Sunday, June 28, 2009

Darn Flu

Well, the flu bug has hit Durham again. The ICN has reinstated the flu restrictions. This means that only parents and grandparents are allowed to see the babies. Bummer. But it is for good reason, and we do appreciate taking precautions to keep those nasty bugs out.

The girls had a so-so day today. Both girls needed a unit of blood, due to low hematocrit levels. This is expected from time to time. This means that they didn't get to eat as much today. When they get blood they have to be NPO (Latin for nothing by mouth) for four hours prior to and four hours following the transfusion. They also both had to get new IV lines to get the blood with. They were not real happy this afternoon, as you might can imagine.

They should be a bit happier tomorrow as they should be able to resume their normal feeds.

Saturday, June 27, 2009

If only it was this hard for me to gain weight...

Everything is still going well. Both girls are handling their feeds well, and they are increasing each day. Evelyn may have a little reflux problem, but that's not much to worry about. I was watching her near the end of her afternoon feed and she started getting a big fidgety. She was laying on her tummy and starting arching her back as if she was trying ease her tummy off. They don't make Tums small enough for her. :)

Jessica is doing a bit better than Evelyn with her oxygen. She's very rarely ever desatting (dropping her oxygen saturation below 85%). She's probably a bit closer to getting a chance to try handling things without the CPAP. Stay tuned...

Jessica's weight is up and down day by day. She's getting feeds and extra calories, but they just don't seem to stick yet. After changing her diaper today, I think I know why!!! Whew! Hopefully, she'll have put some weight on today. She's at about 2 lbs 2 oz, which is great, but we really want her to start packing on the ounces. Evelyn is at a soild 2 lbs 6 oz, and doesn't seem to have a problem adding a little bit each day.



Everyone has been great in the ICN. The nurses are wonderful and are just the best people. Even though we've got the best doctors, best medicines and best nurses around, sometimes bad things happen that no one can do anything about. We just want to lift up all of the mommies and daddies of all of the babies that are in the ICN. We especially want to pray for those who don't get to take their babies home with them.

Thursday, June 25, 2009

Best Day Yet

We had another good day today. Evelyn and Jessica are both still on their CPAP's, but haven't needed any extra oxygen lately. YAY! If they continue to do well, we may be able to try to start weaning them off the CPAP in a few days.

They are both almost back up to full feeds. Of course, the increase in food resulted in some MAJOR poop during their 4:00 assessments. We're not complaining, especially since we've been waiting for Evelyn's bowels to start working again, but we're wondering how so much stuff can come out of babies that are so tiny. And you know it's bad when two nurses and Mom (who happens to be a seasoned diaper changer) declare in unison, "Oh, gross!!!"

And, the best for last...I got to hold Evelyn for almost 2 hours this afternoon! She really likes to be held--I think she's going to be our lap baby. Jessica on the other hand, only likes to be held for about 20 minutes and is then ready to be put back to bed. I have discovered that Evelyn seems to really like it when I hum "Down in the Valley" while Jessica likes "Clemintine." I'm not sure why they like these particular songs, but they relax and calm right down when I hum these when I hold them. I guess the notes must resonate just right in my chest. It will be interesting to see if these tendancies continue once they're bigger.

Wednesday, June 24, 2009

All's well

Both girls are doing well today. Evelyn had a little problem with her digestion at her 4 PM feed, but after checking with the nurses this evening, she was able to handle her 8 PM feed fine. I guess it was nothing a little glycerin wouldn't help. We were there for her assessment this afternoon, and she was wide awake. Her head is evidently growing a little bit. The nurse had to get her a new cap. She's on room air, but still can't go for longer than about 10 minutes without the CPAP. That will be the next goal.

After a fussy day yesterday, Jessica was much calmer today. Her feeds are getting increased day by day to what they were before she got the blood on Monday, so hopefully she'll get back to putting o wait. Right now she is holding at just over 2 lbs. Evelyn gained some more today, and is back to her birth weight of 2.5 lbs.

Monday, June 22, 2009

Up and down we go...

Evelyn was doing great today. She was breathing room air for most of the day, and I was able to hold her again for about and hour and a half this afternoon. She started getting her feeds again, so she will slowly start building herself back up.

Jessica had a little harder day. Her regular labs overnight showed that her hematocrit and sodium were low. The hematocrit is the measure of the percentage of red blood cells in the blood. It's normal for premies hematocrit to be low with all the tests that are run on them with their low blood volume. The remedy is for her to get a unit of blood, which she did this afternoon. Her sodium levels are low because of the diuretics she had been recieving to try to get the fluid off of her lungs. That can be replaced with saline fluids.

Niether of these are major problems, except that Jessica had had her IVs and PICC lines removed last week. Blood and saline can't be given in the same IV, so she had to have two new IVs put in either arm today. Since their arms are so tiny, the nurses tape support boards to their wrists so that they cannot pull the IVs out as easy. That means that both of Jessica's wrists have the supports on them. She was not real happy this afternoon when she couldn't rub her fact like she likes to do.

The blood and saline helped her out though, so that is good. In fact, while I was holding Evelyn, Jessica completely turned her body about 90 degrees as if to see what we were doing. I think she may have been a bit jealous. :)

Sunday, June 21, 2009

Happy Father's Day!

Jason received some good presents for his first Father's Day. The girls got him some ties (courtesy of the nurses), he was able to hold Evelyn for a long time (over an hour), and he got to give Jessica a bath (he let me give Evelyn her bath)!


Ties from the girls.


Daddy looking at Evelyn's sweet little face.


Daddy rocking Evelyn.


Evelyn giving her lungs a work out, telling Mommy she does not like bath time.


So maybe Evelyn likes having her hair washed/scalp massaged, but who doesn't?


Jessica likes having her hair washed too, but cried through the rest of the bath.


Jessica tuckered out after having her bath.

Evelyn and Jessica were both doing well today. They are still receiving some extra oxygen from time to time, but are able to stay under 25% most of the time. Evelyn has FINALLY had some decent urine output! Hopefully she'll be able to start back on some food tomorrow. Happy Father's Day to all you daddies out there!

Saturday, June 20, 2009

Not much new today

As the saying goes, no news is good news. It's true in our case too.

Evelyn and Jessica are still doing well. Jessica is getting more and more food each day, and her tummy is handling it well. Her breathing is still a little erratic, but it's just more of an annoyance to mommy and daddy rather than a real worry. I still think she likes to do it on purpose just to make sure we're paying attention to her.

Evelyn has not started back on her feeds yet. The nurses are having to wait for her urine output to get back up after the PDA treatment she went through earlier in the week. As soon as it gets back to above normal, they can start her feeds back. Don't ask me what "above normal" is. The nurses tried to explain the formula to me, but during that Jessica got a bit jealous and made an alarm go off, so I've got no idea. :)

Other than that, not much else going on. Mom slept in her own bed last night for the first time in about 6 weeks. Other than being a bit tired, she's doing good. It's tough leaving the two princesses in their current castles everyday, but we do feel better knowing that they have some of the best caretakers available in this or any other kingdom.

Thursday, June 18, 2009

Baby Steps

Well... pardon the pun... :)

Jessica had a rough morning today. She was real fussy and fidgety. That is until we turned her on her tummy. That is by far her favorite position, and once we did that she calmed down and started breathing a bit easier. She's now getting a little boost in her feedings, to supply her with more calories to help her start putting on some weight. No South Beach or Atkins diet for her :)

We just checked in with the nurse, and they have been able to remove her PICC line. This is a line that is similar to a IV, but can be left in longer if necessary. The nurses used this line to get Jessica her medicines. Since she has been able to handle her feedings well, they can add her medicines through her feedings. This is good progress, and it is one less thing for Jessica to try to stick in her mouth!

Evelyn had another ultrasound of her heart today to see if the flap that is causing the murmur had closed. This particular flap is called a patent ductus arteriosis, or PDA. The ultrasound showed the the flap appeared closed, which is a good thing. When we checked with the nurses this evening, Evelyn was down to 22 % on her oxygen, which is about a good as that has been in a week. The PDA can cause extra swelling around the lungs, which can prevent her from getting the oxygen she needs. Now that the PDA is closed, she should be able to use her lungs easier.

Part of the treatment for the PDA was to reduce the amount of fluids that Evelyn was getting. Now that the PDA appears closed, they can start to increase the fluids slowly. We don't want to increase them at too fast a rate, becuase it could cause the PDA to reopen. Evelyn should start getting small feedings tomorrow that will increase over the next couple of days.

Wednesday, June 17, 2009

Some improvement

The treatment that Evelyn is on for the heart murmur seems to be working a little bit. She seems a bit less agitated, and able to hold her oxygen saturation better today than yesterday or the day before. We are going to try to be with her when her docs make their rounds in the morning to see what's next.

Cynthia got some really good snuggle time with Jessica this afternoon. When it was time for Jessica to go back into the isolet and the nurse picked her up, she gave the most pitiful cry. It was like she was saying, "Please, please don't take me away from mommy!!". She's doing much better with her oxygen too, and is getting ever so close to 21 percent.

Monday, June 15, 2009

Evelyn's rough day

Today was a tough one for little Evelyn. First of all, preemies get several blood draws, for labs and such. Evelyn's blood counts came back last night showing she was a little low in red blood cells. That's not unexpected, but the doctors decided to give her a unit of blood this afternoon. That seemed to perk her up a bit.

Evelyn's nurse also found a heart murmur yesterday. Tests showed that the murmur is being caused by a flap in her heart that has not closed yet. This flap normally closes at birth once the lungs first get used. In Evelyn's case, as in the case for many preemies, the flap doesn't close right away. This is something that the doctors expected, so not too large a cause for concern. The only problems that it causes right now is that Evelyn's lungs get a little too much blood circulation. This can make it harder for her to get the oxygen she should be getting in her lungs, and she has to have more oxygen supplied by her CPAP machine.

The doctors started treatment for this today, so we should know in a few days how it is going. Unfortunately, she can't eat while she is getting the treatment, so she is going to be a few days behind on her feedings.

The good news is that by the time we left today she was slowly getting less and less oxygen from her CPAP machine. The goal is to be at 21 percent, which is room air. She was down to 25 by the time we left. She had been higher earlier in the day.

Jessica is doing ok. The doctors are going to keep a close eye on her to see if she shows any signs of having the same murmur. So far tests haven't shown anything. She's getting a little more than room air through her CPAP today as well. When we were there for her afternoon assessment, she was wide awake. She even gave a few giggles when Cynthia was tickling her feet.

Both girls are in the same room now, which is good and bad. The good is that we don't have to go up and down the halls of the ICN to see them. The bad news is that they like to make their alarms go off at the same time!! That's not good for Dad's blood pressure.

All in all both girls are still doing well. This past Sunday would have been 28 weeks gestation, and both girls are where they should be at this point.

Sunday, June 14, 2009

The Royal Paparazzi

It's time for the news that everyone has been waiting for...pictures are here! We were finally able to get some better shots of the girls today. They both had baths today and we were able to catch Evelyn during her bath time. She could not decide if she liked bath time or not. She definitely enjoyed having her hair washed, but not her face! Both girls are continuing to feed well and are beginning to gain some weight back. Hope you enjoy the pictures!


Jessica during her assessment.


Jessica snoozing with her c-pap (just to help keep her airways open).
Look at how big her hands are!


Evelyn during her assessment/bath.


Evelyn up close and personal after having her hair washed.

Friday, June 12, 2009

First time tag team

For the first of I'm sure many chances, Cynthia and I were tag teaming today changing diapers during the girls' afternoon assessments. Cynthia took Jessica, while I had Evelyn. We were both glad to see that both tummies are working! I think that Evelyn was excited too. After I got her cleaned up and had the new diaper in place, she ... expressed her gratitude again :)

Both girls are now on feeding pumps, and are steadily getting increases in the amount of food they receive. The pumps allow them to get the food over a longer period of time.

On Thursday, Evelyn and Jessica received head ultrasounds to check for any bleeding. This is standard as little ones like our girls are susceptible to bleeds. Both reports showed no problems.

I think that Jessica likes to pick on me already. She'll wait until things get real quiet, and then she'll make one of her monitor alarms go off. It's just temporary, and then she picks right back up. When you look at her she has this little grin on her face as if to say, "just wanted to make sure you were paying attention." I think she is going to be trouble :)

Evelyn is just content to be left alone. She is just happy to lay there and not be bothered. I think she gave us a "can't you tell I'm sleeping" look earlier today.

Thursday, June 11, 2009

I love snuggle time!!

Jessica and Evelyn are 1 week old today! I don't understand how the time can go by so quickly and feel like an eternity at the same time.

Evelyn seems to be doing better with her food. Her tummy is still a little sluggish, but that seems to be her only issue, for which we are very thankful. Both girls got an increase in their food today. They are now being fed every 4 hours, instead of every 6 hours. Hopefully they'll both start gaining some weight and filling out soon. The nurse took Jessica's c-pap machine off for a little while today. She did very well without it for about an hour and a half. The plan is to remove it again in a couple of days and see how she does then.

Our favorite part of the day was snuggle time. Evelyn and I spent about 30 minutes together, while Jason and Jessica got to hang out for about an hour. The good news with twins is that Jason and I each get to hold a baby so neither of us feels left out from the bonding process. I'm looking forward to the day they get to come home and all 4 of us can snuggle together!

Wednesday, June 10, 2009

Another good day!

Mom was pretty tuckered out after being at the ICN for the better part of yesterday afternoon. We decided to take it easy today and only stay for a couple of hours.

Evelyn's digestion has improved. She had a small poop this morning. She's still not digesting all of her food, but it is getting better. I got to hold her today for about 45 minutes. That was great! After some whimpers, she got real snug right down. For a little while we were both asleep.

Jessica is still doing well. Cynthia and I got to watch and I even helped out during the assessment. I got to change her diaper again, (2 days in a row!!). I also got to swab the inside of her mouth with a prophylactic liquid. This is just to prevent any possible infection due to the CPAP machine.

She's such a good girl, she opened her mouth right up and let me swab her. I'm not going to lie, I was a bit nervous. As soon as I got the swab out and handed it back to the nurse, she gave me a really good gag face. :)

Mom is still tired so we are going to try to take it easy again tomorrow.

It's tough to get really good pictures of the girls right now. They keep the lights low in the room, or cover their special beds with a blanket which makes getting clear pictures tough. As soon as we get some good ones, I'll post them.

Tuesday, June 9, 2009

Today's news

Cynthia got to hold Jessica for the first time today. She held her for about an hour. Jessica made her first poop. That's good because it means that her tummy is working. YAY!!! During the afternoon assessment, I got to change her diaper. I didn't know they made things so tiny, and then the nurse reminded me that the top flap needs to be folded over, because they are still too big for the babies.

That should change soon.

Evelyn is still doing well, although her tummy is not working quite as well as her sister's. I was supposed to get a chance to hold her this afternoon, but we decided to wait until tomorrow to see if the tummy processes improved any. The tests that were ran didn't show any problems, so the docs think that her tummy is just a bit slow. That should improve over the next couple of days.

Update on the Queen

Mom is doing well. Cynthia is still a bit sore from the surgery, but is moving around better and better all the time. She still has not tried stairs yet, so she is sleeping downstairs. I'm sure that she will be extremely excited when she can make it back upstairs and can sleep in her bed again. She hasn't been able to do that since May 11.

Catching Up

Previously on "Two Princesses"... Evelyn and Jessica were born on Thursday, June 4th. Evelyn Louise Spruill was born at 11:26 PM and weighed 2 lbs 8 ozs and was 14 inches long. Jessica Catherine Spruill was born at 11:27 PM and weighed 2 lbs 2 ozs and was 13 inches long.

Both girls are currently wowing the nurses at the Duke Intensive Care Nursery (ICN). They are enjoying their spa treatments and being waited on hand and foot. This should get them completely ready for when daddy gets to spoil them later.

Both girls have been completely breathing on their own. Jessica since Friday, and Evelyn since late Friday night/Saturday morning. They've both been treated under the bilirubin lights (aka the spa treatment), and have responded wonderfully.

Both girls started getting a little more nourishment on Monday. Add to that they are getting some milk now and they are doing very well.

Cynthia got a added treat of getting to hold Evelyn for the first time on Monday for about an hour.