Getting to Know Bridget and Christopher

I think most of my posts about the twins for a while is going to be about breastfeeding because that is mostly what I am doing. Ummm, that's all I'm doing. The good news is that we took the twins in for their one month check up today and their weight gain has been great! I am a whole milk cow!! They are growing with leaps and bounds and hopefully, soon, they will be on the regular baby growth charts and not the preemie growth charts.

I have to admit I am so proud of how well they are doing with transitioning from bottles to boobs. We occassionally have to supplement one or the other, but for the most part they get everything they need straight from the source. (There is an issue of using fortified breastmilk twice a day to increase their calcium and phosphorous and also they are taking vitamins, but more on that later)

One funny thing the twins do is that they are very vocal when they eat. They are constantly talking and making noises about the quality of the milk. Sometimes it sounds like a flock of geese are nursing at my breasts. And then Bridget likes to snort a lot. We sometimes have a hard time telling whether she has burped or just snorted at us. Bridget also will let us know with no hesitation if she is displeased with the situation. She can yell loudly enough and at a high enough pitch that I am concerned that glass will crack. Honestly, though, it's endearing because she is feeling so much that she just has to let us (and the world) know about it.

As for breastfeeding *twins*, we are trying to feed them together although they are not always awake at the same time. I think that as they get a little older and more skilled at eating, we'll be doing more tandem feedings. The nice thing is that they like eating together and will actually reach out towards each other and even hold hands while they nurse. Yes, this is as adorable as it sounds. Actually, it's more adorable that it sounds. It's beyond precious and as soon as I get a picture that doesn't show too much of the boobage, we'll post it.

As for now, I think I have about 15 minutes in which I can nap. however, I'm hearing squeakage, so I may be mooing again sooner rather than later.

It's worth it. Oh, but I'm looking forward to some decent sleep. In a couple of months.

Life with the Twins

Are they not adorable? Christopher is on the left and Bridget is on the right. This is their reunion photo, taken minutes after Christopher came home from the hospital. You might think I'm being facetious, but as soon as Bridget figured out he was there, she had her arm out and was touching him. I think he subsequently poked her in the eye.

Things are going well, for the most part. They are both gaining good weight, eating on demand instead of on a schedule. On Tuesday, I tried feeding them both at the same time at nearly every feeding, which went well. However, yesterday, I decided to focus a little bit more on each twin individually. It, ironically, out to be a little easier, especially when Bridget demonstrated that she could drain a boob by herself in about 10 minutes. Whereas Christopher takes his time to enjoy the ambiance of the boobage, Bridget is making up for "sharing the groceries" as the nurses called it in my uterus.

Sleeping is not as hellish as I remember with Conor. However, my parents are helping out a lot. They essentially moved in here in April after my first hospitalization had have been helping out a great deal. Lately, that includes delivering a baby to me if one is already on the boob as well as keeping an eye on them in the afternoon (and rocking down Bridget through her massive burps) while I take a nap.

Conor is being an amazing big brother. Who would expect anything differently? Yes, there are some whinage issues but really, we're ALL doing that right now more than usual. Here is Conor holding Christopher for the first time. And yes, Christopher is smiling at his big brother. Is that not the cutest thing you've seen?

One of the Differences

One of the differences between NICU and home is feeding on a schedule (NICU) or on demand (home). This translates into a difference of a half-ounce weight gain per day (NICU) and a one 1/2 to two-ounce weight gain per day (home). Bridget has quite a bit of weight to make up. But as of last night she's moved from 4 lbs 9 oz on Wednesday to 4 lbs 15 oz on Satuday night.

It also means the difference between a fine poop in a diaper and a blow out that leaves a spray pattern 3 feet along the wall and the ceiling. Yeah. We nearly called in CSI to get an analysis of the poopie crime.

You can imagine with that sort of force going out that we're having some gas pains going in. We're recognizing the differences in cries: I'm hungry! I really need to burp!! You people are idiots!!! We recognize the last one from Conor's days as a newborn.

It's going well, altogether. And we're looking forward to Christopher coming home tomorrow. And no, we're not going to be feeding both twins separately on demand. Whoever is hungriest gets to start the dual feeding session. And we already know Christopher is still hungry in NICU. We cannot wait to get him home and introduce him to the two-for-one daily special at the milk bar.

Soon, we think they are going to both be on the "typical" growth charts soon.

I hear squeaks. It's time to go give Bridget the nummies she wants and needs.

Bridget is Home

So I wrote the title of this blog about 12 hours ago. I am now hoping to write the rest of the entry.

Hooray! Bridget is home! She came home on Wednesday and it was a hell worse than you can imagine leaving Christopher there. However, as we left, we saw one of Christopher's neighbor's moms. Her son had been in NICU for 2 1/2 months already and is likely to stay there for another 2 1/2 months. So our complaining about leaving Christopher for 4 more days seemed very trivial in comparison to the 5 months her son is staying in NICU.

Nonetheless, it sucks. And it's wonderful because Bridet is home. And it's stunningly tiring now that she's home, too. I haven't been sleeping because I've been pumping. But now I'm getting even less sleep and I'm not sure I can even focus on the words on this page.

Yes, I am fully aware that it's going to get tougher when Christopher comes home. But at least then, I won't have to shower or get dressed. I can stay in my pajamas all day and nurse and pump and give them supplements until they get strong enough to fully breastfeed.

As far as that goes, Bridget does well, and then, not so much. But I'm still having to pump to provide enough food for Christopher, too, and work around his schedule at the hospital.

Must go. She's crying. This is probably as good as it will get any time soon.

The Whole NICU Thing

NICU. Yuck. And then not as bad as it was.

That's the summary of our twins' stay in NICU. The first part of them being there, with all their alien looking tubes and wires was not fun at all. And then they got off the tubes and most of the wires and we got to hold them and breastfeed them and it wasn't so bad.

But it is still sort of bad. The NICU is very noisy. There are alarms going off all the time. Some to let you know that the babies' monitors have come unattached. Some to let you know they have too little or too much oxygen in their bloodstream. And the worst of all, the brady monitors, which tell you that they've stopped breathing and their heart rate is going down below 80. This monitor's alarm is 3 very loud, very short beeps. You can hear them all over the NICU. The sound is so pervasive that I hear them in the house sometime. (Ghost bradys). A police car with its light and siren on came up behind us the other day and I thought it was a brady alarm.

Any time one of these alarms goes off, parents freak out to check whether it's their child and the nurses all stop what they are doing and run over to the child whose alarm is going off. If it's a "good" brady, the baby will recover on his or her own. If it's a moderate brady, a nurse provides gentle stimulation by patting the baby to get the baby to start breathing again. A bad brady requres a dose of caffeine to start the breathing process again. They actually have an espresso coffee machine going to feed them a shot of coffee. (Just kidding! That espresso is for us!) :-)

So NICU is noisy and alarming, in every sense of the word. And the worst is the brady alarms. The reason this has more meaning for us today than it did yesterday is that Christopher has started having a few more bradys again. Last week, during the doctor's rounds, they said Christopher's last "moderate" brady was June 13. Because he was eating so well, they and we thought we could bring him home on Sunday, seven days after his last brady requiring stimulation. Then on Friday, the 18th, he had a brady while breastfeeding in which I had to remove him from my breast so he would start breathing again. (He didn't remember to start breathing on his own). That meant he would stay in longer and we thought this Wednesday the 24th. Then yesterday, he had another brady while breastfeeding. And last night he had a brady that required gentle stimulation while he was sleeping. (That one is the worst)

Now, we don't know what is going on. Bridget is coming home on Wednesday. She has had very very few bradys to begin with and her last one requiring gentle stimulation was June 13th. And she is going through an amazing growth spurt right now and eating like a wild baby and putting on weight.

After last night's brady, I am doubtful that he'll get to come home Wednesday, too. We are hoping he can come home on Friday, and I will have taken the infant CPR class on Thursday night. If he does come home this week, he is going to be on an apnea monitor. This is a little belt that goes around his chest to measure breathing and heart rate and sounds an AMAZINGLY LOUD alarm should his breathing or heart rate get too low. When/if the alarm goes off, after we all pry ourselves off the ceiling, we run over to him and do something. (I'm assuming that training from the hospital will tell us what we are supposed to do)

The good news is that preemies outgrow bradys. In fact, term babies have bradies all the time, they are just not monitored as closely as preemies, and they likely recover on their own. Usually, preemies outgrow bradies by term. (3 more weeks for us). A very few children continue to have bradys for the first 6 months. (I hope that's not our guy!) And best of all, there is not a relationship between bradys and SIDS.

We're just playing the waiting game with Christopher for his brain to mature enough to remember to breathe all the time. It's really not an uncommon problem, it's just a pain and very worrisome to his parents. And I don't know how long we will go until we don't hear brady alarms all over the place. That's the weirdest part about NICU. It's really pervasive, beyond just the hospital.

Now for some cuteness:

This is Christopher last week.

This is Bridget last week.

I may be short on words in the next few days, but I'm going to be posting more pictures. They are getting cuter and cuter every day.

The Whole Breastfeeding Thing

Long time readers may recall that I breastfed my son. Forever. It was a relatively easy experience and definitely rewarding. I expected that breastfeedingt twins would be different. But breastfeeding twins in the NICU is a whole other experience.

The first thing to note is that I'm pumping almost exclusively. And I know that many people who pump exclusively have a hard time getting and maintaining an adequate milk supply. I have a good idea why: the pumping schedule given to me by the NICU lactation consultants is (sort of) appropriate for singletons and not even close to appropriate for twins. At one point, someone said "This is what you need to pump for twins, but you need to make double what this schedule says."

I'm not economist, but I think I have a better idea of that following a guide to make supply equal demand for singltetons and just "hoping" it doubles for twins is not appropriate.

So the first thing I did was based on my experience nursing Conor: I pretended I was actually feeding the twins and pumped as often as they thought they would want to eat. Lactation Consultant Caustic (LCC) immediately called me irresponsible on day 2 of pumping for not following her directions, saying I would mess up my nipps before I really needed to use them. I, still being a bit hormonal, was pretty annoyed.

I then checked the NICU chapter of my Mothering Multiples Book, one of the best books I've found on this journey. Instead of the 8 pumping times as recommended by LCC, the author recommends pumping 10 times in 24 hours, with 1 to 2 more sessions if you want your body to know you're serious about breastfeeding your twins. I did pump 12 times for a couple of days, but for the most part, I'm pumping 11 times per day. I'm currently right on schedule to have enough milk at the end of two weeks to support to good sized babies.

Let's review that: I am pumping 3 times more per day than recommended and I'm right on schedule. I can tell you right now, those 3 extra pumpings make all the difference. All the nurses in NICU are amazed at my supply....and I keep pointing out that the schedule women are given is not adequate to produce enough milk. It's even more important because the easiest time to increase supply is the first two weeks. After that it gets more difficult. So I'm willing to do this pumping schedule for two weeks and then figure out how I can maintain it until the babies are breastfeeding fulltime.

So, yes. The goal is not for me to pump for the twins. the goal is for me to breastfeed (mostly exclusively) the twins. The good news is that both children "get it". The bad news, or actually the typical preemie news, is that it's going to be a while before they are strong enough to breastfeed for most of their feedings. And you know what? That's absolutely ok. My perspective on what is "normal" and the "right path" for preemies is evolving and is not even close to the same for what happens for term babies.

My children are doing great in learning how to breastfeed and I am so proud of them. (As an aside: how is it possible to fall so hard in love with two people that I have just met? I honestly get overwhelmed with how wonderful and amazing they are. I think knowing how much I love Dave and Conor makes me see how much love I can feel and it's really damn easy to feel it for these two children) So back to being proud of my twins.

Christopher actually got off to a slower start than Bridget did. And I just figured out today that it just may be his style: he likes to take his time and enjoy his fresh from the breast gourmet milk. He does not like to be rushed as he indicated by grabbing my boob with both hands when I tried to remove him thought he had fallen asleep. So he takes a while.

Bridget, on the other hand, well...cue to the 70's music by Heart Barracuda. (I love YouTube) The girl likes to eat. Her first time breastfeeding was like she had never eaten before. Guess what? At 7 days old, that was the truth. And she ate like she meant it. I've been underestimating how much she's been getting because she's on and off so quickly compared to Christopher. But then I realized that she nurses so strongly that she loosens my toenails.

Plus, yesterday I felt so guilty about trying to push her into nursing. She started off really well on Sunday. Monday was good but not great. And then on Tuesday and Wednesday, she just sort of pooped out. This is all part of that two steps forward, one step back issue with preemies. They had to start gavaging her (feeding her through a tube in her nose) because she was too pooped to even bottle feed. This is a problem because she doesn't get her get of jail free card until she can eat for 3 days from either a bottle or from me and still gain weight. And here I was really trying to push her to nurse and she just really needed to get her strength about her.

The whole preemie thing is really humbling. Even more than with term babies, you have to wait and let them set the pace. And the advice one gets for term babies? It's not appropriate for preemies. It just doesn't work.

So, as I have multiple times over the last 12 days, I take another step back and see where they are on this journey. The good news is that we're now approaching 48 hours since Christopher's last brady (a brady occurs when they forget to breathe and their heartrate drops down). He has to go one week with no bradys to get his get out of jail free card. They are thinking he will be ready to leave in one week. I would really prefer that this issue resolves before we go home. And how will it resolve? His brain will mature and breathing will be automatic for him like it is for you.

Bridget needs to figure out how to eat. She will. It is highly unlikely that she is going to enter kindergarten still being fed by a nasal gavage. We just have to wait until she develops enough strength and stamina to eat her food. She has the skills; she just needs the energy. I can wait happily and patiently for that, too. I'm also learning how to bottle feed her. They won't let her go home with us until both Dave and I can demonstrate bottle feeding skills. Dave gets a pass on the breastfeeding.

It will probably take until they are 40 weeks or past until they can fully breastfeed. They just hit 36 weeks yesterday. It may take 4 to 8 more weeks before we have an easy time with the breastfeeding around here. No problem. I can wait. And we will figure it out together.

***********

Bonus track: the Jesus Jones song for Right Here Right Now. Loves it.

So What Happened?

I should be getting my final nap of the day, but I also feel the real need to get this out. So writing wins over napping, at least in this instance.

So why on earth did we have the babies last week? I had been in the hospital for 5 days for the pre-eclampsia. It wasn't getting better, but it wasn't getting worse. I was still hitting blood pressure highs of greater than 160/100. But the numbers stayed in the 160's and in the low 100's, so even though those numbers were bad, the doctors were willing to wait awhile as long as they could watch me closely in the hospital. In fact, Friday's doctor went ahead and scheduled my c-section in two more weeks: June 19th. I would have been term for twins and it was only 14 more days. I was honestly so excited to have a concrete goal to work towards. And I figured that, really, once I had 7 more days under my (enormous) belt, the next 7 days would be gravy.

Then....

At exactly 2:00 am, I suddenly awoke and heard and felt a pop. And immediately afterwards, I was soaked. I hit the nurse call button and told them my water had broke. I called up Dave and told him my water had broken and he came to the hospital immediately. (Honestly, it wasn't 10 minutes until he was there). The nurses arrived and it was absolutely clear to everyone that not only had my water broken, it had completely broken. This was no leak that we could watch and wait. I started having real contractions and there was more and more water until there wasn't.

At 4:05, Bridget was born and they rushed her literally straight into the neonatologist's and NICU nursing staff's arms. I don't think I got to see her before they took her to NICU. Dave said that he saw them break Christopher's water which "gushed like a fountain." Then Dave saw Christopher stick a hand out of my belly, check out what was going on and then scurry back inside the warm part of my belly. He was also so jammed up in my ute that they had to fish around for him and stand on top of my stomach to force him out. It was such an ordeal to get him out of me that Dave got a little lightheaded and had to sit down. He arrived at 4:08 and I did get to see him before he was rushed down to NICU.

Then they started closing me up which took FOREVER. The doctor said something about the "layers" he had to sew through and I asked him if he just called me fat and we decided, No, it was more like I was Shrek, an ogre with lots of layers.

They took me down to recovey to stabilize. And they kindly refrained from giving me the incapacitating magnesium sulfate for about 5 hours. During that time, they wheeled me down to NICU so I could at least see my babies for the first and only time for the next 24 hours. They were obviously adorable, but they were also covered in tubes and wires and big space alien hats to help them breathe. And that just about killed me. I felt like such a failure that I had not been able to keep them inside me to term. Everyone kept congratulating me and telling me how big they were, and all I kept thinking was just that one more week would have made a tremendous difference and I couldn't do it.

I went back to recovery and got the mag. They waited to see if I had any reactions. I had none out of the ordinary and I went back to my room.

After the required 24 hours, I got off the mag and the first thing I did was go to see the babies. Actually, no. The first thing I tried to do was to get out of my bed to go see the babies. Oh. My. God. For those of you who have only had c-sections, bless your little hearts. Vaginal births are so much easier and less painful. Yes, they are messier because the doc doesn't vacuum out your ute after you give birth, but they are far, far less painful than c-sections. Even now, more than a week later, I'm in far more pain with the c-section than I was with Conor's birth.

So I finally got to see Bridget and Christopher again. Not much had changed. They were still looking like alien babies with all their tubes and wiring and I was still crying and feeling like a shit that they weren't still inside me.

I also noted the new sound track in my head. I always have background music playing in my head that often lets me know what is going on for me emotionally. I have no doubt that is some sign of weirdness, but I like it, especially when it's a new song and it's tells me something about myself. In this case, I heard two songs: "I want my baby back, baby back, baby back. I want my baby back, baby back, baby back, baby back, baby back." That one is no surprise. It's a little too literal to be that insightful.

The other song was more of a surprise and much more moving. I'm not sure why my psyche chose this song and I can see that Jesus Jones originally sang it in the past tense, but I hear it in the present tense, but here is what keeps playing in my head:

I [am] alive and waiting, waiting 

I [am] alive and waiting for this 

Right here, right now 
there is no other place I want to be 

Right here, right now watching the world wake up from history

In my head, the babies are singing the first part and I answer to them that there is no place I'd rather be than right beside them as they wake up to be in this world.

Yes, well, it feels emotional to me and makes me want to be by their side pretty much every waking moment. Something I was hoping to be doing with them at home and not in NICU.

So when another doctor asked me wasn't I relieved to not be pregnant any more? Wasn't I relieved to have everything resolved? I could only answer incredulously that No, I was not relieved. I wanted them to still be in my belly and I didn't want them to be in NICU. Wow. He was shocked. When I told one of my nurses, she said yes, I was unlike 90 to 95% of the other women in the special maternity ward at the hospital. Every other one of them, except me, wanted their baby or babies out of them as soon as possible. Maybe their children wouldn't end up in NICU like mine, but why take that risk? My discomfort for two more weeks felt like very little in comparison to keeping them healthy.

Of course, Bridget had other ideas and that's why we're here. The choices were made and we had our babies.

So an update on the twins: Briget is a fiesty little firecracker. She knows what she likes and what she doesn't. And she doesn't like the CPAP breathing assistance on her head. She came off for a while and then went back on. I actually saw her levitate in anger about having to be back on it and she has an open prescription to have "kiddie valium" should she need it. However, now that they've kept her off of it, she has calmed down. She was diagnosed with PDA, a not uncommon problem in preemies in which their heart doesn't completely switch over from being in utero to the outside world. She's been on special medicine (essentially, ibuprofen) for the last three days and we find out today whether it has cured her. So far, the signs are good: the murmur that let them know it was there has not been heard since the first treatment. Should the echo cardiogram show it's gone, she gets to start eating again and I think she'll start on a quick recovery, just like her brother.

As the doctor said it, Christopher is taking the easy way out. He's cruising his way out of NICU, while his sister plays the drama queen. He's up to full feeding and last night lustily ate all of his first bottles. I am thrilled because I have been breastfeeding him and using kangaroo care for the last two days. He has a wonderful latch and is doing quite well getting his nummies. Of course, yesterday we had a bit of a setback with Nurse Control A Lot not wanting me to either breastfeed him nor hold him. So Dave informed the Charge Nurse of our problems with Nurse CAL and we had her moved off of our case. Hopefully, this morning's nurse and I will not yell at each other. Their primary nurse comes back tomorrow and not a moment too soon to be quite honest.

I'm hoping that by tomorrow, we can let Bridget try a little breastfeeding. Even if she's just playing around, I want her to know her mommy is here. Actually, I don't think she's going to play around. I think she's going to come at me like a tribble and we're going to be off and running with breastfeeding.

It's two steps forward, one step back with babies in NICU. But the ultimate movement is always forward. And that's what counts.

And here is a picture of me holding them in Kangaroo for the first time. Bridget is on the left and Chrisopher is on the left. They definitley recognized each other. And it felt like a reunion for the three of us.