One Month Birthday

The girls celebrated their one-month birthday with lots of activity and a visit from G-ma Ann. We went shopping in Frisco, visited the NiCU nurses, and made their debut at church. We took them to get weighed and were shocked to find that both girls are the same weight now at 7 lbs 5 oz. Lia has gained 2 pounds this first month and has closed the gap between her and her sister. This is consistent with her personality. She doesn't make a lot of fuss about anything but will sneak up on you and get what she needs. I see her as being a humble and hard worker someday--she gets the job done. She is super sweet and patient, but if you take advantage of her patience she will scream bloody murder and make it known that she will NOT be overlooked.

Zadie, on the other hand is dramatic about everything. She typically looks disgruntled and tends to make a Lot of noisy grunts and groans if she is in the least bit uncomfortable--light in her eyes? Grunt. Carseat strap getting tightened? Moan. Waking up? Groan. Nonetheless, she brings us a lot of laughs and is a lot of fun.

This series of one-month photos wonderfully captures both personalities. Lia is happy and cooperative while Zadie looks to be putting up with our shenanigans and not very happy about it. We'll see if their personalities stay consistent through the years or if we see a change as time progresses.

Night at the Symphony

Zadie has always been very effective at letting us know where she is and that she may be disgruntled about something. She grunts and groans to try to get unswaddled or to just let us know she is unhappy. These sounds occur just after we lay her in her bassinet, turn out the lights, breathe, and turn over to fall asleep. She starts with a quiet little grunt before progressively getting louder eventually turning into a wail or two prior to giving up and falling asleep. It's an entirely bearable routine that lasts for less than 3-5 minutes and just makes us laugh as it is completely predictable.

Recently, Lia has joined her sister in the grunting games. Zadie will grunt, then Lia will respond, then it goes back and forth, but really does not turn into much of a cry at all. We are quite certain that they are communicating with each other and already conspiring against us. We could be in for a world of trouble--or they could be moving to their cribs in the nursery much sooner than we had initially planned if this late night chatter keeps up. I've attempted to attach a video of the grunting games though it does not do it justice.

First Weeks

Thanks to the NICU, we have maintained a fairly strict schedule with the girls since they arrived home. Zadie came home after 7 days in the NICU on October 5. Lia followed after 9 days in the NICU on October 7. Both have strong little feeding clocks and start fussing at about 2 1\2 hours since their last feed so that we never extend beyond the 3 hour time. That said, we have been able to push them a bit at night as they have gone up to 5 hours between feedings. They are becoming more efficient little eaters, and we can finish a feeding including a diaper change in about 40 minutes now--compared to 70-85 minutes before. This is only if we are both present. Feeding them solo is quite the art (or maybe more of a science) as it requires a few extra hands and a lot of extra preparedness. While we love cuddling with the girls as little newborns, we will not miss the 2 am feedings or the wobbly little heads that have to be constantly supported. For now, our daily routine looks something like this.

7 am- Warm bottles.
7:01- Change diapers (watch out Lia WILL squirt you most of the time)
7:05- Switch bottles in warmer, switch girls for diapering. Start feeding Lia.
7:09- Start feeding Zadie (or Lia, depending on who was more inconsolable)
7:15- burp both girls, continue feeding
7:25 burp girls again, continue feeding
7:28 Bottle should be done; cuddle girls briefly
7:35- Swaddle girls and put back to bed.
7:40- Shower, get dressed, clean up bottles from middle of the night
**Assuming both girls are content....
8:00- Breakfast
8:15- Brush teeth, comb hair
8:30- Throw in some laundry
8:40- Fold laundry
8:45- Take out diaper trash
8:50- Re-stock diapers in the diaper station areas
9:00- Breathe, likely do something else to prepare for the day.
9:30- Girls wake up...start the process over again.

It's a lot of work, but we have it down to a good system now and have even been able to throw in some outings, walks, and other things to remind us that there is life out there. It's always fun to go out in public with them where everyone points and oohs/ahhs over twins. They are pretty cute, after all.

Nurses

While we were in the hospital, we had several different nurses. Of course, some were amazing while others were awful. Thankfully, most of the NICU nurses were amazing. They each had a slightly different philosophy, but they each helped the girls progress in different ways. Here is what we remember of each nurse:
Labor/Delivery/Recovery Nurse Carly:
Very nice young lady we had during the middle of the night while P was on the Magnesium. She kept scolding P for not getting enough sleep, but didn't put it together how helpless a person feels after giving birth and not even being able to see the product or contribute to their health in any way. She finally let P pump in the middle of the night which at least gave P something to feel like she could work on to make progress toward helping the girls.
Labor/Delivery/Recovery Cary: She was horrible. She acted very nice, but did absolutely nothing, and P was her only patient. She was supposed to try to help P get to see the girls but didn't act like she even cared that P was completely helpless. Finally, around 2 pm, K got on her a little bit telling her that P NEEDED to see the girls. She finally got on the horse a little bit, only to shuffle P and her high blood pressure problems onto another nurse in Post Pardum without even wheeling P by the NICU.
Post-Pardum Pam- We have mixed emotions about Pam. She was a talker and would not stop talking for anything. She called herself "crazy cat lady" and told us stories of her days working in a vet's office and how similar our drugs were to those of her animals. That said, she got P into the NICU to see the girls and mostly did her job. One day she decided it was time to remove P's IV and did so squirting blood all over the place as she yelled "oh shit!" We were all certain she had just done something horrific and were relieved to only find some blood spilt on the bed and P'd night gown. Pam's southern charm wore off quickly though after we had heard the same old stories multiple tea
Post-Pardum Annafe- As a little tiny Asian woman, full of spunk and a thick accent, Annafe was a Godsend of a night nurse. She came in, scribbled some goals on the board, and told P to get up and go pee so she would feel less pressure and wouldn't have to re-insert another catheter (thanks to the incompetent recovery nurse, P had no idea she was "on the clock" and needed to use the restroom. P had no idea going pee would be so difficult, but finally went at the 11th hour and Annafe cheered and gave her a big hug--I don't know who was more relieved that we didn't have RtI reinsert a catheter. She told P she was going to need a shower and pushed her to walk more so she would feel better. She was fabulous for two nights.
Most of our other post pardum nurses were kind but forgettable-except for Myrna, the night nurse who was comparable to Annafe, but not quite as spunky.
NICU nurse Mandy- She was our original NICU nurse and was super kind, light-hearted, and kept things in perspective. She was good at teasing and took good care of our girls while they were on the CPAP machine for the first day.
NICU nurse Carmen- 35 weeks pregnant with a little girl. She was very compassionate.
Kristi- We had Kristi for several days. She was not the most sugary sweet person in the world, but helped us to push the girls and gave us a lot of extra one-one time to teach us new ways to burp the girls, tape their wires to the diapers, mix the breast milk with the formula, get them to eat better, and countless other priceless lessons for the girls.
Emily- She helped us push the girls with their eating and with their breast feeds. Initially we were unsure of her personality, but we soon learned that she knew what she was doing and she we there to help us. Emily was one of P'a favorites.
Cheryl- discharged Lia and hooked us up with extra formula and supplies.
Barbara- a very sweet woman who took care of the girls in the evenings. She had a very kind demeanor.
Teresa- She took care of the girls several different nights. She had a way with getting Lia to eat and was the first one to get Lia past 20 cc's of milk. She had her own set of twins who were about 16 Yeats old.
Lisa- Lisa was all about helping us and doing us favors. She clearly loves her job and helped us get 2 bathtubs for the girls--which was G-ma Ann's favorite item from the hospital.
TK- She was the nurse practitioner who was in charge of Zadie and lia's health plans. She was I'm charge of all the other nurses and did a great job of keeping us informed at all times about what was happening and what our strategy was.

Overall we had a wonderful experience at the hospital and have many great memories from our time there.

Birth

After the week of "rest," we had to return to the doctor on Friday afternoon for a check up. P stayed home from school that day to catch up on school paperwork and to spend the entire day relegated to the couch. We headed out to the doctor for our 3:00 appointment to find a very busy office. It was nearly 4:30 before we saw the doctor at which point he sent us straight over to the hospital for more checks and a likely delivery. He said it was very likely we would have these babies before the end of the weekend--and then escorted us over to a room. Once at the hospital, he verified that protein levels and blood pressure were way too high so we were admitted to the hospital only to have the babies in less than an hour. Needless to say we were shocked. We entered the OR at 6:00, got a spinal and an epidural, and at 6:28 Zadie came out screaming only to be followed by her sister, Lia, at 6:30-- not wanting to come out and "jack-knifed" inside.

Zadie was 5 lbs 11 oz and Lia was 5 lbs 6 oz--both had good, strong cries, but Lia was not quite as pink as they would have liked. P got to hold them both briefly as the doctor closed her up. They then took the girls to the NICU and K followed shortly to get to know his girls.

After delivery, P had to be put on magnesium in order to relax muscles to avoid seizures or other scary things associated with high blood pressure. She was concerned about this when all the nurses and doctors groaned about "mag" being such "wicked stuff" with nasty side effects. P was already feeling a bit out of sorts and shaking quite a bit from the changes in blood pressure and the adrenaline, but braced herself for more. As it turns out the mag was wicked, but the worst part of this was that she could not leave her bed or eat solids for almost 24 hours which delayed recovery and delayed seeing the girls.

Both girls were placed on CPAP machines to help regulate breathing. Neither needed extra oxygen, but they just needed the puffs of air to make sure they didn't breathe too fast. They do NOT like these machines one little bit and tend to fight to get the nose plugs out of their nostrils. The nurses also started an IV on Lia to help supplement her feeding tube as they want all her energy to go into learning to breathe. Lia seemed to have a different plan as much of her energy went into removing the IV, screaming, and grabbing things--she likes K's hand. Zadie was able to get off her CPAP within the first 24 hours and held in strong, though her breathing was still a bit fast. Lia graduated from her CPAP about 12 hours later.

After both proved to have mastered breathing (within another 8 hours or so), we moved onto eating and regulating temperatures. Their feeding tubes were switched to their noses and they got to switch to regular old baby beds with no extra bells and whistles by day 3. They were able to be in a space right next to each other so we kind of had our own semi-private room. Temperatures were no problem--just monitored carefully. So it was just feeding that we needed to figure out--8 feeds per day by nipple along with weight gain is the goal. Zadie has been highly motivated to eat, but Lia is much less so because she is more of the typical preemie who lacks the coordination to suck, swallow, then breathe. The nurses have been training her to do this and she is now taking close to three entire feedings by bottle each day Zadie is taking all 8 and will likely be released to go home today or tomorrow. It is amazing to see their progress each day as we see lots of developmental changes and more awake time each day.