Maggie free of tubes

Now that Maggie is getting all her nourishment from bottle and breast, her gavage tube has gone the way of the Edsel, and her face is tube (and tape) free. Huzzah! This is a splendid development, especially since Maggie's face was covered by breathing tubes for the first several days, putting her at a decided disadvantage to her sister in the photo department. Not to be outdone, Bea has been pounding bottles with wild abandon, so her gavage-tube days are certainly numbered.

Slaves to fashion

When we arrived this morning for the girls' feeding, we found Maggie styling in bright yellow pajamas. Well, maybe drowning would be the right word. But she's determined to make it work. Bea's new look features a big cap like her sister -- no more jacobin stocking-cap for her. She took her first bottle from her dad but couldn't quite finish it, so is seen here receiving the remainder via her gavage tube to make sure she doesn't miss a drop of goodness. Finally, just an update on Bea's growth: Her thumb is still smaller than Dave's.

Maggie gets a new monitor

Maggie has been hooked up to a new monitor (small box on the counter at the right of the left photo) to closely track and chart her breathing and heart rate to make sure that she's ready to be set loose in the world. A decision could come on Monday in which case we would likely sleep over that night or the following night as transition and then bring her home the day after that. We are to bring in the car seat this weekend so all is ready for The Car Seat Challenge, a grueling one-hour marathon of, um, sitting. In a car seat. The Maggie photo is identifiable because a) she's in an open crib, and b) that crib has a nice sign that Cami, one of her all-time favorite nurses, made for her -- Maggie Moo. The other photo shows Cami's other handiwork: Bumble Bea. Yes, the girls appear to be gaining a NICU following. Bea had her first bottle today, downing the whole thing, and both girls breastfed like champs.

Little Hands

Both girls continue to make progress, getting more and more of their daily breastmilk intake by mouth and putting on the ounces. After their evening feeding, they both seemed to have particularly fetching hands, so here is Bea with hands nearly crossed in her mother's arms, and Maggie all swaddled with a few fingers out and about.

Maggie out in the open

Maggie is now in an open crib and doing a fine job maintaining her temperature without the assist of an incubator. She is no fan of baths either, but since her father was the one bathing her while Heidi nursed Bea, there is no photographic record of her misery. So instead here she is following said bath, now all swaddled and cozy. Great look!

Bathing Bea

It is difficult to express in words how much Bea does not like taking a bath, but these pictures provide a pretty good idea of the Sturm und Drang that accompanies this maneuver. Tonight's bath from her mom was the first in Bea and Maggie's new digs: the step-down room within the NICU. Most of the babies in this room, which is adjacent to the main NICU facility, are in open cribs and several have car seats next to their cribs ready for them to take the Car Seat Challenge (an hour therein), which is the final test before heading home. 

Big yawn!

In this fabulous photo taken by our dear friend Rennie on her iPhone, Maggie shows off her ability to express ennui. She will soon be wearing a black beret and drinking absinthe if we let her.  Maggie graduated from her incubator today, moving to an open-air crib. Both girls will be moving to the "step-down" part of the NICU for those requiring less monitoring (and on their way up and out). The doctors told Heidi that they would like to talk to us on Thursday about Maggie going home, so we imagine it could be just a day or two beyond that. 

Bea under shirt

We promise to get back to mother and child imagery in the near future, but for now the entertainment value is with the father and child interactions. The past two evenings we have gone to the NICU for late-night feedings and changings followed by near-catatonic quality time. Bea is so small that she can simply be dropped into the top of Dave's t-shirt and sack out snuggled inside getting kangaroo care. Were it not for the monitoring wires, there would not be much evidence of her presence. Both girls continue to eat more and more. The temperature in Maggie's incubator/isolette has been dropped to the minimum, so she may be ready for an open crib in the next few days. Bea is being kept a bit warmer so that she can continue to focus all of her energy on bulking up. Every ounce counts!

Dave has his arms full

Dave had his first go at holding both girls this evening. With a full stomach, Maggie was completely sacked out, but the equally well fed Bea was all bright-eyed, a reaction that likely does not bode well for her night-time feedings when we get them home. 

Milestones and music

Both girls are now free of IV's and are down to just one tiny feeding (gavage) tube that delivers milk directly to their stomachs. And that one is on its way out.  Both Bea and Maggie were introduced to the bottle yesterday, the speech therapist (no, seriously!) having determined that their little mouths and tongues were ready. Both are also beginning to experiment with getting milk direct from the source, their explorations considerably more successful when being held by their mother rather than dad. 

In order to expand their musical horizons beyond the NICU beeps, their Grandma Joan sent them a CD player that can go in their incubators (and is on Heidi's lap in the photos). This evening we introduced them to the Bach unaccompanied cello suites to prepare them for their father's cello playing when they get home. We can only hope that they will be forgiving of the multiple steps down in quality from Rostropovich to the live-in talent.

Weighing in

Bea raises her arm in triumph after weighing in at 2 pounds, 11 ounces, her birth weight regained and now exceeded by an ounce. Wahoo! She's packing away nearly an ounce of milk every three hours, an amount that has been steadily increasing day by day. 

Blonde or Brown?

There has not been much question about hair color when it comes to Bea, who has been exceedingly blonde since day one. Said blondeness is evident in the accompanying photo of Bea being held by her dad this evening. Maggie on the other hand has been a tougher nut to crack, sometimes appearing to have dark brown hair but other times -- as here in the glare of the flash -- looking awfully blonde herself. So what's it going to be? Blue/green/purple-dyed mohawk in all likelihood, but not until the tween years we hope. 

Week-old burritos

Maggie and Bea are a week old. Both are done with the blue lights, which means they can be swaddled up nice and tight in fine burrito fashion (Maggie on the left, Bea on the right). This evening, we had lessons in the art of proper swaddling, had some practice changing diapers (a challenge with the various monitoring cords), and had some good long kangaroo cuddling time with the girls. Maggie is taking a greater interest in the outside world, eyes now wide open and inquisitive. 

Pacification and progress

Among the visitors that these two girls receive, today brought a speech therapist. Now this may seem a trifle premature (as it were), but speech therapists in a NICU are the judges of suck-reflex development and thus whether the girls are ready to hit the bottle. Who knew? Along those lines, the images show that both girls have been working their pacifiers in anticipation of the big test. They are now getting most of their nourishment from breastmilk instead of an IV -- major improvement. Bea is getting another dose of blue-light therapy to ward off jaundice and can be seen adopting a splayed position for her blue-sun worship. Maggie is done with the blue-sun bathing so can now be swaddled, which she appears to enjoy immensely (along with said pacifier). Maggie had a typical preemie condition called patent ductus arteriosis (PDA of the non-Blackberry kind) in which a heart-lung duct had not yet closed up, but now it has. Hurrah! They also have scaled back her oxygen to the point that she may be tube-free by tomorrow. Progress progress progress...

NICU Symphony in the key of Beep

We had almost two hours worth of holding the wee ones this evening, ample time to consider the amazing variety of beeps, alarms, and various other sounds emitted by the many  monitors that keep track of the tiny people in the neonatal intensive care unit (NICU). Both Maggie and Bea appear unfazed in contrast to our worried glances in the direction of the latest blaring alert. This will stand them in good stead should they decide to live in New York City at some future date. Dave never quite mastered the art of sleeping through the wail of the fire trucks and ambulances that zoomed past Heidi's apartment on 113th Street (there being both a hospital and fire station at the Amsterdam Avenue end of the block). The fire trucks in particular would not only emit their own wail but also would set off all the car alarms as they passed, creating a doppler-effect cacaphony. Based on the evidence so far, Maggie and Bea will not have a problem getting a good night's rest under such conditions.

Dave gets to hold Maggie

Milestones come a bit slower with preemies, but they do come. Dave had over an hour of holding Maggie this evening while Heidi in her first post-discharge visit to the hospital held Bea. Both slept soundly, and the nurses didn't banish Dave for inappropriate use of the Monty Python philosopher's drinking song as a lullaby. 

Heidi comes home

Okay, we're making progress. The biggest of the girls came home this afternoon, five days after going to the hospital for her regular ultrasound. Just two (rather important) girls to go! Heidi is now ensconced in bed with a stack of salty oatmeal cookies from Teaism. Quite the improvement over hospital food....

Heidi holds them both!

Late last evening when the NICU was nice and quiet, Heidi was able to hold both little girls for a nice long time. Bea was all swaddled up after a bath, just about the size of a large burrito. As a special added bonus, Maggie opened an eye!

Whew! Their first Friday (even if it is the 13th)

Maggie is finally free of the big CPAP respirator, and instead getting a much less invasive oxygen assist. She's having typical preemie adjustments to the world outside the womb and has received some caffeine and ibuprofen (or Vitamin I as Pete Folger, a wizened triathlete, memorably describes it) to get her heart and lungs to settle into their outside-world rhythms. She appears to be camera shy, peacefully hiding behind her blue light mask every time we have visited today, but she won't escape the photo shoot much longer.

Bea is now happily indulging in breastmilk and in general remains blissfully unaware of her small size. She has great lungs (as does Maggie) but generously pipes down as soon as she's placed on her mom's chest.

What's in a name

Dave's sister Mary announced that Maggie and Bea must be short for Magnificent and Beautiful, and who are we to disagree? There were, however, a few other drivers. We had settled on most of the names a month ago but were still going back and forth quite a bit on Baby B's names in particular. On Monday night after Heidi had been admitted for closer monitoring, we decided it would be a good idea to do some more noodling, just in case. And good thing that. 

Margaret was the first name to be decided. It is a family name that belonged to Dave's mother's aunt and also is the middle name of niece Gillian, who was a wee baby when we were married. We both have lots of good connotations with Maggies we have known. Evelyn is first and foremost a lovely sounding name. It is the name of an aunt of Heidi's mom and several dear family friends, so more good connotations. It also has the special added bonus of delivering the initials MEA that Maggie will share with Dave's best friend since the age of 3, Martin Erskine Anderson. He and wife Rachel used the occasion of their wedding to set Dave and Heidi up, so they have a lot to answer for. 

We chose Iris because it is the state flower of Tennessee. No, no, no. We chose it because irises are a favorite flower for both of us. And for a little girl who struggled to make it this far, we liked the Greek origin as a symbol of power and strength, a messenger goddess affiliated with Juno making the rounds between Mount Olympus and the mortals (riding rainbows, but we'll not dwell on that, although she might some day). The philosopher Iris Murdoch certainly lived a rip-roaring life and one who was fascinated with goodness (and we're pro-goodness). For those geologically minded, IRIS the acronym (see iris.edu) is the mother ship for seismology (and there have been quite a large number of earthquakes the past several days). Bea emerged out of worrying about Baby B, who was the smaller of the two. It is also a Shakespearean nod in honor of Dave's dad. Should our Bea have half the wit of the Bard's Beatrice, then she will be a force to be reckoned with. And Dante's Beatrice was a great muse for those who wander in shall we say interesting places. 

Maggie and Bea meet Grandmas Janet and Joan

Maggie and Bea met Grandmas Janet and Joan this afternoon. Both received some grandmaternal strokes, and Maggie received a first back massage from the expert hand of her Grandma Janet. Maggie has high hopes of getting off the ventilator in the next day or so, but this is all par for the course with an undercooked preemie. By contrast, Bea seems oblivious to how tiny she is, breathing without aid and ready to shift over to breastmilk. Amazingly scrappy little girl!

Bea enters her blue period

Mom and daughters all continue to do well. Bea is now getting a jaundice-preventing blue-light treatment -- her first tanning-bed experience. And here she is in a pre-blue period photo of her with her dad's hand. Great hands!

Maggie makes an appearance

Despite being the younger sister by a minute, Bea is definitely getting the first-child treatment when it comes to photography, shrewdly taking advantage of her sister being accessorized with a ventilator to get some help kick-starting her lungs. But here is Maggie getting some quality snuggling time with her mom this morning (both girls had some last evening).  

Heidi meets Bea

En route from recovery room to maternity ward, Heidi swung by the NICU for a visit with the girls. Here we are with Bea and then there is Bea looking up at her mother. Somehow my earlier NICU foray to bring back photographic proof to Heidi that she had in fact given birth to twin girls just didn't have the same effect as Bea's little hand grabbing on to her finger, although it certainly left me beaming. 

Maggie may decide to wait for her big photo op until she gets her lungs cleared and starts breathing fully on her own (which could be as early as tomorrow morning). She appears to be a tad non-plussed at having been yanked from uterine slumber by her sister's insistent need to be out and about. I sense a future bone of contention between them.

Birthday!

The wait is over! The girls decided that they wanted to be born on February 10, 2009, and so be it, just a day shy of 34 weeks. Baby A is now Margaret Evelyn Applegate, a fine 4 pound 7 ouncer who arrived at 6:31am. Baby B is now Iris Bea Applegate, a whopping 2 pounds 10 ounces, who arrived at 6:32am. Both are in the NICU and doing well. Dave has had a finger squeeze from each of them, and Heidi will get to do the same on her way to the maternity ward. 

Baby pictures to come! For now, here's Heidi and Dave from last evening. We arrived at Georgetown yesterday morning for Heidi's regular ultrasound. Bea's umbilical cord flow wasn't what it should be, so Heidi was sent to the labor and delivery ward for constant monitoring. 

Preparing the nursery

In preparation for the arrival of the girls, work is well underway to transform the back bedroom at 152 Duddington Place into a nursery. New window, new insulation, sky-blue walls and...sheep. Flying sheep, to be precise. Here now are three of the artists at work: Thanks to Mark, Rennie and Kai (with hand lens). More sheep to come...