3 Pound Babies! False Alarm on the Hernias

I know many of you have been antsy the last couple of weeks because the frequency of our posts has slowed down. For that we apologize, but we hope you all understand that the reduction of posts is indicative of the boys' positive progress. While I hate to be repetitive, no news is good news, so thank you for your patience between updates, and thank you so much for your support and prayers.

As you can tell from the title of this post, both boys now tip the scales at over 3lbs. Anthony checked in tonight at 3lbs. 5oz. and Jared weighed in at 3lbs. 2oz. Breaking that down into NICU-speak, both boys are tipping the scales between 1450 and 1500 grams. The magic number to get out of the isolettes (incubators) is 1800 grams which is roughly four pounds.

The steady weight gain is a result of the large amount (relatively) of food the boys are eating. Jared is currently up to 25cc and Anthony is up to 27cc. Both boys continue to eat via a tube that goes through the mouth and into the stomach. Anthony is fed via a syringe that uses gravity to get the food into his belly. This is called "bolus" feeding. Jared on the other hand, is still using the pump set over 30 minutes to get his food. In speaking with Jared's nurse tonight, they may try to move him over to bolus feedings tomorrow. Nurse Kim asked Dr. Rehan tonight if she could try to bolus feed Jared, but the doctor was reluctant because he wanted to give him a chance to adjust to his increased feeds. Both boys have had their feeds increased by roughly 4cc over the last week, which relative to the total amount of food they are eating is significant.

On the breathing front, both boys are doing superbly. As we have noted along this whole journey, the apnic spells and spells of bradycardia (decreased heart rate) are common and expected. Nonetheless, Anthony has gone several days without one of these spells. The same goes for Jared. According to Nurse Hilda, Jared has not had an apnic or "brady" spell since Wednesday. That is quite a feat for Jared considering he was intubated just four short weeks ago. Also keep in mind that the boys will grow out of these spells completely. We were told at the beginning that the spells are common until about 34 weeks gestational age. On this upcoming Wednesday the boys will be 33 weeks gestational age. 34 weeks is sort of a milestone because the spells should subside, but also because the boys can hopefully start nippling.

Nippling is the NICU term for eating food via a bottle or an actual nipple. For those of you confused, that would be Momma's nipple. Though Daddy does have nipples he cannot be milked. Now that we've cleared that up, we are excited for the boys to get a chance to nipple their feeds. Momma is anxious, but as with everything else we are confident the boys will let us know when they are ready.

This week's less positive news came via a diagnosis that Jared may have had an ingunial hernia. As with just about everything you've heard thus far, this sort of thing is common with preemies of the boys' gestational age. Here's what a inguinal hernia is: in the womb the sex organs develop. Early in development the organs are simply present and will eventually become testicles for males or ovaries for females.

When male babies are in the womb the testicles will not descend into the scrotum until later in the pregnancy. Sometimes they won't descend until well after birth. In any event, the testicles descend through the inguinal canal into the scrotum. Normally, once the testicles descend the canal closes up, though sometimes these openings can remain well into adulthood. In premature babies this canal often remains open, kind of like the ductus arterious (PDA). When this occurs sometimes a portion of the fatty material surrounding the small intestine or even a small portion of the intestine itself can protrude (herniate) through the opening. This is the same sort of thing that happens in male adults who get hernias. If you've had a hernia as a male adult chances are once your testicles descended, your inguinal canal remained open.

So, how do we fix this? We fix it just like we do in adults; surgery. Now to the good news: at first the doctors thought Jared had a hernia. The doctors thought Anthony may have had one too. Earlier this week Dr. Hicks was back on and was alerted to the possiblilty. Upon hearing this news he immediately ordered an ultrasound on both boys to confirm the presence of any hernias. Thankfully, neither boy has a hernia. We then asked why their little balls appeared to be swollen. Dr. Hicks explained to us that the reason they were swollen was due to hydrocele, which is just an accumulation of fluid around the testicles; again a common occurrence in preemies, and even adult men.

Over time the fluid should absorb back into the body (like the brain bleeds) and the boys will have normal twigs and berries, just like the rest of us. But, because there isn't a hernia now, doesn't mean one cannot or will not develop. The NICU staff will watch carefully for any growth (hernia growth, that is) in that region. Even if a hernia does develop though, surgery will not happen until they are almost ready to go home, or even after they go home. Hernias are not usually painful, and provided they don't cause complications can be dealt with in time.

So now that the boys' testicles have been discussed at length, we can move on to some other news. The nursery furniture was delivered this weekend much to Momma's delight. Contractor Mark came Thursday to install a chair rail, and crown moulding. Mark is the brother of Nurse Michelle in Labor & Delivery at St. Jude, who Daddy has known since they were Conflict Manager partners in 4th grade. Mark did an amazing job, and even more amazing it was cheap. He will be back to crown mould the rest of the house soon hopefully.

Anyway, the furniture arrived and was placed in the room. The only thing left to do now is have Cousin Tori come over and paint a mural on the wall for us. The theme is monkeys so we are hopeful she can paint a tree or something along those lines. Tori is an exceptional artist and we are confident she will create something amazing. In the meantime though we need to stock the room with the literal mountains of stuff in our dining room and office. Again, thank you to everyone for your generous gifts! Eventually we'd like to stock the nursery with two little boys, but that time will come soon enough.

On that note, many of you have been asking when the boys will come home. The short answer is that we don't know. At the beginning we were told at least until term, which would be around April 14. That isn't to say they won't come home earlier, but unless you hear from us otherwise expect mid-April. Many have also asked if they need to reach five pounds to come home. The answer to that is no as well.

Here are the criteria for discharge: 1) no apnic/brady spells, 2) steady weight gain over a period of weeks, 3) nippling of all food without complication, and 4) the ability to regulate their own body temperature outside the isolette. So as you can see, there is no magic number for weight. It was that way in the old days, but not anymore. That being said, we would expect them to be around 5 pounds around discharge.

So, that's the news over the last few days or so. Things are definitely looking up, but Danielle and I are still nervous. Though they have been doing well, they are still "25 Weekers" and have a long road ahead. Their lives are fragile, and we are ever mindful of that. We are hopeful and remain positive, but still keep grounded with the experiences we have had so far on this arduous journey through the NICU.

The days have become easier to deal with as time goes by, and our outlook and attitude has changed in the last couple of weeks with the boys' positive progress. But, the days are still hard. We still go to bed every night and wake up every day with our boys in the NICU. Daddy still trods off to work and leaves Momma at home alone. Well not totally, since big brother Schnitzel is there. Yet, our lives still revolve around trips to the hospital. Though our lives would never have been "normal" again after the birth of children we long for the opportunity to be "normal" new parents someday.

Everyday that starts to become a reality. We are increasingly doing more and more for the boys at the hospital, as evidenced by Daddy getting pooped on, etc. Yet, we still have an overwhelming guilt because we can't be our children's primary care givers. We love them immensely and want to do all that we can for them. We are well aware of the fact that we can't due to the their medical conditions, but it is still a tough pill to swallow given the way Danielle and I were raised.

We were raised that the consequences of our choices are ours, and ours alone. When we make a decision we were taught that it is our responsibility to bear the cross of that decision. So, it is difficult for us to leave our children in the constant charge of someone else. This isn't because we don't trust the NICU staff, but because Jared and Anthony are our children, our responsibility. But, we are at peace because we know our path has been set by God.

Our faith has told us for years that we need to let go and let God guide us. When you think about that concept it is hard, because God created us to be fiercely independent. We want to be in control and take care of everything. So many times the lesson smacks us in the face that as much was we want to, we cannot control everything. Where we cannot control life, or aren't allowed to control life, God takes control, and that is an amazing thing that allows us to be at peace with our boys in the NICU.

God is in control. He was in control on January 5. He has been in control since. Maybe he hasn't been in direct control the whole time, but we know he has been working through us, and through the wonderful doctors and nurses in the NICU.

For that we are grateful.

Fight On, Little Fighters!- Love Daddy