4 Weeks Later

As you can probably imagine, I don't have a lot of time right now to write a detailed blog but I wanted to give a quick update on how everyone is doing. James and Lauren have continued to make excellent progress in the NICU. They are both out of the incubators (isolettes) and in "cribs" now. They haven't had any apnea episodes in over a week and are now both off of caffeine, which was being used to help remind them to breathe. Both of their pulse / oxygen monitors have been removed now that their heart rates have stopped dropping. James is taking every feeding from breast or bottle and Lauren is taking two out of every three feedings from breast or bottle. James continues to breastfeed very well, however, Lauren still has some catching up to do there. James is 4 lb 15.9 oz (aka 5 lb), and Lauren is officially 4 lb now! Every time we see them, it seems they have changed. They're still tiny, but we can definitely see the weight they've put on.

Their neonatologist informed me this afternoon that if James continues to gain weight, despite some calories being taken away (they've been supplementing my breastmilk with a type of formula that gives them extra calories), that he should be ready to go home on Monday (in 4 days)! Once he comes home with us though, he will be put back on the enhanced breastmilk. If Lauren progresses at the same rate she has been, she should only be a week behind James, if not sooner.

I also had a baby shower last weekend, where some of my family and closest friends came and showered us with wonderful gifts. A big thank you to Kristen, Nicole and Melissa who hosted it! These three girls were so flexible with our family's schedules. The shower was originally suppoesd to be on Saturday, August 30 -- my birthday. But we all remember the slight change in plans that occured. James and Lauren decided to come on into the world! Lauren and James received many fun, special, and meaningful gifts that we look forward to using and showing off. Thank you to all who attended and shared this special event with us! I didn't get many pictures on our personal camera, so after I get some pix from friends and family who came, I'll post to Picasa.

Signs & Diaper Cake by Mel!

Mel & Her Daughter Layla

The present openers: Cody, Clyde, John & Me

2 1/2 Weeks Later...

Well it's been about two and a half weeks and we're all doing very well. As for mom, for being bed ridden for 13 weeks and giving birth to twins, I feel wonderful. It is so great to be able to get up and about without being yelled at, and it's been refreshing to just get in the car and drive whenever I feel like it. I'm back to cooking and cleaning again, and I'm trying to walk a little most days of the week to build my stamina back.

James and Lauren are continuing to make good progress in the NICU. James had a minor set back last week with a gastrointestinal scare but the doctors never could find what was the matter with him. He was taken off of milk for a few days while they administered antibiotics and put him back on an IV with fluids and nutrients. He's now off of that IV and back on milk, and will actually start nipple feeding from a bottle tomorrow. He had an apnea episode today while John was holding him, but that's the first one he's had in over a week.

Lauren has had several more episodes with apnea but has been doing better than James in other ways. She has put on more weight. She is now 3 lb 7.5 oz, compared to her birth weight of 2 lb 13 oz. James' birth weight was 4 lb and he's now up to 4 lb 6 oz. Lauren also started nipple feeding last Sunday and today I actually got to breastfeed her. After about 30 minutes of working with her, she only sucked for about 3 of them. Lauren hasn't quite figured out what to do with her tongue yet, which makes sucking more difficult. The lactation consultant told me not to get discouraged because the sucking reflex is the last to develop in newborns, therefore preemies have an especially hard time breathing, sucking and swallowing all at the same time. But mom is still supplying them plenty of milk through pumping. So much that I've surprised all the nurses, doctors and lactation consultant!

Lauren & James

When I asked the babies' neonatologist how long she thinks it might be before they'll get to come home, she said that if everything continues to go well and we don't have anymore set backs that one or both of them may be ready in four weeks. Let's pray we get them then!

I updated the Picasa album "NICU Life" with more fun photos too!

Lauren & James Status Update (1 week old)

It's been a few days since I've blogged and I know that at least the proud grandparents are aching to see some pictures. I hope to have these pictures and more loaded to Picasa by tomorrow, but for now, these will have to do.

Peaceful James

Why'd you wake me up? (James)

Skin to Skin with Little Lauren

Lauren and James have been making great progress in the NICU all week. Originally, they were both on assisted breathing machines (that's what the tubing was on their heads); IV's to provide extra fluid and nutrients; and phototherapy lights for jaundice. They were also in separate rooms due to a lack of available beds. The NICU's goal is to have the babies able to breath, suck and swallow on their own before they can come home with us. For premature babies, whose coordination isn't that of a term baby, that's a lot to achieve all at once. As of today, Lauren and James are both off of the assisted breathing machines; keeping their food down (although it's still administered by a feeding tube); and their IV's are out. Lauren is off of the phototherapy lights, however, James had gone off and is now back on. The jaundice is cause of his darker skin pigmentation than his tiny sister.

John and I have also had the privelege of holding James and Lauren, changing their diaper, and taking their temperature. Today when I visited them, I got a little more diaper changing practice than I had anticipated. When I first started changing Lauren, I noticed her diaper hadn't been soiled at all -- poop or pee. But after sliding the new diaper in, brown goo began to ooze out of her bottom and just wouldn't stop. I kept wiping her down, and there it would go again. And then she'd start peeing at the same time. I think I won the award for the longest diaper change ever. It must have taken me a solid 15 minutes from start to finish. Thankfully James' diaper change went a lot smoother because it was time for me to go pump.

Start of the Longest Diaper Change Ever (Lauren)

The Money Shot

Ah... I'm clean!

Mission Accomplished!

8/30/08 - Happy Birthday Times Three!

Email update from John on 9/1/08

After last Thursday's update, Caroline took a turn for the worse in the hospital. Friday morning the fluid in her lungs wasn't getting any better leading to breathing problems, and then she started running a temperature of 101. After a battery of tests and meds, it was determined that she contracted some type of viral respiratory infection (probably from the hospital). It being viral, antibiotics weren't effective, so they loaded her up on Tylenol for the fever and a bunch of pain meds to knock her out for the night. During the night her contractions returned. And seeing as how the last round of anti-contraction meds took a toll on her body, the decision was made Saturday morning to not try and suppress her contractions this time around. So they moved her from Antenatal to Labor & Delivery - Saturday was going to be the big day.

The first thing they did was ultrasound the babies to see what position they were in. Upon admission to the hospital, Baby B was breached, but the ultrasound Saturday morning showed that both babies were now head down. This uncommon situation with twins gave us the fortunate opportunity of having a vaginal birth. Greater than 70% of twins are delivered by cesarean. Caroline did receive some additional meds to speed the labor process up and regulate her contractions. So by 7:00 she was fully dilated and ready to start pushing!

After being prepped, Caroline pushed for about 20 minutes in our room with the nurse coaching her on what to do and expect. Once Baby A was crowning, they wheeled her on down to the OR for the actual delivery. With twins, there's a good chance that the second baby will rotate out of position after the first is delivered. This would result in an emergency cesarean, so they deliver multiples in the OR to be safe. Once we were all set up in the OR, Caroline only pushed for three more contractions until Baby A was born. James Paul Laviolette was born at 8:12 pm on August 30th, 2008. He weighed 4lbs and was 17.5 inches long. His proud daddy got to cut his umbilical cord.

After James was gone, Baby B squirmed around for a minute or two before finally settling down - she finally had some room! Luckily she settled head down. Once ready, Caroline started pushing again and Baby B literally squirted out and landed in the doctor's arms on the first push. She was a little smaller than James and was therefore much easier to deliver. Lauren Elizabeth Laviolette was born at 8:16 pm on August 30th, 2008. She weighed 2lbs 13ozs and was 16.25 inches long. Her proud daddy also cut her umbilical cord.

We are still in the hospital, but expect to be discharged tonight. The babies are in the NICU where they will be monitored around the clock for the next 4 to 8 weeks before they can come home. James is having some minor breathing difficulties, but the doctor says that he's doing great for his age and it's to be expected. He's breathing on his own with 26% oxygen (normal air is 21%). She also said he's average size for a 32 week singleton baby, which makes him large for a twin baby. Lauren, on the other hand, is doing great! She is breathing much better than James and is requiring no additional oxygen. Apparently, baby girls develop quicker than boys, so it's normal for the sister to be healthier. The doctor said she's right about average size for a 32 week twin baby.

It has been a difficult 12 weeks (of bed rest) and an even more difficult week here at the hospital, but we are very fortunate to have two healthy babies. Besides being James & Lauren's birth days, it was also Caroline's 30th birthday. She wasn't too happy about the idea of sharing her birthday before their birth, but she now realizes they were the best birthday present she could ask for. And it'll be easy for me to remember, though expensive!

8/26/08 – Hospitalized at 31 Weeks

I was hospitalized Tuesday afternoon (Aug 26) following a checkup at my ObG. Apparently, I had been having minor/moderate contractions for several days (maybe weeks), but was unaware. While at the doctor's office, they started to become more frequent and more intense, maybe the result of my being up and active for the doctor's visit. The doctor also observed that I had dilated past 2cm and my cervix was paper thin, meaning my uterus was stretched to capacity and ready to go into labor.

My doctor immediately sent me to the hospital in an attempt to suppress my contractions and avoid an early delivery. After monitoring how frequent and intense my contractions were, they quickly decided to put me on an IV of magnesium sulfate (Satan) and catheterize me (Satan’s twin brother). They also gave me a round of steroids for the babies' lung development in the event early delivery could not be prevented. My contractions were occurring every 2 minutes with high intensity before the meds finally kicked in and relaxed her uterus. Over the course of the evening and night, the contractions slowly reduced to about every 10 to 15 minutes in frequency, which was great at that point. Over the course of the day, my contractions reduced to 1 or 2 an hour. The morning of Aug 28 they finally weaned me off the IV meds and put me on another medication to stop contractions called Procardia, which is actually a drug for hypertension but serves another purpose in this case. The hope was they would observe me for ~48 hours on these meds before sending me home with them (by Saturday).

Side effects of the magnesium sulfate are numerous. Since it works on the central nervous system, it slows down all your bodily functions including things like vision, digestion, motor function, etc. I felt as if I had the headache from a hangover and the grogginess of taking a whole lotta valium. My vision was blurry so I couldn’t look at people straight, read, or watch TV. I just lay in bed all day. I was on a clear liquid diet, but that didn’t matter much since I had no appetite anyway. Another side effect of this drug is bloating and fluid retention. Besides the great pair of tree trunks and cankles that resulted, the fluid also got sponged up by my lungs. I wound up with pulmonary edema (fluid in the lungs) which they tried to get rid of through diuretics but couldn’t get to quick enough to stop me from coming down with what felt like the flu. Even after coming off of the magnesium, I just felt like I had a bad case of bronchitis. I was achy all over, it hurt to breathe, and my cough was unproductive.

Contractions during Aug 26 ObG Visit

Toni & Me in the Hospital