The VP Babies: Stop Hands (And an Update)

I'll start with an update on the girls...

The other day, we got to put Evie on a transport monitor and bring her in Sophie's room for some family time! Here is a pic of the girls together... (No, they didn't hold hands on their own...)

Evie and Sophie are officially at 34 weeks gestation today!! I can't believe it has already been four weeks since they were born. This has been a crazy four weeks... the happiest and the scariest of my life. It will all be worth it in the end, but Nate and I are starting to get sick of our babies being in the NICU (HA! who are we kidding? We have been sick of it for a very, very long time.) Here are some exciting things that happen at 34 weeks gestation:

The girls start to try to figure out their days and nights. Therefore, we don't have to keep a blanket/quilt on top of their isolettes at all times! If it's bright outside, we pull the shades to avoid overwhelming/overstimulating them with brightness. The upside of this is that we get to look at them all. the. time. So amazing!
The girls' feeding tubes are now officially supposed to be in their noses. Since they've been born, they've been moved back and forth from their noses to their mouths based on a number of different things (My cranky self is sure the nurses at night just like to practice putting them in, but they insist the girls have pulled them out that many times). Now, they are supposed to be in their noses so that their mouths are free to practice "nippling" (nursing and/or bottle feeding as opposed to having the feeding drip in through their feeding tube by gravity).
Speaking of nippling, for the last two weeks, the girls have been allowed to nipple for two feedings per day if they were awake and alert and showing cues that they were interested. Now that they are 34 weeks, we are allowed to try bottle- or breast-feeding them for all of their feedings, as long as they are interested. The nurses even give them bottles when we aren't there if the girls are awake enough.
The substance with which the girls' breast milk is fortified will be weaned off and a new fortifier will be introduced. I have no idea why, but it's another thing that happens at 34 weeks. The girls will most likely go home on this new fortifier or breast milk mixed with formula to make sure they get enough calories until they get to their due date.

The girls at 34 weeks (Sophie on top, Evie on bottom)

Evelyn continues to be a rockstar of a preemie! She is tolerating her feedings (40 mls of fortified breast milk every 3 hours), is doing an excellent job with her bottles and nursing, and is keeping herself warm enough that she can be in a regular crib now! Not having a top on her bed makes me even more of a germophobe than I already was, but it makes her feel like more of a "regular" baby! Last night, Evie was 4 lbs. and 9.6 oz., which is almost 1 lb. and 6 oz. bigger than she was at birth! She is getting a little double chin like her Daddy had when he was a baby! She is having a little bit of reflux/spitting up after her feedings, but so far, nothing to worry about. Because Sophie has a bloodstream infection, the infectious disease doctors are watching Evie closely to make sure she doesn't develop the same infection, since they were in the same environment for such a long time.

Evie's isolette, right after "popping the top". They put her in a regular crib the next day.

Sophie is still our little troublemaker! Like I talked about in the last post, she had a positive blood culture last weekend, meaning she has an infection in her blood. They were able to determine that the bacteria was Group B Strep (which is something they test all pregnant women for, and I was negative, so she must have gotten it somewhere else.) This was a pretty serious infection, but luckily, it was caught early! The infectious disease specialists have been following Sophie closely and recommended a 14 day course of Ampicillin to make sure that the infection clears completely and does not spread.

Unfortunately, needing two weeks of antibiotics means Sophie needs an IV for two weeks, and IVs don't seem to last very long in such tiny babies. The other day, as Nate and I were about to leave, Sophie's IV went bad, and it took at least 10 (that we know of) tries to get a new IV in her. The next day, that one went bad, and they tried unsuccessfully to place a PICC line (a big IV that lasts longer than normal), so they had to put an IV in her scalp. IN. HER. SCALP. I was beside myself! Yesterday, they were able to get a PICC line in, and we are hoping it lasts until her antibiotics and TPN are done so that she doesn't have to be poked for any more IVs. I'm over it now, but her PICC line was placed in her scalp as well, and they had to shave part of the side of her head to put it in. It was devastating! I will show a picture of her PICC line later, because the ones I currently have are too heartbreaking for me to look at!

I almost told them I wanted nothing to do with this, but I figured I'd be upset later if I didn't keep it.

We are very thankful that the blood cultures were repeated, I believe on Monday, and they are completely negative. Also, the fluid from Sophie's spinal tap did NOT grow any organisms, so there is no concern for meningitis.

Sophie has also been going through a vicious cycle with her feedings. The way I interpret it is this:

Sophie's feedings are increased (too quickly for Sophie) to her goal.
She does well for a while, but then it catches up to her and she begins not tolerating the feedings.
The symptoms of not tolerating feedings somewhat mimic the symptoms of a very serious belly infection.
The doctors stop her feedings and order xrays every six hours to watch her belly very closely in case of this very serious belly infection.
I panic.
Sophie is fussy because she is hungry. I panic even more.
After a few xrays, her belly is improved. The doctors restart her feedings at a smaller volume.
The doctors increase her feedings (too quickly for Sophie)... and we start over at step 1.

I am sick of panicking, and the doctors are probably sick of showing me Sophie's xrays and having me cry over them. SO, our new mutually-decided-upon plan is to start her feedings at a VERY small volume and increase them VERY slowly. She is on TPN and lipids (IV nutrition) to make up the difference in calories until she can get to her goal. Her feedings are also dripping in very slowly and continuously instead of falling into her belly by gravity, which usually takes about 5 to 15 minutes.

Last night, Sophie weighed 4 lbs., 3 oz. She is a little bit swollen because of her infection, so we think that some of that weight is just fluid. As she loses that fluid, we think she will lose a little bit of weight too, but no biggie!

We do anticipate that Evelyn will come home before Sophie does. It's not that Sophie is doing badly, but she is a little slower with her feeding tolerance and she still needs to complete her course of antibiotics. As long as Evelyn is healthy, we will be able to bring her to the hospital while we are there with Sophie (although we're still not sure if being there all day with her is a good idea). Who knows, maybe they will be discharged at the same time, but we're not getting our hopes up.

Stop Hands

One of the things that babies do when they are stressed or overwhelmed is to spread their fingers and give the "stop hands" or "stop signs," as the nurses call them. Check it out... it's actually very cute!

Our little Evelyn is not shy about giving the stop hands...