June 22, 2010

Musical Maladies

It was bound to happen. Search and Destroy are currently healthy, rosy, little cherubs. So guess who got sick. You guessed it – Mom.

I was at lunch yesterday, after my morning visit with the muppets, when the restaurant suddenly became as warm as the arctic circle during a cold spell. By the time I shivered my way home I had a fever of 101. Teeth chattering, I called the NICU to let them know I wouldn’t be in for the boys evening bath. (Destroy – this does not mean you’re off the hook for your soggy bottom photo.)

The nurses told me the boys were doing great and that I should get some rest and take care of myself to get all better. So I crawled/fell into bed – highly amused at the latest speed bump on this motherhood ride (which may have been slightly influenced by the fever).

But like the nurses told me, the boys were both doing great. The boys have been competitive with one another since birth. With both developments and setbacks, they tend to follow each other closely. During our care conference (meeting with the NICU doctor, nurses and social worker), the doctor began by reminding us that twins mature at different rates and not to expect them to follow the same timeline. With that, our nurses shared that Search and Destroy both weighed exactly 1,200 grams today. (Yay for chubby cheeked kids!)

Search - 25 Days

During my pregnancy, Destroy was labeled Baby A because he was expected to arrive first. At the last minute (literally), Search debuted before his brother. The two were even born during the same minute; they’re 30 seconds apart in age. Both received the same Apgar score of 5/8. (The Apgar test occurs right after a baby’s birth at 1 and 5 minutes. It’s meant to evaluate their initial condition.)

As their first few days passed, the two traded off between who needed oxygen or assistance breathing. At first, Search got extra aid because he was working to hard to breathe. Three days later, Destroy started having recurring apnea episodes. Not to be outdone, Search followed suit that weekend with both apnea and bradycardia episodes.

Destroy - 25 Days

Search figured out how to rip his nasal cannula out several weeks ago. And when he’s not doing that, he’s got a death grip on his feeding tube. Destroy apparently watched his brother; he has now learned the same skill. As Search practiced his army crawl tactics in his effort to inchworm out of the NICU, Destroy discovered how to turn his head. Yesterday, when I went to visit with Destroy, I discovered his nasal cannula firmly ensconced in his mouth. Nice try dude. Today, Jon asked the nurse why Search no longer had his feeding tube in. “Ask him. He’s the one who took it out,” replied the nurse. Both of them now smile when a nurse has to get up to turn off a false monitor alarm.

As I shared in the Momma Bear post, Search needed a blood transfusion because his hematocrit levels tanked. Quick reminder – a drop in such levels isn’t abnormal for premature babes. In fact, we were expecting the possibility of a transfusion since both boys were slowly dropping. Search just wanted to be a showoff. Search got his blood last Wednesday. Demanding the same VIP treatment as his brother, Destroy received his transfusion on Sunday. Although his levels didn’t drop as quickly, Destroy planned ahead and received Dad’s blood. (You know, with all this talk about blood, perhaps I was subconsciously foreshadowing their needs with my Little Shop of Horrors reference.)

Both love their food. Search reached his full-feed levels before Destroy. But Destroy started taking an extra mL than his brother shortly thereafter. (Full-feed for their current size is 20mL and 24 calories per serving.) For added measure, Destroy also upped his caloric intake to 26 calories. Search matched his brother at 26 calories, but he hasn’t needed that extra mL yet.

All the eating is key to growing big and strong. One of the first questions we ask every morning is “How is their weight today?” Both have reached the upward trend we’ve been waiting for. Yet, there have still been a couple drops – usually of around 10-15 grams. Interestingly enough, the gains and losses seem to continuously equal each other out. Current score: 1,200 g all.

I bought them “The Hungry Caterpillar” today. Besides the fact that is precisely what Search looks like when he’s on the move, I feel it’s an appropriate theme for our muppets. The caterpillar eats and eats and eats and sleeps and emerges as a beautiful butterfly. Our boys will eat and eat and eat and sleep and emerge from the NICU. From their start as our little men to their lives as our big boys. Thank goodness Costco (and corresponding diapers, snack food, etc.) is on my way home from work.

And let’s play a new game. Who can be the healthiest? Winner gets to not be sick.

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June 20, 2010

Fathers Day

Happy Fathers Day. Normally, I’m not a big fan of Hallmark holidays, but this is Jon’s first Fathers Day. And what a ride it’s been. So, HAPPY FATHERS DAY JON!!!

I’ve always known Jon would make a phenomenal father. Ne’er an animal or child have I met that hasn’t instantly been taken with Jon. It’s pretty amazing to think how crazy the journey to fatherhood has been – and we’ve only had the muppets in our world for three weeks.

At the very start of this muppet caper Jon brought home an adorable little black dress for me. It was my first piece of maternity wear. “You can wear it to your shower,” he stated proudly. I’ve gotten to wear it once.

Jon sat next to me at the doctor’s office, mouth agape, when we first heard the babies heart beats. He sat stoically as we realized they were plural – a pair of babies.

During the first trimester, he tried to cook non-arf inducing foods. He never complained as he took away a dish on Friday that I’d loved on Tuesday. He stayed in on his 30th birthday because even the thought of a restaurant made me arf a little bit.

Jon was with me at 16 weeks when we learned we were having two boys. He took that afternoon and discovered the names for our boys.

He made it to the hospital in five minutes flat at 22 weeks when I was admitted to Labor & Delivery. He sat with me as the doctor refused to give us good news. He shuttled back and forth from home to the hospital during the next six weeks – spending mornings and afternoons with me and taking care of our home during the evenings.

Jon sat awake all night on May 27 in an uncomfortable chair. He apologized to the nurses when I had a mild tantrum over the accessibility of water. He was by my side while I informed him that I did not like the contractions at all. He was the first to post on Facebook that we were about to meet the muppets when the doctors started prepping the OR.

He was the first to meet them after the whirlwind surgery circus. And he wheeled me over to meet them the next day.

I’ve seen him smile with a little man in his arms. And I couldn’t agree more with Jon’s assessment that “they’re pretty much the neatest things I’ve ever seen.”

To all those first time Fathers Day fathers – may your kiddos bring you all the joy in the world (and a decreasing level of stress as they grow).

  • The Catalano’s and little Jackson
  • The Cooperman’s and little Molly and Wyatt (Twins Rule!)
  • The Dersom’s and little Emmarie
  • The Francesconi’s and little Leila
  • The Schulman’s and little Luke
  • The Wright’s and little Jason
  • All our fellow NICU parents – whoever you are we’re with you in hoping your babes grow up big and strong.

And these are just the little ones I know about.

To Grandpa Gary – for giving me the father of my children.

To Grandpa Gustavo – for decorating the house in pink streamers and blasting “Thank Heavens for Little Girls” when I was born, for putting up with me during my teenage years, for lasting no more than 15 seconds before bursting into tears when I call to tell you about your grandsons.

To Jon – here’s to our family. You were born to play this game.

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June 18, 2010

Mama Bear

A mother bear with her cubs is in her most aggressive state. Mother bears are dedicated to protecting their cubs and will attack if necessary.

I once played a mama bear. Literally. It was for a children’s theatre program during my junior year of college. Do you know what a 19 year old knows about the devotion of a mother to her cubs? In my case – absolutely nothing. I couldn’t even keep fish alive at that age. (Ok, I still can’t keep fish alive. But I’ve done well with reptiles and mammals since then.) It obviously wasn’t a very inspired performance…

Years before that performance, my high school self was in Lake Arrowhead (home of the infamous Blue Jay incident) with a friend. We peered down on my mother handling a “misunderstanding” with an unfortunate deliveryman. “Never mess with a mom,” my friend sagely stated. Now I understand what she meant.

The doctor called me yesterday morning, asking me to call him back as soon as possible (finishing his message with a quick statement that the boys were fine). I walked into the NICU three minutes later. Search needed a blood transfusion.

His hematocrit levels had tanked. Hematocrits are the proportion of blood volume that is occupied by red blood cells, delivering oxygen to the body. A drop in levels isn’t abnormal for premature babes, but the significance of Search’s drop was. The doctor didn’t know what had caused it. They needed to do additional labs and cultures to find out if he had hematosis (something destroying the red blood cells), an infection or some other rare disease causing a deficiency.

They drew a large amount of blood to test. They hooked Search up to an IV to give him a bag of O- blood. They injected him with antibiotics to stem any possible infection. They inserted a catheter to get a sample for a urine culture. They performed an ultrasound on his brain to check for any bleeding. His arm was wrapped in a sterile gauze arm board to prevent any kinks in the IV. Through it all, they poked and prodded him, kept him awake and generally stressed him out.

And through it all, I couldn’t hold him. I couldn’t soothe him and tell him everything was going to be okay. Because of all the medical stimulation, it was best to leave him alone in his isolette. Because his temperature had dropped, we couldn’t open the doors of his isolette to hold his hand.

And that hurt the most.

I didn’t like giving up control during my pregnancy, not knowing what was happening next. But I absolutely hate feeling like I can’t protect my baby. Why can’t I simply fix it? Why should he have to suffer?

I sat beside him. Just staring into the isolette. Telling him I was there. Letting him know everything would be okay. Praying he could hear my voice through the sterile plastic walls. Needing him to know that he wasn’t isolated in the isolette. Willing my wrath upon any germ, bacteria, virus or medical malady unknown to me that dare threaten my child.

I returned to the NICU this morning. Search was doing great; his numbers had gone up where they should rise and dropped where we wanted decreases. We still don’t know why his hematocrits dropped so suddenly, but the doctor assured me he was healthy as he scooted around, pink and plump, in his isolette.

I held him just to be sure. And like a mama bear, I will do everything I can to protect him. Against all villains no matter how large or small.

And you know what? This evening after his bath, my little man opened his eyes wide and smiled at me. A real smile. Then he fell asleep – soundly, securely and safely.

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June 17, 2010

Soggy Bottom Boys

Pee Pee Teepee

My son christened me into the world of moms with boys today. He peed on me. (Oh, I am a mom of constant sorrow…)

I’d heard tales of such things before, laughed at them. There is even an available item out there called a “pee pee teepee – a must have diapering accessory for newborn boys.” (Yes, that pattern is indeed a wiener dog.) Continue reading →

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Rubber Ducky You’re the One

Well, let’s be serious – obviously no actual rubber duckies were involved. They’re about the same size as our pint-sized water baby.

Search had a bath earlier this week. This wasn’t his first foray into the suds, but it was the first such adventure with Mom and Dad. He is one slippery little dude. But it is clear that he is a fan of the water. Someday I bet it will only take one parent to bathe the baby, but for now it takes two (and the added advice from the nurse).

First, you wash the babies hair. My babies have lots of hair – enough to visibly have bed head. I have never seen Search looking so relaxed. He remained calm and cozy in his blanket while we massaged his little head. His body language clearly expressing the thought, “Yes, they all cater to ME.”

They all cater to ME

After ensuring the quality of his luxurious locks, we lowered the little man into his tub. Ever the fan of his food, he assisted by holding tightly to his feeding tube. One of us held the slippery squirmer as best we could and the other applied soap and water. I have no doubt that as he gets older, splashing will be de rigueur when it comes to bath time.

We did have to endure a bit of screaming. At first I thought he was scared or getting too much stimulation. But one of the bath rituals in the NICU involves removing the sensors. Since they’re attached with stickers, I imagine this part of tub time is a lot like having multiple band-aids ripped off. Yeah, I’d be cranky too.

Search – I apologize now. I’m sure you will be less than thrilled with these photos when you’re older. And I promise to take photos of Destroy’s first bath with Mom and Dad as well. Because who in the world could resist such precious soggy bottom boys.

During his prior dunking, the never satisfied to be still Search, gripped the sides of his tub so tightly that his nurse had a dickens of a time prying him loose. He then attempted to stand up. Search’s aqua affinity from his bathing adventures present three possibilities: (1) You are currently reading about the next Michael Phelps, (2) Search feels his crawling efforts are beneath him and it’s time to walk or (3) how difficult could it really be to walk on water?

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June 16, 2010

Red Light, Green Light

We bought a new car today. And with a heavy heart, I said goodbye to my trusty 1998 Honda Accord.

Farewell Friend

Sadly, this new car process turned out to be an all day event (broken up by our visits to the boys, of course) so today’s originally scheduled blog post has been postponed until tomorrow. But don’t fret – now you also get to look forward to reading about the whole new car back-story.

PS. I now drive a 2011 white Honda Pilot. Yes, I’m an SUV mom now… In my defense, I do have two kids.

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June 14, 2010

The Big 3-0

Jon hit it in February. I’m rushing toward it in November. But today, it’s all about the twins. The big 3-0. Search and Destroy are 30 weeks along today. Even though they’re only two weeks old, they’re considered 30 weeks since preemies have an adjusted age based on their expected due date.

Both show extreme spirit, so if all continues along this path health-wise we hope to have them home in about six weeks. This morning Destroy was sleeping soundly on his tummy when the doctor came to examine him. Much to Destroy’s dismay, the doc put him back on his back. Destroy proceeded to squirm and fidget up the side of his bunting to return to his tummy. His half cries/squeaks clearly stated, “Put me back the way you found me!”

In contrast, his brother is working to perfect his little angel eyes. During Kangaroo time, Search likes to pull his head back and look up at us. It’s sweet, but it also correlates to a drop in his heart rate so we discourage it. Today when I went to turn his head, he looked up at me – eyes wide open and both tiny hands tucked under his chin – with a perfect “I could never do anything wrong” expression. Apparently, no one told our little inchworm Search (who decided to celebrate today by bringing his weight up to 1,030 grams) that he’s still too young to leave the NICU.

Search has also progressed from merely scootching his little tushy straight up in the air to adding an arched back and pressing himself forward. He is developing quite a repertoire, what with the previously acquired tube-ripping-out talent. Naturally, he still can’t crawl (though he’s sure trying) so he has turned himself into the Hungry Caterpillar. At this rate, I highly doubt he’ll be all that far behind his peers in the mobility category.

Both boys continue to tolerate their feedings extremely well. Out of all the wires they keep trying to rip out, the one they don’t seem to mind is the feeding tube. Instead of pouting and pulling at it, they simply lovely wrap their little fingers around the feeding tube and hold on tightly. I am envisioning many future trips to Costco with two growing boys in the house. Rumor has it bottle feeding may be as soon as two weeks away.

Luckily, we seem to be trending upward in size. We’ve been expecting their weight to start rising since they’re doing so well with their food. (Well, the nutrients they retain and don’t poop out.) As I mentioned, Search has plumped up to 1,030 grams and Destroy is up to 1,055 (about 2.3 pounds each).

All these feedings bring us right back around to pooping. The twins also excel at pottying. (Oh, are they going to love me for this blog when they’re older.) Regularity shows the nurses and doctors that their little gastrointestinal tracts are functioning properly. Both my little men are in big boy diapers. At first I worried that their gastrointestinal tracts were functioning too well – I thought they might never gain weight based on the not-so-little gifts wrapped so nicely in the aforementioned big boy diapers.

Yesterday, I changed Search’s diaper after I held him – he was quite wet. The nurse suggested we turn him onto his tummy to tuck him in for the night. (Both Search and Destroy love sleeping on their tummies and can do so because of the 24/7 monitoring in the NICU.) In the few seconds it took me to flip the little squirmer, his diaper was fully soiled. And I do mean that literally. His diaper was full – practically soaked through the outside. The nurse took one whiff, smiled and said, “That’s all you mom.”

Jon and I are getting quite good at diaper changing. But the boys are also getting more creative. When changing Destroy’s wet diaper yesterday, I put a new diaper under him and picked up the wipes. When I looked back, his bed bunting was soaked. Not just one small area – the entire bunting was a misty yellow. The fresh diaper, on the other hand, completely bone dry. Little Destroy had managed to pee out the side of his diaper. Medical professionals say they’re too young for emotions and that it’s likely just gas – but I still say Destroy smiled. He seemed pretty pleased with the mess he made.

It’s still rough – being in parenting limbo. But with each day, I’m starting to feel more like a parent. We’ve got our routine down and I’m learning the boys signs (like an apnea episode is a pretty clear sign that someone needs their diaper changed). Both are opening their eyes a lot more. And even if they can still only see hazy shapes, it’s heartwarming to think they’re looking to see that their parents are visiting.

Although, Search may also be looking to find the best escape route…

Search: 30 Weeks

Destroy: 30 Weeks

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June 12, 2010

Postpartum Pounds

Every morning I get up and get ready for the day. These days each morning is spent preparing to visit the muppets. And it’s getting harder and harder to decide what to wear.

I’m certainly not trying to get dressed up for them. Just trying to find clothes that fit. I have reached that very awkward size stage where maternity clothes are too large but I can’t yet squeeze back into my pre-partum pants. Sad really – because the boys haven’t even reached the developmental stage of spit-up yet.

Even though I gave birth to twins, I only gained 20 pounds (ignoring the hormonal weight gained prior to pregnancy). This is largely attributed to my distinct lack of a third trimester, which I’ve heard is where mom and babies spend three months accumulating fat.

In the two weeks since Search and Destroy’s arrival, I’ve lost my little pregnancy tummy. The weight appears to have migrated elsewhere on my body. All for the betterment of my boys… As we wait for them to grow up big and strong, I am allowed to walk.

Being mobile again is wonderful! After six weeks on bedrest, getting going again was more difficult than I anticipated. I have now accepted that the 2010 Nike Women’s Marathon is not in my future. Given their isolette attitudes, I’m sure I’ll be running the equivalent of ultra-marathons once the boys are home and mobile. Initially, I got lightheaded walking from the hospital entrance to the NICU. But that’s where my boys are – so to the NICU go I.

Today I thought I’d attempt a walk around the block. But then I decided that a walk in 90 degree weather might not be the best decision. I had a nectarine instead. (Oh, McDonald’s, how I’ll miss thee – but my allegiance now lies with Old MacDonald and his farm.)

Many people ask how I’m doing. My standard answer is “worried about the boys.” My attitude generally correlates with the twins’ daily prognosis. It’s a good thing they’re doing well. How am I doing physically? Fine, I suppose. To be honest, I never really paid attention to the whole physical aspect of the surgery. I had over four pounds of other concern.

So aside from looking a little funny in my pants these days, I’m doing great. As I’ve mentioned before, the boys are little fighters. And with that – I’m off to pump and visit the NICU. Someday I’ll be back to the size you all remember. Until then, two little men are awaiting my appearance…

My Little Man Search

My Little Man Destroy

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June 11, 2010

Two Weeks

It’s been two weeks since the twins arrived. The time has passed by in the blink of an eye and taken forever at the same time. No, you’re not experiencing déjà vu – this is just how the One Week post began. It still holds true.

Search and Destroy have now been residents of the NICU for the same length of time as my final hospital stay with them. Overall, they are doing really well. There continue to be some of the ups and downs we were warned about, but they don’t get any easier.

Search: Two weeks

Search is very ready to be a big boy. He remains our little mover – scooting around his isolette and practicing pushups. He has taken to arching his back to take a good look at us when we hold him. As Dr. Yuri pointed out, “he has a genetic disposition to make sure everyone is clear about how he feels.” Stubborn and spirited, his brother may be taking cues from him. Unfortunately, this week that meant breathing issues.

Destroy: Two weeks

Destroy has been dealing with a lot of apnea of prematurity this week. This is the medical term that means our baby has stopped breathing. Based on my vast quantities of medical knowledge – gleaned entirely from seasons of ER, Grey’s Anatomy and Private Practice – I know that after they make their grand world entrance, babies must breathe continuously to get oxygen. But in our little dudes (since they’re younger than 34 weeks) the part of the brain that controls breathing is not mature enough to remember nonstop breathing is required.

Neither the doctors nor any of the nurses seem to think this is a big deal. Every day they reassure us that he’ll grow out of it. I am beginning to believe them based on his behavior when he is not thoroughly chilling out. In order to give him a little extra oomph, he gets a bit of extra air encouragement. This week, due to an increase in episodes, Destroy got socked with the CPAP.

As noted in the NICU 101 post, the CPAP uses small tubes fitted into Destroy’s nostrils to push a continuous flow of air to help keep tiny air passages in his lungs open. It is usually secured to his head by a ridiculous looking sock hood. Destroy does not like the CPAP. At all. Even a little. In fact, I would venture to state that Destroy hates the CPAP.

Yesterday, it took two nurses to hold the little two-pounder down while the respiratory therapist fitted Destroy with the contraption. According to his nurse, with wax-on wax-off karate kid-like strength, Destroy fought with all of his being to keep the blasted thing off. Yes little man, you are indeed your mother’s son (see Missing: My Sense of Humor post).

Mom and Destroy

Today, he’s back on the nasal cannula. The doctor pointed out he just seems much happier. And by happier, I’m pretty sure she means “not ripping tubes from his nose while howling at the nurses.” When I held him this afternoon, he seemed very content. We have also begun noticing a pattern that many of the apnic episodes occur as Destroy poops. A multi-tasker he is not – of course, given the size of said poops, I suppose his forgetfulness is understandable.

Dad and Search

Since they’re now tolerating full feedings and consuming a whopping 127 calories per day, they are expected to start gaining weight soon (provided they don’t poop out all potential gain). I am more than ready for my little muppets to get bigger. As hard as it is to picture, they’ll allegedly gain more than three pounds over the next month. How funny that we’re excited to see chubby five-pound babies.

In any case, I know there will be many more frustrating phases to deal with. Both now in the NICU and throughout their lives. Gramma J – you got your wish. I have two sons just like me. And I couldn’t be more in love with the stubborn and spirited little men.

Stream Two Week Family Photo

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June 9, 2010

What’s in a Name?

The neonatologists at Kaiser’s NICU are all fabulous. They are dedicated to making sure our little ones are getting the best care. They always take the time to stop and talk about the boys progress when they see us – despite having a specialty focused on little tiny babies who can’t talk back.

Search and Destroy’s doctors always seem to be in a good mood when they come to check out the twins. Naturally, they must be smiling because of how well the twins are doing and how special they are.

Mostly, I’m impressed with their ability to communicate with super stressed out parents. And for the past week and a half, they have continuously reassured us that, even though watching our sons struggle, they are doing well and will eventually outgrow their allegedly minor issues. (Breathing still seems to be a relatively major issue in my book – but I’m not a tiny baby specialist.)

Throughout it all, the doctors have kept their sense of humor. After each test, our current attending physician Dr. Yuri Knauer will explain what they’ve just looked at and what it means. Last Friday, after a standard brain ultrasound, Dr. Knauer nonchalantly started washing his hands, looked over his shoulder and asked, “So has anyone given you the good news about the brain scans yet?” And each day, Dr. Knauer has ended our conversation with, “So, nothing to worry about. They’re just still tiny.” He’s always smiling – positive and reassuring even when the info doesn’t sound good to me at all.

When Search and Destroy were two days old, we met Dr. McOmber. Again with the smiles, he inquired if the boys had names other than “Stream, Male Twin A” and the equally original “Stream, Male Twin B.” I was more than happy to educate him. After having kept the twins names a secret for so long, I felt everyone should know the NICU’s newest star residents by name.

Gesturing to the little man I was visiting with, I introduced “Stream, Male Twin B” as our little Destroy. Dr. McOmber paused. Then with a giant goofy grin, he pointed to his nametag saying, “Heyyyyy, that’s MY name!” I was pleased; added incentive to make sure his namesake patient thrived.

Yesterday, Dr. Yuri was giving his daily report to Dr. Destroy as the NICU transitioned from the day shift over to night. Dr. Yuri started to explain how Destroy was doing. Then he stopped. With a slow turn and sly grin he peered over at Dr. Destroy. “Did you have something to do with his name?”

Dr. Destroy very rightly noted that the shared name is awesome. Which is, unsurprisingly enough, precisely why we picked it. Jon joked that Destroy probably isn’t the most popular name in Dr. Yuri’s native Russia. “Only girly boys,” retorted the doctor.

Which was pretty funny considering he followed that statement up by letting us know that Yuri is quite popular in Russia – it’s a form of George, meaning farmer. But apparently, Yuri is also quite popular in Japan. It’s a girl’s name there, meaning lily.

In that short exchange, the doctors got Jon and I smiling and feeling quite at ease. It certainly helped that Dr. Yuri finished his report, concluding, “So, no big deal – they’re easy boys.”

Search, the burrito baby

Destroy (with a CPAP)

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