NICU Time

Being in the NICU was the last thing I wanted for my boys.  When you think NICU you think of the worst.  You think of scary sad stories you hear on TV.  After spending a few days in there I have grown a new respect for the NICU and could see myself working there one day.  ;) 

They were born early Friday morning at 1:09 and 1:10 making their birthday May 16th, 2014.  Here are the first pictures we took of them that day in the NICU and a little information about their care. 

Kane:

Kane started out the most fragile.  He had to work the hardest to breathe.  They started him on high flow oxygen to keep his oxygen saturation up.  He was placed an OG (oral gastric) tube.  This is to monitor his stomach contents.  The nurses are able to decompress his stomach of free air and mucus if need be.  This tube is also used to feed him if he is unable to suck and swallow or has issues with PO intake.  He was placed and IV to his right foot where is received TPN (total parenteral nutrition.) This way he is able to get nutrition and maintain/gain weight while waiting on my milk to come in.  The gold heart monitors his temperature and then he has the typical vital sign monitors such as heart rate, respiratory rate, oxygen saturation and blood pressure.

They think that Kane also has hypospadias.  Wikipedia says that "Hypospadias is a male birth defect in which the opening of the tube that carries urine from the body (urethra) develops abnormally, usually on the underside of the penis. The opening can occur anywhere from just below the end of the penis to the scrotum.  Hypospadias are among the most common birth defects of the male genitalia.  In developed countries, most hypospadias are surgically repaired in infancy. Surgical repair of first and second degree hypospadias is nearly always successful in one procedure, usually performed in the first year of life by a pediatric urologist or a plastic surgeon."

Well, there is one way we can tell them apart if we ever get them mixed up!

Reid:

Reid has all the same monitoring except for he did not need the high flow oxygen.  His IV was in his left hand and he received the same nutrition as his brother.  Reid's complexion was more red than Kane's as you can tell in the pictures.  I have no answer as to why their complexions are so different.  To me Reid looked like the more sick baby but he has been a champ.  Little to no complications at all.

My little tomato :) 

It took me a while to be able to get out of bed after the c-section.  It is so true about nurses being the worst patients.  I was trying to not take any pain medication and that was a big mistake!!! I woke up from a nap with so much pain that I thought I was going to throw up and went into this scary cry! LOL It took a while for me to get my pain under control but once I felt strong enough to get into a wheelchair, Ryan wheeled me down and I got to hold them for the first time.

Holding Reid for the first time.

Holding Kane for the first time.

May 17th, 2014 was Day 2 in the NICU.  The nurses let us be very hands on with the boys.  When we come in to see them at their "hands on" time we get to take their temperature, change their diaper and clean their belly button.  We can then swaddle them and love on them.

Here are Reids' statistics on Day 2.  He had gained 3 oz that day and his nurse was Michele and Kim.  His hands on times are at 8am, 11am, 2pm and 5pm.  We have 30 minutes to get done what we need to and then get him back into his bassinet.  To grow he needs little stimulation and lots of monitoring.  They removed his oxygen today and was able to maintain his own body temperature so his heat lamp was turned off too. 

Kane's Day 2 statistics are that he had lost 1 oz.  His "hands on" times are at 8:30am, 11:30am, 2:30pm and 5:30pm.  Which is 30 minutes after Reid.  This helps the nurse taking care of them if we can't be there.  Ryan and I alternate kids each time.  We both start at the same time that way we have more time with each one.  We usually stay about an hour and then go back to the room and rest.

My milk has not come in yet but my colostrum is there.  I pump every 3 hours.  I have made my pumping schedule 30 minutes before it is time to go see the boys and feed them.  That way we are all on the same schedule and when my milk does come in we will already have a routine going.  I am to save every little drop of milk I get.  I do not necessarily get milk every time I pump right now but I am trying to teach my body to produce more milk by pumping more.  I am only getting 0.2 ml at the MOST each pumping session.  That is not a lot at all.  But it is given to the boys and they love it no matter how small the amount.  It's like a treat for them.

Postpartum belly!  My incision is impressive and not at all what I expected.  You can barely tell where it is.  Dr. Moore stitched it from the inside and then put derma bond which is a surgical glue on top to keep it together.  I am also amazed at what little stretch marks I have.  I got a few more in addition to the ones from Liam.  I was expecting big red creepy ones but not this girl!  Who knows if it is genetics or the fact that I lathered on stretch mark cream and vitamin E oil every chance I got!  Once I am able I hope to start running again and get in a bikini next summer!

Reids' future is so bright he needs his shades on!  Bless it!  His bilirubin level is a little on the high side so to prevent it from getting any higher they have placed him on a bili-blanket. 

They started them on formula today.  They had just been getting TPN through their IV's but wanted to see how well they would do with PO food.  They called us to see if we wanted to give them their first bottle.  Well, duh!!!  They started them with 10ml of Similac.  Reid caught on right away.  Kane, on the other hand, drank about half and then they had to put the rest into his OG tube.  He finally caught on during the 3rd bottle.  They changed some nipples around and it took them about 30 seconds each to down the bottle.  By the end of the day Reid had pulled out his OG tube and they felt it was no longer needed due to his drinking skills :) Making progress!!!  

Mom and her babies!!!

May 18th, 2014 was Day 3 in the NICU.  They have had the same day nurses for the last 3 days and we love them!  I think the like us too.  We seem to be the only parents that are still in the hospital with their baby.  So while the other nurses are having to feed their infants every 3 hours, Ryan and I are taking care of their patient load all day long.  They are just there if we need any assistance and to keep the IV pumps from beeping.

By the end of the afternoon both boys IVs' were non functioning and had to be restarted.  Both them got one in their right hands.  After all they are twins, right?  Why not have matching IV's!  They also pulled Kane's OG tube out due to his improvement in eating skills!  As far as oxygen goes, Kane is now on only 1 liter of oxygen!  Hopefully that will be gone tomorrow!  Now we just need to fatten these boys up!

Kane's bilirubin was elevated this morning so to be just like his brother, he now has a bill-blanket too.  Reid's bilirubin level was really unchanged so both of them are now on the blanket and phototherapy.  The extra lamp helps to give them more exposure to light and keep those levels down.  Jaundice is pretty much a given for a premie baby so all of this was to be expected.  Reid's jaundice is worse.  That is the reasoning for why he looks like a tomato.  He has more blood cells to break down which causes more bilirubin in the blood.  Which in turn is the reason for a higher bilirubin level than this brother.

Reid

Kane

Reid's weight stayed the same today, 4 lbs 13 oz.  Kane once again dropped a pound and is now at 4 lbs 12 oz.  They increased their feedings today and they are both getting 20ml of formula each feeding. They also receive whatever I have pumped and is available at that time as well.  My milk is slowly progressing.  I am up to 1ml of milk each pump now.  So, I am hoping that any day now my milk will be fully in and we can start working on breastfeeding.

Check out how big the pacifier is compared to his little bitty head! 

Liam got to come into the NICU today to meet his brothers for the first time. We washed his hands but explained to him that he couldn't touch them.  We told him who each one was and he never forgot it.  I don't think he realizes that they are coming home with us!  Here are some pictures of him meeting them.  He came prepared with his "Best Brother Ever" shirt on!

Meeting Reid for the first time.

Meeting Kane for the first time.

One big happy family!

with Kane…

with Reid…

May 19th, 2014 started Day 4 in the NICU.  I got up that morning and took a shower.  My recovery has been smooth and I no longer rely on Ryan to wheel me back to the NICU.  I'm not having to take my pain medication as often as I did in the first 2 days.  I'm slowly but surely getting more milk.  I got 3ml each pump throughout the night and I have increased up to 10ml this afternoon.  I am hoping to keep increasing to meet my high demand!

The boys are still doing well with no set backs.  Reid had lost weight.  He is now down to 4 lbs 9oz.  Kane is finally gaining and is 4 lbs 14 oz.  I fed Kane first this morning while Ryan fed Reid.  I can't get over how much they look like little old men.  Here is a picture of Kane all bright eyed and bushy tailed after his bottle this morning.

Reid got a bath last night and got the oxygen tubing stickers off of his head.  They got his footprints and made him a little sign on his bassinet.

We had a few visitors today.  Mom came to the 11am feeding and fed Reid.  This was her first time getting to feed one of them.  Linda came in after mom had finished feeding and got to meet them and hold Reid as well.  They decreased Kane's oxygen to 0.5 liters and took the phototherapy light off of both of them.  The Dr. explained to me that she felt like what they thought was hypospadias on Kane was not really hypospadias but possibly just an adhesion.  She wants Dr. Eastham, our pediatrician, to take a look at it and determine if her feelings are accurate.  Dang, now how are we going to tell them apart?! HAHA! Just kidding! I am happy to know there is a possibility that there is no issue there!

Angela also came to visit us at the 2pm feeding and she brought her camera too!  Over the last almost 2 years Angela has been an important part of our family!  She has been able to capture my growing family ever since Liam was 9 months old.  The way she captures life in film is like no other.  My love for her eye in photography and her love for taking them are not the only things we have in common.  We are both nurses and building houses at the same time!  Here are a few she took of the boys today!  I want to cry every time I see them!  Thank you so much Angela!  I'm not good at taking pictures but I am good at sewing and crocheting, so when another little Zuill comes along he will have all the blankets, gowns and hats imaginable!

Aunt Mandy also came to visit and take a peak at the boys.  She brought me a Gigi's peanut butter cookie sandwich!  She is top notch in my book!  They were hanging out swaddled up in their bill-blankets.

Kane

Reid

JoAnn brought Liam around 4pm and she went back with Ryan and fed one of the boys while Liam and I spent some time together.  It's obvious that this new transition is taking a toll on both Liam and I.  He is showing out and acting up around us and I know he is 2 but I think that is his way of letting us know he doesn't like what is going on.  We both had a little crying moment together in the floor and it was almost like he understood at that moment that I'm still here and it was like his attitude towards me changed.  We colored and he loved on me until they came back to the room and then JoAnn took him to my mom's to spend the night!  Although I am sad that we are leaving the hospital and leaving our boys behind, I am so excited to go home and spend time with Liam.  Ryan also told me that while they were back there they took Kane's oxygen off and he was tolerating it no problem! Yay for more progress!

Last feeding of the night for us before we go to bed and its my turn to feed Kane again.  I didn't take a picture of Reid this morning so before we left I took one quick picture.

Oh, I almost forgot! Earlier in the day I noticed Reid's IV getting puffy and pointed it out to his nurse, Leslie.  She felt the same way and decided that before she started another one she would speak with the doctor about leaving it out.  The Dr. increased their feedings to 31ml each feeding and they monitored Reid's blood sugar and so far he has passed so no more IV!!!!!  Their nurse tonight thinks they will try to take out Kane's tomorrow and see how he tolerates it!  These boys are impressing me with their progress on a hourly basis!!!

This post is very lengthy and I apologize!  I am going to keep posting on this one as the days in the NICU go by.  I will just repost each day as I get them done to keep everyone who wants to know about our amazing journey with our amazing boys informed!

May 20th, 2014 and my babies are 5 days old!  My milk is slowing coming in little by little.  The lactation consultant this morning said that ideally once my milk is in I should be pumping more than 35 ounces a day!  Holy cow!  No pun intended!  Thats a lot of pumping and a lot of milk!

The boys this morning looked great!  Reid looked handsome this morning.  I got to feed him.  He drank 35ml this morning and held all of it down!  I forgot to look at his weight so when we go back at 11am I will be sure to look at that.  Kane also looked good.  He drank 30ml and held most of his down.  The oxygen has dried out his little nose and he has a crusty booger that is making noise and causing him a little distress.  The nurse gave him some saline drops in his nose to help loosen them up.  He still has his IV but we are hopeful that it will be gone today.  The nurse today told us that Dr. Eastham came through this morning to meet them.  He feels that Kane does not have hypospadias and he should be able to be circumcised before discharge.  Yay!!! The nurse said that at this point as long as they can continuously gain or maintain weight for 48-72 hours then they should be able to go home.  The night before they are discharged we will "room in" with them.  That means we will come up here the day before and they will be able to sleep in the room with us and make sure that we are able to take care of them and adjust before they go home.  We also have to do a carseat test where they have to sit in their carseats for 30 minutes to an hour to make sure there aren't any complications with breathing and they properly fit in the seat.

Kane's weight was 4 lbs 14 oz today!  Feedings were once again increased for both of them!  Kane's last picture of him and his bili-blanket.  Now all we need to get rid of is his IV!!! He was weened off of the TPN but the IV is staying in until his blood sugars are consistent and within normal limits and then they will remove it!!!

Reid's weight was 4 lbs 9 oz today!

Kane got a bath last night and he got his foot prints done to match his brother!

Kane sporting his first outfit!  It fits him perfectly and he looks so handsome!

 Kane still has to have his bili-blanket at least for a little while longer.  

Look at these bright eyes!  My handsome little man!  Makes my heart melt!

It was rough and there were many tears shed but we have made it home and we are all adjusting back to the way things were.  Liam wants to help with everything and we are making sure we pay attention to him when he wants to help with things.  Here he is helping Ryan put together their co-sleeper.  We are going back tomorrow for their 11am and 2pm feedings.  I can't wait to see them already!

May 21st, 2014 and its Day 6 in the NICU.  We got up this morning and got everything ready to head to Murfreesboro.  We took Liam to Ryan's parents house, stopped and got breakfast and then hopped on the interstate.  When we got there we met Dr. Walker.  She was by far my favorite doctor for the simple fact that she told us the boys could go home!!!!  She said that both were doing very well and she hopes for us to room in with them Thursday night and then get their circumcision on Friday morning and then hopefully be out of the hospital around noon!  What great news!!! For the 11am feeding I started breastfeeding Reid first.  It was a learning process but he did really well.  It took him some time but he finally figured it out.  We only worked on it for about 15 minutes until he was over it and then I gave him a breast milk bottle to top him off.  Ryan fed Kane a breast milk bottle while I worked with Reid.  We spoke with a social worker about possibly getting a new pump since mine is on its last leg.  Hopefully we will know more about that tomorrow too!

I had mentioned something to Ryan this morning about getting a hair cut today and he said something about getting a straight razor shave because he has never had one.  I Googled it and found a place to go to.  So after the 11am feeding we made our way there.  All I can say is that Ryan has been ruined.  They even gave him a beer while he was getting his hair cut! LOL  It took longer that I expected it would so we stopped at Sonic and grabbed lunch and made our way back to the hospital for the 2pm feeding.

It was Kane's turn to breast feed and I knew that he would be the more difficult one.  I was right.  All he wanted to do was sleep.  We tried for about 15 minutes and then I gave up and gave him a bottle.  Of course he sucked that down!  So he is going to require more work and lots more patience!  The lactation consultant came by and gave me some tips and advice.  I pumped after trying to feed both of them just to make sure I was empty.  After they were fed we left and took some things back to Babies R Us and then made our way home so that I could take a much needed nap!  We plan on going up there around lunch time tomorrow and starting the rooming in process.  I can't wait to bring my babies home!!!!

May 22nd, 2014 and it's our last day in the NICU!  Today we get to room in with them so that we can take them home tomorrow!  I have been a nervous wreck all day.  Running around the house making sure everything was in place before they come home.  We left Manchester around 1pm to make it to their 2pm feeding.  When we walked into the NICU they were laying in their new bassinets.  The nurses went over how the room in works and showed us to our room.  The room looks like a motel room.  It has a full bed, TV, fridge, microwave and two chairs.  NO WINDOWS!!!! But we are only staying one day and I love that they have you do this before you go home.  

Once we got settled in I got Reid ready to eat.  He latched on immediately and ate for about 15 minutes then I supplemented him with a bottle.  Ryan fed Kane and he projectile vomited everywhere.  It scared us because it was coming out of his nose.  We suctioned it out and he finished off the last 15mls that were left in his bottle.  After that we FaceTime'd Liam and let him see his brothers.  I can't wait till I have all 3 of them together!!! They both passed out and I laid down and took a cat nap before it was time to start all over again.  The 5pm feeding I worked with Kane on breastfeeding.  He latched on like a champ which wasn't what I expected after yesterday's feeding.  He then drank all but 10mls of his bottle.  Ryan fed Reid and he drank all of his.  Little piggy!  Once they were done eating we wrapped them both up and laid them together for first time and took pictures.  We FaceTime'd my parents and Maggie and let them see the boys.  Ryan and I ordered pizza from Pizza Hut and watched some Law In Order: SVU then it was time for the 8pm feeding.  Everyone is adjusting well and excited to get home.  Circumcision is scheduled for in the morning along with a bilirubin check.  Then it won't be long till we get out of here!  I better get off here and catch some zzz's before it's 11pm and time to start all over again!!!  

  

                                    

May 23rd, 2014 and this will be the last time I will post on this blog.  Today we get to go home!  Last night went well.  Breastfeeding didn't go so well after I blogged last night.  I know that it is a learning process and the time we spend trying is just getting them introduced to it.  They say that they should fully understand by their due date which is June 21.  So we are practicing at feedings that they are wide awake and look like they would be interested.  The nurse would come in and check on them every 3 hours to see how much they ate and how many wet and dirty diapers they had.  About 830 in the morning one of the nurses came in to take the boys to their circumcision.  They gave us a meal pass for breakfast and then we went back to the room to get everything packed and put into the car.  They came in to let us know that the circumcision and discharge assessment by the doctor was completed and we were ready to go home.  And by the way, Kane was able to be circumcised.  Dr. Eastham said that it was NOT hypospadias but that he had a "natural circumcision" and that everything would look normal.  It was close to feeding time so we decided to stay and get them fed and settled before we went home.

One last picture together before we left the NICU.  Their coming home outfits that I made them were way too big.  I felt like these outfits were fitting! :)

They went over all our discharge instructions and checked their circumcisions one last time and we put them in their car seats.  All the nurses in the NICU we amazing.  We became pretty close to some of them and I can't say enough about the care they received while they were there.  I have fallen in love with the NICU and could eventually see myself working there in the future :)

  Here we are walking to the elevator.

Ryan had the car pulled up by the doors waiting on us to get in.  Here they are in their seats in the car.  Ryan seems to think that I am going to want to trade the Flex in for a mini van.  I just don't see myself driving a mini van.  

So excited to be going home!  Our lives are changing forever and we couldn't be more happy with our little family!

We made it home safely and got the boys settled in to their rockers before big brother came home.

About 15 minutes later Ryan's parents brought Liam home.  He was so in love.  I wasn't sure how he would be with us holding them but all he kept saying was "WOW" and "They're so cute."  He was so gentle and kept a huge smile on his face.  He couldn't keep his eyes off of them! 

When it was time to feed them he wanted to help.  He helped Ryan fix the bottles and then helped each of us feed the boys.

My heart is so full and I can't believe that I have these 4 amazing boys in my life.  Yes, Ryan counts too.  LOL!  I am so lucky.  I'm sure I won't be saying that at 2am in the morning about a week from now when I am sleep deprived.  As for now my life is complete and I couldn't be happier.  I cry tears of joy as I end this blog because this last week has been full of so many emotions, but the emotions that I have right now are pure joy.  I am so thankful for everyone that took care of my precious babies and also myself.  I am thankful for all the calls, texts, visits, gifts, food and prayers.  We couldn't have made it through this without the love and support of our families and friends.  Thank you, thank you, thank you!!!!!