The Schwarthoff Family 2005

Welcome to the Web Site of the Boise Schwarthoff Family!

Please check back for new pictures once a month!

December, 2005

Merry Christmas!

November, 2005

That chair is big, and very comfortable.

October, 2005

In the corner...

September, 2005

Abraham wants to see what's out there, from a safe vantage point.

August, 2005

Look, how small Noah is.

He is about to change that.

July, 2005

Grandma

soooo

happy!

June, 2005

We thank everyone a million times for helping to make this come true! And we thank God for the Guardian Angels and ask Him to be with us in the future.

Noah shows off his favorite pose.

At home for the first time.

Both of them ready to go home.

June 14:

Homecoming. The procedure is involved: Once the nurse practitioner has decided that today is the day, all departure requirements are checked. The babies need to be able to sit in their infant seats for at least the time it takes to drive home, and that has to be practiced. A million pages of paperwork need to be signed. CPR training. Medications. "Do you have this?" "Do you have that?" As it turns out later, the Vitamin D in liquid form we need to give them with their breast milk once a day is not available from any pharmacy.

The discharge is exciting for the nurses, too. They have grown close to our little ones, taking care of them for so long. They did a great job, day and night!

Abraham sitting in his car seat, singing "Hail to the Queen" with graduation hat on top, and oxygen supply in the nose.

Noah sitting in his car seat, not singing, with graduation hat on top.

June 13:

Surprise! Boys go home tomorrow!

The news causes some joy, and some panic. Although we have expected it to happen this week, this is a little early. So we scramble, cancel work meetings and dentist appointments, and try to adjust.

The good part: Finally! And both boys on the same day, thus avoiding the awkward "one here one there".

The bad part: Abraham was not able to stay without oxygen, and we will get an oxygen supply with a heart/breathing monitor for our home. That requires to involve the insurance and the supplier, with instructions and provisions.

The last chapter of the saga is being written!

We can report that the applications for SSI are already approved. We have no official cards yet, but the information has been passed on to the State Department of Social Services. That is what's important, because the State of New York manages their eligibility for Medicaid. And Medicaid will help paying the bills during the time our boys are in the hospital. We are extremely thankful for our health insurance system at this moment. Thanks to all you folks out there who are paying their insurance premiums every month and thus help our babies survive!

Noah is exhausted, after a small while of breastfeeding.

Abraham in the crib. Also sleeping.

June 11:

Hearing exams were ok, and the first round of vaccinations was done without major problems. You won't believe what immunizations they get. Measles!! Chickenpox!! Rubella (for boys!!)!!

5 lb 5oz (2410g) and 5 lb 4oz (2440g). The weights are good and not a source for concern any more.

The feeding tubes have been removed. That means all feedings are taken from the bottle, except when Petra tries to nurse. Drinking from the breast is still too exhausting to be exclusive - we are working on it!

Abraham is off nasal cannula (starting June 10). We hope he can keep it up. Because then, the likelihood is great that both can leave the hospital and come home this week!

June 4:

4 lb 14oz (2215g) and 4 lb 13oz (2180g). Two to three bottles a day, but not a lot of success feeding from the breast. The physical therapist was here and said the motor abilities are ok. Hearing test will be later today.

June 3:

Noah's oxygen monitor has been removed - the doctors think he won't need it any more. Abraham does not fare so well: We try to wean him off his supplemental oxygen every now and then, but he does not tolerate that for more than about one hour. Both boys now learn how to breastfeed and are increasing the amount of milk they can take from the bottle.

Surrounded by, and held warm by, some of the beautiful gifts Friends have given for the boys. Said the frog: "Listen, guys. If you manage to get the hang of this sucking at the breast, and don't forget to breathe at the same time, you'll be out of here in no time!". Said the duck: "Quack!".

May, 2005

May 28:

We are getting into feeding season. 4 lb 10oz (2100g) and 4 lb 6oz (1985g).

HealthNow has rejected our appeal of their decision to deny the transfer to Ithaca. It seems the only thing they accept as relevant is their narrow view of medical necessity, regardless of what the full picture is.

Abraham and Noah are doing pretty well. Apneas/bradycardias are becoming very few, and Noah has been living without nasal cannula for a week now. Abraham still needs it, with a slight flow of oxygen. The attempts to feed at the breast have been somewhat successful. But both have been switched to a 4 hour schedule and can take part of their feeding from the bottle.

Noah attempts to drink from the bottle.

Abraham with his mother, after a 45 min stint at breastfeeding.

They have to train, so they can grab the beer later on.

May 22:

4 lb 2oz (1870g) and 3 lb 15oz (1790g); feeding is 35cc each.

The health insurance (HealthNow) has declined our request to transfer the boys to Cayuga Medical Center. They write there was no medical reason for the transfer, and it would be only "for the convenience of the parents". The real reason most likely is that they pay the current hospital a contract fee that has almost reached its maximum, so any future stay would hardly cost them anything. That would be different if they would transfer to another facility. - That's unfortunate, because we think that we could provide a significantly higher level of care here in Ithaca, by being at their sides much more often. We could do more kangaroo care (especially me, the father, who is working during the week), and Petra would be able to intensify her breastfeeding training.

Why does the system create roadblocks that really have a bad effect on patients' well-being??

Last week, Abraham actually got a phone call!

At what age did you receive your first phone call? Well, I accepted it in his name. It was a call from an automated system from the Social Security Administration, informing him that his application had been received and was being processed. Thus are the strange blossoms of automation. I guess our boys' eligibility for Social Security will long be over by the time that application is approved.

Abraham in the open crib

Noah in the open crib. With hat.

May 20:

Almost four pounds (3 lb 15oz and 3 lb 12oz - 34/33cc). Only few apneas/bradycardias. Noah has a very sore nose. We don't really know why, but it could have been caused by the nasal cannula. That thing is gone for now, to help the nose heal. Fortunately, Noah tolerates it very well.

May 18:

3 lb 12oz (1700g) and 3 lb 9oz (1615g). Apneas are going up and down. Noah is slightly anemic and is treated with EPO, to stimulate red blood cell production by the bone marrow. Both boys are now heavy enough to be in an open crib instead of an isolette. And - they are together in one crib! Wait for the pictures!

Here it is: one crib for the two of them. They don't have any contact, though. We'll see whether we can improve that. Noah has a plastic shield over his head and is treated with water vapor, to prevent the nose from drying out. It looks bad but is really just a simple thing.

May 15:

Five weeks, and the guardian angels are still by their sides. The weight gain is ok (3 lb 8oz and 3 lb 5oz - 29cc of breast milk through the tube every 3 hours). Apneas and Bradycardias are an issue, so both boys have a nasal cannula with some oxygen. The first polio vaccination was on Friday. We are doing cangaroo care, and continue to let them try to take the breast.

The twins' first encounter with each other (outside the womb). They look more like newborns now.

Abraham likes to squeeze a parent's finger with his hand. You can feel the power.

May 9:

Four weeks, and the guardian angels are still by their sides. 26 and 24cc every 3 hours. 3 lb 1oz and 2 lb 13oz. No CPAP any more, and hopefully it will stay that way. The nursing staff got some feeding this time (walnut cake), and they were happy. They are doing a great job, and we are very thankful for it!

Noah is a little behind in weight, but Abraham had a number of bradycardias (slowing of the heart, usually accompanied by apnea) which worried the Docs. A blood test for infection was made, but nothing was found. Kangaroo care is supplemented with putting them at the mother's breast.

We had our first "patient care conference" with the nurse practitioner who has taken over medical care (still supervised by the doctors) and the social worker (both wonderful ladies). We discussed medical status, development so far, how we can get the boys transferred to Ithaca when that is possible, and what is going to happen in the next few months.

Kangaroo care is what we can do whenever we are here. Here, Abraham is alert and looking around. That usually doesn't last long, and the babies get to sleep shortly afterwards.

Noah up close. He didn't like his feeding tube, so he pulled it out. Too bad they taped the nasal cannula real tight this time - he often tries to throw it out, too.

May 5:

Abraham and Noah have been moved from the NICU to the "Progressive Care Nursery". That was more of an organizational move than anything else: The hospital needed space in the NICU for new babies, and ours were the most stable patients. The advantage is that the new room has windows (not so good for the babies, but makes the place much more friendly) and is quieter (good).

Both boys are growing well now (2 lb 13oz and 2 lb 11oz). We have started to get them acquainted with the mother's breast. They are still too weak to nurse there, but this serves as preparation. Kangaroo care by both parents seems to be excellent.

May 1st:

Three weeks, and the guardian angels are still by their sides. Feeding is at 22cc. The nurses are trying to wean the boys from the CPAP (breating support). Doctors and nurses are happy - with the parents. The patients can be on a simple nasal cannula for hours. The cannula only delivers air right into the nose, without pushing it into the lungs.

Kangaroo care with Abraham.

Kangaroo care with Noah.

April, 2005

April 30:

Abraham and Noah have both reached their full feeding amount (20cc for their weight, which means there is no additional IV feeding!). Both are gaining weight now (2 lb 10oz and 2 lb 9oz). Abraham even woke up crying once, because he was hungry. That is good. Today, we have done some kangaroo care (baby lying on parent's breast with skin-to-skin contact) for an hour. Abraham needed to sneeze, because a hair got into his nose. That's funny. They now can regulate their body temperature, which is why they wear clothes and have a blanket over them in the isolette (incubator).

April 27:

Both boys are still on antibiotics, but are going strong. The feeding is being increased successfully (Noah 11cc, Abraham 14cc every three hours, as of yesterday). Breathing is going very well. Abraham has spent almost an hour yesterday without any breathing support lying on his mother's skin.

April 25:

Abraham and Noah have both caught a Staph infection and are being treated with an antibiotic (Vancomycin). Abraham was put on a ventilator for two days or so, as he had more trouble breathing on his own, due to the infection. Noah fared better, because his infection was caught earlier. Feeding was suspended and has now been restarted. Both have surpassed their birth weight and are doing fine otherwise.

April 21:

Abraham gets 8cc of breast milk every 3 hours, Noah gets 4cc. Both have reached their birth weight again and are doing fine.

After one week, on April 17, the twins have lost some weight, which is normal. If you are interested in seeing what the NICU looks like, watch this

1 minute NICU movie

Noah's father changes his mini-diaper.

Abraham out of his box

April 13:

Three days after birth, the nurses and doctors are happy with the boys' progress.

Here they are on their third day, with eyes open, while their tubing is changed.

April 11:

One day after birth, Petra is making a stellar recovery in the brand new maternity ward of the hospital.

Noah and Abraham on their first day. Tubes for breathing, arterial and intravenous lines for blood testing and drugs, a blood oxygen monitor on one foot, a breathing monitor, a skin temperature probe, and three electrodes each for heart surveillance.

The boys are twins, most likely fraternal.
Abraham was born first by natural birth, weighed 1055 grams (2lb 5oz), and was 38.5 cm tall (15 inches).
Noah was born 17 minutes later by caesarian section, weighed 1000 grams (2lb 3oz), and was 37.9 cm tall (14 3/4 inches).

Abraham and Noah Schwarthoff

Born April 10, 2005

The due date was July 11. That means the boys were only in their 26th week and needed to spend the first months of their lives in the neonatal intensive care unit (NICU) at Arnot Ogden Medical Center in Elmira, USA.

The chronology

Names of medical personnel are changed and abbreviated.

By Hubert Schwarthoff.

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