July 27, 2010

Happy Birthday Brother

I was really hoping the muppets would be born today. Today is Uncle Paul and G.G’s birthday. I know the day is a bit crowded, but even Uncle Paul had said it would be fun to share.

Twenty-seven years ago Paul arrived early. Not three months early of course, but a couple of weeks. Mom woke up early, but ignored her symptoms because he wasn’t due yet. (Boy do I know that feeling!) Finally, she realized it would be exceedingly prudent to get her pregnant belly to the hospital ASAP.

Twenty-seven(ish) minutes later, I had been rudely removed from mud-pie preschool and had a new baby brother.

Mom called G.G. “Happy Birthday Mom. You have a new grandson.”

During the first few years, I wasn’t terribly thrilled with his presence. Periods of silence in the house would often be followed by the two of us trying to kill each other. How exciting that Search and Destroy have started fighting early. Search kicked his brother in the head while the two were in utero. Destroy laughs at his brother now when he has to have his nasal cannula replaced.

But then, inexplicably, as we got older Paul got less annoying. We traded baseball cards and played catch on summer evenings. (Sorry about that baseball through the back of the Volvo, Dad.) We entertained each other during long nights before birthday or Christmas. We talked about relationships and argued over whose turn it was to monopolize the phone. We fixed Mom’s computer and rolled our eyes at our parents’ general lack of coolness.

I know that someday the muppets will be rolling their little eyes at Jon and me. But I hope that they will think their brother is cool. And they’re certainly lucky to have such a cool uncle! (Even if I’ve always been a tad jealous that he gets to share such a special relationship with our Grandma.)

Brothers!

5 Comments

July 26, 2010

Five Pound Fashion

When the nurses originally told us it would happen, Jon and I found it very difficult to believe. Really? Three pounds in a month, we questioned. But Nurse Susan assured us that the NICU folks are experts at fattening up children.

Destroy and the fishies

Search - Daddy's All Star

Well, today the muppets hit five pounds. Chunksters!

This past weekend the twins graduated to Newborn size diapers. This may or may not have had anything to do with growth. Diaper size increases are usually determined by the current diapers inability to contain poop. (Prior to having children I never imagined I would care so much about bodily functions.) The new diapers are much kinder to the boys increasingly expanding tummies. Last Friday, Jon noted that Destroy was beginning to look like a football – little arms and legs, big oversize midsection.

Even more exciting is today’s development. Along with the five-pound milestone, Search and Destroy no longer fit into their adorably tiny preemie size onesies. Their wardrobe options have just increased exponentially. Destroy was clad in a standard issue hospital shirt – size 6 months – which is provided to all babies, from preemie to jumbo term size. He may as well have not been wearing anything for how big that shirt is. Search was still wearing his preemie outfit since he hadn’t yet spit up on it. But when the Nurse Susan arrived for her evening shift, she found Search squirming about with the bottom snaps not even closed. Perhaps Nurse Margaret thought he needed extra breathing room.

For outfits that were still rather loose when we first clad the muppets with them, they were awfully snug these past few days. I was a proud mommy this afternoon as I toted the larger outfits into Pod B. Granted, these new outfits are still rather roomy. But they’ll quickly grow into these too. At the rate they’ve been growing, we’ll be taking home babies that actually fit into those size 6-month standard issue shirts…

6 Comments

July 25, 2010

Lifestyles of the Small and Premature

Search

Destroy

For those of you familiar with the MTV show “Cribs,” please enjoy today’s installment of “Cribs: NICU” (ha ha). Please feel free to read the following with a Robin Leach English accent.

While most babies are quickly bundled into their mother’s arms and shuttled out of the hospital mere days after birth, the small and premature enjoy luxury private accommodations where teams of qualified medical staff cater to their every whim.

Think that’s impressive? Well, consider Search and Destroy Stream. Not content to live alone in a Giraffe isolette, the twins have moved into a two-person pedi crib mansion. The crib looks far more like a typical crib than any kind of hospital equipment.

The small and premature are encouraged to relax. The only work required is breathing. And even then, oxygen tubes are provided to any who want to chill out to the point of forgetting to breathe. These nasal cannulas are available 24/7. Adults are required to pay big money at trendy oxygen bars for mere minutes of the same pleasure.

Day and night, these small and premature babies adhere to a strict schedule to ensure no want goes unanswered to. Hungry? Every three hours Search and Destroy receive a bottle of milk. But not just any milk. These small and premature miracles receive two parts growth formula with every feeding. Aimed to plump them up quickly, these children are not burdened with the term babies task of taking only as much as they want. Too tired to eat? Not a problem in the NICU. Here, babies can simply lie back and experience the thrill of a full tummy via a feeding tube.

Without asking, a team of nurses make sure that the babies home is always the perfect temperature and a fresh diaper awaits their cute little tushies. Interested in furthering development? The small and premature have a developmental care coordinator who recommends a weekly plan that will make the little ones the most comfortable. In the interim, physical therapists massage their muscles and work on toning their cute little bodies. Again, something adults continue to pay thousands of dollars a year for in prosperous gyms and spas. And finally, a social worker imparts this and more information to parents to ensure the preemies comfort upon departure.

Remember Search and Destroy’s crib? These preemies are spoiled and pampered. In addition to ditching anything resembling medical supplies, the twins cuddle in personally assembled nests – swaddled in warmed blankets topped with fuzzy stuffed bear blankets. Their bedding arrangements lay atop a handmade quilt. The quilt boasts a primary red background with bright yellow chicks to stimulate the imagination. They look up at a blanket of royal blue with rubber ducks of the same bright yellow to color their dreams. Tired? Their fuzzy bear blankets are a pastel blue and green to calm them.

In honor of the giraffe isolette they left behind, a stuffed giraffe watches over the two of them. In each corner sits a turtle reminding them that slow and steady wins the race. Rattling bumblebees attached to the back of the crib entertain them should they wake up before their next feeding. Still sound mild and pedestrian? A musical jungle mobile swings above their heads – entertaining them with lions and tigers and bears, oh my!

No wonder they’re still camping out in the NICU after eight weeks. This is paradise compared to the cramped conditions in my tummy or the cold glare of the operating room where they were ripped out into the world.

Thus far their lifelong adventure has taken them down the hall of the hospital’s third floor. I can tell they’re getting more adventurous as they get older and bigger (hence the new need for the musical mobile entertainment). This tells me the muppets will be home soon – just think what adventures await them once they breech the barriers of the NICU and actually get to experience the world.

NICU Sweet NICU

2 Comments

July 22, 2010

Still Not Home

Shocking news – the muppets are still in the hospital. If you’ve ever stopped and wondered, “Hmm, I wonder how long it takes for preemie parents to reach extreme levels of frustration,” allow me to enlighten you. The answer is seven and a half weeks.

This week was a particularly difficult one for me. The boys are still doing very well. They’re growing and getting ready to come home via the slow and steady method. But they’re still swinging up and down with their oxygen saturation. This was the first potential week that we may have seen the boys homeward bound. Guess what isn’t happening?

To be fair, I never really thought they’d be home this week – I thought they’d be home next week. Ever since we learned double trouble was upon us, I’d expected to bring them home in late July. But I did expect that perhaps they’d be completely sans nasal cannula and holding a steady saturation level (of 97-100 percent).

No more photos...please!

I know 36 weeks is the average gestation for twins and next Tuesday is G.G and Uncle Paul’s birthday. I thought the twins arrival would be a great birthday gift. Obviously, that didn’t happen. So I thought the next best thing would be to bring them home. Such mental decrees led me to really picture this as their due date. Ultimately, we have always been told to expect them home by their due date (which is actually Aug. 23) but they will let us know when they are ready to blow that NICU popsicle stand.

The combination of unmet expectations, closing in on the two month mark and just how darned cute the muppets are getting led to a very frustrating moment for me. It was hard to take a step back and remind myself that even though their NICU residency seems like it’s been forever, and even though they’re four and a half big boys now, they’re still only 35 weeks – still tiny. I should still be pregnant for another month! (Good grief, I honestly cannot imagine still being pregnant.)

Search

This past weekend was an absolute circus in the NICU. As I mentioned, the unit was at capacity. It seemed like there was a new admittee every five minutes. Young preemies to full term babies were rolling into the unit ensconced in their Giraffe isolettes. Nurses running to and fro, yelling out alphabet soup: TPN, PCH, CBC, ABR, CPAP, CC, ROP, ML, EKG, NG, IV, PDA and – what the heck, we’re talking children here, – ABC, 123. Babies crying. Dinging – oh, the dinging – alarms screaming from every nook and cranny. Nurses tending to babies in multiple pods. The charge nurses wandering around asking who wanted to work doubles.

Destroy

Destroy and I were cuddling in a corner, observing the chaos. The one stat I kept noticing were how many of the babies had high steady sat levels. Today I asked Dr. Dong when the swings would stop. He just looked at me with a slightly pitying, slightly amused expression. “I don’t know…when they’re ready.” So much for my hopes that he’d suddenly peer at the boys and reply, “July 23. 1:32 p.m.” However, he did wryly note that yes, it will someday stop. He mentioned, “We’ve seen a lot of kids like this. It seems like the swinging will never stop and then suddenly it just does.”

Search and Destroy truly are our little miracles. And we’ve been really blessed that, despite all they’ve been put through, they’re healthy. (They’re still tiny, but they’re healthy.) They are coming home – it’s just a matter of when at this point. I’ve discovered the cure to my frustration is seeing one of the boys smile or coo. And a slightly calmer NICU helps as well. Homecoming is just a matter of weeks now. Then the boys can cause all other types of frustration for their parents.

Despite the occasionally frustrating situation we’ve found ourselves in, Jon and I are tremendously enjoying getting to know our boys. Their personalities are really starting to shine through. And double trouble is oh so very accurate.

6 Comments

July 19, 2010

Your Child at 35 Weeks

You know it’s time to leave the hospital when the nurse has to leave the pod and decrees, “Mom’s here. She knows what’s going on – she’ll let you know if anything’s wrong.”

The muppets are officially 35 weeks corrected gestation today. That means that today is the very first day they would have stood a chance of coming home without an extended NICU stay. It’s been seven weeks. I like to think of them as being the Pod B Seniors. (The giraffe can be the team mascot – since that’s the brand name of the isolettes all the NICU babes live in.)

The NICU is at capacity again; the last time they were full was when our little dudes were admitted. Yet, so many of the new babies are “older” – 32-34 weekers. I admit to many bouts of jealousy. I look around our pod and see the brand new residents with no need for oxygen assistance. They immediately take their bottles with no need for feeding tubes. And they only stay for a week or two.

So I decided to take a look back at what life would have been like if I was still waiting to meet them. One of my favorite sites during pregnancy details the development of each week. Interestingly, my actual experience wasn’t terribly far off.

Your child – 35 weeks
Due date: Aug. 23, 2010
July 19 – July 25

Do you know the difference between real and false (Braxton Hicks contractions) labor pains?
You betcha! I had real labor pains for many moons. The docs gave the three of us Indocin to stem the contractions. (Dr. Meyer, our perinatologist, called the twins “little Indocin addicts.”)

It’s normal to be nervous about labor and delivery.
Yeah, no kidding! Especially if you’re terrified your babes are too young to face this great world, even if the tiny ones appear to think they’re big bad boys. I was wheeled into the OR muttering “healthy babies” feverishly and incessantly.

Planning to breastfeed? Ask your hospital’s labor ward if they provide on-site lactation consultants, or interview consultants you may want to work with after the baby is born.
They do. Regardless of how long after birth you need them.

Your prenatal visits may be weekly now that you’re in the home stretch.
Well, they’re not prenatal visits so much as postnatal. And they’re not weekly, they’re daily. But back before the muppets arrived…nope – they were daily then too. (Granted, I was living in the hospital.)

Make a tape of music to listen to during labor. Pick songs that perk you up, inspire you, or relax you.
Any calm labor plans went out the window when the muppets decided to grace us with their presence three months before any birth plan could be created. But I’ve got songs for the boys now: songs I love and songs that ones I love have sent their way.

Feathering the nest? Look for fun freebies and coupons.
The nursery is ready and awaiting homecoming! And freebies and coupons are a good idea now that our family is double trouble.

Only 5 percent of babies are born on their due date, so don’t worry if yours comes and goes and you’re still waiting.
Seriously? Do I even need to comment on this one?

How your baby’s growing:
Your baby doesn’t have much room to maneuver now that he’s over 18 inches long and tips the scales at 5 1/4 pounds. Because it’s so snug in your womb, he isn’t likely to be doing somersaults anymore, but the number of times he kicks should remain about the same. His kidneys are fully developed now, and his liver can process some waste products. Most of his basic physical development is now complete — he’ll spend the next few weeks putting on weight.

Only 5 ¼? Although our little guys aren’t quite there, the little porkers are already tipping the scales at 4.6 pounds. Not bad for guys already using a ton of energy out in the world. But yes, they will be spending the next few weeks (months/years) putting on weight.

Search and Destroy started a new medication today. Supposedly it may help with their saturation swings and get them off the oxygen sooner. (Search’s back on his nasal cannula. He got tired.) They’re both getting so close.

I have high hopes for the next two weeks. Weeks 35 and 36 are the weeks twins are often expected, arrive and go home. So even if they’re not quite ready to come home, they’re well on their way. 35 weeks along, seven weeks old and almost five pounds – they’re big boys now!

7 Comments

July 16, 2010

Breaking Up is Hard To Do

Search “The Chubster” and Destroy “Chunky Monkey” are both doing well as they hit their seventh week of life.

When we first joined the NICU family we knew there would be ups and downs in their progress. At the time, I didn’t realize they meant that literally. In Pod B, the Stream boys are known as “The Swing Boys” and “The Dueling Desatters.”

Their oxygen saturation levels continue to bounce up and down. Sometimes we think it may just be to keep their nurses on their toes. The monitors track their heart rate, breathing rate and the aforementioned saturation levels – when levels fall below a set number, an alarm starts beeping. (We may have to find a recording of obnoxious beeping to soothe the boys once they come home.)

Time seems to stretch out as their corrected gestational age closes in on the point where they would no longer need an extended NICU stay. And since Search and Destroy are doing well, we are breathlessly awaiting the time when they come home. (Medical opinion is still placing bets on Search to precede his brother.)

Today, we saw what the light at the end of the tunnel looks like. M, the little girl across the pod, went home today. Born in March at a tiny two pounds, she proved beyond a shadow of a doubt that she was a fighter. On several occasions her mother reminded us to never lose hope – if her little girl could make it, so would ours. And no matter how far away the time seems, someday soon they’d all be home.

M would often sit near the boys crib, charting with the nurses. Sometimes she’d eat her bottle while our boys attempted the new technique of sucking and swallowing. Being the great flirts that they are, the nurses referred to her as the boys’ girlfriend. In that sense, we were sad to see her go. But in the grander scheme – we’re thrilled she’s gone. There will be plenty of older women in their lives…

Seeing our friend depart reminds me that our family is not too far off from being together. Search and Destroy have grown so much already. They’ve doubled their birth weight and are now a giant four pounds each.

This evening the doctor decided they were growing so well, that their calories have been decreased. (We want chubby babies, but the doctor is concerned about the potential for not-as-cute fat toddlers.) Although the boys are on a steady diet of mom’s milk, it’s mixed with human milk fortifier to fatten up babies. It also makes them constipated. So they spend a majority of their days trying to poop.

We’re hoping that the slow decrease of sludge will help relieve their tummies and as a consequence release pressure from their diaphragm, allowing them to maintain a steady oxygen saturation level. This will make for a very much less paranoid mommy.

As a start, Search was relieved of his nasal cannula today. He is no longer receiving any oxygen assistance; breathing is all up to him. So far, so good – here’s hoping he keeps it up! It’s amazing how much cuter he is without giant tubes in his nose.

Keep your eyes peeled – sometime, not too long from now – there should be a post that someone’s coming home.

5 Comments

July 13, 2010

Photo Friendly

Many of you have asked about photos.

I try and put as many adorable pictures as possible in each post, but if that’s not enough, you can always check out the full photo feed over at Flickr.

There is also a link to the set located in the Links suggestions over in the right-hand column of this page.

Photos are updated in real-time as I download them from my camera. None of them have descriptions, but the photo file title will always include the theme, name of muppet involved and date taken.

Once the boys come home, we’ll break up the sets into specific events so you can see individual albums.

Please feel free to become my Flickr friend for other exciting (non-muppet related) album adventures.

2 Comments

Doctors Little Helpers

I have completely lost track of the days. I could not tell you what day of the week it is today nor whether it’s been three days or 30 since the last update. Six and a half weeks into this adventure, the boys are 34 weeks corrected gestational age.

The routine remains exactly the same day in and day out. The routine remains exactly the same day in and day out. The routine remains exactly the same day in and day out.

We park the car in the second or third row of the parking lot. I take off my sunglasses to put on my eyeglasses when we hit the crosswalk leading past the complementary valet and into the Lawrence Hospital Entrance. We walk through the first set of automatic doors and head straight for the second set to our right – you don’t need to slow down, they’ll open right as you think you’re about to smash into them. I immediately prep for the blast of cold air conditioning that cools the hallway. We enter in front of Ambulatory Surgery, pass a set of restrooms and cross one of the hospital’s lobbies. Next to the gift shop are three elevators; we take whichever one arrives first up to the third floor. We then head toward the NICU’s lavender awning located to the right of the elevator bank.

We greet the receptionist with a smile and “hello.” She unlocks the door and we enter, stopping to wash our hands at the sink right on the left. After scrubbing with soap to the length of Twinkle Twinkle Little Star we wind our way past the first door with it’s sign reminding us to be quiet because there are “Babies Developing. Shhhh.” In front of a kiddie table, we pick up the phone and dial Pod B. When one of the nurses answers, we say, “Hi, it’s Jon and Tricia Stream. We’re here to see our boys. Can we come in?”

The door opens and we squirt a shot of antimicrobial gel onto our hands. We greet the nurses as we rub in the gel while heading to the second and third beds (now one pedi-crib) on the left of the pod. I put my purse under their crib and ask, “How are my little guys today?” The nurse tells us they’re doing well. Jon and I set about taking the boys temperature. Destroy screams bloody murder; Search makes grumpy faces. Then it’s time to change diapers. Wipes are located above the pod sink, where we dampen them with lukewarm water. Diapers are stored in each kids respective corner. As we pick up the muppets to feed them their bottle, I ask the nurse what their weight is.

Harumph

We’re all ready to come home. The nurses warned us when Search and Destroy first arrived that time would likely mess with our emotions in this precise manner – although time passed by so quickly at first, it will start slowing down interminably as we approach our homecoming date. We are currently looking at 2-3 weeks more – but at this point, it’s all up to the boys.

Search and Destroy seem equally ready to come home. In fact, they have overheard us speaking about the three big criteria and decided to let the nurses know they’re ready. Destroy has made it his personal mission to permanently remove his nasal cannula. My poor little guy currently has a large red welt on his cheek because of his vigorous removal methods. I assumed that ripping the tape off his face would make him cry. It did not – he just gave us all a sly grin. Every time we swaddle him, we’ll see his little hands sneak out of his wrap and covertly grip at his wires.

“Well you said we couldn’t come home until we were off our oxygen tubes.” Destroy was just speeding that process along.

Search knows he needs to be taking all his meals from a bottle. So when I told him how proud of him I was because he was such a good eater, he took it upon himself to take out his feeding tube. “Look Mom, all done!”

They’re just trying to help out the doctors. And slowly, but surely, they are making great strides. It just seems like forever right now. Today, Nurse Jennifer let us know that we’ll likely see a huge difference between week 34 and 35. And Nurse June think they’ll likely graduate in about two weeks. (And Nurse June doesn’t take any backtalk from the boys. They WILL progress under her care. Period.)

Each day our routine remains the same. I just need to remember to take a step back and remind myself that we weren’t even supposed to have met the munchkins yet. They’re still tiny babies – even if they are rapidly approaching merely “small” as opposed to tiny.

Search

Destroy

7 Comments

July 11, 2010

NICU Sucks

My heart always skips a beat when I see the hospital’s number on the caller ID. So I held my breath a bit last night when the phone rang a couple hours after my afternoon visit with the muppets.

It was Nurse June. “I just had to let you know – Destroy finished another whole bottle!”

Regulating their own temperature. Check. Breathing without assistance? We’re working on it. Taking all feedings from a bottle? Major steps forward. As I mentioned before, Search’s been doing great; he eats all of his meals from his bottle. And now, something has finally clicked with Destroy. Previously, despite his sucking enthusiasm, Destroy had not quite grasped the concept of swallowing. He’d get confused at what to do next with his mouthful of milk and stop breathing while he tried to figure things out.

Nurse June put a note in the boys chart stating, “ALWAYS use the light blue nipple when feeding. Do not change nipples until specifically directed by their primary RN!” (Shockingly, June is their primary nurse.) We’d been having a lot of success with the light blue nipple. And the night before, Destroy had taken half a bottle using it.

Three days after moving in together, Destroy and Search are feeding like champs. There’s no scientific proof that the cobedding spurred the improvement, but I’m pretty sure the two had a conversation about the fastest ways to get the heck out of dodge.

There’s also the competition angle. They’ve been naturally competitive since birth (see Musical Maladies), but their morning nurses have begun adding fuel to the fire of sibling rivalry. Margaret is Search’s nurse; Ann is Destroy’s. Their nurses taunt each other over the twins development.

“Gee, my baby takes all his bottles.”
“My baby finishes his bottles without desatting.”
“I hope your baby doesn’t get too lonely when my baby goes home first.”

I’ve tried explaining that we do not need to be playing favorites, but I don’t discourage them too much since their tough love bickering seems to be spurring along the boys development.

Despite the blatant favoritism, Search and Destroy seem to have a great relationship with their nurses. (Of course, they’re so cute I naturally assume everyone falls madly in love with them.)

"Handsome Like Daddy" - The shirt says it all.

It must be an interesting dynamic – the longer they care for a baby, the more attached they become – the more they care, the more they want to get rid of the child. Nurse Margaret is going on vacation this week. When she said goodbye, she let me know with a bit of a guilty tone that she hopes her Search is still around when she gets back.

We’ll come back and visit, I promise. But don’t get too attached. We can’t wait to be rid of you either. Besides, thanks to the boys nurses, the NICU sucks. My self-regulated toasty little muppets are both downing more than an ounce every three hours.

And this time, when I say the NICU sucks – it’s a very very good thing.

Hi Search!

Hello Destroy!

5 Comments

July 8, 2010

Roommates

Search and Destroy moved out of their individual little plastic boxes and together into a pedi-crib bachelor pad today.

When we walked into the NICU this morning, the two 3.5 pound brothers were squirming around in their new digs. Even though the move doesn’t indicate any major change, it makes the muppets seem so much bigger to me.

And they’ve already clearly demonstrated their capability as mischief makers. I should have named them Fred and George (thank you Harry Potter fans who got that). Destroy greeted us with a major diaper blowout. Search bid us a fond farewell with the same. In between, Search demonstrated all the new faces he’d learned to refuse his bottle and Destroy shot milk out of his nose. The 10 a.m. feeding involves nasty smelling vitamins – I can only imagine how they taste. So Search refused to participate in any event that involved tasting the foul liquid. Brother Destroy, who isn’t quite taking a bottle, solved the issue by simply removing his own feeding tube.

The twins are learning to share their space much sooner than I ever had to share. I didn’t have to share my room until I moved away to college. My mom and Aunt J spent the summer before I left trying to convince me that I shouldn’t expect to be best friends with my roommate – I just needed to tolerate the situation for a year. My roommate’s mom thought she was nuts for noting that she had an interest in theatre on her living arrangement form – she was going get a nut to live with.

Once I got my roommate’s information, the two of us spent the summer emailing back and forth as we prepped for the big move. I think we were both scared of what it would be like when we were finally stuck together, but at least we had some idea of what to expect thanks to our exchanges. I still vividly remember standing in the hallway of the 11th floor of our dorm building. Face to face for the first time, I asked, “Are you Rebecca?” “Yes,” she replied hesitantly. “Are you Patricia?” As our parents drove away I stared after them wondering what I’d just gotten myself into.

Four years ago, I stood up for Becca at her wedding; three years ago, she stood up at mine. Last year her little girl was born and I traveled to meet my niece. This May, Becca traveled to visit me – spending a day in the hospital with me, where I was on bedrest with her nephews. (So, as you can extrapolate from this memory interlude, the roommate situation was just fine.)

When Jon and I said goodbye to our boys after today’s morning visit, our two little angels looked positively peaceful and content. I assume they were cavorting together in dreamland, conjuring new shenanigans to amuse themselves with.

Since they were ripped away from Mom and each other so early, I am confident that being together will help them to thrive. Although there is not currently any concrete research I have found on cobedding, the majority of studies find that it is a very positive experience for siblings. It is even standard preemie care practice in Europe (the U.S. is just now starting to catch on with regards to routine care). Rooming together can improve their rate of growth and development, stabilize heart and breathing rates and decrease their length of hospital stay.

3 Comments