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.

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...