Mommy's Home!

Indeed, she is...but first to the boys.

Charles has begun to receive small amounts of milk every 3 hours. He is still receiving 2 liters of Oxygen, but no support to help him breathe. He's doing it all on his own. Gina has helped change his diaper and feed him through a bolus syringe. He's starting off with 1cc of milk and they'll see if he's able to tolerate it. If so, then he'll go up to 2cc every 3 hours and, probably, increase the amount depending on how he handles it.

Ambrose has been weaned from his blood pressure meds. He is still receiving Lipids, TPN, and two antibiotics. He also can receive morphine if he appears to be in pain. His O2 has been lowered to around 35% and the Nitric is down to 3.5 or so. The doctor today lowered Ambrose's pressure on the oscillator, but his O2 Sats started to drop into the 70s. The pressure was then returned to its previous number and the doctor said they will try again the next day. Overall, he is pretty much the same. He's still a sick little boy that needs lots of prayers. They may remove the chest tube Friday and they have a few x-rays still to do. I think they mentioned chest, head, and stomach. There is still a long road in front of him and we have to be really patient. It's hard to go from Charles to Ambrose, because we've seen so much growth already from Charles and we're still waiting for some glimmers from Ambrose. It's all a matter of time.

Gina was discharged today around 5pm. It was quite a shock for her to be back in the real world. She said all the colors were so vibrant and everything seemed so hectic to her. Her transition to home life will be slow, because she needs lots of rest still to recover from the cesarean. She's also dealing with her hormones diving, her milk coming in, constantly pumping and bottling, two eager kids at home that want to hold her and have her attention, leaving a hospital that she's stayed at for the last four weeks, and, most obviously, knowing that her two sweet babies are still in the NICU and she can't walk down the hall and see them whenever she wants.

She really appreciates all the emails, letters, calls, and visits she's received over the last four weeks. I want to encourage you to continue to support and pray for her. She's an incredible wife, mother, and friend. I'm so proud of her and all that she's done in taking care of the twins throughout this difficult pregnancy. I know how fortunate I am to have her in my life and I'm sure many of you are, too. So please keep praying for our little family and we'll keep all of you in our prayers as well. If you want to see the babies, let us know and we can tell you when we'll be at the hospital. It requires a parent to take a visitor into the NICU.

God bless you.
Ryan

FIrst Videos in the NICU

Since Ambrose is on an oscillator he has quite a jiggle to his tummy. We took this video yesterday. Hopefully, you're able to see the jiggle.

Charles really likes to stretch and move around. Here he is before he pulled a tube out of his mouth.

A Day of Peace

We anointed the twins Monday with Lourdes water and Padre Pio oil and they have shown some improvement, but it's still a little early in the game. We still anticipate a long road ahead of us with small victories and defeats along the way.

Ambrose had a really rough first day, as Ryan mentioned in the previous post, but has shown significant improvement. He's been weaned from the Debutamine entirely and they are decreasing his other meds very slowly. His appearance has definitely improved: his color is much better now that his oxygen and blood pressure have stabilized and he has been producing urine, so he's not as puffy.

As Ryan said, they are receiving nourishment intravenously. When they are ready they can start on the colostrum and breast milk that's waiting for them in the fridge. Charlie's little belly will probably be ready in the next couple of days.

They both have the bili lights on them to help prevent jaundice. So they look like they're in little tanning beds with their cute little foam sunglasses on, soaking up some rays. Charlie is still covered with lanugo (fine white hair that is usually shed before birth), which shows up nice and shiny in the blue light.

The nurses try not to disturb the little boys while they sleep, so they change their diapers, linens, reposition their bodies, and do whatever else is needed, while the boys are able to rest at long intervals in between rounds. This afternoon we were able to see the nurse do rounds with Ambrose. It was a wonderful glimpse at this little one. With the bili lights off and his mask removed, he became alert and active with his eyes opening and looking around. The only unfortunate part was that we forgot to bring the camera! Charlie is much more active, of course, flailing his long skinny arms around, kicking his legs, tugging at his nasal cannula and so forth. In fact, today he yanked a tube out of his mouth and had to have it taped down!

The NICU staff has been wonderfully informative and communicative as far as offering detailed explanations, updating us on progress, and not hesitating to tell us their concerns so there are no surprises. We are confident that they will continue to take good care of our little boys and are doing everything that can be done for them.

It's pretty convenient living just down the hall from the NICU, but I'll probably go home in a couple days, which would be a nice change of scenery, too. The last couple of days have been pretty busy - especially compared to my level of activity for the last two months. I feel good, am walking and sleeping well, have a good appetite, am producing milk, and am in a pretty good mood most of the time. I did get a little cranky today and had to go back to my room for some pain meds and a nap.

While spending so much time in the NICU these last couple of days, you can't miss seeing all the young, teen mothers there with their babies. One of the nurses told us that the highest percentage of preemie babies were to teen mothers. These poor girls who had just given birth looked very overwhelmed, while standing by their babies and observing the nurses adjusting breathing tubes and being told their child still has a long road in front of them. One young couple near Charles today was being told about a surgery their baby was about to undergo within that hour. We were happy to hear that the nurse really explained everything to them about the procedure (they were so close to us we couldn't miss overhearing). Our hearts went out to them and we pray that the surgery went well for the little one.

One request: Monday night one of our dear friends suffered a miscarriage, after managing to make it through a rough first trimester, which included a week in the hospital for dehydration. Please keep her in your prayers as she lives out of the country with her husband and does not have any other family with her.

God bless you!

Recap and Update

Charles Robert Iker

Ambrose Augustine Iker

Ambrose receiving Baptism.

Wow...what a crazy two days! There are some who are not aware what happened over the last couple days. Let me recap.

Sunday afternoon Gina was having contractions and was given Terbutaline. The contractions stopped briefly, but started up again a couple hours later. She again was given Terbutaline. The contractions stopped, but soon started up again. Terbutaline can only be given twice in 12 hours. The plan that was agreed upon with the doctor was to give Terbutaline and if it did not stop the contractions completely, then to deliver the babies. Gina's contractions became more frequent to 2-3 minutes apart and the decision was then made to deliver the babies in an hour's time. I was about 30 miles away and really flew up the freeway.

Dr. Chavira came to Gina's room and we said a Hail Mary together. He took Gina to get her prepped and I put on my bunny suit (I think I pulled a muscle in my neck trying to get the shoe covers on!). There was quite a large team of nurses and doctors that arrived to take the babies once they were delivered. It was great to see how prepared they all were. During the cesarian, Gina was pretty medicated. I stroked her head and let her know everything was looking good and that I was able to see the babies. Once the babies came out, they were quickly whisked away to be with their teams. It was craziness after that. I ran around checking on the babies hoping to hear some sort of cry or any noise from them. I did hear a few grunts from Twin A, but could see Twin B was having difficulty taking a breath.

The babies were then taken to the NICU and Gina was sewn up. I went to see the babies after I knew Gina was ok. There was a lot going on in the NICU and a large team was assembled around Twin B, now known as Ambrose. They had him connected to O2, but he wasn't responding very well. Remember, his amniotic sac ruptured at 20 weeks, so he didn't have much fluid pass through him to develop his lungs. Next they connected him to a standard ventilator to expand his lungs and get a better flow of air into them. The decision was made that the ventilator was not helping him, so they brought in an oscillating ventilator, which "shakes" the oxygen into his lungs and "shakes" the carbon dioxide out. It's really amazing to watch the little boy's chest while the oscillator works. At some point an x-ray was done and they discovered he had a pneumothorax (air that is trapped inside the chest between the chest wall and the lung, causing the lung to collapse). The small hole was probably caused by the high pressure on his lungs by the oscillator. They placed a chest tube and were able to take out the trapped air. On the last x-ray I saw, the doctor said he did not see any other pneumo and part of Ambrose's right lung inflated.

If it wasn't one thing, it was another. If his O2 saturation levels were up, then his blood pressure was extremely low and vice versa. At one point, Gina and I went to check on him and his O2 sats were so low he was turning grey. Very sad sight to see. Eventually, the team was able to get his sats out of the low 40s to the high 80s and low 90s. He was given Dopamine and Debutamine for his blood pressure and then the doctor decided to give him a steroid, hydrocortisone, to improve his respiration. This was probably because he had Pulmonary hypoplasia, which is "a developmental abnormality of the lung characterized by a decrease in the number of alveoli, cells, and airways, eventually resulting in decreased size and weight of the lungs." The day was a roller coaster. So many ups and downs today made it really physically and emotionally draining. There are still more things that occurred to Ambrose today, but I'm not able to recall them all. He also received Lipids and TPN...and he was able to produce some urine.

Twin A (Charles) had a pretty good day overall. He was on a CPAP to give a little pressure to his breathing, but he was not intubated like Ambrose. They also had him on phototherapy to prevent jaundice. At one point, after he had his little protective mask taken off, he opened his eyes and looked around. He stretched and moved his limbs around quite a bit today. Ambrose made small movements, but he was also on morphine and sedated. Charles may be ready for food in a couple days. He received some lipids, fats, and a sweet glucose cocktail full of goodness. Meanwhile, Gina has been pumping and they're freezing the colostrum, until the babies are ready and able to eat.

I'm sure there's much more to say. When Ambrose took a downward turn this afternoon, we really thought we were going to lose him. He's a really sick little boy and it would take a miracle for him to survive. We know that these last eight weeks have been on borrowed time and we're grateful for the safe delivery of the babies and for Gina's health. God has a plan for each little boy and we respect His Will. We're also very grateful that both boys were baptized. Ambrose was given a more shortened form of the Baptismal Rite, due to his condition and the fact that he began to spiral downward at the time, while Charles was able to receive the longer, Extraordinary Form. Please continue to pray for our little boys. Wonderful things can still happen. We thank you for all the prayers you've said for our family over these last eight weeks. They're greatly appreciated! God bless you all. We'll continue to update this blog as events occur.

Ryan

Happy Birthday Iker Twins!

Charles Robert Iker (Baby A)
delivered by cesarean section 5:01pm 2/8/09
2 lbs 2.5 oz 14.5 in

Ambrose Augustine Iker (Baby B)
delivered by cesarean section 5:02pm 2/8/09
2 lbs 2.5 oz 14.5 in

Both babies received the Sacrament of Baptism from Fr. John Muir. Ambrose is having some problems with his lungs, we'll know better what to expect over the next few days. We will continue to post as we learn more.

Borrowed Time

Today my nurse mentioned that this unit where I've been living is mainly for multiples, ruptures, contractions and bleeders. Great, I'm all of the above. And I've been here longer than any of the other current multiples, ruptures, contractions or bleeders. I don't know if I should feel proud or worried. Worried that we're not going to be able to get away this much longer. We'd like to milk it for at least another 4-5 weeks.

I did have some more bleeding yesterday, which turned into lots of contractions by evening - some of them very strong and only 3-5 minutes apart. The nurses kept asking me about my pain, on a scale from 1 t0 10 with annoying corresponding smiley faces. It wasn't the physical discomfort that was bothering me so much as the disappointment in that I was probably going to deliver very soon. The bleeding didn't last very long, and once the nurse administered some terbutaline the contractions stopped as well. I can have up to two doses of the terb within 12 hours, but it may not always work as well as it did last night.

The babies are happy as clams. They tolerated the contractions just fine, no decrease in their heart rates. An ultrasound this morning show they're just as cute as ever (they get that from their Dad).


And a hearty "Hip Hip Hooray!" to Fr. Jim Wall for his appointment by Pope Benedict XVI as the new bishop of Gallup, NM.

One more thing: this baby is super cute.

Say "Cheese"!

An ultrasound Thursday showed the babies weighing about 29 oz each. That's a 9 oz gain from two weeks ago, which is well above the 10% per week that the doctors look for. It's still a few oz short of the magical 2 lb mark, which they prefer as a minimum birth weight. But if they keep it up, they should pass that up in just a few days.
The little guys move around so much, they're hard to pin down on the fetal monitor. We're supposed to record their heartbeats 20 minutes at a stretch twice a day, but it's a little like squeezing a bar of soap - slippery little buggars won't hold still. We're going to have our hands full with these two.
Thank you to all my visitors, it really brightens my day to have you. I can only crochet and play mahjong for so long before I start to go batty. The solitary confinement isn't too bad though, I just remind myself that this will be my last opportunity to rest... ever.