things have changed enough since this morning, that it's worth another update this afternoon. Basically, as of this morning, I thought for sure we'd have babies by this afternoon. But I don't feel that way now.

The doctor has had all kinds of restrictions and orders for Skye - like not eating food for the last 48 hours or so (I know it's to prevent the possibility of aspiration, but how can not eating for 2 days be helpful to anyone?!). After some discussion with the doctor (where she admitted that the hospital is not a prison and that they can't stop Skye from doing what she wants), Skye (with help from her mom) took it upon herself to do a bunch of things she wasn't supposed to do. She took a shower, she ate food (the doctor later gave her permission to eat) and now she's a completely different person. She's calm, relaxed and doesn't look like a woman about to go into labor. So, at this point, who knows - maybe she won't be having babies today. Only time will tell. But things are looking much better than they were this morning.

Saturday morning update

Skye started having pretty strong contractions last night. They put her on magnesium (via the IV) for the last 12 hours. There are a set of factors that determine whether you're a good candidate for a VBAC. The fact that she's had a previous c-section is actually only a very small factor. Current factors include her bag of membranes being broken, she's got an abruption (though small...they think), and she's having abnormally strong contractions without being dilated much at all. Those factors really put her in a high risk situation. So....everyone is recommending she have a c-section, perhaps as soon as this afternoon.

Obviously, this is NOT Skye's preference. But she's being a trooper about it. She's tender-hearted and wants badly to do things nature's way and be able to hold these babies right after they're born. These boys are going to have to spend time in the NICU, but we're going to make sure they're healthy and safe. Deep down, Skye knows that, but it's still going to be hard for her to see her boys connected to lots of tubes for the first few weeks.

But all things considered, I think things are going pretty well...