Tuesday, September 30, 2008

Gabrielle's PICC Line is Out!

We are so relieved. Thanks for all of the prayers, good vibes and crossed fingers.

We got a great report on both girls tonight. The neonatologist is really happy with how well they're eating -- she said most babies are a lot bigger when they eat as well as Gabrielle and Alaina do. It's probably because DH tells them they're getting chicken fingers and Snickers....

A Ride on the Roller Coaster

Since the day the Gabrielle and Alaina were born, the doctors and nurses in the NICU have been telling us to be prepared for a roller coaster ride while the girls are there, meaning that there will be lots of highs and lows along the way. Luckily, we've had mostly highs so far and everyone is overjoyed by their progress, but yesterday we got our first taste of a low.

I went in for my morning visit expecting both Gabrielle and Alaina to be PICC line free and hoping I'd get the chance to hold them. Sure enough, Alaina's PICC line had come out and she was obviously enjoying having her arm free. But Gaby's line was still in. After we left Sunday night, she threw up her 6 o'clock feeding. One of the biggest risks the girls face right now is a condition called Necrotizing Enterocolitis (NEC), which is a gastrointestinal disease where infection or inflammation can cause damage to, or even the destruction of, their intestines. If the girls don't keep their feedings down, the doctors' main concern is making sure NEC isn't the reason why. After she got sick, Gaby's next four feedings were held until X-rays could be taken of her belly to make sure she didn't have NEC. The good news is by the time I arrived at 11:00 yesterday, they had ruled it out and started her feedings again with 10 cc's of milk, but now she has to tolerate 15 cc's again before the PICC line can come out. Even though this was a really small setback, it was still draining.

Jan and I went for our night visit and were happy to hear that Gaby had done well with her feedings and was up to 12 cc's, and the doctor was confident that her PICC line would come out overnight. But we had a new issue to deal with -- Alaina had thrown up her 3:00 feed and the X-ray technician was on his way down so they could check her for NEC. We watched as our little 2 pound baby was X-rayed and waited for the results to come back. During the wait, the doctor showed us Gabrielle's X-rays from earlier in the day. It turned out that the reason she had gotten sick was that her O.G. didn't go all the way down to her stomach so when she was being fed, the food couldn't make it where it needed to go. It wasn't her fault she had gotten sick and there wasn't anything wrong with her -- her feeding tube just wasn't in properly. She missed four feedings and her PICC line was still in because of something silly like that. Poor baby!

A few minutes later, Alaina's films came back and lo and behold -- her O.G. wasn't in her stomach either! Our girls love to pull at their wires and tubing (I had seen Alaina pull her O.G. almost all of the way out of her mouth earlier in the day) and now that they've both had vomiting incidents from the O.G. not being in place, I'm sure the nurses will be checking them much more closely from here on out.

So that was our day yesterday. In the end, both Gabrielle and Alaina were fine but the fear that comes along with any little setback, even something as simple as vomiting, is tortuous. The roller coaster analogy is right on.

One perk that came out of the crazy day was that little Alaina needed to be cleaned up while we were there and we got to see her pretty little face without all of the tubes and tape she normally has on. Here are some pictures:

Thursday, September 25, 2008

Diapers & Feedings & Temperatures, Oh My!

During our visits yesterday, DH and I got to change the girls' diapers, feed them and take their temperatures for the first time. I know, this probably doesn't sound like a big deal, but when your babies are in the NICU and you can't do "normal" parental tasks, even the littlest things are milestones.

The girls still have their central lines in so we can't pick them up, but when I went for my afternoon visit, Gaby's nurse decided that she was stable enough for me to help with her care (each of the girls has a different nurse and some let the parents be more hands on than others). First, I changed her tiny little diaper. The NICU has preemie sized diapers for the girls but even those are too big on them right now. We're going to take a few of them home with us for their baby books so when they're older, they'll see just how little they were. Next, I helped take her temperature, which was perfect, and then I got to give her her milk. She drank all of it and then proceeded to wail for the next five minutes until we put her back on her tummy with her pacifier which finally lulled her to sleep. When DH and I went to visit the girls later that evening, I took care of Gabrielle again and daddy got to feed Miss Alaina. It was a great day.

We also got really good reports on their feedings. Gabrielle is getting 5 cc's of milk a day and Alaina is getting 4. They've been tolerating the milk really well and if they continue to keep it down, they'll get 1 cc raises every 12 hours. That would mean they could have their PIC lines removed in the next week or two and we'll finally be able to hold our little ones! Keep your fingers crossed.

Tuesday, September 23, 2008

Tummy time all around

When we went to visit the girls yesterday, both were lounging on their tummies. It's so cute to see them in this position! And they seem to love it. This is the calmest Alaina's been -- she's usually flailing her legs all over the place -- but tummy time agrees with her.

Gabrielle got to spend her second day on her tummy and did her best Maggie Simpson impression by sucking on her little pacifier:

Gaby's nurse shut her phototherapy lights off for a bit so we could peek at her with her eye coverings off. Her little face is so sweet!

We got great updates on both girls yesterday. They're both being fed milk through the tubes they have in their mouths. If they were still in the womb, they would be swallowing amniotic fluid which would kick start their digestive systems so the goal is to do the same with the milk now. They started out getting 1 cc of milk at each feeding and each time they keep it down, their feeding amount gets increased. Last night, Gabrielle was getting 3 cc's and Alaina was getting 2. Once they can tolerate enough milk at each feeding, the lines the have in their arms, which give them supplemental feedings, can come out. When those lines are removed, we'll be able to hold the girls outside of their Isolettes. Since they were taken straight to the NICU after they were delivered, we haven't been able to do more than touch them in the Isolettes yet. So keep up the eating, little ones. We can't wait for the day we'll be able to hold you in our arms!

Monday, September 22, 2008

Gabrielle & Alaina's Birth Announcement

With the girls in the NICU, I need something to occupy my time in between visits and I've been reading so many posts about Scrapblog that I decided to give it a try.

We started telling people about the girls late last week once their progress reports kept comng back positive but there was no way we could call everybody so I figured I'd try to create a birth announcment we could send out. Here are the three pages I put together and when I e-mailed the link to our friends and family, they played to the tune of Twinkle Twinkle Little Star. I'm pretty happy with the result if I do say so myself!

Project Nursery Part Deux

Now that the girls are here, we're making more progress on the nursery. I have to catch up on taking photos of the new additions to the room but here were the next steps we tackled.

Once the closet was done, we moved on to the flooring. My vision for the nursery was to create a room that's bright, cheerful and modern. It took me forever to find the perfect carpet (DH was appalled by how many samples I ordered!) but once I saw these floor tiles, I knew we'd found the winner.

The floor tiles are from Flor and they are terrific. We have them in different colors and styles throughout our apartment -- in the entryway, the dining room and the office -- and they're perfect for children since if one gets dirty, we can just replace that tile with another. The style I chose for the nursery is Toy Poodle and we got them in canary, fuschia, teal, lime, orange and lilac.

Here's our four-legged child, Fiona, helping us lay the tiles:

After we got the flooring done, the cribs arrived. We chose the Oeuf Classic cribs for the girls and ordered them from Buy Buy Baby with their multiple discount and using a coupon. I've loved this modern style for a while and they convert into the cutest toddler beds.

And of course Fiona had to check to make sure they were sturdy enough for the girls.

So that's the latest from Project Nursery. I'll post our new dresser and the fabrics for the bedding later this week. We're working hard to get it finished so everything will be ready when Gabrielle and Alaina get to come home!

Oh, and one more note. I'm planning to put a quote on the wall above the cribs. I've listed three options in my blog poll but for some odd reason, I can't get them to show the whole quotes so I'm going to list them here:

1. Of all the stars we wished upon, the brightest one has brought us you.

2. We had each other and then we had you and now we have everything.

3. Precious ones, so small and sweet, dancing in on angels' feet, straight from heaven's brightest star, what miracles you truly are.

Please cast a vote!

Sunday, September 21, 2008

Gabrielle & Alaina are one week old!

Yesterday was the girls' one week birthday and they had a wonderful day. Alaina kept her milk down for the first time and we got to turn off her phototherapy lights for a bit and see her little eyes open. Gabrielle had her first taste of tummy time in her Isolette and spent the day sucking on her purple pacifier. It's so funny to see them developing their own personalities even at this young age. Alaina is the dramatic one, which shouldn't really surprise us considering she spent so much time kicking her sister in the head while they were in the womb. She cries whenever her diaper is dirty and once it's changed, immediately poops or pees and cries for it to be changed again. Meanwhile, Gaby is totally chill and happy to kick back and relax. Both girls are doing so well that it's hard to believe that just a week ago we had no idea whether they'd even make it.

I had my own milestone yesterday when I FINALLY saw some milk after pumping. I was starting to think that after 7 days and no results that I might not have any milk supply, but I woke up yesterday with some drops on my nipples. Sure enough, my first pump of the day was a good one and the rest weren't bad either. DH was so cute -- he was cheering my boobs on every time I pumped, and we were so excited to bring the milk with us to the NICU. Knowing that the girls were starting to get milk was hard when I wasn't producing any so I was so relieved that things seemed to finally be working. But by nighttime, my supply was waning again and so far today, I've had little to nothing. A good friend of mine is an LC and she said that even though the Medela PIS is the best pump you can buy, with preemies I should really be renting a hospital grade pump. So that's our plan for tomorrow -- trying to rent a Medela Symphony so that I can hopefully get my milk flowing again.

Wednesday, September 17, 2008

I'm a Mommy!

Yes, you read that right. The girls arrived at 27 weeks and 4 days. We had no signs that they were coming early and yet here I am, less than a week later, a mommy. Life works in mysterious ways.

Let's rewind to Friday, September 12th. I'd been having some back pain in the days before but nothing that seemed out of the ordinary for a pregnant lady. DH and I spent that night at Newborn CPR class. At one point, when we were talking about car seats and the instructor made a joke that DH and I should get ours installed sooner rather than later because we might be delivering soon, we laughed, having no idea what was in store for us later that night. After class, we grabbed some McDonald's for dinner (which DH insists is what started everything!), watched some TV and went to bed by 10:00 which was pretty typical for me and my big belly. At around 10:30, I woke up feeling like I'd peed. This sensation wasn't all that surprising since I've been feeling leaky, for lack of a better word, for weeks now, but something about it worried me. I headed into the bathroom and the water continued to flow. After a few minutes, I called DH in and we paged my OB. By the time he called back, the water was pink tinged and we got dressed and headed to L&D. There didn’t seem to be any cabs coming so our doorman, who was heading home after his shift, drove us. With the night starting off like something out of a bad sitcom with the doorman rushing us off to the hospital, I should have known more craziness was coming!

We walked into L&D a little after 11:00 pm having a sense of déjà vu since we had just taken our hospital tour the weekend before. Luckily, we had also submitted all of our pre-admission papers that day so that was all taken care of. They checked me in, got me changed and immediately took an ultrasound which showed that Baby A's water was broken and she didn't have much fluid left. Baby B was looking fine and the residents assured me that the fact I wasn't having contractions was good and that we should be able to hold off labor. I got a huge and painful steroid shot after that for the girls' lungs and they started magnesium to keep labor at bay. Afterwards, the nurse asked me was what my birth plan was. I had been joking for weeks with friends that my birth plan was drugs, drugs and more drugs so I told her my only request was an epidural and that the rest was up to my doctors. Famous last words…

My OB arrived and reiterated what we had been hearing -- that we would do everything we could to hold off labor while administering steroid shots to make sure the girls’ lungs were as mature as possible when we finally delivered. He said it could be hours, days or even weeks but seemed confident enough that it would be more than hours to have me transferred into a room with a window. Quite a few mommies on my pregnancy boards had been on hospital bed rest after their water broke, so the idea of being there for a few days or weeks didn’t seems that implausible. I figured I’d be able to relax and catch up on some of my soap operas. How bad could it be?

At this point, DH and I had to laugh a little about where we were. Our plans for the weekend had included packing my hospital bag (I figured I’d have it done really early!), finishing the baby shower thank you’s (if we still owe you one, it’s coming, I swear!) and finally picking names for the girls. Considering what was going on, we decided it made sense to make a choice. So after weeks of debate, we picked names in less than five minutes. I guess sometimes you just need to focus!

Around 2:00 am, I started feeling terrible pains in my back. As I mentioned before, I had been having back pain for about a week – I’d actually just started wearing a maternity belt contraption that day hoping it would help – but this was different. The nurse confirmed that what I was feeling were contractions and said not to worry. By 2:30, they were coming less than five minutes apart and I was in excruciating pain. She told me to breathe through them and most importantly not to push. Here was the thing – I had no idea how to breathe! DH and I hadn’t taken childbirth classes (it was way too early and honestly, we were so sure the girls would arrive via c-section that learning breathing techniques was never high on our list of priorities). I have no pain tolerance whatsoever – I’m not kidding, I cannot stand any sort of discomfort – so the contractions were pushing me over the edge. DH was amazing at keeping me focused and breathing considering I was writhing off the table and desperately trying to pull my oxygen mask off. I was squeezing his hand as hard as possible like I had seen people do in movies but even that wasn’t making me feel better. I could feel tons of pressure in my groin so I had my legs crossed as tightly as possible to make sure I wasn’t pushing but I was sure something was coming. The doctors hadn’t checked to see if I was dilated any earlier because with Baby A’s water broken, they were concerned about introducing germs into the birth canal, but now they decided they had to look based on the frequency of the contractions. Sure enough, Baby A’s head was right there. A little after 3:00 am, they told me she was coming and it was time to push. I asked if I could have an epidural now and they laughed that she was almost out and there was no time for that now. They told me to start pushing and I asked what that meant so the nurse coached me and DH through it. There were no stirrups so I had one leg on DH’s shoulder (things happened so fast, he wasn’t even in scrubs!) and another on the nurse’s. After a few of what I was told were good pushes, Gabrielle Victoria was born at 2:33 am. DH saw her wriggling around and we heard her make a few gurgling noises before she was whisked off to the NICU. All I knew at that point was that she was alive and unbelievably, I was a mommy!

After Gabrielle was born, everyone’s attention turned to Baby B. My OB arrived – oh, did I mention that he missed Gaby’s birth? As far as I can tell, a bunch of residents and interns delivered her. It was like something out of Grey’s Anatomy – “Where’s Dr. Montgomery-Shepard?” “This baby’s not waiting for the doctor! She’s coming now!” It ended up being fine, and when my OB showed up, I told him he missed all of the fun. Looking at Baby B on the ultrasound, she still had a full sac of fluid and was looking good so the doctor’s were debating whether it made sense to hold off on delivering her. Because she was breech and her umbilical cord was what was presenting, they were concerned that if I did go into labor again, she would head down the birth canal cord first so the decision was made to deliver Baby B via c-section. I had always joked that my biggest birth nightmare was having both a vaginal and a c-section but at this point, I was honestly relieved. I was so exhausted from Gabrielle’s birth and the idea of doing it again – possibly without pain killers – terrified me. I was whisked off to the operating room where I got my spinal and was prepped for surgery. It seemed like there were 100 people bustling around but no sign of DH. He finally arrived dressed in what looked like a white paper Hazmat suit (it even had a collar – what I would have given for a camera!) and things got underway. There was a lot of pulling and tugging but other than that I couldn’t feel a thing which was just fine with me. Alaina Marie arrived at 4:33 am and we heard her crying before she headed down to the NICU to join her sister. It took another hour to get me stitched up – they hadn’t removed Gabrielle’s placenta after the vaginal birth and the doctors cracked up when I confirmed they had removed both before they closed me – and then I was wheeled into recovery.

One of the NICU doctors met us there and told us that both girls weighed a little more than two pound each and were breathing on their own which was a huge relief for babies their age. Whether they would be able to continue was a big concern but the fact that things started off so well was good. The doctor explained that the first 72 hours were going to be critical in terms of determining their lung strength, identifying any potential brain bleeds and keeping infection at bay. Based on their breathing, they were cautiously optimistic but only time would tell. She took DH down to see the girls and I made him promise to take pictures. When he came back, he was visibly shaken. The girls were really tiny, very swollen and hooked up to tons of wires and monitors and I think when he saw them, the seriousness of the situation finally set in. Everything had happened so fast up to that point – just six hours before, we had been in bed – that we really hadn’t been able to think about what everything meant. We hadn’t had time to ask any questions but now that’s all we had.

I spent a few hours in recovery and we decided while we were there that until we had a better idea of how the girls were doing, we didn’t want to share the news with anyone other than our parents and siblings. It was just too much for us to make a big announcement when we weren’t sure what was going to happen. DH called his mom around 6:00 am and caught her so off guard, she had to call back an hour later to make sure she heard everything right. Meanwhile, my parents were in Italy on a three-week vacation for their 40th anniversary. We had joked when my mother sent us every contact number under the sun that we’d never need them, but little did we know! We left messages everywhere and waited to hear back. At around 7:00 am, I was moved into a private room – ironically, the one we had looked at during our hospital tour the week before – and DH ran home to check on our kitty and get the things we might need for the next few days.

I finally got to see the girls later that night. DH wheeled me down to the NICU where Gabrielle was in an open bassinet. She had been having some breathing issues so they had intubated her during the day but it was already out. I couldn’t get over how tiny she was! But even being so small, she had 10 perfect toes, ten perfect fingers, little fingernails and eyebrows and a full head of wavy brown hair. She was wriggling around and even though her eyes were covered up, she seemed totally aware. I couldn’t believe this was the same baby we’d seen just a week before on the ultrasound and now here she was. The whole situation was still so surreal! Alaina’s isolette was nearby and other than being enclosed, she had the same wires and IV’s as her sister. Like Gabrielle, Alaina was fidgeting around, waving her hands and her legs, like she was happy to have more room than she did in the womb. She had a full head of hair like her sister and long long little legs. At the ultrasound the week before, Alaina was clearly kicking Gabrielle in the head so we teased her that she chased her sister out early. Seeing the girls was so emotional – we had waited for them for so long and even though they arrived early, having them there was a dream come true. To say it was love at first sight would be an understatement.

The next few days went by in a bit of a blur. DH’s mom and stepdad came down on Sunday to meet the girls and my parents got in from Italy on Monday. The girls’ middle names are for their grandmothers – Victoria for DH’s mom and Marie for mine – so seeing them meet their namesakes was pretty amazing. We counted down the hours everyday (waiting to pass that 72 hour mark was torture!) and continued to get good updates from the NICU doctors. In fact, I think the girls surprised everyone with how well they did. On Monday, Alaina managed to pull her IV out of her hand so they had to restrain her arms. The staff said they’d never seen a preemie at that age have the strength or coordination to do anything like that. That night, she managed to get her toe looped around the feeding tube that was going through her umbilical cord and she tried to yank that out too! So by the end of day three, she had baby restraints on both her arms and legs. We found the whole thing funny and extremely encouraging but it looks like we’re going to have our hands full with that one. She’s already a baby Houdini.

We’ve had great progress reports on the girls all week and the doctors are starting to be more and more positive with us. They spent the first few days really trying to manage expectations, which based on how critical and precarious things were makes total sense, but now they see things looking up. Both girls had brain scans and showed no sign of bleeds, which is great. They’re both on CPAP, which basically delivers air into their noses, and they’re getting room air at this point, which is excellent. Earlier this week, they had scans of their hearts done to check for openings that normally close in full term babies during birth. Alaina’s had closed on its own but Gabrielle’s was still slightly open. They gave her some medicine to close it up and her scan yesterday showed that it was almost gone so now we’re going to wait and see if it will go away without any more treatment. Since their hearts and brains look great, they’ve pulled the intravenous lines out of their belly buttons and put a PIC line into each girl (this is a central catheter that can deliver any medicine or fluids they need) and they started getting 1 ML each of milk yesterday through a feeding tube which will hopefully kick start their digestive systems to start working. And they’re pooing and peeing like champs and are really active. All of these are fantastic signs and the head of the NICU said we couldn’t ask for anything more at this point. That being said, we know the girls have a long road ahead – they expect that they’ll be there for at least 10-12 weeks – and while we’ve had lots of highs these first few days, we’re prepared for the lows that will eventually be coming. But knowing they’ve made it through this critical time with flying colors helps immensely.

I was discharged on Wednesday and am resting at home. Considering I had both a vaginal birth and a c-section combined with the fact that we’ve been through the emotional wringer all week, I have to say I’m feeling really well. The hospital is 7 blocks from our apartment and I walked there and back to visit the girls this morning. I’ve been trying to pump since the girls were born on Saturday and finally got a small result today so hopefully my body is kicking into gear. Ironically, I had appointments with both my MFM and my OB today for my 28 week check ups. I never would have guessed I’d be home pumping when I made those appointments!

So that’s the latest from here. Thank you to everyone who has been sending us well wishes and prayers. We are so lucky to have so many wonderful people who care about all of us. I’ll post more pictures later but here are two for now. Here's a picture of Gabrielle at 3 days old:

And here's Alaina at 3 days old. Notice the gauze on her legs and arms? That's how she was restrained from pulling out her wires. She could still move around but she couldn't wreak any havoc!

Friday, September 12, 2008

Project Nursery is Underway!

So while I haven't been blogging for the past few months, I have been busy decorating the girls' nursery. We have two spare bedrooms on the lower level of our apartment and up until now, we've been using one as a guest room and the second as a den. Since we have a pull out sofa in the den (which we've been told by our guests is very comfortable!), we decided that would become our playroom/guest room and we'd make the current guest room the nursery. Here's a picture of the room before:

Our first step toward transforming the guest room into baby central was to have the closet done. We have California Closets in our bedroom but decided to use Elfa for the girls' room and we are so happy with the result! We were able to customize everything and the system is adjustable so if after the girls arrive, we decide we need different storage options, we can easily change it up. Here's a picture of the closet before:

And here it is after:

We cannot rave enough about Elfa. The closet holds so much more now that it did before. Here's the proof (excuse the mess -- we're still organizing all of our wonderful shower gifts!):

We're using the drawers for the little things like socks and hats....

And bibs. Here are two of my favorite that we got at our shower.

So that's the closet transformation. More Project Nursery updates to come!

I'm back!

I don't know where the time has gone! It seems like just yesterday I was posting our first ultrasound pictures and now here I am starting my third trimester. Crazy!

I'm 27 weeks and 3 days today. We had a growth scan last week and the girls are measuring right on target. Baby A is 2 pounds and Baby B is 2 pounds 3 ounces. We got a great 4D picture of Baby B ans she is the spitting image of DH -- same lips, same nose and everything. She's adorable!

We couldn't get a shot of what Baby A looks like because Baby B was kicking her in the head so she was hiding her face. I'm hoping she's got at least a little bit of me in her!
The bad news at the growth scan was that my cervix seems to shortening. I have to go back next week for another cervix check. I was feeling great up until last week and now all of the extra weight is starting to take its toll on me. My back hurts all the time and my feet are pretty swollen. I just bought a back support brace that I'll start wearing and when I'm not at work, I pretty much park myself on the couch with my feet up. I'm hoping I can hold off on bed rest for at least a few more weeks.