August 30, 2014

One Month Old!

Our baby girls are one month old today! Like every day I don't actually have time to write, there are a number of things to get done but I'm going to take a nap instead. Dad's home today early for the holiday weekend so we're going to try to get out for a walk later before it rains tomorrow. I can't believe they're already one month old. Time is absolutely flying by (and yet the hours seem to drag lol). We don't go to the doctor's again until next Friday but if they're gaining like they should be then Jules should be around 7 lbs. 8 oz. and Viv should be about 7 lbs. 2 oz. Two lbs. over their birth weights! They are the most fun we've ever had, even though we do miss sleep a little bit. We make a great team and really help each other out when it comes to the feeding/changing/sleep thing. I'm so amazed at the awesome father C is and I try to compliment him every day to let him know how much I appreciate everything he does. We are making a great team and haven't turned on each other yet (although there were some words exchanged during the 4am feeding that one night...)

It only gets better from here and we just can't wait. Happy Month Birthday girls!


August 13, 2014

We're home!!!

Today was a big day in our house and our lives as we finally welcomed our baby girls home after two weeks in the NICU. What an amazing feeling it is to have my girls here! 

Here we are busting out of the NICU and my Viv giving a little wave goodbye to some of our favorite nurses.

 When we got home their big brother Boots aka Boodah was eager to greet them. All he did was sniff around and then quickly lose interest as they started to fuss.Willow was more scarce but she warmed up as the night wore on.

Ahhh.. relaxing for the first time next to each other in the coming home outfits their grandmother, Nova, bought for them. They just look more relaxed and zen being at home!

And finally all settled in for our first night (ok well 2-3 hour stretch of sleep) at home. They are such noisy little sleepers and they keep trying to roll on to their sides since that's how they slept in the NICU. Not at all terrifying!

What an amazing day. It's been a trying two weeks. I am grateful for the chance to heal completely. I had my follow up appointment with Dr. K today and had my steri strips removed. He said everything looks great. I feel good, much better than I did a week and a half ago when we would have brought them home if they didn't need the NICU. We feel pretty prepared and are ready to tackle this parenting thing head on. I gotta admit, them being so darn cute helps a lot!  I might not be able to write as much as I'd like now that they're here but I will try my best to keep up. And so we begin our journey as an insta-family!


August 11, 2014

FIAO 6.2 - Navigating the N.I.C.U. - 7 Tips To Help You Get Through Baby's Extended Hospital Stay

Oh the NICU. What a place. For most people it's mysterious and scary but really it's where miracles happen and it's been our home away from home for the last two weeks. I knew a little about it before, from my boss's son's stay a few years ago but knowing what I know now has completely changed my perspective on them. A lot of people have had bad experiences or don't agree with the way things are done but every hospital is different and our experience has been so positive and I think the girls are growing so well because of it.

That said, I am happy to report that this morning we received word that the girls would be discharged Wednesday, August 15th at exactly two weeks old!!! This is much better than the Sept. 3rd original estimate so we are over the moon.  Relief, happiness, fear, anticipation, so many feelings are passing over us right now. It's quite incredible.

We've definitely learned a few tricks to help make a NICU stay more bearable. If you find yourself facing NICU time try some of these and I hope they can help make an easier stay for everyone!

1. Bring items from home to make your babies (and you!) more comfortable. 

We brought pictures of our cats and put one in each girls' bed, all the preemie clothes we received as gifts, their Aden and Anais swaddling blankets and Dad's good luck charm, a tiny Buddha figurine that we taped to the window next to Jules' bed. I highly suggest a good luck charm, no matter how ridiculous it seems. Jules got off oxygen the night we put him up. Coincidence or not I don't know but I do know that Dad bought the Buddha in Bermuda while on a cruise and then he helped us clean up at the roulette table that night. One of the nurses added some index cards with inspirational quotes next to him. It always lightens up the mood in the room and he's a great conversation starter.

2. Learn the equipment. 

Those are some spiffy first digs!
Know what it does, what to watch out for, what the alarms mean and when to worry. Know your wires, what goes where and which ones to really be careful of. You don't want to unplug the oxygen, NG/Feeding tubes and IVs but the monitors are temperamental and can alarm over slight changes like burping, bouncing and crying. They also fall off. Remember to look at the heart rate before freaking out when your baby's respiration flatlines. It probably means a patch came off, not that baby is not breathing. Don't panic when your baby's monitor flashes tachycardia while you are burping baby unless a nurse starts to panic too. After a few days you'll know what's a big deal and what's not so you're not spending the day as a bundle of nerves.

3. Don't be afraid to ask questions and be involved in your child's care.

Some nurses will be very encouraging and helpful, stopping to explain things and keep you informed. Others will be very by the book or matter of fact and just kind of do their work around you. I found that older nurses want to help but sometimes you need to ask for it. We were really struggling with getting Jules to take her bottle and two nurses just kind watched us suck at it (no pun intended) and then took over to make her finish. We finally asked one of them to show us how she does it and now we're master feeders just like her. She warmed up after that too, helping us understand why her methods work and advising me on pumping. Take advantage of their expertise while you have access to it and be sure to thank the ones who help make your time more comfortable and less stressful. 

4. Embrace the little blessings of the NICU. 

It's not a picnic and I would never say we're lucky that our girls didn't come home with us but there are tiny benefits to NICU time. For instance, the established schedule, the time you get to rest and recover after surgery/childbirth, and the ability to learn the basics like feeding, diaper changing and burping from the pros. It's like having a safety net while you're figuring out how your new baby works, which is important as preemies or sick babies can be extremely daunting to care for. I will never forget how fragile Viv felt in my hands that first afternoon or how terrifying it was when they simply would not eat for us. It was so helpful to have a nurse show me exactly how to provide all aspects of their care and for a doctor to assure me of all my concerns every day. I am confident going in to motherhood and that's definitely the shiniest silver lining of NICU time.

5. Bring your carseat ASAP!

If your hospital requires a carseat challenge before going home and baby is doing well you should bring the carseat as soon as possible. Odds are, if the carseat is there, then they will perform the test as soon as the baby is ready, whether you're there or not. This can sometimes speed up discharge and it can also provide you some peace of mind! In our case it was the morning after a particularly rough afternoon during which Jules fought her feedings and Viv wasn't awake most of the time we were there so it wasn't as satisfying. I just wanted them home and when we got there we got the news that Jules had passed her carseat and congenital heart disease tests the night before. It was the perfect way to start a day and her discharge papers were being drawn up that afternoon for the following Wednesday. Viv took hers a day later and passed too. I am so glad I just brought it in (on the suggestion of a nurse) and the next day it was done!

The girls new beds after they both maintained their temps!

6. Help baby get home ASAP!

Learn what your baby needs to do to leave and how you can help it along. Our NICU doesn't have a weight requirement, as long as baby is eating every feeding from the bottle/breast, consistently gaining weight and able to maintain their body temperature, heart rate and breathing on their own. I now know that they will hold them for three days of observation once all of these milestones are achieved and as much as I wish they were here I'm glad for this as it's just extra precaution. I would also suggest you allow interventions that they think are necessary such as supplements or pacifiers. The pacifiers helped my girls learn the suck-swallow-breathe reflex which allowed them to eat more and I really think the milk fortifier helped them gain so quickly. Not to mention I know that having my breast milk and skin-to-skin time as much as possible are definitely helping! Our original estimate was September 3rd and *fingers crossed* we're breaking out on August 13th!

7. Be positive. 

Above all else, seriously, BE POSITIVE. We sing, talk to and dance with our girls. We don't allow tears or what-if talks in their room and we are constantly praising them for their "small victories" like getting milliliters added to their minimum feedings or a temp reading above 36.5c.  Even after moving to the open cribs I still get nervous taking their temps. I have a mini panic attack with each bottle just praying they finish it and won't need the feeding tube again. But I never let them, or the nurses, know. I am super confident in my babies and even when I'm worried I fake it 'til I (or they) make it. It's helpful that my girls are so strong and I get my strength from them. And it's easy to be strong though when you're surrounded by positivity!

Every families' NICU experience, like the birthing experience, is different from the next. I can only say what's worked for me but I hope you consider trying them out if you ever (hopefully not) find yourself in one of these mysterious places with your strange new tiny human like we have.

Do you have experience with the NICU? What did you learn?


August 9, 2014

FIAO 5.3 - Feeding The Twins - Pumping is the Pits!

Note: This is one of those TMI posts that should really only be read by people who want to pump or are looking for help with pumping! This is my detailed experience with exclusively pumping so far and I really don't think C and my dad need to know this stuff about me!


I have been pumping since the girls were about 4 hours old. I hate it. But I am doing it because it's what I need to do to give my girls what I think is best. It's been quite the experience since then and I'm only a week in. My supply is pretty darn good, I'm up to 4-6 oz./session, but it's been an adjustment period getting used to this new aspect of my lifestyle! I'm not sure how it will be once they're home but for now this gives me peace of mind knowing I am doing all I can for them until they're here.

I am attempting to establish my supply so I am pumping every 2-3.5 hours, trying desperately not to go over the 4 hour mark in between sessions. This has been by far the hardest part for me - keeping a consistent and frequent enough schedule. Not to mention I'm getting so little sleep (ha! they're not even home yet, I am so jinxing myself) that when I do sleep it's like the dead. So far, I have slept through/turned off my middle of the night alarm at least 3 times, allowing myself to go 5-6 hours between sessions. This is not fun, in fact it's effing painful, so now I'm to the point where I set 5 alarms, 2 minutes apart, all with a puzzle lock to wake myself up. It will probably be easier when there are actual crying babies waking me up, huh?  I will definitely be trying to breastfeed at home where it will be much more comfortable than the NICU for both me and the girls. The plan is for them to eat and then I will pump to build up my stash. Eventually I may exclusively nurse or exclusively pump, I haven't had a chance to figure out what works best for us yet.

My colostrum was ridiculously frustrating. It only dripped, the syringe and cups they gave me to catch it just squashed the drops and it transitioned relatively quickly to mature milk considering I had a c-section. Since then though my production has only fluctuated by .5-1 oz. for each breast and I haven't produced less than 2 oz./pump in over a week. Tonight I pumped over 6 oz. for the first time and I'm hoping it goes up from there but this was after two days of struggling with supply.

I'm not in pain but sometimes I massage too hard or use too high of suction as I'm getting used to it. I learned that rubbing colostrum and breastmilk on to your skin after finishing is one of the best healers and I have to attest that this works! I also use cooconut oil and Lansinoh Lanolin if absolutely necessary. My lactation consultant made sure I had a prescription for a hospital grade pump and after finally reading the directions I'm learning how to use the let-down function to my advantage! I highly recommend this for building a supply. I tried my Medela Pump in Style and it was nowhere near as efficient. It will be fine once my body knows what to make but definitely not yet.

As for nursing... the girls have each attempted to latch a handful of times but it's usually while I'm holding them both during skin to skin or when they're really hungry already so it's stressful for both of us. I can't wait to have them home where I can play around with positions and such. The LC also told me to come back anytime for more help, and a nurse got me in touch with a private LC too just in case. We will see how it goes! I am just loving the fact that I am nourishing my girls as much as I can and that I'm not too proud to accept supplemental formula. As much as I worry about the ingredients being gross, they're not going to kill my kids. Maybe some of those added ingredients are helping bulk them up which is only going to get them home faster.

Other than that it's going so well. I am so happy to be able to feed my girls and help them grow!

How was your experience with pumping or nursing?  Any tips to help me be successful at doing both?


August 5, 2014

FIAO 6.1 - Navigating the NICU - Looking At The Bright Side When You Can't Bring Baby Home With You

A week ago tonight I was out at my last hurrah dinner with C's family, celebrating the fact that in less than 12 hours we would be having babies. It's hard to believe it's been nearly a week since we became parents. I guess that has a lot to do with the fact that we don't actually have our babies at home with us yet. That's right, I've been a mom for a week and I have yet to hold my babies in my home. We have yet to be woken up in the middle of the night by a tiny cry. We have not been able to break down over sleep deprivation. We haven't even had an epic poosplosion diaper change with a mad dash to the washing machine. Our hearts feel half full at this time, all because our baby girls were born at 35 weeks and are spending the first weeks of their lives in the hospital NICU away from their mama and dad.

We knew way back in January that this would likely happen. I think that's the only reason I am not a basket case over it. Having mono-di twins, depending on your care provider, you are usually told that your babies will have to come early. My MFM, Dr. Margono, said at that very first appointment that he would allow us to go no further than 35 weeks. He knew the risks of going longer all too well and had the research to back it up. At first I was less than convinced. I thought that my body would instinctively know what to do to care for my girls. I was sure that if it was really necessary to go early my body would take care of it for me. After all, I originally planned on an all natural home birth with a midwife and a doula. I hated to admit that my body might not know what was best. So I did research of my own and what I found was terrifying.

Mono-di twins (sharing a placenta) who are allowed to go on their own are can encounter a number of issues from placental degredation, uneven placenta sharing and intrauterine growth restriction. Problems could be as minute as small weight discordance or as severe as complete loss due to the death of the placenta. The more I learned the more convinced I was that going early wasn't nearly as bad was what could happen if I let my body do its thing. I simply was not willing to take the risk. So we set a date for induction (or in our case planned c-section) for exactly 35 weeks. I knew they would be small and would more than likely need NICU time. I also knew that no matter what happened it was absolutely better than the risk of the alternative, despite other peoples' attempts to make me reconsider.

I am blessed in that I was able to prepare for this. My old boss was not so lucky. Her pregnancy was hard, much worse than mine. She was sick almost the whole time, consumed with exhaustion and her third trimester was plagued with hip pain and an inability to walk as her hip slipped out of its' socket thanks to stretching of her ligaments and weight of the baby. Then she started to have contractions at 30 weeks. They were able to stop them twice but at 32 weeks after a very difficult labor in which she suffered placental abruption, her son Jack was born. Amazingly he was over 6 lbs but contrary to popular belief high birth weight does not in fact mean healthy. He had trouble with breathing, eating and temperature and ended up spending almost a month in the NICU.

She was devastated. I watched my friend, normally upbeat and positive, become a shell of herself as she spent her days in there with him, often from sun up to sun down. She hated the interventions that were forced on her and hated leaving every night without her baby. We hadn't even had her shower yet so when we had it a week after his birth it was clear that she wanted to be with him and not with us. I recalled all of this over the months of my pregnancy and prepared myself for the feelings of hopelessness that I knew would come if I had to leave my girls behind. But here I sit, two days after being discharged from the hospital myself and I am surprisingly peaceful. You may wonder how on earth I can say that. After all, it's unnatural. And my body knows that. My body was screaming that first day when they weren't brought to my room to be with me. But I am lucky. Really I am.

First, I am so lucky to have been prepared for this experience, so much so that instead of feelings of anger and sadness I have feelings of hope and gratitude. Mostly, I am lucky to live within 15 minutes of a hospital with a fantastic Level III NICU, comprised of neonatologists and nurses who absolutely love what they do and whose care for my children rivals that which I would provide myself. From the first second that I was wheeled in to Juliette's room and saw the faces of the nurses beaming at me I knew they were in the best possible hands and that I had nothing to worry about. I will not ever say it's been easy, but it has not been the uphill battle that I anticipated.

The Doctors and Nurses are so informative, answering every question I have. They are incredibly encouraging, allowing and expecting us to be as involved as we can be in the care of our girls. Above all else they are educated and experienced, to the point that I don't question for one second their ability to make the best decisions for my babies. I go to sleep at night knowing that if my babies can't be with me at least they are in the best possible place for them. For that I consider us the luckiest parents in the world. There are so many parents of multiples that receive inadequate prenatal care by doctors who just do not understand the risks and who are then thrown in to the hands of a cold, isolating NICU and forced to watch helplessly as their babies are cared for by strangers. Our experience so far has been more positive and wonderful than I could have ever dreamed and for that I am truly grateful.

As for my girls, the most recent updates are fantastic. They are both breathing on their own and are currently only hooked up to monitors and a feeding tube to supplement their bottle feedings. They are still in the isolettes but they are together in a room and each have only two degrees of temperature control to go before they are in open cribs. They are the most beautiful, amazing creatures I have ever laid my eyes on and I feel so incredibly blessed to call them mine. I cannot wait to bring them home but I want them to get as healthy as they can before that happens and I know that the NICU is the best place for that. Here's to happy, healthy babies being given the best start in life despite the circumstances.

Did your baby or babies have any special needs when they arrived? How did you handle being away from them?


August 1, 2014

Happy Birthday to the most beautiful girls in the world...

On Wednesday July 30, 2014 my heart became complete as we welcomed our little loves to the world. As I lay on a table, 35 weeks along and numb with a spinal and a sheet pulled up to my chest, my amazing doctors Dr. Kittle, Dr. Baker and a surgical resident Dr. Keller quickly began my scheduled c-section. With bright lights and noises all I around I felt some pulling and pressure but my heart was so filled with anticipation I can't even remember if it was uncomfortable. Everything happened so quickly and before I knew it my beautiful babies were pulled from inside me, took their first breaths of air and let out the most incredible screams I had ever heard.

Juliette Marie joined our family at 8:13 a.m. weighing in at 4 lbs. 9 oz, 21 inches long and Vivienne Mae followed quickly after at 8:14 a.m. weighing 4 lbs. 2 oz. and measuring 17 and 1/2 inches long. After getting cleaned up and photographed by OR nurse Alyson they were swaddled and brought over for their first snuggles with Mom and Dad. The sight and smell of my girls was like the most intoxicating drug I could imagine and my heart filled with a more incredible love than I could have ever dreamed up. As the anesthesiologist, Emily, held a screaming Juliette up to my face I quickly did all I could and kissed her tiny face, breathing in her smell, and was even more amazed as I shushed her and she quieted down immediately. Although her eyes were not open she turned her tiny head to the sound of my voice and snuggled right in. Dad was a natural at holding them and did not want to let them go, describing to me the dark hair peaking out from under their hats and how light and tiny they felt in his arms. We switched and my Vivienne was brought in for our first touch and just like her sister she was instantly calmed at the smell of me and the sound of my shushing. She opened her mouth and stuck out her tongue and I instantly felt a push to help her eat but considering the circumstances that was not possible so we settled for a few kisses instead.

All too quickly my babies were whisked away to the NICU by Dr. Markowitz with promises that we could visit as soon as I left recovery. Dr. K talked technique with a surgical resident while closing me up. I remember asking if they cut my tattoo and everyone laughing as Dr. K said "No, of course not." Dad and I cried a bit as we marveled over how beautiful our girls were, how strong their cries had been and how quickly it all happened. I thanked the team over and over for their support and they all agreed that our girls were so beautiful, even though they were smaller than we thought they would be. Soon I was wheeled to recovery where Alyson kept us company and I began to get feeling back in my body. Dr. Kittle stopped by to check on me and said everything had gone perfectly and that he would be back Friday to check on me. C spent the whole time texting everyone we know the news and receiving tons of congratulations. By 11am I was so ready to go see my girls in the NICU. And oh what a sight it was.  I have to admit it was one of the most bittersweet and conflicting moments of my life. My mind knew that what I was seeing was ok and necessary but my heart was screaming that this was not right. My arms literally ached to hold them and my eyes filled with tears as they wheeled my bed right up to the bed that held my big baby girl Juliette, with her beautiful dark brown hair and At this point they were both only on IV and they were settling in nicely but something in my heart told me Jules had a battle ahead of her. I'm glad their eyes were still closed so they couldn't see how much it killed their mother to see them and not hold them. We said hello and she turned to our voices, making my heart soar. Too soon it was time to go so we wheeled over to visit Vivienne, our little peanut. I couldn't believe how much smaller she was than her sister, but I knew instantly that she was strong as her tiny hand grasped my finger with a grip that was entirely unexpected. Before I knew it it was time to head to our room so we said some see you soons and headed off to see the family.

Grandmothers Nova (my mom) and Jama (C's mom), GiGi (great grandma), Papa T (my dad) and Aunt K (my sister) were waiting in the waiting room and seeking as much support as I could I called them immediately to let them know we were ready for them.  They brought adorable gifts and we have a little Noah's Ark on our window now of animals lined up two by two. I was still numb and just starting the pain meds so I stayed behind and visited with the group while C took them one by one to meet the girls. We talked about the surgery and how they looked and as people returned from the NICU what the next leg of our journey looked like. I could tell it was just as hard on everyone else seeing the girls in their boxes rather than my arms. Family is the best soothing for the soul though and it was so nice to just sit and visit. We talked about the day and created memory lists for the girls, including famous people born on the same day and any fun anecdotes from our morning. I started my list of all the amazing people I had come in contact with so I could write up thank yous at some point. My nurse, Maureen, joined us and went over all the important papers, procedures and what I could expect from this experience. Soon she arrived with my breast pump and explained how to use it and when. As the family took a break to get some food I began my pumping routine, actually producing some drops of colostrum that went back to me instead of the girls (two days later and I'm still getting the hang of actually collecting it rather than just rubbing it in).

As we wrapped up our visit and people started leaving I was starting to feel normal again and I was itching to go see our girls.  I hadn't yet been released from the bed so I still had to wait a bit. And that is when my first break down happened. My heart was breaking and my body was screaming that something was wrong. From our first ultrasound with Dr. M I knew this might happen but that didn't make it any easier. I cried and cried until the nurse came in with my first pain dosage and happily helped get me into a wheelchair so we could go see our girls. Imagine the change in emotions when I saw that not only were they awake and alert but doing so incredibly well. My Juliette was on oxygen as she had had a few sleep apnea spells in which she forgot to breathe but she was also so strong and I swear she looked happy to see me. I did not get to hold her just yet as her nurses Sue and Colleen explained that they were trying to regulate her temp and monitoring her a bit more closely. But my Vivienne was ready for me and the pain instantly faded as they settled her into my arms. Her nurse, Sarah, happily explained how well she was doing and how happy she was with her strength, especially given her size. I wanted to never let her go but happily handed her over to C so he could get his fix as well. We learned about what to expect from the NICU, how long to expect them to be there. It could be as long as until their original due date of September 3rd or as short as a week depending on how well they do. The bottom line is that they will not be coming home with us when we leave on Sunday. It's killing me but I know that this is the best thing for them. They are in amazing hands and every time we go see them they are doing better and better. The next few weeks will go by as quickly as the pregnancy did and before we know it we will be a family again, at home where we belong.

How was your birth experience? Did your children need the NICU?  How did you handle this?

Mama M.