A very belated update from the twinmageddon household!

Girls are now 11 months old and tomorrow is the anniversary of the  day everything started to change. A year ago today we arrived in Boston for the marathon and tomorrow is the anniversary of the bombing (which occurred well after we left the finish area). A year ago on the 17th, Lara went in for a routine 24 week check-up and it was discovered that she had preeclampsia and Kat was <5th percentile and not growing appropriately. Lara was immediately admitted to hospital and put on bed rest. Lara can’t believe she was only on bed rest for a month. It seemed like at least 2 months.

How life has changed since then! Last check with the pediatrician a few weeks ago, Tasha and Kat were 16.5 and 15.5 lb, respectively. By our scale they are now in the 17 to 18 lb range. They have been healthy and happy with the exception of one cold (upper respiratory only, thank goodness). Tash got the worst of it, Kat and Lara got mild versions, and somehow Neil escaped it. We will consider ourselves incredibly fortunate if it’s the worst we experience for our preemies this first winter. Here are Kat & Tasha at about 10 months unadjusted age, both having mastered “sitting with stability”:

And here at 11 months unadjusted:

Lounging as the case may be for our Tasha bear:

Note incoming teeth and hair. Kat’s forte is the former and Tash’s the latter. On the food front, “mum-mum” crackers and cheerios are extremely well loved by Kat. She’s ready to end the bottle nonsense and move on to 100% solid foods. Tash is more a mushy banana girl and doesn’t yet appreciate chewing solids. Kat shows off her four of her six pearly whites and competes with mom at cracker-eating:

We’ve done a couple of road trips to Leavenworth and Whidbey Island. Amazingly the girls sleep very well in the car. Apparently road trips are the way to go for us right now! We also had several lovely visitors: Kelly made the trip from Saskatoon, and Grandpa and Grandma Diener from Toronto. We have also been thrilled to use the double Bob stroller. This thing is a remarkable piece of engineering and a joy to maneuver compared to the unwieldy Snap and Go we were using. Kind of like comparing a tricycle to a Bianchi. The girls clearly aren’t yet appreciating the marvel of this device, though Grandma and
Grandpa Diener did:

In other news, we are pleased to report that baby-Bruno bonding is going well: Dad & girls (“hoodie-off” and aquarium):

A sunny day at Green Lake…the girls have become more than a handful. Biceps are coming along well on mom’s part:

And of course some video footage for the hard core fans 🙂

Tash clapping, Kat playing peekaboo: https://www.youtube.com/watch?v=GWhDXho_-aY

Tash crawling, almost: https://www.youtube.com/watch?v=Y6FNxIeHcVc

Girls supposed to be sleeping: https://www.youtube.com/watch?v=y3Dsfmiqu0w

Tash consonants,Kat bouncing: https://www.youtube.com/watch?v=F9xmLuq83J0

Kat bouncing on mom: https://www.youtube.com/watch?v=kgrDIPBv5B8

Kat peekaboo with grandma D. and Tash: https://www.youtube.com/watch?v=-C8zmw7F07g

Happy to report the girls have been thriving!  They are now six months adjusted age and almost 9 months unadjusted. Tasha is a whopping 15 lb 11 oz and Kat is 14 lb 5 oz. That’s impressive growth for two girls who were two pounds not that long ago!!!

Tasha now looks like this:

Kat now looks like this:

They are more interactive with us, with each other, and with Bruno.

Kat telling Tash about her tricks…

Tash’s response…

…and then deciding the logical thing to do is stick her finger in Kat’s mouth.

OK. Maybe the girls are interacting with Bruno (grabbing at his fur as he strolls past) but he may not be so interested in interacting with them quite yet. Food droppings have helped so we think it’s just a matter of time.

The big “new” event of the last few weeks has been the introduction of pureed food.  Carrots, sweet potato, and avocado were all met with Bollywood-caliber dramatic grimaces and face scrunching looks of disgust. Banana was more successful. On every front, Kat has been more willing to open up her mouth and receive the spoonful of food, whereas Tasha’s mouth is more like a bank vault. We knew they were very different personalities from the get-go and watching how they deal with the newness of life at this young age has been tons of fun.

What do we do with this stuff??

oh….this is not much better…

Videos of the girls attempting food…

Girls v. Carrot:http://www.youtube.com/watch?v=ldcCZjI7Ph8

Girls v. Sweet Potato:http://www.youtube.com/watch?v=TTpEVtt7Jlg

Katarina v. Banana:http://www.youtube.com/watch?v=JnzP2dBC96A

Natasha v. Banana:http://www.youtube.com/watch?v=SC33VcaFHTg

Top three updates from the twinmageddon household!

#3: The teeth are here, the teeth are here!  Kat is leading the pack with her two lower teeth having popped up. She tolerated this very well. Tasha, on the other hand, has had teething angst. Generally more prone to crying and lots of pulling at her gums with her fingers. Infant Tylenol has been our friend at night to ease her discomfort.

#2: Kat made another big step in her feeding journey. She has had a thickener (xanthum gum to be precise) added to her feeds to help her with swallowing. The idea is that thickened, slightly gel-like milk goes down the throat more easily. This is one of the big reasons she was able to get off her feeding tube and avoid surgery. As of a couple days ago, we tried feeding her without thickener and she continued to drink like a champ. A wonderful advance for her.

#1: Seeing teeth and ditching thickener have both been fantastic. But I must confess my favorite highlight for January has been watching the girls make each other laugh for the first time. Warms the cockles of the heart, not times two but times 1000. At least. We discovered that Tasha is amused by Kat’s chatter and now cracks smiles her way. She broke into full guffaws when Kat was made to “jump” up and down in front of her. Seeing as Tash is usually the more serious one (i.e. harder to crack a smile out of her), it’s been tons of fun watching Kat provoke grins. Not a huge surprise as Kat smiles at everyone and it’s been said by several non-biased individuals that she has a most contagious smile. We sorta caught part of this on video:http://youtu.be/4TUdJvzMaCI

Sometimes, however, Katarina is not quite as successful: http://youtu.be/L_73JXQP0FY

Happy winter/summer solstice and other assorted holidays to family and friends on several continents!  We hope you’re all enjoying good company, health, and of course food and drink this holiday season.

After a year such as ours, we can’t help but reflect on the journey thus far. Thirty plus days of bed rest and uncertainty, a 28 week twin birth on Mother’s Day, 100 plus days of daily NICU visits, one daughter home and one in hospital, hospital parent rooms, endless hours of tube feeding by hand, and medical appointments galore. However, we can now say that it’s all somehow culminated in a pair of happy, healthy 5 month (adjusted) old twin girls who bring us immense joy. Natasha is now 14lb, 3.5oz (6.5kg) which (just) gets her onto the growth chart without adjustment, while Katarina is 12lb,10oz (5.7kg).  So we thank our good fortune and look forward to many years soaking up our girls…whatever their personalities may turn out to be! (REALLY hoping they’re good sleepers though).

A few holiday pics to help get you all in the mood if you’re not already. This is our impromptu holiday photo shoot in the living room rather than on Santa’s lap. Note usual photo bombing by Bruno:

Tasha enjoying a Christmas Eve photo op:

Neil hangin’ with the girls who still don’t seem too sure about each other:

Grandma and Grandpa Diener paid us a lovely pre-Christmas visit in early December:

And Uncle Anton and Aunt Vinaya met their nieces in November!

And some video because that’s the good stuff where you really see their “true selves” coming through- and we can prove that Kat is actually super smiley and laughs a ton even though it never appears that way when the black device comes out to take photos. Most recently she’s discovered bouncing on her own legs is hysterically funny (especially from 44sec onwards) (http://youtu.be/7c4pccC3geg). Meanwhile Natasha is more serious and instead of laughing makes a noise more like what we imagine a velociraptor sounds like. But in a cute way of course. We haven’t managed to catch that yet on video but here is her “Xmas Eve Address”: http://youtu.be/kOM3UCBlXX4

Short update today to let you know that Katarina now looks like this:

That’s  right,no more tube. She took to bottle feeding like we had been starving her for months. Here is the updated graph, and you can see she is doing really well.

And the girls have been improving their, ummmm, communication skills,mostly by showing joy and happiness and while Katarina has been showing this in a fairly traditional manner (http://youtu.be/dhsq58Oi-ww) Natasha has,well,found other methods (http://youtu.be/KaDz4IrWLh8). But generally everyone is getting along OK,even Bruno (http://youtu.be/1fpxHzOUwp4).

Oh and Natasha now looks like this:           

and Bruno like this:                                                                      

First off, a big thank you to Grandma and Grandpa Kitchen who have been visiting and providing extra help around the twinmaggedon household this month! Well timed visit as the girls were just ramping up their smiling and cooing frequencies, and fall color has been not too shabby.

In other big news, we are so very pleased to report that Katarina began feeding from a bottle (versus the NG tube or binky trainer device) and at impressive volumes. The feeding specialist at Children’s Hospital felt that she was old enough to have a thickener added to her formula…this magically made a world of difference. There was much celebration when she downed her first full bottle. She seemed proud.

The graph says it all and actually doesn’t even reflect her all time record volume achieved today (>500 mL orally by bottle). It’s a huge step and means we can begin to contemplate life without the NG tube and without having had to go down the road of a surgical G tube. The girls are still on a staggered feeding schedule (7am, 8, 10, 12pm, 2, 4, and repeat) so we are constantly feeding someone here, but feeding Kat by bottle with her nestled on our laps has been a joy and a vast improvement time-wise.

A noteworthy “first” for the girls was Canadian Thanksgiving, with the US holiday to come as round two. The girls seemingly had an instant fascination with meat (thanks to Aunt Meredith for this up close and personal introduction to meat).

Otherwise, the pediatrician has been happy with the girls’ development. They are very engaged in their surroundings, chit chat (especially Kat who seems to be the socialite already) at length, grab for toys, and can lift and hold their heads up. Even more fun is that they seem to have noticed each other. They lie on their mats and gaze at each other for short bursts, swatting their hands at each other and sometimes making contact and holding hands momentarily. It is very nice for us that despite all the flailing arms, Tash has not managed to pull out Kat’s tube a second time.

At this point, pics are far more entertaining than words so here are a few.

Smiling Natasha

Laughing Katarina

Lara and the girls

The whole fam

Close up of Bruno’s dapper haircut

Video links for those who need more baby time to come soon.

Happy Halloween!

To summarize: the babies are smiling, the babies are smiling!! This is definitely the focus of our photography now. It makes us even happier parents and you gotta love how babies have evolved to smile just when the cry-eat-sleep routine is getting a bit old. It’s especially gratifying that Kat, our previously reflux-ridden girl who struggled with every feed, was the first to beam at us at about 5 weeks (adjusted age of course). Thankfully a formula change has made a world of difference for Kat and throw-ups are now rare. We’re just working on increasing the volume of her feeds…which have greatly improved. Many graphs have been plotted by us. We love graphs. We will spare you the graphs. And statistics. 

Instead, smiling baby pics:

The other fun development has been letting the girls “play” together.

They lie on the play mat together and flail about quite happily hitting each other’s faces periodically without crying. I also thought I heard them exchanging coos back and forth during this morning’s play session. But then Kat let out a big yelp and I realized her sister had managed to pull out the feeding tube. No permanent damage. This was a good excuse to take a bunch of pics of lovely Kat without her feeding tube “accessory”.

Bruno has also adapted well. He now sleeps through nighttime feeds without lifting his head. He is still Eeyore-like but seems to be a tad more interested in the girls in a positive, they-could-be-part-of-my-pack kind of way. He is learning to share. We are very proud of him.

We’ve even been able to successfully navigate some outings, including quick lunches at (off hour, empty) local pubs, walks along Fremont canal, and a seriously major expedition to Golden Gardens.

Or we “relax” at home. Lucky for us Tasha is actually good at relaxing. Good thing as cooler, rainier fall weather has descended here in Seattle.

OK, so we need to start with a photo.

Yes, those are fairly standard expressions. No, they cannot scratch the top of their own heads. Mind you, they are not always like the above photo. Sometimes they are more like:

And sometimes, minutes later, they can be quite different (http://youtu.be/9wHI_7u58j8)

We’ve had them both at home now for 2 weeks and getting into a rhythm – this is definitely an at-least-two-person job. All the twins support groups/books say that it is critical to get them onto the same schedule so that you can feed them both at the same time. Unfortunately that is not possible as they are at completely different places in their feeding routine. Natasha is being fed by bottle and it is up to her how much she takes – usually around 60-70mLs which is appropriate for a three hour schedule.  Katarina however has been taken off the bottle as she appears to have developed a feeding aversion due to her reflux issues. This is a common complication with preemies, especially IUGR (intrauterine growth restriction) babies such as her. Basically, when she feeds she gets reflux which causes pain and so she is starting to associate the act of feeding with pain. So now she is on a special “binky trainer” and is fed through that until she shows any sign of discomfort (usually anywhere between 0-50mLs) and then gets the rest fed (total 80mLs) through her NG tube. Here is a photo of the set up. 

Note: Bruno is an optional accessory.

What this means for us is that Natasha is on a 3hr schedule and Katarina is on a 4hr schedule, which makes feeding a full time job. In fact, calculating it out, it takes 17-18hrs per day to just feed them both ( I’m not even sure how we would feed both of them simultaneously). This has been OK so far, mainly because I am on leave (it would be insane to be working right now) and because of all the help we have been getting from people. Big thanksyous have to go out to everyone who has been preparing meals for us. This has been incredibly helpful (and delicious!). Also big, huge thank you to Linda and Steve (the Diener grandparents),

who were with us for the last month – definitely a cause for celebration!

It was great to have you here. With the extra pairs of hands we were able to get out more:

Yes, the girls have already been to The Yard.

Bruno is adjusting. Sort of. Has his good days:

and his more “sad-face-I’m-being-ignored” days

and he is still getting very, very tired (http://youtu.be/Rl5i35FIWKs, http://youtu.be/EU3-52UkJtA).

The days have been spent feeding, holding (http://youtu.be/dSc2e_WYXEM), doing tummy time (http://youtu.be/c1ypDCCQ5kQ, http://youtu.be/2957v1cNPkc) and soothing the girls. We really enjoy holding them in devices like this:

because http://youtu.be/j_9wxLBeQWg

Anyway, better leave it there…I’m on the late shift tonight and the girls need feeding 🙂

After 103 days in the hospital, 117 days if you include the time spent inside Lara inside the hospital, Katarina came home today. She is right now sitting on the couch getting a feed from Lara after a big tandem cry session with her sister. And no, they were not cries of happiness at being reunited, they were cries of hunger and over tiredness. I’m not sure they really realize each other exist yet 🙂

She ended up coming home with a nasal-gastric (NG) tube as she couldn’t make the feed volumes required through the bottle. She needed about 70mL per feed (7-8 feeds per day) but usually only managed ~50mL so I inserted a NG tube yesterday to allow her to make up the difference. Yes, that’s correct, I did it. Of all the things I never thought I’d be doing to my children that is pretty high on the list. And if you had asked me before all this started whether I would be fine with that outcome then I would have had to think about the answer, but right now, of course, I am perfectly happy with it…because it means Katarina is now home.

We took a bunch of video. Here is Katarina being disconnected from the monitoring system (http://youtu.be/uIyngUSEqvE), breaking out of the ISCU (http://youtu.be/OJydsgqifh8) and coming home (http://youtu.be/XrKpJFsJcNE). Obviously more to follow, when we have time, maybe a couple of years from now 😉

Natasha, Katarina, Lara and I want to give a big shout out to their girlfriends still in the NICU:  Ellie (bug) and her mum Megan, and the twins Lola and Emilia and their proud parents, Kim and Albert. You are amazingly resilient, we are thinking of you all, and looking forward to the day that your girls break out and turn their faces away from the intense glow of the sun for the first time!

Short update today and no pictures (still or moving) because they are all stored on the home computer and I am writing this from a parent room in Swedish Hospital. These are the rooms where parents room-in with their kids as a final step to bringing them home. Last night Lara stayed with Katarina, handling all her feeds etc, and tonight (drum roll) I am rooming-in with Katarina! And we are going to party so hard we might stay up until 2am! In fact, we might not sleep at all!

So yes, this means that Katarina is in the final stretch before coming home 🙂

Katarina is completely off oxygen and still gaining weight appropriately (today was at 7lb 11oz) but has been having trouble feeding. She has a lot of reflux and does not appear to have as much energy as she should. So most of her feed volume has been delivered through her nasal-gastric tube (NG tube). At this stage it is difficult to know how to resolve this as there is no simple “one size fits all” solution. But everyone agrees (nurses, doctors, Lara, me) that it would be much better to have her at home rather than here in the hospital. Even if we have to bring her home with an NG tube or…there has even been talk of a surgically implanted gastric tube (G tube). So this weekend we are trying a bit of a “hail mary” pass – we have taken out the NG tube and are spending three days with her, giving all her feeds by bottle – she has no other option to feed, so if she get hungry she’s gotta learn to eat. Removing the NG tube could also help because these can be irritating (to say the least). So far she has an acceptable average but a very wide standard deviation. What this means to normal people is that she is doing ok but being inconsistent, sometimes takes, an enormous, 70mL and sometimes 15mL. And no, there is no obvious reason for the difference.

In other news, Katarina is no longer blonde, or rather the sides of her head are still blonde but the top is black. That should be an interesting style if it continues. Their eye color is starting to resolve and they both currently have dark blue eyes. Natasha uses them to flicker her glance all around the room and only occasionally meeting your gaze. Katarina just stares at you. Like, right into your eyes. And holds your gaze for a disconcertingly long time. Then sloooooooowly blinks. I’m starting to get the theme song from “The Good, The Bad, and The Ugly” stuck in my head (She’s Blondie, The Good, in case you were confused…)

Natasha has been at home now for a couple of weeks and we are starting to get into a rhythm. Sometimes Natasha lends her voice to the rhythm and it is a mighty voice, although needs training. Usually there is a reason for it although she does appear to have a “witching hour” which is late evening or early morning depending on what time we are expecting it. Yes, it’s always the opposite to what we expect. No, I don’t know how she knows. I’m sure this rhythm will not last with two of them, or at least will be a more, ummm, complex melody. I’m not even sure how we are going to feed them both at the same time. Natasha has broken the 8lb mark which means I can now carry her around in a backpack. Bruno is just about getting used to having her around. Poor thing. Doesn’t know what’s about to hit him.

Before I sign off: big thank you to the Diener grandparents. They flew in this week to help and it has been great having the extra hands around, especially since either me or Lara are in the hospital. While I’m at it, kudos to Meredith for the insane vegetable garden she grew – we have eaten zucchini and corn (!!) from the garden this week. Corn growing in Seattle. It’s been  a fertile year 😉