Monday, December 6, 2010

Who's Who?!


These are probably the closest pictures we have of the boys. I sure hope we can tell them apart when they come home!! :D

Growing by leaps and bounds!

The boys are getting so big! It is crazy how fast time is flying!! After being weighed last night, Logan is currently 1LB 15.3OZ and Nolan is 1LB 14.6OZ! Logan actually looks like he may be developing a double chin! YAY for chunky preemies!! :D They are definitely becoming noticably bigger boys! This is a step in the right direction.

The boys both remain on increased oxygen. Logan is at 51% and Nolan is at 46%. They continue to sat in the high 80's low 90's. We were spoiled in the begining with their O2 settings being at 21% (room air) for the first week and a half or so. Hopefully the boys will be able to wean back down to 21% soon.

Both boys have PICC lines (IV's) Nolan and his changed yesterday and Logan will have his changed tonight. When they change the lines, everything must remain sterile to avoid infection. Everyone must leave the room or put on the blue surgical looking masks if they wish to remain in the room. I don't really like to watch. The oxygen is increased dramatically during the procedure. For an adult, or even an older child, an IV is a simple "no big deal" thing but, for the boys they can get over stimulated and very frustrated. This is when their vitals start to really go wacky. So far though, both boys have handled their changes well.

BIG NEWS: As mentioned in previous posts, both boys have a PDA. They were each given 3 doses of medication to help the duct to close. Praise the Lord, both Nolan and Logan, had echocardiograms done today to check their PDAs and they are both small or closing! :D As of now, there is no need for further treatment of the PDAs and they should be closed soon! :D We will continue to pray that they fully close with out the need for ligation.

Nolan received a blood transfusion two days ago. He tolerated well. The morning after his transfusion, he did have to go back under the billy lights to help his liver break down his new blood. Today the lights were DC'ed (discontinued/stopped). Nolan is set to finish up his Vanko (antibiotic for the slight redness/rash around his belly button). Once the Vanko is complete we should have a better idea as to when the OG (feeding) tube will be replaced and feedings will begin. I had mentioned in a preivous post that Nolan and some fluid around his lungs and was being put on a diretic. Today his diretic was increased to try to get him to pee out the excess fluids.

Logan started to feed yesterday. He gets 1mL of breast milk every 2 hours. So far he is handling his feedings well. I am very excited about this! The breast milk is better for him all around and will also help him to gain more weight! :D Logan was under the billy lights yesterday as well. He had a change in some of his fluids which caused his bili number to go up so, after morning labs, they put a new order in to have him back on the light. This morning, his light was also DC'ed. I don't particulary like to see the boys under the lights. Not because it is painful or uncomfortable for them but, because I can't see their sweet little faces due to the big 'ol shades to block the light from their eyes. Logan is still exhibiting his new found personality trait but, overall he does seem to be more content since the discovery of the fluid around his lungs and starting his diretic. His dose was also increased to help him pee out the excess fluids he is retaining.

It really bothers me how dry the boys skin is. Yesterday poor Nolan looked like a snake! The Nurse was explaining to me that they can't use lotion on them until they are over their bili issues and no longer need the lights. She was saying that if they use lotion the babies and then they go under the lights, the light will burn their skin. EEK! Their dry skin is the least of my worries. They are getting fluids and peeing out adequate amounts so, we know they are not dehydrated.

Im not sure who is in charge of this but, there have been little things brought in for the boys. I have found little tiny hats all made with different types of yarn and today I found two little foam Christmas ornaments with each of their names on them. They were very cute. I wonder who makes them. Either way, it was a great gesture.

We got our tree up and decorated this weekend. At my baby shower I got an "N" and an "L" ornament. I found the perfect spot on the tree for each of them :) Grandma has already got their "First Christmas" stockings and will soon have those hung as well. Grandma is super excited for their first Christmas. Mommy and Daddy are torn. We are very excited that they are here and doing well but, very sad that they wont be "here" on Christmas. I know, I know, it is far better that they get as big as they can and do as well as they can in the NICU so that when they do come home, they are given the best chance to thrive and do well here. It just stinks a little bit. I know beyond a shadow of a doubt that I will be an emotional mess on Christmas morning. Espeically when Mommy and Daddy have to open Nolan and Logan's presents from their Grandma and Grandpa and other family members. Oh sheesh, Im rambling....I will leave you all with pictures from today. I think they do look bigger than they have!


little baby, BIG mouth!

Nolan after Hands on Care. He looks so exhausted!

I know, it is very dark but, this is another shot of Logan!

Mommy was able to help with Nolan's hands on care tonight!

Saturday, December 4, 2010

Happy Two Week "Birthday" Guys!!!

With the Holidays right around the corner and guests coming in from out of town and most of all, the boys in the NICU, we have been quite busy the last few days. I apologize for not keeping up with my blog.

Today Nolan  and Logan are two weeks old (or 27 weeks and 5 days)!! Overall the boys are doing well.

On Wednesday when I went to visit, Logan had developed this temper. He was insatiable. He would fuss, the nurse would reposition him. He would fuss some more, she would change his diaper. He would get fussy again she would check the ventilator settings (oh, I should clarify, by "fussing", I mean that his pulse ox would drop) and he would still just fuss! Thursday he was doing the same thing. I wasn't sure what was going on with him. After nearly three days of this "attitude" the doc ordered a chest x-ray. My poor baby has fluid around his lungs. He has been put on a diretic to get him to pee out the excess fluid. We saw him tonight and he seems to be much more comfortable and relaxed. He is definitely resting better tonight than he has been.

Logan has received his 3rd and final dose of medication for his PDA. We are praying that the medication will cause the duct to close with no problem and that surgery will be able to be avoided. Within the next couple of days or so, the doc should order another echocardiogram to take a look at the PDA and make sure it is closed or is at least closing.

Nolan has also been started on the meds for his PDA. He is one dose behind Logan. He will be getting his second of three. The start for his meds was delayed because (as previously mentioned) he was on an antibiotic that is rough on the kidneys (as is the med for the PDA). Before giving Nolan his first dose of meds, they did another scan of his kidneys and the report showed that his kidney function was excellent and that they were doing exactly what they should be in terms of processing the antibiotic so, they went ahead with prescribing his PDA meds as well. I am thankful that they have decided to start meds prior to finishing the antibiotic because Nolan has been becoming a bit more sympomatic than he was a few days ago. Nolan is also on a diretic to help him pee out the extra fluid around his lungs. We learned tonight that the fluid, which was originally thought to be caused by his chest tube, is being caused by his PDA. Same thing for Logan. His PDA is causing the excess fluid around his lungs.

Both boys have had their oxygen increased. They have gone from 21-23% up to 54-57%. This is a little upsetting but, it could be so much worse. The reason for the increase in vent settings is also because of their PDAs. When the PDA duct is left open, the blood bypasses the lungs. During pregnancy, a baby's duct is open so that the blood will go to other organs that are developing. Since the lungs are last to fully develop and babies dont breathe on their own in the womb, the duct is one of the last things to be completed or closed. As frustrating and scary as it is for me and Jeremy, it is more common to find a preemie baby with a PDA as opposed to a preemie with out a PDA. Docs and Nurses alike have told us that they would be more alarmed if the boys' ducts were closed.

Over the last few days, Logan and Nolan have each had a blood transfusion. Because they keep having so much lab work done and as "immature" as their bodys are, they can not produce blood fast enough so, the transfusions are necessary to keep their numbers where they should be. One down fall to the transfusion is that typically the following day the boys are back under the billy lights. I hate when their under the lights because I can't see their tiny little eyes and the shades take up the majority of their faces. I do have to say though, the lights are the least of our worries. I mean, in the grand skeem of things, the lights are on for a day or so depending on how low their bili number is and then boom! Once their liver has had time to process and break down the new blood, their bili number rebounds and the lights are removed. Once we get past the stage of needing the transfusions, we will more than likely be out of the stage where we need the billy lights.

I know you have been dying to hear about KANGAROO CARE!!!!!!

As previously posted, on Thursday we were going to get to hold the boys. We would be holding them Skin to Skin. We were told that we would only be holding them for 10 min each tops because they can't really sustain their own body temps in regular room settings. Well, we didn't mind. We were just excited to really hold our little boys for the first time.

Much to our surprise, we got there and were unable to hold Logan. He had just received a blood transfusion and was desating. He was just acting very strange (this was prior to discovering the fluid around his lungs). His nurse said that it would be best if we didn't bother him too much so that he could have a chance to calm down and rest. We were very upset about not being able to hold him but, we both agreed that it was clearly for the best that we let him rest. Not being able to hold Logan did make me feel a little guilty for holding Nolan. Jeremy felt the same way. I just felt like we were excluding him. My chair was facing away from him because of the way the space was set up and it killed me to know that I couldnt hold him or touch him.

The process leading up to getting to hold Nolan was very hectic. All of his leads (IV lines) were strung through the opposite side of the bed from where I was sitting and where the vent was. The lines had to be moved to the correct side which meant disconecting them and then reconecting them. That wasn't nearly as stressful as moving the vent tubes. His oxygen was turned way up to give him a little extra boost before disconnecting the tubes for a few seconds. The tubes were pulled out of his isolette and brought around to the side by the me and the vent. The tubes were reconnected. One nurse grabbed Nolan and placed him on my chest while the other was busy taping the tubes to my shoulder. He was so warm. I couldn't believe I was really holding him. Looking down at him he looked normal size to me. I mean, I know their tiny but, their perfect. The nurses were repositioning him and making sure I was comfortable and relaxed. I was fine. I was better than fine. I could have been hanging upside down from a tree by my toes but, with him in my arms I couldn't have cared less. It was a feeling I never thought I would have the chance to feel. Holding him was effortless because he is so light. I just put my hand under his bottom for a little support and he laid there perfectly. He went right to sleep. It actually made me pretty sleepy too. Nolan is going to be a drooler. As embarassed as I am to admit, he gets it from me. Ten minutes passed and no one said a word, his vitals were perfect, better than perfect. He was tolerating everything amazingly well. 15 min passed and I was still holding him. Finally, at 20 min, I had to put him back. I hated to do it. I could have sat like that forever. I wanted to stuff him and Logan both in my pockets and just bring them home with me. Leaving them in the NICU at night has not gotten any easier. Aside from not getting to hold Logan, Kangaroo Care was everything I thought it would be and more. That feeling a momma gets, holding her baby for the first time, thats a powerful feeling. One I will never ever forget.

Size Matters: The boys are weighed every Thursday and Sunday. This Thursday they were weighed and Nolan was 1LB 10OZ and Logan was 1LB 14OZ. Nolan gained 2.2ishOZ and Logan gained 6OZ. The nurse did say that the massive gain in Logan could mainly be from the fluid around his lungs. She said not to be alarmed if he drops a little bit by tomorrow or even next Thursday.

Hopefully we will find out soon about the boys starting feeds. They will only be started with 1/2-1 cc of breastmilk per feeding (in addition to their normal fluids, lipids, and sugars) until the docs are sure their tummies can handle and process the milk. Breastmilk is the best for babies digestive systems so, they shouldn't have any problems but, there is always a small chance that they will struggle with the first couple of feeds. We will simply continue to pray about it!

I do believe this is all I have at the moment. Jeremy just called and checked on the boys for the night and we are off to bed. I am pooped. :D Until next time!!





Not the clearest picture but, this is Nolan. He was just hangin out while brother was gettin blood!


Logan after his blood transfusion. Such a tough little guy!

Kangaroo Care with Nolan!
This is the only picture we have of the boys "together". Thank you Carrie and Joe! :D


Wednesday, December 1, 2010

My baby has a TEMPER!


I have been a grump most, if not all, of today. I went to visit the boys and saw a side of Logan I had not yet seen. Something was really bothering my little man! He was on his tummy and kept lifting his head pulling away from his vent tube. He was kicking his legs like he was throwing a temper tantrum. He scrunched up his face real tight and it got very red. He seemed angry. The nurse tried to adjust him thinking that maybe he was just uncomfortable. She put him on his back and he continued to freak out. His arms and legs were moving so fast. He was still scrunching his face and turning red. I kept asking him what was wrong (I know that he can't answer me) and at one point he stopped and just sort of grinned. I thought maybe he was starting to calm down so, I went to check on Nolan. Don't ya know that Logan started to throw another fit and was desating. I walked back over to his isolette and asked again what was wrong. He had just had his diaper changed, he was on his back, his tubes were placed so that they weren't pulling against his gums or lips, he was tucked in, temp was normal, all other vital signs were good. I talked to him for a minute and he let out the same grin and calmed down. What a stinker! Jeremy is at the hospital now and I asked him if Logan was still throwing his fits, he said he had started to desat a little bit when he first got there but the nurse turned up his oxygen a little and started his hands on care and he's been fine since. I really don't know what was bugging my little guy today but sheesh! If looks could kill, I think his nurse would have been in serious trouble. ;)

So in my last post I told you about the boys' PDAs. Today I had the opportunity to speak with Logan's doc and he informed me that his head ultrasound came back good and there was no sign of a bleed on his brain so, they went ahead and started the medicine today. The meds are given in 3 doses. There are some side effects but, they are monitoring him closesly to make sure that his body, mainly his kidneys, handle the meds well. If they do not, then surgery will be discussed. Aside from the new meds, and his newly found temper, Logan is doing well and they are pleased with his progress thus far.

Nolan's head scan came back clean as well. He however, has not started taking the meds for his PDA. The reason for this is because he is currently on an antibiotic that is hard on his kidneys and the meds for the PDA are also hard on the kidneys. The antibiotic was ordered because of a red irritation that was forming around his belly button. The doc was concerned about an infection from the IVs that were in his umbilical cord and ordered the meds as more of a preventative thing. The area was tested and so far, no sign of infection. Once the meds for the infection are done, then he will start the meds for his PDA as to not over work his kidneys. When Nolan had his morning lab work done today, they found that his Bili (Billy) numbers were high. The doctor ordered that he be put back under two bili lights until the morning. The labs will be re-ordered and if his numbers are back down, he will then come back off of the lights. After speaking with the Nurse practitioner for Nolan, she also confirmed that they are pleased with his progress thus far.

Tomorrow we are hoping to be able to start a little Kangaroo Care or Skin-to-Skin contact. So long as their vitals are stable, the boys will both be able to come out of their isolettes to be held for 10 min each. I can't explain how excited and nervous we are for this! This is a big to do since the boys are on vents still. Respiratory has to be involved and in the room while we hold the boys. Their vent tubes will be taped to our shoulder and their oxygen may need to be adjusted depending on how well they handle being out of the isolette and touched. So far, when in the isolette, they handle stimulation very well. Typically if they don't want to be bothered they will let you know. If you put a finger in their hand they will grab it. When they don't want to hold anymore, they will let go and move their hand away from you. If you gently lay your hand on them (either back or belly) like a blanket, they will arch their back and give a little wiggle to get you to move your hand off of them. We are starting Kangaroo Care a little early but, the day time nurse for the boys thinks they will do fine. She wants to start early in case they have to have the surgery for their PDAs. If they do, it will be quite a while before we are able to hold them and have them outside of their isolettes. If they each do well tomorrow with Kangaroo Care, we will be able to KC the boys every Thursday and Sunday which just so happens to also be the days that they are weighed. Kangaroo Care will also help with breastfeeding. Typically Kangaroo Care is not introduced until a baby is ready to start feeds. If they are comfortable with KC then, they will be more relaxed when it comes time to try and get them to latch! Anything to help that process is more than welcomed. I have been told that sometimes with preemies it is a little bit of a struggle to get them to latch right away. At the same time though, Ive also been told that most babies "just get it". I sure hope the boys "just get it". My only concern here is about nipple confusion. The nurse keeps reassuring me that I need not worry and that very rarely if ever do they get babies that end up suffering from nipple confusion. We shall see. I can't be there 24/7 so, it is impossible to breast feed exclusively which stinks a little but, as long as they are getting breast milk one way or another, I should be happy.

Speaking of breast milk and breast feeding, I am pumping. What a task this is! First of all, I was very unsure as to whether or not I would breast feed. Pre-pregnancy, I was a smoker. I am actually ashamed to admit that I had an incredibly difficult time with smoking during my pregnancy. This was the main reason that I did not think I would breast feed. Being admitted into the hospital at 23 weeks was the best thing that could have happened for me and the boys. I was able to quit smoking and answer "YES!" when asked if I would be breast feeding. I had been told before that you could smoke and then pump and dump but, It just seemed so wrong to me. I am not doing exceptionally well with pumping, I'm not getting the amounts that my chart thing from the lactation consultant says I should be but, either way, some is better than none! I plan to do so for the first year. If I don't make it the first year, I will settle for the first 6 months. This morning I pumped and got an entire oz out of each breast and I was so excited. I just need to relax and know that I am trying my best. Maybe being able to hold the boys tomorrow will help with my "lack" of "lac"tation! :D
Nolan gettin' his tan on!
Logan: The Calm Before the Storm!

New in Town

I have never had a blog before. I mean, I am a Facebook junkie but, this is new for me! Up until tonight, I have been posting updates on FB, BBC, emailing them, sending them via text msg, and even making phone calls. The text messages and phone calls will still happen but, I am trying to avoid updating all over the internet and just keeping up with one place. I am not sure how good I am going to be at this but, I am going to try my best to make this blog work!

The boys are 11 days old today. I can't believe they are almost 2 weeks old!! It barely feels like it has been a week let alone nearly two. For their gestational age (born at 25w and 5d currently 27w and 2d) the boys are doing awesome. Their vital signs are stable, they handle hands on care very well, and, they are on minimal vent settings (21% or room air). Both of the boys do have a PDA(http://en.wikipedia.org/wiki/Patent_ductus_arteriosus). Jeremy and I have been told that it is more common to see a PDA in preemies than it is to not see a PDA. PDAs can be fixed with either medication or surgery. To determine treatment brain ultrasounds are done to check for a bleed on the brain. If there is no bleed, medication can be used. Sometimes the meds don't quite do the job and surgery is necessary to ligate the PDA. We are praying that the doctors are able to treat with medication and that surgery will not be necessary. This is currently the biggest issue the boys face.

We are trying to find a happy medium between being excited yet cautious. We have been reminded over and over that the NICU is a roller coaster of events. Two steps forward, one step back. I just don't want to get my hopes up too high and be disappointed when we hit a bump bigger than their PDAs. Jeremy and I are both confident that God will watch over our boys and guide the doctors in their care of Nolan and Logan. It is merely human to worry.



Nolan Wesley

Logan Lee