Destroy needs to poop.

We think the high calorie diet the NICU concocts to fatten up the babes is difficult to digest. Our poor little baby is struggling hard to process all his weight-gaining goodness. And he has apparently decided the entire NICU staff should accompany him on this journey.

Recently, Destroy has started to wail when his tummy hurts. It is heartbreaking to see him crying and not be able to fix it. He’ll scrunch up his little face, turn his head up to the side, hold his breath and try. Sometimes putting him on his tummy and rubbing his back helps calm him down a bit. I know when my tummy hurts I prefer to be curled up face down in the fetal position.

Now that we’ve moved down on the calories, Destroy’s feeling a bit better. He’s still not pooping to his preferred potential, but he’s finding some relief. Destroy is now gaseous. And Destroy is potent.

Back when the boys still lived in closed isolettes, we arrived one morning to find Destroy sans blanket. “I just couldn’t keep him covered when it smelled like that in there,” she apologized. Popular opinion at the time was that his apnea was due to Destroy holding his breath to avoid the foul odiferous fumes generated by his gastrointestinal discomfort. We all laughed – assuming our nurse was joking.

Now Destroy is much bigger. He is beginning to resemble a football due to the size of his stomach (one of his nurses also suggested he may bear resemblance to a frog). Last night, Jon was holding Destroy while he struggled with his tummy troubles.  Suddenly the nurse on the opposite end of the pod exclaimed, “Oh. My. God! Is that ALL Destroy?!”

It was.

And it wasn’t even a poop. Just gas. Several times we’ve changed his diaper because there HAD to be something in there.

Nope.

Whoever said newborn poops didn’t start to smell bad until they started eating big kid food was seriously misinformed. Perhaps this is our little ones revenge on the NICU for having to eat the sludge.

At the very least, I know Destroy feels better when he toots because every one, big or small, is followed by a mischievous little grin.

Visitors be forewarned. When you come to meet the muppets, you will be visiting a house with two small formula-added babies and two large plum-eating dogs. Enter at your own risk.

Happy two months to my little muppets! Sixty-one days down in the NICU, but we’re making progress. The last two hurdles to clear are a full five days with no As and Bs (apnea and bradcardias) and steady oxygen saturation and two full days of taking all their feedings via the bottle.

Mommy's Little Man

We’ve now reached that point where time has slowed down. We’re so close, but not quite there yet – or should I say not quite home yet. And every progressing day brings stronger feelings that they are MY children (with subtle overtones of “back off nurse”). We are eager to take on the life-changing experience of full parenthood.

This morning a nurse told us not to bother Search because they liked to let him rest. Jon was in process of changing a poopy diaper. This was the first time in two months someone had told us not to touch our babies without a very specific medial reason. (And as Search’s mommy and daddy, we’d made the executive parental decision that our child would rest better when not stuck in a smelly diaper.)

Naturally, Jon and I have grown incredibly close with them and feel that we are getting pretty good at reading their cues. This particular skill has been greatly enhanced by some of our favorite nurses who subscribe to the “they’re your babies – you deal with them” method of care. Yet because their regular nurses spend so much time with them, they’re part of our family right now too.

During their NICU stay the boys have amassed an awesome team of nurses who know them and their quirks as well as us. (Dear Search and Destroy’s regular night nurses – I’ve never met you, but I’m assuming you’re just as awesome as our day and evening nurses).

Destroy

Search and Destroy still swing. One of the neonatologists continues to call them the “Swing Boys” instead of the “Stream Boys.” But they’re recoveries back up to full oxygen saturation have become so much faster that the monitors are often up to half a minute behind. Last week, Destroy’s levels dipped low. A nurse unfamiliar with him rushed to his bedside and hurriedly started trying to stimulate him while frantically looking back and forth between a bemused looking Destroy and the offending monitor. Moments later, our nurse returned from her break. She peered into the crib and calmly noted, “He’s fine.”

“But I really don’t like those numbers!” the unfamiliar nurse retorted.

“So don’t look at the numbers,” our nurse suggested. “Look at the kid.”

When the boys swing during feedings, our nurses barely give us a second glance. They know the boys and they know us. They’ve made it clear when we’re visiting they rely on us to let them know if something is off. Jon and I have chosen to interpret this as a great sign of confidence.

Search

But a nurse who doesn’t know them often thinks of them as “the twins” or “the baby.” Our nurses know them as Search and Destroy. The nurses who don’t know them don’t know that they’ll immediately recover from a swing. A nurse who doesn’t know them doesn’t know if they have competent parents. And a nurse who doesn’t know them charts EVERYTHING. As we get closer to bringing them home, the slightest look of concern by an unfamiliar nurse prods exclamations of “Don’t chart that!” out of fear that it will ultimately delay homecoming.

It’s a vicious little circle since the reason our boys are doing so well is due to the conscientious team of nurses and doctors who don’t take any abnormality lackadaisically. Jon and I appreciate everything that the NICU staff have done for the muppets. And to Search and Destroy’s regular team of NICU family – we can’t thank you enough. You are amazing, informative and entertaining. And we can’t wait to be rid of you.

The muppets are scheduled to have a multitude of vaccines today. (What a way to celebrate two months on Earth…) So we’re happy to have all that additional help taking care of potentially tired, cranky, sore, sick boys.

I was really hoping the muppets would be born today. Today is Uncle Paul and G.G’s birthday. I know the day is a bit crowded, but even Uncle Paul had said it would be fun to share.

Twenty-seven years ago Paul arrived early. Not three months early of course, but a couple of weeks. Mom woke up early, but ignored her symptoms because he wasn’t due yet. (Boy do I know that feeling!) Finally, she realized it would be exceedingly prudent to get her pregnant belly to the hospital ASAP.

Twenty-seven(ish) minutes later, I had been rudely removed from mud-pie preschool and had a new baby brother.

Mom called G.G. “Happy Birthday Mom. You have a new grandson.”

During the first few years, I wasn’t terribly thrilled with his presence. Periods of silence in the house would often be followed by the two of us trying to kill each other. How exciting that Search and Destroy have started fighting early. Search kicked his brother in the head while the two were in utero. Destroy laughs at his brother now when he has to have his nasal cannula replaced.

But then, inexplicably, as we got older Paul got less annoying. We traded baseball cards and played catch on summer evenings. (Sorry about that baseball through the back of the Volvo, Dad.) We entertained each other during long nights before birthday or Christmas. We talked about relationships and argued over whose turn it was to monopolize the phone. We fixed Mom’s computer and rolled our eyes at our parents’ general lack of coolness.

I know that someday the muppets will be rolling their little eyes at Jon and me. But I hope that they will think their brother is cool. And they’re certainly lucky to have such a cool uncle! (Even if I’ve always been a tad jealous that he gets to share such a special relationship with our Grandma.)

Brothers!

When the nurses originally told us it would happen, Jon and I found it very difficult to believe. Really? Three pounds in a month, we questioned. But Nurse Susan assured us that the NICU folks are experts at fattening up children.

Destroy and the fishies

Search - Daddy's All Star

Well, today the muppets hit five pounds. Chunksters!

This past weekend the twins graduated to Newborn size diapers. This may or may not have had anything to do with growth. Diaper size increases are usually determined by the current diapers inability to contain poop. (Prior to having children I never imagined I would care so much about bodily functions.) The new diapers are much kinder to the boys increasingly expanding tummies. Last Friday, Jon noted that Destroy was beginning to look like a football – little arms and legs, big oversize midsection.

Even more exciting is today’s development. Along with the five-pound milestone, Search and Destroy no longer fit into their adorably tiny preemie size onesies. Their wardrobe options have just increased exponentially. Destroy was clad in a standard issue hospital shirt – size 6 months – which is provided to all babies, from preemie to jumbo term size. He may as well have not been wearing anything for how big that shirt is. Search was still wearing his preemie outfit since he hadn’t yet spit up on it. But when the Nurse Susan arrived for her evening shift, she found Search squirming about with the bottom snaps not even closed. Perhaps Nurse Margaret thought he needed extra breathing room.

For outfits that were still rather loose when we first clad the muppets with them, they were awfully snug these past few days. I was a proud mommy this afternoon as I toted the larger outfits into Pod B. Granted, these new outfits are still rather roomy. But they’ll quickly grow into these too. At the rate they’ve been growing, we’ll be taking home babies that actually fit into those size 6-month standard issue shirts…

Search

Destroy

For those of you familiar with the MTV show “Cribs,” please enjoy today’s installment of “Cribs: NICU” (ha ha). Please feel free to read the following with a Robin Leach English accent.

While most babies are quickly bundled into their mother’s arms and shuttled out of the hospital mere days after birth, the small and premature enjoy luxury private accommodations where teams of qualified medical staff cater to their every whim.

Think that’s impressive? Well, consider Search and Destroy Stream. Not content to live alone in a Giraffe isolette, the twins have moved into a two-person pedi crib mansion. The crib looks far more like a typical crib than any kind of hospital equipment.

The small and premature are encouraged to relax. The only work required is breathing. And even then, oxygen tubes are provided to any who want to chill out to the point of forgetting to breathe. These nasal cannulas are available 24/7. Adults are required to pay big money at trendy oxygen bars for mere minutes of the same pleasure.

Day and night, these small and premature babies adhere to a strict schedule to ensure no want goes unanswered to. Hungry? Every three hours Search and Destroy receive a bottle of milk. But not just any milk. These small and premature miracles receive two parts growth formula with every feeding. Aimed to plump them up quickly, these children are not burdened with the term babies task of taking only as much as they want. Too tired to eat? Not a problem in the NICU. Here, babies can simply lie back and experience the thrill of a full tummy via a feeding tube.

Without asking, a team of nurses make sure that the babies home is always the perfect temperature and a fresh diaper awaits their cute little tushies. Interested in furthering development? The small and premature have a developmental care coordinator who recommends a weekly plan that will make the little ones the most comfortable. In the interim, physical therapists massage their muscles and work on toning their cute little bodies. Again, something adults continue to pay thousands of dollars a year for in prosperous gyms and spas. And finally, a social worker imparts this and more information to parents to ensure the preemies comfort upon departure.

Remember Search and Destroy’s crib? These preemies are spoiled and pampered. In addition to ditching anything resembling medical supplies, the twins cuddle in personally assembled nests – swaddled in warmed blankets topped with fuzzy stuffed bear blankets. Their bedding arrangements lay atop a handmade quilt. The quilt boasts a primary red background with bright yellow chicks to stimulate the imagination. They look up at a blanket of royal blue with rubber ducks of the same bright yellow to color their dreams. Tired? Their fuzzy bear blankets are a pastel blue and green to calm them.

In honor of the giraffe isolette they left behind, a stuffed giraffe watches over the two of them. In each corner sits a turtle reminding them that slow and steady wins the race. Rattling bumblebees attached to the back of the crib entertain them should they wake up before their next feeding. Still sound mild and pedestrian? A musical jungle mobile swings above their heads – entertaining them with lions and tigers and bears, oh my!

No wonder they’re still camping out in the NICU after eight weeks. This is paradise compared to the cramped conditions in my tummy or the cold glare of the operating room where they were ripped out into the world.

Thus far their lifelong adventure has taken them down the hall of the hospital’s third floor. I can tell they’re getting more adventurous as they get older and bigger (hence the new need for the musical mobile entertainment). This tells me the muppets will be home soon – just think what adventures await them once they breech the barriers of the NICU and actually get to experience the world.

NICU Sweet NICU

Shocking news – the muppets are still in the hospital. If you’ve ever stopped and wondered, “Hmm, I wonder how long it takes for preemie parents to reach extreme levels of frustration,” allow me to enlighten you. The answer is seven and a half weeks.

This week was a particularly difficult one for me. The boys are still doing very well. They’re growing and getting ready to come home via the slow and steady method. But they’re still swinging up and down with their oxygen saturation. This was the first potential week that we may have seen the boys homeward bound. Guess what isn’t happening?

To be fair, I never really thought they’d be home this week – I thought they’d be home next week. Ever since we learned double trouble was upon us, I’d expected to bring them home in late July. But I did expect that perhaps they’d be completely sans nasal cannula and holding a steady saturation level (of 97-100 percent).

No more photos...please!

I know 36 weeks is the average gestation for twins and next Tuesday is G.G and Uncle Paul’s birthday. I thought the twins arrival would be a great birthday gift. Obviously, that didn’t happen. So I thought the next best thing would be to bring them home. Such mental decrees led me to really picture this as their due date. Ultimately, we have always been told to expect them home by their due date (which is actually Aug. 23) but they will let us know when they are ready to blow that NICU popsicle stand.

The combination of unmet expectations, closing in on the two month mark and just how darned cute the muppets are getting led to a very frustrating moment for me. It was hard to take a step back and remind myself that even though their NICU residency seems like it’s been forever, and even though they’re four and a half big boys now, they’re still only 35 weeks – still tiny. I should still be pregnant for another month! (Good grief, I honestly cannot imagine still being pregnant.)

Search

This past weekend was an absolute circus in the NICU. As I mentioned, the unit was at capacity. It seemed like there was a new admittee every five minutes. Young preemies to full term babies were rolling into the unit ensconced in their Giraffe isolettes. Nurses running to and fro, yelling out alphabet soup: TPN, PCH, CBC, ABR, CPAP, CC, ROP, ML, EKG, NG, IV, PDA and – what the heck, we’re talking children here, – ABC, 123. Babies crying. Dinging – oh, the dinging – alarms screaming from every nook and cranny. Nurses tending to babies in multiple pods. The charge nurses wandering around asking who wanted to work doubles.

Destroy

Destroy and I were cuddling in a corner, observing the chaos. The one stat I kept noticing were how many of the babies had high steady sat levels. Today I asked Dr. Dong when the swings would stop. He just looked at me with a slightly pitying, slightly amused expression. “I don’t know…when they’re ready.” So much for my hopes that he’d suddenly peer at the boys and reply, “July 23. 1:32 p.m.” However, he did wryly note that yes, it will someday stop. He mentioned, “We’ve seen a lot of kids like this. It seems like the swinging will never stop and then suddenly it just does.”

Search and Destroy truly are our little miracles. And we’ve been really blessed that, despite all they’ve been put through, they’re healthy. (They’re still tiny, but they’re healthy.) They are coming home – it’s just a matter of when at this point. I’ve discovered the cure to my frustration is seeing one of the boys smile or coo. And a slightly calmer NICU helps as well. Homecoming is just a matter of weeks now. Then the boys can cause all other types of frustration for their parents.

Despite the occasionally frustrating situation we’ve found ourselves in, Jon and I are tremendously enjoying getting to know our boys. Their personalities are really starting to shine through. And double trouble is oh so very accurate.

You know it’s time to leave the hospital when the nurse has to leave the pod and decrees, “Mom’s here. She knows what’s going on – she’ll let you know if anything’s wrong.”

The muppets are officially 35 weeks corrected gestation today. That means that today is the very first day they would have stood a chance of coming home without an extended NICU stay. It’s been seven weeks. I like to think of them as being the Pod B Seniors. (The giraffe can be the team mascot – since that’s the brand name of the isolettes all the NICU babes live in.)

The NICU is at capacity again; the last time they were full was when our little dudes were admitted. Yet, so many of the new babies are “older” – 32-34 weekers. I admit to many bouts of jealousy. I look around our pod and see the brand new residents with no need for oxygen assistance. They immediately take their bottles with no need for feeding tubes. And they only stay for a week or two.

So I decided to take a look back at what life would have been like if I was still waiting to meet them. One of my favorite sites during pregnancy details the development of each week. Interestingly, my actual experience wasn’t terribly far off.

Your child – 35 weeks
Due date: Aug. 23, 2010
July 19 – July 25

Do you know the difference between real and false (Braxton Hicks contractions) labor pains?
You betcha! I had real labor pains for many moons. The docs gave the three of us Indocin to stem the contractions. (Dr. Meyer, our perinatologist, called the twins “little Indocin addicts.”)

It’s normal to be nervous about labor and delivery.
Yeah, no kidding! Especially if you’re terrified your babes are too young to face this great world, even if the tiny ones appear to think they’re big bad boys. I was wheeled into the OR muttering “healthy babies” feverishly and incessantly.

Planning to breastfeed? Ask your hospital’s labor ward if they provide on-site lactation consultants, or interview consultants you may want to work with after the baby is born.
They do. Regardless of how long after birth you need them.

Your prenatal visits may be weekly now that you’re in the home stretch.
Well, they’re not prenatal visits so much as postnatal. And they’re not weekly, they’re daily. But back before the muppets arrived…nope – they were daily then too. (Granted, I was living in the hospital.)

Make a tape of music to listen to during labor. Pick songs that perk you up, inspire you, or relax you.
Any calm labor plans went out the window when the muppets decided to grace us with their presence three months before any birth plan could be created. But I’ve got songs for the boys now: songs I love and songs that ones I love have sent their way.

Feathering the nest? Look for fun freebies and coupons.
The nursery is ready and awaiting homecoming! And freebies and coupons are a good idea now that our family is double trouble.

Only 5 percent of babies are born on their due date, so don’t worry if yours comes and goes and you’re still waiting.
Seriously? Do I even need to comment on this one?

How your baby’s growing:
Your baby doesn’t have much room to maneuver now that he’s over 18 inches long and tips the scales at 5 1/4 pounds. Because it’s so snug in your womb, he isn’t likely to be doing somersaults anymore, but the number of times he kicks should remain about the same. His kidneys are fully developed now, and his liver can process some waste products. Most of his basic physical development is now complete — he’ll spend the next few weeks putting on weight.

Only 5 ¼? Although our little guys aren’t quite there, the little porkers are already tipping the scales at 4.6 pounds. Not bad for guys already using a ton of energy out in the world. But yes, they will be spending the next few weeks (months/years) putting on weight.

Search and Destroy started a new medication today. Supposedly it may help with their saturation swings and get them off the oxygen sooner. (Search’s back on his nasal cannula. He got tired.) They’re both getting so close.

I have high hopes for the next two weeks. Weeks 35 and 36 are the weeks twins are often expected, arrive and go home. So even if they’re not quite ready to come home, they’re well on their way. 35 weeks along, seven weeks old and almost five pounds – they’re big boys now!

Search “The Chubster” and Destroy “Chunky Monkey” are both doing well as they hit their seventh week of life.

When we first joined the NICU family we knew there would be ups and downs in their progress. At the time, I didn’t realize they meant that literally. In Pod B, the Stream boys are known as “The Swing Boys” and “The Dueling Desatters.”

Their oxygen saturation levels continue to bounce up and down. Sometimes we think it may just be to keep their nurses on their toes. The monitors track their heart rate, breathing rate and the aforementioned saturation levels – when levels fall below a set number, an alarm starts beeping. (We may have to find a recording of obnoxious beeping to soothe the boys once they come home.)

Time seems to stretch out as their corrected gestational age closes in on the point where they would no longer need an extended NICU stay. And since Search and Destroy are doing well, we are breathlessly awaiting the time when they come home. (Medical opinion is still placing bets on Search to precede his brother.)

Today, we saw what the light at the end of the tunnel looks like. M, the little girl across the pod, went home today. Born in March at a tiny two pounds, she proved beyond a shadow of a doubt that she was a fighter. On several occasions her mother reminded us to never lose hope – if her little girl could make it, so would ours. And no matter how far away the time seems, someday soon they’d all be home.

M would often sit near the boys crib, charting with the nurses. Sometimes she’d eat her bottle while our boys attempted the new technique of sucking and swallowing. Being the great flirts that they are, the nurses referred to her as the boys’ girlfriend. In that sense, we were sad to see her go. But in the grander scheme – we’re thrilled she’s gone. There will be plenty of older women in their lives…

Seeing our friend depart reminds me that our family is not too far off from being together. Search and Destroy have grown so much already. They’ve doubled their birth weight and are now a giant four pounds each.

This evening the doctor decided they were growing so well, that their calories have been decreased. (We want chubby babies, but the doctor is concerned about the potential for not-as-cute fat toddlers.) Although the boys are on a steady diet of mom’s milk, it’s mixed with human milk fortifier to fatten up babies. It also makes them constipated. So they spend a majority of their days trying to poop.

We’re hoping that the slow decrease of sludge will help relieve their tummies and as a consequence release pressure from their diaphragm, allowing them to maintain a steady oxygen saturation level. This will make for a very much less paranoid mommy.

As a start, Search was relieved of his nasal cannula today. He is no longer receiving any oxygen assistance; breathing is all up to him. So far, so good – here’s hoping he keeps it up! It’s amazing how much cuter he is without giant tubes in his nose.

Keep your eyes peeled – sometime, not too long from now – there should be a post that someone’s coming home.

Many of you have asked about photos.

I try and put as many adorable pictures as possible in each post, but if that’s not enough, you can always check out the full photo feed over at Flickr.

There is also a link to the set located in the Links suggestions over in the right-hand column of this page.

Photos are updated in real-time as I download them from my camera. None of them have descriptions, but the photo file title will always include the theme, name of muppet involved and date taken.

Once the boys come home, we’ll break up the sets into specific events so you can see individual albums.

Please feel free to become my Flickr friend for other exciting (non-muppet related) album adventures.

I have completely lost track of the days. I could not tell you what day of the week it is today nor whether it’s been three days or 30 since the last update. Six and a half weeks into this adventure, the boys are 34 weeks corrected gestational age.

The routine remains exactly the same day in and day out. The routine remains exactly the same day in and day out. The routine remains exactly the same day in and day out.

We park the car in the second or third row of the parking lot. I take off my sunglasses to put on my eyeglasses when we hit the crosswalk leading past the complementary valet and into the Lawrence Hospital Entrance. We walk through the first set of automatic doors and head straight for the second set to our right – you don’t need to slow down, they’ll open right as you think you’re about to smash into them. I immediately prep for the blast of cold air conditioning that cools the hallway. We enter in front of Ambulatory Surgery, pass a set of restrooms and cross one of the hospital’s lobbies. Next to the gift shop are three elevators; we take whichever one arrives first up to the third floor. We then head toward the NICU’s lavender awning located to the right of the elevator bank.

We greet the receptionist with a smile and “hello.” She unlocks the door and we enter, stopping to wash our hands at the sink right on the left. After scrubbing with soap to the length of Twinkle Twinkle Little Star we wind our way past the first door with it’s sign reminding us to be quiet because there are “Babies Developing. Shhhh.” In front of a kiddie table, we pick up the phone and dial Pod B. When one of the nurses answers, we say, “Hi, it’s Jon and Tricia Stream. We’re here to see our boys. Can we come in?”

The door opens and we squirt a shot of antimicrobial gel onto our hands. We greet the nurses as we rub in the gel while heading to the second and third beds (now one pedi-crib) on the left of the pod. I put my purse under their crib and ask, “How are my little guys today?” The nurse tells us they’re doing well. Jon and I set about taking the boys temperature. Destroy screams bloody murder; Search makes grumpy faces. Then it’s time to change diapers. Wipes are located above the pod sink, where we dampen them with lukewarm water. Diapers are stored in each kids respective corner. As we pick up the muppets to feed them their bottle, I ask the nurse what their weight is.

Harumph

We’re all ready to come home. The nurses warned us when Search and Destroy first arrived that time would likely mess with our emotions in this precise manner – although time passed by so quickly at first, it will start slowing down interminably as we approach our homecoming date. We are currently looking at 2-3 weeks more – but at this point, it’s all up to the boys.

Search and Destroy seem equally ready to come home. In fact, they have overheard us speaking about the three big criteria and decided to let the nurses know they’re ready. Destroy has made it his personal mission to permanently remove his nasal cannula. My poor little guy currently has a large red welt on his cheek because of his vigorous removal methods. I assumed that ripping the tape off his face would make him cry. It did not – he just gave us all a sly grin. Every time we swaddle him, we’ll see his little hands sneak out of his wrap and covertly grip at his wires.

“Well you said we couldn’t come home until we were off our oxygen tubes.” Destroy was just speeding that process along.

Search knows he needs to be taking all his meals from a bottle. So when I told him how proud of him I was because he was such a good eater, he took it upon himself to take out his feeding tube. “Look Mom, all done!”

They’re just trying to help out the doctors. And slowly, but surely, they are making great strides. It just seems like forever right now. Today, Nurse Jennifer let us know that we’ll likely see a huge difference between week 34 and 35. And Nurse June think they’ll likely graduate in about two weeks. (And Nurse June doesn’t take any backtalk from the boys. They WILL progress under her care. Period.)

Each day our routine remains the same. I just need to remember to take a step back and remind myself that we weren’t even supposed to have met the munchkins yet. They’re still tiny babies – even if they are rapidly approaching merely “small” as opposed to tiny.

Search

Destroy