And In This Corner...

Weighing in at 2 pounds 14 ounces is Samuel Wyatt who has already gone below and rose back up almost 9 ounces over his birth weight of 2 pounds 5 ounces. He is still on 24 hour continuous feeds with steady increases of 1/2 mL every 12 hours. He is starting to look a lot bigger. We are hoping once he reaches 3 pounds, they may take him out of the isolette to try and let him regulate his own body temperature. This will make it a whole lot easier to hold him and interact with him. He is doing very well overall and is starting to have regular bowel movements. I got to "kangaroo care" Wyatt this evening and was hoping that he wouldn't choke on any chest hairs. Fortunately, a catastrophe was averted.

Emerson Parks is now at 5 pounds 6 ounces, 4 ounces over his birth weight. He is practicing nursing a couple of times a day. He keeps adding weight each day, which is a big step towards us taking him home. At two weeks old, he has already learned how to self-soothe. Yesterday, we watched him take the thumb on his left hand, place it in his mouth, and commence to sucking. He could not fully coordinate forming his hand into a fist so all four fingers lay draped across his face like octopus tentacles. Moments later, we saw him repeat this feat with his right hand in exactly the same manner and form.

Keeping Odd Hours

Randi and I have been settling into a routine this last week. I have gone back to work, and Randi is at home recovering from surgery. We have been trying to visit the boys twice a day in the afternoons and evenings. We are also able to call at any time for updates on how they are doing. Randi has been cheating a little and driving up to the hospital for visits between 2-6 p.m., and I usually meet her up there after work. We then go home, grab something to eat, and return for either the 8-10 p.m. or 11 p.m.-1 a.m. visitation. We prefer the 11-1 period because there is hardly anyone there, we can get more assistance from the nurses, and not have to listen to the constant "pings" of monitors as the other babies get stimulation from their parents. Although, this does not bode well for getting up early for work.

We have been able to hold both Wyatt and Parks regularly. We are able to feed, bathe, change, check vitals, and recently Randi has been able to nurse Parks during our visits as well. He has been taken off IV nourishment in hopes that he will gain weight from breast milk alone. They are steadily increasing his feeds about 5 ml per day. He is currently up to 40 ml per feeding with our goal being 60 ml in order for him to go home. We had a very encouraging day yesterday when Randi successfully nursed him for 15 minutes, and it appeared that he took in a good amount because he would not take very much from the bottle afterwards. Parks still has a little bit of jaundice, but his levels continue to drop each day. We also had echo's done on both boys' hearts. Parks results looked very good. He only showed a slight intermittent heart murmur. Most likely he will be making his departure from the ICN sometime this week.

Wyatt is, of course, on a much slower pace. He is still in the isolette regulating his body temperature. He is on continuous feeds via a nasogastric tube. They have been steadily increasing his feeds and decreasing his TPN, additional fluids and nourishment. We are still concerned about his little bowels. He has been taking the feeds well, but has not had many bowel movements. Sometimes his intestines appear to be distended. The nurses and neonatologists are keeping a close eye on what he does here. They weigh his stool, measure his belly circumference, check his stool for blood, and look for the twists and turns of his intestines to show through visibly on his belly. All of this to try and ward off any complications. Recently, on a bad day, they took an x-ray of his intestines to make sure they were no blockages. They did not appear to be so, and he was finally able to use the bathroom with stimulation. Wyatt also has had his heart checked out with an echo cardiogram. He also showed the benign, intermittent heart murmur the Parks did, but no real issues with him either. We are still projecting another 3-4 weeks that he will be in the ICN before we can take him home. All in all, he appears to be doing very well. We are a little on the paranoid side because what we've read tells us that severely growth restricted babies do well at first and then begin to have complications days to weeks after birth. The Lord has been so faithful as have you all, and we know that He is in control. He has blessed us beyond what we could have imagined. We just have to continue to give this one to God and let him handle it.

...And Even More Pictures

Wyatt wearing my wedding ring with his feeding tube in

Wyatt holding the pen like a javelin

Who does Parks look like? (see below)

Why it's Randi as a newborn

Update

Hi everyone! So sorry we haven't posted in a few days. I have lots to share, so let's see how organized I can keep this...

First of all, everyone is still doing great. Parks is eating from a bottle, and they have discontinued his TPN (IV nutrition) in hopes that he will take more by bottle. He is now back up to his birth weight. Wyatt is on continuous feed through a nasogastric tube. He is doing well and is now 2 lbs. 7.3 oz., well above his birth weight. He even looks bigger to me!

Both head ultrasounds were done late Monday evening. We received the results from the Neonatologist last night. If I understand correctly, Wyatt may have had a Grade 1 bleed in utero that is now classified as Choroid Plexus Cyst (CPC). The choroid plexus is the part of the brain that makes cerebrospinal fluid, the fluid that normally bathes and protects the brain and spinal column. In about 1 percent to 2 percent of normal babies -- 1 out of 50 to 100 -- a tiny bubble of fluid is pinched off as the choroid plexus forms. This appears as a cyst inside the choroid plexus at the time of ultrasound. A choroid plexus cyst can be likened to a blister and is not considered a brain abnormality. As I did a little research last night, it seems that most of these CPC's are diagnosed in utero. This makes me very curious because I remember the U/S technicians measuring both babies choroids' almost every time we had an U/S. Maybe I'll ask the peri next time I see him. Regardless, it sounds like it may be completely benign and not something we should be worried with. Parks passed his scans with flying colors, no abnormalities whatsoever. They will both have a repeat U/S in a month to see if there have been any changes.

I am continuing to recover from the c-section. Everyone says they are a breeze, but I think they have just forgotten, much like women seem to forget all the bad stuff that occurs during pregnancy. I had a very rough first day and am still in some pain, but I am getting around much better. I can only imagine if I had both babies home with me. I would need some serious help!

Todd and I feel like Parks could come home any day now. The NICU doesn't like to predict these things, so we feel like they'll probably let us know he's coming home a few hours before he actually does. We are working hard at home to get everything ready for him. It's going to be tough having one at home and one in the NICU. I hate that they have to be apart for so long, but I cannot wait to get him home.

It's almost time to feed Parks, so I better run. Thanks to everyone for your faithfulness and prayers.

More Pictures

Randi and I with the boys for our first family shotWyatt "kangaroo-ing" it on mommy

Wyatt alert and curious

Parks and Wyatt holding hands

Parks held by me

The Duece, The Scare and Rolling Over

THE DEUCE: Randi spent her first night at home last night. It's good to get back to our routine, even if it is abbreviated. The boys will be home soon enough, and we will have to learn a new routine. Luckily, we will get a practice round with Parks coming home first before we get the full brunt of two newborns at once. Wyatt and Parks moved to the Level II ICN this morning. It sounds like Wyatt only has one more day under the bili lights. Parks's levels are still increasing, although he still does not need the same treatment. Wyatt is now on continuous feeds at a higher rate than Parks. This is great, but we are concerned again that they are trying to push him too much. We are going to set up a meeting with a neonatologist on Monday in order for them to give us a good reason to increase his feeds so much. We are risking so many things going wrong with his bowels that were starved of blood flow for so long in utero. Parks is still resisting increased food. We are hoping that he will pull out of this slump so that we can get him coordinating his suck-swallow-breathe reflex and take him home. This seems to be the only real hurdle he needs to overcome.

THE SCARE: I had my first experience performing kangaroo care late last night with Wyatt. I made sure to wear a button up shirt so that I could tuck him in well against my bare skin. I was really hoping he wasn't going to find out about the nipple while I was holding him. Anyways, I was holding him for over an hour with no one around singing some Johnny Cash to him. I was sitting in a position to where I could watch all his monitors while rocking him. All of a sudden his heart rate and breathing go completely ____________________________________flat. I started to see if I had unhooked one of his cords with my foot, but I could see no problem. I held him back away from my chest, and he was completely still. Not a muscle moved. I got panicked. I looked over to Randi, who was holding Parks and was in no position to jump up from her seat three days after surgery. I yelled for a nurse to come over and found that the lead monitor on his chest had come loose and lost signal. I'm sure that this is not the last time for a scare, but, crap, the first must be the worst.

ROLLING OVER: I arrived at the ICN today to speak with the nurse who had charge over our boys for the first day in Level II. As we mentioned before, Wyatt hates, I mean hates, to be on his stomach. The nurse told us today that she was trying to turn him over on his belly, and he was going to have none of it. He managed to flail himself about to, first, prop himself up on his side, and then, roll himself completely over onto his back. Of course, promptly after these gymnastics he fell into a deep, content sleep.

Answers To Questions

I wanted to answer a few questions that have been raised over the last couple days that I might have failed to address earlier and give an update on the day's event.

Wyatt was 15 1/4 inches long, and Parks was 17 inches long at birth. Almost two inches makes a lot of difference. They have both started to lose a little weight, which is to be expected. Wyatt has lost less than an ounce, and Parks has lost 3 ounces. They have started taking to the feeds, and Randi is doing a lot better with the pumping. Every drop of that stuff is "liquid gold." I've been trying to help her out as much as I can, and I will NEVER look at those things the same way. We have seen a couple lactation consultants that have been very helpful, and I have to say that they were not shy to give demonstrations. It was quite odd to see a woman my mother's age massaging her breast in front of me, and I not think twice about it. I was too focused on the technique and form she used to get "weirded out" about it. As Randi will probably reaffirm, you gain a lot of humility and lose a lot of unabashed modesty throughout the course of this whole process.

Wyatt and Parks are doing very well also. They are still located in the Intensive Care Nursery (ICN) Level III, although they have been stepped down in the hospital's system to the Level II ICN. This is great news. We have found a couple great RN's and NP's that we really like taking care of our boys. Wyatt is still under the bili lights in the isolette and hates to get turned over on his belly. Every time they try to put him in this position, he looks like he is trying to swim out of his fish bowl. We figure that this is his first chance to stretch out, and he is taking advantage of every second of it. Parks's bilirubin levels are also becoming elevated. So, it is most likely that he will be under the bili lights soon. They are also trying to find an appropriate level on the feeds. Wyatt is going slow, and they are not trying to push him too much. I believe they are being a little more cavalier with Parks because of his size. He has resisted a few feeds, but they are working to find a happy medium to put more weight on them both.

The perinatologist made his first visit this morning. I believe that he was very excited to see the boys and check their progress. He is still amazed at how well the whole situation turned out. He told us flat out today that if Randi had not of been able to put up with what she did, he would have delivered weeks ago and put it in the hands of the ICN. We are going to try and do something for his office and bring the boys around when we are able. They also had to put up with a lot for us.

Updated Video of Wyatt and Parks

I am sorry for the technical difficulties any of you might have experienced with the video I recently posted. It was an error on my part. Hope this works out better.

Emerson Parks

Samuel Wyatt

Today In The ICN

Wyatt's little hand

Wyatt's little feet

Parks's accommodations- a crib

Parks next to a pen for reference

Wyatt next to a pen for reference

Wyatt's accommodations- an isolette under bili lights

eMotion Pictures (Nice Double Entendre)

I am posting videos above of the boys shortly after birth.

Randi and the boys are doing well. Randi is up and around, and she is feeling exponentially better today over yesterday. She is eating solids and trying to get some nourishment to the babies. More on that later. I want to stress again our gratitude to everyone out there for the phone calls, emails, and comments on this blog. Also, I wanted to let you all know that I am printing off copies of the posts I am writing while she is admitted and their comments for her to read in the hospital, since we still have no internet and spotty cell phone reception. She enjoys the encouragement.

They started feeding both babies last night, and so far, they have taken the food well via feeding tube. We are trying to give them as much natural food as possible but are having intermittent results. She is trying her best not to get discouraged here at the beginning but push on through. They have moved Parks out of the warming drawer and into a regular crib because he is regulating his body temperature so well. He is taking the feeds and is looking great. Wyatt is still in the isolette only because of his weight and lack of body fat stores. Both boys are most likely getting put under the bili lights for neonatal jaundice. This is common in premature babies and usually lasts at the most 14 days. It is presumably a consequence of metabolic and physiological adjustments after birth.

We are getting to see them both several times a day and hold them twice a day. Randi held Wyatt for the first time last night. She has to hold him skin to skin to her chest, in what's called "kangaroo care," since he loses body heat so fast. We are also hoping that it will help him want the breast and aid Randi in pumping. Randi most likely going to be discharged tomorrow. I'm sure she will be happy to go home and get rested better in preparation for the boys coming home, although it has been nice to just walk down the hall to see them. We are so thankful for the outcomes thus far. For as many REAL concerns as we had, it only shows that God it good.

Pins And Needles

Emerson Parks

Samuel Wyatt

I'm sure that this is the feeling everyone is experiencing now. Sorry for the delay. We are not able to get Internet access at the hospital we are in now. No Internet access is like a restaurant being "cash only" now days. Who does that? So, I ran home to gather supplies and try to get more pictures out there. Mister Toad ain't got nothing on this wild ride. So, finally an update for everyone.

Randi and the babies pulled through the C-section great. Wyatt came out first, and we were able to hold him for about 10 minutes while they cleaned-up Parks. Then, we got to hold him as well until they whisked them both off to the NICU. The perinatologist was amazed at how big Wyatt (and Parks) was. He remarked that the umbilical cord for Wyatt was not as bad as he predicted.

Late last night, the grandparents and I were able to visit both babies in the Level III NICU, sans Randi, who had to wait until she was up and around to see them. Both babies, as you can see, are on room air. NO VENTS for either of them, thank you kindly steroids. Parks had a little bit of a groan from left over fluid in the lungs, and Wyatt had low, 53, blood sugars from lack of glycogen stores in his body. Both as predicted, and both conditions corrected themselves through the night, with Wyatt's blood sugars being 93 at last count. Randi was able to visit them today for the first time. She was also able to get pumping today since they are going to start trying to feed them tonight, extremely slowly. I am talking about 1 cc every 6 hours for Wyatt and 3 cc every 4 hours for Parks. They are also suggesting that they may have them stepped down to the Level II NICU observation. We may be able to take Parks home in 4-5 days, but it will be 4-6 weeks for Wyatt. He will need to be at least 4 pounds before they discharge him. He is going to stay there as a feeder and grower. They are going to perform an ultrasound on the head to check for any brain bleeds. We are praying that both boys will be free and clear. We thank you all for your continued prayers and support. We feel that we've got one set of prayer requests marked off our list and a whole new one opened up. I will try to come home once a day for an update to the blog and new pictures.

Hot Off The Presses

Jennifer gave you the skinny. I got the visuals. We get to visit them for the first time around 8 p.m. We will give a lengthy update after that. Enjoy.

The Boys Have Arrived

Jennifer here, reporting for Randi & Todd:

Praise God!
Samuel Wyatt was born at 4:55PM weighing 2lb 5.8 oz.
Emerson Parks arrived at 4:57PM weighing 5lb 2oz.
Randi is doing great!

There will be a lengthier post once the dust settles, hopefully to include pictures.

To God be the Glory!

Fever Pitched

It's 1:30 a.m., and we just finished a biophysical profile via ultrasound with the perinatologist. Poor guy never gets any sleep, and he still has a surgery tonight. Both boys passed the biophysical proile. Wyatt still has absent end flow but no consistent signs of reversal. He also has very little deep pockets of amniotic fluid, as the doctor said, "he's saran wrapped to the side of the uterus." They are both breathing regularly and moving well.

To the events of the day. We found out that the C-section is not scheduled until 4 p.m. tomorrow due to either the OB or the OR, anyways it's one of the O's. Randi was not very happy after seeing the bad heart rate tracings and remembering that Wyatt has been in reverse end diastolic flow for over a week. She was ready to evict these babies today. We were very close to transferring hospitals today and taking our chances there. At least that way, if the situation becomes emergent, we would all be at the right location. The only flaw in that plan is that the nurses at the other hospital would cut our perinatologist out of the loop if something went wrong, and we didn't want that.

So, at 8 am in the morning Randi and I are transferring hospitals. The perinatologist is going with us to expedite the situation. Hopefully, we will have time for a consult with the neonatologist that will be taking care of the boys when they finally do come. From what I understand, the OR will be a packed house of controlled chaos with standing room only.

Whooa Nelly

Looks like the plan is to throw a birthday party for Wyatt and Parks tomorrow either at 7:30 am or at noon. The OB is trying to get the OR scheduled. In the meantime, Randi and the nurse have decided that it would be better if Wyatt stayed on the monitors continuously. We have continued to see some intermittent decelerations in his heart rate. If we continue to see these bad tracings, we might be delivering tonight in an emergency situation. Let's pray that that will not be necessary. If we deliver here, the babies will have to shipped off to the big hospital with the Level III NICU. I would also need to follow the babies to the NICU to make sure everything goes as planned there. This would leave Randi at our current hospital without her babies or husband and 3-4 days until she was well enough from the C-section to be discharged.

By The Numbers

The delivery is imminant, and I was trying to look back at everything that have happened over the last 30 some odd weeks. Randi is 33 weeks, 2 days gestation today. It is 3:52 in the a.m., and you are watching Perspectives. (Sorry, really bad, old SNL sketch) Anyways, here it is, by the numbers. It has been:

30 weeks since we found out that Randi was pregnant
27 weeks since we found out we were having twins
26 weeks since Randi had a hematoma that sent us to the perinatologist
21 weeks since the first trimester ended
19 weeks since we first found out that we were having twin boys
15 weeks since we first saw increased resistance in both umbilical cords
12 weeks since Wyatt started measuring behind on his growth scans
9 weeks since Wyatt started having absent end diastolic flow
7 weeks since Randi was put on bed rest until delivery
6 weeks since we made the first trip to L & D for Randi's cramping
5 weeks since the second trimester ended
4 weeks since Wyatt exhibited reverse end diastolic flow
4 weeks since Randi received IV fluids to reverse the reverse flow
3 weeks since we announced the boys names
3 weeks since Randi got her first set of steroid shots to help the boys lungs
2 weeks since we found tricuspid valve regurgitation in Wyatt
1 week since IV fluids stopped helping the reverse flow
1 week since Randi was admitted full time to the hopsital
1 week since the second round of steroids the help lung development
3 days since Randi had pulmonary edema
2 days since Wyatt started having late decelerations in heart rate

and

1 day until delivery of Samuel Wyatt and Emerson Parks

I'm gonna be a baby-daddy

Sooner Rather Than Later?

I thought I would post a quick update this morning. I have had Wyatt on the fetal heart rate monitors for almost three hours this morning and he is having some pretty serious heart decelerations during my contractions. The nurse has seen it and paged my peri who should be in to see me shortly. She has suggested that she thinks he will probably send me to the big hospital for delivery today. I am at the end of my rope and this is near unbearable for me to watch. So, I am hoping he is thinking the same thing she is thinking, if not I will have to kindly explain to him what he's doing to me emotionally. The good news is my bloodwork looks great, so it at least appears I am well enough to deliver if I have to. More updates to follow...

Setting A Date!

I am feeling even better today. My lab values are on their way down and are hovering just a little above normal. We will redo them in the morning and hopefully everything will be normal with no signs of infection. For the most part, I have been able to maintain my oxygen saturation levels on my own.

Wyatt had a few small decelerations on the heart rate monitors last night and then one or two today. Todd and I were both extremely nervous, but everyone has assured us that the remainder of his tracings look great, so there's nothing to worry about. Please keep him in your prayers.

The peri came to visit and said he wants to give me at least another day or two to get well and then we'll throw a birthday party. He is calling my OB tomorrow to see what her surgery schedule looks like for the rest of the week. I cannot believe this time is upon us. I am scared, but extremely excited to meet our two boys!

I Should Have Thought Of This Earlier

All the exciting moments in the hospital are bookended by long stretches of waiting and boredom. For some reason, I started thinking about our in uetero names of Pooh and Tigger. They are really lovable characters, but I wondered what other names we could have come up with.
Of course, we could have named them after other classics, like Donald and Mickey, Tom and Jerry, Chip and Dale, Fred and Barney, and countless others. Being a true male reared in the 80's, I thought about the toys I played with and the cartoons I watched as a child growing up, and then it popped into my head. Now, I know that this reference will not ring true to most of the women out there, and I'm sure that this would have never gotten past the veto power of the executive branch, Randi. If I would have thought of this earlier, I would have named them Tomax and Xamot, the Crimson Guard Commanders that worked for COBRA in the G.I. Joe universe. They were mirror images of each other and felt one another's pain. The only way to tell them apart was by a scar on Xamot's right cheek. Now you know and knowing is half the battle. See, I told you I was really bored. Thank you Wikipedia.

33 Weeks Today!!

We have lots to be thankful for today...we have made it to 33 weeks, the babies are holding steady on the scans, and I am on the mend. The peri just left and he feels I most likely have a kidney infection, which is what appears to have caused the fever last night. I could have probably handled the fluids, but when you put the kidney infection on top of a twin pregnancy, steroids in the last few days, IV fluids, and Albumin, my body just couldn't handle it. He wants to give me two or three days to get better before we deliver. He said if I were to deliver today, I might end up feeling like I did yesterday. I don't think I can handle another day like that. So, as long as the babies continue to look good on the monitors and scans, then he said we will deliver middle to end of the week.

You all are wonderful! I hear more and more stories everyday of people that read this blog and are praying for us. I know that's how we've made it this far.

A New Day

The sun is out, the birds are chirping. Things are looking a lot better in L&D Room 3. The tightness in Randi's chest is gone and her fever has broken. Both babies are looking good on the heart rate monitors. No more late deceleration variables in Wyatt, and they both have been active this morning. Both babies were also running elevated heart rates last night because of Randi's fever. That also has subsided. In order to make sure that her heart was in good working order, Randi pushed to get an echo done this morning. The echo came back well within the normal range, but a cardiologist will take a look at it to be sure. There is some leaking in her valves, but that could well be from the large expanse of blood in her body from the twin pregnancy.

Randi is still on forced oxygen because her O2 saturation levels in her blood keep dipping down below 92%. She is also continuing antibiotics to K.O. any bacterial infection that may be present. We are planning to see the perinatologist some time today, but he is making rounds at three hospitals, so it may be late this afternoon. When he does get here, he will perform an ultrasound on the babies to check their umbilical cord blood flow. Hopefully, we'll get a game plan for delivery, especially since it doesn't appear Randi can tolerate the fluids.

Update: Todd drafted the above post, but I wanted to let everyone know I am feeling a hundred times better than yesterday. Other than a little shortness of breath and still being on the oxygen I am almost back to normal. Thanks so much for all of your prayers. I have never felt as bad in my life as I did yesterday and I was very scared. It was very comforting for me to know that you all were out there praying.

...And Its Not Over Yet

I'm not sure if you read JenMom's comments on our last post, but here is an update since the perinatolgist came in after his clinic hours. It's late, and we are trying to switch rooms. We have been in Triage all day and are trying to get a room I can sleep in and stay with Randi.

The Doctor was definitely concerned with the deterioration of Randi's well-being since last night at his office. He ordered an additional 20 mg Lasix to keep pushing fluids out of Randi and get rid of the pulmonary edema. He also ordered Albuterol that is a bronchial dilator to assist with the wheezing. Furthermore, Randi started to exhibit a fever of 102. He next ordered a chest x-ray to make sure that she did not have bronchitis or pneumonia. Those x-rays did come back negative, but there was something bacterial that showed up in her urine as well as in her bloodwork. She is now on two broad-spectrum antibiotics. She has been stuck a lot today. They keep ordering a blood test called a BNP that assesses the condition of her heart. We have one more round of antibiotics tonight, and then we get to do reassess everything tomorrow. Luckily, our perinatologist is the doctor that is on call all weekend. I'm sure we will have more information soon. Thanks again for the prayers, gifts and help with everything.

Bad Day

I took Randi back into the hospital today to be admitted for the duration. Last night things got pretty emotional around our house, and Randi started to have shortness of breathe and constant, strong contractions. The contractions continued through the night and into the morning. We arrived at Labor and Delivery early, got a room and did not wait for the nurses to set us up on the fetal heart rate monitors. We did it ourselves. The babies looked stable on the heart rate monitors. They blew two liters of IV fluids into her in 3 hours to hyper hydrate her and aid in stopping the contractions.

Not long after that Randi had another contraction. What was different about this one was that on the down side of the contraction, Wyatt's heart rate dropped from its normal 120-160 bpm to 79 bpm. It stayed down for a while before coming back up. This could be a normal variable that could come at any time, but it could be a late deceleration which can be extremely dangerous. Whatever it was, it got the nurse down to the room quick. Randi and her watched to make sure that it was not a repetitive pattern after contractions. Per doctors orders Randi is now on contiuous monitoring and we have not seen another dip like that.

The tightness in Randi's chest continued to persist, and her oxygen saturation levels began to dip below 90%. This can lead to pulmonary edema, or fluid in the lungs. They hooked her up to an oxygen cannula to help resolve the problem and all but discontinued IV fluids. The forced oxygen had some positive affect but was not working fast enough. Finally, the nurse checked her lungs and she was having pulmonary edema in her upper right lung. They took it a step further by injecting Lasix to help her get rid of some of the fluid buildup. Basically, undoing the effects of the IV fluids. We are waiting for the doctor to come in this evening after his clinic hours for further direction. I am not very concerned if they come now or seven days from now, as long as we can get everyone home safely.

The Scoop

This afternoon I carted Randi, via wheelchair, to the perinatologist's office for our regularly schedule scans. We were moved from the 2 p.m. slot to the 3:15 slot to make sure that she was the last patient that he saw this afternoon.

During the ultrasound, the doctor came in to witness them for himself, a first. The fluids and Albumin were not able to reverse the reverse flow of blood at the umbilical cord insertion. This obviously had us at a loss. Parks is completely encroaching upon Wyatt, and we feared that we would not get an accurate measurement again. Remember that we are 32 weeks, 5 days today. Parks head measured 35 weeks, and his belly measured 33 weeks. He is weighing 4 pounds, 13 ounces. All the blood flow issues are looking great for him. Wyatt is, of course, a different story. His head is measuring 29 weeks, and his belly is measuring 27 weeks. He is FINALLY weighing in over 2 pounds, an answer to prayer. He is a full 2 pounds, 4 ounces. Of course the sonographer was sure to let us know that the measurement may not have been exactly accurate due to his position. This is what we thought two weeks ago when he only weighed 1 lb 11 oz. We are hoping he really weighed more then, and the measurement today was at least closer to accurate.

The consult after the scans was the heaviest since we had the "no babies delivered before 28 weeks" discussion at 24 weeks that left Randi in tears as we left his office. The doctor gave us the option of delivering tomorrow, but he truly believed that we could make it the extra week with Wyatt still in reverse end diastolic flow. He wanted Randi to come in every couple days for non-stress tests (NST's), hydration, and ultrasound scans. Randi and I did not feel comfortable with this. We, at least, wanted her to get monitored every day. Randi decided to bite the bullet and take it one step further. She is at home tonight to get her metaphorical house in order, and she will return to Labor and Delivery tomorrow for the duration of the pregnancy. She will have fetal heart rate monitoring at least three to four times per day and fluids and Albumin treatments as long as the blood work continues to look good and her body can handle the additional fluids. If we make it all week, it sounds like we will deliver next Saturday, exactly 34 weeks, but if at any time the babies look distressed or fail a biophysical profile, we will be transferred to the NICU hospital for delivery.

What is the point in waiting, and who does it benefit? Parks will reap the greatest benefit from the prolonged stay at the In Utero Motel. At 34 weeks gestation, he has almost a 100% chance of arriving unscathed from the pregnancy. The main thing is his lungs will be more developed and he will have virtually no chance of respiratory distress. The additional week will allow both boys time to develop their suck/swallow reflex coordination to aid in feeding once they arrive.

So, this will be our reality until we create a new one with the birth of our two sons. Randi said it before, but I will say it again...thank you so very much for all that you have done for us, no matter how small you believe your part has been, it really means a lot to us both.

Accommodations

Great comment, Ted. I feel the need to elaborate. Although the rooms at the hospital we have been in and out of over the last month have been enormous compared to the rooms at the hospital with the NICU where we will be delivering, I firmly believe that there are no good hospital beds anywhere. I would much rather be on my ThermaRest and mummy bag, than on a cot or fold-away. The rooms at our "delivery" hospital are, no lie, about the size of the bathrooms at our current facilities. At least at out current place, I had a sleeper-sofa. At the next place, there might not be a cot in the room if I do not request one by the time they run out. I have heard horror stories from other dads.

I do not feel any better for Randi. She has been staying in true Labor and Delivery rooms. This means that all the beds break-away for delivery in-room with stirrups and large red trash bags underneath to catch God knows what. She sounded like she would gladly switch with me. Anyways, I thought I would lighten the mood before we came back with any serious updates later tonight. I know you're all pregnant with anticipation. (pun intended-EAYC)

Thank You, Thank You, Thank You

...for all of the prayers, encouragement, and support. I continue to be overwhelmed and humbled by how many people we have praying for us. I honestly believe Wyatt would not have held out this long without all of your prayers. This has definitely tested my faith like nothing I have experienced in life, but how can I not have faith more than ever when I see how the body of Christ has come together to support us.

"...But God has combined the members of the body and has given greater honor to the parts that lacked it, so that there should be no division in the body, but that its parts should have equal concern for each other. If one part suffers, every part suffers with it; if one part is honored, every part rejoices with it." I Cor. 12:24-26 NIV

As for the hospital stay - last night and today in the hospital have been relatively boring. There were a couple of small misunderstandings regarding doses and when to dose, etc. For all of you that have been in the hospital before, I am sure you can relate. Luckily for me the wonderful nurse from yesterday was here again today. Considering this is a labor & delivery floor they don't seem to understand my persistence and lack of patience regarding treatment for my unborn children. I guess they have more to worry with than just me. The only peak into the babies world I have gotten today is through the fetal heart rate monitoring. They both look beautiful. We will have scans at 2:30 pm tomorrow to see if all this Albumin has propped Wyatt's blood flow up for a little longer. Because of the fluids, steroids, and the Albumin, not to mention the twin pregnancy, I am at an increased risk for Pulmonary Adema (fluid in my lungs) so my paranoid self has requested that Todd spend the night with me tonight. Of course, he agreed willingly. So, we'll see how much sleep he gets between nurse visits every two hours or so.

I almost forgot...we get growth scans in addition to the doppler scans tomorrow afternoon. Please pray again that Wyatt is now two pounds. It is so upsetting to me when we do these and he hasn't grown.

Spooky Intuition or the Holy Spirit

We are still at the hospital tonight, and Randi will be spending the night here. This is it. This is the day that Randi said would come in her last post. The fluids did nothing for the reverse end diastolic blood flow from yesterday. There is one particular spot on the umbilical cord that has been giving us problems. It's near where it inserts into Wyatt's belly. The sweet nurse commented after the scan and the doctor left, that getting him up here was the indeed right thing to do. She was very persistent throughout the day to insure that he would be up to L&D to do scans on Randi.

They have taken Randi off the Lovenox and baby aspirin, both blood thinners that were being used to increase total blood flow to the placentas. They have taken blood for a CBC, metabolic profile, and several clotting tests. She is back on additional IV fluids and fetal heart rate monitoring every six hours. She received her first dose of the second round of two steroid shots to encourage fetal lung development. We are actually getting these a couple days early, but the doctor thinks they are necessary since delivery may be imminent. If all the bloodwork comes back good, then the plan is to give her plasma albumin, which is a intravascular protein. Theoretically, it should work to correct the reverse blood flow much the way the IV fluids have. This is our last ditch effort to get rid of the reverse end flow before we run out of options. At the very least, the peri will try to put off delivery for 48 hours so the babies can get the full benefit of the steroids. At best, the albumin will buy us a little more time before delivery.

I am asking all out there to PLEASE PRAY that the Lord will keep the boys safe until they make their entrance in this world. We are indeed so thankful that we have been given the last 8 weeks under these conditions. This pregnancy has been so unbelievably different than Randi and I could have imagined. So much joy, but so much pain as well.

Emotions Are Flying

I had a rough night last night and it seems to have continued into today. I’m not sure exactly why. Well, I know why, but I’m not certain why yesterday and today as opposed to any other day on this emotional roller coaster we have been on for nearly 10 weeks. I couldn’t seem to keep control of my emotions last night and just had a breakdown. Todd thought it was something he said because a conversation we were having is what triggered it, but in reality it has absolutely nothing to do with him. I have been overcome with fear, and while I am so thankful we have made it this far, I am afraid that we are pushing Wyatt too far and am fearful we may suddenly lose him. The doctor has assured me that “generally” there will be plenty of signs before a fetal demise and as soon as we see any one of these signs we will bail on this pregnancy. While I completely trust the doctor, there are no guarantees and there is still a risk that we could lose him before we deliver. The further we get in gestation the more fearful I get and the harder it is for me to go even a day without ultrasound scans or some kind of medical intervention. I had IV fluids on Saturday, things looked good and then by Monday afternoon the blood flow was consistently reversed. I’m at the hospital as I type this, receiving fluids again, but the doctor said he would only scan if I felt like I needed or wanted him to. Otherwise I won’t see him again until Thursday afternoon. As Todd mentioned in his post yesterday, it has become evident that our interventions are no longer providing a benefit for as long as they did previously. With that being the case, I just don’t feel comfortable going without scans from Monday to Thursday, with or without fluids. I feel there will come a day when the fluids don’t correct the reverse blood flow and what if that day is today. I don’t know if we have stressed how serious the reverse flow is, but all the literature out there suggests that morbidity and mortality rates are extremely high and this is the time you must deliver. Had the IV fluids not corrected the reverse flow (albeit temporarily) all this time, we would have delivered weeks ago.

So anyway, I came in to the hospital this morning and one of the many wonderful nurses here was asking me questions about the babies, the pregnancy, how I was doing, etc. and I just lost it. She decided at that point that it was best if we have the doctor come up to do scans. So, now it’s almost 5:30 pm and I am still waiting for the doctor. But really what else do I have to do? This is my job now.

“So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.” Isaiah 41:10 NIV

The Law of Diminishing Returns

The American Heritage dictionary states that the Law of Diminishing Returns is "the tendency for a continuing application of effort or skill toward a particular project or goal to decline in effectiveness after a certain level of result has been achieved."

Our application of effort is the injection of IV fluids into Randi. Our particular goal is to undo the reverse end diastolic flow in Wyatt and keep Randi "preggers." Our level of effectiveness on this curve is drawing close to zero. At our perinatologist appointment this afternoon, Wyatt has slipped back into reverse flow on the Doppler's after Randi received fluids on Saturday. It appears the treatments are having discounted efficacy in keeping the blood flow out of this dangerous condition. He looks so displaced on the ultrasound images. Parks looks like he's taking up 2/3's of Randi's uterus. On the plus side, he continues to have good reactive tracings on the heart rate monitors. These are important because they give us an extended window into their world, usually 1-3 hours, whereas the ultrasound Doppler's are more like a snapshot at any one point in time.

Randi will return, yet again, to Labor and Delivery tomorrow for more IV fluids and possibly scans. Thirty-two weeks and two days; everyday continues to count.

Week 32 Ultrasounds

Here are some pictures from Friday's appointment at the perinatologist. We were able to finally get a couple good shots of Wyatt, who turned back chest up instead of facing Randi's spine. You can really see Parks cheeks getting some baby fat on them now. We'll be seeing the real thing soon.

If you've been reading, you know that Randi was in the hospital yesterday for additional fluids and scans after a sub par evaluation on Friday. When that doctor scans, he typically takes samples in three different places in the umbilical cord. He told us on Friday that there is one spot in the cord, near Wyatt's head, where we keep seeing the reverse end diastolic flow. On his first two samples on Saturday afternoon, he found no reverse blood flow and a return to consistent absent end diastolic flow. In the one spot where we saw continuous reverse flow on Friday, there was very good (for Wyatt) diastolic blood flow that looked more like Parks'. Wyatt's S/D ratio, systolic to diastolic ratio, on that sample was seven. With absent and reverse blood flow, there is no S/D ratio because dividing by zero is zero, but even when we have some diastolic flow the ratios were in the 30's and 40's, and we may have even seen one in the 90's once. The lower the number the better, for example, Parks ratio was four. It was the first time we had seen a very good sample since the first of April and even before that. When the doctor saw it, he was speechless, he really didn't know what to think of it. We are certain it was/is nothing short of a miracle. Our prayer is still 34 weeks. At that point, we will setup a date for the C-section. Randi returns tomorrow to the perinatologist for doppler scans and we will do growth scans again on Thursday. I assume she'll be in the hospital either Tuesday or Wednesday for more fluids. We are still praying that Wyatt has made it to 2 lbs.

32 Weeks Today!!!

I had every intention of posting yesterday, but some of my aunt's sweet friends decided to throw me a small impromptu baby shower and I didn't get home until late. Our peri appointment was quite disappointing. After receiving fluids just 24 hours prior, there were places in Wyatt's cord where it was already complete reverse end diastolic flow (that's the really bad stuff). We had not seen it that bad since the first time I went in for fluids, almost a month ago. So, as I type this I am back in the hospital receiving more fluids and the doctor is coming up on his day off to do more dopplers and see if the fluids are still temporarily correcting the blood flow. Even though yesterday's news was a bummer, we did decide that Todd should go ahead to JazzFest, as there's not anything he can do here and we felt confident I wouldn't deliver before this evening when he returns. My good friend, who just happens to be pregnant with triplets, is sitting here beside me to keep me company. It's like the blind leading the blind.

The peri was pretty downtrodden yesterday, especially compared to how optimistic we all were feeling on Tuesday. Todd and I were both very disappointed as we were starting to really believe we could make it to 34 weeks. We know the God is completely in control and He knows at what point these babies are safer outside than inside, and if it's before 34 weeks then that's fine. In the meantime, we are still praying for at least another week if not two.

More to come this afternoon...

One Down, One To Go

We went to the OB this morning for our 32 week appointment. The OB really didn't think that we would still be pregnant when we scheduled this appointment, so we showed her. Everything there was pretty cut and dry. Even though she will be the one delivering the boys, we really feel like we have more of a relationship with the perinatologist. They are also at different hospitals across town, so there is a little bit of tension that preexists anyways. Randi's belly is measuring 36 weeks in size, but neither of us feels that she looks like shes about to "pop."

We have another appointment with the perinatologist this afternoon. I thought I would go ahead and post now, in between doctor's visits, because I am going to be scrambling to get out of town if everything looks good with Randi. I'll leave this afternoon, meet up my friends that are already down there for a 3 a.m. show tonight, go to the fairgrounds on Saturday all day, and come home later that evening. It's not the extended weekend I am used to, but I am completely thankful that I am getting to go at all.

Finally, I Have A Visual

With all this talk about about reverse end diastolic, absent end diastolic, increased resistance, etc., etc., etc., we have been struggling to find a good graphic representation of what we are experiencing. The diagram below shows what a normal blood flow waveform should look like with the systolic going up and the diastolic going down. It is primarily used to determine the velocity at which the blood is flowing and with what pressure it is being exerted. We noticed as early as 17 weeks that neither baby had normal waveforms. Parks currently has blood flow with increased resistance, or reduced end diastolic flow. Since, he is growing well and is active, we find this condition to not be too concerning. We have seen virtually no diastolic flow on Wyatt since approximately 24 weeks. His Doppler images mainly look like the lower left-hand picture, absent end diastolic, with some episodes of the extremely serious reverse end diastolic flow. In this case, the blood has met all the resistance in pressure it can take and has actually reversed its path. This is the reason we are administering IV fluids, and as long as they alleviate this condition, Randi will remain pregnant.

Furthermore, we returned to the perinatologist this afternoon for more of the usual. Everything is looking par for the course with Wyatt. He is holding steady with absent end diastolic flow in the umbilical artery and is showing decreased resistance in his mid-cerebral artery and ductus venosus, in his belly. Parks looks good again, giving us little cause for concern. Randi returns to Labor and Delivery on Thursday, and we are considering putting in a PIC line to give her hands a break from the constant IV's. After that, it's back to the perinatologist for a regular exam on Friday afternoon. If everything looks good, I am going to sneak away to New Orleans for Friday evening and Saturday to go to the Jazz and Heritage Festival. This will be my 11th year in a row. This has been a silent, selfish prayer of mine for awhile. Hopefully, everything will work out. Don't worry about Randi; she has a very good friend coming to spend the night with her.