"To eat is a necessity, but to eat intelligently is an art." - La Rochefoucauld

Monday, September 25, 2006

Dear Family, Friends and Blog Junkies!

Danielle and I wanted to take this opportunity to thank everyone who has helped us through this very trying time in our lives. We thank you all for your prayers, thoughts, letters, emails, blog posts and phone calls of constant support. We truly believe in our hearts that the positive thoughts and many, many prayers have given our boys this opportunity to thrive in the NICU.

While this experience has been difficult for me personally, I cannot explain how difficult this has been for my beautiful bride. Imagine being bedridden for nearly 4 months straight. After that first week of rest and relaxation, the idle time begins to turn into clock watching, restlessness and the feeling of being unable to be self-sufficient. I cannot begin to explain the amount of respect I have for my wife for doing whatever was best for our boys when they needed it most. I know as parents, we would do anything necessary for our boys, but the consumption of 315 cans of Boost protein shakes warrants high praise. I drank one can myself and I can honestly say it was utterly disgusting. It tasted of medicine, metal and chocolate. A wonderful combination!

So our boys continue to amaze us every day. They are doing exceptionally well in the NICU. They remain on room air with the assistance of nasal cannula’s lightly blowing the room air through their tiny nasal canals. They both have done very well with their feedings, which are administered via feeding tube every three hours. Jake is currently taking about an ounce every 3 hours and his lil’ bro is sucking down about 2/3 an ounce every three hours. I was asked why they were fed so little and it made me think about the amount they were receiving. When you put this amount in perspective it makes a little more sense. Currently Ben weighs approximately 34 ounces ( 2lbs 2 ozs) and he is receiving daily feedings of approximately 5.5 ounces of milk. That amount of milk is over 16% of Ben’s total weight. That would be like a 150lb person consuming 24 pounds of milk…….daily!!!

All in all we are absolutely thrilled with the boys continual progress and their overall good health. We continue to ask everyone that has a direct line to the big man upstairs to continue to give a shout out for Jake and Ben, our little miracles. We hope to update the blog more frequently now that we have somewhat of a routine in order and the dust has begun to settle. Keep visiting the blog for the latest action photos.

Love Kevin and Danielle
Big Jake

Little Benny Boy

Wednesday, September 20, 2006

We get to hold them once a day for about one-two hours. It is heaven on earth!!! We cherish every second we get to touch them. It is so hard not being able to cuddle with them all day long. This is a picture of us holding them for the first time on day three. I am holding Jake and Kevin is holding Ben.




Jake & Ben 6 days old

Our little boys are almost one week old! We can’t believe it!! We fall in love with these little guys more and more each day we see them! They are so precious!


JAKE AT 3 DAYS OLD

BEN AT 3 DAYS OLD

The first week in the NICU has been pretty uneventful. The doctors are very pleased with the boy’s progress. Jake came off the vent after 24 hours and went right to the nasal cannula which just pushes air up his nose to help expand his lungs. They expect to take that out today. His feedings are going really well. He is digesting his food and going to the bathroom as he should. Ben was on the vent for 4 hours, the c-pap for 24 hours and then had his cannula taken out today. He is officially getting no help with his breathing. His feedings are also going very well. Both boys had brain scans that came back normal. We will have another brain scan to look for brain bleeds on Thursday. The doctor said it is highly unlikely that they we will have a brain bleed at this point with as well as they are doing.

Both boys are experiencing random bradycadira spells. This is where their heart rate dips down and pops right back up. The doctor told me he expects babies of this gestational age to be doing this. He said they will out grow these spells. Thank God!!! They are really hard to watch! The nurse usually has to go over to the baby and tap his foot to get his heart rate to pop back up. Every time I see this happen my eyes well up with tears. The nurses said I will get use to seeing them but I don’t think that’s possible!

The boys have to meet three goals before they can come home. 1) Breathing on their own, which we have accomplished, 2) Sucking and eating via a bottle. Usually babies don’t develop their sucking reflex until 34 weeks and that’s when they will begin bottle/breast feeding. 3) Maintaining their body temperature. So one goal down and two to go! Today they actually lowered Jake’s isolette temperature which means he is almost ready for goal number two.

It is very hard to leave these little angels every night. I usually have a good cry on the way home after leaving them. I know they are in great hands but it doesn’t make it any easier. We are just so grateful that they are doing well. I just pray every night that they can stay on this path. We are so grateful for all of your prayers. I know I have said that a million times..but I can’t thank you enough.

Friday, September 15, 2006

Our Birth Story
September 14, 2006

Kevin and I are proud to welcome Jake Francis and Benedict William into the world!!!!!! We are so happy to report that the boys are doing very well. Jake was born at 4:37 p.m. weighing 3 pounds two ounces. Ben was born at 4:39 p.m. weighing two pounds on the nose. It was truly the most wonderful day of our lives!!!!!

The birth of our boys may be a shock to most of you as it was a snap decision made on Wednesday afternoon. We are so sorry that we have not been able to call or email anyone till now. We always had this vision that on the night of their birth we would spend the evening calling friends and family…but with the way the day went we were lucky to get a minute in edgewise to do anything. We are hoping things will settle a little so we can catch up on some calls and chat with some friends.

RECAP: Wednesday we went to our routine ultrasound and we found continued reversal flow of Ben’s umbilical artery. We also did two other Doppler scans (DV and MCA) that showed Ben was not getting what he needed and time was running out. Our doctor pulled us into the conference room and said Thursday will be the day!!! He wanted to give us one more steroid shot to further the boy’s lung development, which needed a 24 hour period of time to go into full effect. At this point, delivery was planned for 1:00 p.m. on the 15th.

We were feeling very good about this plan until late Wednesday night when we were doing our routine NST (Nonstress Test) when we saw Ben have a significant deceleration. His baseline also went from 150/160 to 120. Kevin had just stepped out to get dinner for us when the nurse asked me where my husband went. I asked her why and she replied, “Can he get here as soon as possible?” At this point, I started to panic. I called Kevin and told him not to panic but to get back as quick as possible.

They moved us back down to the high-risk floor where they prepped us for delivery. They set me up with the I.V. and all the monitors. They said if we don’t deliver tonight, you will need to be on 24 hour monitoring all night just incase we have an emergency. At this point, I felt it was time to deliver and did not want to put these boys in jeopardy any longer. I tried talking the doctor on call and Kevin in to delivering these babies NOW. They both calmed me down and said if we can make it to Thursday morning, the babies will have received that extra boost they need from the steroid shots, plus Kevin and I desperately wanted our doctors and nurses there that we had hand picked for the surgery. The plan at this point was to try to make it until morning, but if something comes up…we were going to go for it.

Wednesday night was the most challenging night of my life. I was either starring at the heart rate monitors or the clock all night. I just kept praying that God would give us those few extra hours we so desperately needed. Time went so slow. Finally, at 7:00 a.m. I heard my nurse and doctor’s voice in the hallway and started crying because I knew we made it!!! Plus Ben’s heart rate looked great so the team was comfortable waiting till our scheduled time at 1:00 p.m.

Our immediate family arrived around 10:00 a.m. We all sat their anxiously awaiting the nurse to come in and tell us it was time. Unfortunately, because of a backed up schedule we did not get called back till 4:00 p.m. They got us prepped for delivery and we began the c-section. My very good friend Amy, a new mom herself, told me not to let my nerves get the best of me and to cherish every moment of this miracle. I did just that! I loved every minute of it! After being told such tragic news at week 17, we couldn’t believe we were going to see our little miracles for the first time. Yes, it was painful at times but as soon as I heard each of the boys cry I became overjoyed with happiness. Kevin was soooooooooooo strong!!! He actually videotaped the entire procedure…a video I am not quite ready to see yet!

The doctors showed me Jake but could not show me Ben, but just hearing his little cry I knew he was ok. The boys were rushed to a room where they would get stabilized and then off to the NICU. Well the boys were being treated, the doctors told us something we had been waiting to hear for so long…the answer to this entire mystery. Why had Ben not grown appropriately and why had we experienced so many complications during our pregnancy. Pathology still needs to do their report, which can take 6-8 weeks, but at first glance of the placenta and the cords, the doctors were able to tell us a lot. They said Ben’s cord was extremely narrow at the umbilicus insertion. Initially, this probably caused the growth discordance between the boys. By the way, Dr. Sue (A.K.A. mom/our case manager) predicted this complication before a doctor even suggested this could be the case. The latest decline in Ben’s restriction was probably due to IUGR. It looked like about a 65/35 split at first glance. This means that Ben was getting approximately 35% of the placenta and Jake was getting 65%. Ben was starting to outgrow his portion of the placenta. This will all be confirmed after the pathology reports come back. We will also know what sort of TTTS connections Jake and Ben were sharing. Our neonatologist told us if you have a growth restricted baby, this is the best kind to have. Ben’s slower growth was most likely due to the placenta insufficiency and cord narrowing versus a chromosomal problem or infection.

Once I got stitched up, it was off to see our little guys for the first time. They are so beautiful!! They are so tiny and so perfect!!! Sadly, we could not hold them but we could stick our hand through their isolates and touch their cute little bodies. We still can’t believe they both belong to us. It was so hard splitting our time between the two of them. Jake has a lot of hair and is our big boy. Ben, our little guy, is just as feisty as we imagined he would be. Actually, the nurses said they both are very active.

We were so happy to hear that the doctors said “they had a perfect start into this world.” That was probably the best news we have ever heard. We know that things can change, but we were so happy our boys had the best start possible. In fact, Ben actually went off the vent only four hours after delivery!!! He is now on a c-pap and doing well. I could not believe it when they told us that. He said their lungs are in excellent condition and Jake should be off shortly too. The boys also got an 8/9 out of 10 on their Apgar test, which we were really pleased about also. It was good news after good news last night.

It was so hard to leave them last night. We actually did not sleep well again and called down to the nursery several times to see how they were doing. I can’t wait to go see them again today!!!

For the first time, we feel at ease. We know our boys are getting exactly what they need and are being monitored 24/7 by an excellent team of people. We pray to God they continue to do well. The first week is really important and indicative of their prognosis. Again, I have a great feeling they are going to do very well!

Now for part two of this journey. We are ready to embrace the NICU. It is now time to move on from pregnancy 101 to NICU 101. Lots of studying to do!!

Thank you very much for everything and we will keep posting to update you on the boy’s progress.

Love,
Kevin, Danielle, Jake, & Ben

Wednesday, September 13, 2006

30 Weeks 3 Days (14 weeks of bed rest, ONE DAY TO DELIVERY)

That’s right……We only have one day left of being pregnant with these little miracles! Kevin and I are excited to announce Jake and Ben will be born on September 14th, during a scheduled c-section at approximately 1:00 p.m. We are excited, nervous, anxious, etc., etc.

This morning at our routine ultrasound the doctors detected persistent reverse flow of the umbilical artery. This indicates that Ben is experiencing increased resistance from the placenta. Ben looked great otherwise. He had wonderful activity, normal amniotic fluid, and was practicing breathing movements for a sustained amount of time. The doctors believe this is the best time to deliver because he is stable. They do not want to let things progress for the worse. They feel its better to deliver a healthy baby versus a sick baby.

We feel very good about this decision. Ben held out as long as he possibly could. He gave his big brother Jake the very best chance for survival. I am so proud of both of them. They are such fighters. I know they will continue this fight throughout the NICU journey.

Tonight we are celebrating our four year anniversary and enjoying our last night as a family of two. I cannot believe at this time tomorrow we will be a family of four...ok five including Abbie! We are so grateful for everyone’s continued support and we will be sure to post a quick update Thursday night as to how things went. As you can imagine, the next two weeks are going to be very crazy and we ask that everyone would kindly wait until the boys are stable before visiting. Trust me, as soon as we can show these boys off, we will! We will be sure to post pictures as soon as possible.

Thanks again!

Love,

Soon-to-be Mom & Dad

30 Weeks and growing!!!!

Saturday, September 09, 2006

29 Weeks 6 Days (13 weeks of bed rest, 2 left to go!!!)

Yea, you heard me!!! Two weeks left to go! We have set a delivery date for September 25th. As of today, we have a scheduled c-section the morning of the 25th. Jake and Ben will be 32 weeks and one day. Our doctors do not think it would be a good idea to go beyond this point. Ben has started to demonstrate something called a brain sparing effect. This sounds very scary but it actually is a good thing. Due to his small size and restricted blood flow, his body is sending all of his blood to his head to protect his brain. When this stops, we know his time is up! Right now he is doing exactly what he should be doing. We don’t know how much longer he will continue to do this and that is why the doctors don’t think it’s a good idea to let me keep going. They feel 32 weeks is also a good time for Jake too. A baby is done developing neurologically at 32 weeks. My doctor said long-term complications are very rare at this gestational age. We are praying we can make it two more weeks. If anything happens before then, we will go ahead and deliver but we are holding out for the big 32!!

We are very nervous and very excited at the same time. Lord knows I would sit in this bed for another three more months if it would help but I can’t deny that I am happy this part of the journey will be over soon. I have so enjoyed being pregnant but I have not enjoyed the restrictions. I will be a free woman soon!!! We still will be at the hospital 24/7 with the boys but I will actually be able to walk again!! Woo Hooooo!! The things we take for granted!

What’s nice about having a scheduled c-section is that we can actually hand pick our nurses and doctors. We also can mentally prepare for the big day. I just can’t believe we are going to be parents in two weeks!! I am so excited to meet Jake and Ben!

Tonight I am sitting at home while my entire family is celebrating my niece/God Child’s 1st birthday. I am so sad I can’t be there. My sister planned a huge party for her little girl that I am sure is going to be outstanding. Kevin is videotaping for me so I can see her eating her cake. He is also bringing me a plate of food so I don’t have to eat hospital food tonight, so that will be nice.

Oh by the way, my dedicated husband found an air mattress that he can squish between my bed and the bathroom door so he can stay the night with me. He actually said it is better then the pull out chair he has been sleeping on the last three weeks. He is so patient and never complains. He gets my vote for “father of the year!” :)

Well I better get going…I have lots to do!! :) I am in the process of planning FAD #30!!!!!

Thanks for staying in touch and we will keep you posted!
HAPPY FIRST BIRTHDAY SOPHIA RENEE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Thursday, September 07, 2006

29 Weeks 4 Days

Our little Ben grew!!!! He still is a little peanut but he is now one pound eleven ounces. He is starting to fall off his growth curve and is under the 10th percentile but the doctors feel it is still best to stay pregnant for now and let these babies cook!!!

Our little fatty cakes Jake also did some awesome growing too!! He is now two pounds fifteen ounces and I like to round up and call him three pounds!!! He is in the 46th percentile. The boys now have 40% growth discordance.

Kevin and I are very happy! Even though Ben is very small, he is still growing and showing other very encouraging signs. He got an 8 out of 8 on his B.P.P. (Biophysical Profile) and has excellent amniotic fluid and movement.

Overall, they hope we can get to 32 weeks. Hopefully, that would get Ben over two pounds. As the docs keep telling us, as long as he has the maturity, we can fatten him up in the NICU.

Since we are going on our 4th week in the hospital and remain stable, they had to move us to a different room. We are very sad. We loved our nurses and our accommodations in “apartment 4.” Now we are in “closet #45.” Our room is not even half the size it was. There also isn’t a bed for Kevin to sleep in which will force him to go home and get a good nights rest, which he really needs!!! This definitely made things a bit more challenging, but on the upside, we are still PREGNANT!!!!!!

Your prayers are working!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! THANK YOU!

Wednesday, September 06, 2006

29 Weeks 3 Days

Thursday is a really big day for the four of us. We are getting the boys growth scans at our routine ultrasound. We are really nervous. If Ben has not grown in two weeks we might be making a decision as far as delivery. The doctors feel that both boys are at a safe point to deliver if we need to make such a decision. We all would obviously like to get a few more weeks if we can.

I have a very good feeling. I know the boys had a big growth spurt in the last week or two. I am starting to feel whole body parts sticking out of my stomach. I think I have a pretty good idea which baby is which.

Two weeks ago (at 27 weeks), Jake was two pounds one ounce (39th percentile) and Ben was one pound five ounces (10th percentile.) They were at a 34% weight discordance. We are praying very hard tonight for some big growth!!! :)

Saturday, September 02, 2006

28 Weeks 6 Days (3 months of bed rest)

We are in the process of planning FAD (Fetal Appreciation Day) #29!!! Yup, we made it one more week! We have been told that everyday we are pregnant is about five less days in the NICU. Our goal is to keep those babies cooking as long as possible, which I think is quite possible at this point. Our doctors have actually said they are perplexed by our case. Jake and Ben have a mind of their own and continue to defy the odds. As my doctor said, babies do not read the textbooks.

At our ultrasound yesterday, no reverse flow of the umbilical artery was detected. Ben actually had more amniotic fluid then Jake, which was a first. When a baby starts to decline and they are not getting the blood/oxygen/nutrients they need, they are unable to produce amniotic fluid. Ben’s fluid continues to be stable if not better, which doctors are happily surprised about.

Jake is doing so well. He continues to inspire his little brother to grow. Ben is holding out as long as he can to give Jake the best chance possible. I am so happy they have each other. They have already impressed me with their strong will.

The last three weeks we have become very close with this couple going through a very similar situation with their twin girls. They have mo mo twins, which means they have one placenta and one sac. As you may remember, we have one placenta and two sacs (di mo twins.) The outcome for an identical twin pregnancy depends on how many days after conception the egg splits. Read below to see the five variations of identical twins.
  • Dichorionic and diamniotic (DI DI): These types of identical twins develop 2 separate placentas and 2 separate amniotic sacs (similar to fraternal or non-identical twins). They generally occur if the fertilized egg splits before 3 days after conception.
  • Monochorionic and diamniotic (DI MO): JAKE & BEN ARE DI MO’s These identical twins share 1 placenta (monochorionic) but develop 2 separate fluid sacs (diamniotic). This is the most common type, accounting for around 75% of identical twin pregnancies and happens if the split occurs between days 3 and 8 after conception.
  • Monochorionic and monoamniotic (MO MO): OUR FRIEND’S BABIES These twins share 1 placenta (monochorionic) and 1 sac (monoamniotic). This is the rarest type of identical twins, occurring if the split does not occur until 8 to 13 days after conception. Monochorionic/monoamniotic twins are associated with more pregnancy complications for the babies.
  • Conjoined or Siamese twins: In very rare circumstances, the twins do not split until the 13th to 15th days after conception. This leads to the babies themselves being physically joined together to some degree, as well as sharing 1 placenta and 1 amniotic sac (monochorionic and monoamniotic). The joining may just involve the baby’s skin on some part of their body (being easy to surgically separate soon after birth), or it may involve the babies sharing vital organs such as their brain or heart (making surgical separation more involved or not possible). These babies need to be born by Caesarean, with any proposed surgical separation being performed at some stage after they are born.
  • Acardiac twins: This is a very rare type of twinning that is similar to conjoined twins, except the babies share one heart. Separation may be possible, but the second twin cannot survive. However, the condition itself is also life threatening for the first twin because of an overload on the heart trying to support both babies. This can lead to heart failure (in 50% of cases). Again, the babies need to be born by caesarean and any proposed surgical separation is performed at some stage after they are born.

The splitting of a developing baby to create twins is not possible once the pregnancy is more than 15 days after conception.

We have two different types of pregnancies, but have had very similar treatment and monitoring plans. They had to come in three times a day to be monitored so they would always stop by and chat. It has been quite a bonding experience.

Last night Kevin and I were coming back from a wheel chair stroll with some friends only to find out it was time for our friends with the mo mo twins to deliver. At 30 weeks they delivered two healthy three pound baby girls. We are so happy to report the girls are doing very well. This experience made things very real for Kevin and I. Seeing them head off to the OR for the big moment made us realize our day to be parents is right around the corner. A feeling of excitement came over us. With all of the hardship and constant worry, we have forgotten that the most amazing experience of our life is going to be here before we know it!!! We are so excited to meet Jake and Ben. However, we have told them we will wait as long as we need to!!

All in all Kevin and I are doing well. Our spirits are much better. We are very confident there will be a positive outcome. Other then sore backs and nasty hospital food, we are doing pretty well. We can’t thank you enough for your prayers and well wishes. I can say without a doubt the reason we are here today and doing well is because of the power of prayer.

Happy Labor Day!!
XOXOXO