Team Sage & Gemma - Day 23

Dear Family and Friends, near and far,

Almost 10 days have passed since the last update - and as the old adage goes, "No News is Good News." The girls have hit most of their major milestones earlier on, so the past 10 days have been about giving the girls time to grow and get stronger. The doctors keep saying that this period is just about being patient and waiting, which we are getting very good at! Tomorrow, the girls reach their 33-week gestational age - lots of developing still to do. But it's been amazing how much progress has been made since their birth!

Celebratory crafts from our night nurses :-)

Sage and Gemma have been keeping up with their new Oxygen level requirements so there has been no need to go back on any kind of breathing supports! They tend to do much better when they lay sleeping on their tummies (which sounds surprising and scary for anyone who has had experience with newborns.) Apparently with Preemies, laying on their backs can cause too much gravity on their little lungs to expand upwards sufficiently which decreases their Oxygen levels and makes breathing challenging. Laying downward allows gravity to do the work of drawing the lungs down to expand. Once they hit full-term, they'll be on their backs like most newborns are. 

Little by little, the girls are gaining weight. At this point, Sage weighs 3 lbs, 6 oz. Gemma weighs 3 lbs, 7 oz. Once they hit approximately the 4 pound mark, they will be able to have the open-top isolettes, as they will be able to better regulate their body temperature. Right now, the girls would be outputting too much energy if they were required to keep warm on their own. When they do hit this milestone, they will also be able to co-sleep in the same crib! We're really looking forward to this!

We've continued to enjoy our skin-to-skin time with the babes, as well as the occasional bath-time, and the daily breastfeeding sessions. The girls have been more alert and social this past week. They open their big dark eyes and love to look at all the sights. We've also had a lot of company this week - friends and family from Seattle and Portland have come to meet the girls.

Gemma on top; Sage on bottom

Next week, the Occupational Therapists will being working with the girls. If the girls were still in utero, they would be tucked tightly into the fetal position and have distinct borders that they could not cross (aka, my skin). Because they were born about 8-10 weeks early, these positions and borders aren't naturally occurring anymore, so we have to do our best to recreate them with blankets and squishy, moldable pads. Even still, it's not as effective as in the womb. Preemies often lack flexion, which is how the muscles known to draw themselves back in. Imagine extending your arm or your leg, and not knowing how to flex it back in toward your body. This neurological development is something that has to be taught and practiced so that the girls don't develop a lack of muscle tone. So far, the doctors and nurses say that the girls are doing really well making these brain-to-muscle connections on their own, but we will still will work with the specialists to get advice and information. 

As we transition into the new month, continue to keep us in your thoughts and prayers. We are about half-way there! As always, things can change, but the projected time for going home is the end of October - (at which point we will have a huge party!) We love hearing from you and if you haven't already, we look forward to you meeting Sage and Gemma, our stars! 

Sage

   

Gemma

    

With all our love,

Megan & Chris, Sage & Gemma

and of course, Grizzly (who can't wait to take care of his little sisters!)

Team Sage & Gemma - Day 14

Hello Sage and Gemma supporters, prayer warriors, and energy senders, 

What a difference a week makes! Today we celebrate the girls turning 2 weeks old! I can't believe how time is flying by. 

On day 8, both girls came off of CPAP! The doctors weren't sure if it was going to be permanent but Gemma and Sage have both kept their Oxygen levels up high enough over the past week to not go back on any breathing support - they have to maintain a level of 88% Oxygen intake or higher. This being said, they no longer have to wear the restrictive hats and tubing, and are able to turn their heads from side to side and open their eyes. Chris and I are also able to get them in and out of their isolettes without assistance too! Going by their gestational age, the girls are 31 1/2 weeks. At 32 weeks, the Oxygen requirements are increased. This means that they both have to maintain Oxygen levels of 94% or higher. This is going to be a little bit of a stretch, and one or both of them might need to go back on a less-invasive breathing support (aka not CPAP) in the future. The doctors say that it wouldn't be "a step backwards," it just helps their little lungs get stronger as everything else is growing vigorously too. 

Sage

  

Gemma

  

On the same day, the girls' IV's came out which means they are no longer getting nutritional supplementation intravenously. Rather, their vitamins are now added to their milk feedings which is still being delivered through the feeding tube. The really exciting part is that we've been able to start practicing breastfeeding now that their faces are clear. Even though the girls are still too premature to fully coordinate everything that goes into breastfeeding, they are still able to get acquainted with the tastes, positioning, motions, and movements. The lactation specialists have been so attentive and helpful with this. 

Cuddly Twins just graduated to "Preemie" Diapers

What else?! At last night's weighing, Sage weighs 3 lbs. 2 oz. and Gemma weighs 3 lbs. 0 oz. Gemma has had a little more trouble keeping all her food down after her feedings but is still gaining a little weight. Both girls have now gotten their first and second baths. Chris and I were able to bathe Gemma and I bathed Sage today. They LOVE the water; they totally just melt into it. ​​

Bath time for Gemma

  

There are a lot of tests and procedures that babies in the NICU have to endure. On Friday, the girls had ultrasounds of their heads to look for potential brain bleeds and cerebral palsy. Everything checked out as normal *sigh of relief.* They will have a few more followup ultrasounds as their time at the NICU goes on. They also have eye exams coming up to look for a condition called ROP. When babies are born prematurely, sustained high levels of oxygen can cause the blood vessels in the eyes to grow abnormally. It's a strange connection, but it can cause serious damage to vision. That is why, (going back to the first paragraph) they are allowed to have oxygen levels of 88% at this age, and it increases slowly as they get older. The doctors don't see any of these conditions being likely, but they have to rule out all potential complications early on. 

On a lighter note, Chris and I decided to save the girls' umbilical cords for their baby books. All the nurses know to be on the lookout and to save them if they notice them fall off. On Friday evening, we noticed that Gemma's cord had fallen off, but it was nowhere to be found. Both the day and night nurses didn't remember seeing it, and had changed out all the blankets earlier in the day. Housekeeping had also come earlier and emptied the garbage. We still decided to look through the hamper and check Gemma's bed. Right before we left for the night (and had long-past given up the search), I glanced down on the ground and saw the little stump underneath a table, clear across the room from Gemma's bed. We don't know how it got there, but were really glad we found it! We are still waiting for Sage's cord to fall off. Hopefully that one doesn't wander so far. 

Thank you, everyone, for continuing to keep the girls in your thoughts and prayers. We are so blessed to have you surrounding the babies in so much love from near and far. We'll be in touch!

Megan & Chris, and Sage & Gemma

& Grizzly (woof)

p.s. If you are new to the Team S&G list, you can see past updates on my blog: http://meg0801.blogspot.com/

Team Sage and Gemma - Day 7

Hi Family and Friends -

Thank you all for your thoughtful replies and constant support. We think all the prayers are being answered and the encouragement is really working - the girls are progressing with leaps and bounds. I have nothing but good news to report! It's hard to believe it's already been a week since they were born! 

Chris and I have already started to see Sage and Gemma's personalities begin to develop. The nurses are getting to know the girls as well and are having fun sharing their observations. Sage has been described as "calm," "consistent," "go with the flow," and a "model NICU patient." Gemma has been described as "feisty," "0-100 in no time flat," and "will definitely get her sister into trouble later on." I wonder who they get these qualities from!?

I've been able to be here everyday from about 11 am - past midnight. Chris joins me here when he gets off of work for more skin to skin time, and for the midnight "hat check." Because the girls are still on CPAP, they have to wear little stocking hats that keep all the tubing in place. Each day at noon and midnight, the Respiratory Therapist comes in to change out all the dressings and check the stats. Both girls are now down to the lowest CPAP setting and are still maintaining Oxygen levels in the normal range! It should only be a few more days, according to the Neonatologist, that they will require CPAP at all! One of the nurses has shown me how to give the girls head massages for when the stocking hats come off, and how to reshape their little ears that have been squished down by all the tubing and hats. Since their faces aren't crowded with all of the tape and tubing, the girls usually open their eyes during "hat check" to check out all the sights! "Hat checks" are one of our favorite times with the girls!

Picture of the babes at "Hat Check" 

Sage on top - Gemma on bottom

Tomorrow, their IV's will come out as they no longer require intravenous nutritional support. All their nutrition will be provided as a liquid supplement added to the milk they get through their feeding tubes. Yay! One less wire for the girls to be connected to. In addition, their feeding volumes are increasing by 5 ml. per feeding per day and their itty-bitty tummies are tolerating this increase fantastically! Only one spit-up to date! 

The girls have also been taken off the "Bili-lights" as well. The lab tests over the past few days have shown that the girls' bilirubin levels have gone down enough to not be concerned. They will be tested again, as jaundice can rebound, but so far, they have enjoyed being swaddled in their isolettes - rather than laying in only their diapers. 

Cozy Sage                                                               Cozy Gemma

 

In other news, the girls have both gained a little weight (they are both 1 oz. away from their original birth weight - Sage now: 2lbs 14 oz and Gemma now: 2lbs 13 oz.); they've gotten their footprints stamped for their certificate of birth, and will soon start to train for breastfeeding. At 30 weeks (their current gestational age), their simultaneous reflex for sucking/breathing/and swallowing has not yet developed, but by 32 weeks, we will start to train with Lactation Specialists. The girls will also have upcoming appointments with Physical Therapy, Occupational Therapists, and Eye Doctors to make sure their development is on track. Many things don't develop the same outside of the womb as they naturally do on the inside, so it's beneficial to work with specialists who can help identify any needs early on and teach us ways to handle and support the babies. The hospital staff has been great, setting up all these appointments for us. We haven't had to worry about any of it.

Continue to keep us in your thoughts and prayers! I love sharing news about the babies. We are head over heels in love with them and are enjoying this journey already; and being able to share it with you! We appreciate all your replies and if I haven't gotten a chance to email you back individually, I apologize. Know that we truly cherish the love that has been surrounding us. 

Love, 

Megan, Chris, Sage & Gemma

P.S. I posted the past email update on my blog in case you missed it! http://meg0801.blogspot.com/ and will continue to add more along the way.

Our "home away from home"

Sage getting footprinted

Team Sage and Gemma - Day 4

Hi Friends and Family - 

Thank you for your constant thoughts, prayers, and energy during this exciting, challenging, healing, and joyful time! Chris and I, and the girls, have been overwhelmed with the love and support from near and far. We put together an email list so that we can send you updates on how the girls are doing, plus pictures and other info! If you know of anyone else who would want to be on our Team Sage & Gemma list, let me know! 

: : Delivery Story : :

The girls were born via emergency C-section on Sunday, September 6 at 7:29 in the morning. 

I had been in the hospital for nearly two weeks already. My water broke mid-August so I was at Legacy Hospital in Salmon Creek being closely and constantly monitored. The doctors were trying to keep me pregnant until the babies were 34 weeks, but the babies have a mind of their own! In the middle of the night on Sunday (29 weeks, 4 days), I started losing a lot of blood and it wasn't stopping. Around 7:15 am, the doctor announced the need for the babies to be delivered and less than 14 minutes later, they joined our world! It all happened incredibly fast, and was very emotional - almost no time to process what was about to, and what had just happened. My sister, Annie (who is a nurse) just happened to be visiting me at the hospital overnight and was there in the morning when I started showing symptoms of labor/distress. She called Chris around 6:45 am and told him he "better get here quick." Chris made it a few minutes before they wheeled me to the OR and was able to scrub in for the delivery. 

Sage was delivered first (at 7:29 am), head first, and by the time she was in the doctors hands, Gemma already had her feet sticking out of my belly. Gemma was delivered also at 7:29 am. It was amazing hearing both of them let out a little cry right away, and I caught a quick glimpse of them before they were whisked away to the NICU. Most beautiful moment ever!

: : 4 Days Old : :

The girls are both in the NICU (neonatal intensive care unit) at Legacy Hospital - Salmon Creek. They are able to share a room, but both are in their own isolette (incubator.) Although Chris and I live less than 5 minutes from the hospital, we are able to stay in the girls' room on the bench-bed. Or there are little personal rooms (with a double bed and bathroom) in the NICU wing that we can reserve and sleep in. We are also able and encouraged to visit, hang out, eat, and interact with the babies as much as possible in their room. 

Gemma and Sage, being premature, have a lot of growing and developing to do that a baby in the womb would be doing before they are born. Because their lungs are still a little underdeveloped, they are on CPAP machines 24/7. The CPAP helps the air in and out, but unlike a respirator, they're lungs aren't dependent on the machine; its just a helpful support. At this point, both girls are not on any additional oxygen anymore (yay!) - Gemma has been breathing room air the whole time, while Sage graduated off oxygen support today!They should be off CPAP within the week if all continues as it has. In addition to that, the girls both have feeding tubes - they are getting nutrients through IV but are getting mama's milk :-) through the feeding tubes. They are tolerating the milk and digesting great! The girls are hooked up to heart rate monitors, oxygen monitors, and breathing rate monitors. All of these stats are continually monitored by the NICU nursing team and if any of the rates drop or trigger the signal, the nurses know immediately and can intervene if necessary. There is always one nurse assigned to the girls each day and night; all NICU patients have 1:1 support which is great. They have been so helpful, supportive; the girls are in VERY capable hands. 

The girls have both lost a little weight, which is normal for newborns, and are looking a lot less puffy than a few days ago. We are finally starting to see what their facial features look like. They have a lot blonde hair on their heads and white-blonde eyebrows; they have the longest arms and legs! They are absolutely perfect! At the their weighing last night, they both weighed 2 lbs. 10 oz. At the last meeting with the neonatologist, he said that both girls have "turned the corner" and "are doing as good as we would hope!" For now, whenever the girls are in the isolettes, they are underneath "Bili-lights" which help stabilize the bilirubin levels which cause Jaundice. They are bright blue lights; the girls have to wear little velcro-sunglasses to protect their eyes. They look like they are laying in tanning beds! Hopefully they'll only need a few more days of the lights. They both have also started sucking on pacifiers to help self-soothe. (Yes! They make pacifiers small enough! I was surprised too!)

We have been IN LOVE WITH our skin-to-skin time with the girls. We are able to sit for hours each day with they girls laying on our bare chests. Even though we are all covered in wires and tubes, the bonding time is special and so important for the girls' development.Today was the first day that I was able to hold both girls at the same time. At one point, Gemma stretched out her hand it laid it across Sage's back and left if there for several minutes. *Melting heart* It's really hard to put the girls back in their isolettes after our skin-to-skin time. 

I hope that helps give some more info on what's been going on in our lives the past 4 days! Not every email will be this long (don't worry!) I'll send updates when I can. If you have questions make sure to just reply to me; not "reply all" just to save everyone's inbox :-) Can't wait to share more along the way! And thank you again, for all the support and love <3 

  Megan, Chris, Sage & Gemma

Skin to Skin with <Sage and Gemma>