If you've ever seen the movie "Office Space" you know the meaning of that phrase. I had a case of the Mondays today, as did Christie, and the boys. Ugh.
Aiden was still under the lights. Docs really like to get their rubin levels down to nothing. They will be tested again tomorrow, and he may be off of them if all looks good. After his infection that wasn't actually an infection scare on Friday, the culture came back negative, but his blood counts were low, and his CO2 levels were high, so his oxygen was upped on the vent to 33% (when I got to the hospital), and was also getting blood. The reason for the blood and increased oxygen settings is to, in theory, bring those CO2 levels down to a normal range. Once that happens, the vent settings can continue to be lowered. Aiden is also retaining a fair amount of fluid, which is normal for premmies, and he received lasiks to help him excrete it. He's actually 2lbs. 2oz. now, but my guess is that 3-4 oz. of that is fluid retention. It is also possible that the excess fluid has built up around his lungs, which is another potential factor in the lower oxygen levels, the need for new blood, and the higher vent settings. What a perfect example of how everything is tied to together in the human body. Amazing. Aiden continues to give back at least 1ml of his 2ml feeds, and is having trouble pooping. The nurses have an on-going order to administer glycerin to help him go every 48 hours.
Jackson also had a case of the Mondays. He was re-intubated this morning, because he was having some apnea episodes last night on the SiPAP. He rocked it hard for nearly four days on that thing, and was exhausted from all that work. He was resting peacefully this afternoon when we visited, riding the vent the entire time. It's tough to see him going from doing nearly all of the breathing work on his own, and then a day later, letting the ventilator do it all for him. I had to be reminded by the nurses that it is completely normal for them to go back and forth a couple of times. Their lungs are still very immature, they need to rest, and gain some more strength. If I have not said it before, any time off of the ventilator is a step in the right direction. Even if it is only for the four hours that Aiden was off of it on Thursday. Jackson is slamming down mom's milk like it's nobody's business. He'll be going up to 8ml delivered over an hour every three hours. He continues to go up 1ml every 12 hours, and will plateau at 18ml for a while. Jackson was also getting blood today because his CO2 levels were off as well (we think).
Both boys had another echo again today. Aiden still has his mini PDA opening, and a small murmur was heard on Jackson, so the echos were done to check both statuses. No results as of 10:11pm.
No pictures today, as the boys were resting for the most part, and were not very active. Christie got to kanagroo both boys yesterday though. It was so awesome to see her bonding with her boys! I hope they gain some more strength soon, so that we can resume kangarooing. Maybe dad will have a turn later in the week!
Celine: I bet you all of your earnings on that horrific "Titanic" song that we have your delivery story beat!
http://www.people.com/people/article/0,,20436792,00.html
'Til tomorrow -
Jeff
Monday, October 25, 2010
Sunday, October 24, 2010
Days 17 & 18: Up and Down
I hate roller coasters. In fact, I despise them. It took me until I turned 18 to go on one that went upside down. I hated every minute of that ride. In the past 48 hours, our boys have given us quite the roller coaster ride, of which we did not enjoy one bit.
A number of positive steps have taken place in the past two days. Namely, weight gains. Aiden is now 1 lb. 15 oz. and Jackson is weighing in at the 2 lb. mark! That's right I said 2 lbs.! He will be getting a new sign above his isolette today and we'll be sure to capture that Kodak moment. One more ounce and Aiden will be there too!
Another positive: Kanagrooing! On both Friday and Saturday, Christie got to hold Jackson chest to chest for an hour. Both him and Christie absolutely loved it! There are photos below. You can actually hear Jackson cry and wimper now that he is no longer intubated. One correction that I have to make is that the boys were not on 'CPAP,' they are on 'SiPAP.' Without getting too technical (and because I really cannot explain the technical differences), the SiPAP is a step before CPAP, that provides some additional breathing assistance that CPAP does not. Next step will be CPAP.
Mr. Aiden gave us a bit of a scare Friday night when his chest x-ray showed some fogginess in his lungs. The docs took a culture to determine the exact diagonsis, but for precautionary purposes, he was put on antibiotics for 48 hrs until the culture results were available. He rode the vent pretty much all day on Friday, which is not surprising since he was tired from 4 hours on SiPAP the day before. Saturday's noon x-ray showed that the fogginess had cleared (thank God), but he would continue on his antibiotics through Sunday. Aiden was also giving back nearly all of his feeds, but no sign of bile. Saturday afternoon after a position change to the belly, he started digesting about half of his feeds, and only returning the other 50%. Nurses think he's gotta poop again to get things moving. He had a couple days without feeds when he was off the vent, so he may get some glycerin today to help stimulate the movement. His vent settings went down on Saturday and he was doing most of the breathing with the vent and also breathing above the assisted breaths he was getting. A huge improvement from his lethargy on Friday.
Chrisite is super excited because she gets to kanagroo both boys today! Maybe by this next weekend, we will start to share the kangarooing between us.
A ton of pictures and video are below. Enjoy!
A number of positive steps have taken place in the past two days. Namely, weight gains. Aiden is now 1 lb. 15 oz. and Jackson is weighing in at the 2 lb. mark! That's right I said 2 lbs.! He will be getting a new sign above his isolette today and we'll be sure to capture that Kodak moment. One more ounce and Aiden will be there too!
Another positive: Kanagrooing! On both Friday and Saturday, Christie got to hold Jackson chest to chest for an hour. Both him and Christie absolutely loved it! There are photos below. You can actually hear Jackson cry and wimper now that he is no longer intubated. One correction that I have to make is that the boys were not on 'CPAP,' they are on 'SiPAP.' Without getting too technical (and because I really cannot explain the technical differences), the SiPAP is a step before CPAP, that provides some additional breathing assistance that CPAP does not. Next step will be CPAP.
Mr. Aiden gave us a bit of a scare Friday night when his chest x-ray showed some fogginess in his lungs. The docs took a culture to determine the exact diagonsis, but for precautionary purposes, he was put on antibiotics for 48 hrs until the culture results were available. He rode the vent pretty much all day on Friday, which is not surprising since he was tired from 4 hours on SiPAP the day before. Saturday's noon x-ray showed that the fogginess had cleared (thank God), but he would continue on his antibiotics through Sunday. Aiden was also giving back nearly all of his feeds, but no sign of bile. Saturday afternoon after a position change to the belly, he started digesting about half of his feeds, and only returning the other 50%. Nurses think he's gotta poop again to get things moving. He had a couple days without feeds when he was off the vent, so he may get some glycerin today to help stimulate the movement. His vent settings went down on Saturday and he was doing most of the breathing with the vent and also breathing above the assisted breaths he was getting. A huge improvement from his lethargy on Friday.
Chrisite is super excited because she gets to kanagroo both boys today! Maybe by this next weekend, we will start to share the kangarooing between us.
A ton of pictures and video are below. Enjoy!
Above and 2 Below: Jackson sporting his SiPAP mask. He is doing awesome on it!
Above: Jackson laying on mom.
Above: Jackson hanging out in his bed without the top on!
Above: Video of Jackson getting situated.
Above: Video of Aiden.
Above and Below: Mr. Aiden sans mask for a bit. His hands are in his favorite position!
Above: Aiden with my wedding band next to his hand. Unbelievable size comparison!
Above: Aiden still enjoying the sunshine :) One hand on top of his head, the other by his mouth. It's his signature position.
Above: Aiden under the sunshine...again :)
Thursday, October 21, 2010
Day 16: See Pop and CPAP
Jackson saw me again today - eyes WIDE open! Now, I may be kidding myself a bit when I say that he saw me, because really, he can only see about 12 inches in front of him, and everything is mostly shadows. Both boys do respond to light changes though, because even when their eyes were not yet opened, when we would turn on the light over their isolettes, they would squint their eyes shut. Either way, in my mind he saw me, or at least was responding to me, because his eyes did not open until I started talking. Jackson also gained 1.5 oz and is up to 1 lb. 14.5 oz! The 2 lb. club is not far away - almost like making the honor roll!
I decided to visit the boys twice today, for no other reason than just to see them. I have been talking to them more, because everything I read and am told is that the best thing that we can do is let them know that we are there. And, what a great surprise I was greeted with when I got there a litte after noon! Aiden was extubated and put on the CPAP! At first I only noticed his hat, but then looked closer and there was the new machine next to his isolette. So happy! Being that it was his first time on the CPAP, I knew that going back to the vent was inevitable, because CPAP take some adjusting for those tiny guys. Aiden made it 4 hrs today on CPAP, and then was intubated again, so he didn't get too tired out from the extra breathing work, and burn too many calories. They held his feeds through this afternoon because they didn't want to re-introduce that and take him off the vent at the same time. His feeds continued this evening though, and I'm hoping for a positive report tonight when we call.
As I was leaving from my lunch time visit, the docs and NP came in to say they were going to extubate Jackson! Awesome! One goes off, the other goes on! Jack got on the CPAP after 2pm today and when I visited after 5, he was doing awesome. I have a couple pictures of him that I will post. The cool thing is that since he no longer has a tube going between his vocal cords, you can hear him wimper and cry! It's so awesome. Yes, Jackson exists :) First the eyes, now the cries. Fingers crossed that he does not have to go back to the vent anytime soon.
Aiden will have this rubin levels checked tomorrow, and hopefully he'll be off the lights...finally. I feel like I am favoring Jackson because I can see his eyes and his response to me speaking to him. Aiden will also remain on the vent through the weekend, while his feeds continue and he builds up some more strength. He's still holding tight at 1 lb. 9 oz.
I should also mention that we've been cleared to kangaroo both boys. Essentially, we get to hold them on our chests for an hour or so at a time! It's starting to feel real. To read more about kanagroo care, check this link: http://www.prematurity.org/baby/kangaroo.html.
Pics to be loaded later. That's all for today.
Thanks for the support!
Jeff
I decided to visit the boys twice today, for no other reason than just to see them. I have been talking to them more, because everything I read and am told is that the best thing that we can do is let them know that we are there. And, what a great surprise I was greeted with when I got there a litte after noon! Aiden was extubated and put on the CPAP! At first I only noticed his hat, but then looked closer and there was the new machine next to his isolette. So happy! Being that it was his first time on the CPAP, I knew that going back to the vent was inevitable, because CPAP take some adjusting for those tiny guys. Aiden made it 4 hrs today on CPAP, and then was intubated again, so he didn't get too tired out from the extra breathing work, and burn too many calories. They held his feeds through this afternoon because they didn't want to re-introduce that and take him off the vent at the same time. His feeds continued this evening though, and I'm hoping for a positive report tonight when we call.
As I was leaving from my lunch time visit, the docs and NP came in to say they were going to extubate Jackson! Awesome! One goes off, the other goes on! Jack got on the CPAP after 2pm today and when I visited after 5, he was doing awesome. I have a couple pictures of him that I will post. The cool thing is that since he no longer has a tube going between his vocal cords, you can hear him wimper and cry! It's so awesome. Yes, Jackson exists :) First the eyes, now the cries. Fingers crossed that he does not have to go back to the vent anytime soon.
Aiden will have this rubin levels checked tomorrow, and hopefully he'll be off the lights...finally. I feel like I am favoring Jackson because I can see his eyes and his response to me speaking to him. Aiden will also remain on the vent through the weekend, while his feeds continue and he builds up some more strength. He's still holding tight at 1 lb. 9 oz.
I should also mention that we've been cleared to kangaroo both boys. Essentially, we get to hold them on our chests for an hour or so at a time! It's starting to feel real. To read more about kanagroo care, check this link: http://www.prematurity.org/baby/kangaroo.html.
Pics to be loaded later. That's all for today.
Thanks for the support!
Jeff
Wednesday, October 20, 2010
Day 15: Dad's Diaper Duty
I got to change Jackson's diaper today, which was pretty cool! At first I was a bit skeptical because he is so fragile, but I got my hands right in there...with a little prep help from the nurse. It was a pretty eventful changing too - he decided to poop mid change, and all the while had his hand on his junk! I love it! Not even full-term and checking to make sure "it" is still there. Jackson also decided to open his eyes quite a bit today, after his diaper change and I have a couple videos below (the second one is better) with Jackson showing off his eyes. I got a pretty good look at them, and they look blue-ish gray. Jackson did not gain any weight today, but is hanging tight at 1 lb. 13 oz still. He continue to tolerate his feeds, and is behaving like a good boy.
Aiden's feeds were put on hold today because he kept having a large amount of residual after his meals. He was given glycerin to help move his bowels along, and as of 5 mins ago (10:10 pm), the update from the nurse is that he had one excellent stool, with some mucus included. I guess there is a mucus plug that sometimes needs to be pushed out to get the GI track going. Aiden will resume his feeds tomorrow, and hoping that his stools become regular to continue priming hat gut for increased amounts. The increased movements should also eliminate some of the rubin. Mom tells me that while she was changing Aiden's diaper today, he was giving her "the finger!" I love it! Unfortunately, we did not get any pictures to capture this signature Kodak moment, but I will be sure to watch for any future flips of the bird. It amazes me that they are not even full gestation, and are already talking back!
Nothing else to report today, but just asking for continued positive thoughts and prayers that the boys continue progressing and statuses continue to remain positive! Thanks for the continued support!
-Jeff
Aiden's feeds were put on hold today because he kept having a large amount of residual after his meals. He was given glycerin to help move his bowels along, and as of 5 mins ago (10:10 pm), the update from the nurse is that he had one excellent stool, with some mucus included. I guess there is a mucus plug that sometimes needs to be pushed out to get the GI track going. Aiden will resume his feeds tomorrow, and hoping that his stools become regular to continue priming hat gut for increased amounts. The increased movements should also eliminate some of the rubin. Mom tells me that while she was changing Aiden's diaper today, he was giving her "the finger!" I love it! Unfortunately, we did not get any pictures to capture this signature Kodak moment, but I will be sure to watch for any future flips of the bird. It amazes me that they are not even full gestation, and are already talking back!
Nothing else to report today, but just asking for continued positive thoughts and prayers that the boys continue progressing and statuses continue to remain positive! Thanks for the continued support!
-Jeff
Tuesday, October 19, 2010
Day 14: Moving forward
I think the last book I read was the cliff notes for "To Kill a Mockingbird" in high school. That is, until now. Since I have officially done everything short of blocking google.com on our computer in order to prevent myself from googling anything you can possibly think of that has to do with premmies, I have now resorted to the old school style of reference to find my answers - a book! What a novell concept. I am officially addicted to reading "The Premature Baby Book" and believe it is my outlet for not being able to control any of this situation. I have become so well versed with the medical lingo that I ask the nurses about specific settings on the ventilator. I have a feeling I am becoming that psycho dad though, so I have to start taking a few steps back when I visit. Maybe I will do a little more observing for a while.
I saw Aiden under the room lights today and without his mask, and I have to say he looks incredible! Comparing his physical appearance shortly after birth to what he looked like today is a complete 180. His skin looks like ours and he opened his eyes as I was talking to him, much like Jackson did the other day to tell me that they know I am there. So happy they are starting to have a normal physical appearance.
Jackson continues to tolerate his feeds, which is no surprise since we think he has my personality. Aiden however, just like his mom, is being difficult with his feeds, and leaving it all for the nurses to suck back out after each feeding. This is very common of premmies, and am surprised that Jackson has had no residual to date! The feeds continue....
Christie changed Jackson's diaper again today, and took his temperature for the nurses. There has been no change in either boys' weight in the past 2 days, but am hopeful for some large weight gains once their food intake increases.
I have some pictures, but need to hit the hay for the evening, so will upload tomorrow.
Thanks for your support!
P.S. Be sure to read Day 13 entry that I posted today also. There is a great video clip of Christie changing Jackson's diaper for the first time.
I saw Aiden under the room lights today and without his mask, and I have to say he looks incredible! Comparing his physical appearance shortly after birth to what he looked like today is a complete 180. His skin looks like ours and he opened his eyes as I was talking to him, much like Jackson did the other day to tell me that they know I am there. So happy they are starting to have a normal physical appearance.
Jackson continues to tolerate his feeds, which is no surprise since we think he has my personality. Aiden however, just like his mom, is being difficult with his feeds, and leaving it all for the nurses to suck back out after each feeding. This is very common of premmies, and am surprised that Jackson has had no residual to date! The feeds continue....
Christie changed Jackson's diaper again today, and took his temperature for the nurses. There has been no change in either boys' weight in the past 2 days, but am hopeful for some large weight gains once their food intake increases.
I have some pictures, but need to hit the hay for the evening, so will upload tomorrow.
Thanks for your support!
P.S. Be sure to read Day 13 entry that I posted today also. There is a great video clip of Christie changing Jackson's diaper for the first time.
Day 13: Dad's Lucky Number...
...is 13. The boys were each 13 inches long when they were born, and so it seems fitting that today on their 13th day of life we share some good news on the boys. We found out today that at this point, both boys' PDA is closed (or has a very tiny opening like Aiden), and therefore will not require the surgical ligation. We will remain cautiously optimistic about this, and the fact that since their fluids are increasing, the potential exists for the PDA to open up again. If so, the ligation may be required. But again, it is the most common surgery performed on preemies.
Aiden has been tolerating is food, but had a bit of residual after one of his feedings, so they decreased the amount of food in one of his feedings, and as a result had no residual. Food intake was upped back to the original dosage. Aiden and Jack continue to receive approx. .5 oz of food per day.
Christie changed Jackson's diaper today for the first time! And, I caught it all on film. It is posted below. Beware, there is sound and I believe the nurse says 'penis' so if you are at work, you may not want to have the volume turned up. I'm just sayin'.
Both Jackson and Aiden were under the lights again today to lower their rubin levels. Have a feeling Jack will be off soon though since, he's been on/off for the past week, while his big brother, has been on them everyday.
Aiden has been tolerating is food, but had a bit of residual after one of his feedings, so they decreased the amount of food in one of his feedings, and as a result had no residual. Food intake was upped back to the original dosage. Aiden and Jack continue to receive approx. .5 oz of food per day.
Christie changed Jackson's diaper today for the first time! And, I caught it all on film. It is posted below. Beware, there is sound and I believe the nurse says 'penis' so if you are at work, you may not want to have the volume turned up. I'm just sayin'.
Both Jackson and Aiden were under the lights again today to lower their rubin levels. Have a feeling Jack will be off soon though since, he's been on/off for the past week, while his big brother, has been on them everyday.
Sunday, October 17, 2010
Day 12: Don't compare
Next update will be Tuesday, 10/19.
They say you should not compare any of your children to each other since each one of them is unique. This holds especially true when you have twins on an extended stay in the NICU. This is probably one of the best lessons that the boys are teaching us from their early entrance into the world. With each new hurdle that they face, one boy is always a step ahead of the other. Perhaps the earliest reminder of this began with their actual entrace into the world, with Aiden coming out naturally, and Jackson not far behind via cesarean. Jackson started feeds this past Friday, while his brother continued on the indicin for another two days to close his PDA. Part of me is ecstatic about Jackson's progress, while another part of me struggles with Aiden being a bit behind. Thing is, everything changes on a daily basis, and the next hurdle, which I consider to be tolerating the feeds and getting off of the ventilators, Aiden may surpass his brother. So, I'm learning it is not a matter of what one is doing compared to the other, especially since they are both in the exact same situation, it is taking it day by day and looking at them as individuals and making sure they get to where they need to be. Because, after all, they will get there, they will choose their own path in doing so.
I am thrilled that Aiden gained 2 ounces and is now up to 1 lb. 12 oz. officially surpassing his birth weight. That is a 2 ounce gain from yesterday's weight, and hoping that it is not all fluid, since fluids were just re-upped because the indicin was stopped yesterday. No echo for Mr. Aiden today, as the doc postponed until tomorrow, so that both boys can be rechecked for PDA status. Doc heard a slight murmur on Aiden via stethescope, but believes it is related to mitro valve prolapse (inherited from mom), and not related to PDA. Aiden continues to be under the billirubin lights, as he had a 4.1 reading this morning. Remember, a reading of 1 is considered normal. Nurse tells me that both boys should be at their peak age now of highest rubin levels. The blue lights help, but I learned today that bowel movements are the primary way to get rid of the high rubin level. Since Aiden is eating now, I expect him to be off of the lights very soon.
Jackson gained another ounce and is up to 1 lb. 13 oz! He has been tolerating his feeds for almost three days with no residue in his GI track, and the nurse reports good movement down there. They changed his diaper while we were there and the poop looked like 2 poppy seeds - no lie! Jackson is back under the lights again because his rubin levels were around 4, but again, as long as the pooping continues (and picks up) he should be off of them soon.
A & J's baby shower was today, and man did they get some good stuff! Thank you to everyone!
A bit of comedy as I sign off tonight. As we were leaving the hospital tonight I handed Christie the camera to put in her purse. When we got home, I searched the purse 3 times - ALL pockets, zippers, etc. and no sign of the camera. Christie looks in the purse and pulls it out immediately. I swear that thing is like the black hole.
Since I featured Aiden in yesterday's post, today we are featuring Jackson.
They say you should not compare any of your children to each other since each one of them is unique. This holds especially true when you have twins on an extended stay in the NICU. This is probably one of the best lessons that the boys are teaching us from their early entrance into the world. With each new hurdle that they face, one boy is always a step ahead of the other. Perhaps the earliest reminder of this began with their actual entrace into the world, with Aiden coming out naturally, and Jackson not far behind via cesarean. Jackson started feeds this past Friday, while his brother continued on the indicin for another two days to close his PDA. Part of me is ecstatic about Jackson's progress, while another part of me struggles with Aiden being a bit behind. Thing is, everything changes on a daily basis, and the next hurdle, which I consider to be tolerating the feeds and getting off of the ventilators, Aiden may surpass his brother. So, I'm learning it is not a matter of what one is doing compared to the other, especially since they are both in the exact same situation, it is taking it day by day and looking at them as individuals and making sure they get to where they need to be. Because, after all, they will get there, they will choose their own path in doing so.
I am thrilled that Aiden gained 2 ounces and is now up to 1 lb. 12 oz. officially surpassing his birth weight. That is a 2 ounce gain from yesterday's weight, and hoping that it is not all fluid, since fluids were just re-upped because the indicin was stopped yesterday. No echo for Mr. Aiden today, as the doc postponed until tomorrow, so that both boys can be rechecked for PDA status. Doc heard a slight murmur on Aiden via stethescope, but believes it is related to mitro valve prolapse (inherited from mom), and not related to PDA. Aiden continues to be under the billirubin lights, as he had a 4.1 reading this morning. Remember, a reading of 1 is considered normal. Nurse tells me that both boys should be at their peak age now of highest rubin levels. The blue lights help, but I learned today that bowel movements are the primary way to get rid of the high rubin level. Since Aiden is eating now, I expect him to be off of the lights very soon.
Jackson gained another ounce and is up to 1 lb. 13 oz! He has been tolerating his feeds for almost three days with no residue in his GI track, and the nurse reports good movement down there. They changed his diaper while we were there and the poop looked like 2 poppy seeds - no lie! Jackson is back under the lights again because his rubin levels were around 4, but again, as long as the pooping continues (and picks up) he should be off of them soon.
A & J's baby shower was today, and man did they get some good stuff! Thank you to everyone!
A bit of comedy as I sign off tonight. As we were leaving the hospital tonight I handed Christie the camera to put in her purse. When we got home, I searched the purse 3 times - ALL pockets, zippers, etc. and no sign of the camera. Christie looks in the purse and pulls it out immediately. I swear that thing is like the black hole.
Since I featured Aiden in yesterday's post, today we are featuring Jackson.
Above: Jackson getting examined.
Above: Jackson, long view.
Above: Aiden under the lights...still :(
Above: Jackson hanging out under the lights.
Above: Mom and dad opening gifts at the shower. Dad is sporting facial hair until the boys are home from the hospital.
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