Cole's 1st pediatrician appointment!

Today, Cole had his first pediatrician appointment. He weighed in at 5 lbs 10 oz and was 18 1/8 inches long. The appointment went very well. Both babies will have weight checks this Friday and then see the pediatrician as well.

We wanted to wish each and every one of you a joyous New Year!!

Finally a complete family!!!

In about two hours, our family will finally be COMPLETE!!! Cole will be discharged at 3:30 p.m. today and the best part.....he's been on room air since yesterday afternoon and is doing GREAT, thus no oxygen is needed at home!!! We are very excited to have our boy home with us!!! He passed his hearing and car seat tests with flying colors and is coming home on the same formula combination as Olivia, though we will start exclusive breastfeeding this evening, with the help of our post partum doula, Joyel. Cole will be seeing the pediatrician on Wednesday morning for his first newborn appointment. Both Olivia and Cole will be going back to the pediatrician for a weight check on Friday afternoon!

Olivia's first pediatrician appointment went GREAT this morning! She has managed to gain 3 oz in 3 days!!! She now weighs 4 lbs 12 oz! Dr. Antone said that is the same/more than full-term babies gain in 3 days. He was very pleased! He also shared his discussion with Dr. Desai, the Neonatalogist at St. Joe's. Most importantly, because Olivia and Cole are at such a high risk for RSV due to being born prematurely with heart and lung problems, family history of asthma, being multiples, and having an older sibling who attends school; he is going to try to see that they get the Synagis shots. YAY!!!!

We asked Dr. Antone about visitors as we are very anxious to introduce Olivia and Cole to all of you. We have been urged to limit visitors as much as possible and to not allow children, other than Luukas and my nephew J.J. who is visiting from NYC this week, to visit with Olivia and Cole just yet since it is the middle of cold, flu, and RSV season. Please understand that we truly want you all to share in this exciting time with us. At the same time, we must protect Olivia and Cole from getting sick.
PLEASE READ THE POST What is RSV and what does it mean to YOU?! FOR MORE INFORMATION.



Olivia's first pediatrician appointment! She weighed in at 4 lbs 12 oz.


Daddy and Olivia wait patiently for Dr. Antone!


Olivia cracks a smile for us!


Luukas sings Olivia a lullaby!


Luukas holding Olivia for the first time!


Cole's homecoming!!!


The TWINS!!!!

Week of 12/22 to 12/27/08

Photo and video editing at www.OneTrueMedia.com

">

Christmas Day 2008

Thanks to Auntie Shawn who made this wonderful video!

Our prayers have been answered!!

On Friday afternoon, George and I received the best news that any parent could ask for. Both Olivia and Cole's PDA's have closed, according to Friday's echo cardiogram results. Cole still has a PFO, but it is not a concern now that the PDA has closed. PDA's can spontaneously reopen thus I will be asking that one more echo cardiogram be performed on Cole before he comes home. Both babies will be seeing the Director of Cardiology at Children's Hospital (Dr. Humes) for a follow-up appointment at the end of January. Dr. Humes was Luukas' cardiologist when he had his PDA ligated in 2004 and he has been following Olivia and Cole since they were diagnosed with the PDA's. Both babies will also follow-up with the St. Joe's Audiology Clinic at one years old.

On an even happier note, Olivia was discharged on Friday night!! She passed her hearing and car seat tests with flying colors on Thursday night/Friday morning and came home around 10 p.m. Friday night after getting her Hepatitis B vaccine and Newborn Screen Test done. She is doing really well at home, other than showing signs of Reflux, and is currently on Enfamil Lacto Free formula with Thick-It. She gets Fer-In-Sol iron drops daily. Her weight at discharge was 4 lbs 9 oz and height was 18.7 inches!!! Olivia's first pediatrician appointment is Monday at 9 a.m.

Cole is slated to come home on Monday afternoon. He is still struggling with immature lungs, thus he will most likely be coming home on oxygen. He was circumsized on Saturday evening, received his Newborn Screen Test on Friday, and should be having his car seat and hearing test done on Sunday. As of Friday night, he weighed 5 lbs 8.9 oz. Yesterday afternoon, he was switched from breast milk to the same formula combination as Olivia. It appears that both babies may have Reflux, just like Luukas did. If Cole comes home on Monday as planned, he will see the pediatrician on Wednesday morning.

As for Luukas, George and I, we are adjusting to having Olivia home. We'll be glad when Cole comes home, as it will make our family complete and stop the logistical nightmare of trying to visit him while caring for Olivia too! Luukas is doing as well as can be expected with Olivia being home. He is very good to her!

As always, thanks for all of your support! We are excited for the twins to meet all of you. We ask that you please be understanding in when/how soon that will occur as we were instructed to limit visitors at first due to the babies prematurity. Please read the post What is RSV and what does it mean to YOU?! for more information.

What is RSV and what does it mean to YOU?!

If you are not aware of RSV, you are among the majority. Although nearly every child by the age of 2 has been infected with RSV, most have not heard of it. For full-term babies, RSV is typically not any worse than a common cold. For preemies, it is much different. It is a serious virus that is very easily contracted, and for those born earlier than 36 weeks, it poses major risks (pneumonia, bronchiolitis, and other more serious complications, some fatal).

The following are factors which place Olivia and Cole at risk for getting RSV:

* Premature birth. In infants born prematurely (ie, more than 4 weeks early), RSV can become a serious respiratory tract infection that requires hospitalization, especially early in life. Olivia and Cole were born 6 weeks early.
* Being born with lung disease. Babies younger than 2 years old born with chronic lung disease who have needed medical care for it within 6 months before RSV season are at high risk.
* Being born with heart disease. Babies younger than 2 years old born with serious heart disease may be at high risk.
* Low birth weight. Low birth weight (less than 5½ pounds) greatly increases the risk of death from RSV.
* Older brothers and sisters. Babies in contact with school-aged siblings can get RSV, particularly during the cold and flu season.
* Family history of asthma. There is a higher risk for severe RSV in children with a family history of asthma.
* Tobacco smoke and other air pollutants. You should never allow anyone to smoke around your baby. Tobacco smoke and other air pollutants can irritate your baby’s lungs and make it harder to fight RSV.
* Multiple births. Multiple births (for example, twins) increase the risk for RSV because of low birth weight and an increased number of young siblings in the household.

Stopping the spread of RSV is very difficult. Thus, we must be vigilant about keeping our children safe during RSV season (October through April). It is spread through physical contact, through the air via a cough or sneeze, or picked up via touching an infected object. Since it can live as long as 6 hours on your hands and up to 12 hours on objects, you can see how difficult it is to prevent exposure. It is very easily spread, especially from child to child, and studies have shown that other infants pose an even higher risk at spreading RSV from one infant to another. Some people have asked, “Can’t they just fight it off and it will build up their immune system? Kids need to get sick, right?”. The simple answer is no. Since our babies were born 6 weeks pre-term, they did not acquire the necessary immunities to fight off infection. If they acquire RSV, they could likely be hospitalized and develop other serious complications. The saying, "there is no cure for the common cold" is true for RSV. It’s up to the baby’s very weak immune system to fight off the infection, which is why many times it leads to more complications. Here is a great visual comparison of a preemies lungs compared to a full-term baby:




According to an online RSV tracking page, there are cases of RSV in Michigan. Thus, we’ll be asking our visitors to follow a few guidelines in hopes of preventing Olivia and Cole from contracting RSV or any other illness.

We ask that all visitors do the following:

- When you arrive, please wash your hands AND use hand-sanitizer as needed before touching the kids
- Please refrain from coming over if you are currently sick, if you live with someone who is currently sick, have been in contact with someone who is sick, and/or if you have not been symptom-free for at least 7 days.
- If you smoke, we ask that you refrain from smoking just prior to visiting, as their lungs are very sensitive. Most RSV sites recommend against passive smoke exposure. Although it’s not second hand smoke, it does linger and we’d prefer to be safe rather than add another risk factor. We will also be asking smokers to change into a clean shirt from our home when you arrive.
- If you are parents to a baby or toddler, please refrain from bringing them to the house during RSV season. If you have to bring over your child, please speak with us about it in advance.

There is a shot to prevent RSV. Unfortunately, Olivia and Cole do not currently meet the guidelines for getting the shot (Synagis), thus they are at even more risk for getting RSV. Because of this, we will not be attending events during RSV season, which unfortunately coincides with numerous gatherings. It is our goal to make it through this RSV season without Olivia and Cole contracting RSV or any other serious illness. Their lungs are still developing and are very fragile, at least until they are 2. Then we can all breathe a little easier. We hope you understand and we appreciate your support as always!

Echo cardiogram results...

Today, Cole had his follow-up echo and Olivia had her first echo. Cole's PDA (Patent Ductus Arteriosis) has went from large to mild/moderate...a sign that the Indomethacin is working some. He is going to stay on the medicine for a few more days (1 dose every 12 hours) and then have a follow-up echo sometime later this week or next week depending on his symptoms. He will definitely have one before coming home. When I called tonight to check on the babies, I was told that our baby boy has graduated to a crib!!! YAY Cole! Graduating to a crib means that babies are able to maintain their own body temps. Unfortunately though, Cole and Olivia were separated. They are no longer next to each other as they are now on different sides of the room.

Olivia was diagnosed with a small PDA today. She is starting her first round of Indomethacin (also 1 dose every 12 hours) to close it. She had to have her IV restarted since the Indomethacin is given through the IV. She will have a follow-up echo prior to coming home to see if it has closed. The neonatalogists stated that they don't usually give the Indomethacin to babies with small PDA's as the small PDA usually closes on its own and is not usually a problem to the baby (i.e. baby is able to breathe while eating bottles). They are giving it to Olivia to ease our minds with hopes of it closing faster.

For information on PDA's, go to:


http://www.nlm.nih.gov/medlineplus/ency/article/001560.htm

Both babies have also been diagnosed with Patent Foramen Ovale (PFO). The doctor's stated that this is a normal hole in the heart that is there while babies grow in the womb. For more information go to:


http://www.nlm.nih.gov/medlineplus/ency/article/001113.htm


We are handling things as best as possible....George better than I. As of right now, we have not been told when to expect the babies home. Olivia continues to progress well on room air and in her big girl bed, while Cole is growing and eating, receiving some IV fluids, and oxygen via the nasal cannula.

Thanks for thinking of us doing this time!

Happy Holidays!! Love, The Anders

Since I won't be getting around to Xmas cards this year, we put together another slideshow of pictures for all of you! We hope you have a safe, joyous and restful Holiday season!!! Best wishes for 2009!

Make photo slide shows at www.OneTrueMedia.com

A quick update...

Today our baby girl moved from the isolate to her big girl crib!!! You can imagine the looks on our faces when we saw that! She's also IV free! She's still having bouts of fast breathing and was diagnosed with a murmur yesterday (Saturday). She will be having an echo cardiogram on Monday. The neonatalogist is assuming the murmur is either a PDA or an ASD, both of which Luukas had as a preemie. Yesterday was a very hard day for me as hearing the news that all 3 of my children have (or had) heart defects was devastating to me. I'm very hopeful though and know that things will be OK. I just really don't want to watch either of the babies go through surgery. Luukas' scenario was traumatic enough.

On another note, Olivia is being given ONLY Soy Formula to see if that helps with the spit-up's. She is taking some of her feeds in bottles and others via tube. She had one bout of projectile vomiting this morning and many spit-up's prompting the move to the Soy Formula. So far so good! Boy, am I glad the NICU is gonna have her all figured out before she comes home!!! It took us two months after Luukas came home to figure out which treatment was best for his Reflux.

As for Cole....he's still on the nasal cannula (lowest setting). He is having less bouts of fast breathing, which is a good sign that hopefully the meds are working to close his PDA! Also, they increased his feedings today and he's tolerating it well. His feedings are a mixture of formula and breast milk. He receives approximately 2-3 feeds per day in the bottle and the rest via tube.

Cole had a really good day, as did Olivia!!! George, Luukas and I spent about an hour with them this afternoon. It was a great visit as we each (George and I) got to hold both babies!! Luukas wanted to feed them and had a hard time understanding that it wasn't quite time yet. He was very gentle with his brother and sister and very well-mannered in the NICU. On the way out, he told George "Daddy, I can't wait til Olivia and Cole come home!!" Hmmmmm...I wonder if he'll be saying that when they really do make their homecoming!

PLEASE CONTINUE TO PRAY FOR US as tomorrow Cole is having his follow-up echo cardiogram for his large PDA. He has been on Indomethacin since Thursday for it. If you'd like more information about PDA's.....please go to:


http://www.nlm.nih.gov/medlineplus/ency/article/001560.htm

Also, Olivia will be having her echo cardiogram as well tomorrow to diagnose her heart murmur (assumed to be a PDA or an ASD). For information regarding ASD's, please go to:

http://www.nlm.nih.gov/medlineplus/ency/article/000157.htm

Both echo's will be Live Reads with the pediatric cardiology group at Children's Hospital. George and I will be spending a few hours at the hospital consulting with the neonatalogists and taking a mandatory CPR/Safety class for NICU parents.

We hope you all have a great week!!!

Please say a prayer...

Hi....The last few days have been pretty eventful for our family. On Tuesday morning, Cole decided to pull out his ventilator and was moved to the CPAP. His sister followed later that day. By Wednesday morning, both babies were on the nasal canulas and wouldn't you know it....today (Thursday) they are both on ROOM AIR (Cole still has the nasal canula in his nose, but is breathing almost all room air). Cole spent one day under the "tanning beds" as he was a little jaundice. Both babies are also receiving 1-2 feeds per day via bottles!!! YAY!!!! They are very persistent and easily stimulated. They get agitated easily and according to the nurses, do not like it when the nurses spend more time with one of them than the other. We have not been able to hold either baby since last Friday, but should be able to tomorrow or Saturday. Also, tomorrow I'll be able to assist with their baths!!

Sooooo....here is where we need the prayers....

Both babies are breathing fast. Cole more than Olivia. Cole has also had a murmur for the last few days. Today, he was diagnosed with a Patent Ductus Arteriosis (PDA - open heart valve that closes at birth for most kids). You may remember this term, as it is the valve that Luukas had to have surgically closed at one month old at Children's Hospital. Cole's PDA is considered LARGE, while Luukas' was considered moderate/medium. The neonatalogists here work with the pediatric cardiologists at Children's and Cole's echocardiogram took place today as a live read with Children's Hospital. He will be given Indocin (the same medicine I was on to stop pre-term labor) tonight and tomorrow in an attempt to close the valve. His follow-up echocardiogram will be Monday, another live read with Children's cardiologist. If it remains open, a second course of Indocin will be considered and a consult will be ordered with the cardiologist at Children's. Dr. Holtrop, one of the neonatalogist working with the twins, is very hopeful that the PDA will close with the medication. He stated he has seen this occur with more mature/older babies who are having no other heart problems. Let's hope he's right!!!!

On another note, I was readmitted to the hospital last night due to severe anemia. I was having lightheadedness, chills, was extremely worn down, chest pains wrapping around my back and shortness of breath. I was in the ER for 6 hours while they ruled out blood clots in the lungs. My blood pressure and pulse rates were VERY HIGH when we got here and I now have a heart murmur from the anemia, which will hopefully correct itself. When I left the hospital after my c-section, my hemocrit was 7.4 and the doctor's increased my iron tablets to twice per day. Last night, it was 7.9. My body did not rebound as well as my doctor's had hoped, as I apparently lost a lot of blood during my surgery, and I am now very symptomatic. Thus, I was admitted and received two bags of blood today. I'm feeling a little better and have a little more energy tonight. The best news....my hemocrit is back up to 10.4!! YAY!!! I will be taking iron tablets three times a day now and will probably go home tomorrow night.

As I said....this week, especially today, has been full of ups and downs. I'm very sad for Cole and what he has to go through (it definitely is hard to not feel like we've been dealt the same card twice)...but I know he will be fine and home before we know it. I'm trying to stay positive!! It's very hard to not transfer our traumatic experience with Luukas onto Cole and the doctor's are constantly reminding me that each baby is different. We can only hope that the meds will close Cole's PDA and thus, I will have a more positive vision about PDA's.

PLEASE SAY A PRAYER FOR COLE!!! HE NEEDS THEM!!!! PRAY THAT THE MEDS CORRECT HIS PDA AND NO FURTHER TREATMENT IS NEEDED!!!!

Love to all!
-Rebecca

P.S. - Once I get home, I will upload more pictures!!!!

The last couple of days...

The last couple of days have been up and down for Cole and Olivia as the struggles of immature lungs usually peaks on Day 2-3 and stays that way for a day or so. As of 4:30 this morning, they have been able to be weaned off the ventilators some. We are hoping to see more of this over the next few days!! They may start feedings today (through a tube) and as soon as they're off the ventilators, things will move quickly to the point where George and I will be able to bottle feed them. George and I have to constantly remind ourselves that sometimes it's two steps back before a step forward. The good news is that there doesn't seem to be any other preemie related complications. That is a HUGE blessing!!! Last night, George and I visited Cole and Olivia together (and just us) for the first time since their birth on Friday. Cole (who has my feet and looks like Luukas) opened his eyes while we talked to him. He totally knew his mommy and daddy were there!! It was VERY precious. Olivia (she has George's feet and the nurses say she looks like George, though he thinks she looks like me) was sleeping away, but knew we were there. She looked so comfy in her isolette. Both babies are very easily stimulated so we have to be very quiet when we visit them, as they get agitated very quickly causing their respirations to drop. The doctor said this is largely in part due to their healthy size and gestation and that they just don't like the ventilator and tubes.

I'll try to get some more pics today....and definitely once they are off the ventilators!! Thanks, in advance, for the prayers!!!

Olivia and Cole's Birth Day!

Make video montages at www.OneTrueMedia.com

The TWINS have arrived!!!

As many of you know....Olivia Christine and Cole Justice arrived via c-section yesterday (12-12-08) at 33 weeks and 6 days gestation. The surgery went well and we were able to hold both babies just after their birth!! Luukas was able to meet his brother and sister within a few hours of them being born.

Olivia (bottom picture)- was born at 9:25 a.m. and weighed in at 4 lbs 8 1/2 oz. She is 17 inches long. Today she weighs 4 lbs 9 oz.

Cole (top picture) - was born at 9:26 a.m and weighed in at 5 lbs 6 oz. He is 17 1/2 inches long. Today he weighs 5 lbs 8 oz!!!

Both babies entered the world crying and screaming which were sweet sounds to hear. They are spending a few weeks in the NICU while they work on maturing their lungs. At birth, Cole was started on a nasal canela, while Oliva was starting on a CPAP. Both babies required intubation at about 2 p.m. yesterday afternoon. Being ventilated allows the NICU doctor's to give the babies Servanta (surfactent) which will help their lungs to fully mature. Also, Cole's calcium levels were low, so he is being given meds for that.

While both Olivia and Cole are doing OK, please say a prayer for them, as they are not out of the woods yet.

Love,
Rebecca, George and Luukas

We have a date on Friday morning....

TO MEET OUR BABIES!!!!!! Unless, of course, they decide to come sooner. YEP, you heard it right. My c-section has been scheduled for Friday morning!!! We are SUPER excited to meet Cole and Olivia and to give Luukas not one, but two siblings!!! AND even more excited that on Friday, I'll be one day short of 34 weeks! What a miracle!!

So to back track a little....On Sunday morning (4 a.m.), George brought me to St. Joe's bc I was having signs of labor. When we got here, the resident said I was 3-4 cm dilated. They checked me 3 more times and each time I was 4 cm. After that I didn't make any change, so I was admitted to the antenatal unit. Yesterday morning, Dr. Kazzi and Dr. Fabian (my favorite resident) stopped by. Dr. Kazzi said he is VERY happy with how far I have come and that since I will be 34 weeks on Saturday, he is more than comfortable with delivering the twins on Friday. He stopped the blood thinners (which means I have to walk the halls 3 times a day so I don't get a clot) and had the neonatalogist (Dr. Desai) come see me. Dr. Desai stopped by a few hours later and introduced himself. He told me all about the NICU, risk factors for preemies, etc. He was very nice and genuine and said there will be 4 NICU staff in the operating room on Friday. He said if the twins don't have any complications, they could be home within a week or two!!!

I'm having an ultrasound in a little while to look at weights and biophysical profile. The babies have been moving around and doing great on the monitors!! We are soooo thankful for that! I'll update in a little bit!

Love,
Rebecca

UPDATE 12/9/08 - Well, my ultrasound was postponed for a day, but I got to see my babies today for one last time before their birth on Friday. Both babies passed their Biophysical profile ultrasounds with FLYING COLORS!!!! Olivia weighed in a 4lbs 2 oz and Cole weighed in at 4lbs 14 oz. They expect him to be over 5 lbs by Friday!!! It's VERY VERY hard to believe that I have over 9lbs of baby inside of me, especially considering the fact that Luukas weighed 4lbs 12oz at birth. SOOOOO, we are more excited than ever about Friday!!! Dr. Kazzi and 3 residents will be performing my c-section. NOW, let's just hope these contractions stop and I make it to Friday (or at least to Thursday since Dr. Kazzi won't be here tomorrow).

Still playing the waiting game at 33 weeks!!!!

Let me just start by saying WHOEVER THOUGHT I'D GET TO 33 WEEKS!!!! I'm totally stoked to have passed 32 weeks and 4 days, which is when Luukas was born. Sooooo, here goes it.....my 33 week pic for you all to see!

Who wants bedrest anyways??

Apparentally Jena does!! She's in a debate with me and wrote a column about it in today's Tidewater News (Franklin, VA).

http://www.tidewaternews.com/news/2008/dec/04/trading-places/

32 weeks and 5 days!!!

Today I am 32 weeks and 5 days pregnant with TWINS. Luukas was born at 32 weeks and 4 days, so you can imagine the relief and pride I feel for having gotten this far.

We just got home from our NST and ultrasound appt. The twins look great. Fluid levels, heartrates, and movements are great. Both babies are practiciing breathing too. Dr. Fabian (Dr. Kazzi's resident) checked me and I'm still 90% effaced, though I am now 2-3 cm dilated. So, we're making progress but it is VERY slow which is great for the babies sake! As for me, it's getting harder and harder to walk around, sleep, shower, and just plain 'ol get comfortable. I'm definitely walking SLOW these days and waddling BIG TIME!!! I can hardly even fit into George's shirts and I can barely zip his coat over my big belly. LOL! I'm sooooooo ecstatic to have gotten this far though!! Each day is one less day the babies will be in the NICU and who knows, maybe I'll make it so far that they'll come straight home with us from the hospital. That would be WONDERFUL!!!

Hope everyone is enjoying this cold weather!!

-Rebecca