New Normal

Both Max and Michaela are on the right path.  Their doctors and nurses even say that they are ahead of the curve in terms of stability and development for babies their age.  They both look a little bigger and more comfortable every time we visit, which is reassuring as well.

Despite their amazing progress, it’s still a bit difficult for us to get used to the ‘normal’ or ‘typical’ hiccups that premature babies have to work through.  Michaela is still receiving continuous positive airway pressure (CPAP).  Although she is no longer on a full ventilator and can breathe room air, CPAP ensures that her not fully developed lungs expand properly with each breath.  This requires that she wears a (very uncomfortable) mask at all times – ‘typical’ for babies at this stage.

Max’s nurses heard a heart murmur while listening to his heartbeat yesterday.  It was loud enough that a cardiologist was called to do an echocardiogram (sonogram of Max’s heart) in the afternoon to make sure everything was okay. The cardiologist determined that Max has a small patent ductus arteriosus (PDA).  The blood vessel (ductus arteriosus) that connects that arteries of the heart and lungs while babies are in the womb typically closes with minutes or days of birth in full term babies. Max’s ductus arteriosus remains slightly open (patent).  Since the opening is so small, it doesn’t seem to be causing any additional strain on Max’s heart, and the cardiologist suspects it will close on its own within the next few weeks – ‘normal’ for premature babies.

The scariest ‘normal’ issues, however, are the occurrences of apnea and bradycardia Max and Michaela both endure as they learn to breathe on their own.  Premature babies’ central nervous systems are not mature enough to support continuous breathing, so they’ll periodically go through either short periods of shallow breath or stop breathing altogether (apnea).  If the apnea lasts long enough, it will cause their heart rates to drop rapidly (bradycardia).  Sometimes they’ll be able to recover from a brady on their own and sometimes they need help in the form of stimulation from us or the nurse.  These episodes are considered ‘normal’ and are not recorded unless they last for more than 20 seconds. Thankfully neither baby has had very many episodes that last long enough to be recorded, but we’ve never experienced a longer 10 to 15 seconds than the 10 to 15 seconds where one of them is not breathing.

 As seems typical for them, though, they continue to pull through… with a little help and a lot of love from their family and friends!

Max sleeping with his Goodnight Moon "lovey" from Cousin F

Max sleeping with his Goodnight Moon “lovey” from Cousin F

Michaela with her pink blanket and Ducky Lovey

Michaela’s incubator with her pink blanket and Duckie lovey

Mom's even learning to knit so M & M will have something homemade to hold on to soon (if you know anything about Mom's coordination or lack of domestic abilities, you appreciate how big of a deal this is...!)

Mom’s even learning to knit so M & M will have something homemade to hold on to soon (if you know anything about Mom’s lack of hand-eye coordination and/or domestic abilities, you appreciate how big of a deal this is…!)

Bonus shot... love this hair :)

Bonus shot… love this hair 🙂

Family Photos!

Since both Max and Michaela had their arterial lines removed last week, we were able to hold them for the 1st time over the weekend.  Judging from their vital signs and movements while being held (which all stabilize!), it looks like M & M enjoy their snuggle time just as much as Mom and Dad do.

Boys!

Girls!

Girls!

First Family Photo!
First Family Photo!

28 Weeks

Last Thursday, Max and Michaela hit the 28 week (gestational age) mark.  Each week gets us closer to when we’ll be able to welcome them home!  In order for to be discharged from the NICU, they must be:

  • At least 35 weeks gestational age;
  • Eating on their own;
  • Maintaining their own body temperature.

This means we’ve got at least 7 more weeks left.  We’re hoping they continue on their current trend and can come home right at the 35 week mark.

M & M have had a great weekend!  A few highlights –

  • Both are tolerating their increased feeds (Max is at 15 cc, and Michaela is at 13 cc) and continuing to gain weight
  • Michaela had her arterial line removed from her umbilical cord, which means she can now be held!
  • The second round of cranial ultrasound results came back normal – no sign of developmental complications
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Both Max & Michaela have gained back up to their birth weight

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Dad performs his first temperature check...

Dad performs his first temperature check…

...and diaper change!

…and diaper change!

Michaela chatting with Auntie Melissa

Max trying to see who gave him the rough diaper change.

Max trying to see who gave him the rough diaper change.

The NICU Team

Max and Michaela spend all day and night under the close watch of what must be one of the world’s best pit crews.  Every aspect of the babies’ health is constantly monitored; real-time treatment updates are carried out seamlessly; and every NICU nurse and doctor and we’ve worked with so far has been totally caring and knowledgeable.  Best of all, the nurses are genuinely excited to walk us through the process of understanding just what is going on.  They do a great job of answering all of our questions – regardless of how many times we ask the same thing over and over again.

Michael and one of our nurses discussing Michaela's heart rate.

Michael and one of our nurses discussing Michaela’s heart rate

From adjusting breathing tubes and sleeping positions to making name tags and translating test results to layman’s terms, the nurses take great care to make sure the three M’s and I are all as comfortable as possible during our pit stop in the NICU.

These cute name tags appeared on the babies' beds one day last week.

These cute name tags appeared on the babies’ beds one day last week.

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One of the monitoring screens we spend hours looking at (and thinking about!) each day

One of the monitoring screens we spend hours looking at (and thinking about!) each day

More good news to report today!

Both Max & Michaela have continued to tolerate their feedings and are up to 7 cc and 5 cc per feeding, respectively.  Both are scheduled to have their arterial lines removed from their umbilical cords today, which means we may be able to hold them soon!  They are both slowly continuing to gain weight, and they look more comfortable now that phototherapy is complete (no more masks).

Max snoozing

Max snoozing

Michaela getting some love from Dad

Michaela getting some love from Dad

Weight Gain!

Premature babies typically lose weight in their first few days to a week after birth and then work their way back up to their birth weight by within about two weeks.  Today we got the first sign that they both may have turned the corner to start gaining weight, which is great news!  Here are their current weight and length charts (Max’s is 1st):

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Hopefully they will continue to gain from here on out.  They’ve each been bumped up to 3 cc of milk per feeding, and as long as they keep tolerating it, they should continue to get increased doses.

Michaela finished her phototherapy this morning, so her face is finally uncovered and she looks a little more comfortable.  She was modest for this shot, though, and decided she would cover her own face…

Michaela's not ready for her close-up yet.

Michaela’s not ready for her close-up yet.

Max and his sister received their very 1st piece of mail last night from Great Grandma and Grandpa Cain.  They weren’t around to open the letter themselves, so we were sure to relay the message!

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The 1st Week

Max and Michaela have gone through countless tests (and photo shoots!) this 1st week of their lives.  Here are a few of their larger milestones:

  • Both babies were able to move off of full ventilation by day 2 and are now breathing on their own with minimal intervention.
  • Both Max & Michaela were treated for jaundice with phototherapy (blue light + ‘sunglasses’ you see in their early pictures) and have responded well.  Max completed his phototherapy on day 5 and Michaela should follow shortly afterwards.
  • Both Max & Michaela received cranial ultrasounds on day 3 to screen for perinatal brain injury (bleeding around the brain) which can be a sign of potential long term developmental issues.  Scans are completed on day 3 because most abnormalities occur within the 1st 72 hours of birth.  Both of their cranial scans came back perfectly normal – a great sign for future development and a HUGE relief!
  • Both babies have been introduced to breast milk (1 cc per feeding) and are beginning to tolerate it well.  This will help protect them from respiratory and intestinal infections.

So far they’ve done remarkably well for babies of their size and gestational age.  They’ve remained stable throughout their first week of life and we are beyond thrilled!  Here are some pictures from the last few days:

Michaela under her phototherapy light holding Ashley's hand.  She's got a strong grasp reflex!

Michaela under her phototherapy light holding Ashley’s hand. She’s got a strong grasp reflex!

Max opening his eyes while crying during his cares (diaper change, temperature check, belly measurements...)

Max opening his eyes while crying during his cares (diaper change, temperature check, belly measurements…)

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Max’s big foot

Michaela's got long fingers like her mom...

Michaela’s got long fingers like her mom…

A visit from Grandma 🙂

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Dad watches over his little girl

They've each got a full head of wavy hair.

They’ve each got a full head of wavy hair!

Day 1

**We’re still busy moving and running back and forth between the hospital and home, so the 1st couple posts may be slow – but we’ll catch up soon!  

Day One

Contractions began around 7pm on Sunday, December 29th, Max’s (Baby A) water broke around 5am, and Max and Michaela were born at 7:28am and 7:41am, respectively, the morning of the 30th.  Although Max’s 1-minute APGAR score was a 1, he cried as soon as he was born!  Michaela’s 1-minute APGAR score was an 8.  By 5 minutes, they both had a score of 8 and were stabilized by the NICU team.

Max hiding under his hat right after birth. He weighed 2 pounds, 1 ounce.

Michaela's 1st picture!  She weighted 1 pound, 14.5 ounces at birth.

Michaela’s 1st picture! She weighed 1 pound, 14.5 ounces at birth.

Delivery – although completely unexpected – went well and my recovery has been quick.  Michael and I stayed at the hospital for 3 days (Happy New Year!), and were visited by some of our favorite people!

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We are so happy to welcome Max & Michaela into the world, and can’t wait until they’re big enough to squeeze.