Moving Up

This weekend, the kids have taken some great positive strides, but we'll save the best for last: First, all three are no longer on IVs, which means they are getting all the nutrients they need from feeding (including a growing diet of breastmilk, courtesy of Mom) and shows their capacity to absorb food. Second, the girls both came off their CPAP machines; CPAPs (continuous positive air pressure) are not ventilators since they do not breath for the patient (it is a major positive sign that the kids have never been on ventilators), but instead have a tiny tube that sits just inside the exterior tip of the nostrils and mildly blows compressed air to make sure breathing passages are open so the kids can breath on their own. Third, all their bloodwork has been excellent.

Which leads to the first part of the exciting news: Today, Easter Sunday of all days, Rory graduated from the NICU (neonatal intensive care unit) to the next step up, the SICU (special intensive care unit). Babies only get moved up if they've demonstrated a steady capacity over a day or two to breath without a CPAP (i.e., no apnea, or "apnic events" as the docs and nurses call them), require no IV, and have excellent bloodwork. Tonight at 7 p.m. Danni graduates to the SICU to join her sister. Tomorrow or the next day, Leo is likely to join them there. Typically, we've learned, boys move more slowly through the NICU than girls, so it's either that or the girls are just showing off. We spent the better part of the weekend with the kids, and after a little break today will be going back tonight to root Leo on and to see Rory and Danni in their new digs.

A SICU and a NICU, though, can be daunting places. At this hospital, which actually has one of the best such units in the country, there are 38 infants in this care at any one time. Each baby is on monitors 24 hours a day checking their heart rates, breathing rates, temperatures, percentage of oxygen intake, and more, and we have gotten pretty good at reading the meaning of the figures on the computers near them. Every 12 or 24 hours, depending on each child's status, the children get bloodtests, which means a prick with a needle in their little heels. Intravenous tubes run from the tiny arms of those needing extra nutrient support, and most, like our babies at this point, have tiny tubes running into their mouths down to their stomachs for feeding since they are not yet strong enough to suckle for themselves. A specialist nurse keeps a close eye on every two to three infants and manages their care. The nurses, by the way, are outstanding down the line, and across the shifts we've met many of them. It is incredibly comforting to experience their affection for their charges and to learn from them as they describe what they're doing -- and let us join in too, such as changing the kids.

Meanwhile, every day, one of the NICU doctors leads a small team of a couple residents and a nurse on "rounds," evaluating a host of data about each child's status and altering their feed rates, IVs, and so forth depending on their progress. We have been lucky enough to be there for rounds every day for our threesome, and the doctor really is excited about how well they are doing. We're counting on Leo to join his sisters at the next level soon!

Now, the second piece of the really exciting news: Because the girls are off the CPAPs, they no longer have the gear on their heads or faces that these devices requires, which means that we have been able to see both of their faces for the first time for an extended period, and today held them for a long while as they looked at us in all their glory and studied our faces as we studied theirs. In case you're wondering, yes, they are indeed identical. And, if we don't mind saying, they are absolutely beautiful.