Let the antibiotics begin!

Thank goodness! Today seemed to be a more stable day. Both girls are getting antibiotics, Allison for a blood infection and Mia for a possible lung infection. Lets pray these miraculous meds do the trick... Here is the picture of Alli in her swim cap. I have actually grown to hate this hat because it makes her head a weird shape, kind of cone-y. I've been assured that her head will go back to normal once it is removed. None-the-less, I made sure the doctor and nurses knew I was concerned. I think my protective mother instinct is well intact.

I got to hold Allison today because she was due for a new house. She seemed to have learned some tricks from her sister because she too dropped her oxygen saturation and needed to go back into her bed. I got to hold her for at least 20 minutes though before that happened. Aside from having to hold her nose piece in place, it was a good snuggle. I even got to tell her the story of the little nut brown hare (Guess How Much I Love You). It was an improvised version though because I didn't have enough hands to be able to read the real thing. (Mia has heard the story now a couple of times and though she didn't seem to like it at first, I think it is growing on her...)

Daily grind UPDATE...

I did get to hold Mia today which was awesome. I have been getting really sad thinking about how long it had been since I got to hold either of my baby girls. Unfortunately, it will probably be another week before I get to hold Mia again... She had another spell as I was holding her which cut our cuddle session short after about 10 minutes. Then she continued to have frequent spells throughout the afternoon. They did some blood tests and didn't like the numbers and decided tonight that they would reintubate her and hold her feedings. They'll continue to do some other tests to see why she's having such a hard time. Now her sister, infection and all, who I was so worried yesterday seems to be the better of the two! I was reminded by one of the nurses that we can expect one step forward and 2 steps back with preemies of this age. I much prefer 2 steps forward, period.

The Daily Grind...

Thanks for so many hopeful comments on the blog, cards, and e-mails. Shawn and I both have enjoyed reading them and find the support really encouraging.

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I had to go back to work this past week and I'm sure any parent can relate to my mental struggle blending my old role as a teacher with my new role as mommy. It was much easier doing just one or the other. Being back at work has been an emotional struggle as time spent at work is time I was spending with the little girls. It doesn't help that Allison has been having more (and bigger) spells and has been less tolerant of her care and feedings lately. They gave her a transfusion yesterday though, and since then she has seemed more comfortable. They ran some blood tests to see if she had anything else going on to cause the fussiness and once again she seems to have developed an infection, unidentified as of this morning. She really likes to keep me on my toes and tearful. What she may not know is the more spells and fussiness she has, the less of a chance I have to hold her.It's been well over a week now since I've gotten to hold either of them.

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Mia has been having spells also, but they've determined that they are due to reflux issues at the time of feeding. To hopefully help her out, they've gone to continuous feedings. (Wouldn't that be nice...) She is due for a new bed today, so rumor has it I may get to hold her today!!! I could really use some snuggle time.

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There is a new set of twins in the same room as the girls. It has been helpful to get to know their mom and dad. It is nice to have someone, not working with the girls, to check in with each day at the NICU, who knows exactly what we're dealing with.

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I'll try to take more pictures soon. Allison got a new kind of CPAP nose piece and the hat attached makes her look like a synchronized swimmer!

Happy 1 Month Birthday!!!!

The girls are one month old today with many thanks due to the caring staff at the St. Cloud NICU! It is very hard to believe that the time has passed so quickly. I guess that's the illusion when your head is in a cloud due to lack of sleep, too much new information, and a bit more stress than we are used to handling. Maybe the clouded state is some sort of self preservation, keeping you alert enough to know what's going on, but protecting you from the emotional impact of every little instant. Don't worry though, there is still a lot of emotional impact getting through!
Shawn and I started the day in typical fashion, 'up to our elbows' in snuggles. We brought them each a little bunny to celebrate (an earlier gift from Grandma and Grandpa A.) I also made a carrot birthday cake for the staff (and because I really like carrot cake, too!)
Both of the girls had new party hats on when we arrived. They are cute and functional, as they help keep the CPAP nose piece in place. Mia had to go back to 'kindergarten', using the kind of CPAP that gives her some breaths. I'm still proud, of course! She just must have wanted to be like her sister.
Allison was feeling a little camera shy, but she too got back on CPAP this morning following a stint on the vent because of her travel and surgery. It seemed to be a good day for both girls with few spells and lots of attention!

The gangs all here!

The whole family is back in St Cloud today (Friday). Allison and her transport team left Minneapolis at about 8:30 this morning and I wasn't far behind. (I thought I was following the ambulance, but realized after about 60 miles that it was a non-descript white van...) Allison had a couple of spells in the ambulance and as she was getting settled back in to her spot next to her sister. The thought was that the bumpy ambulance ride rattled loose some of the gunk in her lungs and complicated things a bit until it could get suctioned out. All in all it was a successful trip.

When I got to Minneapolis yesterday I saw this little bear and balloon bouquet at Alli's bedside. The card attached said...

We found out back in St Cloud that it was the girls' doctor, Chip, that gave Mia the money to send her sister balloons!

Thanks for all of your prayers and thoughts. We think things will go smoother for Allison now that she her surgery went so well. Mia is doing well. She started on the more advanced kind of CPAP, the one that leaves her responsible for taking all of her breaths- none are given to her. I'm pretty proud. It's like she skipped kindergarten!

Photos of our big city girl...

This was the scene of the surgery. Alli was on a normal bed in a single room so the staff had a little more privacy and room to move.
The procedure took about an hour, beginning to end. We met with both the anesthesiologists and the surgeon beforehand. I did my best to check the doctor out, making sure he was well rested and confident that he would know the artery in question from the aorta or pulmonary artery. He passed my pop quiz with flying colors and did a great job with our baby girl. He made a small incision under her left arm and peeked between her ribs to apply a titanium clamp to the ductus. (I, of course, asked what the metal clip would mean for her future air travel... I was assured it wouldn't slow her down through airport security at all.)
After the surgery Allison was resting well, still enjoying her cocktail of pain meds. When we went back to see her after the surgery, we walked in on one of her nurses as she was telling Alli how beautiful she was and how much she loved her hair. I think she's in loving hands!
This is her new room for the next couple of nights. It looks a little crowded from this angle... The expectation is that Allison will be back in St. Cloud with us on Friday, give or take a day. Shawn and I came home Wednesday afternoon to be with Mia and to spend some time with both grandmas. Uncle Chris and Aunt Katie are planning to peek in on Allison tonight!

Update from Grandma Karyl...

Heard from Jen and Shawn around 10:30AM this morning (Weds.), that Alli's surgery is over, and everything went smoothly. Allison had an uneventful ride to Minneapolis last night...slept the whole way, and never once asked, "Are we there yet?" Jen and Shawn stayed in a room just off the NICU and were able to get a little sleep.

Mia had a good night, and was wide-eyed and looking around this morning when I visited with her. I'm heading back there now to hold her hand (Mommy's orders), and tell her that her sister is doing just fine. Mia was to have an echocardiogram this morning at some point, but she looked good and sounded good this morning, so hopefully she won't demand equal time with a roadtrip to Minneapolis. These two little girls seem to like to do things at the same time, including having hiccups together! I'm continually amazed at their strength...both girls kick their legs up (leg lifts?!) all the time, and both have exhibited a round-house pitching arm too. They both seem to be exhibiting their Mommy's fetish (always having her feet sticking out from under the covers) when they sleep.

Thanks to everyone for the continued support, positive energy, prayers etc.. Chip (Dr. Martin) wants to concentrate on fattening them up and letting them grow at this point. Sounds good to me! Jen will update with more info. later. Grandma Karyl

Allison's first road trip, and Mom's 32847375th freak out...

At a little past 7pm the crew from Fairview University hospital came to pick up little Allison. It didn't all seem scary until they, a nurse practitioner, a neonatology fellow, and two paramedics in space suits, got there.
The U of M staff talked with the nurses, nurse practitioner, and doctor from St Cloud to get all briefed on who Alli is and what she requires. It happened to also be a shift change so there were four nurses instead of the usual 2 in addition to all of the other personnel. At one point the fellow was going through paper work with Shawn and I and there were little pods of conversation taking place all around us. It became very overwhelming and I felt the need to either faint or cry so I went and sat by my mom, told her there were people everywhere and started to cry.
When I pulled it back together, the fellow finished going through the procedures and paper work with us. The nurse gave me a little time to snuggle Alli before they scooped her into the little 'space capsule' (isolette on the end of a gurney) and drove away. She seemed to have handled the whole transition ok.
Now we're packing to go down to the cities. There we'll find out how she liked her first ambulance ride. (They took her by ambulance because it wasn't an emergency situation.) They have a room arranged for us in the hospital just around the corner from their NICU. Shawn's not too excited to stay there, but I'm glad we'll be close. The surgery is tomorrow, we think, although there was some confusion about exactly when. Grandma Affeldt volunteered to stay in St. Cloud to puppy sit and visit Mia who is still in the St. Cloud NICU. THANKS GRANDMA!

A busy day for the babies...& ROADTRIP UPDATE

The day started with a visit from Grandma Affeldt and me. Allison was due for a new bed so I got to hold her while the nurses swapped her house. This was the second time ever, in three weeks that I got to hold her!!! She snuggled in just like her little sister, who for some reason we get to hold more often. She is still on CPAP and had few spells today. She got a sponge bath from her nurse and was wiped out for the rest of the day. She seems to really like baths!
Then... It was Mia's turn for a bath. Unfortunately she got stuck with an amateur bather, her mother. She tolerated my inexperience pretty well, but in the end of it all, she had spiked hair with some shampoo still in it. (Her hair is getting longer and at this rate we may need to trim it before she heads home!)

As a final hurrah, Mia got some tummy time with her daddy. The hold started out a little rocky as the tube from the ventilator came loose in the transfer. She had to get bagged for a little bit, but bounced back once everything was reconnected. Shawn thought she looked uncomfortable because under the blankie she was curled into a little ball with her knees in her armpits. She did send a little probe out from under the covers. She got her first feel of whiskers and held on to Shawn's finger!

We also got an update from Chip (Dr. Martin). It seems Allison's ductus is wide open and will need to be surgically closed. UPDATE: Since the surgeons aren't available later this week, she's scheduled to get transported to Minneapolis tonight (Tuesday) at 6:30PM and will have surgery on Wednesday. I'm told it is a common procedure that is done at the bedside, so she won't even need to go to the OR. It'll be a tiny little incision under her arm. Then they just tie off the ductus and that's it. Sounds simple enough??? They suspect she'll be back with her sister in St. Cloud by the weekend, assuming her sister doesn't end up needing the same procedure. Her murmur was a bit bigger today than yesterday so Chip will check an echo-cardiogram tomorrow and then decide if we can apply for the two for one discount...

3 weeks old!

This is the TV show that captures all of our attention lately. Now that the girls are both on CPAP, we are constantly monitoring their heart rate (the upper green number) and their oxygen level (the lower green number). The white spread in the middle shows the trends of the two numbers. On the screen you can see that Allison just rebounded from a little fit that took place while I was changing her diaper. I guess I still need to work on my touch... The spells they have are pretty scary to watch, but happen often enough that we've gotten lots of practice trying to stomach them. Now I only cry once in a while...

Allison is now on day 4 of CPAP. It seems that her ductus is open again which could explain some of the spells she's been having (spell = dropped heart rate and oxygen rate that can be mild or severe depending on how fast and what is required to help her bounce back). She's getting another round of meds to hopefully help her close it. The next step if the meds don't work is surgery, so we're hoping she responds well. Surgery would be a helicopter ride and a day or two down in the Cities...
Mia is on day 2 of CPAP. She has broken her previous record of 18 successful hours before getting reintubated. Things are going pretty well for her, but she also has spells and an open ductus just like her sister. The CPAP provides oxygen and a little preassure to help her breathe. Instead of an invasive tube, she just has a little band under her nose with a couple of soft prongs that fit inside her little nostrils. Both girls are still hovering just below 2 pounds, but we think they look a little bigger!

Calmer seas...

After the scary morning we had on Monday, things seemed to have calmed down significantly. I still flinch when I hear the phone ring, but I'm overall I feel a bit less 'on edge'... (see Montana photo above :)) Mia was able to bounce back from her nearly tragic experience and was doing much better by Monday afternoon. Both girls have developed lung infections and are being treated with antibiotics. None of the medical staff seems to perplexed by that development, so I'm taking the cue that everything will be fine after the antibiotics work their magic. Both girls are eating well, through a tube, but well. They are up to 10 mls (1/3 oz) of milk with a little formula added for extra calories every three hours. Their weight shows that they're growing. With the three week birthday tomorrow, they are sneaking up on 2 pounds each!

We're still not completely at ease though. They started Allison on the CPAP machine today. She seemed to be doing well on it, but time will tell. Ideally she will manage the extra work of more independent breathing and not have to be reintubated. Too much time on the ventilator can cause lung damage. At the same time, it was being on the CPAP, getting tired from the extra work and being reintubated that caused so much trouble for Mia earlier this week. We can just hope that Allison is ready for the challenge! So far so good...

The worst kind of morning...

This morning we woke to a 5 am phone call. It was the charge nurse from the NICU who told me that Mia was being given oxygen and receiving chest compressions and did I want her to call the chaplin to come and that we should go in to the hospital. We were at the hospital by 5:15. Mia didn't have good coloring, her heart rate was racing, but she was oxygenating better. The chaplin arrived and said the 'though I walk through the valley of the shadow of death' prayer. Shawn and I sat with her for a while, holding her little hands and rubbing her forehead. She seemed to have better color and aside from a high heart rate, she seemed to be stable.

The thought that we could still lose these little girls is mind numbing. The fact that there is little I can do to prevent it from happening is worse yet. Please pray, send healing energy and love.

Daddy's Turn...

Here's the proud papa snuggling Mia!

2 steps forward, one step back...

I realized over the last couple of days that this roller coaster Shawn and I are on rivals any we've been on with such high highs and, unfortunately, such frightening drops. After the extreme joy of finally getting to snuggle Mia, I learned just how much I never want to again see a doctor and two nurses working quickly around our baby Alli whose levels had crashed, bagging her to try to raise her oxygen levels and hoping that her heart rate would rebound. Shawn witnessed this with Mia just a couple days ago, and though I could see he was shaken by the experience, I didn't understand just how scary it was until I saw it happen for myself. The doctor and nurses were so understanding, and reassured me that this sort of thing is just preemies acting like preemies. I guess it is good to remember just how fragile these little girls are and that we can't take for granted all of the good things that have been going their way, because things can sure take turns for the worse, and quickly too.

In addition to respiratory difficulties for both girls, Allison has developed a Staph infection. It is the kind of bacteria that wouldn't phase you, or a full term baby, but because Allison is so little and has little immunity to anything, it is giving her a bit of trouble. Part of the effects (I never know if it is an a-ffect or e-ffect, but please don't feel you need to let me know the rule... I'll figure it out later) of the infection is that her platelet count dropped. That raised fear of bleeding all over again, particularly in the brain which could be devastating. Luckily, the doctor was able to start an antibiotic early enough that her levels rebounded before there were many complications. Then later I got to hold Allison- Right back up on top of the coaster! She was just as snuggly as her sister!

As we continue to look for an exit from this roller coaster, to hopefully get on to a smoother ride like the swings, we want to thank you all again for sending your thoughts and prayers our way. There are definitely lots of angels both in heaven and on earth that are looking out for our girls, and their efforts couldn't be more appreciated.

I got to hold Mia!!!

Wow! She's a looks a lot smaller when she's out of her little house! She was so warm and snuggly. She tickled me with her little fingers and even peaked at me a little. Both her eyes and Alli's eyes are starting to open. Next, it's daddy's turn to do some holding!

Results are in!

We got the results from the second ultrasound today and were relieved to hear that the brain bleeds have dwindled. Neither one has progressed and in fact, they have gotten smaller. Today was a big day for us as Shawn went back to working full days and I started walking to the hospital. I must be feeling better! The nurses put me to work today and had me take Mia's temperature and even change her little diaper. I had a co-pilot though, thank goodness! With all of the monitors and with how fragile little Mia seems to be, it was a lot harder than you may think, and kind of scary too! Little Allison let me cradle her head today. Later in the evening she got some of her tummy lines removed and an IV line in her leg instead. She may not have liked it, but it should help to keep her infection free! Thanks again for your thoughts and prayers!

Still growing... Reaching Milestones...

Mia is liking attention a little more than her sister right now...

Little Allison still prefers to be left alone...

Now just over a week old the littles are doing their very best to grow strong. They started taking breast milk through a tube to get their tummies ready for eating. They seem to be digesting well and are up to 4 and 5 ml feedings 3-4 times a day. As Mia grows more and more tolerant of being handled and cared for, the nurses gave the OK for Shawn and I to hold her. She still seems so fragile so we were both afraid to, but I got to at least cradle her little head and hold her hand. Both girls have lots of hair. Mia's is a little darker than Alli's. (We're still not sure how we'll spell Ally, Alli...) The potentially scary news came following an ultrasound of the girls' heads. One major risk of premature birth are brain bleeds and since these two are so preemie, they were almost guaranteed to have one. The bleeds are ranked on a 1-4 scale, 1 and 2s rarely have significant longterm effects, and 3-4s tend to have significant effects on cognition and development. Fortunately the first ultrasound ranked Allison at a 2 and Mia at a 1. The ultrasound will be repeated soon. PLEASE PRAY THEY HAVEN'T PROGRESSED TO BIGGER BLEEDS!!! Today Mia even got off of her ventilator for a little while. She seemed content with the C-PAP machine for a little while, but showed some signs of stress and was put back on the vent. She did get her belly button lines removed though and now has an IV line in her arm instead- less risk of infection. We're hoping Allison will get her tummy lines removed soon too.

Thank you to all of you who have been sending well wishes, offers of help, meals, cards and flowers. The support has been overwhelming and so appreciated.

Great Grandpa Krug sends his best...

Uncle Jay took this picture on the way up from Madison on July 26th. My grandpa always declared sky blue pink to be his favorite color. Anytime there is a pink sunrise or sunset, it has meant to me that Grandpa Krug was saying hi. He sent a really special hello to his new great- granddaughters! They've got a really special angel looking over them.

Almost 1 week!

It is hard to believe that this much time has passed already. I'm getting around better, and despite a sore tummy, I am having a better time with physical health than I am with emotional health. We are so grateful for the doctors and nurses in the NICU who are all taking such great care of Mia and Allison, and me as I have the occasional bedside breakdown. I just wish so badly that I were still pregnant so I could experience things like having a big belly, wearing maternity clothes, feeling what labor is like, and most importantly, so the littles wouldn't have such a tough road ahead of them. I feel like I was cheated out of that whole experience.

I couldn't be luckier though to have such cute little girls who as of one week seem to be doing OK. Mia is using a different kind of ventilator (an oscillator) to help her breathing and lung clarity. Allison is doing well on the same kind of ventilator as she started with. They're giving her chest vibrations (there's a fancy term for this but I can't remember it...) to break up some of the 'gunk' in her lungs. Both girls have an open ductus, or valve between their lungs and aorta. It typically closes at birth but because of their age they need some help. It causes irregularity in blood pressure and heart rate and other levels, but they're working hard to close them.

A Crash Course in Neonatology...

The girls were taken up to the NICU immediately after delivery. Shawn and I are allowed to visit as often as we'd like, and any time we do visit, we are given so much information as to what is happening with the girls that I often find myself completely overwhelmed. The girls are on ventilators and are being monitored for oxygen levels, breaths per minute, carbon dioxide levels, Ph levels, heart rate, blood pressure, temperature, and more. They have little wire leads in through their belly buttons and other sensors on their tummies, feet, and arms, as well as a tube in their mouths for breathing. Because Shawn knows much of the staff in the NICU from his rotation during residency, the explanations of care are delivered mostly in doctor speak. I'm starting to catch on to abbreviations and other lingo, but am grateful for the translations from Shawn and the patient re-explanations from the doctors and nurses. I got to hold their little hands! (They even squeezed my finger!)

I was discharged from the hospital on Sunday, July 29th. I was really nervous about going home and leaving the little babies behind, but was so relieved to sleep in our own bed by Shawn again! The solitude in the hospital at nights lended too easily to thoughts of having failed my little girls already by not being able to carry them for longer, and all other dark thoughts as to what may or may not lay ahead for all of us. My parents being at home with us helped for a smooth transition as well. My homecoming was complete with pizza sandwiches, another one of my Affeldt family favorites!

A Sudden Delivery...

Wednesday July 25th, Shawn and I went in for the pre-scheduled 24 week appointment. I had called a couple of times to be sure the appointment was necessary because I was wanting to move as little as possible, and sometimes those pre-scheduled visits are not that informative. We were assured we should go, but found my doctor was called to a delivery right as we got there. We thought we'd be asked to reschedule, but instead we met with a different doctor. She checked my cervix and said, "Oh, boy... This isn't good news, guys". I was dialated to 4 cms and she had us go straight to the hospital. Being that dialated, it was unsafe to do bed rest at home.

On the 26th, a case manager came in and was talking to Mom and I about what sorts of things could be brought in for me to preserve sanity during the weeks I'd be there on bedrest. She even said our dog, Rudy, could come visit me! Just as she was finishing up, the rounding doctor came in and shared more bad news. My blood work from the night before indicated the beginnings of a possible infection and that to give the babies the best chance possible, they needed to be delivered that very day. I'm so glad my mom was there with me. The news was very hard to swallow, but she was able to stop my tears so I could focus on what was ahead. Shawn was called away from work and came right to the hospital. Shawn's mom came to the hospital also and by 1:00 I was being wheeled into surgery. The Cesearean section was the weirdest feeling I've ever had, and we were so scared of what would lay ahead for the babies that were being born 16 weeks premature. They entered the world with squeaky little cries and were taken immediately up to the NICU where they'll stay for the next three months.

Mia Margaret Day was born at 1:28pm and Allison Karyl Day was born at 1:30pm on July 26th, 2007. Each weighed 1lb 9oz, and were 13-14 inches long.

A Short Honeymoon...

A couple weeks after returning from the Montana wedding trip, I felt things with my tummy were a little different. A doctors appointment July 11th revealed that I was dialated to 1 cm and my cervix seemed to be thinning out. A couple days later I had an ultrasound and found that though the little girls were doing well, my cervix was funneling and very thinned out. A short stay at the hospital confirmed that I wasn't contracting so I was sent home for what we'd hoped would be several weeks of strict bedrest.

A week later Shawn and I met with a perinatologist. He found that at times I had no residual cervix and we could see on the ultrasound that "Baby A" was kicking her little foot through my cervix. Upset that bedrest didn't seem to be slowing things down, I started a course of steroid shots and meds to help prevent contractions. Then I was home for more bed rest.

Shawn had a lot to do between working, keeping up with the yard and dogs, and making sure I had meals and company. I hate feeling helpless and I'm even more uncomfortable asking people for help, but I was glad to lay flat to help our littles. Many thanks to our friends and families for bringing meals, providing rides, and surrenduring themselves to countless licks from our dogs.

My mom came up on Monday, July 23rd and provided some relief to Shawn and lots of comfort for me. It was no vacation as she too got licked a lot, cleaned our house that was still in 'post-camping' condition. She also made several meals that could be fridged or frozen, including my favorite- Tator-Tot Hotdish!!!!