At first glance, both boys seemed extremely healthy at their 36 week delivery . . . as Adam mentioned, Ethan Carsner Knippa Milam was brought into the world at 11:30 and called at 6lb 2oz and 18.5 inches. Noel Ledger Knippa Milam came shortly thereafter at 11:30 and was called at 5lb 12 oz and 18 inches. Their names have significance to both families, as Adam and I decided to include both of our mothers' maiden names (Barbara Carsner and Rita Ledger, for reference) and both of our family names. Our joy was immediate . . . they cried and wriggled like healthy babies and each had ten toes and ten fingers . . . it was an incredible moment that we shared with Kim, who was still awake while they were cleaning the boys. We were then immediately ushered out of the operating room with the boys in tow so that our MD could finish working on Kim . . . we passed the eager grandparents (Papa, Gramma, Avo in person with Buck with us in spirit) who immediately fled to the small nursery viewing window for their first glimpses of their new grandsons.
Once the boys had been through their initial weighing and swaddling, they were placed in the small Victor Valley Hospital NICU (2 beds in a room that is about the size of a standard master bedroom closet) for monitoring, during which we were informed that both boys appeared to have respiratory issues (insufficient lung development). We weren't able to hold them, but we stayed by their side to soothe them while the nurses flew in and out of the room . . . it was definitely not the experience we expected and the sight of the boys in distress was definitely unsettling.
Once the boys had been through their initial weighing and swaddling, they were placed in the small Victor Valley Hospital NICU (2 beds in a room that is about the size of a standard master bedroom closet) for monitoring, during which we were informed that both boys appeared to have respiratory issues (insufficient lung development). We weren't able to hold them, but we stayed by their side to soothe them while the nurses flew in and out of the room . . . it was definitely not the experience we expected and the sight of the boys in distress was definitely unsettling.
Ethan and Noel struggled for about 5 hours during which time we quickly learned that the Victorville Hospital was a sub-standard facility that couldn't provide the requisite care (or even get their remote X-ray machine to work, for goodness sake!) . . . at 5 PM, the on-call MD informed us that he had made the decision to have the boys care flighted from the Victorville hospital to a fantastic Loma Linda Childrens Hospital in San Bernardino which has an 82 bed NICU. As we digested the shock of such a severe change in plans, everyone involved assured us
that this was for the best and completely standard as the hospital "is really only equipped to provide care for 5 - 8 hours maximum" (seriously). At 7 PM, two separate phenominal care flight teams arrived and our concerns were immediately assuaged . . . each and every person was competent and intellingent that they were immediately able to communicate how much better this was for the boys . . . but that didn't make the act of watching them transfer Ethan and Noel into transport bread boxes and load them into separate helicopters any easier.
During the transport, we were incredibly thankful that we'd had some support with us . . . our folks helped pack up the rooms and transferred into a new Hilton hotel near the Loma Linda hospital so that Adam and I could focus all of our energy on the boys. We finally made our own hour drive around 8 pm after Noel's helicopter departed and the sense of relief upon finally reaching the Loma Linda NICU was immediate.
In the span of 2 hours, Ethan had fully stabilized and they'd placed on a C-PAP for moderate breathing assistance . . . he was peacefully sleeping for the first time since coming into the world and he seemed to have gained as much comfort from Loma Linda as we had. Within 24 hours he would be subsequently upgraded further to a simple nasal canula with an eye towards hopefully breating on his own soon. We were finally able to hold Ethan during the afternoon of Day 2 and he clearly loved it, tho likely not as much as we did.
Noel definitely has had the harder journey of the two, but he's fought hard to get well and is doing better every day . . . he had a more extreme respiratory distress syndrome (RDS) post-birth, but reacted well to a dose of Curaserf that helped round out his lung development. He stayed on the deep C-PAC assistance for the first 36 hours and then moved to the shallow C-PAC assistance late during Day 2. . . he's since been struggling to keep a good oxygen level, so he's continued to get a higher oxygen stimulation to help him out. The MD has estimated that Noel may be 2-3 days behind Ethan in development, but we're definitely happy with the progress he's made and everyone has assured us that this is all relatively normal for a baby with RDS. Noel also has an IV feeding tube and received his first small batch of formula late on Day 2, which we hope will digest well. He's loved his pacifier since the very beginning (he has a little Maggie Simpson syndrome) which is great - learning to continue breathing through the CPAC while sucking on the pacifier is definitely encouraging behavior and will hopefully help him take to the bottle when he's ready for it. Noel also seems to have a small bout of pneumonia, likely a holdover from the womb, and they are giving him a 7-day round of antibiotics to help him move past that - gladly, he's not exhibiting any negative symptoms from the pneumonia. We were finally able to hold Noel for the first time last night for about an hour during the evening of Day 2 and we've been promised a there's more to come tomorrow if he continues to improve. Given his slower progression and the current course of antibiotics, they've hedged a bit on his timeframe in the NICU, but I think its safe to say we're looking at 10 days give/take as a best case scenario.
Now that we're past all of the medical discussion, we'll cover the fun stuff . . . though the process started off a little frightening, Adam and I are LOVING every second of parenting . . . we visit the hospital at 8 am, 1pm, and 9 pm every day according to the visitation hours and every milestone is extra special . . . Noel is by far the more alert of the two and loves to look around . . . he is by far the more temperamental and definitely knows how to indicate he'd rather be left alone, but then again the C-PAP seems to be miserably uncomfortable, so we're guessing that's the primary contributor to his mood. We've found that we can soothe Noel by patting his tummy and have gotten a lot of practice. Ethan just started opening his eyes today, as he seems to enjoy sleep like his daddies - as a result we're a little light on eye contact at the moment, but it was great when it finally happened. Ethan loves to hold onto our fingers and loves a hand resting on his belly while he sleeps. Ethan has been much more relaxed and loves sleeping with his mouth wide open. The are both unbelievably adorable and we've had fun getting to know their features and figuring out how we'll tell them apart when we get them home, as they look very similar at this stage (Ethan is a little larger and Noel has more ridges in his ears - so far that's all we've got to use).
From the very beginning they have both recognized our voices thanks to Kim (our phenomenal surrogate) who played a digital recorder for them in utero each day . . . the NICU nurses have all noted how much calmer the boys are when we're around and speaking to them and we love being their "constants" through all the craziness. For those that have asked, Kim is doing much better after a really scare post-delivery experience . . . she has been an unbelievable God-send and we could not have been more fortunate than to go through this experience with her.
OK - that's a lot of reading I'm sure, but I don't know when I'll be able to have this much time at the keyboard again, so I wanted to get a lot out there . . . we have definitely appreciated everyone's positive wishes and kind words . . . we definitely have everything we physically need, so please just focus any efforts on sending the boys your warm wishes.
Here are some pics once we got settled into the Loma Linda NICU . . . Adam holding Ethan for the first time and Bruce holding Noel for the first time. Also including some digital images of Adam's first diaper change - ever! He handled it like a champ, especially when you look at the plethora of wires that he had to fight against . . . nice job, Pai!
In the span of 2 hours, Ethan had fully stabilized and they'd placed on a C-PAP for moderate breathing assistance . . . he was peacefully sleeping for the first time since coming into the world and he seemed to have gained as much comfort from Loma Linda as we had. Within 24 hours he would be subsequently upgraded further to a simple nasal canula with an eye towards hopefully breating on his own soon. We were finally able to hold Ethan during the afternoon of Day 2 and he clearly loved it, tho likely not as much as we did.
Noel definitely has had the harder journey of the two, but he's fought hard to get well and is doing better every day . . . he had a more extreme respiratory distress syndrome (RDS) post-birth, but reacted well to a dose of Curaserf that helped round out his lung development. He stayed on the deep C-PAC assistance for the first 36 hours and then moved to the shallow C-PAC assistance late during Day 2. . . he's since been struggling to keep a good oxygen level, so he's continued to get a higher oxygen stimulation to help him out. The MD has estimated that Noel may be 2-3 days behind Ethan in development, but we're definitely happy with the progress he's made and everyone has assured us that this is all relatively normal for a baby with RDS. Noel also has an IV feeding tube and received his first small batch of formula late on Day 2, which we hope will digest well. He's loved his pacifier since the very beginning (he has a little Maggie Simpson syndrome) which is great - learning to continue breathing through the CPAC while sucking on the pacifier is definitely encouraging behavior and will hopefully help him take to the bottle when he's ready for it. Noel also seems to have a small bout of pneumonia, likely a holdover from the womb, and they are giving him a 7-day round of antibiotics to help him move past that - gladly, he's not exhibiting any negative symptoms from the pneumonia. We were finally able to hold Noel for the first time last night for about an hour during the evening of Day 2 and we've been promised a there's more to come tomorrow if he continues to improve. Given his slower progression and the current course of antibiotics, they've hedged a bit on his timeframe in the NICU, but I think its safe to say we're looking at 10 days give/take as a best case scenario.
Now that we're past all of the medical discussion, we'll cover the fun stuff . . . though the process started off a little frightening, Adam and I are LOVING every second of parenting . . . we visit the hospital at 8 am, 1pm, and 9 pm every day according to the visitation hours and every milestone is extra special . . . Noel is by far the more alert of the two and loves to look around . . . he is by far the more temperamental and definitely knows how to indicate he'd rather be left alone, but then again the C-PAP seems to be miserably uncomfortable, so we're guessing that's the primary contributor to his mood. We've found that we can soothe Noel by patting his tummy and have gotten a lot of practice. Ethan just started opening his eyes today, as he seems to enjoy sleep like his daddies - as a result we're a little light on eye contact at the moment, but it was great when it finally happened. Ethan loves to hold onto our fingers and loves a hand resting on his belly while he sleeps. Ethan has been much more relaxed and loves sleeping with his mouth wide open. The are both unbelievably adorable and we've had fun getting to know their features and figuring out how we'll tell them apart when we get them home, as they look very similar at this stage (Ethan is a little larger and Noel has more ridges in his ears - so far that's all we've got to use).
From the very beginning they have both recognized our voices thanks to Kim (our phenomenal surrogate) who played a digital recorder for them in utero each day . . . the NICU nurses have all noted how much calmer the boys are when we're around and speaking to them and we love being their "constants" through all the craziness. For those that have asked, Kim is doing much better after a really scare post-delivery experience . . . she has been an unbelievable God-send and we could not have been more fortunate than to go through this experience with her.
OK - that's a lot of reading I'm sure, but I don't know when I'll be able to have this much time at the keyboard again, so I wanted to get a lot out there . . . we have definitely appreciated everyone's positive wishes and kind words . . . we definitely have everything we physically need, so please just focus any efforts on sending the boys your warm wishes.
Here are some pics once we got settled into the Loma Linda NICU . . . Adam holding Ethan for the first time and Bruce holding Noel for the first time. Also including some digital images of Adam's first diaper change - ever! He handled it like a champ, especially when you look at the plethora of wires that he had to fight against . . . nice job, Pai!
During...
After :)
Looking forward to forward progress in the days to come . . .
Brudam
Ok, so now I'm officially crying. I love what Allyson does because she has the distinct pleasure of caring for babies, which she loves, under the prestigious umbrella of support provided by Loma Linda University Children's Hospital. I am so thankful that your boys made it to their NICU with no problems. Your little darlings were in the hands of the finest staff in the U.S.
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