Thursday we got some really amazing news about Liam. They did an ultrasound on both kids heads to see if there was any fluid or other bad things floating around in there. Not only were both kids free of fluid, Liam's brain bleed is resolving!!! I don't think I posted on this before so let me give you some background. Micro preemies like ours are at risk for lots of things. One danger is brain bleeds. Liam had level 3 and 4 brain bleeds. 4 is the highest and worst level with the most damage. Outcomes for kids with level 4 bleeds can range from very mild developmental problems all the way to cerebral palsy. Both kids are at risk for CP but so far they don't show significant signs of it. Liam's recent ultrasound showed that his bleed has almost entirely dissapated and his head looks almost the same as Chloe's. His Dr. couldn't believe the results. She said it is likely he will develop with very mild to no problems. There is of course no guarantee but these results are really encouraging. As the twins progress and hit or miss developmental milestones (which don't really start until they hit their due date in 6 weeks) we will get a better idea of what issues we may be dealing with. We feel strongly that God has big plans for these little ones and whether that includes developmental challenges or not, we are so excited to be their parents and help them fulfill their life's missions.
Some of you have asked about their eyes. They are doing great. Another risk for preemies on lots of oxygen is Retinopathy of Prematurity or ROP. The worst level/stage of ROP can result in blindness. I learned this week that Stevie Wonder was a preemie and it was because of excessive oxygen that he became blind. Doctors understand all of this much better now and they have learned to keep the oxygen levels as low as possible to protect their eyes while still helping them get enough oxygen for brain development. It is a balancing act. The twins last eye exams were a week and a half ago. Both of them have Level 1 Stage 2 ROP. This is good. It would be impossible for them to escape without some level of it given how early they were and how much oxygen they've needed. Chloe's has even improved some since the last test which reflects her progress towards breathing on her own. Hopefully hers will continue to improve and she may totally outgrow this problem. Liam's has not gotten worse and when he finally comes off oxygen his will hopefully improve too.
Here's an update on all their discharge criteria.
Weight: Liam has been gaining on Chloe this week. Don't have the exact number on hand but both kids are at about 1300 grams. Yeah! Some of the Doctors are concerned they they aren't gaining weight fast enough but they seem otherwise healthy and they started out so small (600 grams) that we can't expect them to be as big as other babies.
Take all food orally: Chloe is a rockstar. She is now taking 2 feedings a day orally. Sometimes she doesn't finish the whole thing but she gets most of it. It is so fun to nurse her and see her big eyes looking up at me. She loves our time together and anticipates it when I go to get her from her isolette. She starts rooting and wiggling and trying to get out herself. Liam has started doing some oral feedings too but he gets tired after about 5 minutes. He also enjoys the experience but mostly wants to sleep through it. Such a guy:)
Maintain Body Temp: They are both staying at about 32 degrees on their isolettes. The Doctors may experiment with taking them out of their isolettes next week. We'll see how that goes.
Breathing Room Air on their Own: Chloe has been doing this for over a week. Liam has struggled a bit more with this. He is using 1 liter of nasul cannula flow (that's in increase) but this allows him to use a lot less oxygen. His range is between 21 - 26% most of the day now. (Room air is 21% oxygen) We hope that he will start hanging out in the 21% range more often and then they will try to take his flow down again.
As you may have guessed Chloe is progressing rapidly. It is not unlikely that she will be discharged in 2-3 weeks. We are excited and terrified at the prospect. It will be really hard to have the twins in two different places and I'm not sure how we'll deal with that. We are praying that Liam will catch up soon.
Kelly got here yesterday and he brought camera stuff. We should be able to start downloading pictures more easily soon. It's so nice to be all together again (sort of). Isabel really missed him. She got a fish this week named Ariel and Isabel takes her care very seriously. Belle went to visit cousins overnight for a few days this week and asked Grandma to take time off work to babysit Ariel while Belle was gone. She has also made up a lot of rules about how close you can stand to Ariel and how you may interact with her. Sounds sort of familiar...
Thanks once again for all your prayers and kind thoughts. We love to read your comments and we know that all your support has made a difference.
To all our friends in Utah, I hope you can come to the shower next week. Isabel and I would really love to see you!