Day 70: Swing...and a miss

As some of you know Dave & I were supposed to take Adalyn home yesterday. We never said a specific day on the blog because the world of premies can change at any moment. Adalyn was definitely the one running the show yesterday. In the morning she was spitting up a lot and a couple of the events lead to alarms and one needed suctioning. So the doctors re-evaluated whether or not she was ready to leave. The consensus was made to have Dave & I room in with Adalyn last night and regroup in the morning after we saw how the night went. Well the night went great, both Dave & I enjoyed hearing her coo, grunt, cry etc. She did have some spit ups, but nothing major. This morning Dr. B (who tends to be a little more on the conservative side) said that all the neonatologists agreed that Adalyn should stay til at least Friday and see how she does. The other glitch is that she lost some more weight. So Adalyn is staying in the NICU with her sister & only God knows when she will be ready to come home. Dave & I are bummed, but greatful at the same time. We believe that Adalyn had this event for a reason. Maybe because God knew it was not time for her to come home yet & if she had something bad would have happened. Maybe it was to better prepare Dave & I for what could happen at home. Maybe it is that Miss Adalyn was not ready to leave her sister.

We will post a little more extensive update later on both girls. Emma is doing well & is taking about 50% of her feedings by bottle and loving it.

Please pray that God heal both girls reflux. That He prepare them for home. That he continue to help them grow, develop and progress in the right direction. And please pray that God help Dave & I be accepting of whatever happens, that He keep us positive, and help us not to get worn down.

God is in control!

Day 67: Big Girl Beds

That's right, both girls are now in their "normal cribs" at the hospital! Adalyn continues to do great and is on 27 full bottle feedings in a row. We also think that she passed her "car seat test" but have to hear the official word from the doctors. We also hope that tomorrow we can talk to the doctors about the date that Adalyn gets to come home. She lost 20 grams last night but was back up 15 grams tonight and is weighing in at 4lbs 11oz(2145) tonight. We think that her weight loss is probably from all the bottle/breast feeding she has done and she is now on the formula she is going home on which has less calories. She seems to be slowing down a little bit with her feedings so please continue to pray that GOD gives her the strength she needs so that she can prove herself ready to come home.

Emma has had a really good week! We are so proud of her and the big steps forward that she has taken. She proved to everyone that she didn't need the CPAP anymore, a couple days later she came off of the high flow nasal cannula, and now they have compressed her feedings to 33ml over 2.5 hours instead of a continuous drip. She tolerated that so well that today we were able to start bottle feeding her 10ml every 3 hours!(She gets the remaining 23ml compressed over 2 hours.) So far she has done that 3 times in a row and she loves it as much as her big sister. She has had fewer spit ups but continues to struggle with her reflux.(We are just happy she is keeping her food down.) Emma gained 5 grams yesterday and 20 grams tonight which puts her weight at 4lbs 3oz.(1910) Please continue to pray that GOD takes away her reflux and that she continues to tolerate her feedings. Please also pray for both girls to stay free from infection.

GOD is in Control!

Day 65: Feedings

Adalyn is doing great! She has now taken 12 full feedings in a row from her bottle. 2 of those feedings were a combination of breast feeding and bottle and she did both wonderfully. It is so amazing to watch this tiny baby that has never eaten by mouth before just latch on and go to town. She enjoys it so much and makes the cutest cooing noises while she eats. As some of you know the requirements for the girls to come home before their due date are: to be 34 weeks gestation, over 4 pounds and holding their own temperature up, off oxygen and any other breathing support, and to take all of their feedings by mouth for 48 hours(16 in a row) and digesting well. Abi and I talked to the doctor today because Adalyn meets all of these except the feedings and she appears to be well on her way to 16 in a row now that she is at 12. The doctor said that because Adalyn is only just 34 weeks gestation the standard 2 days will not be enough and he is looking for more like 5 days in a row instead. This is just to make sure she doesn't tire out after a few days. Having the word HOME come up in our conversations is really weird/exciting after 9 weeks in the NICU and 14 weeks since Abi was put on bed rest. We have now begun to prepare for Adalyn's departure from the hospital and have everything ready at home. We also have had all our education and training except for her meds because we are unsure of what she will come home on. Her weight tonight was 4lbs 12oz. Please pray that Adalyn continues to do as well as she has been and that she doesn't tire out with her feedings. Please also keep Abi and I in your prayers as we prepare to have one child at home and one in the NICU.

Emma is also doing great! She has now been off the high flow nasal cannula for 3 days and is have fewer alarms. As Abi wrote yesterday, the doctors decided to pull Emma's NJ back to an NG today.(nose to intestines=NJ/nose to stomach=NG) She has done well all day but seems to continue to reflux a lot. She has not had any major spit ups and the Zantac seems to make her much more comfortable. If she continues to do as well as she did today they will probably start compressing her feeds again on Sunday. Abi and I are worried about her reflux and are praying that this doesn't cause her to stay at the hospital too much longer than her sister. Emma's weight was 4lbs 2oz tonight. Please pray that GOD takes away her reflux, she looks so uncomfortable when she does this and it breaks our hearts to see her have that pain. (It reminds us of dry-heaving) Please also pray that she continues to do well off of the nasal cannula and CPAP so that she can put those things behind her. Also pray that she continues to tolerate the NG feeding tube. GOD, thank you for all the many blessings You have showered upon our daughters. We know that You are in Control! Amen.

Day 64: 9 weeks old

The girls are doing well. Emma has done well off the high flow. There has been an increase in her number of alarms, but nothing more than she had had on the CPAP in the past. They are all quick and self-resolved so the doctors are not concerned. She is still at 10ml an hour on her feedings and doing fine with that through the NJ. They are talking about moving her feedings to NG tomorrow if she has a good night tonight. Her weight tonight was 4lbs 2oz (1875 grams).

Adalyn had a good day as well. She is now allowed to feed by mouth at any of her care times if she is awake and showing interest. She still gets 15 minutes to take as much as she can and what she does not take gets compressed over 30 minutes. So far she has taken all of her noon, 3pm, 6pm & 9pm feedings by mouth. She also got moved to a memory monitor which is the type of monitor she will come home on. Her weight tonight was 4lbs 10oz (2110 grams).

Please pray that...
-Emma continues to do well off the high flow cannula.
-When they move Emma to NG feeds that she tolerates that well.
-Both girls continue to have less and less alarms.
-Adalyn continue to do well with her oral feedings and not get too tired.
-Both girls continue to grow and develop well.
-God protect both girls from infection.
-God heal Emma's reflux.

Thanks for faithfully praying for the twinners!

Day 63: 2 months old!

So the twinners were 2 months old yesterday, wow! They have come so far in the past 2 months & I praise God for that! I must say they are the most beautiful, most precious, 2 month old twins around :)

The girls are doing well. Emma has had no bleeding since Monday afternoon. So today they took the IV out that they placed monday while her feedings were on hold. They are continuing Zantac for now via her feeding tube to see if it makes her more comfortable from her reflux. And...she is off her high flow nasal cannula and on room air! Pray with us that she will get to stay off! So far so good! Her weight tonight was 4lbs 2oz (1885 grams).

Adalyn is doing well also. She is still doing well taking her full bottle 3 times a day so today they increased it so she can nipple 4 times a day. She has been doing a little more spitting up but nothing excessive. Adalyn's remaining 4 feedings for the day will be compressed over 1 hour. Her weight tonight was 4lbs 9oz (2080 grams).

Both girls continue to have some alarms, pray that this continues to improve. Please pray that Emma can stay off the high flow cannula and on room air. Also, the Zantac that Emma is on for her reflux makes her gut more susceptible to infection. Please pray that God continue to protect both girls from infection. Praise God for the girl's weight gain! And pray that God continue to help them grow and develop well. Please pray that God heal Emma's eyes so that there is no worsening of her ROP.

Day 61: A rocky start

Adalyn and Emma had a rocky start to their day today. A little background first. Adalyn took a full bottle (36 mL) at 9pm on Sunday and 3am Monday for her nurse Erin. She took the bottles in 15 minutes or less, with no alarms, spit ups, and burped like a champ. Then this morning at her 9am care time she spit up a fair amount and her belly measurement was up 2 cm. So this started the usual process of put the feeds on hold, call the doctors, and wait. Well the docs were not worried. They felt it was pretty appropriate given that she was for the first time in a long time taking a large volume all at once. So they resumed her feeds. At noon she took a full bottle again. Later that afternoon the docs decided to increase her feeding volume to 39 mL every 3 hours. They did not increase how often she is allowed to take a feeding by mouth. So her orders are still that she can take a feeding by mouth 3 times a day and she gets 15 minutes to take as much as she can. What she does not take in 15 minutes gets compressed over 1 1/2 hours. Her other feedings she gets 39mL compressed over 2 hours. So after a rocky start she ended up having a fine day. She did good with her alarms. At 9pm Dave got to give her a bottle. This was her first bottle of the new volume. She still did great, but was only able to get 30 mL in in 15 minutes. So they had to compress 9mL over 1 1/2 hours...seems a little silly :) But Adalyn was pooped and ready to cuddle with Dad anyway. Her weight last night was 4lbs 9oz (2070 grams)...what a little piggy :)

Emma's rough start yesterday lasted a bit longer than Adalyn's. In the morning Emma spit up some dark brown coffee ground looking emesis (which means it is old blood). She has done this before if you will recall. So the nurse called the doctors and they put Emma's feedings on hold and did an abdominal x-ray. The x-ray looked fine so they restarted her feedings at 11mL an hour just like they were before. In the afternoon Emma spit up fresh blood. So her nurse aspirated her OG tube and got some more fresh blood from there. So she called Dr. S who put Emma's feedings on hold again and ordered another abdominal x-ray and some blood work. In the meantime they put an IV in Emma's foot to give her IV fluid so that she would not get dehydrated. They also started her on Zantac and Maalox. The blood work looked fine. The x-ray showed that her OG tube was in too far which is what Dr. S thinks caused the bleed (irritation from the OG tube rubbing on her stomach). So they resumed her feedings at 10mL an hour and left her IV running at 1mL an hour. She is still getting the Zantac which I think is good because it will help her not to feel so uncomfortable from her reflux. The whole rest of the day she did not get any blood out of her stomach via her OG or through spit up...yay! She had another eye exam yesterday which showed that the ROP in her right eye is the same, Stage 1 and that she also has stage 1 in her left eye. I am happy to report that through all of what Emma went through yesterday she hardly had any alarms! Her nurse said that Emma had not had the bleeding in her stomach they probably would have trialed her off the high flow nasal cannula. Oh well, another day. I am just so proud of Emma for being such a big girl through all of that! Also, with a rough day where her feedings were on hold twice she still gained some weight! Emma's weight last night was 4 lbs (1815 grams).

Oh wait, I don't think I ever gave you Sunday's measurements. Adalyn was 4 lbs 7oz (2000 grams) and 17 1/4 inches long. Emma was 4 lbs (1800 grams) and 17 1/4 inches long.

Please pray that God continues to help Adalyn progress well with her feedings. Pray that this is the last time Emma has to have bleeding in her belly. Join us in praising God that the bleeding stopped and there were no signs of NEC. Pray that God heal Emma's reflux so that she can make progress with her feedings. Praise God for both of the girls having few alarms yesterday! Pray that God heal Emma's eyes and prevent any further progression of the ROP. Pray that He protect Adalyn's eyes from developing ROP. Please continue to pray that God help the twinners grow and develop well and that He protect them from infection.

Day 60: Big girls

Emma

Adalyn

Soooooooooo sorry I have been a bad blogger. I promise I will try get back into the routine of posting a new blog every evening...or Dave will if I cannot. Again, there have been quite a few changes since the last time I posted. Let's start with Emma. On Wednesday when I posted Emma was off CPAP. She remained off CPAP through the night, but according to her nurse Erin she looked tired. So on Thursday afternoon they put her back on CPAP. She did well through the rest of Thursday and Friday morning so around 11am Friday they decided to try her off the CPAP once again (what a roller coaster). They also decided to change her OJ to an NJ and discontinue her OG. Well, within the first hour she had about 3 brady alarms and she was retching. So her wonderful nurse Marsha had the idea to give her the OG back and try her on a high flow nasal cannula (on room air) before she got too tired. So that is what Emma has been on since about 12:30pm on Friday, we are so proud of her! She has been doing well, but she continues to have alarms on and off. The doctors are not concerned because she holds her oxygen saturations with all of them and they are all self-resolved. Her feedings continue to go at 11 mL an hour via her NJ tube and her OG tube is open to vent to help with her reflux. She is still definitely struggling with the reflux and has some retching off and on, but has not been spitting up much with the OG. Emma was moved to an open crib Saturday morning and is maintaining her temperature well. Dave gave Emma her first tub bath today and he did great, and so did she, but I am not convinced she liked it a whole lot :). Emma's weight last night was 3lbs 15oz (1775 grams)...way to go girl!

Adalyn is still in an open crib and on room air and doing great. She has a few brady alarms here and there, but not much. Her big changes lately have been with her feedings. Her feeding orders as of yesterday were that she was allowed to try breast/bottle feed 2 times a day and what she does not take by mouth and for the other feedings of the day she gets 36mL compressed over 2 hours. So, she got to try a bottle for the first time yesterday! Dave fed her and she was allowed to take 10mL which she took like a champ in 7 minutes with no alarms and no spitting up. She also got to breast feed in the evening which she did pretty good with, but it made her really sleepy. Since she did so well yesterday, her new feeding orders for today were that she can try breast/bottle feed 3 times a day and she gets 15 minutes to take as much as she can. What she does not take by mouth gets compressed over 1 1/2 hours. The other feedings of the day she gets 36mL compressed over 2 hours. I got to give her a bottle today and she took all 36mL! It took her a bit longer than 15 minutes, but her nurse wanted to let her keep going because she was doing so well with it. She paced herself (coordinated suck, swallow & breathe) and had no alarms or spit ups. We are so proud. Adalyn also got a tub bath today, her's was from me, and she was not real amused either :) Oh, and Adalyn passed her hearing test the other night and Emma should be getting her's today. Adalyn's weight last night was 4lbs 6oz (1980 grams).

A HUGE prayer request that we would like everyone to be praying earnestly for is that God heal Emma's reflux. Her reflux affects her feeding progression and causes her to have brady alarms. But it also makes her uncomfortable, which is the hardest thing for Dave and I to see. Please pray for this so Emma can make progress towards coming home and so that she can be more comfortable. Emma has another eye exam this week so please pray that there is no progression in her ROP. Please also pray that Emma does not have to go back on CPAP and that she continues to make progress in the right direction so that she can come off the high flow nasal cannula soon. Adalyn's final hurdle at this point before she can come home is that she has to take all her feedings by mouth for 48 hours and have good weight gain. So please pray that she continues to do well with her feedings and weight gain. Please continue to pray that God help Adalyn & Emma develop appropriately and that He protect them from infection.