Plumping Up!

Exciting News!

Danny and Sammy hit 2 pounds today!  Danny is up to 2 lbs 2oz, Sammy to 2 lbs even, and Elsie is almost there at 1 lb 14.5 oz.  Since it is normal to lose 20% of their birth weight initially, it feels like it has taken a while to get moving in the right direction. Now that they are, there is no stopping them!

We also notice now that they are getting bigger, they are getting stronger.  They are using their arms and legs to push themselves around the isolette, much to the demise of their nurses.  They want to go places their vent tubes don't reach, and they seem to forget those tubes are taped to their faces.  Today the boys got swaddled to decrease their activity, and though it worked, Sammy had a big pout face on the whole day about it.

Danny didn't seem to mind his at all...

Miss Elsie got to wear her first onesie today.  Nurse Kathy wanted to bundle her up to come out of the isolette and get held by Daddy.  This gives you an idea of how small they still are considering this is a preemie onesie.

On a side note, it appears that exhaustion has finally set in with Mommy.  Only sleeping in 2-3 hour chunks is worth it if it means providing milk for my babies, but apparently it also provides entertaining dreams. Two nights ago I had a dream that my pump was chasing me (it was more like a nightmare), and today while napping, half the cast of ER (circa 1992) was hanging out having lunch with me.  Can't wait to see what the rest of the week brings! :)

Looking forward to celebrating the 4 week old milestone this weekend!  

Danny using sign language to tell me he wants to eat 

Danny patting himself on his back 

Danny napping and holding his feeding tube with his toes

Elsie napping 

Apparently she is going to be a sleeper that sticks a leg out of the covers :)

Sammy napping with his binkie

This is the dramatic sleeping pose

Sammy covering his eyes from the sun

Changing of the guard

Women and Infants hospital is a teaching hospital,  and therefore every 4 weeks a new team comes in to provide care.  The team is made up of an attending Neonatologist, a fellow, and several residents and medical students.  Today we welcomed or new team led by Dr. Bliss. In our extended stay here at the NICU we will see 4 teams of doctors. 

The team talked strategy about how to get the boys off the vents.  They seem to be in a cycle of doing ok, so the doctors wean their vent settings to get them as low as possible before taking them off... then the next day they struggle so they bump their settings back up so they don't overexert their little lungs. .. then back to a good day,  etc...

The problem with this cycle is it requires a lot of heel sticks to get blood to measure their progress and the babies get purple heels after 3 or 4 sticks in a day :(   It also is very stressing on their little bodies to be constantly challenged to the point of collapse.  And since this cycle hasn't produced significant progress over the course of 2.5 weeks,  the doctors decided to keep the boys comfortable and focus on growing them.  The bigger they get,  the more mature their lungs get,  and the closer they will be to extubation.

So there won't be a lot to report for the next week or 2, but I promise to keep the updates coming even if they are just pics :)

Today's boards with current weights:

Daddy holding Danny

Sammy sprawling

Mommy with Danny and Daddy with Sammy

Elsie's new dance move 

Sammy trying to roll on his side

Danny mimmicking Sammy

Elsie taking an afternoon nap

3 WEEKS OLD!

Very exciting to hit another milestone!

Elsie continues to do well on the CPAP and it is great to be able to hear her when she cries.  Here is a little video of her with the hiccups.  Right now she is very soft spoken, but her voice will continue to find itself and get stronger in time (and I will not be posting videos of her cries then!)

The boys are still feeding and growing while we wait for their lungs to be mature enough to move off their vents.  Although there has been much talk about trying to extubate them this week, they do not show enough consistency in their breathing pattern to comfortably make the jump to CPAP.  So we are in a holding pattern with them while their bodies develop.

Here are some pics:

Sammy with his eyes open...doesn't happen often!

Daddy holding Danny

Elsie gets very alert every time you go near her isolette

Sammy back to his favorite napping position

Danny with a big yawn 

Elsie getting some tummy time 

Elsie watching Daddy intensely during care time

Daddy's Turn!

Big news of the day...Daddy got to hold Elsie!

Nurse Barbara making the transfer

First snuggles

One happy Daddy!

Hopefully today Miguel can hold the boys as well!  I am still enjoying lots of kangaroo care with the babies, which the nurses like to do for about 90 min at a time, so it feels the day flies by between care time and holding babies!  Almost like a normal day :)  And the babies are becoming more responsive and alert during holding times.

Danny with his eyes wide open during Mommy time - he kept trying to turn his head and look up

Elsie looking alert during kangaroo care

The other big news is that all babies are now at a full feed, so all of their PICC lines have come out!  The nurses put an added protein fortifier in my breast milk in hopes of bulking them up, so we are noticing even in the last 2 days a difference in their legs and faces.  

Now that they are on full feeds, they are acting like normal babies and getting fussy as feeding time approaches.

Mommy soothing Danny as he fusses close to care time

Elsie super relaxed right after feeding time

Every picture of Sammy is the same...sleeping.  He likes to eat, and he likes to sleep.  The boy knows what he wants.  Although he does fuss on and off throughout the day, it is usually when he is disturbed from this pattern of eating and sleeping :)

Sammy sleeping

A rare view of Sammy awake and opening his eyes!

And he is sleeping again...

This is his 'Shhh everyone, I am sleeping' look...

Looking forward to celebrating another milestone tomorrow with 3 weeks!

Elsie leads the charge!

Day 18 today!

So not a lot of variety in today's blog, the doctors still have the 2 main objectives of upping their breast milk intake and getting them off the ventilators.

We extubated Sammy on Monday, and he moved to CPAP, which means he has to do all the breathing on his own.  The mouth tube comes out, and is replaced with little oxygen nose tubes that provide oxygen support without breathing for him.  He tried hard for a solid 12 hours, but had to be reintubated late Monday night because he was getting pale in color from working so hard to breathe on his own.  Even though they told us it is very common for preemies to not be able to do it on the first try, it was a rough day for us emotionally when we had to see him struggle to breathe.  We will try Sammy again in a few days.

Danny is looking like he will get his chance off the tube later today or tomorrow.  He had a little pneumonia and they want to make sure he has full capacity before making him do all the extra work.  He is the fussiest of the crew, and so it is also important that he is ultra comfortable before this big transition.

And then there is Miss Elsie Mae...leaving the boys in the dust! (She knows this may be the only time in her life she has the advantage since there are two of them and she is taking charge!)  Elsie jumped to CPAP on Monday evening and is doing fantastic.  Breathing on her own, low oxygen settings, and resting comfortably with good color.  They have also upped her feedings and so her PICC line was taken out because she no longer needs additional IV nutrition now that she is tolerating a good amount of breast milk.  Without the vent tube and the IV line and all the wires associated she is looking naked and we love it!  She only has the body temperature sensor and the oxygen sensor now, which means easier transfer for skin to skin time :)

I have now gotten to hold all 3 babies, so in my eyes it's been a great few days.  This bonding time has also helped my postpartum and has almost doubled my milk production so it's a win win all around!

Here are a few pics...

Danny - VOGUE!

Danny with his eyes wide open 

Danny in his Blueberry hat!

Danny wrapped in his swaddling cocoon!

Mommy and Danny snuggling for the first time!

Big yawn for Elsie

My little flower hat

Mommy's first hold with Elsie

Cuddling with my Carrot hat on!

2 days in a row Sammy gets to snuggle Mommy!  Yaa!

Sammy likes to scoot down and throw his feet off the bed!

Or to pull his foot out of the covers :)

Look at Sammy's cool Apple hat!

Even when Sammy's locked down in the bed he manages to scoot down to hang his feet!