thisnewday | Entries tagged with twins

Got a late text from Sarah which I didn't open until this morning. She said the hospital had called to inform her that the girls had been moved from level D of the NIC-U to level G. A-C are intensive care, with A being the most critical.

All infants are admitted at level A and then evaluated for most appropriate placement. And the twins were moved from A to D on their first day in the NIC-U, levels D-G being "progressive care."

Their move to G, last night, means they are at the least critical level in progressive care and, of course, the new mom, and everyone else, is now saying, "When will they be coming home?"

Which is a great thing to be saying and thinking after the anxious months before, and the hours just after, their arrival...

LPK
LiveJournal
1.26.2012 (a)

Today we start the routine that will hopefully be little more than the next step in getting Sarah's twin girls home. As I said in a previous post, Sarah was released from the hospital yesterday but had to leave her little ones in the NIC-U. I haven't heard how that has affected her, but I know it can't have been easy.

Because there's a period of hours during which nursing staff gets report and does rounds, followed by doctors' rounds, the unit is closed to ALL visitors including parents. So I'll be driving her up to the hill, as it's known around here, around 10:30 AM and she'll spend the rest of the day and part of the evening. And she'll be joined by the kids' dad after he gets done with work.

After visiting hours, they'll both come home and prepare themselves for another day of the same. I suppose in some ways it's actually a good transition for them. Sarah will have at least a few days to rest and recover from the surgery before she has to assume the full burden and responsibility of their care at home. So hopefully that part of it will be beneficial to her.

And even though I know that she won't necessarily feel that way about it, I hope that at another level she understands and adjusts and uses it for whatever good may be made of it...

LPK
LiveJournal
1.25.2012 (a)

Just learned that Sarah will be coming home today - without the twins. I know that will be hard on her, as will traveling back and forth for feeding and child-parent bonding. I've told her to set up a schedule that will work best for her and we'll help with the travel.

I think my notion of what Sarah might be like as a parent began to take shape when she was in the second grade and her teacher told us, with tears in her eyes, that when asked what they wanted to be when they grew up, Sarah was the only one in her class who responded, "I want to be a mommy."

Nothing I've seen, through this long and challenging pregnancy, has changed my view that she'll be one of those who is dedicated, heart and soul, to her kids. So, yeah, we'll be doing our best to help her to be just that.

My wife, who tries to visit each night before her shift on another unit at the hospital, says that Layla, who is now being allowed to nurse at the same intervals as her more robust twin, is a voracious little feeder. And that there's just something about her that suggests that, of the two, she's gonna be the little instigator.

To that I could only reply, "Takes one to know one." Because, as a kid, my wife was legendary for dragging her older siblings into all sorts of misadventures in the old eastside neighborhood where they grew up. For Layla, it may well be that her very survival has been due to her ability to thrive as the feisty little underdog.

And, as we all know, that can be an asset later on in life as well...

LPK
LiveJournal
1.24.2012 (b)

Part of my own recovery has been catching up on things left undone while I was struggling just to do what no one else could or would do, so I'm a day behind with the twins.

Yesterday the report was simply that they had been placed under ultraviolet light, a therapy which is sometimes necessary for newborns, including full-term, normal birth-weight babies. The purpose of this therapy is to help break down a yellow pigment in the skin, called bilirubin, which is normally removed from red blood cells by the mature liver.

In full-term infants, this process takes about two weeks. I'll have to do a little research on the prognosis for preemies like our little ones. When I find out, I'll post an update here.

LPK
LiveJournal
1.24.2012 (a)

As of last night, I'm told, the twins are nursing once a day and have been maintaining normal blood sugar levels.

However, that's with the supplemental IV, so one of the benchmarks to be achieved before their release will be their ability to maintain normal blood glucose without the IV. Another will be their ability to maintain normal body temp without the incubator.

Still, so far, everything looks good. You go, little grrls!

LPK
LiveJournal
1.22.2012

The NIC-U where my granddaughters spent their first day after delivery has seven levels of care, designated A-G, with level A being the most critical. They started the day Friday at level A but by today had progressed to level D. Earlier in the day, there had been a drop in their blood glucose levels, but that was handled through an adjustment in their IV solution.

Today, they are going to try to feed them by mouth as the next step in their progress toward going home. At delivery, Amelia was 4 lbs. 5 ozs. and Layla was 3 lbs. 7 ozs. I know that weight is not the only factor in determining viability and all other indicators have apparently been good, so we'll see. Mom and dad seem to be doing fine as well.

Still haven't been up to see them due to the lingering effects of this flu or whatever that I've had but my wife has gotten some awfully cute pictures on her digital camara. Will try to post some of those as soon as I figure out how.

LPK
LiveJournal
1.21.2012

We got the call from our youngest last night. Based on the most recent growth sonogram, "Baby B" has stopped growing and that's the indicator for scheduling the C-section. Based on that, she's now back in the hospital for the work-ups for a Friday C-section.

LPK
LiveJournal
1.19.2012

My youngest daughter was admitted to the hospital last night because two out of three strips on her twice-weekly sonogram indicated restricted blood flow to "Baby B" and because there were indications that a particular vein to the same baby's liver was beginning to close, something that's not supposed to happen until after birth.

The reappearance of the blood flow problem was disappointing, given that the condition had recently improved enough for the weekly sonograms to be reduced from three to two. But it's the emergence of the second condition, the vein closure, which seems to be the more imminent threat to fetal well-being.

Also, following her admission, she began having contractions and dilating. And this evening she was told to skip her dinner, an indication that a decision to perform the planned C-section may be imminent.

Her mom works tonight, in the same hospital, so she was planning to see her for a few minutes before starting her shift. She said that Sarah was tired, feeling a lot of anxiety, and hadn't felt like eating her lunch.

When she called me yesterday, to tell me about her sonogram and planned admission, we talked about what a good thing it was that her two little ones had had the benefit of these extra weeks, since the blood-flow problem had been discovered, to grow and develop.

At that point, "Baby A" was less than 2 lbs. and "Baby B" was barely more than 1 lb. Now, "Baby A" is almost 4 lbs. and "Baby B" is well over 3 lbs.

The hospital where our daughter is being cared for has the regional Neo-natal Intensive Care Unit or NIC-U. Although we take some comfort in its availability, we had hoped that our two little granddaughters would not have to begin their lives there.

Now, our hope is simply that life may be sustained, for our daughter and her two little ones...

LPK
LiveJournal
1.13.2012 (a)

My youngest daughter is now in her 33rd week of pregnancy with identical twin girls. The greatest blessing of this past Christmas was that she didn't have to spend it in the hospital hooked up to fetal monitors, IVs, etc.

Hers is considered a high-risk pregnancy because of a condition, found only with identical twins, where the blood flow to one is so much less that it can cause a deficit in fetal development, growth, and survivability.

The condition is initially detected when growth differential between the two fetuses passes a certain percentage as shown by periodic growth sonograms. At that point, the frequency of growth sonograms is increased and a second type is added which monitors blood flow to the smaller twin.

So instead of two sonos per week, my daughter was having three. And she had spent the two weekends before Christmas in the hospital because the facilities at her ob-gyn practice were only available during the week.

At the time when they first started monitoring this, the babies were only a little more than a pound each and she had been screened and prepped for an emergency Cesarean Section should the need arise.

Thankfully, the sonos before Christmas showed sufficient improvement that she was able to spend the holiday at home and the ones since have actually shown considerable improvement.

To update, she's now in her 34th week, the twins are now over three pounds each, and she will be scheduled for Cesarean delivery during the 38th week which is protocol for this type of pregnancy.

Her physician has been quite encouraged by her progress and indicates that, if maintained, the babies may not have to pass through the NICU (Neo-natal Intensive Care Unit) and may be able to come home with their mom four days after delivery.

Everyone in the family has been following this closely, especially my twin sisters who were born under similar circumstances some sixty years ago...

LPK
LiveJournal
1.4.2012