February 26, 2008 – Why a full diaper is very good news

Coming back to the office yesterday forced me to evaluate the various tasks, work-related or not, that need to be prioritized and completed.  On the home front, we have a few items pertaining to Adam’s education coming into view shortly.  This Thursday marks our parent-teacher conference with Adam’s preschool teacher, and we are very eager to get a progress report.  I am especially curious to hear if there have been any noticeable changes in our son’s behavior since January 18th, the day Jenn-Jen was admitted to the hospital.  Jenn-Jen and I well know that Adam has been put into a very different environment the past month, but we are also very sensitive to ensuring we keep things as normal as we possibly can.  As Adam is preparing to enter elementary school this fall, we are also eager to hear about his readiness assessment.  Additionally, on Friday evening, we will find out if Adam was able to secure one of sixty one Kindergarten spots at our first choice of schools.  The assignment is done through a lottery system, as the demand is apparently quite high each year.  Our second choice is excellent as well, so we will be happy either way.

As for the twins, both are doing very well today.  Daria still has her occasional apnea and bradycardia events, but recovers fine with a little stimulation.  We are hoping to get the results of her head ultrasound performed yesterday to find out if her intraventricular hemorrhage (IVH) has stabilized.  As much as I would like to say I am ready to accept whatever outcome shows up in the findings, it would still be very painful emotionally if we discover the bleeding has worsened.  Keep your prayers coming here and I will try my best to remind myself that this, as is true with everything else that has happened, is really in God’s hands.  

I am a little embarrassed to be so forthcoming, but it was so nice to hear from Jenn-Jen that Katelynn had a massive bowel movement during the day.  Our little girl has been dealing with a big belly for some time, and while the size seemed to shrink and grow a little each day, today’s output really made a difference in how she looks.  The evening nurse told me that Katelynn actually had another large stool before I came in tonight, so I am hoping the trend will continue.  Why I am very concerned about big bellies and lack of poopie diapers is because of a very nasty, and potentially life-threatening condition called necrotizing enterocolitis (http://www.kidshealth.org/parent/medical/digestive/nec.html) or NEC.  This is a disease of the digestive tract that can have a very sudden onset for premature infants and some of the warning signs are intolerance to feedings, a bloated abdomen, and infrequent stools.  If NEC hits, sometimes surgery is required to remove part of the afflicted baby’s intestines that has torn away.  As you can imagine, this disease, while rare, is tremendously worrisome to us.  Once the girls reach their sixth week of life, the odds of them being affected by NEC is significantly reduced.  So Katelynn’s full diaper today is another tangible sign pointing us in the right direction.

Jenn-Jen and I spend a significant amount of time tending to our children these days, and unfortunately, that time is often spent apart.  One of the struggles we have been facing is making enough time for each other, as our marriage is not meant to be put on the back burner, even through the birth of Katelynn and Daria.  I admit I have not been making as much of an effort as I should to make sure all is well within our relationship, so it is now a priority to have some time to ourselves and, perhaps even have a real date.  We may have to agree not to spend our date at the hospital, watching and holding the girls, as tempting as it might be.  I am very thankful to say that between family, friends and neighbors, there are quite a few of you who have graciously volunteered to help watch Adam while my wife and I have some time alone.  With everything keeping me so busy these days, I would love to hear any suggestions you may have in terms of your favorite thing to do on a date night.

February 25, 2008 – Day and night shifts

Taking an extended amount of time off inevitably creates a backlog of e-mail messages requiring varying levels of urgency upon the return to the office.  Thankfully, I work with a fantastic team that has been instrumental in keeping the workload manageable during my absence, and for that, I owe them my deepest gratitude.  I will remain quite busy during this week, as there are plenty of tasks requiring my attention.  Still, I am relieved to find nothing catastrophic occurred while I was out on leave. 

As Jenn-Jen and I work to establish our day and night shifts at the hospital, I already find myself missing the extended amount of time I had spent with Katelynn and Daria since their birth.  Looking at the calendar today, I was astonished to come to the realization that the girls will reach their first month of life this Thursday.  The perception of time still puzzles me, and lately, I find myself reminded of its passage only by checking calendars and reflecting upon the amount of blog posts I have journaled to date. 

During my day of playing catch-up with work, Jenn-Jen took Adam to a friend’s house and spent a significant amount of time visiting Katelynn and Daria.  I was very happy to hear that my wife had the opportunity to hold each of the girls without distraction.  Jenn-Jen was also present during Katelynn’s daytime tap of cerebrospinal fluid and reports that there is less blood in the draw, which is very welcome news.  Unfortunately, Daria still experienced a few heart rate drops, or bradys, during the day.  Some stimulation and temporary changes to her oxygen levels seem to bring Daria back.  Both girls are still receiving caffeine to help stave off the apnea. 

After having a nice family dinner at home, I helped Adam wash up for the night and read him a bedtime story about honeybees.  Driving to the hospital was very relaxing tonight, since the last round of rain ended yesterday.  The air felt particularly crisp, clean and soothing tonight, and everything seemed to be moving at a slower pace.  Even Room B in the NICU, where Katelynn and Daria call home right now, was dimly lit and peaceful as I entered.  The girls were undergoing their assessments and snoozing away despite being handled by the nurse.

Daria had not been weighed yet for the evening, but I did learn that Katelynn has broken the one kilogram mark in her weight.  She will also have her intravenous TPN and lipids discontinued shortly, as she is handling the increased feedings of breast milk with flying colors.  The nurse asked me if I cared to hold the girls tonight, and how could I resist?  They are still so small and fragile, but I mustered up my confidence and had the nurse put one daughter in each arm.  The three of us sat in a rocking chair for a good hour peeking at each other and getting sleepy together.

Toward the half hour mark, Daria actually had a brief heart rate drop, but came back just fine with some mild tickling.  I felt her small hand shortly thereafter and it seemed colder than usual.  The nurse checked her temperature and decided to bundle Daria up to keep her warm.  A few minutes later, Daria’s temperature remained lower than it should be, so the decision was made to move her over to the warming bed.  This bed makes me think of an open air toaster oven, but it sure did the job of warming up Daria.

I also had the opportunity to watch our neonatologist perform the evening fluid tap for Katelynn.  He drew out five milliliters of yellow-tinged CSF, which is a fantastic improvement from the wine-colored fluid tapped just a few days back.  If Katelynn can keep up the absorption rate of her CSF, we may be able to avoid taking the next steps in resolving her hydrocephalus. 

As I wrap up tonight’s post, I am already thinking about the girls spending quality time with Jenn-Jen tomorrow during the daytime.  I’ll have my time with them again at night, but my heavy eyelids are telling me to find the bed for now.