Julia took her first unsupported step yesterday.  It was a side step and then a slide step, so I didn't want to count it as her first step.  But today she took one big forward step into my arms, then two steps to her GrandMarmy, and then a step to her Daddy.  WOW!  We are so excited for her to be walking, yes it will bring a new set of challenges but we are ready for them and ready for a new freedom too.  Hopefully Marayla is right behind her, as it is nice to move to another phase as a family.

Marayla was, and has been of late, very fussy.  Before dinner I knew she was tired and possibly hungry, but I thought maybe she was teething too.  The girls still only have their two bottom teeth so I check their gums often; I have been patiently waiting for more teeth so we can expand their diets.   Julia just happened to be sitting on my lap so I decided to check and see if she had any new teeth.  I felt her top gums and, go figure, her two top teeth have broken through!  I am very excited.   Seems that when a baby progresses forward, they don’t take baby steps but leaps!

We are weaning the girls off formula—which is harder for Mommy than babies.  We are down to one bottle at night, and have introduced whole milk to replace the calcium and vitamin D from the formula during the day.  The girls are now eating a full and varied diet and have at least three meals a day.  Some days they eat up to five meals and some snacks too, which is why I LIVE in the kitchen making and cleaning up food.  Today they ate an omelet, cheerios, a banana, strawberries, watermelon, chicken, black beans (everyday!), carrots, corn, peas, tuna fish, a cream cheese sandwich on cinnamon bread, ground turkey taco meat, yogurt, and their new favorite--Goldfish crackers.  Today was a good day for eating and they didn’t need to drink mass amounts of formula to top off their stomachs for a good night’s sleep.  Marayla uses formula as a clutch when she doesn’t eat enough during the day.  I am having a hard time not buying more formula.  I did it today, as I am worried that Marayla will throw a fit without her bedtime bottle and A) not go to sleep and throw a fit (not that uncommon!) or B) wake up hungry in the middle of the night.  I am sure that all will be fine once we stop giving the nighttime bottle but for some reason I am not ready for this change and dealing with what will be the minor and short lived consequences.

There is a sweet song that Ryan’s Mom sang to her babies called “Wind, wind little baby.” It’s an interactive little diddy that involves winding the baby’s arms, then pulling them, and then clapping.  Ryan sang this song to his nieces, Sydney and Rachel, when they were babies as he was their nanny—bet you didn’t know that!  Grandma reminded her son of this song and Daddy started singing it to our girls.  It is an easy and catchy song which I now love to sing.  There is another sweet girl that loves this song and she has created her own version that she sings, too.  The other night after a round of Wind-Wind, Marayla, who rubs her hands together or rubs an arm with her hand for the winding part of the song, sat down on the couch and clearly sang “Wind Wind Baba Baby.”  Ryan and I looked at each other in amazement and I cried.  It was so sweet because she has the prettiest little voice and the fact that she all of a sudden put it all together.  Since then, her rendition is not as clear as that first time, but the action and the “baba” are always included.  More than walking or any other milestone, I can’t wait to hear in song and conversation what my girls have to say.

Part II – The Nurses

During Julia and Marayla’s three month stay at the NICU, Arianne and I interacted with a diverse cast of characters.  The resident doctors, specialists, receptionists, and other parents made our days quite colorful.  But when it comes to high impact, no one compares with the nurses.  Generally, each nurse maintained the charge of two preemies during each shift:  feeding, changing, medicating, holding, cleaning, all of this on top of the responsibilities that a nurse has to a patient (in the case of the NICU, two patients).  In the beginning of our stay, Julia and Marayla had different nurses, because their isolettes were not yet next to each other.  There were some nurses who requested to care for Marayla, and others who requested Julia.  That was a really nice feeling, to know that these women (all the nurses were women) truly cared for our girls.  However, Arianne and I could not wait until the girls were together, for many reasons, but one reason was so we would only have one nurse to speak with each day.  Because dealing with the nurses could be, at many times, the biggest challenge we faced in the NICU.

With each visit, Ari and I fell into a groove with the NICU, one that was at times difficult to deal with.  It became apparent from the get-go that, even though we were the girls’ parents, our roles would fall secondary to that of the nurses.  At times, we felt like kids who were sometimes allowed to hold the babies, but only under the strictest of rules.  What an event it would be when we would be told it was time to start changing the girls’ diapers, under careful watch.  And whatever you do, don’t let them catch you with more than two people in the breast-feeding/pumping station.  Rules are rules.

Once we knew the girls were in the NICU, Ari and I familiarized ourselves with what that meant for them, by doing research on the Internet.  What is life like in the NICU for the babies?  And for the parents?  We educated ourselves about progressive NICU practices, such as Kangaroo Care (holding the preemie under your shirt to your bare chest, for skin to skin contact).  We read articles about NICUs that were changing the environment to avoid stimulating the patients, such as dim lighting, low noises, and gentle medical procedures.  Our NICU strongly encouraged Kangaroo Care from the beginning, and this comforted Arianne and I.  However, we soon learned that our NICU was not as progressive as we would have hoped.

The lights were always super bright in there; there were hundreds of loud machines with beeps and alarms.  Most of the times, the nurses didn’t pay attention to the beeps unless they reached a critical level, so many times the beeping would just go and go.  Blaring right next to the isolettes.  Yes, these machines are necessary to alert a nurse and/or doctor to a problem.  However, the root of NICU is Intensive Care Unit.  An adult ICU is run in a specific way to help the patients rest and heal.  The Neonatal Intensive Care Unit should be run in the same manner, if not more on the softer side.  Preemies are born into the world sick, they are easily startled, and they don’t have the immediate comfort of their mother throughout the day.  These progressive NICUs are simply trying to provide as comfortable environment for these brand new people as possible.

So, Arianne and I asked for the lights above the girls’ isolettes to be dimmed; the nurses obliged and dimmed them, but they would turn them up again when they needed to tend to them.  And they would leave them up when they were done.  We knew that it was a losing battle – once we left to go home, the lights would be up permanently again.  So, we brought in their quilts.  We would lay the quilts on the top of the isolettes, blocking out as much light as possible.  Those quilts remained with the girls until they came home.  However, we would often walk into the NICU to find the quilts folded up, defeating the purpose completely.  The reason for the fold:  without it, the nurses would have to lift it up all the time to look in on the girls and tend to them.  In addition to this, we would always find large medical equipment stored on top of the isolettes.  This wouldn’t be so bad save for the manner that they are rested there; the nurses would not gently place the equipment down, but they would put it down hard, like they were putting it on a table.  A table with a two-pound baby trying to sleep in it.  This brings me to another notable:  the isolette doors.  During our “orientation” into NICU life, one of the nurses made a point to show us the proper way to open and close the doors, so as not to startle the baby inside.  You hold the clips out while closing, otherwise the clips will snap shut; most likely would echo in the enclosed isolette.  Arianne and I abided by this with every opening and closing for both isolettes.  We lost count how many times many of the nurses would simply push the doors closed without the care that was preached to us.  Bright lights, blaring alarms, loud bangs on the roof and at the doors.  These are some of the sensory disruptions that the girls lived through. 

The greatest disruption for Arianne and I were the inconsistencies with the girls’ care and the instructions for us.  Often times we would get contradictory instructions from one nurse to the next (or even contradictions from NICU policy to practice).  At the entrance to the NICU, there is a posting asking all who enter not to answer their cell phones inside, but to answer (if necessary) and have the conversation in the hallway.  One night, the girls’ nurse had quite a long conversation on her cell phone, sitting on her stool right next to their isolettes.  Some nurses had their own version of "care."  One nurse in particular, while trying to fix a wire on Marayla within one week of life, said right in front of us, “Sit still, dummy!”  Granted, she said this endearingly, as much as is possible with that term.  Some nurses were purposely laid back to insure that Arianne and I were as hands-on as possible; on the other hand, some nurses were so overbearing that we had to ask permission to do anything for fear of a lecture and a stern look.  Some nurses were amenable to our wishes, others were the opposite.  Many of our nurses had such a wonderful impact on our lives, and gave us the greatest gift possible.  Despite our concerns, Arianne and I both believe that NICU nurses all deserve recognition.  On Valentine’s Day, we were able to witness Marayla’s nurse receive such recognition.  However, Arianne and I left the NICU that day angrier and more frustrated than ever. 

Julia and Marayla had yet to be moved together; so, Arianne was sitting with Julia on her chest, while I was standing at Marayla’s isolette.  Her nurse was getting ready to change her IV, a most unpleasant process for anyone, let alone a preemie with veins the size of dental floss.  But her nurse was a pro.  So much so, that the hospital wanted to show how much she was appreciated.  As she was getting Marayla ready, with her little isolette doors open, I noticed a crowd of people enter the NICU.  A man in a sharp suit (some sort of high roller with the hospital), other top hospital staff, and some cherry stripers.  They had balloons and one of those huge checks you see lottery winners receive.  None of these people wore scrubs, and I wondered if they even washed up.  They stepped into the center of the NICU, just feet from Arianne holding Julia, and the man spoke, loud enough for everyone to hear:  “May I have your attention please!”  Keep in mind; this is an Intensive Care Unit.  He went on to make a long, loud speech about how people who go the extra yard are regarded highly by the hospital staff.  He then turned to Marayla’s nurse; apparently, the to-do was all for her.  At this point, the nurse was standing there, watching on with the rest of us, with Marayla’s isolette doors wide open the entire time.  Who knows how far she had gotten into her prep, and how this ceremony would affect her focus.  I was standing there with my mouth wide open, so tempted to interrupt and ask them to take this to another location.  He called the nurse over to accept the check and the certificate.  She started to cry and was so overjoyed.  She left Marayla’s isolette doors open.  I walked over and closed them.  The doctor on duty (again, a staff member we love), joined in the celebration, basically dropping what she was doing to take part.  Good for the nurse, seriously.  We were happy that one of the nurses we had all the time was being recognized.  But we found it totally intrusive and inappropriate to conduct that in the middle of an intensive care unit, with frightened parents and sick babies forced to act as spectators.  Everyone went to the nurse to congratulate her and hug her.  She continued to cry, but she then tried to regain her focus, and returned to Marayla.  Arianne and I both had deer in the headlights all over our faces.  We felt like we were in the twilight zone. 

We left the hospital that day flabbergasted, and we continued to reflect on what happened.  The nurses, doctors, executive staff…they were all oblivious to how their behavior can affect those they are treating.  The final shoe had fallen.  There was no way I would address the issue at that moment; it would not have been wise to spoil the party right when it started (in hindsight, I wished I had).  We left the NICU that day reserved to speak to our doctor about our concerns with the NICU environment.  We were ready to step up.

Arianne
One year ago today we brought Julia home from the hospital.  One year ago today we became parents in the true sense of the work.  I mean work.  Before she came home, we had been going through the actions to be good parents and fulfill our duty to our preemies.  Tonight, in our true hustle and bustle style, we forgot that today was the anniversary, until she had fallen asleep in Ryan's arms.  When we remembered, I cried and Ryan squeezed her tight. 

 I love Julia.  Pure and simple.  She brings overwhelming joy to my life.  Her laugh is as big as her personality.  She is my biggest fan, needing me to be near her at all times.  She loves her GrandMarmy and can't decide who she favors when we are both in the room.  She gets frustrated easily and turns her face red while she yells out her opinion.  She is an excellent sleeper and if she didn't share a room with Marayla she would take two naps a day and sleep late into the morning.  She loves to have her belly tickled and could live upside down like a little monkey.  She loves to eat and usually doesn’t turn her head to anything new we give her.  She loves shoes and toes, and grins from ear to ear when Ryan sings the Little Piggy song.  Julia will be walking soon, her hair is growing in thick, and just the other day I left her alone with a playgroup Mommy friend and she didn’t cry for me.  She is becoming a little girl.  She is moving out of the baby stage and I can’t believe how quickly this long year went.  Julia, I love you.

Ryan

One year ago today we brought Julia home from the hospital.  Paroled from the NICU, Julia came home to our apartment and was instantly comfortable.  That night, Arianne went to the NICU to visit Marayla and I stayed home with Julia; I laid her in the laundry basket to sleep.  It’s funny to think about that because she could barely fit in there now.  Reflecting on this last year with our Jem at home was bittersweet – Ari’s right, it’s been a long year, but it flew by!

I love Julia.  She is a fireball, a burst of energy from the moment she wakes up.  I love walking into the nursery when naptime ends, because Julia expresses so much excitement at seeing Ari and/or I enter.  I love making her laugh, whether it’s playing with her feet, making raspberries on her belly, or playing with her in the girls’ toy tunnel. I love when she offers me some of her food.  I love watching her explore her world and take control of it, bit by bit.  Julia loves to play with Tupperware; she loves to knock down the towers of Tupperware that Daddy builds for her.  She loves to chase her sister across the floors.  Her newest passion is crawling up the stairs at breakneck speed.  Julia is fearless, with one notable exception:  Googly-eyed non-slip bath-grip Frogs.  She’ll tread carefully before messing with things like that.  That’s another thing I love about Julia – she recognizes her limits.  Steep stairs:  bring it on.  Freaky froggies:  not right away.  Julia is always ready for a party, but knows when it’s over and time for sleep.  She speaks her mind, and speaks it so all can hear. Julia begins everyday with so much energy, and closes each day like it was her best yet.  Julia is an individual, but one whose characteristics have only started to shine through.  Julia is Daddy’s Jem.  Julia, I love you.