Nate is still on the nasal canula and was given Lasiks to help purge some fluids today. He was up to 4lbs., 2oz. He nursed every meal today! No more orange tubes! (maybe)

Thomas's face is tape free! He yanked his tube early yesterday, and hasn't forced any nurse to put another back in. He was up to 4lbs., 6oz. He has completed day 2 without any Apneas or Bradycardias, which means he is still on target to go home either late Sunday or more likely Monday. Since he slurped down more than he needed to at every feeding, he will most likely go on ad lib feeding due to his breaking of the 2kg barrier.

Quick Update

Nathan and Thomas are doing well. So far, Tommy was spell free today! He yanked his feeding tube and has behaved himself with the bottle to the point that he has gone 12 hours without it being reinserted... Kathleen (the nurse practicianer)figures that Tommy will go straight home and Nate will go to Emerson. Nate is finishing bottles but he still arches his back and then Desats about halfway between feedings. Otherwise, I think he is O2 is <25%. He got a humidifier tube on Monday and I think that has helped the snots...

Jen bathed them both last night.

Upgrade

Nate was moved back into intermediate care yesterday. Hopefully this time he can stick with his brother! The nurses (and we) think he has had a cold. Hecertainly has a lot of snot for a little snot and that's not a joke! He seems to be getting better each day though, and he is gaining weight.




Right now, we are cautiously optimistic about thepossibility of Thomas coming home this week. He is bottle feeding (although he tires for the last 10cc'sof his milk...)

Jennifer is doing better also. Her mood tends to be closely bound to their condition. Nate had a pretty bad week before Milford, but he is doing much better
now.

Today's weights:
Tommy is at 4lbs., 5oz. (One pound above his birth weight!)
Nate is at 4lbs., 1oz. (One pound and one ounce above his birth weight!)

We had a nice long night tonight.Thomas is really starting to understand the bottle, and slurps down ~15 to 20ml of milk at each feeding now. The nurse on duty said she thought he'd definately be home in less than two weeks.


Nathan also looked better tonight, although he is still on the CPAP. He kangarooed with me for over 3 hours and sucked on his pacifier for over an hour of it. They tried to take him off today, but it is still borderline. They'll try again tomorrow.

He went for almost a week breathing with partially colapsed lungs before he got tired and started taking little breaks, called Apnea Episodes. After putting it back on him Monday, they tried to take him off today, but it is still borderline. They'll try again tomorrow. He kangarooed with me for over 3 hours and sucked on his pacifier for over an hour of it.

Because, Tommy is learning to suckle, and they've been separated due to Nate's remedial breathing classes, I've spent most of my time (I don't have the equipment for Tommy) with my buddy Nate. He's definately breathing easier and purging the CO2 better with the CPAP. The CPAP is not really a walk in the park though. Picture having two garden hoses hanging off your nostrils and an hot ski cap that has velcro to help hold the garden hoses in place. Now picture you are a rather warm little boy who would like to move your head because the hat is ichy. The hat rotates as you move your head so that the little things that go into your nose start to yank your nose sideways and you feel like a fish on the hook. If you can picture all that, don't you think you might be a little cranky? I would! Well, so is Nate, and I say good for him! He doesn't like to be moved around much (rightly so) but when he does get moved, he has no problem using the CPAP enhanced lung capacity to voice his opinion! He apparently finds that bowel movements are also painful to his nose as he seems to save up until he is being moved around for times like a diaper change. Being the crafty fellow that he is, he seems to like to emphasize how uncomfortable he is by not releasing until after the old diaper is removed. One time this week, I found out just how necessary those diaper wipes are, and that you need to have more there than you ever expect use. I ran out. The next time, I was more prepared, but we still went through two diapers...

The thing that happened though that I won't soon forget was that Dad seems to have a calming effect on him. Jen was changing him and he started into a fit which pushed him into a Desat (low blood oxygen saturation) and it wasn't until Dad held his hand that he calmed down. That was pretty cool. Thanks, Nate!

Here are the weigh-ins as of Friday evening:

Tommy: 3lbs., 15.8oz. Oooh, so close!

Nate: 3lbs., 10.2oz. The upward march continues.

The good and the bad

Nathan is still putting on weight, (3lbs., 10oz.) but he still can't breathe on his own. He was put back on assisted breathing CPAP (Constant Positive Air Presure) to keep his lungs from colapsing again. Certainly the talk on transferring him to Emerson was very optimistic, and he not going anywhere soon.

Thomas, on the other hand is doing very well. He is out of his Isolette and into a crib, pushing 4lbs. (actually 3lbs., 15.8oz.). He is starting to nurse some, which helps his mother a great deal, too.

A big step backwards

Nathan went back into the Level 3 ICU yesterday. He had been having a very hard time breathing for most of late last week, so he has the CPAP again to keep his lungs from collapsing. Tommy was in his crib last night when we got there. Jen held him for two and a half hours. He watched me for about an hour while Jen slept..;-) He is doing really well.

Finally an Update...

I'm sorry that I have been lax on sending out any updates. It is a lot easier to give good news than not so
good. We do have good news, but not everything is great. I will start with the good stuff first, though.

Both boys were moved from the Level Three Newborn ICU (NICU C) to the Level Two ICU (NICU D) , or as I call
it, from Cell Block C to Cell Block D. The difference is that the Level Three ICU does IVs, respirators, and CPAPs. The level two is more relaxed, with one nurse to four babies instead of one nurse to two babies. Emerson Hospital in Concord has the Level Two Newborn ICU but not the Level Three.

Thomas is doing extremely well. He has rebounded from bottom out weight of 3lbs., 2oz., to 3lbs., 12oz. That puts him 7oz. above his birthweight. He has been off of any type of breathing assistance for over a
week and a half. As of today he is able to maintain his own bodyweight and is coming out of the Isolette Incubator for a crib. He actually seems very aware and stays awake for as much as an hour. He took a bottle this morning for the first time and ate about
8ml of milk. There are three things that he has to be able to do before he can head home: He has to breathe on his own, he has to maintain his body temp unassisted, and he has to be able to be able to take nurse. He is well on his way on two of these and he is tackling the third with a vengance, according toJen.

Nathan is not doing as well as his brother. From the start, he has had an issue with low blood sugar. In
an effort to treat that, other things in his development needed to be traded off. He had no trouble breathing from 4/6-4/11, but the increased fluids he received to treat the the glucose levels made it harder to breathe and he ended up going back on a nasal canula to deliver more oxygen. As last
week progressed, he required more and more. There was a rattle in his lungs this morning and he is having frequent Apnea spells where he stops breathing and his heart starts to shut down. They x-rayed him this morning and gave him a diuretic to dry him out a little. They also plan to reduce the fluids he has been taking in. He is also fighting a bacterial infection in his eyes... His weight gain is as good as his brothers. He also is 7oz. above his birth weight and 10oz. above his minimum weight of 2lbs., 13oz., at 3lbs., 7oz. While he is keeping pace withTommy, Nate's weight gain has been sporatic. One day
he'll gain 80grams (~2ounces) and then he'll go two days without an increase. The medical staff said it is healthier if they gain a half to three quarters of an ounce per day like Tommy has done. All in all, they say Nathan is a typical premie, and will be fine. As his Dad, I wish he were a little healthier.

In the last email, I had said that they were ready to go to Emerson, which is a lot closer to home and work.
We were told on April 8th, 11th, 14th, and 15th, that there was no room at the inn. (I know, my opinion of my kids might be a little high if I use that phase...) It's been quite a roller coaster of hoping today they'd be moved and then being disappointed. On Friday, I requested that the medical staff at Brigham and Women's not use the word "Emerson" unless the word
was preceeded with the phrase "ambulance your boys is on the way to"... Well, last night they forgot I'd asked that and told us that Emerson called yesterday and that they had the beds ready for Tommy and Nate.
However, the pediatrician covering for the one that just left for a two week vacation wanted to watch Nathan for another day or two because of his
condition... So it looks like we may have while yet at B&W fighting Fenway or Marathon or just typical Boston traffic...

At then end of this, you might ask, so how is Nathan really doing? I wish I knew. I know he is adorable. I know he smiled at his mother before his brother did. I know he likes to grab the hairs on his father chest, and that if he weren't fight the eye infection, he'd also be coming out of his Isolette. Based on everything I've heard from others who have gone through this, he'll be fine. It is just a little hard right now to think long term.

Still not transferred...

The babies are doing ok. Nathan is doing "Typical Premie Stuff." That means he needs more O2 now...

Thomas is doing really well on the caffeine...

Emerson is playing Lucy and we get to be Charlie Brown. I asked the staff at B&W to stop telling us they called unless they are going to be moved.

Tommy is doing extremely well, while Nathan is doing about average for a premie. Nathan had a low blood sugar issue last week which has snowballed into another round of minor assistance in breathing. Right now though, it's Jen I'm worried about. She doing great physically, but she just loses it whenever we see a pregnant woman, which is nearly every day. Through in the fact that when we get to hold them, we have to be prepared for them to have episodes where the stop breathing, or their hearts stop breathing. No big deal, really, it happens 4 or 5 times a day. Right now I really wish that it was a big deal when my kids heart stops.

Leave issues

I called about the FMLA this morning after the third time this week Emerson said to call another day. I've not done as well with updates this week, but, it's been a mostly a frustrating week. It's really starting to wear on Jen. Today, she is the one I'm worried about the most. I don't know if it's post pardum or no babies at home, but she seems to be slipping into depression the last day or two. Emerson would give her a a room and I'd feel a lot better leaving her at the hospital before work than by herself right now. Nathan has had a couple setbacks this week, although he is still gaining weight... Tom is doing extremely well, and I suspect will come home much sooner than Nathan.

Emerson is hard to get into...

Still no room, but Emerson said to call tommorow.

No room...

Emerson told B&W yesterday that they were full and to check back on Thursday. None of this is working out like I had planned...

Tommy and Nate were upgraded from the class 3 ICU to a class 2 today. We had hoped that would also mean a change in hospitals, but so far that isn't working out... They are both 2 oz. above their birthweights as of last evening...

Next stop Emerson!

The boys are doing well, although the parents are getting tired and cranky. If you call us and I bite your head off, please don't take offense. It's been a long week, and we've seen more than we ever wanted to see. Both are now a little above their birth weights.




Thomas is up to 3lbs., 6oz. while Nathan is still trying to break the 3lb. barrier at 2lbs., 15.97oz. Actually, that is 10 grams higher than his birth mass.

Nathan seemed a little low on his blood Oxygen levels today, so they put the little nasal tubes that even adults get to deliver O2. Once they did that, however, his levels went right up even before they turn the oxygen on. Oh, well...


Thomas's heart kept wanting to act like a grownup's heart and slow down to around 75 today. That was because he was snuggled in and sooo comfortable on Jennifer's chest today during Kangaroo care.

They no longer require level three intensive care and we hope they can be transferred to Emerson Hospital in Concord ASAP. They have a level two NICU and it is much closer to home and only 15 minutes from work. We stopped there last night for a tour and it sounds so much more calm. While they might forget to breathe of their heart skips a beat or two, they are basicly healthy premature babies who need to grow.




What they and their parents don't need is any more drama. In the last email I mentioned that there had
been triplets born and two of them ended up on either side of Nate. Jen and I even felt like our guys were
being ignored a little Thursday night because of them. Well, one of them was conspicuously gone Friday.
Hoping that he had just been moved was silly. Leave it to the five year old brother of the triplets to
tell the nurse and the rest of the room that he had three brothers, but one was dead. The Mom never even
made it down to the NICU to see the little guy named Kevin. The Dad never seems to shed a tear and still
is proud of having two sons, but I did as soon as I heard that five year old.






Then I offered a little
prayer of thanks that my guys are going to be OK.

Mom is home but misses her babies...

Jen got home last night. It seems almost cruel to send a mom home without her babies.She handled it very well though.

The boys are improving. Tommy has been off his CPAP (the the thing on Nathan's nose) for a couple of days now, an Nathan will probably come off it today. They both maintained their weight yesterday, so hopefully everything will be on the up and up...

Pics 04/05

Too tired for words. Sorry.













-m

Couple pics of Thomas...

Tommy did pretty well today. Jen was able to hold him for over an hour. Nathan started to improve tonight to the point that he was going to be fed for the first time. He is a little behind his brother, but he is pretty typical for a 31 week premie...

Have to got to bed now...

-Matt

Early arrival of Thomas Paul and Nathan Gordon Rider

We have two baby boys who seem to have broken the the Rider tradition of always being late in that they arrived two months early today.

Thomas Paul was delivered at 11:24AM weighing in at 3lbs.,5oz.

Nathan Gordon was delivered at 11:25AM weighing in at 2lbs 15oz.

While the boys are in the NICU at Brigham and Women's in Boston, they seem to be doing better than expected for babies at 7 months.

Jennifer is doing very well and is in room 832.

Matt is thunderstruck and already badly lacking sleep. He should go to bed now.

Love Matt and Jen and Tommy and Nate

Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz