Saturday and Sunday

I’ve just been to see the two. Sister is doing well. She had her eyes closed and was sleepier this time, but was still chewing on her moisture stick. She was doing the baby “frog” position (is this what it’s called?) with her arms above her head and her legs bowed. She’s actually the one in the pictures with the blue towel.

Brother had his eyes open this time, which was a first. He clearly responded to my presence and seemed to be doing well. I also sang to both of them, held their hands and feet and rubbed their bodies, and they both seemed responsive. They’re very red—surprisingly red—which surprised me, but the nurse said that this is a good thing. It was fun to see the boy look at me. I was wearing a mask, so I don’t know what he’ll make of that. I remember I shaved my beard with Sam in part because I wanted to be more expressive with him.

Earlier today I got home for a while. I had lunch with the family watching Sam, then came home, and promptly fell asleep. Sam was very enthusiastic about lunch because they made a big tilapia, and gave him lots and lots of fish. He ate pretty much all fish. It was nice to have a home-cooked meal. Sam fell asleep as I was leaving. As of tonight at 9, I haven’t heard from those he’s staying with, but hopefully he’ll be able to sleep there okay. I felt a bit guilty heading back this afternoon because it meant leaving Emily alone at the hospital for a few hours. She is sleeping A LOT, which I think surprised her. However, after a mostly sleepness night following a full day and major surgery, I expect she has a lot of sleeping ahead of her. (And I probably do too.) I don’t usually sleep great at hospitals. We may have a single room tonight, which would be very nice.

I like the hospital situation in Taiwan. I was realizing how challenging it was with Sam, when we were both busy and struggling to learn something totally new. In many ways this is a comparable challenge, but the community is a bit smaller and probably knows us better. I really loved the community in NJ and we still miss it, but this community is also pretty impressive. It’s nice to know that we’ll have more than 2 days here, and the nurses are more hands on with the babies. This means they have stronger opinions, but they’re also more encouraging and engaged (perhaps just because there are more of them). Every time we go there’s a resident or doctor to talk to and I get to spend a nice amount of time with each. It’s also nice to be in this location, which is a $4-5 cab ride from the school and where there are lots of restaurants, 7-11’s, etc. I may actually go catch a late dinner here in a little while.

In a few hours, they can start feeding the babies. This is a good improvement. We have to pick a formula, which I’m not thrilled with, but we’ll do our best to get them formula.

4am I am having trouble sleeping now, probably a consequence of two earlier naps and a fair amount of time resting. Or, maybe, it’s the biological expectation of waking and sleeping? Either way, it’s hard to concentrate. No wireless in the hospital, no one to talk to, and I don’t feel like doing real work.

Things are basically okay. I always struggle some with medical systems. I see several challenges in the system: (1) medicine relies in large part on a law of averages—what works best for the majority of patients; (2) the prioritization of physical health sometimes come at the expense of the spiritual, inner, or even just community life; and (3) medicine is fundamentally work, so the normal challenges of human relationship and culture apply. Per #1, I think that the system has to establish baselines, which are always frustrating for the individual. Example: I would like to be feeding them myself at this point, but this is regulated by nurses and doctors. This is frustrating, but I also understand that in a NICU you have to limit the number of people just “hanging out.” I don’t really like this, but I am trying to live with it. I also think that since the babies look healthy and well-cared for, and I get some time with them, this is probably a reasonable system. For #2, I feel like minute risks often trump general health and well-being. Hospitals here often include a required period of observation, sometimes one or more days, where the babies don’t stay with the parents. Don’t really like this. Our hospital is accommodating, but being in the NICU puts us back into a more complicated, regulated system. Here this also means that I couldn’t be at the c-section, which freaked Emily out some, and in general am more limited than I’d like. Ideally, they’d have found a way to have at least the sister in Emily’s arms for feeding now, but between catheters, pain meds, and different floors it will probably wait until tomorrow. #3, I think people here really are exceptional, but they’re still basically doing a job. It’s a job they’re good at, but sometimes they are pushing an idiosyncratic preference or ideal.

These things play out in the context of things like breastfeeding. The hospital has done essentially zero training or work with us. They have a lots of signs and posters, but on a one-on-one level they’re not a huge help. They seemed a bit annoyed, or maybe just surprised, that we wanted to avoid a pacifier and bottles at first. They also don’t really seem invested in getting colostrums to the twins. Emily is expressing milk now, but it’s all in little tiny amounts, one or two milliliters every few hours. Over the course of a day, this is a fair amount, certainly enough for one infant and possibly for two. I also was surprised that NICU babies don’t get any liquids for the first 24 hours, but after this I think they will be pushing formula. All hard to figure out. Anyway, we are doing okay. We’ve found a way to get the milk to the babies, but at some point we’ll have to figure out how to work out feeding, formula, etc. I think Emily probably capable of feeding twins, especially since she was nursing Sam until a few months ago. Nonetheless, it may not be in her (or our) best interest to have her trying to feed two infants eight to ten times a day for a half-hour each time. It may not even be possible. But we’re going to try to keep up on the pumping and hopefully head towards more breastfeeding soon.

I know this probably seems like way too much reflection for fairly standard topics. I think I’m trying to figure out all the new life permutations here. Family transitions compounded by culture, more people, etc. Sam seems very happy, but I probably won’t know until tomorrow exactly how he’s doing. Emily is doing well, but I know what she’s doing/has done/ will be doing is just monumentally difficult. Our twins still look like a bit like they’ve taken up scuba diving, what with all of the pipes, pumps, and machines. And we’ll have family here soon, which is good but brings its own challenges. A lot to take account of. I hope that things improve in the coming days. I probably need to do a lot of sleeping on Monday and/or Tuesday.

Some positives: everyone is basically healthy; the hospital is near the church we attend; we have a great supportive community; one class was already off this week and the other one I have a back-up activity I can use; support is coming, and in the mean time we’ve helped bring some co-workers into the process… It’s all coming together, but still hard to sort out at the exhausted husband and dad level. Thank you all for the well wishing and support. Thank you also for listening to me as I try to work out the mysteries surrounding us.

7 PM Sunday

A good day today. I slept in the afternoon. Emily was able to hold the boy for a while this afternoon. I saw them this morning and we can both go to see them again in about a half hour. They are looking good and their breathing is smooth. We can do “kangaroo care” skin-to-skin contact in a few days, and Emily’s be able to feed them directly after that. Her milk seems to be coming in soon. She went from one cc yesterday per session to five cc at the last one. Here they feed 40/day x 2 kids, so it will still be a while, but she may be able to do most or all of the breastfeeding (which would be nice, but may be a bad idea given the nature of twins). Our doctor checked in this morning, which was nice. So, all in all, we are doing well.

I’ll check in shortly once I see how Sam did today.

1 AM early Monday

Sam is great! He was playing with our friends and seemed very happy. He was almost reluctant to go home. He seems to have briefly forgotten he has a mother—not sure what to make of this. I will take it as a sign that we are raising a child who loves the world and is fairly trusting that things are okay, and is happy to enjoy new friends and deepen old friendships in the interim. Is this too much to imagine of a toddler? He really is doing very well.

Our apartment, however, is a bit of a wreck. It’s good that there’s no protective services for apartments, because they would definitely take this one away because of neglect. It has a fruity smell, owing to fruit left in the sink, and clothes are strewn throughout the house. I’m catching up on all the detail work now—finishing dishes, boiling water, starting or finishing laundry, etc.

I’m pretty much toast right now. I’ll post this then head to bed. There’s a lot more I could say. I haven’t written about Sam running around naked as we threw together the bags we took to the hospital. I haven’t described Emily’s, um, interesting postpartum meals at the hospital. I haven’t described the process for entering the NICU or the quality of hospital convenience stores. All topics for another evening.

Smaller Babies for a Bigger World

On Thursday, Emily thought she might be losing her plug, but said that after this it can still be weeks. However, yesterday evening, a little before 8, her water began to break. We greeted the news mostly with anxiety. Luckily, I’d just seen our designated Sam watcher, and she came over quickly. I also called two of the other professors, who started to arrange for things. We hurriedly packed and tried to get things in order (transferring laundry, getting things for Sam ready, putting together our bags). Emily at this point was around 35 weeks and 3-4 days. At first she was convinced it was still week 34, and we found ourselves trying to quickly review original plans and possibilities. A colleague came to drive us and the spouse of another went with us to the hospital. We were greeted by four or five nurses and a doctor, which was an encouraging sign. We began filling out paperwork, and we tried to figure out how we wanted to do things for the birth. Emily had assumed a c-section would be necessary, but the boy was head down. We were both, however, sort of terrified at doing full labor with preterm twins, and the doctor recommended a c-section. At the time of the delivery, the boy had already shifted again, so perhaps this way to go.

I don’t know quite how to discuss the pacing. I feel like the last twelve hours have gone very quickly, with a series of things to do. So, after the decision was made, Emily went in for the c-section while I stayed with the coworker’s wife. (Emily tells me that she was a little panicky with the anesthesia, just because it was such a strange procedure and she had an imperfect grasp of what was going on; however, she also says it went quickly, and when the babies came out they were crying, but calmed at the sound of her voice.) Emily was out very quickly, and we briefly saw the babies. We had to wrap up registration procedures, which included visiting several floors. Maybe forty minutes later I was able to see the two. The girl came a minute earlier and was a little heavier, and she is in good shape. She’s in the less intensive room, is clearly breathing well, and is moving around. I was able to touch her arms, chest, legs, and face. She seemed to like it. The boy looked very sleepy and was not moving much, but should be okay. Initially, he still has “wet lung,” and they give extra oxygen. They’ll probably be here at least a week, perhaps a tad longer. They’re both good weights, but I think that people here forget that while 5 lbs may be pretty normal for local kids, we’re used to bruisers. Compared to Sam, they both look small, and I still can’t quite believe they are out.

Initially, I’ll be able to visit twice a day and Emily will be able to nurse as able. She’s started expressing colostrum already and will hopefully begin feeding the babies tonight. It feels strange to not be sitting next to them a lot of the time, as with Sam, but they didn’t look anxious and I think the care here is good. We’re close to our church, which will be nice tomorrow, and we’re getting some rest. I’m going to try to take a nap with Sam this afternoon before we head back to the hospital. Basically, all is well, but it will take a while to get the hang of things. I know realistically that they are not that small, and that, indeed, we could have scheduled a c-section for the end of this coming week. But I still feel bad that they’re tubed and confined and small. May the coming days bring them better health.

Sam is well. He stayed with the coworker and she said he did pretty well. He woke up a few times, but then slept until 8 today. He's with our old friends we knew in NJ and seems to be doing fine. We probably won't bring him to the hospital for another day or two...

34 Weeks

Emily's officially 34 weeks today. This is a big step, since we have been told that "34 is the new 37." (Thanks Anna!) We're hopeful that Emily will make it to 37 or 38 so that her parents can arrive and settle a bit, and so that we have more direct support for Sam when the twins come. At the same time, we're glad she's made it into a presumably safer phase. It feels as if Boy has now turned head down, but we won't know until our next appointment on Friday. It would be good news, although it would also reintroduce more choice and agency into the process, which means making decisions.

Still no name decision. A possible boy choice would have the initials EWS, which I'm not sure about. We like Biblical prophetic names, but we also know gazillions of children with those names. We've wrapped up language for a few weeks. At first it felt like I was missing a part of my day, as if someone had cancelled morning or afternoon, but now I am excited that I have time to do my own work and to prep for class without feeling entirely frantic. I still don't know how to feel about this semester. I have help now on language, which is a big improvement, but it's still a stretch for me. Essentially, I can prep full lecture notes OR powerpoint OR an outline, but not all three. I am also more academic than practical, which I know will be a growing edge, and I'm not really sure what is most helpful for students.

My professional life has also been shaken a bit by the realization that my immediate USA boss has resigned, is wrapping up his work and will be replaced (or not?) at some point in the next weeks. I feel like Denom is becoming a ghost town, able to receive e-mails and provide a word of encouragement, but not necessarily a lot more. Of the six or eight people I worked with during orientation, probably half are moved or gone now. The upside is that I have a lot of freedom, but I also get very little feedback. Sigh...

Sam is mostly charming. He is developing a mischievous side, and an iron-strong toddler will. He's very taken with an older coworker, who feeds him chocolate and walks him around campus. Any time he's allowed out he tries to visit her. It's a good arrangement actually, because she's also a foreigner so we are all a bit in our own bubble. He will need some personal fans when the twins come. He can say "no" to pretty much anything, and cycles through categories of foods he will eat. He gets tired at night UNLESS you take him somewhere new, in which case he gets wired, exploring and babbling in the new environment and looking for anything breakable. Actually, he's very good with strangers, but as parents we always feel like we are taking a half-housebroken pet to visit neighbors: there's always a little feeling of danger in going somewhere new. Sam's language is coming along also, which makes us happy. I think probably his English is still better, but he may be able to grow up bilingual, which would be awesome.

We found out a church friend is pregnant, which is exciting. It would be fun to have a community of fellow babies.

That's it from here. It's distracted work for the next few weeks and then a new chapter. I'll miss this single-child phase :( It's been fun to have such a great kid, and I hope we are not wrecking his life. Emily still remembers receiving a too-small "big sis" shirt, but Sam probably won't even remember these days. Pray for the older siblings of the world, pressed into growing up before they are even potty trained.