Movin' on Up! (lots of news, long post)

Well a lot has happened since the last post. The girls have made tremendous progress in the last week. Today they are 34 weeks (gestation age) and they have been in the NICU for six weeks. Both girls are off all breathing support now. Kathryn is now completely on breast milk just like her sister and she is tolerating it very well. That is wonderful progress for her because she did not tolerate it well when she was first introduced to it and the nurses would have to pull all the undigested milk from her belly which obviously didn’t do her any good for weight gain if she couldn’t digest it. But this time around she digests it just fine. Speaking of weight gain, Sophia is at 3 lbs. 13 ozs. and Kathryn is at 3 lbs. 9.5 ozs. They are really filling out and looking less fragile.

The girls had been getting doses of caffeine in their feedings which helped to keep them from dropping their heart rates. They are now currently off the caffeine which shows their progress because until yesterday the girls weren’t having nearly any episodes, however, yesterday Sophia began to have a few episodes throughout the day which may just mean she needs to go back on caffeine. The nurse told me today the caffeine stays in their system for about five days after coming off of it, and tomorrow makes day five, so if her episodes increase tomorrow then that is a clear indication the caffeine doses should resume. The only reason that bothers me is because if she has to remain on the caffeine when she comes home, then she will definitely be sent home on a monitor. That’s not the worse thing in the world, but it would be really nice if they could be without the monitors when the come home.

As for more of the good news, on Wednesday the girls were moved out of the critical care room and into a “feeders and growers” room. This room is a much more relaxed environment and it’s not nearly as noisy with all the beeping monitors that constantly alarmed in the critical care room. This room is where they will learn to feed in preparation for coming home. This morning the girls had their first bottle feeding and the nurse said they did VERY well. They get rated based on whether they finish the feed in under 20 minutes, do they keep the food down, and can they get through the feed without a drop in heart rate, so it’s a very good thing they rated well. Kathryn had a slightly harder time taking the bottle than Sophia because she gulped up the feeding really fast and she forgot to breathe while doing so, so her rate dropped slightly, but the nurse just pulled back until she recouped. They start with one bottle feed per day (other feedings by tube) and they will slowly work their way up to more per day if they remain tolerating them. Since they did so good today, they will try two feeds tomorrow. They don’t get to try breastfeeding for awhile yet because that is really tiring for them. They will try that closer to coming home time.

They’ve recently spent a lot of time together and a new activity for them is to spend time together in one incubator for a few hours per day so they can get some cuddle time together. It’s so fun to watch them together. They stretch and touch each other’s face and hands. I could watch them together all day long. They look so adorable and you can tell they really enjoy each others company.

Sorry for the long post, its just that they have made so much progress this last week and grow stronger every day. Please continue to keep them in your thoughts and prayers during this holiday season in hopes we can spend Christmas with them in our home.

Enjoy plenty of pictures below and God Bless!

Thier old room, closest bed was Sophia's, Kathryn's is in the background.

The Step Down Room - The "quiet" room, one more closer to home!

Sleeping together in Kathryn's incubator for the first time.

Holding hands for the first time.

Just plain ol' cuddling.

Sophia Grace

Kathryn Lydia

Daddy "feeding" Sophia.

The result of that feeding.

Mommy giving Sophia a bath.

Happy Thankgiving!

How we spent the first half of Thankgiving, Emily is holding Sophia and Kathryn is on her lap under the small blue & pink blanket...hands a little full?

Daddy feeding Sophia her Thanksgiving milk.

Kathryn after getting her Thankgiving milk from Mommy.

No more pictures please.

WIDE awake after Mommy gives her a bath.

Some Thanksgiving cuddling for a couple of hours.

Holding hands again.

Some comfortable girls taking advantage of some quiet time together.

Together At Last!

After a whole month of being apart, the girls were finally reunited over the weekend. The nurses were able to turn Sophia’s incubator around, so now the girls face each other and when we get them out, we can hold them at the same time. On their first meeting they slept during most of the momentous event, but they did get to cuddle and touch each other a little bit. We know they were comfortable with each other’s presence because they were very calm and content while they slept side by side.

Personally, I got my first taste of what my future will be like with twins. Holding two babies at one time sounds and looks easier than it is. You have no spare hands! I had to have Tom scratch my nose and had to sneeze so bad but there was no way to cover it from the girls, so I held it in and nearly choked and my eyes started to water! I definitely need more practice at this.

Recent milestones:

- Both girls have surpassed the 3 lb mark and continue to be neck and neck during every step of the way, a slight competition in a way to see who can get healthier first.

- As of today, Sophia is officially off any means of additional breathing assitance, no cannula, no tape, just a pretty face! Kathryn is off “hi-flow” and is now only on a nasal cannula for breathing assistance, but should be off soon.

- Both girls got their one month head ultrasounds and everything looked normal.

- They both were born at 15”and are now 15.75” long. Almost an inch in a month, how tall are they going to be?

- Today they started working Kathryn towards every 3 hours feeds instead of every hour. If she tolerates that change well then they can introduce the breast milk again. Yeah! You all should see our deep freezer – I could start a breast milk factory.

- Sophia is still taking breast milk every 3 hours and she tolerates it well.

- They are having more bowel movements on their own without the need of suppositories.

- They are having minimal amounts of “episodes”, (reduced heart rates or apnea spells).

Our babies are growing up slowly but surely!

From Dad:

It seems most of the updates come from Emily, I have her type up her thoughts and I post them when I can (with slight additions from me). I finally got to give Kathryn a bath on Monday during my after hours visit and she seemed to take it pretty well, couple of whiny moments, but we got through it. Their little bodies and skin are SO soft, you just want to hold them as close as you can. I have limited time with them during the week, so most of my time is spent just staring at them in amazement and kissing their little forheads. The poor quality, no-flash, pictures do not do them justice and I must say I've got some pretty good looking girls in my family! They are so absolutely beautiful, I seem to get lost in the moment every time I see them.

I also wanted to say how proud I am of my wife. She has been a trooper from the very beginning and surely gets the woman and mom of the year award. Her dedication to her daughters is unmatched and I am honored to have her in my life. I watch her handle and bath them, change their diapers and outfits, take their temperature, and hold them. It simply amazes me how natural all of it is to her; it's as if she was an NICU nurse in a former life. Thank you Emily!

During this time, Evelyn and I have become very close, and this past weekend we went on a little adventure in the woods across from the hospital. For hours, we had a blast walking through the leaves, climbing hills, and feeding french fries to the squirrels. Because of our situation, she obviously has had less attention from both of us, but I finally understood how much our time together means to her. As we were driving back to the hospital to pick up Emily, completely out of the blue, she says to me, "Daddy, I love you..." As I nonchalantly wiped the tears from my eyes, I thought, "Does life get much better than this..."

Anyway, thank you for letting me share my thoughts and enjoy some more pics!

Can you see the look on Em's face? Only slightly nervous!

Sophia in this Fall's hottest styles and colors...

Kathryn too, but she prefers to accessorize (pacifier)

Two peas in a pod (well, two pods)

Relaxed?

"No dad, we will not open our eyes..."

Our nature adventure in the park

Wave so we can show mommy our adventure

Thank You!

Thank you to everyone who leaves comments on the blog for us to read. We look forward to reading each one - it helps us stay positive and feel more like we're part of the world a little bit since we haven't seen or talked to many people since the girls arrived.

Abigail, Evelyn said Hi back at ya, and she hopes to have a play date with you soon.

Shawn, keep the comments coming - I can't wait to see all of our (6) girls playing together! Poor David and Tom, they need boys.

Aunt Lolee, Pup and Grandma Short - the girls aren't learning any of your names yet cause I am teaching them math and science and Tom is working on thier golf grip (they have the hands for it!). I think they both want to be NICU nurses. They know all about monitors, vitals, and patient care already!

As of yesterday, both girls are out of isolation; which means that we don't have to worry about wearing gowns and gloves when we handle them. That's actually a huge relief for us because worrying about spreading germs back and forth was stressful. They both weigh 2 lbs. 14 ozs. Although they aren't identical, they like to stay equal in their progress. They are so considerate of each other. We dress them in little preemie outfits now, which are adorable but huge on them. Other than that things are pretty much the same. I get little ideas of how their personalities are going to be now and then. Sophia looks so much like Evelyn did when she was born, but her temperment is calm and easy going (opposite of Evelyn as an infant). I'm not sure yet who Kathryn is going to look like. I think that maybe some of the Carrabino genes got into her cause her hair and skin is darker (so far). She has a much more fiesty personality (just like Evelyn). She squeals and lets you know when she doesn't like you handling her. There are some similarities between them, but mostly they are each completely their own person. It's going to see so fun to see how each develops and changes over time.

Thank you everyone, and even though we don't reply to all of them, please continue to post your thoughts, we love to read them!

God Bless!

Emily (Tom & Evelyn too)

Update From Emily

Last week was a good week with the girls, can you believe it has already been a month? It seemed like a lot of the commotion of the first two weeks had died down a little and we seemed to fall into more of a routine. For now we’ve decided that I stay home on Mondays to spend time with Evelyn and then Tom goes to the hospital after work (which makes about three hours on the road for him that day). Tuesday through Thursday I go the hospital alone all day, Friday I spend the day with Evelyn again and wait for Tom to go together in the evening. On Saturdays we both go all day and take Evelyn with us and we take turns watching her at the Ronald McDonald House. Then on Sunday I usually go alone for the whole day again while Tom takes care of thing for our "normal" lives.

I am able to sponge bathe the girls myself now, so one day I give Kathryn a bath and hold Sophia skin to skin and then the next day we switch. They don’t like us to bathe and hold the same baby on the same day because it’s too tiring for them, that’s why we switch every other day. I love to bathe them – they both behave so well and they hardly fuss at all. Usually, as soon as I give them a bath, they fall right to sleep afterwards from all the activity.

As far as progress goes, as of today, both girls weighed 2 lbs. 12 ozs. Sophia is taking breast milk regularly and she is up to 22 ml every three hours. Unfortunately, Kathryn is still on the special formula, but the amount went up to 7 ml per hour, which means that if she tolerates that well, then they soon will start to wean her off of the formula and onto the breast milk.

Both girls still have occasional episodes of apnea so their oxygen levels get adjusted daily based on how well they are doing each day. Some days are better than others for each of the girls, but we’re assured by the nurses that this is all typical preemie behavior. It is scary when the monitor alarms because they are having an episode. A few times I’ve even seen their skin color change to a bluish hue, but as soon as you rouse them they come out of it and turn pink again. Other than a few minor things that are expected for preemies, the girls are doing very well.

Again, by this news you can tell that everyone’s prayers are being heard and helping the girls to thrive slowly but surely. My personal prayer is that they can both come home by Christmas!

Thank you and enjoy some more pics.

Mommy getting Kathryn ready for her "bath".

No one is taking that pacifier from Sophia.

Same day, same time. No one is taking Kathryn's pacifier either. Notice the fuzzy hair, she just had her bath.

Kathryn fast asleep.

Hmmm.

Dad, please stop taking my picture and let me sleep.

Happy Halloween Part Deux

I know everyone has been anxiously waiting to see more pictures, so I am going to keep my synopsis brief and the pics a plenty.

I've already done a Halloween post, but I wanted to do a second one to show everyone what Emily did for the girls at the hospital. This was a great way for Kathryn and Sophia to get in on the Halloween fun. The girls are doing very well and continue to thrive. Both have surpassed thier birth weight and are nearing the 1-month mark. Emily will post an update soon.

I've also posted some pictures of Evelyn on Halloween night. Her and I walked the neighborhood while Emily handed out candy at home. We had the best time ever, she is now a trick or treating professional. Evelyn knew exactly what to do; before she even reached the house, she would yell "Trick or Treat", hand over her princess pail and say "Thank you" to each person. As she walked away she would enthusiastically yell "HAPPY HALLOWEEN!". The people handing out candy loved it. At a particular house, she was half way down the driveway and says "Oops daddy, I forgot to say thank you", turns around and walks back up to the porch. The lady says "did you want some more?", and Evelyn says, "No, that's OK, I have enough. Thank you", and walks away. I kid you not, that was exactly what she said, it was the cutest thing she has ever done. That girl amazes me every day.

Anyhow, enjoy some pics below of the girls on Halloween and Evelyn's trip to the apple orchard. Emily is going to post another update today or tomorrow with more pics of the girls.

Thank you and God Bless!

Kathryn playing peek-a-boo!

Sophia was not as enthusiastic as Kathryn, she was WAY to relaxed.

Kathryn had to much excitement for the day, all tuckered out.

Hi Kathryn!

Hi Sophia! (do they look like twins?)

Evelyn "gutting" her pumpkin on Halloween Eve.

Princess on a mission! (Note the serious facial expression)

The fruits of her labor.

The first and only time my girls will see me with hair. Gotta love the mullet.

Farm girls.

Our country bumpkin on her first hayride and pumpkin picking.

Visitation Update / Information

I know many of you are very eager to see the girls just as Emily and I are excited to introduce them both to everyone, but I just wanted to give everyone an update on visitation for the time being.

Unfortunately for the girls, their premature births occurred during the cold/flu season. Because of the increased risk of passing on any type of infection to them, the hospital has asked us to limit visitation as much as we possibly can. Although the girls are allowed visitors during certain times of the day, the hospital cannot insist we limit visitation; they can only make suggestions based on their years of experience.

Their little lungs and immune systems are so fragile that exposure to even a common cold could be devastating to their progress. Because of this we have been extremely cautious with them. As Emily, Evelyn and I are taking vitamins and washing our hands religiously, we are limiting visitation to just our parents for the time being. They have also stressed the importance of limiting visitation even after they come home until Spring/Summer-time. We have been told that the girls will likely have respiratory issues until they are older toddlers and so during infancy we should avoid public places (malls, grocery stores, church, etc.)

Below are some excerpts from the visitation pamphlet all visitors get, and as you can see, they take it pretty seriously:

- Before coming to the hospital, ask yourself - do you feel sick today? If you say yes, it would be better that you did not come.

- If you have a cold sore or open sore around your mouth or nose, then you must wear a mask before entering.

- ALWAYS wash your hands with soap and water for 15 seconds before entering.

- ALWAYS use waterless hand sanitizer at the bedside before and after touching your baby.

- Remember if you change your baby's diaper or clean spit up, wash your hands again and use hand sanitizer.

- If you leave the room, you MUST wash your hands before you reenter.

- It is suggested that you wash your hands when you leave the NICU, even if you don't plan on returning the same day.

Because Kathryn has been fighting a bacterial eye infection, the girls are in what they call “isolation”, which means that we have to take added measures not to pass this bacteria on. When we care for the girls we have to wear gowns and gloves in addition to hand washing and sanitizing. Sophia does not have the infection, but they ask us to treat her as if she is in isolation also so we do not pass it from Kathryn to Sophia.

Only 2 people are allowed at the bedside at one time, including Emily or I. Visitors must be 13 years or older, so this means Evelyn has not even met her sisters yet. The time at the bedside is also limited to a couple of minutes and only the parents are able to hold them.

I know everyone understands the seriousness and importance of the guidelines the hospital has asked us to put into place. We want our baby girls to come home as soon as they can. As soon as we get the OK from the Doctors to allow more visitors, we will pass on the word so we can schedule times for family and friends to meet them.

Thank you all for understanding, and I promise, I will post more updates and pics this weekend, got some really cute ones of them WIDE awake.