Isaac's surgery

It has been a long, exhausting day. Lance and I and Erik were at the hospital by 8 to snuggle Isaac before they started getting him ready. We took turns with him since one of us had to stay in the waiting room with Erik. So we held and loved on him and then started the waiting. He went to surgery at 12:15 and was out about an hour later. The surgeon was happy with how the procedure went. The nurse said his vital signs were rock solid the whole time. We went to see him again and he was just resting. They are waking him up slowly so there isn't really anything we can do or much to report. Every 2 hours they are adjusting his medications. He is doing some breathing on his own and will probably be extubated in the morning. He is on IV hyperalimentation as he will not be allowed any feedings by mouth for a couple of days. Then they will start slowly with pedialyte (the neonate version of clear liquids) before going to milk. He weighs 5# now. The incision is from his xyphoid to his umbilicus. Not very long but it takes up a lot of room on him. We are back in Chester tonight.

Isaac is having surgery today.

Isaac had an upper GI study on Monday to look at the reflux problems he has been having. The study showed that he is refluxing into his airway, which is why he is having the respiratory problems he has been having. The doctors recommended a 24 hour room air trial (off his oxygen) and see how he did with all the reflux precautions in place (thickened feedings, medications, head of crib elevated). He did okay for most of the day but eventually flunked the test so the next step is to look at an antireflux surgery. This procedure is called a Nissen fundoplication and involves wrapping the upper portion of the stomach (fundus) around the lower segment of the esophagus to create a one way valve. This is a technically simple, permanent procedure that will fix the reflux problem. After talking extensively with both the neonatologist and the general surgeon we have decided to go ahead with this. It is difficult to make this decision for our tiny baby but we have tried all the other alternatives for managing the problem medically and they are not working. If he continues to reflux into his airway he is at risk for aspiration pneumonia and other chronic lung diseases, besides needing to be on oxygen. So there really is no alternative. We drove to Great Falls last night and snuggled with little Isaac this morning before he goes to surgery at 11 a.m. He is 5# now and is so cute and snuggly. The neonatologist believes that he may be home in another week or so without meds, oxygen and most importantly, without reflux. We are cautiously optimistic about this prediction since he was supposed to come home twice already. Mom and Dad Benjamin came to Chester and picked up Ivan last night. Erik is with us.

Laugh or cry moment...

It was getting to be nap time and all so I was feeding Erik and Ivan was entertaining himself at the kitchen sink for the moment. I was changing Erik on my lap-head at my knees when suddenly yellow mustard squirted everywhere. It looked like the bottle had exploded on my shirt and skirt. At that very moment I heard a scream of pain from the kitchen. Ivan had turned the water to hot and burned himself. I scooped up the mustard mess with the baby somewhere in the middle of it and headed for the kitchen. Just as I got there the messy diaper somehow evaded my arms and went skidding across the kitchen floor, spraying mustard as it went. I got the burn victim settled down and taken care of and proceeded to strip both the baby and myself. I wrapped him in a blanket and set him on my bed while I got reorganized. In the mean time he spit up and wet the bed. I got him bathed and both of us in new clothes only to find Ivan with a brand new jar of lotion open in the living room. Luckily I intercepted that one in time. Thankfully they are now both clean and napping, the kitchen mess is taken care of and the washer is running. For a few minutes there I had way too many children-and that's only 2 of them!

Saturday's visit with Isaac.

We went to Great Falls to visit little Isaac on Saturday. He is 1 oz away from being 5#. Probably will hit that mark tonight. They gain an ounce or more every day. He was so cute and sweet. We hadn't seen him since Tuesday. A few days makes a big difference. He is definitely starting to put on a tiny bit of fat. Lance thinks he looks more like Erik as he chubs up a bit. We each went to a care time and I know I had a hard time putting him down when it was my turn. We taped pictures of our family up on his crib for him and gave him a good snuggling. He is still needing some extra attention. I feel like I am describing a nursing home resident when I talk about his treatments. They are thickening his feedings with rice cereal to help with the reflux along with 2 medications-prevacid (acid blocker) and reglan (motility). The "suspicious spot" on the chest x-ray was seemingly inconsequential. He had a borderline low hematocrit and they would not have done anything about it except that in conjuction with his other issues (high heart rate and oxygenation issues) they thought some blood might help him. Red blood cells carry oxygen so that makes sense. So he got some blood Saturday afternoon. He did look a bit pale and the nurses say he is much pinker after the blood. We only saw him before he got it. However, it did not help the tachycardia so the docs are a little stumped. He was also looking a little puffy around his eyes and in his feet so he got Lasix after the blood. Preemies have immature kidneys so I guess that's that. Still on a low dose of oxygen.
Erik is a very good, mild baby. One benefit of having a baby in the NICU is they come home on a very good schedule so he eats every 3 hours and otherwise he looks around or sleeps. At 5 weeks old he is about the size of Ivan when he was born. Ivan is adjusting well. He likes to hold him-I make him wash his hands first.
Ivan has a new sandbox that he got for his birthday. We still haven't gotten any sand in it yet but Lance dumped a couple shovels full of dirt in it last night and that entertained Ivan for hours. He drove his trucks and tractors and scooped and dumped to his little heart's content. You couldn't help but smile watching him. What a happy kid! He's been so happy to be home. He entertains himself very well-playing and singing away...
We are having absolutely beautiful fall weather-my very favorite season.

Home in Chester with Erik.

Thought I better update. We are home in Chester with Ivan and Erik. Erik is doing great-had his first appt with his new family doctor and she said he was perfect. He is right around 6# now. Ivan is adjusting quite well-esp. considering all he has had to adjust to in the last month! My Mom came and helped us yesterday and he was so glad to see Grama Jewell! They played outside for 1 1/2 hours while I took a lovely nap. The neighbor kids have been over to look at him-I held him up in the window for them. I put a big sheet of freezer paper on the front door so they wrote him messages.

Isaac is still in the NICU. He is on antibiotics for 48 hours for a "suspicious spot" on his lungs that may be pneumonia. They just treat right away instead of waiting for him to get really sick so that's good. Last night's report was that he is doing well. He is on oxygen at a very low dose and his O2 saturation is good. We are planning to go down to visit tomorrow. Lance and I will take turns with the other 2 so we can each go to a care time. He is about 4 1/2 pounds now.

Erik is sleeping and Ivan is wanting some attention so better run along.

Isaac hits 4#!

Isaac weighed in at 4# 4oz. tonight. He is doing fine and expected to be discharged Tuesday. The plan changed a bit as they reviewed the situation a bit more. He is off the caffeine and oxygen and on prevacid (for reflux) instead. The thought process is that at his gestation (37 wks) he really shouldn't be needing the caffeine, he has never needed oxygen so that didn't really make sense, and the fact that caffeine can cause reflux, plus the fact that his incident was feeding related made them think that his problem could just be a weak sphincter leading to reflux-which will resolve in time. He's been off the oxygen for 36 hours and doing great. He will still go home on an apnea monitor.
Erik is home with Lance and me in Chester for the night. He has his first appointment at the clinic here tomorrow to meet his new doctor and establish care.
Ivan is at Grampa and Grama Wickums for a few days. By the end of this week we should all be under one roof again. And Ivan may be wondering if we're ever going to stop introducing new babies!

Erik's homecoming!!

Yesterday Erik was discharged from the hospital. My Mom and Ivan came down to stay with me and Erik at the apartment so I can keep coming to the hospital to take care of Isaac. So it was bittersweet to take one baby home and leave the other one. Poor little Isaac looks kind of lonely in there all by himself. He had a little setback with his breathing two days before they were supposed to both be discharged so he needed some oxygen and will be a couple more days. They ran a bunch of tests to see what the deal was since it seemed to come on rather suddenly but the consensus is that he is just acting like a preemie. Chest x-ray, blood tests, urine culture all negative. He had been off caffeine for several days and seemingly was doing fine but apparently just ran out of reserve. So they are talking of starting the caffeine again and going home with it and an apnea monitor. It was unnerving for him to be having problems again but I am thankful that they happened here. In Chester, it would have been way more involved.

Erik is doing very well at home. Bummer-now I have to do the night shift:) Ivan was very impressed with his new brother at first but now is starting to wonder why he doesn't get all of Mom's attention. Wait until the other one comes home! He was very sweet and gentle with him and said, "He's so cute." And he's great about washing his hands before touching him. He was 5# 8oz. the day of discharge. Isaac is 3# 15oz. So close to the 4# mark!

New pictures of the fam.

Ivan and Lance playing with play doh. Good thing they make those little tiny chairs sturdy! Isaac picking at his feeding tube. He finally got it!

Grama Jewell with her little sidekick. Does he look like a bundle of energy or what?!

Two tuckered out babies.

Lance with an armful of babes. They are both in cribs now. Hopefully we will be taking them home the end of this week! (Yikes! But we can't wait!).

Ivan baking "cookies." He was very busy scooping and dumping and I think coffee grounds was one of the ingredients. Grampa Warren and Grama Marcia looking on. Erik sucking his thumb.

Little Isaac snoozing peacefully.

Erik with his bright little eyeballs.

Isaac's first bath (a couple weeks ago). The little dots on his head were to hold the eye protection on when he was under the bili lights. They are long gone now.

3 weeks old and Erik hits 5#!

The twins were 3 weeks old yesterday. Can't believe it. Erik is now 5# 2 oz. and Isaac is 3# 10 oz. They can eat as much as they are interested in now and Isaac is eating more than Erik so he is doing his best to catch up. I am home for a day to get ready for babies. I washed and put away tiny things today. I don't know if I'll ever really feel ready but here we go anyway. Babies should be able to come home in about a week or so if they continue their current progress. The doctors' advice is to be extremely restricted with visitors for the first year and especially during the winter with the risk for swine flu and any other bugs that happen to be out and about. So we are planning to heed that advice and be very careful. We hate to turn away visitors who would love to see our babies but they are very fragile and we would hate it even more if they were to get sick. It was homecoming week in Chester so Ivan and I enjoyed the beautiful weather and watched the parade this afternoon. The parades aren't very long here but the kids don't go short on candy.

Feeding tubes out.

Isaac pulled out his own. He still had it clenched in his tight little fist. So the pressure is on to keep eating good. Must continue to consistently gain weight. Erik failed the crib test for the 4th time. I guess he likes his little cozy isolette. I don't blame him-some of those babies are crying and carrying on all the time. I'd stay in the nice little quiet isolette too. Better to be warm and gaining weight than using all their calories to stay warm. I'm off to give them baths and tuck them in.

The little men.

Erik is 4# 14 oz., Isaac is 3 # 6 oz. Isaac is off caffeine again for a trial period. It has a half life of 5 days so hard to tell for a bit if he will have to go back on. So far so good. Erik is nearly ready for a crib. He easily overheats in the isolette at the lowest setting but when they turn it off he gets too cold. Just have to fatten them both up a bit more. They are both chugging down their bottles and gaining weight consistently. They have the greatest expressions.

2 weeks old.

I was sick for a few days and out of commission so will try to catch up. Let's see-weights are always a hot topic. Erik was 4# 10 oz. at last weigh-in. Isaac was 3# 3 oz. So they were both up 7 oz from their birth weights. I think I even detected a little sliver of fat under Isaac's chin:) Erik already had an extra chin. While I was gone for a couple days they made some progress on their feedings. The nurses fed them with a bottle every other feeding and both of them chugged it right down. Now we are back to bottle 1x/day and breastfeeding 2x/day. I tried feeding them both at once today-that was a dog-pile! Their feedings are increased to 30cc (1 oz) for Isaac and 40cc for Erik. They are both in their isolettes at the lowest temp setting. They have bright little eyes and they are so sweet:) While I was home we had Ivan with us and it was great to see him. He is growing too I think-every time I see him! And learning new words. I'll try to update some pics on here soon. Seems like my day goes by pretty fast between trips to the NICU.