Snuggling!

I was able to hold both girls at the same time yesterday!  It was so awesome!  Lots of pictures were taken, and several of the nurses came over to ooh and aah at the cuteness:

I was originally supposed to just hold Hazel (it was her day), but after changing Abigail, she (Abby) was wide awake and staring in our direction.  I mentioned or the nurse (Lindsey) mentioned the possibility of holding her too, and I was like YES!

As for medical stuff, Dr. Breed came by and said Hazel's sodium level was still a bit low, so he was adding sodium to her food to increase it.  Abby's was low normal, so nothing would be added at this time.  He'd then check the girls on Monday (I think that is the normal lab day).  Both were generally doing better with residuals, although they still had feedings with a bunch coming back up.

After getting to hold the girls together for over an hour ... SO awesome, Lindsey put Hazel back, as she was having a few apneas/bradys, and I held Abby alone for another 45 minutes or so.  I finally had to give her back too around 5:45, and during this feeding/diaper change she was clothed for the first time!  Check out her cute outfit ... I know her dad really liked it:

Last night Matt and I stayed up way too late talking about which insurance to select, but I think we finally figured it out.  Is it possible the whole topic could be any more confusing???

17 & 18 Days

The girls have been doing well.  Fortunately, this means there is not much news to report.  ;)

On Wednesday, the occupational therapist came by during the 2:30 feeding and introduced herself.  She works with the girls twice a week (normally in the morning), and overall she is happy with their progress.  She also said it is best if we don't hear from her - it means things are okay.

Both girls were officially over birth weight on Wednesday, too.  Hazel was 2 pounds, 12 ounces and Abigail was 2 pounds 9 ounces.  Yay for them.  Wednesday was also my day to hold Hazel, and the little squirt was able to pull off her nasal cannula twice during our kangaroo visit:

Dr. Kinstra also came by during our kangaroo time and said the only change she was making was to split Hazel's caffeine dose, so instead of getting 10 ml per day, she'd get 5 ml every 12 hours; the doctor was going to decide whether to change Abby's until later that night.  

Afterwards, I helped change both diapers, and Abby had a large and rather gooey surprise at the 5:30 change.  It leaked from her original diaper,  past her new diaper, and on to the bedding below, and took both me and Cathy the nurse to clean and wipe her.  Pretty impressive for such a little girl!

So, yesterday, turns out the girls had gained even more weight!  Hazel was up to 2'14 and Abby was at 2'12!!!  Woohoo!  No medical news to report, aside from less residual at their feedings.

I held Abby yesterday.  She didn't pull any cords out, but did manage to squirm out of her hat several times:

The other interesting thing is Hazel got swaddled and clothed for the first time!  Apparently it was help keep her from pulling her cords out.  ;)  Here's a pic of her in her first outfit!

Seems to have worked somewhat, although while I was kangarooing Abby I could tell that H's hands were already free of the swaddle.  She managed to keep her cords in, though.  :)

Last night Matt and I also met up at the theater to see The Hunger Games.  I haven't read the books yet - Matt has - so it was interesting to go into the movie without any much of an idea regarding the plot.  Pretty good movie, and I liked how it drew from Greek mythology, Roman history, etc.  Now I can't wait to read the book...you know, in all of my spare time.  ;)

After getting home we had a discussion about insurance.  Since the premiums are so high with mine, we planned to switch to his, and he has several options, so we want to make sure we get the maximum benefit.  I had previously googled the cost of a NICU visit for a baby ... we'll see what it is once we get the bill, but depending on where you go (and how long, of course), it is anywhere from $7K to $12K PER DAY.  And we've got two (doubtful there is a twin discount).  And they will be in there for close to two months.  Wowza.  Thank goodness for insurance.

Length Surprises

Yesterday was the first time to visit the hospital without Matt.  It did feel a bit weird without him there, especially during kangaroo care time, when only one of the girls was held.  I'm planning to hold each one every other day, and yesterday it was Hazel's turn:

I felt bad that I was not giving Abby enough attention, though!

Yesterday was also my mom's birthday, so I sent them a text with pictures while at the hospital and when I got home last night gave them a call to update them on the status of everything.

Finally, I felt like I had a really good pumping day yesterday.  I ate well, squeezed in nine pumps, and, while I didn't add it up, felt like the milk production went well.

Today - completely different story.  For some reason the alarm didn't go off at 5:00 am like it was supposed to, so I woke up at 6 realizing I had missed my pump time, and that seemed to through me off for the whole day.  On top of that, during one of the pumping sessions, I got less than 20 ml total!!  Argh.

I met Matt for lunch at the hospital, afterwards ran over to the Financial Counseling office to start the process of the Social Security paperwork, and then spent the afternoon in the NICU with the girls.  Hazel was wide awake during her two diaper changes, and had a wonderful time pulling out her feeding tube with her tongue and pulling out her cannula with her hand.  At the 5:30 feeding, she had a pretty strong grip on that thing!  Cathy, the nurse, told me she thought Hazel was going to be the instigator when she got older.  ;)

Abby, on the other hand, was pretty calm.  I was able to kangaroo care her today, and she and I had a nice little afternoon nap.  It was so sweet - she cried a bit when Cathy picked her up to put her back in the isolette.

So...medical news...both girls (not Hazel) are on the medication to help with their residual, and it seems to be working.  Apneas have also gone down a bit, too.  Otherwise, there was not much to report.

BUT...the most interesting tidbits of the day ... first, it turns out Abby was 14 & 3/16 inches when she was born, not 10 & 1/4!  Turns out that number was the circumference of her head, not her length.  You'd think we would have picked up on this sooner, but apparently not.  ;)

The other interesting tidbit ... the girls have grown about an *inch* in the two weeks since they were born!!!  Cathy showed me the measurements on their charts, and gave me two tape measures so I could track it.  They are measured every week, on Saturday night.  Check out the leap from week one to week two:

 Both gained about 1 cm in the their first week of life, and then gained 3 (A) or 4 (H) cm in their second week!  Wow!!!

Obligatory pic of Hazel - note how she is all splayed out:

And pic of Abby...note how she is more tucked in:

 Cuteness to the extreme. ;)

Two Weeks!

The email update to my office this morning (note I borrowed the personality section from Matt's opus):

Hi everyone,

So far, things are still progressing well.  As Christa mentioned to me though, both girls have had some ups and downs, which is to be expected.

Yesterday was their two week birthday!  As you probably know, babies initially lose weight after they are born and then are supposed to gradually gain it back over the first few weeks of life.  Fortunately, that is happening with the girls.  Hazel is up to 2 pounds 12 ounces (1 oz over birth weight) and Abigail weighs 2 pounds 7 ounces (1 oz under birth weight).  Hazel and Abby now receive about the same amount of food per feeding (23 and 22 ounces, respectively), although both have had issues regarding "residual," which is (basically) undigested leftover food in their tummies.  Because of these issues, yesterday the doctor had x-rays done of the girls' stomachs, and all seemed clear.  Since Hazel's residual was a bit higher than the doctor liked, however, he decided to give Hazel a medication that would help "move things along" in her tummy.  It already seems to be helping, fortunately.

Both girls are now using a the nasal cannula (prongs in the nose) to breathe.  Abby seems to be tolerating it a bit better than Hazel, as Hazel has had a few more apnea episodes (forgetting to breath) than her sister.  The doctor upped H's oxygen level to 4 liters (Abby is at 3), which seems to be working for now, and slightly upped H's caffeine level, which is also used to treat this - and no, she's not given a straight dose of Dr. Pepper. ;)  As the doctor told us a few days ago, apnea is not uncommon in babies this small; normally it is either due to the brain forgetting to tell the body to breathe (since normally the baby would in the womb and wouldn't have to worry about that yet) or low muscle tone in the chest cavity.  Normally, we were told, apnea episodes tend to clear up around 34 weeks of gestational age, and the girls will be 31 weeks on Wednesday, so we likely have a few more weeks of apneas.

The girls had brain scans when they were initially born; Hazel's had some white sections (which could indicate a problem) and Abby's were clear.  The docs performed a routine follow up brain scan last week and both brains are clear now.  They will get another follow up brain scan when they are a month old to see if anything else appears.

Labs were also done yesterday - both girls looked good.  Both girls had their IVs taken out last week too, which makes it easier for us to hold them every day!

Personality stuff:  We've already been able to tell a difference between the girls.  Hazel likes to kick, Abigail likes to squirm.  We've heard three types of cries from Hazel; one of discomfort, one distress, and one feisty mad.  Abigail has three we've heard as well; a very delicate little squeal of protest, as well as the distressed and a feisty mad ones too.  When you change Abigail's diaper, she'll often cooperate with you by extending or tucking her legs when you need to maneuver the diaper around legs and wires and tubes.  Hazel mostly sticks her legs straight out and holds still until you've got her fastened up again (although she wiggling quite a bit yesterday).  Abby likes to sleep all tucked in and curled up.  Hazel is a casual sleeper that likes to stick a leg out, or throw her arm up over her face with her elbow pointed out.  Both the girls really like naptime on Mom when they can be held.  Their heart rates are steadier, their respiration rates are steadier, and their oxygen saturation goes up and holds there longer.  Both girls like Matt's singing and humming (he sang "99 Bottles of Milk on the Wall" a few days ago - I got a kick out of that). Hazel fusses with her tubes and wires, and pulls on them when she's not happy.  Abby tries to ignore them, and will do so as long as she can get nice and still.  Hazel likes to run up front.  Abigail starts slow, gains momentum and finishes ahead.  Both of them are active and responsive with us and all the attending NICU staff, and both open their eyes and seem to focus when we are there talking to them.

Pictures!  I'm attaching a few I took yesterday.  Hazel is the one on my chest, and Abby is the one sleeping in the isolette. 

I'll try to send updates about every week!  Thanks to all of y'all who emailed me - I tried to respond to everyone, but apologize if I missed someone.

Nancy

Hospitals & Weddings

Yesterday we went over to the hospital "early" to visit the girls.  Dr. Kinstra told us Hazel had several apnea episodes during the night, so they increased her oxygen from 3 liters to 4 liters, and were also going to test her caffeine level to see if it could be upped.  If neither of those options work, the doc may put her back on the CPAP for awhile.  When asked, Dr. Kinstra said the apneas could either be from weak muscles (ie, chest not ready to support breathing) or developmental brain function (ie, her brain hasn't yet figured out she is supposed to breath regularly, since in the womb it wouldn't be an issue), but in practice it doesn't really matter what the reason is (although she figures it is probably a combination of both).  The doctor said this was pretty common, though, and normally it resolves itself around 34 weeks (although she also cautioned that babies don't always "read the book").   H also probably has a blocked tear duct (not surprisingly, they are really small at H's age), so they'll keep an eye on that (haha), and massage it at every feeding to help clear that up. Other than that, though, Dr. Kinstra was pleased with Hazel's progress and activity, and told us that she definitely has noticed H's personality, saying H whacked her (the doctor) with some of her tubes earlier in the day.  Hazel also gets 23 ml per feeding, and overall doesn't have much residue, which is good, too.

Abby is also doing well.  She seems to be tolerating the cannula pretty well, and her feedings have increased to 22 ml per, which is awesome (especially considering about a week ago she was 3 to 6 milliliters behind her sister).  She had several apnea episodes too, but nothing to worry about.

So Matt held Hazel again, and I held Abby, since I didn't get to hold her on Saturday.  Pictures of them after being put back down:

Hazel:

Abby:

During the kangaroo care, Matt sang "99 Bottles of Milk on the Wall" to Hazel while I provided commentary about it to Abby.  At various points in the song, when Matt got to an interesting number, he'd stop and explain why the number was important.  Several of his stops involved the calibration of ammunition for various weapons ... and if either of the girls becomes interested in that later, my cousin Matthew is going to flip for joy.  ;)

Afterwards, we drove home (me, for the first time in two weeks - finally off meds!), got changed, and headed down to Kyle, Texas for Tim & Rebecca's wedding.  The wedding was beautiful, Rebecca looked awesome, Tim was having fun, and we had a good time chatting with several bunches of friends.  Overall, I was much more comfortable at the wedding than I had been at the rehearsal dinner.  It probably helped that Matt and I talked about what our response would be on Saturday (after the dinner) AND that most of the people we spoke to at the wedding were people that actually cared what our response was to the "how are the twins doing" question.

And, as a side note, the rehearsal dinner and the wedding were the first time I wore my wedding and engagement rings in about a month.  They were still a bit tight, but it felt nice to wear them again.  I also wore heels to both events, and that was a first since I think December.  Surprisingly, no problems at all there - and we ended up standing for the entire wedding portion (30 min) since we arrived a bit late (and didn't want to sit in the sun, since it was pretty hot). 

Saturday - 13 Days Old

Today was a shorter visit, since we planned to go to Tim & Rebecca's rehearsal dinner in the evening.  We got over to the hospital for the 2:30 feeding/changing/kangaroo care, but we were only able to hold Hazel today.  Abby had tummy problems earlier (Kathy, the nurse, thought it was due to the fortifier because it happened about the same time), and so Kathy had to give her a bath, which brought down Abby's temperature enough that Kathy didn't feel comfortable getting her out of the isolette.  So Matt held Hazel (since he held Abby yesterday), and I pumped and took a few pictures:

Here's a pic of Abby sleeping after her diaper change:

Dr. Kinstra came by and said they were doing pretty well.  Both have increased their weight (she told us what it was, but then I promptly forgot), and both had apneas/bradys last night, but nothing out of the ordinary.  Matt asked about timeline stuff - when the girls would get their newborn screens, and developmental timelines.  The doctor said they did the newborn screens (required by the State of Texas) a few days after they were born, as with a typical full term baby, but to not be surprised if there were some anomalies, as that was common with premature babies (plus the tests are super sensitive, so it is more likely to catch stuff than let things slip through).  Regarding the developmental stuff, Dr. Kinstra said their age would have to be "adjusted" based on their birth date, so when reading books and things about when stuff normally happens for babies (rolling over, crawling, smiling, etc), we'd need to use the adjusted age (birth date minus due date).

After getting a snack at the hospital, we headed home, changed, and then went to the rehearsal dinner at Jack Allen's Kitchen.  It was our first public appearance (so to speak) since the twins were born, and, honestly, it felt a bit weird to be there (although I was happy to be there for T&R).  Several of the people we knew came up to us and asked how the twins were doing (and for pictures), and both Tim and Rebecca expressed how happy they were that we were there (which was really nice of them).  Overall, though, I felt somewhat anti-social, and I certainly didn't want to take any attention away from them, since it is their big weekend, so pretty soon after dinner we slipped out.

Matt's Opus

Many people have been inquiring as to how we and the girls are doing.  So, for several nights in a row, Matt wrote a long, detailed update, and I sent it to 70 family and friends early on Wednesday morning (3/23).  Here's his "opus:"

Hello,

Nancy and I wanted to respond and update the many people that have extended their best to us over the past week.  We are sincerely touched by your concern, your hope, your help, and your prayers. I hope to go into more detail and send updates more often, but please understand how difficult that is at the time.  Nancy and I are first and foremost responsible for doing everything we possibly can for the benefit of our children, and it is a 24 hour a day job to keep us all healthy right now, although it will get easier.  More on that later.  Getting to the point, here is the overview of where everything is at.

What Happened:

Just over a week ago, on Sunday March 11, Nancy went into preterm labor.  A "normal" full term pregnancy is about 40 weeks long.  However, in a twin pregnancy, a full 40 week term can actually become stressful or even hazardous to both twins and the mother.  The short version is that there is a limited amount the body can support, and sharing that much nutrition, blood and oxygen among three people gets difficult.  It is not uncommon for twin pregnancies to come earlier than a 40 week term.  This can be either by a scheduled delivery(as a precaution), or as a result of naturally occurring preterm labor.  As a precaution for the children and the mother, we were scheduled to perform the former at 38 weeks.  Instead, what happened was the latter, at 28 weeks.

Hazel Annette and Abigail Jeanne were born at 2:44 and 2:45 AM on Monday, March 12, 2012.  They weighed 2'11" and 2'8" at birth, and measured 15 in and 10.75 in long.  They were stabilized and taken to the Neonatal Intensive Care Unit (NICU), while Nancy completed post operative procedures from C-section delivery and went into recovery.  (Note from Nancy:  the girls' middle names are from their grandmothers ... Annette is Nancy's mom's and Nancy's grandmother's middle name; Jeanne is Matt's mom's middle name and Matt's grandmother's first name.)

Both of the girls are doing well, and Nancy is recovering steadily.  We have been told by the doctors that we should expect for the twins to remain in the NICU until approximately their original due date (which was May 16).  The girls were 12 weeks premature, so we could be visiting the NICU anywhere between 8 to 12 weeks depending on their health and progress. We hope to take them home sometime around the middle of May.

How Mom and Dad are Doing:

- Caesarean sections are common these days, nevertheless, they are major abdominal surgeries.  So, while Nancy is doing very well, it will take some time recover enough to do all the things she's used to doing.  She is restricted from driving for at least the rest of this week, and cannot lift anything more than 10 lbs until her core can heal up enough to handle more than mild strain (she was given this restriction for 6 weeks).  I'm doing most of the menial duties to keep her as rested as possible, and both our parents have done a great deal to help us out these first two weeks so we have as little to worry about as possible.

- It is very difficult to leave your newborn children every day.  While most people spend 3-4 days in the hospital very near to their newborn and then take them right home, Hazel and Abigail (or Abby) are relatively isolated in a controlled access NICU.  They are kept inside an incubator/isolette, and separated from contact most of the day to minimize risk of infection, regulate temperature, and otherwise give them an environment as safe and similar to a womb as possible.  Since Nancy was released from the hospital last Friday, we now drive around 20 miles one way, daily, from our house to the hospital.  We can touch the girls, help take their temperature, and change diapers, but only during their regularly scheduled checkups that happen every three hours.  At this stage, we can also hold them for about an hour or two per day outside the isolette so they can have the clinically noted benefits of skin to skin contact (called "kangaroo care"). We perform a full surgical scrub prior to entering the NICU whether we arrive at a time we can touch them or not.  However, we are careful to give them only the stimulation they are currently capable of handling, as advised by the very capable NICU staff.  Most of what the girls do is sleep, eat and breathe.  For Nancy and I, we take an attitude of "the dude abides," and do our best to take care of each other while the girls grow strong enough to come home.  I noted to Nancy that I spent just over 12 weeks in boot camp, and that was the conservative estimate for the time in NICU we'd all have to endure.  It's not really that long, but it can feel pretty arduous.  All of this has been so sudden that we've mostly been living very much in the now.  We haven't been able to look into the future far enough to feel overwhelmed.  Mainly we're just keeping up with ourselves from insurance form to insurance form, pump to pump, meal to meal, and day to day.  The only time we've felt overwhelmed/panicky is when we're exhausted, so we've made a point to be in control of that.  We've got a strict schedule to get the work done, get enough rest, and keep ourselves from getting sick.

- Our daily schedule is actually sort of rigorous, mainly due to feeding cycle that any parent is familiar with.  The American Academy of Pediatrics recognizes several benefits from breastfeeding.  For a premature baby, those benefits are considerably larger and more dramatic.  The term we continually hear from the staff here about mother's milk for a preemie is "like gold."  Therefore, Nancy is just as busy feeding the girls as any mother would be at home.  Every 2-3 hours we pump, bottle, freeze and store the milk for transport to the hospital.  All the gear is washed after each pump and sanitized every 24 hours. We barely have enough time between those periods to do some basic home maintenance, eat meals, feed cats, make notes in a journal, fill out insurance paperwork, and catch enough sleep to keep us from getting ill.  Nancy can get several hours straight at night, as well as catch a few hourlong naps here and there while maintaining the feeding schedule.

All About the Girls:

- Hazel and Abigail/Abby were known as twin A and twin B for the first few days of their lives.  Nancy and I were down to about 10-12 names at the time they were born, assuming we had several more weeks to decide things.  In the hospital we were asked about it no less than 10 times per day, but as much as we wanted to discuss it in depth and make a decision, the first several days in the hospital were a total blur, and we were far too exhausted to discuss it much more than a few minutes a day (quite literally).  As things settled into a more manageable routine and our fatigue lessened, we were able to narrow it down to our favorites.  Near the latter half of Nancy's hospital stay, NICU staff informed us that the girls were stable enough that we would be able to hold the girls for a short time. So, we decided to hold each of the girls to see if the names we liked "felt" right.  After that, we visited them once more to ask them if they were ok with the names we favored.  They seemed quite amenable when we asked, so we informed the hospital staff the next morning to get the birth certificates in order.

- Premature birth is well studied, and there are many advanced statistics to describe it.  Without getting into the heavy math on it, there are several practical takeaways.  Twenty-four weeks is a big deal, and 28 weeks is a very big deal. For surviving children, many of the toughest issues with preemie birth correlate to 22-25 weeks.  By reaching the 28th week of gestation, Hazel and Abigail had developed most of the important systems they need to a relatively mature point, and their odds of facing the some of the most dangerous challenges dropped off considerably.  What is in front of them is still very challenging, but statistically there is very good reason for confidence.

- For what is still in front of them, however, the director of NICU gave us some good advice.  The director is a keen eyed woman that exudes perception and a high level of attention.  She indicated that the natural progression for the babies is to take a step forward, then two steps back.  After they've done that a few times, they will take one step forward and one step back.  Following that, I guess you get the picture.  They will move backwards some, and once they move steadily forward, it is still a marathon and not a sprint.  We should expect some setbacks, and the only main concern is whether they don't recover from a setback.  That has proven to be very true and a comfort so far.  In the 10 days the girls have been here, they have lost weight, which is normal and a good indicator that their livers are in good working order.  They have also just started to regain the weight they lost, and are within 3 ounces of reaching their original birth weights.  Both girls have suffered from mild jaundice, also a very common issue at this stage.  They responded to therapy, eliminated the jaundice, and are currently continuing to hold it off.  Both girls have been feeding steadily, and there has been a gradual increase in the amount they are fed every day.  Hazel and Abby also graduated from a ventilator to room quality air on a CPAP (a type of breathing therapy) about a day or two into their hospital stay, and just today - Wednesday - (at 10 days old) were switched to a nasal cannula (the one with the prongs in the nose), so we can now see their faces (and, of course, they are very cute).  Hazel also had her IV taken out last night (Tues), and Abby's will be taken out in the next day or two.  Heart scans and brain scans, at this point, also continue to be clear.  Overall, we've seen steps, backsteps, and a few times of jogging in place.  Fortunately, they have encountered several of the common issues and done very well in advancing through them.

- Apart from raw statistics, the doctors and nurses are very pleased with how active the girls are, and how rigorously they respond to beat the common issues.  We continue to hear them described by the staff as "very vigorous little girls," "feisty," "progress is stellar," and several other glowing descriptions. Hazel and Abigail are very determined, which may be the best indicator of all.  While we expect to be confronted with normal problems, we've been thrilled to see how strongly and swiftly the twins tend to work through them.  The time it took to start gaining weight was shorter than initially expected, they are moving very steadily up in feedings and tolerating it well.  They handled the jaundice in short order.  Their respiratory progress in particular has been pretty aggressive.  In the sage words of L.L. Cool J, "I'm gonna knock you out, Momma said knock you out."

- Pictures, pictures, pictures.  As they say on the internet, "pics or it didn't happen."  We do have pictures of the girls, but Nancy and I have some concerns.  We are a little protective of the girls right now, and would like to focus on providing them as much as we can for feeding, and as much "kangaroo care" as they can get handle.  Any time spent taking, organizing, and sharing photos (while it should be easy) is consistently complicated by technical, format, network, and user error type issues.  Labeling and commenting them takes time, and time in tech support is time away from Hazel and Abby.  Please be patient while we get that together, and understand that we are in fact taking photos and notes we will begin to share.  Also, while Hazel and Abby are beautiful, they are also vulnerable and look that way.   Up to now, I can (though I wouldn't) hold their heads and torsos in a single hand.  They have multiple tubes and wires coming out of places, including, as of yesterday, a head strap and nosepiece for the CPAP machine that obscured most of their faces.  It is not the type of picture we want on Facebook or a company intranet. We're urging everyone to use good judgment about that, and understand that we will feel a lot more like sharing photos the stronger they are and the further that dangers are behind them.  Last of all, we would like to be sensitive to anyone else that has experienced something like this, especially if they have lost a child.  We do not want to put anything out in a forwarded set of photos that would cause distress to someone sensitive to this sort of thing. We are happy to share, and we are fine if you do, just keep it in perspective and use your heads. This is me with my Dad hat on ;-)

 - Personalities:  Hazel likes to kick, Abigail likes to squirm.  I've heard three types of cries from Hazel, one of discomfort, one distress, and one feisty mad.  Abigail has three I've heard as well: a very delicate little squeal of protest, as well as the distressed and a feisty mad ones too.  When you change Abigail's diaper, she'll often cooperate with you by extending or tucking her legs when you need to maneuver the diaper around legs and wires and tubes.  Hazel mostly sticks her legs straight out and holds still until you've got her fastened up again.  Abby likes to sleep all tucked in and curled up.  Hazel is a casual sleeper that likes to stick a leg out, or throw her arm up over her face with her elbow pointed out.  Both the girls really like naptime on Mom when they can be held.  Their heart rates are steadier, there respiration rates are steadier, and their oxygen saturation goes up and holds there longer.  Both girls kind of like my singing and humming.  It settles them a bit when they are a little agitated.  Both girls like grabbing their facemasks when they are initially trying to get back to sleep.  Hazel fusses with her tubes and wires, and pulls on them when she's not happy.  Abby tries to ignore them, and will do so as long as she can get nice and still.  Hazel likes to run up front.  Abigail starts slow, gains momentum and finishes ahead.  Both of them are active and responsive with us and all the attending NICU staff.

A note on the Hospital and NICU:

We've been very impressed with St. David's and their staff.  I was particularly impressed with Dr. Christy Capet, who delivered the girls.  We've both been very happy with how balanced the nursing staff is in their professional demeanor and personal compassion.  I noticed that every time we complimented them on the level of care, they continually turned the compliment over to the patient.  "Oh, the patient tells us what to do, we just see to their needs".  It seems to be a general culture that insists that we don't heal patients, patients heal themselves, we just remove obstacles and help them out where they need it.  I find their ability to put aside ego like that both reassuring and very impressive.


I'm way past my bedtime, so this has to be it for now, but it has been over a week without extended feedback and I wanted to get this out to all the family and friends that have been so kind and concerned for us.  Every very little step by the girls is a big deal, and we are just starting to see the pattern and feel the pace of it.  Know that we'll keep you posted ourselves or through our parents and other friends as significant things happen.  Most of all, we're really looking forward to a time you can meet Hazel and Abigail for yourselves.


Matt & Nancy Scates

PS:  Note from Nancy - we tried to include as many people as possible on this email, but realize there may have been a few that did not receive it.  Using your best judgment, of course, please feel free to forward this to family/close friends who would be interested.

12 Days & Free Dessert

Received a call from Dr. Breed this morning.  Everything is still going well.  The test of their electrolytes came back okay.  Abby is getting her second dose of fortifier (she took to the first one well), and had her IV come out last night.  Both girls' feedings have increased...Hazel is up to 22 ml per, and Abby is catching up at 21 ml per feeding.  The doctor said he was going to increase their caffeine, as it may help eliminate some of the desats and bradys that the girls have had the last few days/nights.  Anyway, aside from that, really nothing new to report - which is actually a good thing.

We did the "short' visit again today ... arriving around 2 and leaving after their 5:30 feeding/diaper change.  Today was my turn to hold Hazel.  Her head was just below my chin, and about halfway through she reached up her hand and it was in the nape of my neck.  She also did some twitching and leg raising, too (the latter was interesting, to say the least, since her legs were tucked underneath her body. 

Matt held Abby - I got a great picture of them napping together:

Here's one of me and Hazel (self portraits are kinda tough with the iPhone):

After visiting the girls, Matt took me to dinner at the California Pizza Kitchen in the Domain.  The weather was beautiful today, and it was nice to walk around a bit and enjoy peoplewatching to get my mind off of heavier things.  Of course, I completely forgot that it was Friday night, so while we were seated immediately, there was still a slight wait for our food.  The waiter came by several times to apologize (not that we were complaining or showing any signs of impatience), and he even sent his manager over to say something.  While the manager was talking to us, he noticed the NICU ID bracelets on Matt's wrist, and apparently knew enough to realize it meant we had just had a baby.  Upon finding out we had just had twins, he comped us two desserts.  Very cool of him.

10 Days Old

On Wednesday, March 21, the girls were 10 days old!  Dr. Soon said a week to 10 days of life is a milestone, of sorts, so it is nice to get past that one, and generally with flying colors!

On the 10th day, both Hazel and Abby had their CPAPs taken off and were put on nasal cannulas (breathing prongs through the nose), so we could see their full faces (and ears) for the first time.  Both, of course, are very very cute.  ;)  The doctor said Hazel was on her second batch of fortifier (she tolerated the first batch well), and Abby was on to her first.  Also, they did a followup brain scan on both girls, and both were clear.  The white spots that they had seen on Hazel's original scan had gone away (which is awesome).  Dr. Soon said they will do another brain scan at about a month of life, so in about three weeks, and once again said the girls were doing really well.  

I held Hazel today and Matt held Abby (with several pics taken by my parents, who stopped by before heading back to Dallas).  She wiggled a little on my chest, but generally had a really nice nap.  She also sneezed a few times, which was seriously the cutest thing ever.  Matt said Abby had a nice cuddly nap, too.  We think Abby is definitely the cuddler of the two. ;)

Their feedings have also increased as well.  Hazel is up to 21 ml of food (breast milk) daily, and Abby is up to 18 ml.  All mine!  I'm working on pumping, which is definitely going to be interesting with two kids.  Anyway, the increased feeding is a great sign, too.

The Birth of the Twins - Nancy's version

(Note:  this was written in several sittings during late March and April 2012).

Short version:

Hazel Annette, born at 0244 am on Monday, March 12, 2012. 
Weight at birth:  2 lbs, 11 oz.  Length: 15 inches.

Abigail Jeanne, born at 0245 am on Monday, March 12, 2012. 
Weight at birth:  2 lbs, 8 oz.  Length: 10 3/4 inches.

First picture of Hazel, a few minutes after she was born:

First picture of both girls (H in foreground, A in the background):

The long version (to find Matt's version of the events, click here.)

The evening of Saturday, March 10, we co-hosted a wedding shower ("Cocktails & Desserts") at our house for Tim and Rebecca.  We were busy all day that day getting ready, and during the shower, every time I felt tired, I sat down and tried to get off my feet.  Seemed like everyone had a great time (most especially, the guests of honor), and after all the guests left, Matt and I did a bit of straightening and then I went to bed around midnight or so.

The next morning - Sunday, March 11 - I just felt off.  I hadn't slept well during the night, and my lower back hurt (which was a new symptom - hadn't really felt that since the first trimester).  I figured I felt the way I did because of how I slept.  After sleeping in, due to the long & tiring previous day and evening, Matt and I went over to Waterloo for a late breakfast.  I ordered, but after the food arrived I didn't even feel like eating.  Matt and I had planned to go run some errands/hang at a coffee shop after breakfast, but he could tell I didn't feel so hot, so we quickly paid the check and headed home (he asked how I was doing, and I said I wanted to lay down).  As we left Waterloo I began to tear up, which was also kinda weird for me, as I'm not normally a crier.

We got home and I laid on the couch.  After awhile, I felt asleep, and was out for about an hour.  Waking up, I still didn't feel well, and at this point I had cramps (probably contractions, but I didn't know that at the time), albeit sporadically.  Matt brought me some food (leftover fruit and cheese from the party), but after a few bites I couldn't eat any more.  I sat there thinking about what I should do...should I wait it out, and hope I just felt better after some rest that night, or should I call the nurse, as I was having back pain (preterm labor sign) and cramps (possible preterm labor sign)?  I debated and hesitated ... which in no small part is attributable to the fact that we had just seen a doctor on FRIDAY - two days before - that had checked my cervix and said everything looked great.

Finally, I talked to Matt, and we agreed I should call the nurse.  After hearing my symptoms, she suggested I go in to the hospital, since with twins there is a higher chance of preterm labor, and suggested I put together a small overnight bag in case they wanted to keep me for observation.

We drive to the hospital (about 20 miles) and the whole time I've got conflicting feelings - on one hand, I'm hoping nothing is going on, and on the other hand, I'm hoping there is a slight something so the trip won't be completely wasted.  At this point, however, I am starting to have what even I think are contractions about 4 to 6 minutes apart.

After checking in around 8 pm, and getting my vitals, we go to a triage room in the Labor and Delivery section of the Women's Center.  Lisa, our nurse, hooks me up to a monitor so they can watch the girls' heart rates and also monitor my contractions.  I remember waiting around the room for a bit, switching the TV channel off of MSNBC (coverage of the year anniversary of the Japan tsunami) to ESPN (coverage of March Madness Selection Sunday), but I have no idea how two hours passed.

At this point, Dr. Monk came in, introduced himself as the L&D triage doctor (he called himself an ER doc for L&D stuff), checked the monitors, swabbed me with a thingie to detect if I was in preterm labor, and then checked my cervix (which, OW, that hurts), announcing I was already 3 cm dilated and 90% effaced ... and both of us had no idea what the latter part meant (we hadn't gotten that far in the readings yet).  Lisa helpfully explained, and even pulled out a small model to show us examples of dilation and effaced stages.  Dr. Monk said "you are going to be admitted - it is preterm labor," and suddenly my heart sank.  The whole time, honestly, I had fully expected this to be a 'drill' ... we would get to the hospital, they'd check me out, maybe run some tests, and then send me home, and Matt and I would laugh about it later.  Um ... apparently not.

Well, my regular doctor was not there (not surprising since it was late on a Sunday night), and the doctor on call in his practice (AAOBYGN) was Dr. Christy Capet, who was relatively new to Austin from Dallas.  I'm wheeled in to a L&D room and given a steroid (to help the girls' lungs) and magnesium (to help relax all of my muscles, including the ones that were contracting), as well as hooked up to an IV and a cather.  Dr. Capet come by about midnight (about two hours after seeing Dr. Monk), introduces herself, and says she wants to check my cervix too (OW again).  When she checks, it is a "loose" 3 cm and I'm basically 100% effaced.  I remember thinking "well, at least it hasn't gotten significantly worse."  She tells us they are going to try to stop labor, and if so, I'll be on strict bedrest in the hospital for at least a few days until I prove it is gone.  I remember hearing something about a bedpan, and not being too excited about that prospect.

Another two hours (or so) pass.  I go in and out of consciousness, but I remember feeling the contractions (OW).  Lisa tells me the magnesium will make me feel bad, as if I'm on fire; it does, but I distinctly remember thinking that it didn't seem to help relax the contraction muscles, because that was still hurting (and relatively frequently, but I have no idea how often).

Dr. Capet comes in around 2:00 or 2:15 am to check my cervix again (OW for the third time).  About the time she arrives, I throw up (Lisa was also going through paperwork for me to sign - I stopped, threw up, and then went back to the paperwork.  I also remember thinking I was signing a bunch of stuff without actually reading it - not very good practice, especially for a lawyer - but then wondering if it would actually hold up in court since I was not completely coherent).  I remember Dr. Capet noting that throwing up was not a good sign, as it usually indicates labor is progressing (who knew?). At this point, despite all of the magnesium and other things we've tried to stop labor, she announces I'm 70% dilated and 100% effaced.  I remember thinking "oh, crap."  She then announces it is C-section time.

At this point I go in and out of consciousness again.  I remember Dr. Nelson, the anesthesiologist (for some reason, I keep wanting to call him Dr. Abbott) coming to give me the epidural or whatever it was in my back.  He asked me to arch my back, so I did.  The funny thing was he wanted me to arch it out, towards him, and I was arching it inward, with my shoulders back.  So that took a few tries.  I also remember Dr. Capet directing the room, and making a point that time was of the essence (to use a good contract term).  At some point a technician came in to do another ultrasound of the girls (honestly, not sure when this was), and measured them at 2 pounds 10 oz (turns out she was pretty dang close).

I drifted out of consciousness again, and when I came back to I was lying on my back and a big blue screen was under my chin and blocking my view of the rest of my body.  At some point Matt came in, I asked how he was doing (he looked pretty worried).  I realized I wasn't wearing the hairnet Lisa had given me, and wondered if that was a big deal.  

Seems like I drifted out and then in again.  Things were happening, and the doctor or someone indicated the girls had been born, but I hadn't heard them cry (which I had read is what normally happens), so I was worried in the calm way you are when you are drugged.  Matt went over to check on them, and said they were okay.  At that point they were going to take them to the NICU, and Matt looked over at me.  It seemed silly to stick around me, since all they were going to do is sew me up, so he followed the girls to the NICU.  I vaguely remember the doctors and nurses chatting as they put my innards back in (haha), and some sort of question/answer/confusion about which twin was "A" and which was "B."

I went out of consciousness again, and woke up as I was being wheeled into the recovery room.  Matt was already in there, on the phone with someone, and hung up as we approached.  Nurse Lisa stayed in the room with us, and I have no idea (again) how long we were in there.

At some point, we were taken from the L&D side to the postpartum area of St. David's.  If I remember correctly, we got to our room (236) around 5ish am?  At that point, I was exhausted, as was Matt (he hadn't slept at all), and it seemed like people (nurses, doctors, lactation consultants) kept coming in every hour and waking me up when I just wanted to sleep.

Matt had asked Steve to let our parents and my office know what was going on, so we wouldn't have to worry about that at the time.  Eventually, after Matt let me have my phone, I responded to several worried emails from people in my office (most were in the "what just happened???" vein), sent a reminder about March Madness to non-office participants, and then sent a text to various friends and family saying "guess what...I just had a C-section and the girls are here."  Not intentionally, but apparently this announcement out of the blue freaked some people out, especially those who had just seen me less than two days before when I was pregnant and fine.  (To those of you reading this - sorry about that.)

Matt's parents arrived that afternoon, we started receiving flowers, fruit, and cookies from friends and family, and I talked to my parents that afternoon (they were in Florida).  The whole thing just felt surreal...did this really just happen?  (It took me a long time to accept that it did, and that there was not anything I could have done to prevent the preterm labor - sometimes it just happens.)  I was in the hospital until Friday, and spent the time pumping, eating, visiting the girls (we held them for the first time the Wednesday after they were born), responding to texts/emails, receiving visitors, and recovering from my C-section.

The funniest/most annoying thing was deciding on the names for the girls.  Obviously we had figured we'd have more time to decide, although we had narrowed down some choices already, including the middle names.  That was probably the most common question from everyone - friends, family, nurses, doctors, staff - but we kept getting interrupted so much, we didn't have time to decide on it until Thursday.  The good thing, though, is we were able to meet and hold the girls and see if the names we liked "fit" them.  They did, so we filled out the birth certificate paperwork late on Thurs, March 15, sent a text to the parents on Friday morning, and then announced it to everyone else a few hours later.

The worst part was leaving the hospital without the girls.  It was such an empty and horrible feeling - we packed up the room, and I was wheeled down to the car where Matt and my parents were waiting, but there were no babies with me, and I had to leave them behind.  For about a week, seeing newborns leave with their parents choked me up too.

So, there you have it.  The story of their birth, from my perspective.  :)

Greetings and Salutations

Hello from our little corner of the blogosphere.

Obviously, this post was not actually written on the date and time it was published. In actuality, I'm writing this around 2 am, while pumping, on Tuesday, May 1 (pumping allows for so much "free" time in front of the computer at random points in the day).  But since we've decided we may be publishing the blog to friends and family, I figured I should have an intro post, and set it for a significant date and time at the beginning of this journey (side note - wow - that sounds very "Bachelor" like - Some Guy In Austin would be very proud).  The first "real time" post was written 10 days after they were born, on March 22.

Hazel and Abigail were born, unexpectedly early, at 2:44 am and 2:45 am on March 12.  I was 28 weeks, 5 days at the time.  (See my later post and Matt's super detailed post for more info on those happenings.)  I stayed at the hospital until Friday, March 16, and since then I've visited the girls every day that they have been in the NICU (42 miles round trip, but an easy drive up Mopac - unless I hit traffic).  Since I have a hard time remembering what happened 2 hours ago, much less what happened 2 days ago, I decided to blog about our NICU experiences so I'd have a record of how everything went.  I've also tried to add pictures here and there to make the posts more interesting ("this thread is worthless without pics").

So, here goes...