Yesterday (or the day before, depending on the doctor) was Sarah and Alex's due date! So we sang and thought happy
birthday, and now they are officially newborn babies rather than preemies. Of course they are quite a bit farther along
than preemies in terms of size and development, but they are also definitely not 10-week-old babies. Apparently
they will be developing based on gestational age rather than actual age until they are about 2 years old.We are
enjoying a longer newborn stage, and I think will be somewhat sad (as well as happy for their progress) when they start really
moving on. So we'll be celebrating 3 anniversaries for quite awhile - their birthday (March 9), their arrival home (April 19)
and their due date (May 19).

It's been several weeks since writing an entry. I'll post some highlights here.

Alex has completely overtaken Sarah in terms of size. He was about 1 pound heavier at their last visit to Dr.
Spiegel (last Friday, May 13), at about 8 lb 6 oz., while she was at 7 lb, 6 oz. Dr. Spiegel started their growth
charts, which we remember from Max's file with the same doctor. He sat and thought and moved their growth
dots over to minus 10 weeks, and declared that they were both at the 75th percentile, meaning that their
height, weight, and head circumferences are perfectly normal. And our worries about Sarah being 1 pound behind
were meritless since she was in an excellent range, and had also been gaining about 1 oz per day since the
previous visit.

ALEX:
Alex feels quite a bit heavier than Sarah - his head is very solid (I'll definitely work on getting a separate web site
going with pictures). He has huge cheeks and a large brow, and it takes a strong wrist to support him when
we're feeding him. He also has a bit more fat around the middle and around his legs.

Alex outgrew his first outfit about 4 days ago - one of the preemie playsuits that we had brought home from the hospital.
I think that with today's diaper change, he's now outgrown his second suit (a preemie one that we bought at the
Carter's outlet in Carlsbad in March). After just buying 4 more packages of newborn size diapers, I have a feeling
that Sarah will be the only one using them in about a week. He's also graduated to the 8 oz bottles, although
we're still thinking of feedings in cc's. He's eating 120 to 160 ccs ( 4 to 6 oz) every 2 to 3 hours. On the subject
of Poop (Alex, don't cringe when you read this when you're a teenager), Alex has had quite a few bouts with constipation.
At the NICU, the nurses would joke that there was a suppository with his name on it, and he would apparently
(but obviously not) respond with a poop at the next feeding. He did though go for 3 days here, so we had to
go with the suppository, which has completely changed his output to something perhaps more worrisome, so a
doctor's call is now in order.

Alex still has his woody woodpecker noise, so his name is gradually morphing from Alex, or "little man", or
"sweetie pie" to "Woody", which frankly suits him quite well! His lungs have developed, but are used only when
he startles himself awake, on the dot of feeding time. (He's our alarm clock.)

Around about last weekend, Alex started being quite interested in the ball hanging down above his playmat. He
has little playtimes now every afternoon. Sarah joined him on about Tuesday or Wednesday. Alex can, with
great effort, turn himself over now, so we have to start being careful. (It's only happened once or twice.)
He seems to recognize all the main players in his life, and can keep himself nicely entertained while
sitting in his chair, looking around, floating his arms, and hiccupping.


SARAH:
Sarah has a delicate face that is absoloutely angelic when she's in the quiet alert state, but her mouth can open to
mammoth proportions when she's crying (think Jekyll and Hyde). She can be sound asleep, wake slightly, decide
she's hungry, and off we go over the top with crying! Because of her small bradycardia before her discharge
from the hospital, she has had a monitor. After about 1 week with the monitor's false alarms, Sarah's
robust health, and the disagreement between the pediatricians, we decided to stop using the monitor. We asked
our pediatrician if he thought we were bad parents for doing so, and he said not really, but officially he couldn't
recommend stopping. So the day after we had the 1-month checkup with Dr. Lim, Sarah's pulmonologist.
She said that Sarah looks fine (after weighing, measuring, blood pressure, optical oxygen sensor on her big toe which
drove her crazy,requiring intervention from the senior respiratory therapist who waited until Sarah had a bottle
going). Dr. Lim then wrote the order discontinuing the monitor. So there we are, somewhat vindicated I suppose.

Our main saga/experimentation is in the realm of spit-up and gas. We've been using Mylicon with every feeding.
Dr. Spiegel recommended a formula that has rice dissolved in it, and Dr. Lim recommended the older solution
of simply dissolving some infant rice formula in the regular formula. We've also purchased some soy formula,
and bought some gripe water today. Needless to say, our experiment is rather haphazard with no good controls,
so we don't really know what's working and what's not. In any case, all of the above seem to make a difference.
There have been some spectacular 5 to 6 foot projectile spitups (not really vomit, doesn't smell, so don't
get queasy reading this). So we soldier on.

Sarah is now able to move head wherever she wants it, and is starting to push up on her arms when she's
up against someone's chest. She has lovely floaty arm motions, and sits into her meal with relish, bringing her
hands right up to her chin, like the chorus singers in Gilbert and Sullivan.

MAIN EVENTS
Grandma and Grandpa Talley (Phyllis and Vince) arrived from Blacksburg, VA on Monday, May 16. They are staying
at Tom Bond and Laura Jean Hageman's house in Solana Beach and have been spending most of each day with us.
Phyllis is providing a much needed extra pair of hands, lap, and shoulder for holding Sarah and Alex. Vince has
been running some errands. We're greatly enjoying their company, and hope they keep on enjoying ours and
especially Sarah and Alex's! They'll be here for about a month.

After they arrived on Monday, we had a nice afternoon with them and Monique, who came over for her normal
time slot for Alex/Sarah (and Lynne - piano music). Max dropped in unexpectedly, which was a very nice surprise,
so Phyllis had a chance to see his transformation since last July into a full teenager, shooting up taller than the
rest of us, with his voice going in the opposite direction. We picked up Max at his jazz band rehearsal later on
and had dinner at Papachino's in Flower Hill Mall - Alex and Sarah's first dinner out.

On Tuesday, May 17, we went to the local rent-a-wreck to find a 7-passenger vehicle so that we can all travel around together
this summer when needed. We ended up with the "Landship Enterprise" - a Toyota Land Cruiser. I was afraid Jeff would
have a cow at our coming home with an SUV, but he's actually haveing a real blast driving above the rest of the
crowd on the freeway. (Which we do as rarely as possible, during which we make as many comments about SUV
drivers and gas emissions as possible. It did cost a sobering $64 to fill at the local cheap Arco station.)

Wednesday, May 18, was my birthday (I won't say which), and it was wonderful to have my parents here, Mom cooking us
dinner, and baking a chocolate cake (which we ate with strawberries, chocolate ice cream and whipped cream -
a nice alternative to icing). Jeff built a hand rail for the front steps to help all of our family members
and visitors.

Then, Thursday, May 19 - the official zeroth birthday for Sarah and Alex! We are so very very very very happy to be
the parents of these wonderful two beings.

We've been home now for 2 weeks. Alex and Sarah are growing fast, probably close to 7 pounds now. They are now approaching their original due date of May 19, and look like newborns, with some fat on their faces and a little on their legs and arms. They have strong personalities already, very different from each other, and very distinctive voices, so we can easily tell which one is expressing him or herself. Even as they are settling into being comfortable and well, Sarah tells us just about everything that is passing through her system and head, while Alex only makes quite a bit of noise when he's really hungry. He has a little woody-woodpecker sound that we all like to imitate. We are settling into a pretty regular routine, with plenty of sleep for Sarah and Alex and plenty of no sleep for Jeff and Lynne (such a paradox that 2 hours in a row is just fine for babies, and totally inadequate for adults!) Because they are primarily formula fed, we've been able to keep the hospital schedule of feedings every 3 hours. Sarah and Alex almost always wake themselves up at about a quarter of the hour (12, 3, 6, 9 round the clock), ready to have something to eat. They've mainly been sleeping in between, but are starting to have some more wakeful times, especially in the evening. Since I'd gotten used to their drifting off to sleep, it's a little startling and wonderful to look over and see them just watching and looking. Alex already had a little interest in a little flying clown on his ply mat. They both hold pretty tightly to a finger now, and like to keep a hand on their bottle. Once they're asleep (which comes very quickly), they can sleep through almost anything, including all kinds of noise, talking, music, being strapped into car seats, etc. They are often held for quite a while when they are asleep between feedings. They sleep together in a bassinet (that's why you'll see them together so much in the pictures). They have one bassinet in the living room and another in our bedroom right next to the bed, so we can hear anything that's going on during the night. Grandma Elinor Severinghaus was here until last Monday. We really enjoyed having her here, holding babies between feedings and talking about the Severinghaus 4 as babies. Max came over from his father's house a week ago Saturday and went back this past Sunday. He was very much into the whole scene, picking up and carrying Sarah or Alex, interested in who they are, and even volunteering and making dinner on Thursday night when it was clear that it would greatly facilitate matters for all of us. Our main events have been doctor visits: two to Dr. Ben Spiegel (pediatrician) (April 22 and 29) and one to the opthalmologist at Children's Hospital (Dr. Anne Jockin), to check their retinas (a routine concern for premature babies, but almost never a problem for 30-week babies like Alex and Sarah). Dr. Spiegel spent a lot of time with us on the first visit, getting to know Alex and Sarah and answering any and all questions. Over the two visits, he told us that Sarah's spitting-up and pain-after-eating were probably unrelated but normal problems - the first to do with her esophogeal sphincter valve (not yet fully developed) and the second just gas. He suggested Mylicon, an over-the-counter remedy for gas, and it has worked beatifully - breaks up the gas bubbles into small ones, and there's no more pain after eating. The spitting up will go away on its own. We are so glad that Dr. Spiegel was able to take them on, having had 14 years of great experiences with him as Max's doctor. He is a true family doctor - asked specifically about how Max was doing, chit-chatting about his own teenagers. Our other outings have included two Sunday's to the fellowship, and then a first shopping trip to the Albertson's shopping center to go to the store Honeysuckle and Momma, and then a quick spin around the grocery. The two-car-seat-holding-stroller-rig is just great. We just lift the car seats out of the car, and snap them right on the frame, and head out. It steers well, has a great cargo compartment and cup holders. (This sounds like a testimonial that I could paste onto the Babies R Us website.) Our next expedition was to the hair dresser after the opthamologist visit since we didn't have time to get home. The twins were of course an enormous hit there - Dee, my hair dresser, has grown twins (one of each) and so has been very interested in everything to do with Sarah and Alex. Friday night Max and I rolled the stroller down the street to Chief's Burgers (a sort of neighborhood pub with lots of kids in addition to endless TV sets on sports events) to get some dinner. Then on Sunday, Jeff and I finally got a baby announcement put together, after a little photo shoot in front of the house with the flowers, and in the babies' room with the beautiful quilt that Wendy sent Jeff a few years ago. We all loaded up and went to Kinko's, and had a bite to eat, including Sarah and Alex's bottles. We get comments every where we go - people love newborns, and then they see there are twins, and then they see there is one of each, at which point they comment that we're done. We have avoided going into the whole Jeff and I have been able to get to work a little, Jeff more than I. Our plan, which is working thus far, is that I head in in the morning after taking Max and his friends to school (and just do it during the weeks when he isn't here), and Jeff goes in in the afternoon. Since most of the doctor visits etc have been in the morning, the actual amount of time I've gotten to the office has been pretty minimal, but I didn't expect to do much more than just barely keep my head above water (i.e. do email every 3-4 days, necessary paperwork) for quite a while. The real story of newborn Sarah and Alex is that we all just love being together at home, with a routine of sleeping, waking, holding, diapers, bottles, laundry, dishes, and repeat. We are slowly adapting to the 2-hour chunks that sleep comes in, both of us having crashed almost completely once last week (luckily not on the same day). Jeff is really getting into a coffee routine, which is new for him - good beans, a grinder, and a nice cup. We love our house, with the sun in the babies' room in the morning, and orange light streaming into the living room in the late afternon. We are listening to more of our CDs than we knew we had, and keep some quiet ones going all night. Our favorites are one of Segovia's (guitar music) and a CD of Bach cello sonatas (Janos Starker, who plays more gently than Pablo Casals or Yo-Yo-Ma, who are our daytime Bach favorites). We love Sarah's little smile and Alex's woody-woodpecker sound. We love having visitors - Monique last week when Elinor was here, and Marcelline yesterday for the afternoon. They'll be coming regularly - every week. We are looking forward to Grandma and Grandpa Talley's extended visit , which starts May 16.

"We're home!" say Sarah and Alex. (Well, not really - stay tuned for full sentences in a couple of years.)
Today is Thursday, and we've all been home for 1.5 days. They were discharged from Scripps
Memorial Hospital in La Jolla on Tuesday (April 19), at almost 6 weeks (minus 1 day), and at 36 weeks gestational age.
(We're going to be keeping track of that number for the rest of the year, with some checkup dates based on their original
due date of May 19.) This week is about when we had had in our minds that they might be born!

As a wonderful coincidence, Sarah and Alex's Grandma Elinor and Aunt Jean flew in from Oakland on the very same day
and were able to be at the hospital when Sarah and Alex emerged from the land of beeps, blinking lights, banging doors,
and (on the upside) wonderful, nurturing, competent nurses (and our teachers) who had been taking care of them for
6 weeks. The nurses and doctor urged us to come back and visit when Alex and Sarah are bigger - they love to see their little
charges as they grow.

On their first evening at home, Sarah and Alex were visited by their big brother Max and his dad Paul (this is Max's
week at Paul's house), who brought a box of Max's lullaby and kid song tapes.
On their first full day at home, Sarah and Alex were visited by their madrina Monique Kunewalder (who brought lunch on
Tuesday, and dinner on Wednesday - thanks!) and by their surrogate mom Ann Miranda and her kids Mike and Marissa.
Lynne's student Elena came by to work on her conference presentation (in Vienna!) and colleague Larry Pratt who
came over to talk about the northern North Atlantic. This morning (Wednesday), Joe Sweeney (Jeff's trainer)
met Sarah.

Here we go with some very long details of the last couple days!

So Tuesday - the last day at the hospital - a chronicle. We were expecting to be discharged between 9 and 11 AM,
so went prepared with backpacks to load up the piles of accessories/blankets/clothes that have already accumulated.
Dr. Jane O'Donnell reviewed their PCG's - Sarah's had just been done (Saturday or Sunday night). Sarah had had
an episode of a heart rate of 60 during the recording, and Dr. O'Donnell thought it best that she go home on a
monitor that senses heart rate and respiration. So the call went in to the monitor company, and it ended up
being about 5 PM when we were finally finished with learning about the monitor etc. Nurse Linda, (a former
Kiwi), who took care of them and us the last couple of days, gave us a very abbreviated CPR course (required
because of the monitor) and urged us to take a full course for infants, so we'll be signing up for one very soon.

Sarah and Alex are being fed Similac Neosure. It is slightly higher calorie (22) than standard formula and breast
milk (which are 20). They switched to this around April 12 from an Enfamil premature infant formula that was 24
calorie (and which was being mixed down to 22 the last few days before the switch to Neosure.) The formula
switch coincided with Sarah going to bottle feedings (P.O. = per oral) at each feeding. Neosure seems to agree
just fine with Alex, who wolfs down his bottle and then goes right off to sleep. Sarah is having a lot more trouble.
She is now able to get through her feedings without falling asleep, but she is in a lot of digestive pain and
spits up a lot during and after her feedings, so we will be asking their pediatrician, Dr. Spiegel, about switching.

Looks like it's time for noon diaper changes and feedings (and maybe a little song time)! So more
to come later this afternoon!

...back again...
Sarah and Alex's monitors at the NICU: heart rate, respiration from three little electrodes attached to their
chests with bandaid sticky stuff, and a pulse oximeter on the bottom of one foot. The output showed up on a
computer screen that averaged the rate pretty often (5 seconds?) with a curve across the screen that was about
20 seconds long. If a rate was off (often a false oxygen saturation since their feet were cold or kicking around),
then a beep would go off. So 4 wires with 2 connectors coming out the bottom of each little blanketed bundle,
to be moved around when dressing, diapering,feeding, blanketing. We are happy to be almost free of the wires
here at home!

So you can sit in the NICU and hear beeps all around, try to pick out if it's your
own baby, and then check to see if there's anything wrong. Very useful of course, to see that their hearts
are ticking right along, whether they're breathing regularly (often not very, since they were doing "periodic
breathing" - a few regular breaths and then hold, or fast ones), and if oxygen saturation was staying in the
healthy 90 percents. that's how we knew that Alex was having trouble breathing when feeding - so enthusiastic
that he didn't breathe and then his oxygen would drop right down. He also turned a little blue, so I think we
know what to look for at home. (He fixed the problem all by himself though - amazing what 1 week does for
babies their gestational age.)

In pictures from earlier in their NICU stay, there is also a tube going into Sarah's and Alex's noses. This
was their feeding tube (formula). In the earliest pictures, when they were hooked up to everything,
they had 2 IVs (one for total parenatal nutrition - really a "PIC" line (sp?), one for medications), causing
cricket-bat-itis of the arm or foot, and even Voldemortitis of the head at one point for Alex. In the
very earliest days, they had a cannula for oxygen, or sometimes a CPAP when they were a little sicker.
They were also on under billirubin lights for several days, with their cool little eyeshades, sunning in the
blue. During some periods in the NICU, there were lots of babies simultaneously under billirubin lights,
making a beautiful blue glow of the room when the room lights were down in the evening. The other NICU
noise besides the beeps etc, was the oxygen lines with little water pumps - sounding like the aqaurium
in Chuck and Nancy's family room.

Sarah's home monitor: two electrodes under her armpits held on with a wide band around her chest, measuring
heart and respiration rate. The respiratory therapist (who was VERY excited to learn that these were the
grandchildren of the originator of the Severinghaus electrode) set the monitor based on Sarah's normal
rates. It is supposed to go off (with a deafening screech, rather than the incessant NICU beeping) when her rates
are out of range. The monitor is portable, and is to be hooked up when she's asleep, in the car seat or in the
stroller. Rather a pain in the neck, and apparently wouldn't have been prescribed if she had been discharged
on Monday with a different doctor in charge. But better safe than sorry.

---and back ...
Nurses MaryAnn (night nurse) and Linda provided lots of going-home goodies, including 24 cans of powdered
formula (saving a small fortune at the drug store) and said to take all disposable items (syringes, tubes,
diapers, wipes, etc) since the next babies would get a whole new stock. So we loaded up two full backpacks
and a big bag, including the little hats and botties knitted by the hospital auxiliary and the beanie babies
provided by the same group, for every baby in the NICU. We had our last lunch in the hospital cafeteria,
and Jeff headed to the airport to pick up Elinor and Jean (after we'd done some driving to Solana Beach to
get our other car).

Nurse Linda gave us a full list of doctor's orders and medications - vitamins and iron each day to supplmenet the
formula, but nothing else, and phone numbers to make followup appointment calls. At about 5 PM, we finished
with the home monitor therapist, and put little Alex and Sarah in their car setas. (They were already pros, having passed
the 1-hour car seat challenge the day before.) We said goodby to the staff and headed to the waiting
room where Elinor and Jean were, guess what, waiting. One or two photos later, we were in the parking
garage strapping them into the backseat (facing backwards, as required), did some keystone cops on who
would sit where in which car (Jean wonderfully volunteered to drive the Subaru home, with Sarah and Alex
in the Prius), and off we went.

...our first night at home...
We have a "co-sleeper" which is a little crib set up next to our bed. Alex and Sarah are very used to each
other and will stay in the same crib until they start major interference in each other's sleep (maybe many months from now).
Alex ate and slept. Sarah ate, cried, spit up, and finally ended up sleeping alternately with Mom or Dad, in
kangaroo care position (like she was still in the womb). We are working hard at staying on the 3-hour
schedule from the hospital, which is possible since they are primarily bottle fed so we can regulate the time
between feedings.

And then our first day - see first paragraph above!

The weather is extraordinary!!! beautiful flowers everywhere in the garden, blue sky, cool air, birds.
We'll tell Alex and Sarah that they were born in the year of the rain and butterflies, and we are now
benefitting from all that rain with green and flowers everywhere.

..and now time for the first bath at home...

I'll find a different site to put photos into, since this particular journal site no longer allows new accounts
with photos.

We met with Dr. O'Donnell on Tuesday to hear all about how Alex and Sarah will be getting ready to come home. The first step
is to go to bottle feedings for every feeding. Alex got to this stage on Saturday or Sunday, and Sarah on Tuesday.
The next step is to pull the feeding tube, and Alex's was taken out yesterday!! So now we can take pictures without
tape and tube in the way! Sarah's feeding tube might go today. Then they need to have a PNCG (pneumocardiogram?)
to check that all is OK. Alex's has been ordered for this afternoon. They tell us that this means that he'll be discharged
in a few days. We'll be asked to bring in his car seat so they can test him while he's sitting in it to make sure he can
still breathe (I guess more than just a breath-on-the-mirror test). We hope very much that they'll both be coming home
at the same time! Meanwhile, I'll work on getting photos posted - this site wouldn't take my money the other night!

Hello family and friends - here we go with an attempt at an online journal, following Ann's wonderful example. Since Alex and Sarah are already 33 days old, we have a lot of catching up to do! So mainly we'll post some pictures. They're doing REALLY well. Today both of them passed the magic 5 lb. mark, and are going to 4 bottle feedings a day (the rest are gavage, through a feeding tube). They are both so alert. When it's time to eat, they're pretty easy to wake up, and then they look all around, just interested in all the goings on. (Maybe they're trying to figure out how to push the button to turn off the beepers! Their little cardio stickers come loose, or their pulse oximeter gets a little awry, or a little cold, and they start beeping) Sarah opens her eyes, looks right at us, settles right in for her bottle with her eyes wide open. She wrinkles her brow - hard work making this suck, swallow, breathe business all work! If Mommy sings or rocks too much, she drifts right off, so it's better to just tell her things. Then sit up in her little bundle and BURP. (She's very good at it.) Alex is a little sleepier, but he's looking for his dinner now too, and opens right up - where is it!? Wolfs it down, a chip off the old block, and then looks around for a little more. But when it doesn't show up, he settles right down and goes to sleep. They both love to be held, kangaroo care is the best, now following their feeding. Their O.T. and nurses in the Level 2 Children's Hospital NICU at Scripps Memorial Hospital - Casi, Barbara, Wanda, Lindsay, Michele, Blanca, and all the rest - thank you so much. Big (very big) brother Max got to visit during a very short spell at the end of March when it appeared that flu season was almost over (but it wasn't, so visits were again curtailed). Grandpa Severinghaus visited too, and provided lots of great video, but left only his voice as a record of the visit. And madrena Monique had a chance to come in and take in both little folks.