NICU Day 13

Okay, so today wasnt a great morning visit. It wasnt bad, but it wasnt ideal. The nurse was okay. On a scale from 1-10, I'd give her a 7. Our favorites are 10s. Most are 9s. (The one I didnt like at all: a 4- maybe?). She wasnt a bad nurse. But she wasnt cozy to the babies. She was slightly rough when she turned them over and when she took the tape off of a lead she was changing. Both babies cried in that "that hurt" sort of way, which isnt normal for either of them. They will cry a "leave me alone" cry when they dont like being assessed, but it's been rare that we've heard a real cry. Like when IVs are going in, that sort of thing. So, anyway, she was a little rough with turning them and when removing tape, which irritated me. But, she wasnt terrible and it wasnt enough to say something. However, what I did talk to her about was feeding them and putting them on their backs. Both of them. All of the nurses we've had have said that belly time is best for their digestion right now. It is the only way they can keep up with the higher feeds. So when I come in, I see they are on their backs and she says "I wanted to try them on their backs even though I see they normally eat on their bellies." So, they both went from no residuals to 5cc's (Bobby) and 7 cc's (Maya). "Oh," she says. "For this feed, I guess I'll put them back on their tummies." Perhaps next time we can do what the NPs and the nurses have been doing and continue to do to help the babies. We've discussed back time with the NPs and how they will be weened from their belly time as they progress and get closer to the transitional nursery. They arent there yet. I wasnt rude, I just reiterated that all of the NPs and nurses we've spoken to have recommended they stay on their bellies to help aid with digestion. She agreed (hence the rough flipping over comment from earlier).

The other thing that was a little disconcerting was that she put Maya on a canula. Now, if either baby needs support, we want that for them. What we dont want is someone jumping the gun on something and delaying their progress. Last night while I was holding her, Maya got hiccups and her oxygen saturation dropped into the high 70s-low 80s (the alarm is set for below 82). When the hiccups went away, back to normal (high 90s). Now, we had talked to one of our favorite nurses the night before and she said they were doing great and that having apnea spells are normal, etc. and that, due to their normal breathing and oxygen saturation, they dont foresee putting them on canulas or back on CPAP. So, this morning, Maya has a canula. When I asked why, the nurse says "Oh I didnt like that her oxygen saturation was in the lower 80s and sometimes the 70s. She was lower than average for almost half an hour." Did she have hiccups? "I dont know. I didnt check." Please explain to me how the other nurses know this. How they have checked her and said 'Hmm... This is normal for her..." So, I asked if this was temporary and she explained that Maya isnt on oxygen, just that she has the canula in and that she has been better. (Part of me wanted to say that 99% of her day without the canula is normal! She only drops when she gets hiccups! Which she gets mostly when she lays on her back and gets air in her belly!) I think that this woman jumped the gun (or maybe got tired of the monitor) and put her on the canula. It seemed obvious that she was "concerned" that "these babies went from CPAP to nothing" because she "would have put them both on a canula for at least 2 weeks after the CPAP". Her words. I plan on asking the nurses we know about this. I know there is no harm in having her on there. And if it gives her less stress, fine. But she hates it. She cries and is pulls at the tape holding it in, which makes her cry more. She looked at me today with these eyes that said "Get this off me, Mommy" and all I could do was stroke her perfect little blonde head and tell her how much I love her.

The other thing and, yes, I know I'm sensitive, was a comment she made to my MIL. She asked if Maya and Bobby were her first grandchildren. MIL says "No, we have three older ones, but they passed away because they were very premature." And the nurse says "So these are your..." (struggling for a word: insert my thought as she is struggling "real") "first live grandchildren". It rattled my MIL and the comment stung. Our other nurses have read our file and many have asked details about Nicholas, Sophia, and Alexander. They have mentioned Bobby and Maya's brothers and sister. This nurse seemed very uncomfortable by the whole thing, even though she brought it up.

Now, since I've bitched, let me give the nicer update too. She was very competent. She moved the babies from the giraffe isolettes (the hardcore, baby-may-have-serious-issues bed) to the next level isolettes! And she was very excited to share that they moved very comfortably and were doing really well with their body temps and with the transition. She explained about the new isolettes and how they will be ready to be dressed and swaddled by next week. She also said that the hospital strongly urges the preemie onesies that snap up the front and only those. The other ones are a real pain with the leads. So, I'll go through the items we've been given and see what we have and need to get. She said that they are "happy" and "beautiful" babies (which I must say never gets old and endears the nurses who say it). She said that Maya had the most lovely golden hair she's seen on a baby. (It's nice to know I'm not the only one who admires those locks!) and that Bobby is very aware for a baby of his age, that whenever she did his care, he would wake and watch her and was very responsive. And she commented that I am an awesome cow (okay, she her words were that I have an "excellent response to milk production and pumping" but to me, I keep hearing Sarah's "Moooo-chele" on the "Moo-chine" comments and cant help but want to laugh).

Probably the best part of the visit and the talk with the nurse, though, was her suggestion that I hold the babies together! She said that since their IVs are out, she thinks that moving to the center of the pod and holding them together should be manageable now! Her suggestion was that one of us holds Maya for 30 minutes, then Bobby is added for 30 minutes, then they are moved to the other parent for 30 minutes, then Maya is put away and Bobby stays for another 30 minutes. It ups the holding from an hour to an hour and a half per baby, which she said is pushing it at this age (because you dont want them to get chilly) but that it could really benefit them to be together and for us to hold them together. She said that a lot of times, the twins reach for one another and hold hands and things. She said she would mention it to the night crew so that they can assess whether today would be a good time to try or if we should wait until Maya's canula is gone. But she seemed to be positive with this idea. She also said that it is paramount that I hold at least one of them once a day. That it will help with my pumping and that she often recommends moms hold more than dads (I think Peter might take issue with that one!)

The babies are doing well. They are eating well, growing, and going to the potty well. They are beautiful and wonderful. But my visit today left me wanting my visit tonight even more. I trusted the nurse to go home; she did seem a competent nurse. I just didnt care for her as much as some others. And that, I think, is to be expected. There are a few that have just really taken a place in our hearts and when we see them on duty in our pod, we get so excited. I cant expect to have that feeling for every single nurse. But you want it nonetheless.

We took their snugglies to them last night. The snugglie is a simply head only doll (fabric draped over a fabric circle and sewed off; it looks almost like a ghost but the fabric is well colored. Moms wear them for 3 days in their bras then they are put in the babies' isolettes or cribs so they can smell me. Peter wore the snugglies yesterday for a while too, so they can smell us both.

Well, my pumping is done for now and I am so tired, I think I'll take a brief nap... We'll be going back tonight for our holdings. I'll make sure to try and upload pictures tonight when we get home since I wont post an update tonight (unless there is something huge to post).