All Sorts of Good Stuff

It's been quite a day at the NICU today, with all sorts of amazing little things happening.

Madeline is now doing "sprints" on a nasal cannula once per shift. She did so well on her 30-60 minute sprint regimen, her doctor has now ordered 1-2 hour sprints each shift as tolerated. Maddy's nurses, Annette and Janet, treated Maddy to a day of beauty and got some great pictures of her today while on her cannula (see below). Maddy was awake and alert and was even looking around to see who was talking. She also started looking at her own hands. Not only do the sprints give her a nice break from the CPAP, but we also get to see the little sprout all uncovered!

By the way, Maddy's poor little nostrils are so prominent because of the CPAP mask that she normally has to wear. The CPAP prongs are kept in place by a strap attached to a little hat (see previous pictures) that forces her nose back. Once Maddy is on the cannula permanently, her little schnoz will return to it's normal shape.

Because Madeline is able to use the cannula, we can also do what's known as "recreational breastfeeding" - a strange name for sure. Basically, Maddy gets to give breastfeeding a whirl using whatever instincts she's developed so far, but we don't expect her to get much milk or nutrition out of it. It's basic training for when her muscle tone and breathing-sucking-swallowing reflexes are better coordinated. She did pretty well for her first try and it was really cool for Mom, too. Maddy will probably start doing the real thing in several weeks.

Milo is doing very well after his surgery. He was already awake and semi-alert for a bit today, and has been on standard pain relief. Maddy was in a much tougher spot at this point after her surgery and needed an extra piggy back dose of morphine every 4 hours. Milo is pretty puffy from retaining fluid, but that's a normal after effect of his surgery. There's been a dramatic difference between Milo's and Maddy's experiences with the PDA ligation. Just goes to show the difference a pound of weight and an extra 25 days of maturity makes.

Above: Pudgy little Milo just before his surgery yesterday. The band aide on Milo's right side is holding a chest tube in place.

Milo Makes Good!

Surgery completed about 15 minutes ago and Milo did very well. He's resting comfortably with his PDA securely fastened shut. More to come later. Thanks to all for your good thoughts!

Trading Spaces

Other than the preparations for Milo's surgery, today was a quiet day at the NICU. Elaine was able to hold both babies for over an hour and both did really well. Madeline had to say good-bye to good o'le room 11. She's now residing in room 8 just across from Milo who will need his own room for tomorrow's surgery.

Maddy's big move. A little traveling music please.

Getting Maddy setup in her new pad. The whole move took about 10 minutes thanks to the experts at Alta. It also helps that Maddy's no longer on half a dozen machines.

Maddy sleeps straight through the excitement. Notice she's still waving her fist in the air. She's a Berkeley baby alright -- just not sure what she's protesting today.

A slimmer and trimmer Elaine hangs out back in Milo's room.

Elaine holds Maddy while nurse Cheryl and friend Anthea look on.

I took this shot today with Milo for some size perspective. By the way, he weighed in at a robust 3 lbs. 5.6 ozs this morning -- a pretty impressive gain, and it's even more impressive since he was weighed on a real scale. Like yesterday, some of this is likely water weight, but still a feat. (Maddy also picked up an ounce and is now solidly over 3 lbs.) By the way, I'm wearing gloves because I've developed an allergic reaction to something -- probably one of the soaps at the hospital. That's also why Elaine has been doing all the holding with the kids lately -- just on the off chance that I've got something contagious.

So Milo's big day is tomorrow afternoon at around 3 pm. Look for a blog post tomorrow evening as soon as the surgery is over.

Three Pounders

Well, the tight race to 3 pounds went fairly decisively to Milo. According to the official weight meisters (i.e. the twins' nurses), Milo not only hit 3 pounds earlier this week, but also managed to put on another few ounces, too -- he's now up to 3 lbs. 3.5 ozs. As great as all that new weight is, some of it is just fluid from being back on IV feedings in preparation for his surgery on Monday.

Despite his PDA, Milo continues to do well on CPAP. His oxygen needs are still relatively low, around 25-29%. Elaine has been able to hold him for the past couple days outside of the isolette and he's done well with it. His PDA constricts a bit periodically. If it manages to close completely before Monday then the surgery is unnecessary -- but that's a long shot.

Maddy is also showing good improvement. She has also hit the 3 lb. mark and is eating well. She's a little more finicky about being held, but she still enjoys it for short periods. Next week, Maddy will start doing "sprints" using a nasal cannula. Making the move to a cannula will represent one of the next important steps forward for the babies. It's basically a more mild delivery system for extra oxygen. The plan is to let Maddy use the cannula for up to an hour at a time and see if she can maintain her oxygen saturations. The better she does, the sooner she can make the move to a cannula full time. Milo will eventually try sprinting too, but it will follow his recovery from his surgery.

The latest pictures:

Above: Milo catching some sleep with his CPAP mask on.

Above: Mellow Milo.

Above: Elaine holds Madeline.

Above: Madeline raises her fist in defiance. "Babies against nasal prongs!" Fight the power little girl!

Until next time.