Friday, April 24, 2020

The N.I.C.U - Week 1

What I remember of first 2-3 days post delivery was that my pain wasn't as bad as I had expected.  I remember being surprised at one point because I didn't realized that the spinal was still wearing off so there was one big spike in pain, but otherwise it really was manageable.  I was also surprised by how much my legs and feet swelled the first couple of days, but all in all I was up and even walking quickly.  I think I was up withing the first 2 hours and walking within the first 12.  I also remember pumping and pumping and pumping and holding my girls for hours and hours, as much as I could between feeds.  I remember nurse after nurse telling me I needed to go rest and that this would just make me so furious because ALL I wanted to do was be with my babies.  I honestly didn't care what anyone said at that point.

In the N.I.C.U. everything is on a schedule.  They feed on a STRICT 3 hours schedule, which was hard for me because I wanted to just let the girls nurse all the time, but that's not how it works in the world of the N.I.C.U.  They would let me "try" to nurse each girl for 10-15 minutes and then they would gavage them, which meant feeding them through a tube.  At the beginning they were so tiny and my milk wasn't in, so it really was just practicing or nuzzle nursing as they called it.  After both girls had had a chance to try and had been gavaged, so about an hour later, I would pump for 20 minutes and then either go back downstairs to rest for an hour and a half, or I'd ask to hold the girls until their next feed.  Quickly this became our routine.  It was exhausting emotionally and physically but I wouldn't change it.  I think it was right for us and I really think I needed to be with them as much as they needed me.

God really did design us in such a unique way as mothers.  Brandon always comments on how immediately relaxed I become as soon as they lay the babies on me.  While we were in the N.I.C.U. they were having what they called a kangaroo-a-thon, which was aimed at promoting skin to skin or kangaroo care and I loved this.  For babies the research shows over and over again that skin to skin helps them regulate blood pressure and heart rate, provides respiratory stability, improves cognitive and motor development, improves immune system function, helps babies gain weight and sleep better, and creates stronger bonding with less crying and stress.  Pretty amazing and definitely important for premature babies.  It was neat to really feel throughout this experience how purposeful and perfect God's design is.

Anyway, so on those first days I would pump just a tiny bit, and they would basically divide this between the girls and then supplement with donor milk to gavage feed them the necessary amount.  By about day 3 they were solely getting my breast milk, through the gavage, and about this time we started weighing them.  We would weight them before the feed and then if I thought that they had latched and taken milk we would weigh them again after, and then deduct the amount they took from the amount they needed to be gavaged.   This was a roller coaster ride as some feedings they would take a lot and then others hardly anything.  The nurses kept telling me it was normal.  They kept telling me that they were probably just so tired after a good feed that they were then unable to feed well the next time.  This made sense to me intellectually, but it still felt hard.

It was also hard having so many different nurses.  Some I really liked, others not so much!  Some of the nurses really pushed me to start giving bottles and others were adamant that I not nurse the girls for too long at each feed.  They said that this would wear them out and at one point Aubrey had an episode where she stopped breathing briefly, and they said that this was possibly because I had pushed her too hard which was devastating to me.  I just remember being so frustrated at this point.  I wanted so badly to just be able to feed them, and while many at the hospital were very supportive, I still felt so much pressure ALL THE TIME.  I was literally constantly being watched, which was nerve wracking, and I felt like I had to ask permission to care for my own babies which was uncomfortable and just emotionally hard.

To make matters worse, by this point, about a week in, I was also getting tired and the nurses were starting to really push me to go up to the labor and delivery floor to get some rest.  I know they probably had my best interest at heart, but it felt like they just wanted me out of their way so that they could gavage the girls, which was much quicker than weighing and letting me feed them, and this made me really angry.  It felt like we were in a weird way competing for who knew what was best for my babies and I frankly didn't like it!  I knew that I needed to rest and that I needed to accept that the girls couldn't do what term babies could, but I also knew that they needed me because a nurse just wasn't me.  I remember one night in particular I left them for a few hours, after being pressured, and when I came back Aubrey was crying, she'd pulled out her gavage tube, and the nurse when she finally did come back just blew it off.  I was SO ANGRY thinking well this is why I stay because I could have been sleeping on the couch next to her, probably would have slept better, AND would have heard her when she woke up so we wouldn't be reinserting a feeding tube right now.

These probably weren't some of my best moments but honestly I was doing the best I could.  I know that they were good nurses, but this whole experience was just hard, hard, hard!

DAY 2 - May 11th
On Saturday morning the kids all came down to the hospital to meet the babies.  They had to take turns coming in a couple at a time, and they didn't all get to hold the girls, but they did at least get to meet them.  It was hard not being able to just pass them around, but the nurses keep telling us that if they weren't eating, then they really needed to be sleeping so that they could be putting all of their energy into breathing and growing.



Aubrey



DAY 3 - May 12th
Sunday was Mother's Day!  The kids came back to the hospital to visit and brought me their Mother's Day gifts, Grammy was the only one who got to hold the babies, I had one of my favorite nurses, Aubrey and Maddie got their first baths, and Brandon brought me Panera for lunch.


I just loved the way these two snuggle into one another.  They just stare at each other until they fall asleep, and it really feels like they relax and understand when the other is close.

Snuggle time with Daddy!
Aubrey (L) and Maddie (R)


Maddie

Aubrey

 Aubrey

Maddie

So for as much as we worried ahead of time about getting babies mixed up I'm fairly certain they mixed up the cards right off the bat.  Aubrey, according to her birth certificate, was born at 5:19 and all throughout the pregnancy she was a couple ounces bigger than Maddie.  However, on the cards they had "Baby A", Aubrey, being born at 5:21 and being the smaller of the two.  I vaguely remember them realizing this as they were charting their daily weights.  I think about a day in they realized and fixed their growth charts but still kinda funny.  And honestly, who would ever know.  They look exactly alike.

My Mother's Day Visitors
Aubrey

Aubrey

Maddie

Maddie

Maddie's First Bath - She didn't love it!


But I loved the warm up snuggles..  

Aubrey's First Bath - She enjoyed it more than sis!  I remember the nurse laughing about how she was just soakin'. :)

DAY 4 - May 13th 
Today Auntie Katie came to visit and we got some pictures of what the kids are up to.  We are sooooo thankful for the way everyone is pitching in to care for them while we are here.  They've really gone above and beyond to make this past weekend fun for them and we are just so thankful.  It really does take a village.  Grammy and the Aunts and Uncles are taking care of the 5 big kids, Brandon is taking care of me, and I'm taking care of these new little loves.

Brandon made a trip home today to check on the animals and gather all the things we didn't bring to the hospital but should have.  I had my first male nurse, Willie, which was kinda awkward, and my nurse Katie came by the N.I.C.U. to check on us today which was really thoughtful of her.

 Auntie Katie



Maddie (L) and Aubrey (R)




 Hazel and Evie painting and hanging out at Auntie Amy's house.

 I think this one wore herself out.

 This one too!



I miss my sweet girls!

Uncle Robert went out and bought two toddler beds so that Hazel and Evie had a comfortable place to sleep.  We just moved Evie out of the crib a few months ago so I wasn't sure how she was going do but this was perfect, so thoughtful.  It's these little things all along the way that just put my heart at ease during this time.  It actually brings tears to my eyes still, thinking about how very loved our little ones were and realizing what a blessing it was to be able to focus all of my energy on the babies.

DAY 5 - May 14th 
Today Brandon went back to work.  There's really only so much that can be done right now and I told him I think I'm going to need him more when we actually get these babies home.  So for now
the plan is to sleep in our boarding room, I'll head to the N.I.C.U. at 5:30 a.m. for a feeding, he'll get ready and grab me coffee and breakfast, he'll comes up to say good morning to the girls, and then he'll head to work for a little while.  It's funny how differently we're wired.  He really needs to get out of the hospital a little bit, not necessarily to work, but just to walk around.  I on the other hand have no issue with just staying.  The days do kinda blend together, but I'm okay with it.  Being here just feels right to me and as long as he comes back and forth I'm okay.  Really I'm more than okay.  I'm thankful for all the ways he is taking care of me and supporting me through this.  There's no pressure to get out as quickly as I can and I'm truly deeply grateful.  I KNOW that this is absolutely a blessing!

They moved us to a new room today which was nice.  Our previous room was right across from the nurses station so it was pretty noisy and it only had a rocking chair, although they were kind enough to move in a second one for us.  Our new room is an isolation room that wasn't being used, which means it has a sliding door, a rocking char, and a couch/bed.  It is also the first room when you enter the N.I.C.U. so visitors don't have to walk all through the wing to find us which is probably good for everyone.

Hazel and Evie got to spend some time with Auntie Katie today.
Apparently they were practicing their big sister skills with Harper.

They might love her

A LOT!!!


Maddie (L) and Aubrey (R)

 Aubrey (L) and Maddie (R)

 Oh my heart!  They are just the sweetest!
Their bond is beyond precious!

 Maddie (L) and Aubrey (R)

Today after kindergarten Grammy visited with Cooper, Hazel, and Evie.  
 Cooper and Evie with Miss Maddie

I don't think Maddie knows the silliness that awaits her at home.

Maddie (L) and Aubrey (R)

Uncle Robert has the kids out working in the garden.  I think they're pulling weeds so that they can plant a garden.

After work Brandon picked up the 3 oldest kids from the dairy and brought them and ice cream down to the hospital.  They are all so in love with their new little sisters!


After their visit Brandon took them home for the night.  We figured it might be good for them to sleep in their own beds and to get to see Daddy for a night.

While Brandon was at home tonight he not only washed clothes for me, but he made lactation cookies and homemade scones.  I think I've got a keeper!



DAY 6 - May 15th
This really is a roller coaster ride.  In order for the girls to go home they need to be gaining weight, which they still aren't, and they need meet their daily feeding goal by mouth over a 24 hour period.   Right now their goal is 40 ml but I think this can change.  Last night Maddie took 35ml, 17ml, and 27ml, which was great progress.  Aubrey took 21ml, 36ml, and 0ml, which had to have been an error but that just seems to be how it goes.  One minute you think your almost there and the next it feels like you have so far to go.

Uncle Robert came down to visit with Grandpa and Hazel.  Hazel was in her typical mismatched outfit.  A fancy pink dress she'd just gotten from Autumn and her blue rain boots and she was just so enamored with the babies.  I sure do missed her.  I know that this is where I need to be right now.  I need to focus on getting these girls out of here so that we can all be together, but today when I saw my Hazelnut I couldn't help but feel a little sad that I was missing this time with her.  Although she is having the time of her life with Grammy this must also be a really strange time for her.




Hazel would literally hold her sisters all day.  She just loves them!

Bath #2 given by one of my favorite nurses!

I say this with every baby but seriously everyone should have an Uncle Robert.  He is always so excited for the arrival of each and every baby.  He's excited when we find out that we're expecting, although twins blew all the rest out of the water, he's excited as the due date approaches, and he's excited when they arrive.  Right now his thing is that he's determined to tell the girls apart.  So we've been playing a daily game of guess who where we send him a picture of each girl and let him guess.  He's actually pretty good at it!  He says Aubrey has an old man face.  Not sure what that means, but it works for him and we're thankful for his contagious excitement during this tiring time.




Grandpa was also very excited to meet his great granddaughters and I'm starting to see that there really is something special about twins which I didn't quite understand before.  I believe these are number 15 and 16 for him and I hope I never forget watching him walk back and forth between the two putting his hand on them and just quietly taking it all in.  It took him a long time to sit down and when he finally did I asked if he'd like to hold them.  Right away he said no, but I could tell he wanted to.  Everyone is nervous with them at first because they're so tiny and there are so many cords and wires, but he was so proud of this picture after the fact and so am I.  I love seeing him with my kids and am so thankful for his presence in their lives.


DAY 7 - May 16th - Thursday
Last night was really rough.  Aubrey's breathing was funny for awhile and they blamed it on her being overtired from eating so they wouldn't let me feed her and wanted to give Maddie a break to just as a precaution.  This meant Aubrey got 2 straight tube feeds and Maddie got one and then this morning Aubrey pulled out her tube right before I got there.  So by the time it was fixed she was worn out and I frustrated and once again no one fed well.  On top of all of this I found out that babies have to go 5 days without a spell before they can be discharged which means we will be here at least that long.  Anyway, so I started off this day pretty bummed.  Some days it really just doesn't feel like we're making much progress.

Thankfully I meet with an O.T./Lactation consultant named Shannon this afternoon and I really liked her.  She seemed very experienced and she encouraged me to keep on with what I'm doing in terms of my commitment to breastfeeding, but to think about alternating feedings.  She suggests I "take advantage of the gavage." For now her recommendation is that I feed Aubrey at the first feed and allow the nurse to gavage Maddie her entire feed.  This will allow me to work with Aubrey longer, with less pressure from the nurses, while also respecting their recommendations to let the babies rest.  At the next feed I'll switch and work with Maddie to nurse and allow them to gavage Aubrey so that she gets a break.  My initial response was no I hate that stupid tube and I want to feed them, but I really like Shannon.  I feel like she wants me to succeed and for that reason I think I'm going to trust her and give this a try.

She also pointed out that even though it's a bummer that Aubrey is now on a spell count it might be to our advantage.  She's been the stronger eater and Shannon pointed out that it is always nicer when both babies can be discharged at the same time rather than one being ready a week before the other.  This might just give Maddie the time she needs to catch up.

Lots of pictures of the kids today.  They're loving their days with Grammy.  They're planting a garden and playing with beans and just generally having a good time and I'm thankful!










Apparently EVERY night these two have to sit by Great Grandpa.  I love it!!!