Day 1 (Gestational Age: 28 Weeks 1 Day)

It has been over 24 hours since the twins were born.  Nanette, who is recovering much better now (she lost almost 2 liters of blood after the surgergy), saw her baby twins for the first time this morning. She is walking around a little and the color is starting to return to her face.  She is sleeping when she can and crying when she can't.

First the good news:

Zeke weighed 2 lbs 5 oz and was given Apgar scores of 6.5 and 6.  He was intubated and put on a ventilator right after birth and given pulmonary surfactant to reduce friction in the lungs and help them expand.  His blood sugar was a bit low (40 mg/dL) after birth, which is very typical, and he was given a little sugar (dextrose, I believe) in his IV.  His blood oxygen has been very good so he was extubated, taken off the ventilator, and put on CPAP (positive air pressure).  The air given to Zeke has the same oxygen concentration as regular air (21%).  He is pink in color and very calm and relaxed.  He had his first meal today: 1 mL of colostrum that Nanette had previously pumped.  Overall, Zeke is doing very well for his situation.

Now the bad:

Gabriel weighed 2 lbs 15 oz and was given Apgar scores of 2 and 7.  He was also intubated, put on a ventilator, and given surfactant.  He is still on the ventilator.  He has been under the bili light to help with his jaundice.  Tonight the doctors informed us that Gabe has sepsis, which is an infection of the whole body.  He also has pulmonary hypertension, which means that the pressure in the lung vessels is high.  The high pressure is caused by constricted pulmonary vessels.  The bacteria which is causing the sepsis exacerbates the constriction.  Furthermore, as the antibiotics and the baby's body start to fight the bacteria, toxicity will increase, further increasing the constriction in the vessels.  The result of the poor circulation through his lungs is a low level of oxygen in the blood.  Thus, the air forced in his ventilator is about 90-100% oxygen.  These concentrations have kept his blood oxygen levels in the high 80s/low 90s, as they should.

They are administering all sorts of drugs to Gabe: 

• one to keep the pressure up in the lungs to get the blood moving in the vessels
• one to increase vessel constriction in the rest of the body to decrease the blood pressure there
• one or two other blood pressure medications
• continued antibiotics 
• sedation medication
• At least 6-7 more drugs (I don't know what they do, I just see them by his bedside)

The doctor told us that Gabe has roughly a 60% probability of survival in the next 24-36 hours.  Please fast and pray for our little twins and our family.