Welcome to the Blog on Clara and Wilson McGarvey!

Clara's amniotic sac ruptured on June 7, 2011 when we were 24 weeks and 5 days pregnant. Ten days later, Clara and Wilson were born. They have already enriched our lives in ways we couldn't have imagined, and we wanted to share those experiences with our friends and family. So sit back and enjoy the read - they are full of excitment and surprises!

Saturday, July 30, 2011

Rockin' Roller Coaster

We went to bed last night exhausted from a day of worrying over sweet little Clara. Once again, everyone's thoughts and prayers paid off because her preliminary blood cultures came back negative! This is great news but we are not out of the woods yet. There is a chance Clara's blood cultures could still be positive when the results come back at 48 and/or 72 hours. She also had fewer episodes where she dropped her heart rate today, which is a positive sign. Clara's oxygen level remains around 35% - 40% (21% is considered room air and is the amount of oxygen Wilson is on) but that is down from Friday.

The doctors felt Clara was doing well enough to resume her feeds this evening. Before her episode on Thursday night, Clara was receiving 22cc's of fortified breast milk every 3 hours. The doctors kept the IV line in place and started her back at the cautious rate of 9cc's/3 hours. If Clara tolerates the milk (does not drop her heart rate or oxygen, spit up, have a distended belly, etc), the doctors will quickly move her back up to 22 cc's every 3 hours.

In spite of all this turmoil, Clara still managed to gain weight and is now at 2 pounds 15 ounces!! The doctors do not know what caused Clara to regress so suddenly on Thursday, but believe it could be related a "feeding intolerance." This happens because the digestive systems of preemies are incredibly sensitive and taking milk this early can be difficult. It is hard for us because we don't know what the problem is and there isn't a definitive cure for what we think is happening.  

The great news from today is that Wilson now weighs over 3 pounds!!!!!!!!! For whatever reason this is a major psychological hurdle for  us. We know 3 pounds is still incredibly small but it seems more developmental milestones are within reach once you hit the three pound mark. For example, at 3.5 pounds babies start to keep their body temperature and can be moved from an isolette to something that more closely resembles a crib. We will also be able to hold them more which will be wonderful.

Our little big man shows off his guns.
Three pounds, way to go Wilson!

The "roller coaster" analogy is proving to be true, but we really appreciate everyone joining us for the ride. Sure, we'd much rather be somewhere on an actual roller coaster, but it will be years before the kids are tall enough. (Ok, that was the worst joke ever made on this blog)

Friday, July 29, 2011

"You take the good, you take the bad, you take 'em both . . . ."

Anyone our age should be humming the Facts of Life theme song. You know, we never thought we would reference Blair and Ms. Garrett when describing how things were going for us in the NICU, especially to perfect strangers. Oh well, as we experience these growing pains, we realize it takes different strokes, and try to stay upbeat as life goes on. We just have to take it step by step and hope the kids blossom.  We believe our close family ties will cure our empty nest by giving us a full house so we can eventually experience the wonder years. (Gimme a break, that last one was definitely a stretch. We'll stop referencing 80's TV shows. Cheers!)

The good news from today is Chris went to the hand surgeon and he completely removed her cast! Chris starts physical therapy on Monday and Morgan's short-lived career as a breast pump valet is coming to a close.

"Free at last, free at last, thank God Almighty
my fingers are free at last."
But with the good comes the bad, and Clara is not getting better. So far we've been lucky, but last night we received our first 11:00 p.m. call from the doctor telling us there could be a problem. Clara's oxygen stats and heart rate continued dropping and, for the first time since being in the NICU, her CRP (C-reactive protein) tested positive. This is alarming because a positive CRP test could very well signal the presence of an infection. In response to the raised CRP levels, the doctors stopped Clara's feedings and began IV antibiotics. 

We knew this would be two steps forward and one step back, but this feels like twenty steps forward and 35 steps back. Before Clara and Wilson's intestines could tolerate breast milk, they received their nutrition from TPN (total parenteral nutrition) in their IV fluids. They were weened from the TPN as the amount of breast milk they received increased. Unfortunately Clara is once again receiving all her nutrition from the TPN in her IV. To make matters (seem) worse, the nurses couldn't re-use her IV line from the second blood transfusion, so her new IV was inserted in her head. 

We don't know where this leaves us and will continue praying for the best as the weekend continues. Hopefully this is something simple and normal that will correct quickly. On the other hand, we have to be prepared for something worse, like an infection or a digestive problem. The good news is Clara's echo cardiogram came back "ok" this afternoon, so we do not think this is a result of a problem with her heart.

Regardless of what is wrong or what happens, this reminds us how hard our babies are fighting and the continued fragility of their condition. We also try to look for the positive, and we saw it tonight as we were getting ready to leave the hospital. We went to Clara's isloette and Chris placed her hand on Clara and told her how much we loved her. At the sound of Mom's voice Clara opened her eyes, looked up at us with the IV sticking out of the top of her head, and smiled. She didn't close her eyes until we put the blanket over her isolette so she could get some much needed rest.

You try managing a smile on an all-liquid diet
with a needle sticking out of your head!

Thursday, July 28, 2011

Wake up and get to work!

Um, so it turns out Chris is amazing. Yeah, I know, you already knew that, but she really is amazing. To recap: (1) Chris went to the OBGYN on June 6th and received such a good report they told her not to come back for another month. (2) Less than 24 hours later, her water unexpectedly broke; (3) She drove herself to the hospital before calling me; (4) She was given high-powered drugs to prevent labor, transported in an ambulance to Norton/Kosair, and visited by a doctor who told us we would likely deliver in the next 48 hours and detailed all the things that could be wrong with the kids; (5) Chris laid in a hospital bed for the next 10 days; (6) On the ninth day of bed rest, Chris was in incredible pain, thought she was having contractions, but nothing registered on the contraction monitors; (7) After being awake all night, Chris felt "something" between her legs early in the morning on June 17th; (8) The "something" was Clara's foot; (9) Chris was immediately taken in her hospital bed to a delivery room where she delivered Clara vaginally, breach, with no pain medication; (10) the docs put what they could back in, got an ultrasound monitor, and considered leaving Wilson in utero; (11) Wilson was delivered via c-section; (12) less than a week later Chris' c-section became infected, had to be re-opened, drained, and packed with gauze twice a day; (13) every two hours Chris used, and continues to use, a breast pump to provide the best nutrition for Clara and Wilson; (14) On the kids' one-month birthday we were in a car wreck that totaled our car and required Chris to be taken in an ambulance to the hospital; (15) she received stitches for severe cuts on her hand and was told to consult a hand surgeon; (16) three days later Chris had surgery to repair a severed nerve and severed artery in her hand; (17) yesterday, she went back to work. Seriously. She went back into the office and will hopefully be working at least part-time for the foreseeable future. Uh-May-Zing. It definitely makes me feel like a slacker because really, what have I done this summer?

But yesterday was a big day. The normally strong and stoic Chris returned to work and cried in front of her colleagues at Yum during their team meeting out of a deeply-felt appreciation for their patience, understanding, and loyalty during this entire ordeal. Chris' team at Yum has given us the love and support you expect from family, not from co-workers in major corporation. We will be forever grateful.

Chris back at work with her team at Yum! Brands
We hope Clara follows Chris' lead and gets back to work herself. Unfortunately, the blood infusion she received on Monday did not curb her desats or bradys (dropping oxygen and heart rate). The doctors and nurses think this could be related to the fact Clara isn't receiving enough caffeine. Clara and Wilson have been receiving small doses of caffeine since birth to help elevate their heart rates and maintain other vital functions. Clara's caffeine dosage has not been increased to match her weight, so she will receive more caffeine today. Along with the caffeine, Clara will be given a dose of lasix to help remove any excess water/fluid in and around her lungs. We also just learned her hemoglobin is still low and she will receive another blood transfusion tonight. Hopefully the combination of more blood, lasix, and more caffeine will put Clara back on a track similar to her brother. 

While we are worried about Clara, we continue to be thankful for how well things are going under the circumstances. Wilson is doing very well and Clara will hopefully rebound soon. Chris would have been 32 weeks pregnant today and the kids will instead be 6 weeks old tomorrow. We knew this was going to be a roller coaster, but could not have predicted how hard Clara and Wilson would fight to make the ride as enjoyable as possible. Sure, they are our kids and we're biased, but we are very proud of their progress. Now, if only Clara can get some caffeine and get to work, I'll let her sleep until noon every day when she is thirteen. Maybe.

Tomorrow Chris goes back to the hand surgeon for a check-up and we'll hopefully have more news about Clara's progress. Thanks for checking in with us and continuing to care so much about us and our little ones.

Wednesday, July 27, 2011

Jumpin' Jack Flash

In the last 48 hours three different nurses have described Wilson as an "acrobat." It started on Sunday when Wilson rolled over from his back to his side as one of the nurses was changing his bedding. (For Morgan's bachelor friends and brother who, like Morgan, don't know much about babies . . . rolling over is big deal and isn't supposed to happen yet - even on a full-term baby).  On Tuesday morning, Wilson somehow wiggled so far off his bed (which is really just a piece of malleable foam on top of another mattress) that his head and shoulders were resting on the plastic base of the isolette and his feet, supported by the bed, were straight up in the air! This morning, Wilson had squirmed off the bed again. He didn't go as far - his head and shoulders were off the bed but on the padding - but his feet were again sticking straight up in the air. The nurses have been using pieces of cloth to secure him in his isolette, but it was obvious they were no longer doing the job. So today, our little acrobatic escape artist got a bigger bed that we hope will better contain him. However, as long as Wilson doesn't hurt himself, these signs of restlessness are a good thing. The doctors and nurses agree that the spunky preemies do the the best in the NICU.

Amazingly, he escaped from this strap
Clara has always been described as "feisty," but her antics are less noteworthy than those of her brother. She has had a rougher journey (it was her amniotic sac that ruptured and she is the one who surprised us with a natural feet first delivery) and probably needs to reserve more strength for her fight to remain healthy. Clara received a blood transfusion on Monday and hasn't made a dramatic improvement, but her color looks better and she was doing well enough that Chris was able to hold her last night. We have no doubts that as she hears the stories about her brother, she will catch up in no time. And thus, the sibling rivalry begins.

Yes, this picture is over a week old, but we think it proves
Clara won't let Wilson steal all the thunder

Tuesday, July 26, 2011

True Blood

Unfortunately, Clara's hemoglobin was low and she had to receive another blood infusion yesterday. This is at least the fourth time she has received blood since birth and we're beginning to think she is part vampire. Think about it --- she sleeps all day, her isolette is covered with a blanket to keep light out, and she is getting extra blood to stay healthy. This is obviously a phase we hope she outgrows . . . for so many reasons.

All kidding aside, it was really hard for us to learn Clara needed more blood. Sure, it was a setback, but that's not the reason it was difficult. We think this infusion was harder on us because now, at five weeks old, we feel much closer to Clara. She has more personality, looks more like baby and, other than her oxygen and feeding tube, all of her other lines and tubes have been removed. In order to give her blood, the doctors had to insert another IV. Looking at an IV your child's arm isn't the easiest thing to do, but thinking about them putting it in is almost more difficult. We know this is the best thing for her (and will hopefully help with her oxygen levels), but want her to grow out of this vampire stage soon!   

I love you Mom . . . can I borrow the car tonight?
Wilson, however, took advantage of Clara's setback and made sure he got out of his isolette to curl up on Mom's chest. The kids will be 32 weeks in gestational age this Thursday, and everything we've read indicates this is when they begin to open their eyes with more frequency. Wilson must have read the same thing because he is already flirting with the nurses and sometimes opening his eyes when we (especially Chris) talk to him. If he isn't a "momma's boy" already, then he is playing Chris like a fiddle.

Although, with Chris' hand injury, it is kind of funny to watch her hold the kids. We wonder what Wilson really thought about Mom's big club hand.

Sunday, July 24, 2011

We're Back!

You probably noticed we missed a few posts this week, but one of the bloggers is on short term disability leave, leaving the other to do everything. While it is nice to watch Morgan do all the things I have to do every day, I would like to be able cut my own food or shower on my own. I'm sure Morgan would also like to not have to be such an integral part of certain things, particularly the pumping process. Yep, the honeymoon is truly over.

On Friday, the nurses removed Wilson's air cannula and he breathed on his own - without any assistance - for 24 hours.!!! The air cannula is back under his nose but it is merely providing a small amount of air flow with no added oxygen. Chris was able to hold him without any tubes (other than his feeding tube) and it was great to see his face for the first time.

Watch out ladies
Clara is also doing well but will sometimes experience a drop in her oxygen and/or heart rate. That is typical of preemies and the doctors don't seem too worried, so we try not to be either. Tomorrow both kids will get another CBC ("Complete Blood Count") to see if either of them needs a blood infusion. If Clara is low on hemoglobin or has a low red blood cell count, it could explain the occasional drops in oxygen. However, both Clara and Wilson continue to receive more food (Clara receives 22cc's of milk every 3 hours and Wilson receives 24 cc's / 3hrs), which could also explain some of these episodes. 

The good news is that Clara is really growing. Clara was 13 inches long and weighed 1 lb 8 oz when she was born. Today, she weighed 2 lbs 8 oz and is 14.75 inches long. Wilson still weighs more than she does (he weighs 2 lbs 11 oz) but has gained less weight overall.

Hopefully this week is a little less eventful. We can't thank everyone enough for all of the love, prayers, calls, emails, food, and texts this week. Even if we didn't have time to respond, it meant a lot just to know people were thinking about us. Chris goes back to the hand surgeon on Friday and hopefully he'll outfit her with a smaller splint so some of her fingers will be free.

Clara shows off the dress Chris made last weekend.
She also wants Mom to be able to use her hands again soon.

Thursday, July 21, 2011

Holy !@#$, this is getting totally out of hand

Well, we thought we were getting into a routine. We should have known better. Chris saw the hand surgeon yesterday morning and it took him all of about 30 seconds before he asked "can you have surgery today?" During the initial consultation, the doctor thought both the ulnar and radial nerves were severed in her ring finger. Chris had two deep cuts from the wreck, one where her finger attaches to her hand and one closer to one of her joints, and they needed to open her finger to determine where the nerves were cut so they could fuse them back together.

Chris had the surgery last night and, from all initial signs, it went well. The good news was the nerve and artery were only severed on one side and the nerve on the other side was just bruised. The doctors (including our good friend Joe Greene) fused the nerve back together and were optimistic about our chances for a good recovery. Nerves re-grow at about an inch per month in someone Chris' age, so she should have a good amount of feeling back in 2 - 4 months. The worst part about it right now (as you can see below) is her fingers are in a plaster splint and she will not be able to use her left hand for at least a couple of weeks. Also, for the next 48 hours she is supposed to keep her arm elevated in a foam block they gave her at the hospital. When she is sitting on the couch it looks like she has an old school boom box next to her head. Keep on rockin' Chris!

One other anecdote . . . not that anyone doubted Chris' toughness, but before the paramedics could get to her, she pulled her wedding rings off over her filleted finger so they wouldn't cut the rings while treating her. Tough. As. Nails.    

Since the purpose of the blog is to tell you about Clara and Wilson, we should probably mention them too. We've talked a lot about bowel movements on this blog because they are monitored so closely with preemies. Yesterday, Wilson had a stool that his nurse described as "the biggest I've ever seen from a baby that size!" Wilson's bowel movement weighed 32 grams . . . or 2.9 percent of his body weight!!! (Do your own calculations now and continue to be impressed). Even more unbelievable is that he had another 12 grams waiting for the nurses at his next diaper change. That's roughly 50 grams of poop (30 grams = 1 oz) over a few hours from a kid that only weighed 2 lbs 7 oz at the beginning of the day. That fortified milk must be working!!!

Good thing Wilson didn't let loose in his brand new preemie pouch!
Clara also had some bowel movements yesterday but our little lady didn't do anything worth talking about at the water cooler in the NICU. All in all, we're ok with that as long as things keep moving in the right direction. 

"What!?! You're talking about my bowel movements again?"
Yesterday was a good day but not a great day for the kids. They both had several episodes where they dropped their heart rates and/or oxygen. We hope this is nothing more than an adjustment to the increased feedings. They both have slightly low hemoglobin counts so the doctors will watch today to see if either one of them needs a blood infusion. However, they both pooped and usually self-recovered from their episodes, so we tried not to be too worried. I think they were probably just concerned about Mom and being a little fussy. Don't worry kids, Mom will be back in the NICU soon enough.  

And to show we haven't completely lost our sense of humor, we took this picture of Chris when she was pumping immediately after surgery. We call it the "intentional martyr face." We would have tried planking but it was a logistical nightmare.

The things we do . . . .

Tuesday, July 19, 2011

Brain Scan Results: Round 3

The results from the brain scans are in and Clara and Wilson both have "normal" brains!!! Believe it or not, "normal" was the word the nurses used when giving us the results. These can't be our kids! (Definitely a cliched joke, but hey, they can't all be gems). We recognize these scans are a snapshot and not a long-term prognosis, but are thrilled nonetheless. For over a month now we have had little to no cranial hemorrhaging and both kids have been off the ventilator. (Clara was only on the vent for 36 hours and Wilson still has yet to require a ventilator to breathe). Again, this doesn't guarantee continued success but it does make us thankful and optimistic . . . both of which we needed to feel.

Wilson and Clara also started receiving human fortified breast milk. The proteins and healthy calories are extracted from someone else's breast milk and added to Chris' to enrich the kids' diets and help them gain weight. Wilson is receiving 21cc's of fortified milk over an hour every three hours and Clara is receiving 20cc's at the same rate. The goal is to get Clara and Wilson to gain enough weight that they can hold their own body temperature and move from their isolettes into an "open air" crib. Hopefully this will happen in the next 3 - 6 weeks.

Before we had our accident on Sunday, we took pictures of the kids at one month old with these birthday hats. Maybe when we take their pictures at two months they'll have gained a noticeable amount of weight.

We can't thank all of you enough for your love and prayers the last few days. Chris visits the hand surgeon tomorrow and we'll know more at that time. We were pretty shaken by the whole thing and, on top of everything else, it was almost too much. But as one of our good friends always says, "it's easy to be with your friends when they're winning." If nothing else, we have realized how lucky we are to have the friends and family we do. Morgan's parents are temporarily loaning us a car, our cousin helped us take care of the wrecked one, Chris' co-workers brought dinner, and so many of our friends have reached out that we can't thank you all individually. Please know, from the bottom of our hearts, without you we could not make it through. Okay, enough sappy stuff . . . here is another cute picture.

Seriously Wilson, get off me!

Sunday, July 17, 2011

It was the best of times, it was the worst of times

Clara and Wilson are one month old today. We took cake and birthday hats to the NICU, but the biggest present was for us. For the first time since being born, Clara and Wilson were together (briefly) again.

As it should be and hopefully will be soon.

We were going to post more pictures and provide a thorough recap of Clara and Wilson's first month, but you know what they say about the best laid plans. Unfortunately, we were in a pretty severe car wreck and had to go to the ER. Chris has several stitches in her hand and will consult with a hand surgeon tomorrow to see if there is any nerve damage. The car is most likely totaled, but other than stitches, some scrapes, bruises, and airbag burns, we are mostly just shaken up. (Remember to never ask the question "could it get any worse?")

Tomorrow is a big day though because Clara and Wilson are receiving another round of brain scans. At this point, the doctors will be looking to see how the blood is circulating through their heads. This is a very important test and we remain prayerful for the best possible results. We'll have more pictures and posts tomorrow about the progress the babies are making and hopefully will be able to relay more good news. Thank you for your continued love and support as we move into the second month and beyond.

Saturday, July 16, 2011

Weight, weight . . . don't tell me!

Q: What weighs one kilogram?

A: a baseball bat, a cantaloupe, a lot of cocaine, and CLARA MCGARVEY!!!

Since we bragged on Clara, I'm' sure Wilson would like us to point out that he weighs 1.06 kilograms. Clara and Wilson are both gaining weight, which is good, but not at a fast enough rate. Starting tomorrow or Monday the doctors and nurses will begin fortifying Chris' milk so the kids can gain weight more quickly. The fortifier is a specially designed formula that uses proteins and nutrients from human breast milk and is mixed at a 3:7 ratio with Chris' milk. This will raise the caloric content of Chris' milk from 16 calories per ounce to 24 calories per ounce.

All of this is part of the effort to get Clara and Wilson home by late September. In order to come home they have to be able to breathe on their own, eat on their own, and hold their own temperature. The only way for them to maintain their temperature is by having enough body fat. So while everyone from doctors to Michelle Obama has warned us of the dangers of childhood obesity, we're giving our kids the biggest milk shakes we possibly can.


Thursday, July 14, 2011

What's In a Name?

Yesterday was a good day. Clara and Wilson each went up in their feeds - Clara is at 17cc's/3 hours and Wilson maxed out at 18cc's/ 3 hours. The biggest news from yesterday (literally) is Wilson had a major bowel movement! It was 25 grams, which was 2.5% of his body weight!!! His weight actually went down last night as a result. Clara also had a good poop at 3:00 p.m., but Wilson managed to steal the show. So, in what is the strangest thing we have ever written, thank you for the prayers and positive thoughts on bowel movements, they are working!!!!

After reviewing the blog posts, we realized we never explained how we decided on Clara's and Wilson's names. Clara Marie comes from both our grandmothers. Clara was an African-American woman who helped raise John (Morgan's dad). John loved Clara like a mother and she was a grandmother to his kids. Clara was a feisty, intelligent, hardworking woman! When we shared the name with Judy and John in May, John almost teared up and said "My dad always said Clara was born before her time. If she was born 20 years later she would have been a doctor or lawyer." Wow, did we name Clara correctly.

Marie was Chris's grandma. She was also a strong, independent woman and a GREAT cook! Much of Chris' strength and practicality was inherited and learned from Grandma Danner. Chris lived with Grandma for two years when she was younger and Grandma is the person who taught Chris so many things, including how to cook and play cards.

John  Wilson is named after several special people as well. John is Morgan's first name, his dad's name and was Chris' dad's first name. Also, "John" is a McGarvey family name dating back to when they came to America in the late 1700's / early 1800's. Every generation of McGarvey (except one) has a "John McGarvey," but they all have different middle names. Using the name "John" was practically a given, but coming up with the middle name was a little more difficult.

Many of you know how close Morgan was to his Grandpa, Elmer Morgan, and we wanted to honor him if we had a boy. The problem was Grandpa always said, "if you name your son "Elmer" because of me, I'll change my name!" Chris didn't want another "John Morgan" so we debated naming him "John Elmer" and calling him Jack. Another name we had thrown around to pay homage to Grandpa was "Wilson." Grandpa was kicked out of his home in Hazard, Kentucky when he was just a few months old to live with his Grandmother in Owsley County so his mother could raise his other brothers and sisters. It was Grandma Wilson who taught Grandpa to read, gave him his love for the outdoors, and encouraged his natural curiosity. Grandpa skipped the first and second grades because of the advantages she gave him and he credited her with helping him achieve the successes he enjoyed in life.

There were several other possible combinations of names, but we truly hadn't decided on anything when Chris had her emergency delivery. While Chris was having her c-section, she looked over at Morgan and asked "what are we going to name him?" Morgan replied, "I think you've earned the right to pick his name." Without any hesitation, Chris said "John Wilson, and we'll call him Wilson."  Perfect.

Wednesday, July 13, 2011

Stop PICC'n on Me!

Big news today - Clara and Wilson had their Peripherally Inserted Central Catheter (PICC) lines removed. A PICC line  is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. Clara's PICC line was in her head and Wilson's was in his arm. They are now getting their IV fluids through the feeding tube. It will be much easier for us to get them out of the isolette to hold them now that they are down to two tubes- oxygen and the feeding tube.

Speaking of feedings, Clara is up to 16ccs/3 hours and Wilson is at 17cc/3hours. Although the amount of their feedings is increasing, they still are not gaining weight as quickly as the doctors would like, (typical in preemies). Chris's breast milk was analyzed in the nutrition lab to determine the amount of protein and calories in each ounce. The average is 20 calories/ounce and the typical range is 16 - 34 calories/ounce. Chris's milk only has 16 calories/ounce. As our friends put it tonight, she is more of a meat cow less of a dairy cow. Hey, we all have our strengths. Starting this week, they will fortify her breast milk to help the babies grow.

Chris held Wilson after his 9am assessment. He loves to put his hands on his face! If you look closely, you can see he is gaining weight because his fingers look just the slightest bit chubby. When he was born, his fingers were very long and skinny!

Monday, July 11, 2011

Get in my belly!

Clara and Wilson both went up in their feedings; Clara is now at 15cc of milk every three hours and Wilson is holding steady at 16cc/3 hours. Wilson is eating so much they cannot give him any more food until they remove his IV. The doctors want to take out the IV by the end of the week (for both kids), but must wait to see whether they tolerate these bigger "portions" of food. Anything could happen - the docs and nurses wanted to remove Wilson's IV last week until he had trouble and had to stop his feedings - but we hope this week the kids eat like it's going out of style.  In other good news, both Clara and Wilson produced good stools today. Clara is still having some problems, but the medical staff agrees that her belly doesn't look distended and her bowels sound good, so we just focus on the positive. Today she pooped, and that's a good thing.

Chris also got to hold Clara today and that went very well except when Clara dropped her heart rate. There is no doubt this little girl will keep us on our toes. Tomorrow it is Wilson's turn to be held and we're hoping he doesn't feel the need to copy his sister's behavior. The nurses told us today that, at some point, Chris will be able to hold both of them at the same time. At least one of them needs to have a lot less stuff (the IV line, etc) attached to them and Chris probably needs to sharpen her post-pregnancy coordination skills.

While the kids were eating and sleeping, Chris spent most of the day dealing with insurance companies and doctors' offices. Morgan was at work in an all-day mediation, which fortunately involved parties other than Chris and the insurance companies. We are both exhausted and will save our rant on the ridiculousness of the health care system for another blog. In the meantime, thank you for the continued prayers, love and support.

Sunday, July 10, 2011

All Dolled Up

The NICU has a wardrobe of preemie clothes for little girls and Clara is now wearing "dresses".  These dresses may be smaller than most doll clothes, but they are really cute! The nurse dressed Clara in an Elmo dress yesterday and we brought in her first blanket (don't worry, Wilson got one too) to spruce up her isolette. Somehow these small touches make her seem more like a "normal" newborn. Chris promised Clara many shopping trips when she gets out of the hospital (consignment shops, of course).

Both Clara and Wilson are gaining weight. Clara now weighs 2 pounds and Wilson is up to 2 pounds and 5 ounces. Today Wilson's feeds were increased to 16cc's/3 hours and Clara's feeds were increased to 13cc's/3 hours. This is an all-time high for both of them! Hopefully they will tolerate such large amounts and continue to gain weight. Here is a picture of Clara in her new hat (to go with her new outfits) posing for the camera tonight! We didn't want this post to be the "Clara Show," but Wilson put his hands over his face and acted like he didn't want to be bothered.

Thanks to modern technology, we have at least one picture of what Clara might look like when she gets older. The high tech app,"Face Blender" helped us see into the future. We took a piture of each of us, uploaded the image, and the app automatically blended our faces together to project what our kids could look like. We are now accepting donations for the plastic surgery fund.  It's a good thing there is dentist in the family - look at that grill (Mom, that means mouth). Yikes!

Daddy's Girl

Yay! Dad is holding me!
Saturday was a big day for Morgan and Clara! Morgan got to hold Clara for the first time and immediately broke down in tears. (Somebody should have told him Clara is the one who is supposed to be crying like a baby). Clara was with her dad for over an hour, after which Morgan said, "I'm going to spoil her rotten when she gets out of there"...oh boy, are we in for it. She already has him wrapped around her finger. After being held by daddy, Clara provided another "poopie" for us.

Wilson was not left out of the party because Chris held him for over an hour. Even when being held he is quiet the wiggle worm! Wilson went back up to 13cc's of milk every 3 hours and Clara is holding steady at 11cc's/ 3 hours. Both kids had a few desats, but overall it was a good day.

Friday, July 8, 2011

3 Weeks Old

Today Clara and Wilson are three weeks old! There is not too much to report...both are getting 11cc's of breast milk every three hours (the most Clara has ever received and getting closer to the 13 Wilson was receiving earlier this week). Whether the feedings continue to increase tomorrow will be based on how they tolerate their feedings today.  Clara also gets another heart scan today and we are hoping her PFO closed.

Chris was in the NICU this morning and held Wilson. Clara and Wilson were well behaved this morning - we think it is because their Aunt Sara visited.

More to come later...

Thursday, July 7, 2011

And on the 7th day there was poop!

We are happy to report that Clara finally had a bowel movement today! Every three hours the nurses do assessments on the babies; they change their diapers, take temperatures, and give feedings. The assessments are 9:00 a.m., Noon, 3:00 p.m., 6:00 p.m. ...you get the drift. This morning we went to the hospital together for the 9:00 a.m. assessment. Morgan had to go to work and Chris wanted to make sure she got a chance to hold Clara after her assessment. Luckily, Clara's body temperature was warm enough that Chris got to hold her for over an hour. During this time, while rocking Clara, Chris gave her a very stern lecture about the importance of pooping. At the noon assessment Clara had this surprise for us.

Clara finally has a poop that registers on the richter scale!

To the question posed in a previous blog...who has better parenting skills - well, when Morgan talked to Clara about pooping she gave him the middle finger. When Chris talked to her she listened. Just sayin'...

Clara is holding steady at 8 1/2 cc's of breast milk every 3 hours. Her chest x-rays showed her lungs were a little wet so the doctors prescribed two doses of Lasix to help rid her body of excess water. This seems to have helped  because her breathing is a little more stable today and her color is better.

Unfortunately, Wilson had two stools with blood in them yesterday. Well, they think it might be blood but they are not sure. It could be left over meconium. Regardless, the doctors stopped his feeds yesterday and today said they could resume but only at 7 cc's every 3 hours. (He was at 13 cc/ 3 hours, so this is a significant drop). Again we are reminded that feedings are one of the most challenging parts of our NICU stay. The feedings are so difficult because their digestive tracks are not fully developed. As new parents (probably any parent), this is really tough on us as well because we are pushing them to do things they shouldn't have to do. Clara and Wilson aren't supposed to be here yet, today they are only 29 weeks, but we are asking them to digest breast milk. We know this is the path to healthy babies, but it is still hard to know we are asking more of them than what is fair. We hope by the time they are ready to go home they'll be in the parking lot smoking a cigarette and drinking a Mountain Dew (like many of the patients) while sharing their wisdom with the full-term newborns and bragging about how they have had this whole breathing and eating thing down for a month.

Yesterday Chris got great news from her doctor; she can drive AND she can start exercising - walking and jogging! Her incision only has to be covered with a band aid and will close on it's own shortly. Morgan is happy Chris regained her independence, although he is sad to give up the only family car with air conditioning.

Thanks for the prayers, good vibes, and constant thoughts. They are working and helping us get through each day!

Wednesday, July 6, 2011

"Momma said there'd be days like this . . . ."

When every nurse, doctor, and preemie parent told us the NICU was a "roller coaster," it was probably naive to think our kids would sail through without the "normal" ups and downs. After two straight weeks of positive progress, Clara and Wilson are both starting to act their age. Clara has not had a bowel movement in several days and they stopped her feedings last night to try and get things under control. Wilson was having trouble keeping his heart rate and oxygen up and had to receive a blood infusion. Possibly more troubling, Wilson had some blood in his stool last night which is something the doctors will watch closely. 

We hope these are normal growing pains, but blood and slow bowel movements could be symptoms of NEC (short for necrotizing enterocolitis). NEC is a very serious condition that develops in the intestines of preemies. The doctors do not seem worried about either Clara or Wilson getting NEC yet, but "gut" problems can become serious as we ask them to tolerate more food. We're taking our cues from our docs and nurses and will obviously let you know if something serious develops. Sometimes the worry of what could happen trumps our concern for what is happening. We try to keep that in mind and remain thankful for the fact our little ones are fighting as hard as they can.

Hopefully today will bring some good news. Chris goes to the doctor for another evaluation on the infection from her c-section. If all goes well she will be able to drive for the first time since her water broke on June 7th. We also want Clara to get things moving and have Wilson prove that yesterday was just an aberration on what has otherwise been a remarkable first couple of weeks. 

Momma said there'd be days like this, but through the love, support, and prayers of friends and family we are able to make it through. We also try to continue to laugh and find humor whenever and wherever we can. Below are pictures of Wilson trying to gain his independence by kicking open the door of his isolette on the Fourth of July, Wilson giving me the bird while trying to take his picture, and my Dad already going for the "Grandpa Look" by wearing a gorgeous red, white, and blue polo to grill out on the Fourth. Hopefully next year he'll have a couple of one year olds hanging off him.

"Hey! Let me out of here!" 

"Seriously Dad, don't take my picture."

I don't know if it's the hair or the shirt, but he is starting to look like a Grandpa.

Tuesday, July 5, 2011

Greetings from the NICU!

We got to the hospital early this morning, just in time for the doctors to assess the kiddos. Clara got another blood infusion yesterday because her little body cannot make enough red blood cells. She is still on three liters of oxygen and continues to fluctuate more than we'd like. We hope the main issue with Clara is she is constipated. Poor thing! While important at every stage of life, producing a bowel movement is especially important in the NICU. When a pound and a half baby gets backed up it puts pressure on the diaphragm which makes breathing more difficult and makes it harder for everything else to function properly. The docs gave her a sliver of glycerin yesterday and last night tried liquid glycerin. Nothing worked. We are hoping for an explosion in her isolette bigger than the Fourth of July fireworks and may or may not keep you updated :). This is another reality check that we are parents...we cannot remember ever thinking so much about someone else's bowel movement; but we really need some action from her today!

Wilson is keeping it real in room 7 - just across from Clara. He is quite the wiggle worm. We never know what position he will be in when we lift his blanket to look at him in his isolette. Sometimes he is down at the bottom of his body pillow and yesterday he was kicking the door of the isolette. Over the weekend his nurse, Sarah, told us "your kids do not like to be contained." Clearly they don't like to be contained; they left the womb after only 26 weeks. We know they are our children, impatient and don't want to miss out on the action, and expect a non-stop adventure when they get home!

Wilson is up to 13 cc's of milk every 3 hours (Clara is holding steady at 8 1/2 cc every 3 hours). Apparently he is not porking up as much as they'd like so they are going to fortify his breast milk with formula. Soon he will be the Bam-Bam of the NICU.

Mom and Dad are doing okay and trying to lead somewhat of a normal life. Chris goes to the doctor tomorrow for her two week appointment. Her incision is much better and she is hoping to get permission to start driving. Morgan is back at work hoping this week is not as crazy as last. We cannot help but constantly worry and pray for Clara and Wilson. We are so hopeful that we can look back in a year with two healthy babies and breathe a sigh of relief we made it through. Since that is a ways off, today we just hope for poop.

Monday, July 4, 2011

No Paternity Test Needed

As the doctors and nurses push Clara and Wilson to develop and grow (lower their oxygen and increase their feeds), there will be more ups and downs for all of us in the NICU. It is important for the kids to move toward these milestones on the road to recovery, but it isn't always easy to watch. Thursday and Friday were both hard days. Clara and Wilson had several "desats" (this is when there is a severe desaturation in their oxygen and/or their heart rate slows significantly) and Clara's breath rate was high enough that they moved her back to three liters of flow on oxygen. Our nurses and doctors continue reminding us that this is normal for babies born at 26 weeks, but it doesn't make it any easier for us to watch. (Imagine Kentucky being up one point on Duke and watching Christian Laettner, who is perfect for the game, take the final shot. While the ball is in the air you have a certain feeling in your stomach. Multiply that by a hundred or so and that is what it can be like watching a desat).

Every day, however, we are thankful for the good things that happen. Yesterday was a great day for the McGarvey family as Morgan held his son for the first time. Like his Dad, Wilson knew he had an audience and was eager to perform. Morgan held him for an hour and a half and Wilson soaked up the attention, only going down in his oxygen once for a brief moment. At the end of his kangaroo care (what it is called when you hold the kids with skin-to-skin contact), Wilson also decided to pose for his first family portrait. What a ham! Who knows, maybe Morgan is the father after all. (Just kidding. No really, just kidding)

We don't want you to think Clara was left out of the mix. Chris held Clara most of the time Morgan held Wilson, so they both received plenty of attention yesterday. We'll see which one is having a better day today to determine who is the better parent. (Again, just kidding . . . sort of)

Sunday, July 3, 2011

It is July!

We are all happy to have the month of June behind us! We are 2 weeks closer to bringing Wilson and Clara home. Of course we still have all of July, August and most of September but we are closer . . . .
Wilson is up to 10cc's of milk every 3 hours and we are curious to see how well he tolerates the increased amount. He had a little bit of spit up yesterday and hopefully he doesn't have anymore. Spit up is an obvious sign that a preemie cannot tolerate the higher amount of food. However, Clara had to go back down to 7cc because she had a lot of air on her tummy.

We are going back later today and hoping to kangaroo with them. Wilson's nurse, Sarah, (whom we love!!!!) said she is going to make Morgan kangaroo by the time the weekend is over! Pictures will follow if this actually happens. To be fair, it can be very stressful holding them, especially when they forget to breathe!

Friday, July 1, 2011

Brain Scan Results - Round 2

The brain scans came back with great news today! Both Clara and Wilson no longer have brain bleeds, the Grade 1 hemorrhage self corrected over the week!!! The next brain scan will be on day of life 30  - which is on July 22. It is still possible they could have a brain bleed if they have a very stressful experience between now and the next scan. For instance, if they have to go back on a ventilator or their blood pressure gets out of control.We will take the great news today and pray each day is stable.

There was no change in Clara's heart scan, which means she still has a PFO. The PFO is a concern because the blood should flow left to right and her blood is flowing left to right and right to left. The doctor feels pretty good this will self correct but wants to monitor it. She will have another scan next week. Wilson only has to have another heart scan sometime before we are discharged.

As we mentioned yesterday, Wilson is starting to look a little more like a newborn- here is a picture of him from this week.

Last night the nurse made Clara this adorable hat! She looked so sweet, we just had to share!
Tonight we went to see them and Clara started acting up! She gave us a scare because she wasn't breathing as well as she had been and her "stats" were all over the place. The doctor ordered x-rays of her stomach and blood work. Morgan told her to get well and we loved her and as he lifted the blanket on her isolette he saw this -
Who taught her this???!!!
We called to check on her before we went to bed and it turns out she just needed to have a good poop. They also upped her oxygen to 3 liter flow (she was on 2 liter) and she is doing much better. Ah, so it goes, life in the NICU. It is a bit of a set back to go to 3 liter flow but we'll take it if she is more stable, maybe it will put her in a better mood