Gaining Weight

Sorry for the lack of posting but we moved back into our house this week. After 4 months of living at Scott's Dad's house, we are back! There is still some work to be done and many boxes to unpack, but it feels good to be home (and have new stuff!). Jake seems very excited to see many old toys that we left behind, have his swing right out back, and be able to walk from room to room (due to lack of baby proofing at Scott's Dad's we forced Jake and Emmett to stay in one room to play). Emmett has been a little displaced, but also seems excited to have more room, play with cars and trucks on various window ledges and realize that we had a train table (totally rocking his almost 18 month old world). He has been sleeping in a pack and play for the last 4 months, so after no real nap the last two days he finally settled into his new (old) crib and slept 3 1/2 hours today.

Millie and Ruby are finally gaining some weight. I was starting to worry, but they just needed some time and today Millie weighed 2 lbs 4 oz and Ruby weighed 2 lbs 2 oz! Millie is up to 20 mls of milk every 3 hours (that's 4 teaspoons) and Ruby is up to 19 mls of milk per feed. Today Scott and I got to give them a bath (which means I bathed them and Scott watched - he was too scared the wuss!) Scott got some great pictures, which I will share. They did not like getting their bodies washed, but both liked getting their hair washed. I got to really look at them closely this way, and they do look very alike. Until I get them side by side it's hard to make a true assessment. Millie seems a lot bigger, although there's only a 2 oz difference. She also has a birth mark on her belly that Ruby doesn't have.

Happy New Year's! Love, The Doolots

Ruby getting a bath!

Ruby post bath with her bear lovey (thanks Alison, Joyce and Kate)

Millie getting a bath!

Millie post bath with her bear lovey.

Merry Christmas

I meant to get this out yesterday, but Christmas kept us busy. I had mixed feelings about Christmas this year. Up until two days ago it hardly seemed like Christmas. I spent most of December in the hospital, Jake and Emmett don't really "get" Christmas yet, and we're not living in our house so there was no decorating. Since we're living at Scott's Dad's house, his Step-Mom was nice enough to decorate here and put a tree up, so that helped. On the other hand, it certainly got me out of a lot of shopping and got me thinking more about family and the spirit of Christmas on the actual day. I felt pretty sad going to visit the girls Christmas day. They are only two weeks old, but I definitely felt like a part of our family was missing at home.

Scott finally got a chance to do some kangaroo care. He was nervous, but he really enjoyed it once he relaxed. It made me nervous at first too. They are so light and seem so fragile, but they settle right in once they get on our chests.

Millie now weighs 2 lbs 3 oz and she's up to 18 ml of breast milk every 3 hours. Ruby still weighs 1 lb 15 oz and she's taking 16 ml of milk every 3 hours. I'm amazed that they can take that much since the MD has increased the feeds every day, but so far so good. They still have their PICC lines, but they are only getting some saline in the line. The MD is giving them a little more time to prove they don't need it before they take it out. Both girls have had some spells where they drop their heart rates and oxygen sats. Apparently Millie dropped enough times last night that the MD put her back on 2 L of flow through the nasal cannula today. Her nurse told me that they did find a kink in her tubing this morning, and she also had some big boogies clogging her nose, so that may have been what it was. Their nares are so small that a big boogie can really affect them. Other than that, they are really doing well and that's the best Christmas present of all. I am so thankful for their continued progress and grateful for all our family and friends that are holding us up through this time. It helps more than you know.

Scott holding Ruby

Millie today in her new pink hat (thank you Dana!)

Back to Birth Weight!

Millie is back to her birth weight - 2 lbs 2 oz and Ruby is back to her birth weight 1 lb 15 oz.  The neonatologist has increased their breast milk feeds to 12 cc's for Millie and 11 cc's for Ruby. He has turned off their TPN (the nutrition they are getting through IV). They will keep their PICC lines for a few days to prove that their stomachs can handle the increased feeds, but if all goes well then they will get the PICC lines out (it's a potential source of infection, so getting it out is a good thing if possible).

I am continuing to kangaroo care them for an hour each every day. It is a special time, but I found my mind wandering today and thinking briefly about what I could productively think about while holding them. I then realized that I have been given such a gift to hold them and not have to think about anything but Ruby and Millie. The first day I sang and talked to them the whole time, but now I've realized that the girls like to sleep and maybe they would like a little silence (especially if they are like my college sorority sisters who told me to mouth the words to our rush songs!).

I am also enjoying spending time with Jake and Emmett. They don't understand that they have sisters yet, but Emmett seemed to need a little kangaroo care of his own yesterday when he fell asleep on my lap (yes I am wearing my robe, but I had gotten Emmett dressed, so that should count for something!). I promise to update more about Jake and Emmett when I get the chance. I may not be writing about them, but trust me when I say they are getting plenty of attention!

Kangaroo Care

I got to "kangaroo care"with Ruby and Millie today. I held them each for 1 hour. Kangaroo care is the practice of holding preterm infants skin to skin on your bare chest. The baby is wearing only a diaper and placed on the parent's chest and covered with a blanket. Kangaroo care was first implemented in the late 70's in Bogota, Columbia where there was a lack of power and reliable equipment (incubators) to care for very low birth weight babies. Neonatologists discovered that babies whose parents did kangaroo care had much better outcomes. The practice was adopted in North America in the early 1990's, but even today not all NICUs use kangaroo care. Studies show that the benefits of kangaroo care include fewer infections, better weight gain, decreased stress and pain response, and improved sleep patterns.

The girls' nurse told me yesterday that it was easiest to wear a button down shirt when I came to kangaroo. We are currently living at Scott's Dad (Bob) and Step-Mom's house because we are renovating our house (just to add to our craziness but the renovation was planned unlike the pregnancy - ha!). I didn't have a button down, so I wore one of Bob's old flannel ones I found in the closet. I first had a red and green one on, and I felt like I was really in the Holiday spirit, but then Jake snotted all over it and I had to change. My second choice was a little bit more drab, but it worked great for kangaroo. I also couldn't find any socks this morning, so I grabbed a pair of Bob's. When I got to the NICU I realized I had grabbed blue socks and not black. So my look was large old flannel shirt, maternity pants, blue socks and black clogs. I'm pretty sure I got voted best dressed in the NICU today. Enjoy the pictures!

Kangaroo Care with Millie

Blue Socks!

Holding Baby Girls

Ruby

Millie

No words necessary. Happy Mamma. Happy Baby Girls. It was like holding little cloud pillows. Santa hats courtesy of Scott's Aunt Charlene.

PICC Lines are In!

Ruby's Christmas Ornaments made by her nurses!

Millie cracking a smile!

As of tonight both girls have PICC lines in! Hooray - I am so relieved. Both girls also got blood transfusions today and that probably helped their veins not be so fragile, but regardless I am thrilled. Their nurse had actually started peripheral IV's on Ruby and Millie before they got the PICC lines in, because the neonatologist had decided to start Millie on Indocin today too (Ruby got her first dose last night). The Indocin is supposed to help close their PDA's. They get three doses total 24 hours a part, so we won't know if it works for another day or so.

Ruby's stomach looked better this morning, and she is not acting like she has an infection, which is also good news. We'll have blood cultures back tomorrow or the next day. Both girls looked really good this afternoon after their blood transfusions. The nurses have made ornaments using their footprints which is adorable.

The picture of Millie is after she got her peripheral IV this morning. Scott and I were visiting, and it was heart breaking to hear Millie cry when they placed the IV. She did not cry long and once the nurse finished, and we came over to her she started cracking little smiles. I know they are not real smiles, but I felt like it was her little way of saying she's ok.

I think I will be able to hold the girls tomorrow since their umbilical catheters are gone. I can't wait. Thank you for all your prayers and words of kindness. Today was a good day.

What's in a name?

Scott and I had a running list of girl names for most of the pregnancy. I kept the list on my I-Phone and I would update it every time we heard a name I thought sounded list worthy. We also did a lot of googling of   baby names although I would change up the search words just to see if I would get a new or different name to add to the list. "Baby Names, Girl Baby Names, Celebrity Baby Names, English Baby Names, Popular Baby Names, Unusual Baby Names, Baby Name Meanings" etc etc etc. It was harder than I thought to come up with two names (four actually when you include middle names). Do the names sound good together? Will they roll off the tongue when I am shouting for my FOUR children....Jake, Emmett, ? and ?.  Ahh the pressure.

When it came down to it (in the hospital room after my water broke), we wanted names that were special to us and the generations before us. We wanted the girls to be named after the strong women in both our families. Ruby Margaret is named for Scott's step-grandmother and his biological grandmother on his Father's side. His biological grandmother (Margaret) died when Scott was little, and Ruby is the woman that his grandfather married after his grandmother died. Scott's grandfather passed away many years ago, but Grandma Ruby is still a special part of our lives. She lives in St. Louis and she is one of the spunkiest, sweetest, most fashionable, energetic women I've ever met. She is in her 90's and she told me on the phone this week that she was a little tired, because she headed up the decorations committee at her Retirement Home.

Millie Durand is named after my Mother and Scott's Mother. My Mother's name is Mildred, so Millie is in spirit named after her. We just couldn't use the actual name Mildred for reasons that I think most of you understand (as does my Mother). Durand is Scott's Mother's (Laura) maiden name. My Mother is called Mimi by her grandchildren and Laura is called La La by her grandchildren. We couldn't survive without Mimi and La La. They have stepped in to help us time and time again and our children adore both of them. My Mother is one of the strongest, kindest and most giving women in my life. She has been here for me in the most selfless way. I hope that I can be the kind of Mother that she is to me. La La has an energy and enthusiasm that is contagious and always brings a smile to those around her. She also has such a kind heart, and I can't believe how lucky I got to have such a sweet Mother in Law. You always hear horror stories about in-laws, and I seem to have hit the jackpot with Laura, Bob and Anne. We are truly blessed. I don't know how we would have made it through all our life challenges without our families support.

Today's report on Millie is that she continues to do well off the ventilator. Her chest X-ray looks about the same. She hasn't improved, but it will take awhile for the right side of her lungs to look better. The good news is that it isn't worse, and she is tolerating the nasal cannula on room air oxygen (21%). Her feeds have progressed and she is now getting 3 ml's of breast milk every 3 hours. Her jaundice is still an issue. They decreased her bili lights to 1, but then increased back to 2 when her labs came back today. She is still weighing in at a hefty 1 lb 15 ounces, but I expect she will start to increase soon.

Little Ruby is also still on the nasal cannula and 21 % oxygen. Her nurse noticed last night that her belly is starting to look a little discolored. She called the nurse practitioner and they ordered an X-ray of her abdomen. The X-ray showed a little gas in the upper part of her intestines but was otherwise normal. The neonatologist was concerned when he saw her this morning. He has ordered blood cultures to be drawn tomorrow morning to rule out infection. He also heard a heart murmur in the last few days that sounded worse to him today. This is the same patent ductus arteriosus that Millie has. The other possibility for the discoloration is that her blood is not oxygenating well due to the PDA, and so her intestines are not getting good oxygen perfusion. The MD put her on Indocin which helps the PDA to close, but it means that she can't get any breast milk feeds (not sure why). They are not putting Millie on Indocin yet, because they usually give the PDA 10 days to close on its own, and she is not having any problems from it.

PICC lines were attempted again last night and failed. They will try Ruby again in the morning. They did have to insert a peripheral IV in her leg to give her the indocin. They girls can't keep the umbilical catheters much longer, and they are no longer getting blood to draw up from the umbilical lines. This means they will have to stick both girls to get blood tomorrow. Once the PICC line is in then they get give medication and draw blood from the line.

Please pray that they will be able to get Ruby's PICC line placed tomorrow (and Millie's but not sure when they are attempting hers again). Also pray that her blood cultures will be negative, because an infection would be very harmful to her.