Carter & Logan are 1 Month Old (36+3)!

Though their adjusted age is still negative one month old, our boys are officially one month old and boy, did this month go by in a blink of an eye! Logan gave me the best birthday gift ever – he is off all oxygen support! His nasal cannula came off this morning and he has done great breathing on his own. Both of them are taking 3-4 bottles in a 24 hour period now and to come home, they need to be able to finish 8 bottles (all of their feedings).  Maybe it’s a matter of 2 weeks, maybe 4 – nobody knows. Nurses tell me white boys are the slowest to learn to suck, swallow, and breathe at the same time and black girls are the fastest. But once they get it, they get it. So, we just have to wait until they figure it out!

Out little Logan has really filled out – even since I took these pictures 3 days ago, he looks different. His eyes are less puffy and he just seems overall happier now that he isn’t wasting sooo much energy trying to take his nasal cannula off. He sure was hating that thing on his face!

Carter was ahead for a while there (was allowed to have as many as 5 bottles!) but he got tired and they lowered his bottle feedings to 3-4, which gave Logan time to catch up. Now we think they will come home at the same time…

We are even more used to our routines. I spend my days at the NICU and M goes after work. On weekends our parents visit and by the way, they got to hold the boys for the first time this weekend! It was really cool!  I have been back to running the household – cooking and finding time to do all the other little stuff. I think my body is fully adjusted to getting 5-6 hours of sleep a night. I make myself get up in the mornings and start knocking out errands. My goals are to spend lots of time with my kids and to take care of the house, cook, freeze meals, and make sure I am pumping at least 8 times a day. The NICU milk supply called yesterday and said they ran out of room to store my milk, so our deep freezer is now getting fully utilized. Good problem to have! I got at least 2-3 weeks on these boys!

35+3

Sunday night – exhausted after a long day in the NICU (what’s new?).  M and I got there early to learn how to bathe our litter before our parents came over for visits – his at 1 and mine at 2:30. Bathing lesson went well! So amazing to me how different and BIG these kiddos look each day, even to me and I see them daily! Logan and Carter were both super alert during their baths but seemed to enjoy them. M bathed Logan and I bathed Carter. Team work!

Logan also had his very first nutritive feeding today and knew exactly what to do! So proud of our two little boys for their good appetite and more importantly, breathing/eating coordination. The nurses tell us that each feeding at this age is like running a marathon for them. No wonder they pass out within 15 minutes of us starting the feeding. ;-)

Carter is now completely off all breathing support and takes 5 of his 8 feedings by bottle. Going home is just around the corner!!  Logan is still on 1.5L of room air per hour (think of it as a light wind going through his nasal cannula), and as I mentioned just started learning how to eat.

Tuesday will be a rough day for Logan – he has his Retinopathy of Prematurity (ROP) screening, which he needs to have done only because of his low birth weight.  Carter won’t need to have that one done. The test itself takes only 5 minutes but entails keeping the eye open with a special device, similar to what they put on me when I had LASIK surgery. Of course, babies hate it and scream at the top of their lungs. I hated it too! So, I hope I will conveniently not be there for it. Although, I never know when the doctors make their rounds…

The biggest topic of the day has been the boys’ chins. Logan (our blondie) has a butt chin like his dad. Carter’s chin is rounded and he has dark hair. I don’t think there is any question about them being fraternal now!!

I got my new pump in the mail!! This is a big deal because the Ameda Purely Yours that my insurance paid for was no good and couldn’t do the job. So, I have been renting the Medela Symphony from the hospital for $29/week and it’s been good but very expensive. Anyway! The pump I got is the Spectra Dew 350, a hospital grade pump that they use in Taiwan. It’s even better than the $700 Medela Symphony pump but only cost me $70 on ebay! Woot! I love it.  Considering I don’t have a baby (or two) to love on at all times, I have taken to pumping as my job and became pretty emotionally attached to my pump.  ;-)

In the pics below, Dad's with Logan and I am with Carter.

34+3 or 17 days old

I woke up this morning and told myself “I got this. I can do this.” If another person tries to screen me for postpartum depression or asks me if I am having suicidal thoughts, I will tell them that these repetitive screens alone make me want to push pencils into my ears. And trust me – I have been screened about four times already (OB, NICU case manager, my work wellness program nurse, other nurse who I suspect was just trying to offer help). While its a real issue and many mothers get PPD, I am not one of them. I am strong and I got this. It just took some time to adjust and to learn to talk to people without breaking down. The rest is just a lot of patience, acceptance, and humility.

Here we are 17 days later and still making small gains. The boys are in a shared twin room in the feeder/grower step down nursery. I am so glad they are together again! Carter is almost in the 4lb club and Logan is already 3lb 1oz. They are starting to look like chubby babies to me, with more than just skin and bones on them. Each diaper change that the nurses allow us to help with seems easier and easier. We even manage to get some laughs in there now too, which is a good sign of life returning to its normal hum. The other day, I was changing Logan while he was in his incubator and he had projectile poop that hit the inside of the clear case wall that was directly in front of my face. Startled by being under attack, I actually jumped back immediately after it hit the incubator. The nurse that was caring for them for the day laughed and said that I would one day miss that incubator – my shield from projectile surprises. :)

Carter now eats 3 of his 8 feedings in a 24 hour period by bottle or at the breast. To go home, he will have to take all 8. Logan is still not ready to try eating, so all of his food continues to go through the OG tube into his tummy. The name of the game for him is to gain weight and catch up right now. 150 more grams to gain before he can be moved from the closed incubator to an open crib. He also still has more oxygen support than Carter, but that will get easier as his lungs grow and can hold more air.

Our parents continue to be the only people we've allowed to have visit us. They bring food, remind us that they are there to help, and love on their grandbabies. Tonight, M and I ventured out to Pure for dinner and it almost gave me sensory overload. It has been SOOO long! I had half of a beer and decided to let M finish the rest. Better safe than sorry when it comes to my milk. ;-)

33+2 - Day 9

33+2 and we're on day 9 of NICU life. A few things to celebrate:

• Brain scans came back normal.
• Carter got moved up to the step down nursery today. He is still on the RAM cannula (2L of oxygen an hour – lowest setting before advancing to the nasal cannula), but at his max feeds for his weight and doing well. Hope he can come home in 2-3 weeks! He is still 3.34 lb – just a tad higher than his birth weight 10 days ago.  Pretty soon, he will be sleeping on a plain mattress instead of the temperature-controlled egg-shaped "bed" that sits on top of the mattress now and imitates the womb. And when that happens, he will be able to wear preemie clothes! 
• Logan is continuing to tolerate his feedings and is being weened off his IV. He's also on 2L of oxygen. After he gets to his max feedings, they may move him upstairs to be in the same room at Carter... He's also getting lipids to help fatten him up a bit, but he's still 2.55 lb – also just a little over his birth weight.
• Didn't cry leaving the hospital for the first time today.
• Learned to accept help and allowed mom to drop off meals at our home for a week now. Starting next week, need to try to manage on our own before Carter or both of them can come home.
• I am off my pain medication and the pain level is more tolerable. I still have many discomforts but just as before - nothing comes close to the emotional turmoil, guilt, feeling like this is all my fault, etc... I give myself until Friday to feel better or I should probably bring this up at my doctors appointment. 

I am still stressing about going back to work after such a short bonding time with the babies after they come home. My hope was that we wouldn't have NICU time and I would spend the 12 weeks of my leave with them at home. Never did I think that driving to the NICU would be a way of life in the beginning. I pump like its my job – every 2-3 hours and try to think positively about things not being worse than they are. Not every NICU parent is as fortunate as us... We've seen some pretty grim circumstances there before and have to remind ourselves to keep a leveled head about everything.

M and I made it a goal to do skin to skin time with each of the boys for at least an hour each day. Its so good for them and helps them feel comforted, regulates their body temperature, pulse, etc... M will be going back to work on Monday and I will need to start driving myself. Tomorrow will be my practice run after nearly 3 weeks of no driving (hospital bed rest + recovery). 

NICU Life - Week 1

It’s been 6 days since our boys arrived. As you probably figured, they are spending their time at the hospital NICU and will be there for 3-5 more weeks due to their prematurity. When you look at the specific challenges that come with prematurity, there are pretty much 4 categories: feeding, respiratory, neurological, and cardio. 

·  Feeding - at birth, they were both fed thru an IV (sugar, protein, fats) and began trophic feeds of breast milk through a tube that goes into their tummy to stimulate digestion. Since then, Carter has advanced to eating my milk alone and is continuing to increase his feeds. Logan is still relying on both, but he's getting weaned off the the IV. We are beginning to try eating at the breast, but their jaw muscles are just going to need some time to get stronger. Learning to suck, swallow, and breathe at the same time is a major milestone.

·  Respiratory - they are breathing on their own, but all their respiratory support is designed to help their lungs stay open and make breathing less of an effort so they can use more energy on gaining weight. Still, we have made baby steps in the right direction, advancing from a large scary-looking device called CPAP to a nasal cannula which looks like 2 little tubes going into their noses. Occasionally, preemies forget to breathe (this is called apnea) because they wouldn't have to do that if they were still in utero, so to help them remember, they get small doses of caffeine. 

·  Neurological - the effects of prematurity on the brain will not be fully known for a long time. Things like cerebral palsy and autism get diagnosed later in life when preemies are not hitting their "adjusted age" milestones (they are 8 weeks premature, so their adjusted age is -8 weeks and will be 0 when they are 8 weeks old). However, we do have an ultrasound of the brain scheduled for Sept 13^th at 34+1 which will tell us if there is any bleeding in the brain.

·  Cardio - the main issue with heart prematurity is occasional decelerations in the pulse (this is bradycardia). Sometimes, they are caused by apnea (forgetting to breathe), sometime the baby just gets too comfortable in their sleep and needs to be patted or rubbed to get their heart rate up.  This is a typical preemie issue and is a prime example of why there are 2 babies to each nurse at the NICU - they really do need extremely close monitoring before they grow out of these issues.

Before they can come home, they don't need to be a certain weight, but they do need to 1) maintain their body temperature on their own, 2) suck/swallow/breathe without help for 8 feedings a day, and 3) breathe room air. As of now, all the issues I explained above are typical and expected - nothing is permanent as far as we know today. But it’s a lot to take in for new parents and comes with a heavy emotional toll.  We have been so lucky to have a ton of support around us - from you guys, our families, from my moms of multiples club, and from the hospital preemie group. We also have an amazing team of nurses who take care of our boys. They are all extremely diligent and treat each child as if they were their own. All the nurses have commented that Logan and Carter are equally feisty and will be a lot of fun down the road.

I am sure within a week, the lifestyle of daily trips to the NICU will be second nature for us. For now, we just have to celebrate the baby steps we have made & put one foot in front of the other every morning. We are optimistic that our little guys are fighters and will soon be coming home with us. Each day is a milestone when it’s your child... 

We now get why people told us that life of a NICU parent is a rollercoaster – you have good days and you have not so good days with setbacks.  Two steps forward, one step back. One would think that in a way a parent of a NICU baby would get to “rest” more, but while we don’t know any different, I can tell you that this is the most testing time of our lives.

I made it my priority to establish my milk supply as soon as possible and thankfully that hasn't been an issue. I continue to impress all the lactation consultants that come to visit, but it comes at a cost of pumping every 2 hours around the clock.  M has been my main caretaker this entire time and frequently got up at night with me to help. Even now at 5 days postpartum, he still has more on his plate than ever. It’s almost like we’re dealing with all the same challenges of parenting as other people, but our family is still not 100% complete. It will be that way until the boys get to come home one day when they are ready. With NICU babies, there is also the separation anxiety of coming, going, calling nurses for updates, etc. I am tired of hearing everyone from nurses to doctors to case managers telling me that my risks of postpartum depression are greater than other people. It’s not something I can control and we will need to be strong for them together. 


Logan has dirty blonde hair and Carter has dark brown hair. Both of them have deep blue eyes.

Birth Story

It has been 5 days since my last post and 5 days since my boys were born via C-Section.   Ironically, after I was reassured that baby B still didn't have reverse end diastolic flow during the morning Doppler, he started having decelerations (in his pulse) on the monitors and instead of my 2 one-hour monitoring sessions, I was on the monitor pretty much 24/7. At some point in early afternoon, my doctor came in and said we are in that gray area of delivering or waiting and asked what I wanted to do. I told him I wanted to wait – a part of me begged that we would make it at least another week, that these boys would grow just a little bit more, that risks of scary preemie issues would be reduced, etc.  My doctor pursed his lips and told me he was thinking about delivering me but respected my maternal instinct to wait. I continued on 24/7 monitoring into late evening hours. M was by my bedside and wasn't going to leave me at night. I was emotionally unstable, cried almost nonstop, and was terrified of all the unknowns. The plan was to repeat my Doppler in the morning if baby B was not going to have any more of these decelerations that lasted over a minute and deprived him of oxygen.

But he did… and by then, we came to terms with the fact that for him, being on the outside was better than on the inside. I blamed myself for his failing cord and for being in that predicament, but I somehow found the strength take a 5 minute shower and psych myself into delivering that night, remembering all the things that needed to happen. I don’t know how I would have done it without watching M be strong by my side – he has a way of calming me down without really even doing anything. He just has to be calm and rational & somehow it can make me feel a lot better although every cell in my body is in a state of complete chaos.

I was wheeled to the OR with M in toe. While the epidural was being administered to my back, I got extremely nauseous from fear and threw up. It wasn’t my favorite part of the whole thing. There was no time for me to fast before surgery like you’re supposed to. Modesty over my body had to go out the window: I was manipulated like a piece of steak on a butcher’s block – one nurse was putting in a catheter, another nurse was doing another non-stress test on the babies and monitoring any contractions, the IV nurse was giving me a loading dose of magnesium, which thankfully I remembered to remind them about. I didn’t need it for me, but studies show that magnesium administered right before labor offered neurological protection to the babies. My doctor agreed and said “Thanks for the reminder!”.  Someone else was putting a hair net on me and anesthesiology was asking me my name, DOB, and other questions to check if I was responding well to the anesthetic. Things were happening fast!!  Just 30 minutes ago, my doctor was on speakerphone in my room with us while he himself was back at home.  Pretty soon, time warped and I was gripping to M’s hand as I felt pressure and pulling sensations reaching all the way up to my ribs. A blood splatter landed on the top part of the curtain that ran across my abdomen to keep M and I from seeing everything. Something behind the curtain was beeping and I had to throw up again. I was so embarrassed, but thankfully I had already emptied my stomach back in the other room when my epidural was administered. This was just adrenaline trying to find a way out of my body.  

Soon, we heard they were ready to deliver baby A and seconds later we heard a high pitched cry that Carter made as he was instantly whisked away to a corner of the large room we were in by a team of nurses, a neonatologist, a respiratory specialist, and slew of other personnel dressed in blue sterile jumpsuits. In another corner, the second team was waiting. One of them was waiting for baby B to bring him back to that corner. A minute later, another equally as high-pitched but healthy cry came from Logan. M and I held our breaths as we looked at each other. I told him not to sit with me but to go to them and to remember to take pictures. I knew I may not see these boys until 12 hours or more from now and pictures would be all I have to live with. M went to Logan first as we had more concerns about his well-being – after all it was because of him that we delivered that night. Apparently, M impressed everyone in the OR as he was recognizing the short abbreviations of necessary equipment that was being attached to the twins. I had buzzed in his ears for weeks about what everything was called and what it looked like, as I was starting to accept the reality of NICU parenting even then. Apgar scores were being called out. Logan’s were 8 at 1 minute and 9 at 5 minutes, which was impressive to us all things considered. Carter’s were 5 and 9. M popped back over to me briefly and told me everything looks ok so far. Both boys were put on CPAP and whisked away to the NICU. Soon enough, I was being wheeled to recovery. M never got to say bye to me and I hoped he knew I was gone and that I was ok. He had seen me in enough pain that day that I could tell watching me go through it was hurting him just the same, though he tried not to show it.

Armed with peace of mind, I was being checked by nurses in recovery every so often, but spent most of my time counting minutes until I would be wheeled back to my hospital room where I would be reunited with M and our parents who were already on the way. I knew I had to lay there  for 2 hours and those hours proved to be the toughest yet, because next to me was an empty isolate and a curtain away was a mother with a 9lb crying infant and she was talking to him and comforting him. It stung so bad to hear someone else have a joyful, happy birth experience while mine was full of fear, tears, and stress like I never felt in my entire life. I didn’t exactly picture it that way! The nurses attending to me were cold and to the point, not compassionate like the nurses back at HRP (High Risk Perinatal) where I spent most of my hospital bed rest. The numbness of my body was a stark contrast from the emotional hurt and fear I was feeling.

M popped his head in through the curtain. He was no longer wearing his sterile blue jumpsuit and hair cover. I was SOO relieved to see him! As soon as he saw me crying, he understood why. The people behind the curtain were loud with their baby and not only that, but they were Alabama Roll Tide fans and he was annoyed with them almost immediately. In his hands was a folder with pictures of our boys that the hospital provided, a set of footprints, and stats. M also took photos with his phone and made a few videos to last me until the next day, when I could get up and see them myself.

11:41pm. Carter Lee (baby A) 3lb 6oz, 16.5 inches

11:42pm. Logan James (baby B) 2lb 7oz, 15.5 inches

Shortly after, I was moved to my room and parents came in to congratulate us. We finally revealed the names to them all together and showed them the few photos we had. Everyone in the room was emotional. I looked like complete crap by then after a long day of crying. A colony of pimples appeared across my chin. But I didn’t care about any of that. I was having an out of body experience. It finally started to feel like a happy experience and I drank in every photo and footprint. After parents left, it was about 4am and my nurse had to go through admission papers with me. About an hour of that and I still hadn't tried to pump and though I wanted to sleep so badly, I asked her to bring me a breast pump and I needed to start working. It was the only thing I could do to help my boys grow now that they were under the NICU care. M went there to check on them and brought back more snapshots. It was hard to see much baby under all the monitors and tubes and blankets/hats that they seemed to be swimming in. I just couldn't get over the fact that they were THAT small. I guess that growth scan was more or less accurate. Not much fat on them to throw those estimates off. Skin, bones, and a little bit of hair – Logan’s blonde and Carter’s dark brown… but it was all ours and no matter how they looked, we were ready to do anything in the world for them and knew that from this point forward, they were going to be the most important people in our lives.