Thursday, July 22, 2010

Hitting Milestones

September 8:
Unfortunately, due to the way they calculate the boys “corrected age,” they lost 6 days. (Crystal was 31 6/7 when she delivered, so the boys were considered 31 and 0/7 weeks old when they were born). The neonatologists have specific corrected ages when they will let the babies attempt various things, including attempting to eat on their own. The boys have been very awake during their care times. This is one requirement for beginning to have them eat, rather than have them be fed through their feeding tube. They won’t let the boys even attempt to take a bottle until next week which really stinks, but Crystal was allowed to do non-nutritive nursing with the boys today. Crystal worked all day with the boys on this, but they are definitely still developing their sucking reflex.

September 9:
Today was Daddy’s birthday. The boys’ night nurse, Nurse Jillian, made a footprint card for daddy from the boys. It is great. We have been pushing to try to get Dane off the nasal cannula and today the nurse got the okay to attempt it. He was off it for about 30 minutes, but started to have oxygen saturation issues again and had to go back on it. We really can’t wait for him to get off of it.

Our nurse taught Crystal how to do kangaroo care today. Kangaroo care is something that has been proven to help babies grow and also helps with a mom’s milk supply. Basically, it is skin to skin contact with the boys in their diaper lying on mom. It was great for Crystal to get some good snuggle time with the boys and a nice nap in during the day.

September 10:
The lactation consultants came up today to see how Crystal was doing with the boys and all the fun that comes with breastfeeding preemies. She was amazed at how well they were doing for their age. She also gave Crystal some pointers on how to get more consecutive hours of sleep at night.

September 11:
Today was a long day because Kenny had to close. On these days, we still head up to the hospital at 8 a.m. so that Kenny can get some time with the boys. This allows him to be a part of each of their care times twice. Unfortunately, he doesn’t get back to the hospital to pick Crystal up until around 9:30 and we usually don’t leave until 10 by the time we pack up and get going.
Today was a monumental day for progress for the boys, though. Nyle’s cord fell off and Dane came off the nasal cannula and stayed off of it.
Here’s a picture of him without the nasal cannula.

With the nasal cannula off, Dane’s feeding tube can now be put into his nose to help him with learning to eat with his mouth.
The boys are slowly losing everything that is attached to them (temperature monitors, breathing assistance, oxygen saturation monitor, etc.). The more they can get rid of, the more quickly we should be able to head home!!!

September 12:
Today was another long day because Kenny closed. Crystal has been really tired for the past few days and not eating enough. Since she’s supposed to be eating more calories now than when she was pregnant, she is going to focus on herself a little more today. She’s going to try to get some sleep and make sure she is eating enough. To do this, she is going to attempt the non-nutritive nursing a little less frequently.

The boys are hitting some big milestones and getting us closer and closer to going home. We came into the boys room this morning to see Dane in an open air crib!!!!! How exciting.
Here’s a shot of what we saw first thing this morning.

We had other milestones too. Dane’s cord fell off during the night. Nyle finishes his feeding protocol today, so we will see how his feedings will change. Dane should finish his protocol tomorrow. Yeah!! Nyle’s IV is also coming out today. They will leave it in his foot still, in case his blood sugar goes out of whack, but will disconnect all the tubing, etc. Dane’s should do the same tomorrow. Nyle will begin getting his caffiene through his feeding tube instead of through his IV. If Dane continues to do well with his oxygen levels, his feeding tube will move to his nose tonight to make nursing much easier. Nyle’s feeding tube was moved today and he had a rough time of it. You’d fight having something, even that small, shoved down your nose into your belly. We are getting closer to home every day.

September 13th:
We came to the hospital today to discover that Nyle’s IV was completely removed overnight.
With the IV out, Nyle can finally wear some of the adorable sleepers that Grandpa Hardesty got for him.

Dane’s IV came out today. They took it out immediately because he had never had any issues with his blood sugar. Nyle hadn’t either, but many times, the boys get treated differently depending on which doctor is doing rounds that day.

September 14:
Today was quite eventful for the boys. Nurse Jan took the time today to teach Crystal how to give the boys a bath. Getting them in and out of their beds and doing their care times is much easier since they no longer have their IVs, but they still have their heart and breathing leads on. It is quite an event to do their baths because the tub has to be brought into the room as well as a heat lamp to keep them warm. This is especially important now that Dane is in an open air crib. Nyle is still in the isolette, so he gets some help with staying warm. Crystal and Jan gave Dane a bath first. Crystal made the mistake of getting Dane naked, then testing the water temperature and touching Dane’s naked bottom with her warm hand. He peed all over her. His bath went well and he enjoyed it. He didn’t like coming out and being cold, but warmed up pretty quickly after getting dressed again and covered up with a blanket. Crystal gave Nyle his first bath at his next care time. That went really well too and Nyle really liked the warm water. He handled the cold air pretty well, but definitely liked being wrapped up afterwards. Baths have to be done before they eat or they will get sick, and it really wears them out, so the nurses discouraged any nursing attempts. We just pushed the boys’ food through their tubes and Crystal held them while they ate. Because we had to work so quickly for these baths, we weren’t able to get any pictures, but we’ll have our memories.

September 15:
Nyle got moved to crib today, finally!!

Now the boys only have to be eating on their own to go home!!! We attempted nutritive nursing today, but didn’t have any luck. Any amount of milk the boys might get through nursing has to be taken into consideration, so before nursing them, Crystal has to weigh them, feed them, then weigh them again. The difference in weight in grams is then subtracted from the rest of their feeding. Neither boy was getting any milk today, but they are still getting the hang of things.

More Phototherapy

Saturday Sep 4th – Dane’s biliruben levels are high again, so they have decided to put him on a biliblanket. It gave off a nice “pool light” illumination to the room.

We also came into the NICU today to find out that they had moved the boys to smaller room because 27 week twins would be coming in soon and they need that bigger room for their equipment. We totally understand that because we’d want someone to do the same for us. Although they pulled the boys out of the big room, they did keep them together in the smaller room. That makes it much easier to spend time with both of them and not feel like we are neglecting one or the other.

Sunday Sep 5th – Who knew that one day we’d be praying for the boys to have a poopy diaper. Since their biliruben levels are up and they are slightly jaundice, the nurses have said that all they need to do is just poop, and the color will go away. Thankfully, today was the day! After days with no dirty diapers, we got two poopy diapers from Nyle and one from Dane! Who would have thought that something like this could make us so happy?
We are starting to see the boys’ personalities a little more each day. Neither like having their temperature taken (it’s only in the armpit). The night nurses say Dane has such personality, but he is so quite during the day. Nyle is the one with personality when we are there.

Sep. 6th – Grandma and Grandpa McMasters came up to visit with Uncle Tanner and his girlfriend, Sydney today.

Here’s a shot of Grandma with Dane

Nyle's biliruben levels were high today so they decided to put him on the BiliBlanket.
Doctors say everything is going great. We need to get through the feeding protocol, then we will work on non-nutritive nursing. Non-nutritive nursing is when Crystal will pump before the boys’ care times, but while they are getting fed through their tubes, we will get them to latch on like they are feeding. This is supposed to help them put together nursing with their bellies getting full.
The boys are working on keeping their temperatures up as the isolette temperatures go down. They are both doing great with this, and we hope they’ll be in an open air crib by the end of the week.

One Week Old

Friday, Sep 4th
The boys are 1 week old today.
Here's Dane

Here's Nyle

Nyle’s feeding tube moved from his mouth to his nose today to get him working more on his sucking reflexes without the tube in the way. The nurses have been teaching both of us more and more everyday. They are allowing us to get the boys in and out of the isolette on our own, swaddle them ourselves, and change their clothes, bedding, etc. Feedings continue to increase for each day for both of the babies.

Today was a great day for Crystal. She got to hold both babies at the same time. The boy’s nurse took some pictures for us. Crystal loved this time, but found that holding the boys together sucks the life out of her no differently than holding them individually. She finally had to put both of them back into their isolettes because she couldn’t stay awake.
Here are a few shots of her holding both of them.

Going Home and Finding a Rhythm

September 1st
Crystal was released from hospital today. Here are a few shots of her kicking back in the hospital, dealing with the swelling that happened after the delivery. Her feet were really aching.

Kenny had gone to work and had to close, so the nurses let Crystal wait to be discharged until late afternoon. That way, she could still have a place to rest and could order food rather than pay for it. Kenny had taken all of their things to the car before he left for work. He came back to pick Crystal up once he got off work. It was very difficult to leave tonight. It’s hard to know that you are going home and your babies can’t come with you.

September 2nd
Kenny is back to work full time for now and will bring Crystal up every morning but today he had the day off. We decided that since today is Dad’s day’s off, we wouldn’t accept any visitors, to allow Kenny as much time as possible with the boys. For us, the best time for visitors has been during the boys care times. That off hour is just too difficult to get everything done that needs to get done and entertain people. We are getting into a rhythm with the boys schedule. Right now, we start at 8 a.m. with our day looking like this: Nyle’s care (diaper change, temperature, blood pressure, etc), snuggle with Nyle, Dane’s care, snuggle with Dane, 1 hour break. Unfortunately, in that hour, Crystal has to pump, potty, eat, drink, return phone calls, etc. Once that hour is over, we start all over again. With such a busy schedule, it makes the days fly by.
Here's a shot of Crystal snuggling with Dane after one of his care times.

Today, the nurses tried Dane off of the nasal cannula but he was breathing too fast again, so they put it back on him. He should be done with it soon.

Sep. 3rd – Today, we came in to see that they had moved the boys into the same room. They are in a huge room now. It is big enough for 2 recliners and is great for resting.
Here are a few shots of Kenny doing some care with the boys.

Suntans and Feeding Tubes

August 30th
Kenny’s mom and step dad came up for a visit today. They got to see the boys looking cool with their phototherapy glasses on. Their biliruben levels (jaundice indicator) were a little high, so they had to be put under a really bright light. Because the light is so bright and the boys eyes are also very premature, they have to wear some foam sunglasses that strap around their head. They are unswaddled and stripped down to just their diaper, which most babies don’t like, but Dane and Nyle didn’t seem to mind. They looked like they enojoyed their time in the sun.

Here’s a shot of Nyle and Dane. Their futures’ so bright… (I know it’s lame, but the kids are cute.)

Nyle also began getting breastmilk through a feeding tube today (that’s what is coming out of their mouths in the pictures. They tape the tube to the boys chin to keep it in the correct place. At 6 hour intervals, the nurse will check for aspirate to see what is left in his stomach and not digested yet. If the amount left is okay per a feeding protocol, they will then give them more milk. If there is too much they will skip that feeding. Before this, all of their nutrition came only from their IVs. They boys will remain on their IVs, though, until they are taking more food each day.

August 31st
Dane started getting fed through the feeding tube today. Since he is a little bit bigger than Nyle, he gets more food at each feeding. Dane was a little later getting mik because they were trying to let the blood that he swallowed during delivery work its way through his system. They are both only getting very small amounts (2 or 3 ccs per feeding). Each day, though, the feedings will increase by 2 ccs until they get to 6. Then the feeding schedule changes to every 3 hours. This also changes their care times from every 4 hours to every 3 hours.

The nurses have begun to change the temperature of the boys isolettes based on their temperature at care times, rather than based on a constant monitoring of their body temperature. The little silver leads on their bellies in some of the pictures is what monitored their body temperature and that fed their temperatures to the isolette and it automatically adjusted the temperature inside. The temperature of the isolettes have begun to come down slowly as the boys are showing that they can hold their own temperature.

Dad's First Diaper

August 29th
We headed down to see the boys in the morning. When we got down there, we discovered that Nyle was already off the CPAP machine and that Dane would come off in a few hours. That put both boys on room air in a little over 24 hours. That is spectacular.

Here’s Dane with no breathing assistance, waving to the camera. The things on his cheeks are the velcro that is used to hold the CPAP to his face. The "mustache" came off shortly after this picture was taken.

Here’s Nyle with no breathing assistance.

There were plenty of visitors today. Besides Crystal’s mom and sister, Tennille, Crystal’s Dad, Grandma Hardesty, sister, Jill, and niece, Maddie, all came up to visit and see the boys.
Here’s Crystal and Grandpa checking in on Nyle.

Kenny got taught how to change a diaper today. He did well, considering it was his first diaper ever, Crystal’s entire family was watching, it was through an isolette, and it was meconium. Kenny had also just been told to be very gentle with the boys because they’re nervous system is still developing, so rubbing and caressing can be painful. However, to clean up meconium with just a wet towel, you have to rub a little. Dane made it through the ordeal unscathed. Here’s the progression:

Dad – ready to go

Getting the diaper off

Trying to wipe

Help from Nurse Quinna with Dane’s legs

Trying to wipe again

“You teach me – I promise I’ll do the next one”

All done, phew!

Kenny went back to work for a half day today, since he hadn’t really been into work for almost a week. He really didn’t want to leave and Crystal didn’t really want him to go either, but we decided we’d rather have him take time off of work once the boys are released and at home.