First off I have to apologize for not posting the last few weeks. As yall can imagine, things got very busy for our new Norris family of four around the time I was released from the hospital but I will give a update for everyone who got left in the dark to summarize how we have all spent the last few weeks and then get to how life at home is now Ive been delaying this post because I really wanted to attach pictures but I still have not had time to go thru my camera so Ill try to update again soon with more pics!
We are very happy to say that both boys had a beautiful stay in the NICU with no major medical setbacks to speak of. Both were there primarily to grow a bit more and learn to eat well before going home. They needed all the typical 34 wk preemie assistance that was expected from the beginning yet nothing more… Carter needed a few days of suntanning for jaundice, Brody only one day and both boys has assistance by the isolate maintaining their body temperature for about 2 weeks which gave them more time to use their calories to strictly grow and not have to heat up their little bodies. Both boys had IV’s for 4 day to deliver antibiotics (started prophylactically after delivery and then discontinued when cultures came back normal) and TPN and lipids to help them maintain their blood sugar and nutrition. Josh and I jointly decided we could hold off on holding the boys till the IV’s came out as infants veins are so fragile your lucky to get a full 24 hrs out of one of the IV’s and any movement of the limb the IV is in makes it fail even more quickly… Carter was needing at least two IV sites a day (he squirmed a lot more) thus Josh and I felt we would rather postpone holding them for our own pleasure knowing that the mere act might make them have to get a new IV site placed-a heartbreaking thought! Thus we happily held our boys for the first time when they were 5 days old, right before I was discharged from the hospital after my ceserean-a long awaited moment that was so rewarding! I think it was a great decision in the long run, in addition to the IV consideration it also gave them 5 more days to stay relatively unstimulated in their quiet, dark, and warm isolates designed to mimic the womb before we brought them out into the real world environment and the sensory overload Im sure it presents to a 34 weeker. They were both started immediately on nasal gavage tubes to deliver my breast milk to their stomachs and were slowly introduced to the very coordinated process of learning to drink from a bottle. Brody proudly completely finished his first entire bottle at 8 days old. Carter never showed the hunger cues (rooting, eating hands, etc.) the doctors looked for before they would introduce a bottle but on August 11 they finally decided to just offer him one and see what he would do and he finished the entire bottle on the same day at 16 days old! Brody had occasional episodes of ‘bradycardia of prematurity (where his heartrate drops temporarily when he is in a deep sleep) so after monitoring for about 10 days and attempting to treat it by just delivering room air thru the nasal cannula to keep him more stimulated the decision was made to go ahead and start him on caffeine which meant he would go home on the medication and a apnea monitor for a few weeks. Bradycardia of prematurity is attributed to a neurological immaturity that babies simply grow out of typically between 37 -44 weeks gestation.
Brody was showing the stamina to routinely finish all his bottles just a couple days before Carter and on August 20th at 25 days old Brody was approved to go home with us.Carter had met all the criteria to go home as well yet at the last minute they gave him the carseat challenge and he failed immediately. The carseat test is something all NICU babies have to pass, which involves maintaining all vital signs for 90 minutes while seated in their carseat, sometimes a challenge for preemies due to the crunched position it places the babies in. Brody had no problems but Carter’s blood oxygen levels started dropping almost immediately when he was in place… and it took over 15 attempts over the next 10 days to figure out how to help him pass. I had bought what they considered the best carseat for preemies, the Chico Keyfit, which is designed for babies as little as 4 lbs so Carter fit perfect in the seat thus everyone was stumped for a few days and they told me it had been a really long time since any baby had had so much trouble passing the test without any known reason-JOY what the luck! We did a GI study to see if there was significant reflux causing problems and then did a swallowing study after the GI study showed he had milk silently penetrating down his windpipe with feedings (aka, slightly going down the ‘wrong tube’). The swallow study showed that he ate the best with the Playtex VentAire bottles which have the slowest flow on the market, even slower than Dr. Browns preemie nipple or the NICU preemie nipples so off to buy our third set of bottles I went (luckily I had only bought a couple of the other two types already). Using this bottle combined with us pacing him more for a few weeks helps him to avoid accidently aspirating milk past his trachea and we now feed Brody the same way as he would get choked up himself trying to chug his bottles so quickly, I think he finished his bottles the first few days he was home in about 2 minutes flat! Initially I thought “this is great, he is eating so well-Ill be back asleep in no time” but then I found out from the occupational and speech specialists and nurses that its actually bad for babies to eat that quickly on many levels and that we needed to teach him to pace himself and finish his bottles somewhere between 10-30 minutes. Finally 10 days after we took Brody home, after we had consulted with 4 neonatologists, 2 certified carseat specialists, a speech therapist and 2 occupational therapist on what else could be done to help Carter pass the carseat test, they finally made the call to remove the infant insert from the carseat and place blankets around Carter (outside the harness so still safety approved) to snug him in the seat instead and it positioned him different enough that he passed on the first attempt and was able to go home with us on August 30th, thus having a 35 day NICU stay. WHAT A JOYOUS MOMENT August 30th was for our family! All in all we had all spent 110 days or almost 4 months at Woman’s Hospital of Texas this summer. Thankfully, I endured the majority of them and the worst of it myself with the 80 days of strict bedrest and IV medications and the final leg at the NICU was basically stress free and we have two perfectly healthy, growing boys at home with us now. Praise God!
Speaking of bedrest…many were curious how I felt after finally being released to stand up again for more than 3 minutes at a time. I can say this, the first 2 days home after leaving the hospital were pretty ‘scary’ in the sense that I got winded, my pulse sky rocketed and I routinely almost fainted after just working around the house in 20 minute intervals… I was so nervous it would be weeks if not months till I had even normal stamina back but the 7th day at home I woke up having much more energy with tasks and by the 8th day, or start of the second week after delivery, I felt basically normal with day to day things so it was a very steep improvement in everyday normal endurance. By the eighth day I was full blown decorating the nursery, cleaning closets, ‘running’ up to the NICU, and going thru Target and Babies r Us on the way home, etc. I stayed very busy pumping every two hours, visiting the boys, and getting the mountains of supplies at home unpacked, organized, and ready to bring the boys home. I really hit the ground running with just those two first days at home taking a toll on me, yet Im sure the months of laying in bed dreaming of moving again helped me to recover “quicker than expected”. That and the sight of piles that had accumulated in every corner of every room of my beautiful home while my husband spent every nonworking minute with me in the hospital, lol. The c-section was really a breeze and it didn’t slow me down at all recovery wise, it was definitely more the bedrest those first few days, so I had to really work hard to make sure I still took it easy that second week after delivery to heal properly as I was still only a week out from major abdominal surgery. Of course, Im certain I still did way more than I was supposed to be doing but I felt good and had been planning my moment of release for months so who could blame me… sadly it was much harder to stick to the restrictions when it was only my own health I could be harming and not my unborn children. My OB definitely had a sense of what I would be up to the second I went home so she basically told me just to listen to my body as it would tell me the next day if I had done too much the day before and so that is what I went on. And I am happy to say I had my 6 wk check up and my OB said everything looked fabulous and Im medically released… although she told me to give it another 2 weeks till I exercised ‘how she knows I want to exercise’ meaning no Crossfit or trying to run 5-10 miles till I was 8 weeks out, which I was perfectly okay with- a good 3 mile speedwalk around the neighborhood pushing the boys in the stroller has done me in pretty good this week, haha.
Brody is still on caffeine today going on ’42 wks’ and we still have occasional episodes that our monitor picks up but he always ’pulls himself’ out of them before we can even get to him to stimulate him so the pediatrician said they sound like they may not be actual major events of bradycardia anymore however we will wait a few more days before the monitor computer is actually downloaded and reviewed by a specialist for the first time to determine if Brody still needs the medication for a few more weeks or not. After discontinuing the caffeine we will remain on the apnea monitor another few weeks to monitor closely without medication to make sure we do not have any further episodes. Alot of people ask if this has a correlation to SIDS and what the neonatologist told me was that it has no connection and does not make Brody more at risk for SIDS in the future. This is truly a prematurity issue and by the time we give up the caffeine and monitor we will be in the clear and have the same SIDS risks as any other infant. After much debate Carter ended up coming home on the apnea monitor as well. Although he technically dosent need it, the doctor said that if one twin needs a monitor he almost always sends both home on one and put that with the carseat issues we had we all felt it would be nice to have one for him for at least car rides for a few weeks just to make sure it wasnt a one time miracle that he passed the test. At first the thought of these monitors seemed so awful and I will admit the cords are a hassle for sure but Josh and I both LOVE the security it gives us and the stress it takes away knowing that they are there to alert us to anything out of the norm. We were already so used to relying on the nicu monitors that taking these monitors home with us for a few weeks made for a nice transition as it already felt weird taking the babies directly from such a controlled sanitary environment to our home at the mercy of the two of us unexperienced parents, HA! We have slept peacefully from the start not having to worry about what every little grunt or cough in the night is or worry if they are breathing or not. It will be one very scary day for Josh and I Im sure when we get rid of the monitors after having this safety net for a few weeks!
As I mentioned Carter started showing more and more symptoms of significant acid reflux so we started him on medicine two weeks ago after taking him to the pediatrician. Two weeks ago, just one day shy of the boys due date, Carter weighed 5 lbs and Brody weighed 5 lb 13 oz; and the doctor was very happy with both of their weight gains and feels we will be caught up in no time! I am sure Carter weighs around 6 pounds now and Brody 7! The NICU recommended that due to their prematurity and low birth weights we meet with Early Childhood Intervention to get on top of things early and make sure the boys are hitting their milestones, which are referenced for the first few years to their due date not actual birthday (so treating them like an almost two week old since thats what they truly are developmentally). They will be coming out to the house next week to test the boys spatial skills, motor coordination, cues and reflexes, hearing, etc. so I am very excited about this evaluation and agree it sounds like an excellent idea! From the phone interview and basic questionaire it sounds like the boys are doing really well and actually somewhere developmentally between their actual age (almost 8 wks) and corrected age (almost 2 wks old) which is great but I still look forward to the in depth evaluations and more importantly getting educated from another specialist on ways to help them continue to develop and learn well in the future months as this is all new to this momma anyhow and I always enjoy learning something new!
Josh and I are still adjusting of course to our new lifestyle. I think the biggest change is just not going places together but instead taking turns on the weekend to run errands-its literally like passing the baton on a relay race around here. We also struggle to find the time to do the small things we would like to accomplish (like updating this blog!) but we simply try to remind each other there will be plenty of time for those things later and instead enjoy the little moments with our babies which is much more important-so sorry fellow blog followers for me letting this be the thing that went!
I really hope to post pictures here soon of our little cuties. Our professional newborn shots look amazing and I cant wait to see them all and share!! Thanks for keeping us in your prayers and for continuing them for our new and adjusting family!
Love, Elissa, Josh, Carter & Brody