Day 11!!!

Today we get to meet with the cardiologist so we haven't made our way to the hospital just yet.  The updates from the nurses in the early AM and a little while ago were all positive though!  Nicholas has been slowly decreasing his oxygen assistance as well as Joseph.  We should hear about Nicholas' blood work either this morning, or early afternoon, so hopefully there are no signs of infection and they can take him off of his antibiotics.  Since they put him on those, they stopped his breast milk feedings, so hopefully they can resume those today. He'll have some catching up to do since Joseph is on 5ml every three hours and doesn't seem to be slowing down!!!

The cardiologist will explain in detail the situation with Joseph's heart, and give us an idea of what we can expect moving forward.  The nurses have explained to us that regardless of when he comes home, he will still need follow up with his cardiologist for a while, until they are certain his heart is functioning properly.  We are praying that the report on him is good, and hopefully they can take him off of his last medication today!

A quick update on My wife, she is doing great and getting stronger everyday just like the boys!  Her incision is healing nicely, and she is able to do more each day.  She cannot wait to be able to pick up Vince and hold him, which has definitely been the toughest thing for both Vince and my Wife!  Vince is in good spirits though and has really helped us keep smiling through this stressful situation!  It's still hard for us not to have him see his brothers yet, but again the joy we will experience when he sees them at home where they belong will wash away the feelings we currently have!!!


UPDATE 8/21/2013 2:45 PM:  We had a good meeting today with the cardiologist for Joseph.  According to the cardiologist, the specialist who was monitoring my Wife from the 26 week mark on made the right decision to deliver the boys when we did!  The doctor explained that a normal infant heart around this time is about 2 millimeters thick, and at about 10 hours after delivery Joseph's was about 8 millimeters thick!  He wasn't able to get any pressure behind his right lower chamber contractions to send blood to the lungs to oxygenate.  The doctor also explained to us that he doesn't feel that the boys were suffering from Twin to Twin Transfusion, instead he believes Joseph was suffering from a premature closure of the PDA.  When in utero the babies lungs are collapsed so all blood that goes towards the lungs from the right lower chamber has to be redirected through the PDA.  In Josephs case this wasn't happening because the PDA was closed, and his heart was almost backing up with blood because of the increase in pressure since the blood couldn't circulate.  This caused the right lower ventricle walls to thicken because they were overworked.  The cardiologist said that if we waited any longer to deliver, Joseph probably wouldn't have survived.  Again we can't say enough about the attention that was given to my Wife before delivery, and the attention that has been given to our boys since they were born.  This report from the cardiologist was very comforting because he is starting to see the right ventricle walls shrink and pump blood to the lungs without any major concerns.  We asked about any long term concerns and he stated that at this point he doesn't think this problem will be ongoing, and he believes that within a month or two the walls of Joseph's heart should be back to normal!!!

According to our cardiologist the premature closure of the PDA is a rare, especially at 26 weeks.  He stated that typically if this does occur it is much later in the gestational period around full term from 35 weeks on.  He also stated that it is extremely rare to happen in twins, or at least to one twin and not the other!  After practicing for over 20 years, he said that we are the first case he has seen where the PDA closed in one twin so early, and had no effect on the other!!!  Not something we really wanted to be remembered by, but hey there's a first time for everything!!!

Joseph has not missed a beat either, he is on lower oxygen support today, and has been increased from 5 ml of breast milk to 7 ml of breast milk every 3 hours, so again he is following the Gallelli name in being a good eater! He has responded nicely to both the increase in feedings and the decreases in both the NO2 and his other heart medication.  We hope to have him off of his heart meds by the end of the week, and off of his NO2 shortly thereafter!

Nicholas has been back to himself again today, and they have taken him off of the antibiotics, as they have now ruled out an infection!  The x-ray of his chest and stomach looked clean this morning, so they are attributing his bleeding to either an ulcer or simple irritation.  He has remained high on all of his blood numbers since yesterday morning, and according to his nurse is having a "Fantastic" day!!! We hope to have him feeding on breast milk again soon, but of course they will monitor that very closely and start him off on a very small dose to assess his ability digest the milk!

After our meeting today my Wife and I were very happy, and we looked at each other without saying a word and realized just how lucky we are to still have both of these little guys in our lives.  We are so thankful to the specialist that took care of my Wife and the amount of time he spent with us to make us comfortable with any decisions he made, and after today we know he made the right call to have these boys join us on August 11th!!! 

UPDATE 8/21/2013 10:15 PM:  I just returned from my late visit with the boys, and everything has remained pretty stable today.  Joseph has gained weight again and is currently up to 2lbs 7 oz, just one ounce shy of his birth weight!  Nicholas put on 10 grams which doesn't really alter the ounces much, but it's a good sign, and he is still above his birth weight!

Nicholas has developed a bit of an attitude when the nurses don't lay him the way he wants, he was sleeping on his side and then became really agitated so the nurse moved him to his stomach and he was immediately happy again!  That's okay though, these boys have been through a lot in just a few days, so they can complain a little bit!!! 

Joseph seemed rather content tonight since his tanning light wasn't on, and he had his cool shades removed.  He seemed to be sleeping comfortably, that is of course until I stuck my big paw in there to give him a goodnight high five!  He settled back down with no issues though. 

I'm sure the nurses were happy to see me go tonight since both boys were perfectly quiet until I showed up :).  Oh well, they better get used to it!!!  In all honesty I think the nurses love when the parents visit, they take the time to share their experiences with you and listen to your concerns.  It's probably because they are working with babies and the same nurses all day, so they look forward to another person to listen and talk to!  Okay enough of my analysis on the nurses, someone called them "Angels in Blue Scrubs" which is the best definition we have, so we're going to steal that one!!!  Sorry the pictures are so dark, I didn't want to disturb the boys more than I already had tonight!!! Tomorrow's pictures will be better I promise! 

My little Nicholas all cuddled up!!!  Goodnight sweet baby boy!!!

Jr. enjoying a night without his shades!!! Goodnight little buddy!!!