Stronger and Stronger (three weeks)

Si and Gabe keep getting stronger. Still in the NICU (Neonatal Intensive Care Unit) for a few more days, they're getting close to graduating to "Two South" a step down in care intensity. This week, both had their IV's pulled out after several days of ingesting enough food on their own to go without intravenous supplemental nutrition. Their respiratory and cardiac numbers are getting steadily stronger. Although they both have had some problems with feeding intolerance (regurgitating some of their milk) they are both nearing 3 1/2 pounds (1/2 pound heavier than their birth weight). At last night's weighing, they both weighed exactly 1345 grams - identical to within .1%! We were told that when they reached the "corrected" gestational age of 34 weeks (today) their suckling instinct would start to evidence itself, and it certainly has. For the last couple of days, both have been very enthusiastic about pacifiers. Over the next few days, we'll start to introduce them to oral feeding, and if that goes well, we'll take the next step of getting them out of their isolettes and into cribs. That's about the time they don't need to be in the NICU any longer.

The official hospital line is that we should expect to bring them home on their original due date (Dec 3), but the unofficial word we're getting from their nurses is that just before Thanksgiving is a strong likelihood, if they continue to make this kind of progress. What a way to spend the holiday!

Since they're stronger and not relying on the oxygen and IV anymore, we've been able to spend more time holding them. This week, we were able to get Gabe's isolette moved into the spot next to Si's and we introduced them to each other for the first time since they were born! See below for our first family portrait.

Mom is getting stronger every day as well. The high blood pressure and other symptoms of the pre-eclampsia are declining as concerns, leaving Suzanne to contend mainly with the soreness and fatigue resulting from a major surgery. It will likely be another 3-5 weeks before she's fully recovered. She is very excited to have hands instead of mits and feet that don't look like elephant's (the swelling was really something else!).

Those are the details. Here are some of the photos we promised you:

Grampa Bill and Nana visit with Si.

Gabe in Suzanne's hands.

Our first family photo.

Si's hand in Derek's. Mom's holding Si.

Amma holding Si.

Keep your eyes peeled for a postcard showing you actual size footprints.

Two Weeks Old!

In just a few minutes, Si and JB will be two weeks old. We can't believe it!

The boys are getting bigger and stronger every day. After gradually decreasing the oxygen and pressure settings on their breathing apparatus for several days, the boys both stopped using breathing assistance altogether. They've both been breathing room air all on their own for three days now, and are doing great.

They've also both been "eating" more and more; Si is now getting 100% of his nutrition through his stomach. He has one more day to go in his 10-day protocol and will be at his full-size feedings every three hours. JB is a day behind Si and doing well. They are both still getting their milk through a gavage (feeding tube), but they are nearing the age where their sucking and swallowing reflexes will be strong enough for them to start to actually eat on their own.

They're getting bigger now too. They were both born weighing about 3 pounds and dropped down to about 2 1/2 pounds in the first few days - it's normal for all babies to lose some water weight right after birth. They both passed their original birth weights in the last couple days and now weigh around 3 pounds 2 ounces.

You can start to see that weight in their cheeks. They were born looking incredibly like little old men - now they're starting to look like babies. It also helps that they have all the breathing apparatus away from their faces. They've been having longer and more pronounced periods of alertness at feeding time. They'll hold on to a parent's finger super tight and look around and take everything in.

Suzanne is getting stronger too. She went to the doc last week to get her blood pressure checked and do a general post-op check-in and got all thumbs up. They're so confident about her health at this point that they scheduled her next appointment three weeks out! She's pretty much out of the woods on the pre-eclampsia and related issues. Her main issues now are recovering from a major surgery and adjusting to a schedule of producing milk every three hours.

All their grandparents and several of their uncles and aunts have been able to meet the boys and we can't wait to introduce them to the rest of our family and friends. It's still difficult to meet them, however. They'll be in the NICU for another week or so and still in the hospital until some time around their due date (Dec 3). Visitors need to be with us and we're limited to one accompanying visitor per child at a time. Unfortunately, it's not set up so you can look through a window at them, so it's not much use to go to the hospital without us. We are going for a 2-hour visit a couple times a day, so please do drop us a line to arrange to go with us.

Thanks again to everyone for all the calls, notes, and generous gifts. We're counting our blessings every single day. We'll get some newer photos posted soon.

Gabriel James and Silas William

OK, after much wrestling, reflection, hemming and hawing, we've arrived right where we started with the names: the boys are Si (Silas William) and JB (Gabriel James). JB was an in-utero nickname and he's hanging on to it for now, but we'll call him Gabe or Gabriel as he gets older.

Everyone is getting stronger and healthier!

Both Si and JB are off the ventilator now and are back on the CPAP, which is a non-invasive breathing aide that helps them to fully inflate their lungs (the same thing that people with sleep apnea use). They're also both using their stomachs now. Si's been getting mother's milk for a couple days and is up to 8 cc's of milk every three hours - up from the three cc's he started at. JB just started on milk today as well. He had to wait because a heart murmur had the team concerned that they might need to medicate or take further steps to fix a heart condition that's common in all preemies (PDA). They have a little bit more phototherapy to get through the jaundice. At this point, we're just working to get them stronger - able to breathe with less help and able to eat more - to the point where they can get all the oxygen and nutrition they need on their own.

Suzanne is recovering as well, though not as quickly as she would like. Her blood pressure has remained high and her pain still requires aggressive treatment. She's on modified bed rest at a time when she would like to be with the boys all day, or sorting through all their clothes and setting up their room.

It's just not possible to express how much of a privilege it is to be getting this kind of care! If we had lived in any other time and place, it's a long shot that any of the three would have survived this experience. In the NICU, the boys have one nurse monitoring and caring for them full-time, with a Nurse Practitioner, a Respiratory Therapist, and a Neonatologist present at all times. Everyone on the staff at Swedish has been a top-notch professional and superb human beings. They do their job with confidence and go out of their way to involve, inform, and reassure us.

Suzanne with Si in his isolette under phototherapy

Derek with JB under phototherapy. Note all the equipment for monitoring his health.

We've finally been able to hold the boys for the first time! Last night, Si rested in Suzanne's arms and today we both got to hold JB for a half hour. What a moving experience. Every day we count our blessings that things are going well, but it's hard that we still hadn't held our children. We've now got a small taste of how nice it will be to have the whole family together when the time comes.

Derek and Suzanne hold Si for the first time

Mommy's going home

Folks may know that we've been seeing a team of high-risk pregnancy specialists. We finally met Dr. Brock today, the last of the team we hadn't seen. She got the enviable task of giving Suzanne her release orders!

Suzanne had a very low blood pressure reading this morning and all of the other numbers are trending downward as well. She had her IV removed an hour ago and we're waiting for a nurse to come and remove the staples from her incision. Her swelling has gone way down and she's feeling energetic and clear-headed (as much as the percocet will alow).

It'll still be 10-14 days before she's well enough to drive, and 6-8 weeks before she can do sit-ups, but she's on the mend and excited to be able to go home.

The boys are doing well too. They are receiving the intensive care the name of the Neonatial Intensive Care Unit (NICU) implies, but there are no unexpected complications. Here's some of what's happening:
- They are getting help breathing. They've been intubated and on a ventilator for a day and a half, and are gradually developing a better ability to absorb oxygen on their own. They'll likely be off the ventilator in a day or two.
- They are getting phototherapy for jaundice right now. They are wearing little blinders and have bright lamps shining on them for the next day or so.
- They've been getting their food through the IV. Today, they'll start to get some mother's milk through a feeding tube to their belly. Over the next few weeks, they will gradually get more milk and less nutrition through the IV. It will be a couple weeks before they're able to swallow on their own.

We're being told not to expect to be able to bring them home until their original due date (December 3). It seems so far away and such a long time to be spending hours a day visiting them here in the hospital, but they're getting the best of care and we're counting ourselves very blessed to have them safe and whole. We'll be patient and take it day to day.

Names are percolating and likely to gel by tomorrow. Stay posted.

Suzanne, Derek, and Suzanne's mom Shirley, loaded up to leave the hospital

We're Here!

Last night, October 2, at about 11:00 PM, the Birnie Twins were delivered via Cesarean Section. Mom and Boys (and Dad) are all doing well!

We were in the middle of our discussion on names when we got the lab results back and the doctor recommended the procedure. Things have moved fast since then, so no given names yet, so here are the details and photos using their in utero nicknames.

Si was born first at 3 lbs 1 oz and just over 15 inches long. JB came right after at 2 lbs 15.3 oz and also just over 15 inches long. They both spoke right up after their birth and seem strong and healthy for being born at 31 weeks. They are incredibly beautiful works of wonder!

Si just after birth

JB just after birth

Si & Mom get a moment together

JB & Mom say hi

We'll post as soon as we can - the plans for the babies' care and Suzanne's recovery, the new room information, and more cute pictures. For now, please share our good news and rest assured that we are all fine & happy.

PS. Suzanne would love to hear from you, but please don't be surprised if it's only a short conversation. Likewise, we would really love to see friends and family, but please call before visiting - as Suzanne needs her rest for a few days.