In the days following the arrival of our Thanksgiving blessings, I learned quite a bit of medical terminology that I had never heard before. Apnea, bradycardia and tachycardia were the most frequently heard terms in the first few days.  Many things were referred to in acronyms and all measurements were in the metric system.  It took quite some time to adjust to what a gram meant as far as weight gain – or loss – as well as how much a millimeter of milk was. All three babies had different issues on their journey.  And as brand new parents of three very premature babies, we had much to learn, experience, and accept.  

Twin A

Twin A is our first born little girl.  She was the one ready to enter the world early.  She was also the one to benefit from the doses of steroids that were administered during my 24 hours of labor.  The first thing I truly understood when the neonatologist and nurse practitioner came to my hospital room to give us updates on the second morning, was that she had the strongest lungs of the three.  On the morning I was to be discharged, we were told that Twin A was now breathing room air.  Of course, with no prior NICU knowledge, I assumed that meant she was off the vent and breathing all on her own.  Imagine my shock, (and disappointment) when we reached the NICU to see her still on a vent.  Thus began my first lesson on the oxygen level in our air!  Breathing room air simply meant she was breathing the same amount of oxygenated air that I was, but through the ventilator.  But not needing extra oxygen was a good thing.  Since she was doing better than her siblings, I was able to hold her for a short time before being discharged.  She never took her eyes off my face as long as I talked.  

She did have to battle a bit of jaundice that first week, but continued to improve slowly each day. To help provide nutrition without the need to start new IV’s regularly, a central IV line was surgically placed in her upper chest/neck area. Sometime around week four, she pulled her vent tube out.  She did well for a few minutes, so the NICU staff changed her to CPAP; another type of breathing assistance.  The hardest part of seeing that equipment was that it was placed firmly in her tiny, tiny nose.  But she did well, for about a week or so.  Then, at week six, she began retaining fluid, bruised everywhere she was touched and ended up back on the vent with 100% oxygen needed.  Her platelet count dropped to very dangerous levels.  She received platelets and all the attention and care they could give her.  She had so much fluid under her skin that she was almost twice her birth weight, but not in a good way.  I don’t remember if we were given the name of the problem at the time, but I am sure we wouldn’t have truly understood it all.  The doctor did tell us one afternoon that they had done all they could and for us to talk to God.  Which we were doing, as well as many, many others around the country. Slowly, she began to improve and her journey back on the vent was over.  She was back on the CPAP for a bit before moving to a simple nasal cannula for a small bit of oxygen.  Soon afterward she developed a preemie issue called NEC, an infection that develops in the intestine.  She was moved into a small private room for isolation.  She was watched carefully to make sure emergency surgery was not needed. Fortunately, the prayers of many continued to help her and she recovered in record time without the need for surgery. Miracle #1revealed! She was moved back into the NICU and was soon able to resume receiving small amounts of milk through a feeding tube.  

Another preemie issue is ROP, retinopathy of prematurity, a serious eye concern.  The retina is not completely formed in premature babies and can easily tear and cause blindness or severe vision loss.  A pediatric ophthalmologist checked her eyes regularly during the early morning hours, so we never met him .  Finally, after 110 days in the NICU, Twin A came home. We learned how to attach a belt for a heart and breathing monitor.  We learned infant CPR.  We were given all types of instructions, including making an appointment to see the ophthalmologist within one week of discharge.  We made the appointment with instructions to call the office upon arrival in the parking deck.(There was a phone near the elevators for use.)  We were then met at a private entrance and escorted to the doctors private office.  This was to avoid any possible germs from other children in the waiting room.  Preemies are very delicate for quite some time after going home.  The doctor placed her on his desk and began his exam, which was not pleasant to observe for this new mom!  He would look at her eyes, look at his notes in her file, look at her eyes again, then back to the notes.  Finally, he turned to us and asked if we were certain this was Twin A!  We assured him she was.  Then he informed us that he had expected us to make an emergency call to his office at any moment about her.  He told us that at her exam the week before she was very near the point of needing emergency surgery to save her vision.  Then, with shock in his voice, he informed us that “today, her retina is normal!”.  He would continue to follow her for about a year through regular appointments, but she was out of the woods as far as her eyesight went.  Wow!  Miracle #2 revealed!  

Twin A continued to grow on her own curve for weight and height.  Since her dad and I are in the very lowest percentile for height, she wasn’t expected to be very tall anyway.   She began walking at 15 months (one year, when adjusting for the three months prematurity) and talked a mile a minute by age two.  At her two year check up, the pediatrician felt her toe walking and a few other issues might be attributed to cerebral palsy and sent us to see a pediatric neurologist.  We had become very close friends with one of her NICU nurses, so I asked her to accompany us to her visit.  I knew that she could give him a brief rundown on her various issues in the NICU.  And she did.  When she told him Twin A had survived DIC, he stopped her right there and made her repeat that.  When she assured him she had, he told us that there was no way a 13 weeks premature baby survived DIC.  I sat there not having any idea what DIC was and exactly when she had it.  As the doctor began closely reading her chart, my friend explained to me that DIC was the issue she  battled when she was retaining fluid and bruising.  Again, the doctor said she should not have survived DIC.  Miracle #3 revealed!  I am thankful we were not aware how close to death she ever was. She was diagnosed with mild CP and we had a few short years of physical and occupational therapy.  Today, Twin A is a mom herself to two precious (full term) girls. She is a licensed professional counselor.  She certainly defied many odds with her survival after a sudden premature birth!  

Twin B

Twin B is our firstborn son.  He was the largest of the three by just a few ounces.  As I mentioned in the first blog about their birth, he was the only one of the three I heard cry in the delivery room.  He was feisty and didn’t like being poked and ventilated.  He too battled with jaundice those first few days. I remember his special “sunglasses” to protect his eyes during phototherapy.  After my discharge from the hospital, I had to rely on others to drive me to the hospital to see them until my post surgery check up.  My husband worked from about 3 PM to 1 AM, so he would go visit after work many nights.  His siblings and my sister helped get me back and forth during daytime hours those first few weeks.  This usually gave me about three to five hours each day to sit next to one baby at a time.  On day 11 of our NICU experience, my husband’s sister had driven me up since she had appointments in midtown Atlanta.  I went first to sit with Twin B that day. He was not yet stable enough for us to hold, but I could put my hand in and touch him through the openings in the Isolette.  He quickly grabbed my finger that day.  The hospital social worker came in while I was there to see how we were doing.  She was there to support us and help provide anything we needed during our NICU experience.  After a lengthy talk, I attempted to move over to Twin A & C for a while, but my sweet baby boy squeezed my finger tighter every time I tried to pull my hand away.  So, I stayed with him nearly the entire visit.  

Early the next morning, we received a call from the neonatologist that we needed to come to the hospital.  Our sweet baby boy had suffered heart issues and they didn’t believe he would survive another day.  We quickly dressed and headed to Atlanta.  We were told he would probably slip quickly into a coma.  But he remained alert that day and continued to stay stable.  We went back home for the night knowing another call could come at any moment.  The next morning, a quick phone call to check on him found him still stable and alert.  A friend planned to take me later in the day to stay for evening hours so my husband went on to work.  But, later that afternoon, we were told over another check in call, that he was beginning to slip away.  Family quickly drove me to the hospital while my husband left work.  After our arrival, we were finally allowed to hold our little boy. We sat with him for several hours. His big eyes stayed focused on us for quite some time.  A few family members made their way to the hospital as well to say goodbye – only grandparents were allowed in the NICU itself though.  I was still recovering from surgery and a severe kidney infection, so when they asked if we were ready for them to remove the vent and other tubes, so we could hold him while he left earth, I told them I would take the opportunity to visit the ladies room.  This shocked them, but hey, when you gotta go, you gotta go, right?   As soon as I walked back towards the NICU entry door, I could see my mother-in-law in tears and I knew he was gone.  You see, I truly did not want to hold him as he took his last breath.  God knew it was not something I could face.  But we were able to hold him afterwards.  We were placed in a small private room to hold him and see him for a while.  He was so, so tiny.  We said our goodbyes, each in our own way to our precious first born son.  We then took a quick trip back to the NICU to see our baby girls for a few minutes.  They both seemed to sense and know what had happened.  Just prior to his passing they each had their own “tiny issues” demanding (by setting off their alarms) a bit of extra care.  Once he was with Jesus, they both calmed down and rested well.  On day 16 of our NICU experience, we held a small graveside funeral for our precious little Daniel.  

Twin C

Twin C is our surprise blessing. I still laugh at the fact that she was identified as Twin C.  The nurses had made very tiny beaded bracelets during the night before delivery took place. The beads spelled out “twin A” and “twin B” and were ready to be placed on their Isolettes for one form of identification.  Since a third baby was a total surprise, the nurses quickly made hers to say “twin C” so they all matched.  She too battled a round of jaundice.  I can recall her skin looking the most yellow during those days.  Her hair was darker than her siblings, so I think her natural skin tone was already a bit darker than her two fair haired siblings.  She too was monitored closely for ROP in addition to battling minor issues keeping her heart rate steady the first few weeks.  She depended on her oxygen a good bit too.  But, she never truly seemed near the point of death – that we knew of.  She too had a central IV line put in place to help with nutrition.  She received what little bit of my breast milk she could. She remained on the ventilator for around 8 weeks, then the nasal cannula for a few more.  She kept wanting just the tiniest bit of extra oxygen (room air is 21% oxygen, and she kept breathing better at 23% oxygen.)  She gained weight a bit quicker than Twin A.  She could have been discharged a day or two before her sister, but we really wanted to bring them home together.  After all, if one was at home, how could I visit the other one?  The weekend before they were set to be discharged, the doctor sat down with us and shared a few details about Twin C that we didn’t know.  

You see, there are many protocols when it comes to preemies.  The first one has to do with their first 24 hours of life.  Since they were born at what was the earliest time to survive such a premature birth at the time, it was pretty much the protocol to only revive them twice during their first 24 hours of life.  The doctor shared with us that during that first night she had been called in twice when Daniel “coded” and she had helped administer medications to bring his heart back to life.  Twin C had also coded twice earlier in their first day in the NICU.  As the doctor was standing watch over Daniel, a nurse approached her to let her know that Twin C was coding again and asked what they should do.  The doctor then shared words I will never forget.  She said as she stood there considering options, she strongly felt a tap on her shoulder and heard the words “if you save her just one more time, I promise she won’t give you any more trouble.” (No physical person was there.) So she administered life saving medication once again.  And Twin C never did have any severe complications during the rest of her NICU stay!  Miracle #4 revealed! If her brother had not already been receiving care at that exact moment, we will never know what her own outcome could have been. In that respect, he saved his sister’s life. After 110 days in the NICU, our baby girls came home and we were truly able to be parents at long last! 

Twin C did have lingering vision issues longer than her sister, but her ROP cleared up and instead she faced eye muscle surgery three times over 13 years.  Oddly, at age 20, she was found to have a detached retina at her yearly exam and had surgery within days.  Timing was everything since she was about to start her second year of college.  But God provided once again.  Today Twin C works as a cardiac sonographer in a hospital.  She always wanted to work in the medical field in some way, especially cardiology, since her brother had passed away after his heart simply stopped.  

Following their homecoming, it took years for me to be able to look at another preemie in a hospital setting.  Movies with preemies were impossible to watch.  Even now, the days between their birthday and anniversary of Daniel’s homegoing, every single memory of those long days is foremost in my mind. The trauma of premature birth is hard enough, but add in an unexpected baby to the delivery and it increases the trauma.  But our God is bigger than any trauma.  With the support and prayers of many loved ones and many people we never met, we made it through and have been very blessed by our tiny Thanksgiving blessings!  

“In all this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials”              

1 Peter 1:6