Sunday, May 29, 2011

A Week of Firsts

Today marks day 27 in the NICU.  We are down to 40 days until the boy's due dates.  While every day is starting feel a little bit like groundhog day to Alex and I, we love the little "firsts" that we get to experience with William and Winston and we have had a few great ones this week.  

First Urinary Tract Infection
This might not seem like something to celebrate, but we were thrilled to find out this was why William was sick.  Of all of the scary bacteria that he could have been infected with, we will happily deal with a UTI.  He has responded well to his antibiotics and was acting more like himself within a couple of days.  They are going to run a new urine culture today to make sure that the antibiotics he is on has wiped out the infection.  We will have to do a couple of small procedures to make sure it wasn't an anatomical problem with his urethra that caused the infection (since UTIs in boys are much more rare), but he should be fine.  

He is still on a higher level of oxygen than he was before getting sick and is struggling a little bit more to wean himself off of it.  Unfortunately the oxygen being pushed in his nose tends to dry things out.  He has been a little bit stuffy lately and so they have put him in a strange contraption that gives him more humidified oxygen to help him break up what ever is causing him the stuffiness.  It is a clear case they lay over his head.  So I guess for the next couple of days he will be the bubble boy :-).  


First Cribs
As you probably noticed in the photo above, William is in a crib rather than in an incubator.  Our great nurse Brooke surprised us one day this week by having them both setup in their first cribs before we arrived for our morning visit.  They both passed the 4 pound mark, which is when the NICU likes to wean them off of the incubators.  They still need to be bundled up in a couple of blankets and wear a hat to keep their temperatures up, but it makes such a difference in our visits to have such easy access to the little guys.  

 William
Winston
First Bath
Probably my favorite thing we have been able to do so far is to give Winston his first bath.  William can't participate yet, because he has been sick and still has an IV in, but he should be able to get one tomorrow when his IV is out.  Winston loved his bath.  Essentially we swaddled him in a fleece blanket and then placed him on a bath pillow in a warm tub of water.  We washed his body by pulling one limb out at a time from the swaddle blanket and washing him while doing some massages.  The boys have a physical therapist who comes to help us with this.  The massaging helps their joints with development.



First Bottle
Both William and Winston have been doing great with their breast feedings with Alex, so they were able to start taking a bottle once a day as well.  I had the honor of giving them their first bottle.  Never thought that would be such a thrill.  
 William
Winston

And Finally our First Family Photo!!
We had a great nurse one night this week, who was shocked to learn that we had not had the chance to hold the boys together yet.  She made it her mission to make that happen which was no easy task.  While they boys are in the same room, they are on complete opposite ends of the room and attached to multiple monitors, oxygen, etc.  She was able to move equipment around for us so that we could have them meet up in he middle of the room.  Probably my second favorite moment of this whole experience only after hearing their first little cries. 





Monday, May 23, 2011

A Small Bump in the Road for William

The boys had been having a great week and I think Alex and I just got comfortable with only hearing good news.  So we were completely caught off guard yesterday when the nurse practitioner called and told us that William was sick.  He had been bradying (sudden heart rate drops) more than normal and his labs came back with high blood platelets and a low white blood cell count and he was just acting like he wasn't feeling well by being really lethargic.  They had sent some of his blood to be checked for bacterial infections, but they also needed our consent to do a spinal tap so they could rule out bacterial meningitis.  Pretty scary.  Every time I hear meningitis I can only think of when my sister Sydney got near-death sick with bacterial meningitis at 10 months old and lost her hearing.  On top of that Alex had a minor sore throat that day so she had to stay away from the NICU.

I hurried down to the hospital and walked in the boy's room just as the nurses were prepping William for the spinal tap.  I pray I never have to have one of those and it was pretty tough to watch your 3 week old premie have to have one.  Luckily for my emotions William didn't cry out at all while they did the procedure, which I guess was more indication that he really isn't feeling very well.  The results from the spinal tap were only going to take a few hours so I stuck around the hospital until they came back.  As a big relief to all of us his spinal fluid was normal so they can rule out meningitis.  We need to wait a few days for his bacterial cultures to come back, so in the mean time they have put him back on an IV and started a 3-day series of antibiotics.  It's also possible that he has just got a viral infection in which case we will just have to wait it out.  To help him breath while he is fighting the bug they have put him back on the high-flow oxygen.

It has been tough seeing him go through his increased brady episodes and desat spells.  Both boys normally do this several times a day, however when healthy they quickly recover on their own and if it weren't for their monitor alarms we probably wouldn't notice.  However since William is sick he just doesn't have the energy to bounce back from the episodes, so the the nurse or us need to help stimulate him to get him back and it is the first time I've visually seen him turn blue.  Kind of a wake up call that as well as Winston and William have been doing they really are still sick and need to be in intensive care.

I'm sure that this will turn out to be just a small bump in their road to them coming home with us.  Despite William being sick they both gained weight last night and Winston passed the 4 pound mark!  William is only two ounces behind him.  This morning William looked visibly better than last night and seemed to have more of his usual energy.  Hopefully he will be doing even better tonight when I stop by to visit them.  And hopefully Alex is feeling better soon so that she can get back to visiting them.

Today marks their 21st day in the NICU.  Only 46 days until their due date!  We can't wait for them to be healthy enough to come home.

William shortly after his spinal tap procedure.  Even when he is sick he his pretty darn cute.  

Tuesday, May 17, 2011

Two Weeks Old! - 52 Days until due date

A quick update on Winston and William.  They both are doing great which is mainly why we haven't updated lately.  No news is usually good news as we are learning.

Winston has blown past his birth weight and currently is tipping the scales at a whopping 3 pounds, 11 ounces.  He continues to do amazing off of his oxygen.  He continues on full feeds and they are now adding extra calories to Alex's milk to help him beef up.

William past his birth weight yesterday, but fell back under it tonight.  He currently is weighing 3 pounds 6 ounces.  He is still on a little bit of oxygen and probably will be for a while.  His lungs just weren't quite as developed as Winston's.  He is also on full feeds with extra calories.  He is great at letting us know as soon as he has a wet or messy diaper.

No major tests coming up although they do have their first appointment with the Optometrist tomorrow to see how the blood vessels in their eyes are developing with the oxygen they have been on.

We love coming to visit the boys and take care of them for a few hours each day.  I guess one of the few positives of the whole NICU thing is that we get to ease into the whole parenthood thing.  The boys have also been getting regular visits from their grandparents and their aunts and uncles.  Here are some pics from the past few days:

 Aunt Alex
 Aunt Drew
 Grandma and Grandpa
 Grandma with Winston
 Grandpa with Winston
 A new great grandchild!
 Aunt Sydney
 William spooning
Winston just chilling with his pacifier

Thursday, May 12, 2011

Lots of good news - 57 Days until due date

It has been a lot of good news this week.  We officially crossed the 1 week mark in the NICU which I think will always be a blur in our minds.  Both of us said that yesterday felt like the first semi-normal day for us since they were born so that is good.

The boys have both been doing so well this week.  We keep bracing ourselves for a down day, but so far we couldn't be happier.  We are so glad that they didn't have any major setbacks in this first critical week.  Both boys are off of their antibiotics and up to full feeds through their feeding tubes.  That means that both of their IV's were able to be removed.  This is great for them because it greatly reduces their chances of infection while in the hospital.  All of their blood cultures have come back normal which means the antibiotics did their job.  Whatever was keeping William's white blood cell count low seems to be gone.

Both of the boys have been consistently gaining weight every day now.  It's not much but they are adding about 10 grams per day.  Winston is only .5 ounces away from reaching his birth weight.  William is stil about 3 ounces away.  The next milestone with their weight is to get them to 1800 grams (about 4 pounds) which will allow them to be taken out of their isolets (incubators) so they can start attempting to maintain their own body temperature.  With William at 1470 grams and Winston at 1520 grams and them currently only gaining 10-20 grams per day it is going to take some time to get to that point.

They are also both breathing really well.  In fact today Winston got taken off of all oxygen support completely!!  William is only a couple of days behind his older brother.  It's amazing to see them go from being fully intubated to off oxygen in only 10 days.  They may need some oxygen support when they start oral feedings as it is a big workout for them to learn how to eat, swallow, and breath all at once.

William's billyrubin levels have also dropped on their own without the lights, so hopefully he won't have to sit under the lights anymore.

We love our visits with the boys and I am already having dreams about taking them home.  Last night I had a dream that the mailman delivered Winston to us wrapped in paper.  He came to the door and had me sign for him.  I was so excited to get him and the whole process seemed completely normal.  I then was panicked because we haven't even bought a crib for them yet.  I guess I better start working on that :-).

 William all swaddled up
 Winston free of his oxygen
Winston asleep on his tummy

Tuesday, May 10, 2011

A Huge Sigh of Relief!

We spent most of yesterday extremely anxious to find out about the boy's head ultrasounds that would tell us how much bleeding in their brain had taken place with their premature birth. We waited all day for it to be read only to be told we probably wouldn't find out until the next day. We left the hospital to get some dinner and when we returned the new night nurse was giving us a brief update and ended by nonchalantly saying "oh and by the way their head ultrasounds came back completely normal." After asking exactly what that meant we found out it means that there was no bleeding or at least if there was bleeding that it didn't leave any damage to their developing brains!!! I can't tell you how grateful we are.

While the boys will be in the NICU for weeks to come while they grow, get off oxygen, and learn to eat knowing that their brains are and will continue to develop normally takes the world off our shoulders. Thank you to all of our family and friends who were praying and fasting for them while we found this out.

To celebrate, the boys got their first shampoo job to wash out the gel that was used on their heads for the ultrasound.

Winston getting his spa treatment
William with a clean head of hair

Their Grandpa and Grandma Dunn also came by to visit with them:
 Grandma Dunn and Alex with Winston
 Grandpa Dunn helping William hold his pacifier
William with a new set of designer shades and his pacifier.  Hopefully he will be done with the lights today.  

Monday, May 9, 2011

Happy Mother's Day!

We are coming up on our first week! Still can't believe that the boys are here. They both continue to do so well in different ways.

Winston has made probably the biggest strides the past few days. His breathing continues to strengthen and get better each day. In fact they have taken him entirely off of the high-flow breathing machine. That is the machine that pushes air into his lungs so that he doesn't have to work so hard. He still has a little bit of oxygen being pushed in but currently it is only at .5 Liters per minute instead of the 3.0 liters that he had been on and it is a world of difference from when he was intubated the first day and a half. Winston has also been doing great at gaining weight. He bottomed out at 3 pounds but has gained steadily ever since and probably will hit or surpass his birth weight when they weigh him tonight. I think that the biggest reason he is gaining weight better than his brother is that he sleeps almost constantly while William seems to be awake a lot.

Winston Spooning his Blanket

Holding Winston for the first time

William continue to be super active. It is so fun to be with him because he always has his eyes open and is moving around a lot. In the womb Winston seemed to take up all of the space and in our ultrasounds William was always crowded into a corner. This is why he has less muscle mass and also why Alex and I think that he is constantly stretching and moving around. He is just making up for 7 months of being cramped into a corner by his brother. William has had a little bit of trouble gaining weight. He has sat around 3 pounds for a couple of days. They do think he was fighting a small case of pneumonia, but they gave him a chest X-ray yesterday and the small amount of fluid in his lungs is gone. Hopefully that was what was taking his energy and we will start to see some weight gain. William is also being much more stubborn about weening off his oxygen support. He has been at 3.0 liters per minute of support for the past several days and every time they try lowering it a little bit he isn't happy. We're hoping that today he starts making some progress there.

William loves his pacifier. If only he had the strength to hold it in himself I think he would always have it in his mouth.
William has been suntanning the past few days to help him control his Jaundice. His billyrubin count has been a little too high so this helps him break it down until his Liver functions a little better.

The boys are now at a point where we can hold each of them once per day for up to 3 hours. It is our favorite time of day as you can imagine. Both of us are getting much better and more comfortable in helping to their cares every three hours (changing diapers, cleaning out their mouths, taking their temperature, scalp treatments witha toothbrush). As we get more comfortable they don't seem to be as small or fragile to us which I guess is good because eventually we will have to do these things on our own at home.

Finally I just wanted to let those of you reading this know that they boys are having one of their most important tests today. They will be taking an ultrasound of their heads to see the extent of bleeding in the brain when they were born. Bleeding in the brain can affect their brain development. It is at 32 weeks gestation when babies in the womb begin to form a protective tissue over the blood vessels in their head to protect the brain from bleeding. Because the boys were born prior to that they undoubtedly had some bleeding. This test will show us the extent of that bleeding. However their risk is more limited because they have not had any problems with high blood pressure and they didn't have any complications with their birth.

There are 4 grades of bleeding with 1 being the best to have and 4 being the worst. Our families are all praying today that they was very limited bleeding if any. I will update you on the results when we get them. Thank you again for all of your thoughts and prayers they really are felt.


Friday, May 6, 2011

Day 3 - 63 Days Until Due Date



I feel like once this is all done Alex and I will be neonatoligists with the tons of information that we are learning about premies and how you care for them. It's kind of fun talking to new nurses on shift changes because I feel like I am taking an oral test on what I learned with the last set of nurses.

First I just wanted to give an update on Alex. She has been amazing. Other than the first afternoon she hasn't used a wheel chair and has been making multiple walking trips to the NICU each day. Every nurse we run into can't believe that she just had a C-section. I'm sure the adrenaline of everything and the need to be with her babies is pushing her harder than she normally would have pushed herself. Her percocet and motrin are helping a lot too :-).

I think Alex and I are both starting to realize how overwhelming these next few months are going to be. Our brains try to trick us that because they have done so well these first few days that they are going to be coming home, but the reality is that it will be a long couple of months. We have such respect for our friends that have already gone through all of this. I guess like most things, you really don't understand stuff like this until you go through it.

The boys are continuing to make improvements. It is so great to see them not intubated. You really can see their faces and a little bit of their personalities. So far Winston is much more relaxed which is so funny because he was the one that moved constantly while in the womb. William who was crowded out by Winston is super feisty. He hates being bothered when they have to move or change him and loves tugging at all of his lines.

A little update on each boy:

Winston continues to do really well on room oxygen. That means that he is breathing the same amount of oxygen that we are. He wears a forced air oxygen line that blows the oxygen into his lungs to help make it easier for him to breath. Winston wins the pooping race and was the first of the two to have a bowl movement (when I say bowel movement I mean the tiniest speck of poop you have ever seen). On the down side Winston seems to forget to breath more often than his brother. We learned what Bradying is yesterday, which essential means that they stop breathing and their heartbeat drops below 60 for a moment. Usually all the nurse needs to do is reposition them and they quickly bounce back. As unnerving as this is for us to get used to I guess that it is really common for premies and is a big reason why they are in the NICU and each have a nurse by their side constantly. The best thing with Winston is that Alex got to hold him for the first time yesterday. It took him a while to get situated but once he was in place he was in heaven and help Alex's finger the entire time.

William is still doing great. Like his brother he is adapting really well to regular feedings of milk and formula through his feeding tube. No poop yet, but hopefully he won't be too far behind Winston. He has had much less Brady episodes than Winston all though he needs a lot of adjustments during the day with the amount of oxygen he requires. I have learned how to help the nurses with their cares they do on the babies every three hours and got to do two of them by myself yesterday with William. It is so great to be able to help take care of them. You take their temperature, clean out their mouth with a minty sponge, rub their scalp witha tooth brush, change their diaper, and reposition them. The best part of working with William late last night was that he was the first of the two to wake up for an extended period of time. Usually they just crack their eyes open for a second, but last night William opened his eyes the whole time I was working with him and just looked at me. I guess I am really going to love being a parent because it just melted my heart.

Both of the boys also got a visit from their grandparents yesterday. We love seeing them interact and I was grateful to be able to give each of them a blessing with our Dads.

Anyways I am done rambling for today. Here are some pictures for yesterday. Thank you everyone for your support, thoughts and prayers. They really are felt.

Winston without his breathing tube
William awake for the first time
William staring at me for the first time

Alex holding Winston

Grandma Davis touching Winston for the first time

video
A little video of William awake

Thursday, May 5, 2011

Day 2 - 64 Days until due date


Well the boys have made it through their first full day in the NICU! I put 64 days until due date, because that is what the nurses tell us is a good expectation to have of when they can come home (give or take 14 days). So far they are doing really well. Both Winston and William have been taken off of their ventilators and the nurses were able to start giving them some of Alex's colostrum which we hope will help to build up their immune systems.

Winston has been having issues keeping his blood pressure up, so they have been giving him lots of fluid and may put in a PICC line today to help him get that up. He also still has a central line in his umbilical cord so that they can more easily collect blood samples from him to check his blood gas levels.

William has been the rockstar early on. He came out with weaker cries, but has been all progress ever since. He is off his ventilator and his vitals have been great. He has also been responding well to his early little feedings they give him through his feeding tube. The best part is that because he is doing so well we got to hold him! They gave us 90 minutes with him late last night and Alex got to hold him for 1 hour and I got 30 minutes with him. He responded really well to it and we should get to hold him for at least an hour now every day as long as he stays stable. He is so light and so little

I also got to help change William's diaper and of course on my first diaper change had my first experience of him peeing all over. So not only did I get to help change his diaper but I got to change his sheets as well :-)

Hopefully Winston will only be a day or two behind William so that we can hold them together and get our first family picture with both the additions.

Here are a couple of pics of the experience:




Wednesday, May 4, 2011

Happy Birthday!!

So who would have ever guessed that May 3rd would become such an important day in our lives?

At 11:21 and 11:23 am Winston and William decided that they couldn't wait any longer to join us. As I'm sure everyone's first birthing experiences are it was a surreal experience for us. On Monday, Alex had been having more regular Braxton Hicks contractions than normal and in the evening started to feel some cramping. We called the on-call doctor and he had us come in to see what was going on. Alex really wasn't much more dilated than she had been a week earlier, so he gave her some fluids, sent us home, and had told her to call him if anything changed or got worse and to have her regular doctor check her again at her appointment later in the week.

Well in the next few hours the cramping started getting worse so we headed into the hospital to find that she had jumped to a 4. They called the doctor to take a look and see if they should try and slow it down, but when he got there Alex was suddenly at a 7 and he prepped the OR for a quick C-section. I barely had time to call our Dads before they rushed us into the operating room.

We were both nervous as Alex was only at 30.5 weeks, however we were grateful that the doctors had identified her short cervix early on in the pregnancy so she could be on bedrest and receive a steroids treatment to help the boy's lungs earlier on. The operating room had what Alex called a "drive through window" which allowed the doctors to immediately pass the babies from the OR directly to the NICU.

I don't think I will ever forget the sweetest sound I have ever heard, when Winston was pulled and let out a consistent loud cry. William was two minutes behind and was also crying although with a little less energy. The doctor quickly flashed each baby in front of us before he passed them through the drive through window. Both of them looked bigger than we were expecting and I am still awed that they some how fit inside of Alex's belly minutes earlier.

About an hour following their birth I was able to go back and see them. They both were doing great considering their circumstances. As indicated by their crying, William struggled with his breathing a little bit more than Winston so they immediately put him on a ventilator and treated him with surfactant. They started Winston out on a CPAP to see if he could breath with less help. In the end Winston was working a little too hard so they put him on a ventilator as well.

Alex was able to be wheeled by them in her hospital bed a couple of hours later and we wheeled her down in a wheel chair later that night to spend some quality time. Grandparents and Aunts were able to come in late that night two by two to say hi to their new grandsons/nephews.

Both of them have had a great first day considering their dramatic entrance into the world. We have a long road ahead of us as their official due date was not until July 8th (which they tell us is a good target for them to come home although it could be a few weeks earlier). We are already so appreciative and grateful for the amazing NICU nurses who are holding our hands though this process. We are praying that they will get through these first few critical days without any major setbacks. We'll try and keep you posted through the blog on how things are going. Thanks for all of your support and prayers.

Winston Dunn Davis
Born 11:21am on 5/3/11
3 pounds, 6 ounces
16.5 inches long

William Todd Davis
Born 11:23am on 5/3/11
3 pounds, 7 ounces
16 inches long

Alex meeting William

Alex meeting Winston