Sunday, July 31, 2011

The finish line is in sight

It has been a very exciting weekend for the Schlegel boys.  On Friday afternoon, the doctor called me to ask when our boys decided they knew how to eat.  They have made pretty amazing progress over the past few days.

Anderson is weighing in at 6lbs, almost 8oz.  His feeding tube was removed Friday afternoon and he has been taking all of his feedings by mouth and doing very well!  He has been drinking solely breast milk (no fortifier) and still gaining weight, so he will probably remain off the fortifier unless our pediatrician has a different plan.  For right now, the plan is for Anderson to continue taking all feeds by mouth on Sunday and then to have his 10 hour sleep study on Sunday night/Monday morning.  They will monitor him to ensure he continues to breathe, has no dips in heart rate, etc.  If he passes, then he will have his 1 hour car seat test on Monday morning.  If he passes that, Ty and I will come to the hospital on Monday night and room in with him!  The hospital has rooms that look fairly similar to a hotel room where we will be able to stay the night with Anderson.  Nurses will come in periodically to check on us, but for the most part, Ty and I will be on our own with him.  If all goes well, Anderson could be home by Tuesday afternoon.  We are ridiculously excited for this.

Carter is also doing really well.  He is up to 4lbs, 14oz.  The doctor transitioned him to a different fortifier, one that he can continue taking at home. He is taking 2 out of 3 feedings by mouth and is doing pretty well.  He certainly still gets tired and sometimes has to have the feeding finished through his tube.  But with each day he gets stronger, so we are seeing an increase in what he can take.  The doctor has scheduled his hernia surgery for Wednesday morning at 10am.  They do not perform surgeries on babies at the hospital we are at, so he will be transferred on Tuesday to a different hospital.  The doctor hopes Carter will be taking all feeds by mouth by the time of his surgery so that he can get the surgery, have a few days to recover in the hospital, and then be discharged home.  If he isn't doing as well on feedings, he will have to stay at the hospital until he can take all feedings by mouth consistently.  

We are praying Carter is able to complete his feedings before the surgery for many reasons.  It will be difficult for us to get used to a new nursing staff, a new doctor and a new hospital. The hospital is also downtown and therefore harder to get to as often as we would like.  Also, we believe we might have Anderson at home, so the logistics of feeding one baby in the hospital, and one baby who is home (and cannot come with me into the hospital) will be a little bit tricky.  Most importantly, we are hoping Carter can complete them because it means he is getting bigger and stronger and is ready to come home with us.  

We will keep you updated on their progress this weekend and early this week.  Hopefully I will have at least one baby home very soon!  

Friday, July 29, 2011

More feedings by mouth

Anderson moved up in his feeding plan.  He now receives 2 feedings in a row by mouth, and then one by tube.  He needs to do this consistently for a few days and then they will move him to taking all feedings by mouth.  This new plan started last night and he has taken all of the feedings thus far, so we are hopeful that he is close.

We had a bit of a scare with him a few nights ago.  He consistently had some blood in his diaper and the doctor became concerned about the cause, so he ordered an x-ray.  The x-ray looked okay, but not completely clear, so he ordered another x-ray for the following morning.  Luckily, the next morning it appeared that everything was  clear and the doctor was no longer concerned.  He removed the fortifier from his diet and believes this was likely the cause for the blood. Anderson has been on breast milk only for the past few days and they are hoping he will continue growing solely on breast milk and then they can keep him off of a fortifier.

Carter is still doing very well with getting his feeding by mouth every other time. He has not consistently taken all of it, so it might be a few days before they increase his feedings by mouth.  He definitely knows how to do it, but he just gets tired.  As he gets bigger and bigger, it seems to get easier for him to take down the feedings.

Their weights have remained pretty stable.  They both lost a bit over the past few days, so they're working on gaining that weight back.  Carter weighs 4lbs, 10.5oz and Anderson weighs 6lbs, 7.5oz.

Hopefully one of these days soon we'll be posting that the boys are taking all feedings by mouth and are headed home!

Tuesday, July 26, 2011

Pictures of the boys

Not too much new to report today.  The feedings are going well and we are hoping they will increase the amount of feedings by mouth in the next day or so.

Here are some pictures of the boys:
Anderson in his puppy hat from Aunt Cait
Grandma Jean holding both boys (the boys are staring at each other, probably wondering who the favorite grandchild is)
Carter and Grandma Jean hanging out (Carter is trying to remove his feeding tube)
Caught Anderson dancing in his crib
2 months old!!!
Carter, contemplating the mysteries of life, beginning with why he has a large orange pacifier that smells like vanilla in his mouth 

Monday, July 25, 2011

Yet another post about feeding...

There's really not much else to post about other than feeding and growing. Fortunately, both boys are making great movements in both of those areas.  Carter is weighing in at a whopping 4lbs, 11oz!  And not to be outdone by his older brother, Anderson is weighing in at 6lbs, 5oz!  Every time we start to think Carter is catching up, Anderson has a great day as well. It is really fun to watch them grow and begin to interact with us more and more. They can stay awake longer, lift their heads up and make extended eye contact with us.

Their feeding is steadily progressing as well.  Both boys are now receiving 4 feedings by mouth per day, or every other feeding.  They have both been consistently taking their whole bottles and breastfeeding well.  Carter has actually turned into a much better breast feeder than his brother, but we're hoping Anderson will come around someday soon. As long as they consistently finish their bottles, they will up them to 6 bottle feedings per day, and then take all feedings by mouth.  They need to do each of these steps for 48 hours, consistently finishing each feeding.  We are hoping they keep doing as well as they are and they could potentially be home in the next two weeks!  

They had their two month birthday on Friday, which means they received their 2 month shots this weekend. It was not a great day for them, but they already seem to be fairly well recovered.  Ty and I were planning to be there for it, but the pharmacy didn't have the shots ready, so the nurse gave them the shots at 2am on Saturday.  We can't decide if it was better we weren't there or not.  

Labs this week looked really good. Carter's bone growth and hematocrit continue to look good.  His direct billirubin increased, but only very slightly.  The doctor hopes this is an indication that the level is plateauing and will begin to decrease.  The doctor increased Carter's medicine for this once more, and still has more he can prescribe if Carter's level doesn't decrease.  We are hoping this won't be necessary, but we're glad it's an option.

Overall, both boys look great.  We are starting to get very excited about having them home.  The doctor said we couldn't quote him on this, but that Ty should certainly have them home with him to watch the first college football game of the season.  We'll just have to decide which team's apparel they will be wearing that day....... 

Thursday, July 21, 2011

Slowly but surely learning to eat

The Schlegel boys reached a great milestone today.  Both boys finished their entire bottle this evening, 44ml for Carter and 50ml for Anderson.  They had a pretty big day today with baths and an eye exam, so it was even more incredible that they both finished their whole bottle. Anderson also finished his entire bottle this morning, so we are hopeful that he is really starting to get it and will begin finishing the bottle at each feeding.

Their eating is definitely helping them gain weight.  Anderson is now 6lbs!!!!  It's pretty amazing to hold him now and think about how tiny he once was.  Carter is still gaining as well, weighing 4lbs, 5oz.

Their eye exams went very well this morning. Both of them have progressed in their vision and the doctor believes they will not have any vision problems resulting from their prematurity.  The will likely have to get one more eye exam in the hospital and then will have a follow up appointment at 6 to 9 months post release.  We are very excited that both boys are now cleared for both their vision and hearing, two things the doctors worry about with tiny babies.

The doctor increased Carter's dosage of his liver medication. I spoke with him today about why Carter's direct billirubin has continued to increase. His level is at 3.8, but the doctor assured me they really start to get concerned when it is in the mid to upper teens, so Carter's level is not alarming yet. The doctor did increase the dosage to hopefully see some decrease in his labs this week.  We will keep you updated on how it goes!

Tuesday, July 19, 2011

Lab results for the week

The boys had their labs taken for the week yesterday.  Anderson's labs all looked great.  Carter's were almost all good.  His red blood cell production is up, so he no longer needs his shot to increase them.  His bone growth also increased significantly, so he is no longer receiving calcium and phosphorus.  The only result that was not good was his liver. His direct billirubin increased again. The doctor does not seem concerned about this. Carter has only been receiving the medicine for a week and it likely has not had time to work yet. Additionally, they have eliminated most of the major concerns for what could be causing this by doing ultrasounds.  They believe it is likely related to his small size at birth, or a buildup from some of the IV meds he received when he was first born.  For either of these scenarios, he just needs to get bigger and older.  They will continue to watch this.

Carter has his hearing exam done this week and passed in both ears!  Similar to his brother, we were fairly certain that he could hear, but it's always good to have it confirmed.

Feedings are going well this week.  Anderson is consistently taking the majority of his bottle.  Carter is having a little bit more trouble finishing his, but he is probably getting tired faster since he is out in an open crib.  This morning he did a great job, so we are hoping he is acclimating well to being out in an open crib.  His temperatures have been great, so he will likely be able to stay in the open crib for the rest of his stay at the hospital.

Both boys are doing great.  We are starting to get a little bit anxious to have them home, but we know its best for them to be at the hospital until they are eating well.  Their weights continue to increase though, so we're hoping the end of their hospital stay is coming in the next few weeks or so. Carter is weighing in at 4lbs, 2oz and Anderson is 5lbs, 14oz.

Sunday, July 17, 2011

A cause for celebration!

The Schlegel boys have given their parents, friends and family plenty of reasons to celebrate this weekend.  To start with, on Friday afternoon, the doctor decided to try Carter out in an open crib.  He was not quite 4 lbs yet, but they thought he could do it.  Ty and I were there to give the boys a bath, and then helped put them in the crib together.  It was pretty incredible.  We laid them in there with their heads turned towards each other and they just kept staring at each other.  I guess they were wondering where the other one had been for so long.  Here is a picture of when we first put them in:
The trend seems to be that Carter is fascinated by Anderson, and Anderson is largely ambivalent.  

Carter had to keep his temperature up for 24 hours before they would be moved into a permanent open crib together.  He did great and they were moved into a larger crib together on Saturday evening.  They use cribs from pediatrics to put multiples together in order to have enough space to change diapers, check temperatures, etc.  Here is their new home:
The nurses are waiting on some tables or shelving to put near the crib to get all their stuff out of the way.  Luckily for now, two babies weighing just under 10lbs combined don't take up too much room.

The sign above Carter's head may have given away his other big news.  He successfully crossed the barrier and now weighs 4lbs!!!  This is great for a number of reasons.  1) Gaining weight is always good (for premature babies), 2) He can now be out in an open crib, 3) He now weighs enough to fit into a car seat, so he will be able to go home at this weight once he gets his other stuff figured out, and 4) 4lbs just sounds better than 3.

Anderson also gave us a great reason to celebrate.  He finished an entire bottle on Saturday night!!  He drank all 47ml fairly quickly.  What made this even more impressive was that he had breastfed immediately before this for 15 minutes and had a fairly good feeding just through that.  We are hoping he has had his light bulb moment and will begin taking down his entire bottle each time we feed him.

The boys are both on the following feeding plan: They can receive 3 feedings per day by mouth, 1 by bottle and either 2 breast feedings or 1 breast feeding and 1 bottle feeding.  If they breast feed for less than 10 minutes, they receive half of their feeding through their tube.  If they breast feed for 10 minutes or longer, they get a bottle to supplement if they are still hungry.  Both boys are actually great at breast feeding and haven't had to get a tube feeding in a week or so.  We are hoping the doctor will increase the amount of feedings they receive by mouth in the next few days as this will be a huge step towards them being able to come home.

Their feedings have increased due to their weight increases.  Carter gets 40ml per feeding and Anderson receives 47ml.  It's pretty amazing that Carter is taking in almost as much as his brother, who currently weighs 1lb and 13oz more than him.  We keep thinking Carter is closing the gap in weight, but Anderson keeps on packing on the pounds as well.  Anderson currently weighs 5lbs, 13oz.

As Carter puts on more and more weight, Ty and I are starting to think they may look alike.  Here are a few pictures that we think show some similarity:
Which baby am I?  
And which baby am I?
As I put these in, I'm not sure if the similarities show up as well in photos, but oh well.  The first one is Anderson and the second one is Carter.  Carter definitely looks similar to the photos of Anderson that we have when he was 4 pounds.

Here are a few more pictures of the boys:
Anderson getting a bath
Carter gets a bath
Anderson avoiding Daddy (but looking like he's thinking hard about when to turn)
Then he gives Daddy a little half smile (He learned this tactic from his Mom; just smile halfway and hope the camera  moves back away from your face)
Anderson is also working on eye contact.  He seems to have it down pretty well in this picture.
Carter takes getting a bath much better than his brother, even though he has much less fat to keep him warm
The sweet sign the nurses made for Carter today to celebrate his achievement
Carter practicing his wink at the nurse holding him