The Surprises of Little Girls

Mommy and Jessica were having some quality time relaxing and snuggling this afternoon. Mom tucked Jessica (who was wearing only a diaper) into her shirt for some kangaroo care. Suddenly, things were warm in a new spot on Mom's chest. Had Jessica moved her leg to a new spot? NO!!! Surprise! She peed all over Mommy! Luckily Mom had an extra shirt, so no real damage and she still loves Jessica anyway!

Here are a couple of new pictures of Jessica. Sorry that they're a little dark. Eventhough she's growing, the preemie clothes are still too big!





Evelyn got a bath today. This was the first real bath that Mom and Dad were able to give. Once she got over the shock of being put into the water, Evelyn enjoyed her bath. Here are some cute pictures of her.

Jessica's new tricks

Jessica evidently likes to be the over achiever. She's been handling feeds great, and also has had several successful "Lick and Learn" sessions. Today she even went a step further. The therapists took a specially designed bottle nipple and placed a few drops of milk in it. They then gave it to Jessica to see if she would suck the milk out of the nipple. No problems at all. She had to get used to swallowing, but that should come soon. With as easy as she has taken to everything else, swallowing shouldn't be difficult. If she continues to progress, she may be ready for a bottle feed by next week. Her weight tonight is up to 1422 grams, which is just over 3 lbs, 2 oz.

The therapists have not started the "Lick and Learn" sessions with Evelyn yet. Due to her getting blood early last week, she had several days where she was not gaining weight. The therapists wanted to make sure that she was ok and gaining weight before starting to work with her. These therapies can be very tiring for the girls, so it is important to make sure they don't burn too many calories.

Evelyn has responded well. Her weight as of last night was up to 1452 grams which is 3 lbs, 3 oz. The therapists should start to work with her soon.

Big Babies

So not really BIG babies, but we're getting there. Evelyn is now tipping the scales at a whopping 3 lbs 1 oz! Woo hoo! Not to be too outdone by her big sister, Jessica is only 2 oz behind Evelyn! We're so glad the girls are finally putting on some weight. Hopefully they'll be chunky monkeys before too long.

The girls are beginning to mature a little bit. We have been able to see a big difference over the past week in the way they are acting and responding to their environment and stimulation. The both are doing better tolerating being moved around and transitioning between sleep and awake stages. I guess the doctors can see some of these improvements too because they are weaning both girls off of some of their medications and increasing their feeds. We should be able to tell in a few days if they can handle these adjustments.

Good Stuff

The past two days have been full of good news for us! Jessica had a huge growth spurt. Since last week she has gained 5 ounces and grown 2.5 cm. She is now 2 lbs 13 oz and 15.75 inches! She has caught up with Evelyn in weight and is only 1 cm, or .4 inches, shorter.

Jessica was evaluated by the speech therapists Tuesday afternoon, who said they were very impressed with her. Jessica gave them a great demonstration of all she can do...sucking on her pacifier, calming herself down, being alert, and responding to touch and stimulation. She was delcared very mature for 33 weeks. Since she did so well during the evaluation, the therapists said she was ready to start "Lick and Learn" which allows her practice breastfeeding. This will help her learn to suck and swallow and will help with the transition from the feeding tube to the breast/bottle. We had a "Lick and Learn" session this afternoon and Jessica did very well. The lactation consultant said that Jessica did the best of any baby she's seen on their first try! We're so proud of our little super star!

Evelyn hasn't gained any weight this week, but she did grow 1 cm. She should start gaining some weight soon since she had the blood transfusion on Monday. Evelyn was evaluated by speed therapy this afternoon. She also did very well showing how she can suck on the pacifier, respond to touch/stimulation, and transitioning from asleep to awake. She doesn't calm herself down quite as quickly as Jessica does, but everything she's doing is appropriate for 33 weeks. We should be able to start "Lick and Learn" with her next week, if she gains some weight over the weekend. We'd rather her use her energy to grow right now.

We should see the physical therapy and occupational therapy teams for evaluations soon. Hopefully we'll get good news from them as well. Until then, we're still focusing on growing! We'll keep you posted.

The Big Move

Both girls were moved to the Transitional Care Nursery (TCN). This is a positive step, moving towards bringing our babies home. This nursery allows the parents to be much more hands on with their child. The main care for the babies falls to us while we're there. Right now there's not too much for us to do, just diapers and holding, but soon we'll be adding regular bathing, feeding, and all the other joys of parenting. They weren't able to put the girls next to each other, but hopefully one of our neighbors will get to go home soon and we can move into their spot.

Evelyn had to have a blood transfusion this afternoon because her hematocrit got really low. She was VERY ornery this afternoon since her feeds were suspended. She was screaming at Jason and the nurse because she was so hungry. When Jason tried to hold her hand, she put his finger in her mouth and sucked on it. As bad as we feel for her, we're excited that she did this since it demonstrates that she knows she should be eating this way, rather than through a feeding tube! She was taken off the nasal cannula today and has been breathing on her own since mid-morning without any problems! Another good step for her!

Jessica is about the same. She gained a little bit today, so she's back up to 2 lbs 8 oz. They are going to add a different calorie fortifier to their milk tomorrow to try to get them to put on more weight. We should see in a few days how they are responding. I'm sure this will be the only time in their life that we want our girls to be fat! :-)

Sunday Update

Things are still going very well for our girls. Our biggest news is that both girls have been working on regulating their own body temperature in the isolets. The goal is to be able to maintain their body temps when the air temp is 27 degrees C. Evelyn has been regulating her own body temperature since Friday. Her isolet is currently set to 29.6 degrees C. Jessica's nurse changed her isolet over to air temp today to see how she would do. So far she's been able to maintain her body temp, too! I think her isolet was set at 29C.

We're still trying to get both girls to gain weight, especially Jessica. We incorrectly reported Jessica's weight in Thursday's post. At that time, she was 1144 grams (2 lbs 8 oz), not 1194 grams (2 lbs 10 oz). I'm sure you can see how we mis-read the third digit. Since Thursday Jessica has lost an ounce, but Evelyn is holding steady at 2 lbs 13 oz. The ICN staff is trying to figure out why the girls are not gaining as much weight as they would like, so we'll see what they figure out and decide to do.

Our most exciting news has absolutely nothing to do with us. There's talk that our best ICN buddy may get to go home tomorrow! YAY!!! We are so excited for the family (and a little jealous)! Please pray that tonight goes well for them and that they get to take their little guy home with them tomorrow.

The girls together...

Six Weeks Stats

Yes, our girls are six weeks old today. This means that they are at 32.5 weeks gestation. Evelyn is now 1277 grams and 40 cm long (2 lbs 13 oz and 15.75 inches). Jessica is still slightly smaller weighing in at 1194 grams and measuring 37.5 cm long (2 lbs 10 oz and 14.75 inches). They're both still tiny, but they're growing! We can see the 3 lbs milestone looming on the horizon!

Since Evelyn is getting bigger the doctors have decided that it may be time to see if she can begin regulating her own temperature. So far the isolets have been adjusting the air temperature based on the baby's skin temperature. If she gets cold, the air heats up. If she gains weight (or holds her weight) again tonight, they'll set the air at a certain temperature and see if Evelyn can maintain her body temperature. If she does, they'll slowly decrease the air temperature to room air temp. We'll see how she does with this transition.

The doctors discussed moving Jessica to the Transitional Care Nursery (TCN) this morning. Jason and I aren't completely comfortable with this step since she still occasionally has a desat or brady episode and she can't regulate her own temperature. But considering that we don't have medical degrees I'm not sure our opinions count for much. Fortunately our nurses talked the doctors out of moving Jessica. The ICN nurses all love our girls and want to keep them as long as possible. They also know it's easier on us to have them side by side rather than in two different nurseries. So, for now, they're still together. We'll see how long we have that luxury.

The Great Escape...

I think that Evelyn is trying to do her best Steve McQueen impersonation...

Those would be the doors to the isolet that she is heading for :)

Jessica is just shocked by all this...


... not that she doesn't try the same thing when no one is looking.

Steady as she goes...

So far so good this week. The girls have been doing well, aside from the occasional brady from Evelyn. She still seems to be having problems with reflux during her feeds. The good news is that she was fine while we were visiting Tuesday afternoon. Part of that may be due to the fact that both girls are getting some changes made to their feeds. The total volume that they are getting is being reduced, however their feeds are being supplemented with a calorie rich compound. The net result is that while the girls are getting less food overall, they end up getting more calories.

Both girls are starting to show signs of being able to regulate their own body temperature. The nurses are talking about turning off the heaters in their isolets. This would be a big step, as it is one of the requirements for them to move out of the isolets and into bassinets.

Daddy's Turn

Daddy had his turn today in holding Evelyn and Jessica at the same time. All 3 of them took a long nap together in the recliner. Evelyn was dressed when we got to the hospital today, but Jessica was still just in her diaper. Maybe this means we'll be able to start using some of the cute preemie outfits we have!


Dad and the girls napping.


Sleeping sisters.


Jessica hitting Evelyn in the face.


Jessica apologizes for being mean by holding Evelyn's hand.

Two Peas in a Pod

Evelyn has come off of her CPAP and has transitioned to the nasal cannula. It is so wonderful to be able to see her face! The pictures below are not the best of her, but you can get a better idea of what she looks like.


You want to do what? Can't you people just leave me alone?


I am so ready for bed!

Jessica did very well for about 36 hours without any respiratory assistance. But after that, she started having trouble keeping her oxygen sats up, so they decided to put the nasal cannula back on. It's very common for preemies to go back and forth a couple of times before getting rid of the cannula completely. If she continues to do well, we should be able to try her without the cannula again in a couple of days.

Today's visit had a very special surprise. Mommy was able to hold both girls at the same time! We wondered if the girls would remember if they had a twin and were curious how they would react to each other. Once both girls were on Mom's chest, they started wriggling a little bit. They scooted around until their shoulders and hips were touching and then settled down and went to sleep! Later on they woke up, wriggled around some more and ended up holding hands for a little bit. Amazing! Aren't they precious together? Jessica is on the left and Evelyn is on the right.

Big Steps

Evelyn is steadily improving. Her lungs appear to be getting stronger each day. She's not needing the oxygen increases as frequently as she was just a few days ago. Her diuretics have been reduced some, since they appear to have been working. Because of the diuretics, her electrolytes are a bit off, but that can be taken care of easily. She's caught up with Jessica on the amount of food she is getting, but instead of getting hers over 2 hours, she gets it over 3, to cut down on possible reflux.

Evelyn likes to sleep in the afternoons, so she's not really active when I visit during the week. She seems to be more active overnight. That's one thing we need to get fixed before she comes home. :)

Evelyn does have some ground to make up though to catch up with Jessica. As you can see from the pictures below, she's got a bit of a head start...


Can you tell what is missing? (Hint... look at the nose)


The nurse also removed the feeding tube from her mouth. So we got a chance to see her face without any tape, tubes or masks.


YAY!!! FREEDOM!!!


Hey! What happened... So Jessica is not completely ready for life without a feeding tube yet. It has been moved from her mouth to her nose, which is good. When she becomes able to feed from a bottle she'll lose this tube too. That should come in a few weeks.

Crazy day in the ICN

Before we get to talking about the girls, just a word about the ICN. Leading up to and into the holiday weekend the room that Jessica and Evelyn are in got down to just three babies. The room has a capacity of eight, but for various reasons, we were down to just our two girls, and one of their buddies, who has been there about a month longer than we have. It was very nice and quiet.

Evidently too quiet...

What a difference a day makes. When I got in this afternoon, they were already up to six babies. As soon as I got there they wheeled another one in, and soon brought in one more that had been transferred in from another hospital. It got a bit crazy in there. Kudos to all the nurses, who handled it masterfully, even if some didn't get their lunch break until after 5 pm.

Now more about our girls. Evelyn is steadily improving. The X-ray from this morning (bright and early at 5 am) showed that she no longer had fluid on her lungs. The extra strength dose of the diuretics she was getting did the trick, and she had full diapers all day long. Even with all that, she was still able to show a weight gain today, bringing her to 1166 grams, or just over 2 lbs 9 oz. Her breathing has gotten better as a result. She is able to stay at 21 % for most of the time, only needing a bump up now and then. She still likes to have a brady (heart rate below 100) every now and then, but I think she does that to make sure that folks are still paying attention to her.

Jessica had a bit rougher day today than I think she was planning when she woke up. Her labs from overnight showed that she had a low hematocrit again, which usually means that she gets a unit of blood. The nurses had a hard time getting a IV to stay in on her this afternoon, and after several attempts they decided to give poor Jessica a break. She was able to get her afternoon feed, but then went NPO, as the nurses were able to get an IV in later this evening. She'll get her unit of blood overnight, and should be able to pick back up on her feeds by late morning tomorrow. The good news for Jessica is that the doctors decided that she is ready for life without the CPAP machine. She is on the nasal cannula full time now. This skews her weight measurement a bit, because up until now, her weight had been taken with the CPAP mask on*. It weighs about an ounce, so technically, she lost an ounce over last night's weight.

*For you technical people out there, there is an understanding that when the babies are wearing a CPAP mask that they will actually be an ounce heavier than their "real" weight. The nurses take this into account when making their assessments and reports, even if they just report the measured weight (with or without the mask) to us.

Pictures of Jessica

We don't really have any updates on the girls--things are going about the same as the last post. However, we do have new pictures of Jessica with the nasal cannula, where you can actually see her face.


Jessica sleeping in her isolet.


Mommy holding Jessica.


Just a reference picture--note the "bracelet" on her left arm. This is actually Jason's wedding band!


Most of our new family. Hopefully we'll be able to get pictures of all four of us soon!

Jessica Joins the Kilo Club

Right now Jessica is our little superstar! She has been doing amazingly well the past few days. Jessica has FINALLY started gaining weight. She now weighs more than 1 kilogram (1.010 kg = 2 lbs 3.5 oz)!!! She is also starting to come off of her CPAP. They are in the process of weaning her off the CPAP and transitioning her to the nasal cannula. A nasal cannula is the thin tubing that sits under the nose and tucks behind the ears (except her ears won't hold it in place so we have to tape it to her cheeks). She's doing very well with the nasal cannula, so hopefully she'll be able to come off the CPAP completely in the next couple of days. It was so nice to see her whole face and head without the CPAP on! Jessica is continuing to handle her feeds well and has reached her goal of 5.25 oz per day.

Evelyn is still having kind of a rough time. She still has a little bit of fluid on her lungs, but the fluid is beginning to drain off. She has steadily been improving on keeping her oxygen sats up, but still needs a little help from time to time, especially if she's being moved around or at the end of her feeds when she has a full belly pushing up on her lungs. Evelyn is holding her weight at 2 lbs 8 oz. They were working on increasing her feeds today. I think she's up to about 4.5 oz per day. Hopefully the rest of the fluid on her lungs will drain off soon and she'll be able to gain some more weight since she won't have to be fighting so hard to breath.

Exploding diaper, take 1

So I showed up at just the right time yesterday. As I walk into the ICN, I see Cynthia and Jessica's nurse huddled over top of her bed. I thought that maybe there was something wrong, but no, they had just finished cleaning Jessica's isolet. Evidently, Jessica's diaper is not exactly fitting as well as it once was, and well lets just say, it sounded messy. She may move to the next larger diaper because as her nurse said, "I only like to have to do this once.".

Otherwise things are fairly quiet for our girls this week. Jessica is getting closer and closer to getting a chance to try to go without the CPAP. She held her sats (oxygen saturation) up basically the entire time I was there yesterday afternoon, including a few minutes where we weren't able to get a good seal with the mask.

Evelyn is a little behind with her sats. The doctors did an X-ray on her yesterday and it showed that she does have a little bit of fluid on her lungs, so they have started her on the same diuretics that Jessica has been on. If she responds as well as Jessica did, then that shouldn't be a problem for long.

The problem with being on diuretics is that it makes it harder for the girls to gain weight. Slowly but surely they are increasing, although both girls have been down in their weight the past few days.

It seems like both girls enjoy eating. Aside from a few cases of reflux, while they are getting feeds, you barely hear a peep out of them. If you have to take their feeds away for a period of time, such as when they get a blood transfusion, you will definitely hear about it.