No, not diarrhea or death. Discharge! We now have discharge checklists in our room.

It feels like the tides are turning this week. The gals are now 38 weeks gestational age (6 weeks actual), and I feel like we have entered “get the f out of here” mode. Or maybe just I have. Margo seems to be following along. Annalee isn’t so sure. She’s like “what’s the rush? I’ve got such a nice view here and the living is easy.”

Here were some happenings from the week:

• On Saturday and Sunday, I was sick so I couldn’t go to the NICU at all. Remember, germs are a real problem for preemies, and you can’t go to the NICU at all if you have a cold.
• On Sunday, they discontinued Margo’s caffeine.
• When I returned on Monday, they decided to take Annalee off her cannula.
• Note: This feels like a twin experiment because Margo has cannula but no caffeine, and Annalee has caffeine but no cannula. Who will prevail? So far Margo I would say, but there are other factors.
• On Tuesday, Margo finished her first whole bottle!
• We are starting to see improvements in what they take through bottle/breast vs feeding tube. Now both gals are doing around 30-40% through a bottle. They typically do better with bottle than breast, and it’s still somewhat hit or miss. They get tired and miss some feedings here and there, but overall they are getting much more consistent.
• Margo got a dose of EPO because her iron is low (future pro cyclist?)
• On Thursday, Annalee’s caffeine got discontinued.
• Annalee switched to a breastmilk fortifier that she can come home on (it has some extra calories and vitamins). Margo will switch to this once she exceeds a certain weight threshold (she is a bit smaller)
• Actually, I lied a little bit. They had a few really strong days, but as their caffeine has worn off (and Annalee goes on without the cannula), they have been sleepy and not drinking as much the last few days. Hopefully after a few days of rest, they’ll be more excited about feeding again.
• We got discharge checklists in our room. The main things the girls have to master are:
  • Get off caffeine (check!)
  • Get off cannulas (half way)
  • Have no events that require stimulation to resolve for 5 days (doing better here)
  • Take all their feedings by mouth for 48 hrs (need work here)
  • Pass the car seat test (they just stick the babies in their car seats for a few hours to make sure their numbers stay stable)

We still have a little ways to go in the feeding department, but they are definitely making progress. Margo gets pretty high volumes more consistently, she sounds good, and she doesn’t forget to breathe much anymore. Annalee still forgets to swallow somewhat regularly and is more wheezy when she feeds (partly reflux and partly stridor, which is when they don’t quite have the swallow breathe timing correct and they squeak). It seems like she is just a few days behind Margo. Child development often happens like a light switch, so it’s possible that they’ll quickly get their feeding act together here soon.

Aside from Annalee’s occasional feeding related breathing issues, they’ve been doing much better with their Bradys and desats. We hardly hear any dings anymore!

The doctors are probably going to take Margo off her cannula in the next few days (update: as of Saturday, she is off the cannula!). They are just keeping it on in case it gives her more energy for feeding.

In other words, it feels like we are getting close!

Meanwhile, Erin is finishing the bathroom floor tile as I type this, the baby room is ready, and we now have a high-flowing well in Chelan!