Hospital Nursery Life

I knew before I had the girls that blogging would take a backseat to being a new mom and has it ever. I miss my routine blogging SO MUCH and I miss reading my favorite blogs every day, but most days, there's just not enough hours in the day. This is an incredible season of our lives that we'll never get  to experience again...

blogging can wait. 

Today, I'm sharing all about the girls' first two plus weeks of their lives. They were born on October 2nd; Amelia came home on October 18 and Mae Parker came home the next day on October 19. I could spend hours talking about how wonderful they were cared for in the hospital's nursery by the pediatricians and nursing staff. We will never be able to repay them for the care and love they showed our girls and to us as their parents. They kept us involved in the routine "parenting tasks" even though the girls never left the nursery and then too when we were going back and forth after my discharge three days after their birth. They were the best cheerleaders I could've personally had. God placed these people in our lives and we are forever grateful.

I will try my best to recap a few specifics that the girls encountered during their first couple of weeks, but I will admit I didn't keep notes (that I probably should have) and now 7 weeks later (and a much different sleep pattern for yours truly) some of the details are a tad fuzzy now. 

The girls "journey" was a process of steps. There was never a timeframe of when they would come home - it was just a matter of they had to do a, then b, then c...etc. 

The girls were born at 34 weeks, 1 day gestation. The pediatrician on call that Sunday briefed us before delivery on what to expect health-wise with multiples arriving that soon. Everything he prepared us for, was exactly what ended up happening. As fast as everything happened that Sunday, I still felt like everything regarding their "condition" was "normal and expected" because Dr. Ngito had given us that heads up. Without that, I probably would've been an emotional wreck. 

 At 30 weeks, I had taken a couple of injections to help boost their lung development should something occur early. While those shots did their job, the girls still biggest initial hurdle was breathing and their overall respiratory development. 

Chest x-rays showed that Mae Parker's lungs were weaker than Amelia's. On Tuesday the doctor recommended performing a small procedure that hopefully would strengthen her lungs. They would have to intubate her, and insert a small tube inside the larger one. The small would release a medication, surfactant (SO not sure about the spelling on that one, sorry) - the surfactant would coat the lungs and hopefully improve their ability to expand. She was just having to work harder than she should to breathe. If the treatment didn't work, they would try it again in 12 hours. If the second round didn't work, she would have to be transported to a specialty NICU somewhere; Vanderbilt more than likely. 

All of these steps they had to make all worked together. She was working harder to breathe, so that meant she was burning more calories. Burning more calories meant she wasn't able to regulate her body temperature. Burning more calories meant she wasn't ready to try bottle feeding - she had to be bottle feeding to be able to go home. It was one thing after another, after another...for several days it felt like they would never come home.

Fortunately, the first try with the surfactant did the trick for Mae. Her numbers started improving and she was visibly breathing some easier. They said we'd see a significant difference in 48 hours and man did we ever. Almost 48 hours to the minute she started showing amazing improvements. 

Both girls were on a machine called Vapo-therm following their birth. They would be on this for several days. Basically, it's a step about just plain 'ol oxygen....that would come after they weened off the vapo-therm. 

I was discharged on Wednesday per my request. I was struggling with feeling like we had even actually had babies because they were never in our room with us. We were exhausted from just the regular ins and outs of nursing staff. I was struggling to learn to pump without someone barging through the door. We just needed to go home. The first night was the hardest by far. Coming home...empty handed. I remember telling Stephen that I felt like the house was so empty and yet they had never even been in the house yet. Everything just happened so suddenly on Sunday, then bam I'm back home on Wednesday night...but I have no babies with me to show for it. Did I really just have two babies?! Is it really all over that quick?!  It's hard to put into words how difficult it was that first night. 

(this is where I may start skipping around)

 Both girls were also on feeding tubes for the first few days and received their nutrition through that and through IV fluids. 

On Day 2, I was able to hold Amelia and let me tell you....it felt like it had been weeks that had passed by instead of just 1 day. Mae Parker just wasn't as stable as her sister at that point, so holding her would have to wait another couple of days. 

It's also worth mentioning this particular crocheted hat they had Amelia wearing. The hospital Volunteers have a program that provide items to newborns and their families. Some of the ladies crochet hats for the babies to wear. Stephen deemed this one "Amelia's trademark." She would wear this hat until it became so stretched out that it was too big and started becoming dingy looking. I've since washed it and have it put away for her keepsake. 

Mae Parker was unable to wear a crocheted hat because her IV port was in her head for the majority of the time. They were never able to find a better place / vein to insert it in her, so unfortunately it went into her head. 

The girls were placed in Isolette boxes on Day 3 or 4 if I remember correctly. Preemies do better with as little stimulation as possible, which the boxes provide. Also, another hurdle to overcome would be self-regulating body temperature. Until they would be able to do that, these boxes would keep them nice, cozy and warm. 

Once they started trying formula and breastmilk through their feeding tube, the nurses let us help "feed" them. The milk would be poured into the syringe tube and gravity would do it's magic to flow downstream. We could control how fast it went by tilting and adjusting the tube's height. It was the first thing we were able to do that made us feel like we were actually doing SOMETHING for them. It was the best feeling. 

Then we were able to give them a "taste" of the milk through a small syringe we would inject into their mouth while they were fed through their feeding tube, we would follow the injection with putting their pacifier in their mouth for a bit to develop the sucking and swallowing motions. 

In the below pic, you can see the top part of Mae's IV port coming out of her hat. They would cut a small hole in her hats to allow access without having to remove them. I've since washed and kept those for her keepsake as well.

A few days in, I was able to do skin-to-skin with Amelia. I am so glad the nurses and doctors were such promoters of this technique. I was afraid to bring it up myself because I wasn't sure if they would encourage it with preemies, but as soon as THEY suggested it, I jumped on the opportunity! It's such a special bonding moment with your baby; it was even more special given the fact that we weren't able to have the girls in the room with us and we felt like visitors seeing our babies.

The girls were moved back and forth between two different Nurseries dependent on whether or not there was another baby needing extra care like our girls. If so, then our girls and the other baby would be moved to a secondary nursery. The nurses made our visits as accommodating to us as possible. This was one of our first visits after I was discharged. After that they rearranged their isolette boxes that that they were side my side length-wise and Stephen and I could sit side by side with the girls instead of how we were in the pic below.

One technique they had to learn was the suck, swallow, breathe motions of eating. I think they said this normally develops around 37/38 weeks gestation. so they just hadn't developed those muscles yet. Once they started letting them try bottle feeding, they had to monitor their heart rate and oxygen levels even closer than they were already. 

If they guzzled their bottles, they would often forget, oh hey..I'm supposed to breathe WHILE I do this. Then, their stats would drop. One time, while I was holding Amelia she "forgot to breathe" and literally turned blue / gray within seconds. It absolutely terrified me and I started yelling for help. Their nurse was literally sitting right behind me - she grabbed her up, started stimulating her and slowly her stats started rising and she started pinking back up. It was the scariest moment we had experienced to that point, but that's exactly why they were still in the hospital. They just weren't ready to come home.

When their stats dropped below a certain level and were recorded being there for 20 seconds or longer, they "bought themselves 5 more days." So, they had to make it 5 days without dropping levels again. For instance, Mae Parker's heart rate dropped in the early morning hours on the Friday before she came home. 

Up until then, she had been doing EXCELLENT but strained so hard to poop, her heart rate dropped for a recorded 20 seconds. As soon as she released from straining, it went back to normal. However, because it lasted 20 seconds, that meant she couldn't go home until 5 more days for sure at that point. Had she not done that, she more than likely would've come home first. 

The girls were fed every three hours at the hospital. After I was discharged, and we started making our back and forth trips, we typically were there for the 8am (ish) feeding, the 2pm (ish) and either the 8p or 11p feeding. In between these times, I would try to pump as much breastmilk as I could at home to take back to the next feeding or for the nurses to store in the nursery fridge. 

Once the girls came off their Vapo-therm they were moved to just regular oxygen. It seemed like once this happened, the ball started rolling quick on their respiratory progress. 

One of the nurses they had most frequently during the days, Vickey, had been texting me a few updates one day in between our visit times. What she left out was that Mae was taken off her oxygen...she was going to let that surprise us when we came in to see them. That night when we walked in, Stephen noticed it first and said "Well..look at her!" I was standing right there holding her hand and did not even notice that she was breathing totally on her own. Cue the instant tears. 

Amelia came off of her oxygen the next day if memory serves me correctly. Once they came off the oxygen, they never went back on it - they did really great with this step.

Once they became pros at bottle feeding, they removed their feeding tubes and IV's. At that point they were just on their monitors and still in their isolette boxes. They still needed to get to a certain level to be moved out of their boxes. Once out of their boxes, they had to maintain their temps on their own for at least 24 hours to be given consideration to go home. 

We knew they were getting close to coming out of their boxes and were so excited to walk in at one of our visits to find them in a regular crib! One of their sweet nurses, Alyssa made sure we got this note "from Mae". 

On the two Sundays they were there following their birth, we would stop by before going to church. I'm sure some people wouldn't expect us to be at church, but it just felt right being there and being surrounded by so many people who loved us and were praying for us during that time. We made sure to snap pics of the girls before we left so we could show everyone.

After the girls had come off of all of their tubes, they had their pictures made for the hospital's "Baby of the Month" billboard ads. Since it was coming up on Halloween, we dressed them in jack-o-lantern onesies (that were HUGE on their little bodies). The girls drew quite the crowd in the Nursery while their pictures were being made. 

And voila, the end result...

Before we knew it, two weeks had passed by. If felt more like 2 loooong months, but it had just been a quick 14 days.

The day after they were born, we had several visitors that went back to the Nursery to see them. We were allowed one visitor to go back with each myself and Stephen. We had a steady stream throughout the day of grandparents, great grandparents, aunts, uncles and cousins go back to see them.

That night the pediatrician suggested to us that we take Tuesday and say no visitors. Just let them rest...preemies did better with as little environment stimulation as possible. We took his advice and politely told our family we couldn't have them going back to see the girls until they were stronger. Of course everyone understood, but it was still hard to not let our family see them. 

A couple of days before they came home, we started letting our parents take turns coming with us. We tried to do one extra visitor once a day with us. It was special to see our parents and our own siblings finally getting to love on our girls. 

I can't write this post about their hospital stay without sharing about what I called their "Arts & Crafts Time". It seemed like every day something new had been added to their box or crib. My friend Amy who is an OB nurse came by one day or night and snapped a couple pics of them and attached those to their boxes. 

Nurse Hailee made their big name signs and left us a sweet note. Nurse Lori made their hand and foot prints. Nurse Alyssa helped the girls write us notes and made their butterfly footprint craft. And our youngest nephew Colin, colored Minions pictures for us to take to the girls. 

On Sunday before their discharges on Tuesday and Wednesday, we were shown how to give them baths. I wish they liked their baths at home as much as they did at the hospital. They give our ears a run for our money during bath time at home.

So they were off the Vapo-therm, off regular oxygen and breathing totally on their own, off their IVs, off the feeding tube and doing great with bottle feedings, maintaining their body weight, maintaining their body temps on their own, maintaining their heart rate, respirations, and oxygen levels, and passed their "car seat challenge"...they were ready to GO HOME!

On Tuesday morning, October 18, Day 17, we went through all of our "discharge education", signed a ton of papers, hugged our nurses and walked out with Amelia. It was heartbreaking to leave Mae Parker behind and by herself, but we knew she'd be coming home the next day. (Remember those 5 days she bought herself, yeah, she paid for it. ha) Stephen and I went separately to visit her the rest of that day and night as usual while the other stayed home with Amelia.

The next morning, Stephen's parents came to our house to sit with Amelia while we went to pick up her sister. Since we had completed our discharge education with one already, we didn't have to do that again. We signed the papers, hugged our nurses one last time and off we went with Mae Parker on Wednesday, October 19, Day 18. 

We couldn't be happier to FINALLY be home with both of our girls!! Now, the fun was about to begin....