Which twin is older?

Here's an exchange my wife and I have with strangers all the time that I can't wrap my head around.

"Are they twins?"
"Yes"
"Which twin is older?"

Seriously, they're born on the same day (unless one is born before midnight and one after midnight). One is not older than the other.

Let's say you share a birthday with a friend. You were born at 10am while he/she was born at 3pm. You don't consider yourself older than your friend, right? You're simply the same age and share a birthday. You're not 5 hours older than your friend.

Ok, I get that the real question is "Which twin was born first?"

To be honest, who was born first or second has zero relevance. This makes the question odd and intrusive (coming from a stranger).

Being the first born twin doesn't mean that one is larger, stronger, more mature, or whatever. It just means he/she came out first. It's like being the first user to post a comment on Internet articles. It doesn't make that comment any more relevant than the second, third, fourth, or a hundredth comment.

From a biological/medical/physiological point of view, it makes even less sense.

In a vaginal birth, the baby that's closest to the bottom at the moment of birth will be the first-born. In a c-section, the baby that's closest to the top will be the first-born.

This means that the question now becomes "What was the position of your babies in the womb at birth and what was your delivery method?"
Isn't that a bit personal and, quite frankly, none of anyone's business?

Now, I'm not the type of person who likes to create conflict. So I've developed a peaceful strategy for dealing with the question "which twin is older?". I just alternate my answer every time I get asked. Today, Aidan's older. Tomorrow, Ethan's older. The day after, it's Aidan's turn to be older again.

It's funny how despite who I say is older, the response is always "Yes, I knew it. He's definitely the older one. He looks so much wiser."

Twins Blog - Oct. 24, 2011 - "Fine"

The boys are approaching their first birthday. And I find it frustrating that I still can't answer the question "How are the boys doing?" which just a simple "Fine".

Truth is, they're not fine. Ethan is fine. Aidan is not really. So, they are not fine.

Aidan has some obvious developmental delay. He shows lots of spastic and reflexive behavior. We're told by several medical professionals that it's not too bad. Nobody can comfortably give us a diagnosis other than "developmentally delayed". At this point the diagnosis doesn't really even matter. It doesn't affect the treatment plan or outlook. Using an aggressive and frequent schedule of therapies, we hope to get his development back on track.

Ethan, on the other hand, is the typical cute baby. You know those babies you see on commercials and ads? He's one of those. Just happy all the time. A couple of months ago, he learned how to roll over and he's been doing that non-stop ever since. Lately, he's been able to maintain a sitting posture. He loves to bang things together, put them in his mouth, etc. He's very crafty in that he hides his pacifiers around his bed. We would always find 4 or 5 of them just laying around.

Twins Blog - Jun. 27, 2011 - "How are the babies?"

It has now been exactly 2 months since Aidan returned home to join Ethan.
Friends and family always ask "How are the babies?" to which our default reply is "They're alright."

Actually, they are alright. Not everything is rosy, though. But considering the circumstances, I think we were dealt a pretty darn good hand to play.

So, what's the real answer to "How are the babies?"

They're alright. The boys are nearly 7 months old now but they're smaller than full-term babies at 7 months. They do however, compare more favorably with 4-month-olds which is probably more fair since they were 3 months premature.
Against all odds, the boys:
1. Don't have any signs of ROP (Retinopathy of Prematurity ). The overwhelming majority of babies born at 28-months have at least stage 1 ROP.
2. They were never effected by NEC (Necrotizing enterocolitis). It affects nearly 10% of all babies born less than 1500g. Mortality rate is over 50%. We've personally witnessed several babies in the NICU pass away from this condition. Each of our boys weighed about 1kg at birth. This coupled with the fact that each of them had multiple episodes of distended bowels (ie, possible early indicator of NEC) left us nerve racking for the first few months at the hospital.
3. They never developed meningitis. The boys combined for 5 incidences of fever while in the NICU. Each time, spinal fluid needed to be extracted and tested for meningitis. Thank god the tests never came back positive.

But are they alright in that they're the picture of health and development? Not exactly since there are still hurdles to overcome. But they're alright and it's really all we can ask for.

Twins Blog - Apr. 26, 2011 - "Welcome Home, Aidan"

On April 25 (Easter Monday), the hospital notified us that we may bring Aidan home on hospital leave. That is, we need to bring him back the next morning so the doctors can examine him when they do their rounds. He's not officially discharged, but it was better than nothing.
At around 4:30pm, Aidan finally came home. After 143 days in the hospital, he finally felt the warmth of family.
We brought him back to the NICU this morning, but it's likely he'll be officially discharged later today.

(Aidan on the left, Ethan on the right)

Twins Blog - Apr. 10, 2011 - "Cake"

Today is day 128 in the NICU for Aidan. There's still no end in sight but it does feel like we're at least heading in the right direction. Aidan is still on nasal cannula but the settings are minimal (ie, 0.5 liters per minute flow at only 21% O2 concentration). Apnea episodes still come and go but they're happening much less frequently and he recovers much more rapidly with fewer assistance.

Ethan recently went for his 2nd immunization shot. The doctor warned us that from his experience, babies tend to cry really loud because this shot hurts more, compared to the previous one. Ethan cried for about 45 seconds for the 1st shot. This time, he wailed for just about 15 seconds. It was cake.

A couple of recent shots. (We like dressing them this way; long sleeve inside with short sleeve outside.)

Twins Blog - Mar. 27, 2011 - "This was nothing"

They reduced Aidan's oxygen supplement levels to about 30%. A few weeks ago, my wife and I would take this as good news. But now, we can't help but think that this is just a ploy by the doctor to make it seem like he's doing work. It's complete BS, of course. Adjusting the oxygen levels is as simple as putting a note in the chart to instruct the nurses to do so. It doesn't do anything about his apnea episodes. He only had 1 episode over the last 24 hours and didn't need to be bagged. But our hopes aren't up because last week, there was an instance where he didn't have one for over 24 hours only to have multiple episodes the day after, and the day after, and the day after, etc. We'll still be pushing the doctors for treatment plans and tests until they exhausted all options or until Aidan outgrows the apnea himself.
On a lighter note, Aidan has been very alert and adorable the last few days we came to visit. He looks very much like Ethan except for a few differences: a birth mark on his left temple, he has less hair, and his hair is more curly.  Most of their expressions are fairly similar.

We took Ethan for his immunization shot yesterday. A few items of interest to note:

• We watched as the doctor inserted the syringe needle into Ethan's thigh and we didn't really feel anything. We didn't cringe or felt sorry for putting our child in pain. We just looked at each other, smiled and shrugged. It may sound like we were being emotionless parents but it's just that we've seen much worse when Ethan was still in the NICU. This was nothing. Ethan still carries the battle scars from numerous IV sites where multiple catheters was left in place for days. This doctor made a single insertion and the needle was in&out in 2 seconds. Seriously, this was nothing.
• Ethan took the shot like a man. That's not to say he didn't cry or feel any pain. He cried when the syringe was inserted obviously because it was uncomfortable. But the volume was tolerable. We've heard him scream louder at home when he's hungry. The crying continued for less than a minute. By the time I had him back in my arms, he was quiet and happily sucking away at his pacifier as if nothing happened. I've seen children at age 1 or 2 take shots and then just wail all out for 10-15 minutes. In comparison, my boy is less than a month old adjusted.

Twins Blog - Mar. 24, 2011 - "Trust"

 Ethan is just too cute and adorable at home. We can't wait for Aidan to finally join him. I think we've finally gotten the hang of caring for Ethan. Adding Aidan to the mix should be pretty seamless. It wouldn't be exactly doubling the workload. We'll just be doing everything twice.

Aidan is still experiencing the occasional apnea spells. Every time we go visit him, we ask the nurses how many apnea spells he's had in the last 24 hrs. These days it's usually between 3 and 5. So, we're still praying for his apneas to go away and stay away.

A  revelation hit us in our last hospital visit. A nurse pulled us aside and cryptically suggested that we make an appointment to see Aidan's attending doctor. The message came as a shocking surprise but at the same time, it was clearly evident: Aidan was not getting the medical treatment he deserves.

We had trusted our doctor and it was clear that this trust has been abused. Aidan has been off the vent and suffering from apneas for a month. There were no interventions during this time. About three weeks ago, we asked the doctor for his treatment plan. His response was basically "wait-and-see". It's a fact that apneas tend to just go away on their own, so we accepted this response at the time. We also suggested that perhaps it may be reflux but he brushed it aside saying that it was unlikely. Again, this was almost 3 weeks ago.

Just a few days ago, the nurses informed us that diuretic drugs were prescribed after the doctor personally witnessed one of Aidan's apnea episodes. We didn't think too much into this at the moment but now, it's clear that this was a reactive response and I have reason to believe that the prescription may not even be appropriate.

The next 24hours were truly hectic. We requested an emergency meeting with the attending doctor. Then we were told that the attending doctor was unavailable and that the on-call doctor would be able to see us. So, we agreed but demanded that a more senior doctor was present. We were told the senior doctor was unavailable. So, we decided to consult the hospital's social workers to see what action we can possibly take if we're unsatisfied with the doctor's medical treatment. But apparently, we contacted the wrong department and they subsequently led us to the hospital's public relations officer who handles complaints. We told them that we're not here to complain but we did express our frustration to them. We asked if we can request a different doctor or even move to a different hospital because we have reason to believe that our current doctor is incompetent. It didn't seem like we were able to accomplish much because they kept telling us that we need to meet with the doctor first. So we asked if they can send someone to join our meeting because we felt that a 3rd party needed to be present. They said no but suggested that we ask the head nurse of the NICU to join the meeting.
Shortly after, we received a phone call saying that the senior doctor has agreed to meet with us along with the on-call doctor. Clearly the public relations officer tipped them off which was to our advantage. We arrived for the meeting and asked the head nurse to join us. She agreed. The tables were now set. As Han Solo would say, "This is where the fun begins."

A couple of highlights from the long meeting:

• The doc kept going on and on about Aidan's underdeveloped lungs. In less colorful language, my wife basically told him to shut up and stop blaming everything on his chronic lung disease. CLD is such a general condition that you can use it to explain everything.

• I asked him what are they doing about his apnea. The doc insisted that it's not apnea and that it's a behavioral thing. I called his BS and told him that it is apnea because he's not breathing. That's the definition of apnea. Before his rebuttal, I told him, "Ok, you say it's behavioral. What are you doing about his behavior?"
  The doc said that they were monitoring Aidan's stats and adjusting his oxygen supplementation accordingly. He also said that Aidan's condition is fairly consistent with what similar preemies experience. This was complete crap and we need to look no further than Ethan's condition. I told him that means they're taking a wait-and-see approach and this was not acceptable at this stage. My wife asked them why they were not proactively trying to determine the cause of the problem and then specifically targeting the cause with the appropriate treatment.

• I then asked "Shouldn't you be running all sorts of whatever-tests?"
   Perhaps trying to poke fun at my lack of medical terminology the doctor actually asked me "What whatever-tests?"
  I counter with "You're the doctor. You tell me!"

• The next part is just fun. The doctor goes ahead and mentions several possible tests that they can conduct but seems to suggest that now was too early a stage to warrant them. We knew that was BS. We did our research and knew exactly what those tests were. After he was finished, we basically said something along the lines of: "Ok, all those tests you just mentioned? Do it."

• Then it seems he was trying to buy some time by saying, "Ok, but I'll have to consult with this doctor and that doctor before I can run those tests."
  We responded with, "Ok, go set up those meetings. Consult them. Do whatever you have to. But do it now"

• Towards the end of the meeting, I told him that I would like a another meeting a week from today to followup on everything discussed. His initial look and response was that of "Seriously, is that necessary?". But my and wife and I stared at him with dead serious eyes to let him know that the request was not a question. Game, set, and match.

It's just utterly ridiculous that we needed to push the doctors for treatment. I thought ethics were one of the first things that's taught in med school.

Twins Blog - Mar. 16, 2011 - "You can do it, Aidan"

Poor little Aidan is actually larger than Ethan but is still on the nasal cannula while going through several episodes of apneas and bradycardias every day over the past few weeks. There's not much that can be done. We're told that Aidan just needs to "outgrow" his As & Bs (as they're known).
As & Bs are very common in preemies but it doesn't make them any less scary to witness, especially for parents. The infant's face would suddenly turn purple. Reviving the child generally involves physical stimulation like striking the foot. If that doesn't work, the Ambu-bag is used. It literally feels like the baby has died for a moment before being brought back to life. I'm sure that statement makes no scientific sense, but it really does feel that way.
Fortunately when we visited Aidan on the 15th, we were told that he has not had a single A&B episode in the past 24hrs.
On the 16th, he had a single apnea episode. But his blood oxygen concentration levels looked much better than several days ago. Our fingers are crossed in hopes that he's in the process of outgrowing his As & Bs. In other good news, Aidan is pretty good at oral feeding; that is, much better when compared to when Ethan started.


Ethan has now been home since the evening of Mar 13 and he has been more adorable than we ever imagined. A couple of things we noticed about him:

• He's very used to noise since things get quite loud in the NICU.
• He sleeps through much of the day, waking only during feeds, changes, baths, and occasionally random periods where he would just look around.
• He likes to be held for a while after each feeding session. If we try to put him down after we burped him, he'll cry to be held.
• He especially likes the baby room which we wallpapered and floored with some colorful patterns.
• Sure, it's been just a few days, but he doesn't appear to just cry for no reason. He doesn't even cry if he has a poopy diaper. The only reason he would cry is because he's hungry or he wants to be held.
• He loves to be talked to. He would listen intently with his eyes opened. When I run out of things to talk about, I just count to him.

Twins blog - Mar. 14, 2011 - "Welcome home, Ethan"

After exactly 100 days, Ethan is finally discharged from the hospital last night!
Needless to say, we're ecstatic. Yet, Aidan remains in the NICU so we're not fully out of the clear yet.

Twins Blog - Mar. 7, 2011 - "Apneas and Bathtime"

Huge advances for Ethan lately. His feeding tube was removed and he's been feeding orally exclusively for the past few days and getting quite good at it. Previously, he would be winded after a meal. Just yesterday, he finished the bottle and not only was he not winded, he seemed to want more!
We also bathed him for the first time in the NICU (Not his first time being bathed; just our first time bathing him). He seemed to like being in the warm water. He certainly didn't like being taken out of the water where it was cold...

Aidan is still on nasal cannula. His progress continues to be a tad behind Ethan. He would still suddenly stop breathing and would require the NICU staff to use the Ambu-bag to revive him. This happens about once a day. We're told not to worry about it much as babies tend to outgrow this tendancy.
Aidan loves being held, seriously. He has always been very fussy inside his incubator when he's awake. He'll be twisting and turning, pulling on anything within reach. But once held, he'll be calm and quiet. Everytime we put him back into the incubator, he'll cry and squirm about again.

Twins Blog - Mar. 5, 2011 - "Together at last"

Today was the first time since birth that our twin boys got together!

Their beds are situated in separate areas of the NICU (so that the staff doesn't mix them up). I was bottle feeding Ethan at the time when a nurse asked me to leave the area because they had to perform an x-ray on a baby nearby. I asked playfully whether I can take Ethan with me. To my surprise, she said okay. So, I brought Ethan over to Aidan's bedside, where my wife was at, so the brothers can finally meet!

Twins Blog - Mar. 2, 2011 - "Now is the time"

Today is our boys' due date. That is, it's been almost 3 months since birth but their adjusted age is 0 right now.

Here's Aidan:

and Ethan:


Aidan's color doesn't look as well as Ethan's. It takes a while after babies ween off the ventilator for their color to look more "normal". Ethan has had a head-start but Aidan will soon catch up.
For the first time since birth, we've held Aidan for the first time. Another milestone checked! Our fingers are crossed for them to keep progressing!

Twins Blog - Feb. 28, 2011 - "Bye bye vent 2"

Recap of events

Weight
Over 5lbs each now. Aidan looks particularly chubby.

Breathing
Ethan was breathing without any assistance whatsoever until just recently when he contracted some sort of bacterial infection. They put his nasal cannula back on but it's on extremely low flow. It will likely come back off in a few days.
Aidan was on CPAP for quite a while. It was an awkward stage. Babies generally don't like CPAP. The apparatus has to be pressed up tight against the nose making it uncomfortable and the hose greatly restricts movement. Back when Ethan was on CPAP, he didn't like it but he was too small and weak to do anything about it. Aidan is now large enough and strong enough to be able to consistently (and constantly) tear away from the nose-piece. He doesn't understand that the only way to get rid of that nose-piece is to keep it on!
Fortunately, he's on nasal cannula since Feb 28. This marks the first time in a long time that we have 2 comparable pictures of the boys taken on the same day.


Misc
For a few days Ethan was removed from his incubator and placed in a bassinet wrapped in blankets. We were free to hold him as much as we wanted during visiting hours. We also got to try to bottle feed him. First time didn't go too well. But soon enough, he downed nearly half his bottle before tiring out.

On Feb 21, Ethan moved into another ward which is "less intensive" (as opposed to neonatal intensive care unit). But I guess he didn't like it there because his bowels became distended. As a result, he required multiple IVs inserted back into him. And they placed him back inside an incubator (probably because it's more convenient due to the imminent IV lines).
A doctor attempted to insert the IVs but was unsuccessful for over an hour. Ethan literally had wounds on multiple sites on each of his limbs from this. I had full intention on filing a complaint on this idiot, not for his incompetent skills, but for not requesting assistance after failing numerous times for over an hour and for keeping my boy cold outside his incubator during the whole time. A meeting with his supervisor calmed us down enough to have mercy on that moron.
But seriously, that imbecile just gives the paediatrics staff a bad name. If it were not for my wife insisting to spare him, I would end his medical career right now. Nonetheless, we passed our complaint letter privately to that idiot's supervisor for him to deal with it (as opposed to letting the hospital deal with it).

On Feb 22, they moved Ethan back to the ward he was in initially ie, the "intensive" ward. We're told he's alright and that it's just that he's probably too tired to poop. The NICU nurses shared with us a very odd observation regarding preemies. Most of the time, an infant would either be great at breathing and poor at digesting or great at digesting and poor at breathing. It's rare for a preemie to excel at both feats at the same time. This is certainly the case for our boys. Ethan has got the breathing part, but just not very good at the digestion. We're told Aidan digests everything they put down his feeding tube and poops just fine. But he's still working on the breathing part.

On Feb 27, Ethan had a mild fever and his eyes looked glassy. This means yet another spinal tap to rule out meningitis. This would be his 2nd one. Aidan has had 3 of them already.

There's not much news for Aidan other than he's progressing steadily. We actually would prefer if Ethan was just as newsworthy as Aidan is. In the NICU, no news is good news...

Twins Blog - Feb. 18, 2011 - "Gaining separation"

Feb. 13, 2011
We had our first try at bottle feeding Ethan today. It was a humbling experience and at the end of it, my wife and I were left feeling like we've completely failed at parenting.

What's so hard about bottle feeding, right? Hold the baby, put the bottle in his mouth and he'll happily feed away, right? Not with preemies apparently.

He would suck on the bottle but then couldn't handle the swallowing part as milk would gush out from the sides of his mouth. A few minutes later, he would finally suck and swallow, but would forget to breathe. His whole face turned horrifically blue.

In 15 minutes of bottle feeding, Ethan took in about 5ml while choking back up about 10ml. He was then tube-fed the rest. Sigh...

Feb. 15, 2011

A couple of days ago, Aidan regressed from CPAP back to the traditional vent because of some sort of infection. Today, he's back on CPAP for another go.

Feb. 17, 2011

2 huge milestones for Ethan. He's taken out of his incubator and seems to be just fine regulating his own body temperature. Most importantly, he's taken off the nasal cannula. For the first time ever, he's breathing efficiently on his own without any aid. Now, he just needs to work on feeding!
Aidan is still hanging out in his incubator with CPAP. But he has shown substantial improvement in all areas. I'm estimating he's probably 2 weeks behind Ethan in terms of progress.

Twins Blog - Feb. 7, 2011 - "Are we there yet?"

Recap of Events


Weight
Almost 4 pounds. They're really starting to pack it on now. They're fed about 40ml every 3 hours. No problems with digestion.

Breathing
Ethan is off the vent and on nasal cannula. They use it to supplement additional oxygen to him. He started with 30% and it gets dialed down daily. Once he hits 21%, he won't need it anymore. (ie, ambient oxygen concentration is 21%)
Aidan is still on CPAP. But he's not struggling with it. He'll also be off the vent soon in another few weeks.

Behavior
Neither of the boys have any more IV lines connected to their limbs, so they're free to move their arms and legs around. Previously, the boys had all their limbs occupied with IVs which was definitely not pleasant.

Aidan is now less sensitive to loud noises. He still prefers quiet but he won't overreact to sudden alarms and crying anymore. He likes having his hair gently stroked while light pressure is applied to his abdomen area. He doesn't like having his foot held, but if you insist on not letting go, he eventually submits. He certainly hates his vent tube which restricts his head movements. But at least he doesn't extubate himself as often nowadays. It's probably because of the vent tube, but he seems to be a very sleepy baby. We'll see if this behavior persists when the vent goes away.

As soon as the vent tube went off, Ethan quickly showed his inquisitive personality. He'll touch and grab anything within reach. If we're by his side, he'll show us a variety of facial expressions. It's just brilliant! If no one is visiting him, he'll either sleep or explore his incubator with his hands. Perhaps it's because of his feeding tube, but he likes to make a face as if he's whistling. For whatever reason, he likes to place both his hands on his face.

As mentioned in a previous post, we've finally held Ethan in our arms. He appeared very confused of the world outside the confines of his incubator. It was funny as he maintained a very puzzled expression during the whole time. As soon as he was back in his incubator, he was back to old self, making weird and cute faces.

Both of them are now capable of crying but they only do so on rare occasions. I wonder if they'll stay this way even when they come home.

Today is day 66 at the NICU. No signs of PDA (patent ductus arteriosis), jaundice, brain bleeds or ROP (retinopathy of prematurity). Relief! Bad news are now a rarity in our last few visits and we're finally starting to see the light at the end of the tunnel. It seems likely that Ethan will be coming home first and Aidan will need an additional couple of weeks.

Twins Blog - Feb. 6, 2011 - "Hold me"

Today, my wife and I celebrated our 1-year marriage anniversary by splurging at Spa L'Occitane. We each had a body massage and facial done. After a couple hours of relaxation, we were back to our daily routine in preparing for our visit to the NICU.

(This "daily routine" takes quite a toll on the body. Lots of things to bring and pack every day. Eg, milk, diapers, wipes, etc)

Upon our arrival at the NICU, we were greeted with a reminder of why all our efforts were worth it. We were able to hold baby Ethan for the very first time.



He still had his nasal cannula attached along with various other monitoring equipment, but the nurse was able to route them out of the incubator to accommodate us. My wife and I were pretty much speechless as we have been hoping for this very moment for as long as we can remember. I'm not sure how to describe the moment. Remember the ending of that episode of Friends where Marcel (Ross's monkey) ended up in the hospital after swallowing some Scrabble tiles? Marcel reaches out and grabs Ross's finger. It's like that, sort of...

Being the terrible parents that we are, we almost neglected Aidan today. He's still on CPAP, but he's definitely showing improvement. The vent settings are being lowered daily. At this rate, he'll be off the vent and on nasal cannula in about 2 weeks. Then, we'll finally be able to hold both our boys!

Twins Blog - Feb. 4, 2011 - "Bye bye vent"

A pleasant surprise awaited us at the NICU today. For the first time, Ethan is off the ventilator! They've attached a nasal cannula to supplement some oxygen for him, but he's completely breathing on his own. This is the first time we've seen an entire shot of his face.

Aidan is still on CPAP. But he deserves a break. He did just recently go through surgery. And he's in an area of the NICU that's particularly noisy. Hopefully, he'll soon follow suit and we'll get to see an unobstructed view of him for the first time!

Twins Blog - Jan. 31, 2011 - "Between those NICU walls"

The NICU is a very unique place. It's a melting pot of emotions. Each infant is going through something different which means each respective parents have their own unique set of feelings. Fortunately, the average person would never see the inside of a NICU. But just to share what's going on in there, here's a list of typical emotions felt in that miracle room.


Shock
Usually this happens to parents who see their child for the first time. Society has imprinted into our minds the image of a newborn. When these parents see that the image of their child differs so much from what they're expecting, it just sends a wave of shock through their system.


Guilt
Often after all the medical stuff are settled into the parents' mind, guilt sets in and they start to ask themselves things like "what have I done to deserve this?" or "did I cause this?"


Helplessness
In some ways, feeling helpless may be the worse. One particular child in the NICU suffers from a condition where he can't move. I don't know the name of the condition but it's a nerve condition rather than orthopedic and extremely tricky to treat. His mother comes every day to massage him and move his limbs around. The child never even flinches. The emotionless expression on his mother's face is just heartbreaking.

Despair

After a doctor/nurse presents negative news to parents, it just feels like everything is falling apart. We've been through our share of this. But even when it happens to someone else, we actually feel it too. I've overheard a nurse tell a couple that their child might not make it through because of necrotizing enterocolitis (NEC). I could literally see their wills shatter before my eyes as both of them were reduced to a crying mess of tears and their speech becomes incoherent.

Hope

It's empowering to parents if the doctor/nurse have positive news to report. That's why it's always important to get daily updates even though this puts you at risk of hearing negative news. Every bit of improvement adds to the "we just might make it through this" feeling.

Joy

There are babies who are off the vent, out of the incubator, and are fed via bottles. They have parents who come to feed them, burp them, cuddle them, and play with them. Their faces are just beaming as they use baby-talk and tell their child about how life would be when they get to carry their bundle of love home.

Twins Blog - Jan. 27, 2011 - "It's my party and I'll cry if I want to, cry if I want to..."

We heard Ethan cry for the first time today. He's been pulling out his vent tube everyday. Sometimes, twice a day. So they put him on CPAP which freed his throat to enable him to make noises! Needless to say, it was music to our ears. Sounded like a tiny little kitten. We're told that we should rest as much as possible because once the boys come home, their crying will be non-stop. In response to that, I say bring it on. I would rather be annoyed by constant crying than be worried about their ventilators and feeding tubes, etc.

Aidan is still on the vent. But he's improving steadily. That is, the vent settings are decreasing everyday. Hopefully, it won't be long before we hear Aidan's cry.

Life after birth of the boys

• Diaper changing.
• Baby sleep patterns
• Feeding the baby.
• Bathing the baby.

These are some typical things that parents worry about when they have a child. Oh how we long to be concerned with those things right now. But that's just looking too far down the road. Our boys were born 3 months premature and will be in the NICU for quite some time. Since their birth, here's a sample of things that we worry about everyday:

Heart murmurs, brain bleeds, blood pressure, body temperatures, meningitis, pneumonia, spinal taps, ventilator settings, red blood cells count, blood transfusions, whether or not they're digesting, blood oxygen concentration levels, etc

It's enough to drive anyone mad. You know those parts that you tend to skip over when reading pregnancy books? You figure that it's just talking about things that won't happen to you, so you jump ahead to the "normal" stuff. I had to go back to read those sections because it's actually happening.

"When are the babies coming home?"
That's the question we get asked a lot and it's awkward for a two reasons.
1. The truth is we don't know. The doctors don't know either. Each child is different and there's just no timetable that can be given to us. Some babies spend a month in the NICU, others are there for over half a year. There's just too many variables at the moment. In order for the boys to come home, there are a couple of things they must be able to do:
-Breathe efficiently on their own. That is, they have to ween off the ventilator.
-Regulate their own body temperature. That is, they have to be able to keep warm outside the incubator.
-Feed. That is, they have to be able to take a bottle. For a full-term infant, this comes as a natural instinct. But for a preemie, this is quite a task since feeding is actually a complex synchronization of sucking, swallowing, and breathing.

2. One would assume that having the babies come home from the NICU would be what we're longing for. Sure, that's the ultimate goal but for now, we just want the simplest of things:
-We want to be able to see our babies' faces. We've never had an unobstructed view of our boys' faces. The vent tube is always on them.
-We want our boys to meet each other for the first time. As of now, our boys have never seen each other. Their incubators are situated in different sections of the NICU.
- We want to be able to hold our babies. Since they're attached to the vent, various monitors, and IV tubes, we've never been able to hold them. The most we can do right now is to reach into their incubators and wrap our hands around them.