Weight Gains, Head Ultrasounds and More

I'll go ahead and apologize now for this post in advance.  We're both pretty tired.  (It's amazing how traveling back and forth to the hospital wears on you.)  So tonight's update will be brief.

• Daddy got to hold Isaak tonight!  We've got pictures, but they'll have to wait until tomorrow.  Isaak was so sweet though.  You could tell that he wasn't really able to focus, but he kept opening up his eyes to look up at his daddy.  Neil and I have now held both our son and daughter.  =)
• Penny now weighs 710 grams.  Isaak weighs in at 810 grams.  Both are now above their birth weights of 650 grams and 780 grams, respectively.  A couple days ago they both hit their exact birth weight on the same day.  Could they already be showing us signs of their twin connection?
• The amount of breast milk each is receiving is steadily increasing.  Isaak is getting about 8ml every 3 hours and Penny gets 7ml.  Assuming they continue to tolerate their feeds well, they will get a slight bump in the amount every 24 hours.  If all goes well, they'll be on solely breast milk by the end of next week.  (No more IV nutrition!)
• Respiratory wise, Isaak is still the trouble maker.  He continues to have several apnea and bradycardia spells each day.  Most of the time he self-resolves or needs only mild stimulation to recover.  He has been taken off of the SiPAP and placed back on CPAP.  The nurses are trying to suction him more frequently since he seems to have more gunk in his nose and throat than his sister does.  Penelope has occasional "A's and B's" - as they say in medical parlance - but nearly all of hers are self-resolved.  Neil and I have tried to get her to talk with her brother about these things.  So far, though, she has refused to set him straight.
• Despite several attempts, there is still no PICC line for Penny.  They may have to do just a plain ol' IV for her.  Her UVC in her umbilical cord is still in and still working well, but it will need to be taken out soon.  After 10 or so days, the risk of infection outweighs the benefits it provides.
  
• One of the many things that preemies often experience is a bleed in the brain known as an intraventricular hemorrhage (IVH).  So last night both Penny and Isaak had a head ultrasound. Penny's showed a mild Grade 1, possibly Grade 2, IVH that was isolated to the right side of her brain.  Isaak had a Grade 1 IVH on both the left and right.  Short-term and long-term outcomes with Grade 1 or 2 are very good.  In fact, most doctors and nurse practitioners that we've spoken with say that there is nothing to be worried about.  To be on the safe side, a second head ultrasound will be done in about a week.  This is done just to monitor and track the size of the bleed.  (Who knows...full-term babies may also have mild IVH's, but they aren't screened for them.)
  
  Thank you all again for the many prayers said on our family's behalf.  We sincerely appreciate every one of them.

27 Weeks Today

Today is 27 weeks gestational age for the twins. What an amazing thing. Of course, we wish they'd decided to hang out in mommy's tummy a bit longer but they are moving right along and we are so thankful they are here.

Monday, Isaak managed not to need any "neo-puff" oxygen to get his sats back up after his apnea episodes - he recovered all on his own. He was rambunctious enough to pee everywhere when they were bathing him. I guess he wanted a change of bedding too ;)

On Monday, both babies appear to have gotten back to birth weight. The goal was to have that occur in the first 2 to 2 1/2 weeks so they are a little ahead of schedule. They are currently receiving 4ml of milk every 3 hours with minimal residuals.

On Monday, Bekka got to hold her little baby boy for the first time.

Monday was a better day.

Isaak and his Not so Great but Not so Bad Day + Holding Penny

Today was a tough one for little Isaak. Last night they had discussed the possibility of switching him from bubble CPAP to SiPAP due to his recurring bradycardia and occasional apnea. This morning they made the switch. SiPAP differs from CPAP in that it actually provides "breaths" if they don't breathe themselves. If they are breathing OK, it acts like CPAP but if they need the assistance, it will pulse a set number of times per minute. CPAP simply provides constant pressure to keep their airways open and lungs inflated.

One positive: it appears that some of his issues might be caused by secretions. Twice, they suctioned out some pretty nasty stuff and he immediately began breathing and behaving better. We are well familiar with the impact of secretions thanks to our time with Ollie. We really hope that more frequent suctioning will help Isaak out. He had a fantastic late evening while we were visiting - let's hope it continues through the night.

In other news, Penny has been rock steady and I was even able to hold her this evening! Pictures will be forthcoming but let it suffice to say that it was incredible! She is just a little snuggle-bunny, so warm and soft. Feeling her little heart beat away in her chest is one of the most amazing things I've ever experienced.

Bekka's mom went home today. She was a big help during the week and we are so glad that she was able to meet her new grandchildren. We'll miss her.

Of Seven Days, Kangaroos, Poops, Pics and PICCs

Wow.

A week old. It is really hard to believe seven days have gone by since being woken up in the early morning by doctors talking about c-sections. It's been a crazy few weeks but we have two beautiful children fighting their way forward each and every day.

We are now moving into a critical time. Penny seems to be doing best, but this isn't uncommon as little girls are often at an advantage when born this early. Isaak is still experiencing quite a few bradycardia events but is keeping his O2 sats up. Both babies are pooping regularly; this is a huge step and means they are tolerating their food. The docs  hope to go up to 4ml per feeding on Sunday if all continues well. For reference, 13ml would be a full feed so they are getting there slowly but surely. Their best chance is for the doctors and nurses to follow the protocols gradually and carefully.

Isaak received a Peripherally Inserted Central Catheter, or PICC, today. His umbilical venous catheter had shifted and they needed a way to continue feeding and medicating him. They prefer not to use regular IVs as they don't last long in the tiny little veins. The PICC can stay in place for months and offers higher volume flow and a lower risk of infection. The placement was not picture perfect, but will be OK for now. Penny will probably receive one of her own in the next couple of days as her UVC will need to come out soon. If feeds continue to increase, they may only need it for a week or two. Let's hope that's the case!

Grandma Karla was able to hold Penny yesterday while they did a bed change and Bekka was able to perform a little Kangaroo Care with her today. Dad hasn't gotten to hold either of them yet but hopefully that comes soon. It's pretty tough not having had that chance. If Isaak is doing well tomorrow, I'm hoping to hold him during his bed change.

More pics are up of all this so pop over to the gallery and check them out.