Wednesday, February 8, 2012

Month 2

This month was all about family time. Luke's company has a sabbatical program called "just stay away." After 5 years with the company you get to take a month off with full pay. Luke hit the five year mark in December and opted to take the month of January off. He turned in his computer and they disabled the email on his phone so he was able to truly unplug from work for the month. When you combine his leave, the holidays, and saved up vacation days, he only worked 9 days between the time the girls were born and February 2nd. Although it wasn't a terribly relaxing month for him, it was really nice to have Luke home as we tried to juggle 2 newborns. It was hard even having 2 of us full-time watching the girls - I don't know how people do it when one or both parents are back at work.

The girls became much more alert this month and had to be moved into separate cribs at 7 weeks. Somehow they could sleep through each other's crying, but the second we tried to unswaddle one baby, the other would hear the velcro and open her eyes and look at you like "what  about me???"
Despite the distractions, the girls started sleeping longer through the night at around 5 weeks. Luke and I decided we needed to get them into a better routine, so for 4 days we focused on nothing but keeping them on a schedule. Laundry,  housework, and running errands were all put on hold during that time. It was well worth it because afterwards they'd regularly go 4 hours between feedings at night which meant 2 extra hours of sleep for mommy and daddy!
The girls also seemed to have a growth spurt around 7 weeks - they were like bottomless pits. At their 2 month well-baby checkup they had grown to 9 lbs 4 oz and 21 inches long (Alli) and 9 lbs 8 oz and 22 inches long (Dani). Their doctor was really pleased with how quickly they're growing. They're now falling within the full-term baby growth chart. Although they're on the low end of it, it's a big accomplishment because a month ago they weren't even on the chart and could only be measured on the preemie chart. They've essentially had a month less to grow than most babies since they were born early.
Alli - length: 5.57 percentile, weight: 11.24 percentile
Dani- length: 31.51 percentile, weight: 14.81 percentile
The girls' first Christmas was spent at Grandpa and Grandma's house. They were definitely the center of attention for the day - everyone was more interested in sitting and holding the babies than opening gifts. It was a nice, low-key day which we all needed after the craziness of the last few months.
Alli practicing her Baylor sic 'em in her sleep

Dani wasn't really in the mood for pictures...

Both girls

They were each wearing onesies that said "Mommy's favorite gift" and Aunt Sarah made them headbands for the occasion.

Their 2 month birthday was extra special because Aunt Jennifer, Uncle Bill and cousins Katie and Lisa came for a brief visit. They live in California, but Jennifer was about to deploy to Afghanistan and had training in San Antonio before she left. Bill, Katie and Lisa flew out and met Jennifer in San Antonio and drove up to spend a day with us. It was great seeing all of them and introducing them to the girls. We were sad to see them go so soon, but we are looking forward to some more cousin time in March when Katie and Lisa visit for Spring Break. We took advantage of all the extra helping hands and all went for a picnic on Market Street for lunch.  Excluding trips to the doctor and Grandpa and Grandma's, this was the girls' first time out of the house.

We had a good laugh at the girls' expense that day - are big sunglasses still in style? Looks like they might have to grow into these!

We're so proud of ourselves that we remembered to keep up with the monthly pictures with the bear! Now if only we could get both girls to look happy and awake at the same time...maybe next month

Alli

Dani

Final Stats

Weeks pregnant at delivery: 35 weeks, 5 days - doesn't sound like that long to moms of singletons, but for a mom of multiples it's definitely an accomplishment!

Total weight gain: 40 lbs (30 gone within 3 weeks and the rest was gone by the girls' 2 month birthday)
Fun fact: By the time the girls were born I was nearly as big around as I am tall. I'm 59 inches tall and at last measure (about 2 weeks before I delivered) I was 57 inches around. Luke says I got a lot bigger at the end, so it likely was even closer than that.
Total bed rest needed: 13 weeks
Total time spent in the hospital (Nicki): 30 days (includes 4 day stay after the girls were born for my mystery infection)
Total NICU time needed: 10 days
Birth weights: Alli - 5 lbs 3 oz, Dani - 4 lbs 15 oz. Both girls dropped down to 4 lbs 9 oz about 5 days after they were born and then started gaining again.
Random funny: Although this doesn't entirely apply to our situation, it gives you a taste of the fun conversations you have as a mother of multiples. YouTube link

Thursday, February 2, 2012

Month 1

The first month of having the girls home was definitely rough. We had been given fair warning in our multiples class about how much work it would be, but it didn't really sink in until we got the girls home.
One of the few benefits to having the girls in the NICU was that by the time they came home they were already on a schedule. They would eat every 3 hours and were an hour apart. So Alli would eat at 2am, 5am, 8am... and Dani would eat at 3am, 6am, 9am... By the time you change their diaper and feed and burp them, it pretty much took up their full hour. This meant that you only get a 1 hour break every 3 hours. Now if you want to do laundry or wash/prepare bottles or pump or something crazy like eat a meal or shower, that cuts into your one hour break and before you know it you've gone 24 hours without sleeping. We resorted to taking care of them in shifts because that was the only way either of us would get any rest. Fortunately my family is close by too so we had some backup help. I'm tired all over again just thinking about it!
The highlight of their first month was a photo shoot with Kelly. She got some great shots of them - I am still amazed by how she was able to do such a professional shoot in our living room. They are just short of 4 weeks old in these pictures. A few of my favorites are below, but here is a link to some additional ones. K. Smyth Photography Link


 Dani
 Alli


It was much more successful than when Luke and I tried to do it ourselves - here is the best one we could get of them. They're 2 weeks old here. Dani is on the left and Alli is on the right.


Here is a picture of the girls on their 1 month birthday. We're going to try to take pictures of them with the same bear each month so that we have something constant to compare their size to. One flaw to that plan was that they weren't quite ready to sit up on their own for this month's photo which made for an interesting photo shoot (babies falling all over each other/spitting up on themselves/screaming and all that fun stuff). Dani is on the left and Alli is on the right.


The NICU Stay

The girls’ time in the NICU was an emotional rollercoaster. It was frustrating because they didn’t really feel like our babies since we weren’t their primary caregivers. I was also getting mixed signals from the doctors and nurses which, combined with my raging hormones, was really upsetting to me. For example, on Tuesday, my doctor/nurses were telling me to stay in bed because I needed to recover. Meanwhile, the girls’ doctor was calling me and telling me “Your babies need you. You need to be here with them to help them improve if you want them to go home…” I hear that and called my nurse immediately to have her bring me to the babies. Once I got there, their nurse told me it was a bad time and that I was in the way and I wasn’t allowed to hold them. Grrr!
Here’s the day-by-day summary of the girls’ stay in the NICU. Probably more detail than any of you care about, but I needed to get it down before it becomes any more of a blur.
Tuesday 11/22 – we were told that the girls would need to be in the NICU for observation until Wednesday, but that they appeared to be healthy enough to be moved to the general nursery at that point and could then be brought to my room if we wanted. I tried to go visit the girls, but since they were in the middle of being assessed, they still wouldn’t let me get close to them. Luke was able to spend some time with them that afternoon though. I was finally able to really hold them for the first time that night.
Wednesday 11/23 – Dani was breathing faster than normal and both girls were having problems eating efficiently and had to get fed some of their meals through feeding tubes, so they weren’t ready for the general nursery. The doctor thought they’d likely still be able to go home with me once I was discharged.
Thursday 11/24 (Thanksgiving) – My family picked up a Thanksgiving meal and brought it up to the hospital and we ate together in the cafeteria before going to visit the girls. The girls were having issues keeping their temperatures up but were staying (barely) within the acceptable range. We were told the girls would have to stay in the NICU a little longer than expected – their doctor estimated that they’d be home within the next week though.
Here is Grandma and Grandpa feeding the girls their Thanksgiving lunch.
Friday 11/25 – Luke and I went to visit the girls early in the day and I was shocked to see that they had been moved into isolettes overnight. An isolette is basically a plastic temperature-controlled chamber. I broke down because it really felt like a step in the wrong direction. They were only allowed out for their bottle feedings and had to be put back shortly afterwards. The doctor assured me that it wasn’t as bad as it looked and that they would likely still go home on schedule. Basically the girls didn’t have enough energy to both keep themselves warm and eat, so both their temperature and the amount that they were eating from the bottle were suffering.
Saturday 11/26 – Being in the isolettes really helped the girls’ appetites. They started eating better and were able to get fewer meals through the feeding tubes. I got my discharge orders early in the day, but I was told that insurance would pay for the full day so I just needed to leave before midnight. Luke and I took advantage of that and stayed until about 10:30 that night. It was sad going home without the girls and seeing the empty car seats in the back seat. I was still in a lot of pain though, so it was good to have a little time to recover while someone else was caring for the babies.
Sunday 11/27 – We went down to the hospital for the morning feeds and I was allowed to nurse them for the first time. We talked to the doctor before we left and she was super optimistic about the girls’ progress. We told her we were planning to get a hotel for the week so we’d be closer to the babies and her comment was “I don’t think you’ll need it all week.” She also said that she was off until Wednesday night and didn’t think she would see us again. We were so excited. It had been a really stressful and emotional week, so it was such a relief to hear the girls were doing better than expected. The girls’ orders were also changed so they were moved back to being 100% bottle fed. Dani’s feeding tube was even removed that afternoon since she was eating so well.
Hooray for no more feeding tube!
Alli wasn't so lucky...

Monday 11/28
We packed our bags for the hotel stay and headed to the hospital in the morning. The girls’ new doctor was there when we arrived, so we got an update on their progress right away. We were still on a high from Sunday, but she quickly burst our bubble. She told us there was no way the girls would be able to go home on Wednesday and she expected that it would be more likely the middle of the following week. We couldn’t understand why she had such a different timeline than their previous doctor when nothing had really changed with the girls. The girls were still in isolettes at that point and would have to be weaned back down to room temperature and then monitored before moving into open cribs. She didn’t feel comfortable moving them down quickly and wanted 48 hours of monitoring. I get angry all over again thinking about our conversation with her. Both girls continued to improve in terms of temperature control and feeding, and Alli’s feeding tube was removed in the afternoon.
Tuesday 11/29
We went to visit the girls in the morning. They were doing well and their isolettes were moved closer to room temperature overnight. We finally were given a better explanation of why the process was taking so long. Basically there are rules in place to where the nurses can only change the temperature in the isolettes in half degree increments and they are limited in terms of how many times they can turn it down during a 12 hour shift. In doing the math, it was impossible for the nurses to follow those guidelines and get the girls down to room temperature and then monitored before Thursday. Also, in order for the nurses to turn the isolette down, the baby needs to be maintaining a body temperature above a certain degree. Each time we had them out of the isolette holding them, their temperature would go down. It wasn’t outside of the normal range, but they weren’t staying warm enough to allow the nurses to change the isolette temperature. So basically by sitting and loving on them we were unintentionally prolonging their stay in the NICU.
In the afternoon I went in for a follow up with my doctor because of excessive swelling in my legs. They ran some tests but said I really needed to be on bed rest for at least a couple of days to help me heal. We decided that it was best for everyone if I took some time away from the girls and stayed in bed. That way they could spend the maximum amount of time in their isolettes and hopefully improve more quickly and maybe rest would help me recover.
Wednesday 11/30
We checked out of our hotel and briefly visited the girls before heading home. The doctor called me later that day and told me they were doing much better than she had anticipated and would likely be able to go home on Friday. She decided that she was comfortable only monitoring them on room temperature for 24 hours instead of the 48 she had initially planned on.
Thursday 12/1
I stayed home and rested and Luke went up to the hospital for a few feedings. The girls were moved into open cribs in the afternoon and just needed to be observed overnight before they’d be cleared to go home. I had been having night sweats/chills for several days, but it became extreme on Thursday evening. I took my temperature around 9pm and it was over 102. I called my doctor and she said to head to the ER. I was readmitted into the hospital and during the night my fever continued to get worse and climbed above 103. They weren’t sure what the cause was, so they put me on a number of antibiotics and I slept on a cooling blanket to try to get the mystery infection under control. They weren’t sure if I was contagious so I wasn’t allowed into the NICU.
Friday 12/2
Luke tried to get the NICU to allow the girls to stay until I was ready to go home, but since the discharge process had already been started, insurance wouldn’t continue to cover their care if they stayed. They could have stayed with me in my room but they would have been completely in our care and given I was still sick, the doctors advised against it. Luke ran between my room and the NICU throughout the day and took them home around 9:30pm. I was so upset that I wasn’t able to be a part of their homecoming, but it was out of my control at that point and I was still running a fever and feeling awful. My mom met Luke at the house and helped him take care of the girls overnight.
First night at home and sharing a crib
The doctors were never able to determine for sure what was making me so sick, but my fever finally broke on Saturday and I was allowed to go home on antibiotics on Sunday night. They would have liked to have kept me there longer under observation but everyone was feeling bad about keeping me away from my babies. My doctors were pretty sure they hadn’t really fixed whatever the problem was and told me the fever would likely return and that I’d need to come back to the hospital when/if that happened. Fortunately I surprised them and the fever didn’t come back.
Thanks to our wonderful neighbors, this guy greeted me when I came home
About a week and a half later I went in for a follow up appointment with my doctor. Based on testing performed on the placenta after the babies were born they were able to confirm that the girls are identical. My doctor was pretty confident that was the case, but she said having the placenta tested is something that she always does with twins. It was also noted in that report that there was an infection creeping into Dani’s side of the placenta. We’re lucky that I delivered early because she could have become really sick if she had been exposed to the infection.