15 Months!

ITime is FLYING!!

Evelyn and Sophie are 15 months old and getting so big! They are learning new things and amazing their mom and dad daily. Over the past couple weeks, the girls have both taken their very first steps and are becoming better walkers every day!

In addition to walking, the girls are both doing a lot of other fun stuff. Evie talks nonstop. Her favorite words are Dada, Mama, and ball, but she jabbers constantly about who-knows-what! Sophie talks too, but not constantly like Evie does. Her favorite things to say are Dada and buh-bye (which comes out as duh-dye when Sophie says it and is always accompanied by the sweetest little wave.) They love to clap, feed themselves and do "so big!"

Evie has 9 teeth and Sophie has 11. They are both getting molars, which has been a blast over the last few weeks... NOT.

The girls go to bed between 8 and 8:30 and wake up between 8:30 and 9am. They take one nap which is about an hour and a half long.

Today, we took the girls for a neurodevelopmental checkup... Something little preemies need to do to assess how well they are doing with meeting developmental milestones. Here is a little summary of what we found out:

First and foremost, 8:15 am is not the ideal time to ask toddlers to show off everything they can do... Especially when they don't even normally wake up until at least 9. For all of the assessments today, they could only give credit to the girls if they SHOWED them they could do the "skills." We could tell them that Sophie can walk until we were blue in the face, but they wouldn't give her credit until they saw her do it (which they never did.) So, we didn't really get an accurate assessment in most areas.

Evelyn weighs 26 lbs. 10 oz. (96th percentile!) and is 31.5" long. Based on the physical and occupational therapy evaluations, she is at an 11 month level, but they assured us that is lower than where she's actually at because there were quite a few things she refused to show off. For language understanding, she was at a 15 month level, and for language expression (talking,) she was at a 17 month level. Not surprising... That girl LOVES to talk!

Sophie weighs 22 lbs. 6 oz. (64th percentile) and is 29" long. She was at an 11 month level for gross motor skills and a 9 month level for fine motor skills... Again, lower than the level she is actually at. She scored at a 15 month level for language understanding and a 8 month old level for talking... Probably because by that point she was doing more crying than talking.

Even though the girls appear "delayed" based on the findings of these assessments, nobody was concerned about the girls' development, which brings me to the conclusion that the tests they did were pointless! (Just kidding... kind of.) They sent us home with some things to work on, and we will be deciding along with the girls' pediatrician if it is necessary to go back for another assessment in 8 months. My hunch is that we'll decide that we don't need to go back unless we notice anything concerning before then.

Update

Evie and Sophie had their first neurodevelopmental assessment appointment today. We met with a physical therapist who tested the girls' gross motor skills, an occupational therapist who tested their fine motor skills, a speech language pathologist who tested their verbal/communication skills, and a developmental pediatrics specialist. They also had a hearing test (which they passed with flying colors) and had measurements taken.

According to the physical therapist, occupational therapist, and speech therapist, both girls are right on track with their developmental milestones! For this part of the appointment, they basically consider Evie and Sophie to only be 5 months, 12 days old -- this is called their corrected or adjusted age and is based on if they'd been born on their due date. The appointment took place right when they should have been napping, so the girls were pretty sleepy and crabby and the therapists couldn't quite get their assessments done the way they would have liked to, but based on what Nate and I told them the girls were able to do, they are right on track (sometimes even a little bit ahead of their adjusted age!)

Evie weighs 18 lbs, 12 oz. (50th percentile when NOT correcting for prematurity!) and Sophie weighs 15 lbs., 8 oz. (15th percentile when not correcting for prematurity.) The doctor was very pleased with their weight gain and said that they don't often see such great results. Several people commented that it was nearly impossible to tell that they were preemies. The doctor told us that, solely based on their cheeks, she knew they were getting enough to eat. :) Because Sophie has not yet hit the growth chart for her length, we were advised to place her back on the preemie formula, which has more protein, calcium, and phosphorus than regular formula and can help with bone growth. Such a bummer for me, but I'm glad she'll be getting what she needs.

The girls will go back for another developmental assessment in July. We knew they were doing pretty well with their development, but it was so nice to hear it from the experts. We have so much to be thankful for!

Here are some recent pics of the babes...

Having lots of fun playing. You can see that Evie is Little Miss Personality!

"We LOVE fruits and veggies!"

Had to take Evie to the ER because she had a hair wrapped around her toe that I couldn't get off. Poor thing! It cut her toe all the way around. Apparently, this is something that they see in the ER on a fairly regular basis! Here's my PSA: Check your kids' toes, people! (and other things, if you have boys...)

The girls were 30 weeks old in this picture, so they were out as long as they had been in! (Disclaimer -- I was really only 28 weeks in the first picture. I never got a chance to get another bump picture since my water broke and I was admitted to the hospital a few days before they were born).

One of my favorite pics of my smiley girls. You can see how identical they are!

Our first Halloween! I took the girls to a Halloween party at Nate's work. It was so fun!

The girls were dedicated this past Sunday -- such a special day!

Happy Holidays!

Nate, Sara, Evie & Sophie

6 Months!

The twins are 6 months old today!

We won't know their weights until their pediatrician appointment on Wednesday, but they're definitely growing! They wear 3-6 month clothing (although Sophie can still fit in a lot of the 0-3 month stuff) and size 2 diapers. Evie will be moving on to size 3 diapers soon! They sleep from 9pm until 7-8am (yes, I know, I'm a lucky momma!) and eat 6-8 ounces every 3-4 hours during the day. We're expecting the doctor to give us the go-ahead to try some baby food soon! Hopefully they'll like fruit more than their mommy! I may or may not have given them their first taste of ice cream on Saturday...

Both girls roll from tummy to back, and Sophie just started rolling from back to tummy this weekend. They are getting so close to being able to sit up on their own. They are big talkers and extremely smiley, and they're friendly with anyone who will pay attention to them (which is just about everyone!) Their favorite toys are their keys and Sophie the Giraffe.

Developmentally, the girls seem to be right on track. They might be slightly behind with a couple milestones, but they're not expected to catch up until around 2 years old, so we have some time! We will see a neurodevelopmental specialist in November just to make sure things are progressing as they should be... This is pretty standard for most preemies, from what I understand.

I get emotional every time I think of how blessed we are to have two happy, healthy, beautiful babies after everything we went through. The odds were definitely against us, and we are so thankful not only that Sophie and Evie's lives were spared, but that they have made it through a lot without any lasting problems. When I put the girls to bed by myself, we usually read a story and sing a couple songs before they go to sleep. My new favorite song to sing with them is one I remember from Sunday School:

God is so good,

God is so good,

God is so good,

He's so good to me!

I can't wait until Sophie and Evie can understand just how true this song is! Thank you all again for all of your support and prayers!

Our New Normal

Thought I would check in to let everyone know that things are going well at home! Although we are incredibly exhausted, we are absolutely loving being together as our little family of four!

The girls are doing so well!

Evelyn had a checkup last week and weighed 7 lbs. 7 oz. This is exactly what I weighed when I was born. Since the most baby I ever had inside me was 5 lbs. 11 oz., it's hard to imagine having an Evelyn inside of me, let alone an Evelyn plus a Sophie! I have to give a lot of credit to mommies of twins who are pregnant a lot longer than I was! Evelyn is doing great healthwise! She passed her hearing test today, her eye exams have been normal, and she's growing like a weed!

Sophie weighed 6 lbs. 4 oz. at her checkup this past week. Her weight gain has been a little slower all along, so we're working on that, but the pediatrician was happy with her recent weight gain. Her eye exams have been a little abnormal, but her eyes have been improving. The ophthalmologist thinks that her eyes will heal themselves and not need any treatment. She passed her hearing test today, but she will need to go back for a recheck in eight months because one of the antibiotics she was on in the hospital can cause hearing loss.

Both Evie and Sophie are a little anemic (low blood counts). This is pretty common for preemies, especially since both of them were in the NICU and had their blood drawn frequently. It doesn't seem it, but when you only have a little bit of blood to begin with, a small blood draw can make a big difference. The girls are both on iron supplements and are having their blood drawn weekly or so to monitor their blood counts.

The girls have adjusted well to eating formula. They eat about every three hours, even during the night. The pediatrician told us that they were allowed to go four hours without eating during the night, but it doesn't matter... Evie makes sure we are awake to feed her every three hours on the dot! It turns out that Evie and Sophie did not forget about each other while they were apart for eight weeks (as I had feared)! Neither of them like to sleep in their crib without the other, but they sleep very well together. If you're friends with Nate or me on Facebook, you may have seen the absolutely adorable pictures that we've posted of the girls in their crib together... even if we lay them at least a foot apart, they manage to scooch toward each other to be closer together.

During the day, the girls are awake for a couple hours, but usually sleep unless they're eating. We can't wait until they're more awake and interactive!

Nate went back to work last week Saturday, so I have been getting used to being at home with both girls when he's gone. I'm going back to work on June 25th. It's going to be so hard to leave the girls, but I also feel ready to start our new normal.

Now that we're home, sometimes it's easy for us to forget where we came from. We don't always remember that less than six months ago we were uncertain whether our girls would be born alive, let alone healthy! We are so thankful that we were blessed with two beautiful, healthy, miracle baby girls. Our journey was far from easy, but I think I speak for both Nate and myself when I say that we would do it all over again for our precious babies! God has been SO good to us!

Thank you for your continued prayers and support!

Love,
Nate, Sara, Evie, and Sophie

I'll leave you with some super adorable pictures!

Evie's first tub bath at home

Sophie's first tub bath.. ever! They both loved it!

How to get things done when you have a fussy baby...

Tummy time

2 months old!

Out for a walk downtown Holland. Don't mind Evie's headband slipping off her head!

Yes, the tiny little thing on that chair across the studio is my little Sophie! We had newborn photos done last week.

Snuggling during a nap

Sophie would not go in her crib without Evie, so I had to lay her next to me while I fed Evie.

Snuggles this morning

They both do so well in their car seats!

Quite Possibly My Favorite Day Ever.

Sophie is home!! Today is the day we've been waiting for, of course, since the babies were born, but even more in the last 17 days while Evelyn was home and we all had to kiss Sophie goodbye each night. After 55 days, our family is finally together! :)

As I mentioned last week, Sophie made an amazing turn around after her antibiotics were started. Almost immediately, she started drinking her bottles (which she had never gotten good at), became more alert, and just seemed so much healthier overall. If you remember from when Evelyn came home, one of the criteria to come home is that babies need to nipple (bottle or nurse) for 48 hours straight without having to use their feeding tube. By Sunday night, Sophie had done it! She had met all criteria to come home, but still needed to finish out her ten days of antibiotics. I tried to get the doctors to switch the antibiotics to oral so we could give them to her at home, but I had no luck. So, for the last five days, we have just been waiting (impatiently) for Friday to get here so we could take her home... and hoping that nothing went wrong that would delay this very exciting event! Luckily, everything went as planned for once, and we were able to leave the NICU early this afternoon!

Our family, ready to hit the road! As you can see, we are all thrilled, except Evie.

The girls in their car seats. If it weren't for Sophie's bald spot where her PICC line was, I don't know if I could tell them apart!

The girls ready to come home and never return! (Hopefully)

Daddy holding both of his girls at HOME!

Since arriving at home, we have just been showing Sophie the ropes of the Vander Ploeg household. She and Evie enjoyed a nap together, have been drinking their bottles, and chilling in their Rock-N-Plays, in addition to enjoying some snuggle time with mom and dad. :) As I write this, both of the girls have started fidgeting a little and will probably be ready for a bottle soon.

I was so thankful this week that Sophie was finally going to be able to come home, especially because we did have a major disappointment yesterday. Unfortunately, my breast milk continues to have Group B strep in it. Like I had mentioned before, this is a normal bacteria in many people's bodies, but it can cause severe infections in babies, like it did for Sophie. In fact, it can get even worse than it was for her and cause meningitis leading to severe, long-term neurological problems. The neonatologists and infectious disease specialists (who have never seen a case like this before), unfortunately, recommended that I stop breast feeding and that both girls start formula immediately. This was such a disappointment for Nate and me, given all the time and effort we have put into breast feeding and creating a store of breast milk to give to our babies. On the other hand, giving one or both of the girls another infection is a risk we are not willing to take. We're thankful we were able to breast feed them for 2 months, but it's still a huge bummer. We've been working on thawing our stored breast milk in small batches, and *sniff sniff* dumping it down the drain. :(

I'm done venting...I have a LOT to be thankful for!

Sophie's repeat echocardiogram showed that her PDA (the hole in her heart) was "tiny." It went from "large" to "tiny" in a week! The doctor thinks it will most likely close on its own, but Sophie will be seen by a cardiologist in 4-6 months to reevaluate. If it doesn't close on its own, and as long as it doesn't cause any problems, she will probably have to have it fixed by a minimally invasive procedure when she is one or two-ish.

We would appreciate your prayers as we adjust to life at home with our two precious baby girls.

As always, I want to THANK YOU for your prayers and support through this journey. We have been so touched and blessed to be so loved and cared about by our family and friends and also complete strangers. A special shout out to Abi Arendsen, who prayed for our babies in a precious little psalm she wrote in her preschool class. :)

Love,
The VPs - Together at last :)

Improvement!

If there's one thing I've learned as a NICU Mom, preemies (and their Mommies and Daddies) are constantly experiencing ups and downs ... when things are going well, there's no guarantee they will continue to go well. When things are going badly, they can turn around in a matter of hours... We have noticed a lot of improvements in the past week, and while we want to stay positive, we remain a little bit guarded because we know things can turn anytime.

On that note (sort of), I came across this letter written from a NICU nurse to NICU moms... and it really hits the nail on the head with describing what having a child (or children) in the NICU is like. I almost teared up a little when reading it, since we have experienced a lot of these things first hand.

 From a NICU Nurse to a NICU Mom

Last week Monday, the day we found out Sophie had another infection, was a pretty horrible day for us. By the next day, after being on antibiotics, Sophie was acting healthier than she had in a month! She was alert, crying when she was hungry, interested in drinking her bottles, and generally more awake than she had been since her first infection. Since then, she has continued to improve and is now back to acting how we think a normal, healthy infant should act. In fact, Sophie has drank all of her bottles for almost 48 hours now! Her feeding tube is out and she is doing a great job! Such a relief for us! Sophie also hit the big 5 lb. mark yesterday...such a big girl!

We believe we have figured out where Sophie got both of her infections from. My breast milk from the day I had mastitis and the two days prior was cultured and it was found to have group B strep, the same exact bacteria that infected Sophie's blood. Sophie most likely got some of this milk a few weeks ago and probably got some more again last week. This is really interesting, because when women have mastitis, they are always told to continue breast feeding and not to discard their milk. I guess, once again, Sophie broke the mold, huh? The infectious disease specialist said she has never seen a case like this before, but was able to do some research and find some rare cases in which this has happened. Crazy! So... because I never, ever, ever, ever, EVER want this to happen again, Nate and I had the pleasure of throwing out ten whole days worth of potentially infected milk tonight. Yikes!

Because the doctor believes Sophie was re-infected with the bacteria by drinking the infected milk twice (as opposed to having a recurrence of the same infection that we thought was cleared), she is only recommending 10 days of antibiotics. Today, Sophie was on day 6 or 7, I can't remember.

Besides dealing with the infection, Sophie also had an echocardiogram last week. This was news to us, but apparently the nurses have been documenting off and on that Sophie has a heart murmur. The echocardiogram showed that Sophie has a large PDA (patent ductus arteriosus)... this is a blood vessel that is open while babies are in the womb, but is supposed to close soon after birth. Hers is/was still open. Eventually, this can cause problems for babies by putting strain on the heart and causing breathing issues, among other things. So far, Sophie isn't showing any complications, but it still needs to be fixed eventually. There are three ways to fix it: It can close on its own (it's common for it to stay open longer in preemies than in term kids), it can be fixed by open heart surgery, or it can be fixed by a much less invasive procedure in the cath lab. Unfortunately, the doctor hadn't given us the vibe that he was confident it would close on its own, and babies need to be bigger than Sophie is to have the less invasive procedure to fix it. Imagine how disappointed we were when we found this out, and it sounded like the only option to fix it was going to be open heart surgery...

Until today! When we arrived to the hospital, not only did Sophie not have a feeding tube in, but the nurse also told us that she didn't hear a murmur this morning, and neither did the doctor!! The best news I've heard in a long time. This certainly doesn't prove that the PDA has closed, but we think it's a good sign. At some point, they are going to recheck another echocardiogram to see how the PDA looks. When she's ready to go home, if it hasn't closed, we will just have to follow up regularly with a cardiologist until it can be fixed... hopefully, we will have enough time for her to get big enough to have the less invasive procedure. If it has closed, then she's all set! We are told that stressors such as infection can make the PDA open, so we are praying that it was just associated with the infection and that it has now closed since the infection is clearing.

Evie is still doing great at home! As of two days ago at the pediatrician, she weighed 5 lbs. 14 oz.

Thank you for praying for our little munchkins! We are so thankful they are both doing so well at the moment. We are praying that we will be snuggling them both at home sooner rather than later. :)

Love,
The VPs

Quick Update on Sophie

Sophie is improving a lot! When we got to the hospital this morning, Sophie was off oxygen, awake and alert, and crying because she lost her paci. Not fun seeing your daughter cry, but better than seeing her lethargic and knowing something is wrong!

Sophie's nurse told us this morning that the blood culture from yesterday did, in fact, grow group B strep. This is what we had all suspected, including the pediatric infectious disease specialist, who met with us at length today to explain everything and answer all of our questions. When I asked her about how rare this infection was, she said it actually wasn't that rare, so obviously wherever I read that it only occurred in 4 out of 10,000 infants was incorrect. :) Unfortunately for Sophie, she is one of the approximately 3% of infants who get the infection again after it has cleared. The obvious next question is whether a third occurrence of the infection would be likely. In her career, the infectious disease doctor has only seen one child get the infection a third time, which is reassuring.

Group B strep is an organism that can affect parts of the body other than the blood -- the most common and serious of these is meningitis. This is why Sophie had a spinal tap the first time she had this infection and another one last night. I'm happy to say that her spinal fluid this time looked completely clear! They are still going to culture it to make sure bacteria don't grow, but for right now, they are assuming she does not have meningitis. Thank you, God!

There are a few different places Sophie could have gotten this infection. Group B strep is common in infants, pregnant women, diabetics, and old people, so the obvious best guess is that it came from me, although it could have been through exposure to anyone who has this bacteria in their body. This bacteria can be a normal bacteria and not cause an infection, but it often becomes a serious infection in babies. When I was tested for group B strep during pregnancy, I was negative, but the doctor believes this test could have been incorrect. She recommends that I need to be treated for group B strep in all future pregnancies, regardless of what the test shows. All that entails is two doses of IV antibiotics before delivery... I can handle that. Another possibility is that Sophie got the infection from my breast milk. I had a case of mastitis which started a couple days before Sophie was diagnosed with group B strep the first time, and I was on antibiotics for ten days. The doctor is going to "think about" recommending that all my stored/frozen breast milk be thrown out from those ten days just in case it might be infected. I'm not thrilled about throwing out that much milk, but it will be totally worth it if it prevents another infection in my little one.

The plan to get rid of this nasty infection is 10 to 17 days of ampicillin. The doctor was going to decide whether to do 10, 17, or somewhere in between. We're hoping for closer to 10, but we want her to have the right amount to get rid of the infection. She is also on gentamicin until the spinal culture is negative for 48 hours, at which point the gentamicin would be stopped.

Because of Sophie's multiple episodes of feeding intolerance and another episode with her belly yesterday (which is most likely attributable to the infection, but just to be safe)... the doctors have been throwing around the idea of doing an upper GI study to look at her intestines and make sure nothing is twisted around and causing stoppages. The test is done by giving Sophie a dye through her feeding tube and/or through a bottle and taking multiple xrays to watch the dye move through the stomach and small intestine. The downside to doing this test is that it includes exposure to a lot of radiation. Today, the doctors decided it would probably be a good idea to do this test, just to be sure she had no anatomical problems that were causing all of the feeding intolerance. The test was done this afternoon, and it came back completely normal. Her feedings are likely to be restarted tonight or tomorrow... in fact, they may have already been restarted, I just haven't talked to the nurse yet tonight.

The girls both had their eye exams this morning. Thanks to Nate for staying with Evie and helping hold her while she had her exam so I could go to the waiting room and not watch. From the sounds of it (yes, I could hear it from the waiting room), she didn't like it very much. Evie's exam looked great, with no problems at all. According to Sophie's nurse, she just has stage 1 ROP in one of her eyes, which is nothing to be urgently concerned about and usually reverses itself. Yay! Both girls will have another eye exam in two weeks.

I know there were a lot of people praying for Sophie after my post last night; we really appreciate it. Our prayers are working -- the doctor commented today how impressed she was at the quick turnaround Sophie made after being started on her antibiotics. :)

Love!
The VPs