Tuesday, September 20, 2011

Numbers

A look at the past few months in numbers...

28: The day in June that Dax and Trev were born.

2: The number of minutes their birth was apart.

2#: Trev's weight at birth

1#, 15.5oz: Dax's weight at birth

48: Number of days they slept in seperate beds in the NICU.

74: Number of Days Dax spent in the NICU

82: Number of Days Trev spent in the NICU

1: Number of times Trev was intubated while in the NICU.

3: Number of times Dax was intubated while in the NICU.

8: Number of days Trev was in the NICU without Dax.

137/105: Trev's blood pressure at it's worse.

3: Number of different meds Dax came home on.

2: Number of different meds Trev came home on.

3: Number of blankets that were donated, each, toDax and Trev in the NICU

5# 6.5oz: Trev's weight when discharged

5# 3.4oz: Dax's weight when discharged.

0: Hours Matt and I have slept at the same time since Dax came home.

7: Approximate number of hours Matt and I each get of sleep every night (we have a good system)

57: Number of 2 year old temper tantrums Athan throws daily (or something like that....)

25: Approximate number of diapers we go through daily.

4: Number of Dr. appointments we will be going to this week.

400: The mL amount that is my goal for my boys to eat daily.

390: The average mL/day Trev has eaten since home.

415: The average mL/day Dax has eaten over the past few days.

5: The time in the morning when I go to sleep and Matt wakes up.

10: Number of people in our lives who would immediately drop everything and be here for us at 2am if we asked. For these people, I could not be more grateful!

2: The number of days I have had my whole little (er... big...) family at home together!!!

Saturday, September 3, 2011

68 days and in the home stretch!

Well, in the 23 days since last doing an official update so much has happened!!! I could spend 5 hours giving all the crazy updates, if I had that kind of time... but I don't! Therefore, I am going to give a very simple and quick update about each boy,

For both of them ---

Feedings- both boys were introduced to bottle feedings just before 34 weeks gestational age (around 9/17) They started off doing 1 bottle feed a day and they would suck about 3-6 mL of their 30-35mL feeds and we then put the rest in the tube. Then, the series of events proceeded really quickly in the following order... finished their first full bottle>moved to 2 bottles per day>finished both>1 bottle, 2 tube pattern> finished all feedings well>2 bottle, 1 tube pattern> finishing all feeds well.... Now, we are hoping for the report tomorrow that they will be on a 3 bottle, 1 tube pattern and the next step after that is all bottle!!! I love that both boys have kept up with eachother in the development of their bottle abilities!

Location- The NICU has 1 large room and 1 small room. The big room is for the sicker babies and the smaller is known as the "grower/feeder room". A few weeks back, the boys moved from the middle of the big sick baby room, to the corner and into a crib! Then on 8/31 they were moved to the grower/feeder room! Best part of the move?? Their is a window and Athan got to see his brothers!

Their nurses - When the boys were first born, they each had a personal nurse 24/7 who pretty much sat in front of their bed and kept a constant eye on all their vitals. Now, there are 6 babies in the grower/feeder room and only 2 nurses total!

Dax

Oxygen- Dax came off the nasal cannula for 2 days the first time and then needed to go back on it. Then, about a week later(around 8/25ish) came off the cannula for good and has been doing very well with his O2 saturations since!

He has very steadily gained weight and tonight he was at a whopping 4lb, 15oz! We're hoping to hit the 5lb mark tomorrow!! Dax seems to have a very calm and curious demeanor to him. He rarely fusses and loves to just look around during his bottle feeds.

Eyes - A common preemie problem is known as Retinopathy of Prematurity (ROP). If you look at any diagram of a haelthy eye, you see the blood vessels all grow outward toward the pupils. ROP is when they grown in an abnormal way and become somewhat mangled. There are multiple stages of ROP, the lower the better, as well as 3 zones. The higher the zone, the farther it is from the retina which is better. Currently, Dax has stage 2 ROP in zone 3. stage 1 ROP is common in all preemies and typically goes away as can stage 2. HE will continue follow up eye exams. If ROP does fully develop, it can lead to blindness, but if caught early enough it can be treated with laser surgery.



Trev

Oxygen - Trev has been off of O2 completely for almost 3 weeks now. He is doing great!

ROP - Last checked, Trev has stage 1 ROP in zone 3, which is better from his first exam of stage 1 ROP in zone 2.

A few weeks ago, Trev was very fussy all the time, had some trouble gaining weight and even lost almost 3oz in 2 days. He had very high blood pressure during this time too. A normal blood pressure for a baby his size would be something like 80/40 while a normal blood pressure for an adult is 120/80. Well, Trev's was as high as 137/105. VERY HIGH! The nurses didn't tell let on at the time, but they were getting worried as it was so high at times that the cuff couldn't even get a reading. First, the Dr, took him off of his caffeine (used as apnea prevention). Then they performed a series of tests one of which was an xray and doppler scan of his kidneys. Well, the radiologists reports seemed all over the place and it seemed that the conclusion was that his right kidney was functioning normally, but his left kidney had blood flow through the middle but not the top or bottom. The Dr. decided to send the scans to a pediatric nephrologist at UC Davis to be reviewed by someone who had more experience with preemie scan reading. The nephrologist believes that there is nothing to worry about and any abnormality of his kidney function is something he will grow out of.

We have since put Trev on blood pressure meds. He began on captopril which he was given every 8 hours and was on this for about 2 days with no improvement and then the Dr. switched him to, I think it's called enalapril. The enalapril worked amazingly and quickly too! Within a short time (a day maybe??) Trev's BP was down to a normal level. You could tell when visiting him that he felt soooo much better to. He was instantly in a better mood and less fussy with a better, pinker flesh tone. He was on the enalapril for a short time and the Dr. has since taken him off of it as of about 4-5 days ago and still no high BP! We will be taking Trev for a follow up with the pediatric nephrologist after they have been discharged.

Since Trev had a hard time gaining weight for a short time, he is playing catch up to Dax. At one point Dax was a whole 3/4lb heavier than Trev. But Trev is catching up and is now only 4.6 oz behind at 4lb, 10.4oz!

It is amazing how much the last 68 days have flown by and yet so much has happened. Dr. Jain told us yesterday that we can expect to take them home in about a week and we are now in a bit of a panic with so much still to do to get ready for their arrival! I can't wait to sit in my back yard with a sleeping baby in my arms and my feet in the pool while Athan splashed around!

Wednesday, August 24, 2011

Veering off the tracks...

A nurse told me the first night I saw my boys that the NICU is like a roller coaster. I believe over the past few weeks especially I have experienced the truth behind that. My boys were (and still are!) both doing so well that I was able to see the finish line!! They were both gaining weight well. Breathing well. Keeping their temperature well. Everything was lining right into place! Then the roller coaster kind of decided to jump the tracks for a few days. Literally. The emotional NICU coaster literally jumped tracks from the NICU baby coaster into a whole new one that we have not even begun to ascend. I had a really hard few days and was not really prepared to talk about it, but after reading up on things and mentally processing a lot, I am not so terrified of the future and ready to face what the years to come will bring.

I'm sure anyone reading this now is wondering what the heck I am talking about. On Friday, August 19 my parents came to our house to take care of Athan while Matt and I headed off to the hospital for the boys' 2pm bottle feedings (they are trying their hand at drinking from a bottle all on their own!). We got into the NICU and Dr. T gave us the updates for the day. Dax had been off of any oxygen help for a few days and had begun having a few oxygen D-sats again so they put him back on it and Dr. T ordered a chest xray to make sure he did not have fluid in his lungs or any collapsing of the alveoli. Good news, his lungs look great! Then Dr. T says that when we have a second, he noticed something in the xray that hadn't been remarked upon before and he'd like to show us. I thought nothing of it. We had a few moments with the boys and then went and sat down with Dr. T at the computer. He then showed us Dax's chest xray and explained where his lungs were and his heart and told us that both looked great! Then he continued on to looking at his ribs and spine. He points out that it appears that 2 ribs look to be fused together and at least one vertebrae (maybe two) did not properly develop. The below xray image is NOT Dax, but it shows kind of how his vertebrae look (though not in 2 places like the image shows).
Dr. T explains that he would like our permission to send a referral to Shriners hospital for Dax to be seen by a specialist once his NICU stay is done. As he said this all I could think about was the commercial for Shriners hospitals where the kids are all singing "Imagine" by the Beatles. I always viewed Shriners as a place where only really sick kids went. I NEVER expected that my child would be one of those really sick kids! Matt and I spent another hour or so in the NICU with the boys and I spent the whole time trying not to burst into tears over the news I had been given. How was it that everyone seemed so calm over the situation?

We left the NICU and on the way home I told Matt I did not want to tell anyone about the xray until I had more time to process the information. Basically, I needed to have an emotional mommy breakdown first and I wanted time to myself to have it before I started talking about it.
We got home, gave Athan big hugs as we always do when we get home, thanked my parents for taking care of him (I'm so lucky to have them!) and said bye to Grandma and Grandpa. I spent the rest of the afternoon kind of out of it and finally decided later in the evening that I had to tell someone. I was not going to be able to accept it and process it until I got it off my chest. If I told someone else, it would all be real, I could begin to accept it, fear it and start facing it head on!

I still didn't want to talk about it with someone so I decided to explain it to my mom through a facebook message. As I began typing out the explanation I finally let out all the emotions I had been balling up inside and trying to hide from myself. The fear finally came to me. It was a huge relief. Fear is a completely natural emotion, especially for a mother forced the face the fact that my child had a developmental deformation at birth. Fear is what kicks us into gear and motivates us to act and do everything we can to improve our situation. Fear is fight or flight! I am a fighter (I learned it from my amazing Grandma!) and my 3 boys are fighters as well. Flight was never an option for me, but as I let myself be emotional while typing out my explanation of what was going on, I could feel the fight in me begin to kick in.

I finished typing my knowledge of what was going on with Dax's spine and sent it to my mom only to realize a few minutes later that she only got the last part of the message. All the emotions I had put forth to explain everything were simply lost in the facebook cyberspace abyss. Now, based on the little bit of information my mom got from the message, she only knew something was wrong and had no clue what. Of course, she immediately began calling me. I wasn't sure I was ready to talk about it out loud yet and I ignored her first million calls (it really seemed at the time like she called me 20 times within 5 seconds). Finally I answered the phone and began to explain everything. Out loud. And I really let it out.

I remember back to when I was maybe 11 or 12 and fell while riding my bike at a friends house. I scraped up my knee really badly. I even have a large scar now from the fall. I remember that I wanted to be tough and not cry over it. I don't recall it even hurting that bad. I scraped my knee up and it was ok. My friends mom drove me home and I was fine the whole way. However, as soon as I opened the door and saw my mom, I burst into tears! It's funny how sometimes all a girl needs is her mommy to be there to let it all out. That is exactly what I did as I explained everything to her. I let it all out. And after I felt so much better and completely ready to do whatever I needed to do for my baby boy. My mom, despite the fact that I know she herself was devastated by the news, stayed calm and explained that there is a lot they can do for Dax and that everything would be fine and Dax would be fine.

After speaking with my mom, I began googling spinal malformations to try and gather information and I was so saddened to see some things that sweet innocent little babies have to suffer through. As I saw how bad some babies situations are, I realized how grateful I am. There are many babies out there who are far worse off than mine. Don't get me wrong, I wish every morning, noon and night that my children did not have to endure all that they are going through. But I believe that there is always much to be grateful for in the world and I am a firm believer in truly appreciating all that we have been given in life.

Since Friday I have learned more about Shriners Hospital. I realize now that it is for any child with special medical needs and not just extremely sick children. I look forward to getting my first call from there and getting a chance to speak with a specialist about everything that my beautiful Dax is going to need to grow happy, healthy and strong. And I look forward to giving him all those things. From what the pediatrician (who is not an expert in these things) has said. His abnormal vertebrae can likely be fixed through surgery and it is not affecting him at all right now. Essentially, it is likely to cause something like severe scoliosis later in life. Can't wait to talk to a specialist to find out our specific plan of action!

This is my family. A year ago when Matt and I decided we wanted another baby, we never expected our little family of 3 to become 5. We never expected to have 3 boys. We never expected to be preemie parents. And we never expected that one of our children would ever need to be referred to Shriners hospital. However, this is where we are. I am so grateful for the fact that my little family of 3 is now a not so little family of 5! I am so grateful that my boys, who entered this world way before they needed to, are growing and getting healthier day by day. I would give anything to take all the pain and trauma my boys have endured away. But I am so grateful that they have endured it and are beating it day by day. My children are the most amazing little beings I have ever met and I could not imagine my life being any different!


Thursday, August 11, 2011

They're growing so fast, before we know it they are going to be "newborns" graduating from the NICU!

I got to hold both of the boys together for the first time today!

The boys are getting huge! As of 8/10 Daxton weighed in at 3lb, 6.4oz and Trev at 3lb, 4.4oz. It is interesting to look at them now and think, "My goodness, they are getting soooo big!" Then I think about it and realize that they are still so tiny and less than half the size Athan was at birth (7lb, 3oz.)

Trevyn Update


Last I updated, Trev was getting an MRI for an enlarged ventricle. I am very happy to report that the MRI came back showing that everything is normal!!! While his left ventricle is larger than the right, they are both still within normal parameters and of no concern, though we will still continue to monitor it in the upcoming head ultrasounds. That being said, I looked up some information about people who are dominant with the left side of their brain and found this...


Yesterday in the early morning the Dr. took Trev off of the Oxygen... completely! It was quite exciting! My sweet little boy did so well for so long. However, by about 5am this morning he decided he was a little tired of doing all the breathing work on his own and they needed to give him the nasal cannula once more to keep his O2 saturation levels good. We will try again in a few days.
And now I will leave you with a video of Dax enjoying his zoogie (pacifier)!!!


Thursday, August 4, 2011

The Rollercoaster Continues!

I got a nice cuddle with both of my little ones today. Always makes my heart smile when I see how strong and inspirational they are! I can't wait for the day when I can cuddle with both of them at the same time! That day is probably not far off too!

Daxton Update

Now that Dax is off the ventilator, he seems to be breezing through everything! He has been off for almost 3 days now and on the high flow nasal cannula. With the cannula, there are 2 main settings to control, the O2 level of the air and the pressure (L/hr). Dax started out at 5L/hr when he first came off the vent and is now down to 3L/hr with anywhere from 21%-28% O2. So proud of him! The ventilator actually goes through his vocal cords so he cannot make noise while on it. Consequently, it can also damage the vocal cords. Until today I had yet to hear Dax's little voice, but I finally got a little angry growl/wine out of him. It was so sweet! The nurse told me that he has made plenty of noise while I'm not around and his vocal cords are no worse for wear after being on the vent. Yay!

Trevyn Update

Trev is continuing to do well. He has been at 2.5L/hr flow on his nasal cannula with anywhere from 25%-32% O2 for a while and seems to be just fine at that point. Since the boys blood vessels in the brain are so fragile when they are so young, the Dr's order head sonograms periodically to check for any brain bleeds. A few weeks ago, one of the head sonograms showed that one of Trev's ventricles was slightly larger than the other. Nothing too be concerned with immediately but something to keep an eye on. Well, a few days ago, they did a follow-up sono and found the ventricle was a little larger than before. There is no blood around it however,
which is a good thing but it could potentially indicate that there was a brain bleed at some point that went undetected. So, the Dr. ordered an MRI which Trev got to go on a field trip out of the NICU for today. We should know the results tomorrow and hopefully it turns out to be nothing!!!

Tomorrow would have marked the 32 weeks gestation point! Time flies! Here are some new pictures from today of the boys with their ducky and teddy. Remember, Dax is with the Duck and Trev with the Teddy.

Tuesday, August 2, 2011

Ducky and Teddy

So, as I may have mentioned in one of my first blogs, the first time I met the boys, before we had names for them, they were given the nicknames of Ducky and Teddy. These nicknames stem from the little gold sticker that secured their temperature monitor onto their tiny little bodies (pictured above). Dax had the Ducky, Trev had the Teddy. I hated the idea of referring to them as "Baby A" and "Baby B" but was still not ready to settle on their names yet, so Ducky and Teddy it was! Ducky soon became Daxton and Teddy became Trevyn. Now we have Daxton Ducky and Trevyn Teddy! I can't wait to scream "Go Ducky, Go Teddy!" at a soccer game when they are 12!

Well, I wanted to get a stuffed animal to take pictures of them next to as they grow so we would have a reference to see their progress. So, naturally I decided I needed a Ducky and a Teddy for their pictures. As I looked around, my requirements were that the stuffed animals were similar in size at around 12", similar in style, could be easily cleaned, and cute! This proved more difficult than I expected! It took me a while but I eventually found some I liked, they were just a bit bigger than I had hoped at about 15".

Now that I have the animals, I will be posting weekly update pictures of the boys with their animals respectively. That is, the Ducky will always be with Dax and the Teddy will always be with Trev. These first pictures are from 7/27. Enjoy!

My little boys are becoming babies more and more with every day. It is so amazing to watch! It is pretty interesting when I hold them to think that they are supposed to still be in my tummy and to think that this is what they would look like regardless if they were still there. There would have been two perfect little human beings in there growing, BIG! Every time they kick a leg I wonder, "Would that have been my bladder, or a rib, or eachother??!" I would have gladly welcomed every wonderful kick despite the discomfort I'm sure they would have caused.

A bit on Kangaroo Care...
Kangaroo Care - a technique practiced on newborn, usually preterm, infants wherein the infant is held, skin-to-skin, with an adult.

I have been getting a lot of opportunities to get my skin to skin cuddles with Trevyn over the past few weeks and have read a lot about the benefits. Interestingly, the benefits of Kangaroo Care were discovered by accident in a NICU in Bogota, Colombia. Due to limited funding, the NICU did not have enough isolettes for all the babies and in order to keep the babies temperature stable, the mommy would hold the baby skin to skin on her chest. They have since discovered the trend that generally, babies who receive kangaroo care are have fewer infections, gain weight faster, maintain more stable oxygen levels and are discharged sooner. While reading about the benefits I found one thing in particular very intriguing. A study found that, during kangaroo care, when a babies temperature would decrease, the mothers would subsequently increase to make up for the drop and thus giving the baby the extra heat they needed to warm up to a proper temp again. The bond between mother and child truly is amazing!!!

While I had ample opportunity to care for Trev this way, I was definitely lacking in my chances to really get that bonding time with Dax due to his ventilator and the fear he may extubate(remove the tube) himself while being taken out of his isolette. Only a few brave nurses were comfortable with the idea.
The main reason Dax was still on the ventilator was because he was having oxygen desaturations and bradycardia (drop in heart rate) that were so severe that he would lose all his color and almost have a grey tone to his flesh (bad and scary!). The ventilator was able to give him manual breaths when this occurred that allowed him to pretty quickly recover. However, as of 8/1 at 10am (38 hours and counting!) Dax was extubated and has been doing very well since. While on the vent he was having 1-2 bad color changing episodes a day. Since being extubated, he has not had a single one! I guess his severe bradycardia was his way of throwing a fit and saying "get this thing out of my trachea!!" He went from the ventilator straight to the nasal cannula which is the same machine his brother is on! He completely skipped the Si-Pap and CPAP machines and so far has not needed to step back to them. I'm so proud of him! Immediately after he got the tube out, he found his fingers and started sucking away at them! He must have been waiting so long to do that! Now, he loves his pacifier! Here is Dax showing off his new breathing gear! So proud of him!!
Along with yesterdays surprise of Daxton being extubated, my parents got a great surprise as well! The nurse let them both hold Trev! It was a great moment for all of us and my parents were, of course, very proud Grandparents!

My boys are really starting to chub up now! As of last night, August 1, Daxton weighed in at 2lb, 13.4 oz and Trevyn was 2lb, 12.6oz. they are going to be 3 lbs each before we even know it! I can't wait to pull out one of Athan's favorite outfits from when he was first born! I know my family missed this one!

Tuesday, July 26, 2011

Long overdue update...

Wow, life is crazy and I don't know where the last 8 days went, let alone the last 4 weeks!! That's right, the boys are 4 weeks old today!!!

Life has been so crazy that I have gotten way behind on my updates... I'm going to attempt to update Dax's progress to date and then Trev's. We'll see how this works...

Dax Update

So, last I updated, Dax had been taken off the ventilator. Unfortunately, he was off of it for only 2 days before his O2 desaturations became too frequent and too severe.

On Monday, 7/18 Matt and I got to the hospital and went in to wash up before seeing our babies. As I open up my sterile sponge, I always
look through the window into the NICU room where the boys are just to make sure everything is calm. It usually is, which always calms my nerves a bit. However, this time they had Dax's isolette open with the Dr, his nurse and the respiratory therapist all standing around him. Then I noticed another nurse see me and go over
to talk to the Dr. I knew something wasn't right... The Dr. then came out to inform me that they needed to reintubate Dax and we should come back in a half hour. I can't describe the feeling at that moment more than just to say that it sucked. Matt and I spent some time in the cafeteria for a while before going back up. During that time I kind of kept myself just a step to the side of sanity as a coping mechanism. When we got back up to the NICU Dax was on the ventilator
again and comfortably snuggled into his bed again. There were blankets from his bed still on the ground and it was obvious that they had to do a little scrambling shortly before we had gotten there. A very scary thought and I can't imagine how I would have felt had I been there at that time.

Since he has had so much lung issues for 4 weeks now, the Dr. has classified it as chronic lung disease (CLD) which is definitely a scary thing to think about. However, the nurse gave us some information on it which talks about the potential long term risks including asthma, more severe colds, and a heightened sensitivity to smoke and air pollution among many other things. Then at the end of the form it explains that many preemies with CLD grow up to have perfectly healthy lungs in the long run. We're staying positive and hoping for the best!

Since Dax had such a rapid decrease in O2 that day, Dr. Jain ordered a chest x-ray (check lungs for any abnormalities), blood tests (check for infection) and an ECHO (maybe a PDA issue like Trev had). From all the results we learned that he did not have a PDA. Yay! But it did look like he had a lot of fluid in his lungs and possibly an infection. Which meant he had to stop his feedings for a while and take diuretics as well as antibiotics. He was doing so well gaining weight and this was definitely a setback (he actually lost a little).
Dax getting his ECHO

Currently Dax is still on the vent and likes to simply decide not to breath every once in a while. At this point I have simply accepted it and stopped hating it. It's helping him to stay healthy and it is what he needs, therefore it's a good thing.

Since he had some fluid build up in his lungs, the Dr. started him on continuous feeds as opposed to every 3 hours. He is currently getting 6cc's every hour, 144cc's every 24 hours.

As of last night, Dax weighed a whopping 2lb, 9 oz!!! Though he did have a major diaper blowout shortly after his weight was taken, so I imagine he is a little lower....

Trevyn Update

I believe the word used by the Dr. the other day to describe Trev was "Gangbusters"... Dr. Jain always has an interesting way of saying things... She was referring to his progress and how well he is doing.

His breathing has been good and he is still just on the nasal cannula. He is now getting 24cc's every 3 hours, 192 cc's every 24 hours and he weighs about 2lb, 10oz! He even is starting to develop a little chub in his cheeks!

They did a head sonogram the other day and found that one ventricle is a little larger than the other. This is most likely nothing of concern and it's just a result of natural asymmetry in the body. We will be repeating a head sono in a few weeks to make sure it doesn't continue to get larger (could imply a brain bleed).
Look at Trev's chubby cheeks!


And, just for good measure, let's take a look at what I can expect x3 in about 2 years...
Athan loves his corn!!