Tuesday, March 27, 2012

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

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