Friday, November 24, 2006

Update on Faith & Makaila 9

We have continued to be encouraged by Faith and Makaila's progress over the past couple of days. Both girls are up to full feeds which means they have been taken off their IV lines, their PIC lines have been removed, and so have their arterial lines. This means that other than their feeding tube and ventilator tube, they're tubeless! With no tubes puncturing their skin, there are now far less sites that might contract infection, and keeping infection away is a top priority right now: they can use all their resources for growing instead of fighting infections. Both girls have also gained weight over the past days with the increase in their feeds. Faith has broken the 900 gram mark and Makaila has cracked the 1000 gram mark (that's 1 kilo, yay!).

Both girls are still on the ventilator, though they tried Makaila on the CPAP today for a short period of time. She just wasn't ready yet. So, that's the next goal, getting them off the respirator and onto CPAP so they can grow their little lungs. They are currently 28 weeks and 4 days gestationally and if they can get on CPAP soon and stay infection free until 30 weeks, their chances of survival and normal development will be very good.

Being infection free, off of sedation and antibiotics, tubeless, and relatively stable means we have had several cuddles with Makaila and one cuddle with Faith (and hopefully more tomorrow). These have been great experiences for Karyn, myself, and the girls. This week has been very encouraging and our hope continues to grow. Our biggest concern for the girls continues to be remaining infection free and getting them off the ventilators, so keep praying for those two things! Thank you for all of your prayers and support!

Blessings,

Graham

Thursday, November 23, 2006

New Photos Posted!

I have posted 10 more photos of Faith and Makaila, including our very first McMahon Family photo! Go to mcmahon-family-photo.blogspot.com to view them. Blessings!

Tuesday, November 21, 2006

Update on Faith and Makaila 8

The last few days have been very encouraging! Faith and Makaila have improved considerably over the past week. It appears that both of their infections are almost gone or gone altogether. During the time they were sick, neither Faith nor Makaila were able to take any of their breast milk feeds. Now, however, Faith is up to 4 mls of breast milk every 2 hours and Makaila is up to 9 mls every 2 hours. They are receiving these feeds well which means the amount they receive will be increased on a regular basis. When Makaila gets to 13 mls and Faith gets to 11 mls they will be able to come off of their IV lines. Makaila is obviously closer but it will still be several days for her and probably even more for Faith before this will happen. Both girls are now on the conventional ventilator (Faith was on the oscillator in my last update) and are doing well. Their oxygen saturation levels are good, so they are not relying too heavily on the machines.

While things look positive, Faith and Makaila still have a long road ahead. The key is for them to not get sick again so they can just focus on putting on weight and growing. Faith and Makaila have both put on roughly a hundred grams each but are still bellow the one kilo mark (Faith is around 800 grams and Makaila is around 900 grams). Faith's level one hemorrhage in her brain has not increased which means it is still not a concern. If they can make it to 30 weeks (gestational time) without any significant setbacks and they keep putting on weight, then their odds for survival will be very good (we recently found out that when they were born, their odds of survival where anywhere from 30% to 60%). On November 21st they turned 28 weeks so that's two weeks to go!

Please continue to pray for the protection of their health and that they would keep putting on weight and developing those little lungs (we want them on CPAP soon!). Thank you for all of your support and prayers!

Blessings,

Graham

Friday, November 17, 2006

Photo Blog Updated!

I have posted some photos of Faith and Makaila during their first two days on the planet! Go to mcmahon-family-photos.blogspot.com to see the pictures. Blessings.

Photo Blog!

We have added another blog page to post photos on, so the written entries don't get lost amongst the pictures. I haven't had a chance to post photos yet, but hope to do so this afternoon. So here's the link to the photo blog: mcmahon-family-photos.blogspot.com. Keep checking this blog page (mcmahon-family.blogspot.com) for written updates and I will also post short entries letting you know when I have updated the photo blog. Thanks for reading!

Update on Faith and Makaila 7

Hello everyone! My apologies on the the long gap between this update and the last one. We have had some rough luck with internet access the past couple of days. It has been a crazy few days as of late and we are at the hospital right now. But there is good news. Both Faith and Makaila are doing better. Makaila started off as the worse of the two this past weekend with lots of crashes but has recovered the most so far. She is off the oscillator and back on to the ventilator, which she apparently decided to do on her own. One evening a few nights ago Makaila somehow managed to remove the oscillator tube from her throat and mouth. They're not sure how she did it but they decided to put her on the ventilator and she has done well with the change. Her reliance on the ventilator for oxygen has dropped, which means her levels of oxygen saturation are higher which is good. The ventilator is still doing most of the breathing for Makaila so she can rest, she is being weaned off of the sedation medication at this point, and her blood pressure is better. Makaila's lungs are still filled with and surrounded by fluid so they are putting her on medication to remove some of that fluid and we are still waiting on blood cultures to come back to find out if her lung infection is progressing or regressing.

Faith started off being the strongest of the two girls, but that quickly changed a few days ago and she remained in an unstable critical condition with lots of crashes. Everytime they tried to move her or do any work on her she would crash so she was being heavily sedated. Her lungs have also filled with fluid and are surrounded by fluid. Yesterday they gave her hydrocortizone, a steroid, and this both helped raise her blood pressure (together with another blood transfusion) which had been low and increase her ability to receive oxygen on her own. Faith is still on the oscillator but is only on 38% oxygen which is low (and about the same level Makaila is on) and means she's doing most of the work on her own. She has stabilized significantly and they hope to put her back on the ventilator later on today. We are also waiting to hear the results of her blood cultures to see how her blood infection is progressing.

Both girls are doing much better than a few days ago, but they still have a long way to go to get back to where they were before last weekend. They need to overcome these infections and get strong enough so they can get off the ventilators and onto CPAP. While the ventilators help them breathe, being on them for a long period of time actually works against the healthy development of their lungs. So getting them stable enough as quickly as possible so they can get on to CPAP is our biggest goal right now.

We are encouraged by the turnaround both Faith and Makaila have experienced in the last 24 hours. We have been told that Karyn will even be able to have her second cuddle time with Makaila today! Faith has a bit more to go to catch up to Makaila before she's ready for another cuddle, but we hope that this can happen in the next few days. Thank you for your continued support and prayers, they are very much needed and are making a huge difference!

Blessings,

Graham

Tuesday, November 14, 2006

Update on Faith and Makaila 6

Karyn and I were able to visit with Faith and Makaila for a few hours this evening. They are both on oscillators, which is the setting on the respirator I mentioned in my last post. Both girls are heavily sedated so they don't fight the oscillators and remain comfortable. The oscillator breathes for them with very quick little puffs, so quick it looks like they are trembling. Their oxygen saturation is also being assisted by the oscillator, however, they are able to provide roughly 60% of their own oxygen at this point.

The fact that Faith and Makaila are on oscillators is not the our primary concern at this point. In fact, being on oscillators can actually be better for them then the ventilators they were on before because an oscillator doesn't apply as much pressure to their lungs making it possibly less damaging. The real concern is that both of them are showing signs of infections. Faith has a blood infection and Makaila has a lung infection. The medical staff are not sure what the infections are specifically but they are able to treat them with what they believe are the right antibiotics for the types of infections they are. They hope that early treatment will mean a faster recovery for both Faith and Makaila. This is crucial, because these infections take away the resources their bodies need to grow their lungs, brains, and organs and right now, their lungs are being hit the hardest. Out of a scale of 1 to 10, 1 being the worst state their lungs could be in and 10 being the best state they could be in, Faith and Makaila are at a 3 right now.

The doctor we spoke to tonight said that it could be up to 2 weeks before they get closer to a 10. It is their hope that the combination of oscillators, antibiotics, blood transfusions, blood pressure medication, and sedation will get them there. There were some signs today that this treatment strategy is starting to work because they have settled a little, their oxygen levels are up, and their blood pressure is better. Karyn and I will be going in again tomorrow morning for another visit before I head back out to Abbotsford to work (Karyn will be staying at the apartment in Vancouver and my Dad will be coming to help her take care of Isaiah). We hope that tomorrow will bring more reports that things are looking at least the same as today and hopefully better.

Thank you for your prayers and continued support. Faith and Makaila need them especially now, as do Karyn and I and Isaiah (who has come down with a nasty cold).

Blessings,

Graham

Sunday, November 12, 2006

Update on Faith and Makaila 5

The roller coaster ride continues. Yesterday (Saturday) was probably one of our best days yet with Faith and Makaila because we got to hold and cuddle them for an hour and a half, but it has since been somewhat overshadowed by learning that they both had a difficult night and Makaila has since gotten worse. This morning (Sunday) we received a phone call from the doctor supervising their care last night, which has never happened, so we were very concerned that she was phoning. Faith and Makaila had a difficult night with their breathing last night, and if things got worse, then they would need to change the setting on their respirators to one that is more aggressive and takes over the entire process of breathing. I'm not sure I understand why, but this setting shakes their entire body, so it will be very difficult to see our little babies in this state. As I write this, Karyn is on her way to the hospital to be with the girls.

About an hour after she left, I received another phone call from the resident supervising Faith and Makaila's care today, which again meant that we were probably in for some more bad news. Faith remains in the same condition as she was last night, but Makaila has gotten much worse. She has been switched over to the new setting and is on 100% oxygen saturation, which means her lungs aren't working at all on their own right now. They say that she is "sick" but don't know for sure what she is sick with. They believe that it might be chronic lung disease which can be developed in premature babies as young as Faith and Makaila. The resident assured me there are still ways of treating it so that it can go away. There is still hope, but she is very ill right now. I am not heading out to the hospital yet because I am leading the Young Adults group tonight at our church, but I am very concerned about Karyn being there on her own. If she needs me, I will go out to the hospital tonight. If she is ok, then I will go out tomorrow afternoon.

The struggles with their breathing seem to be the biggest and only challenge for Faith and Makaila right now. They have been eating lots (Faith is up to 9 ml of milk every 2 hours and Makaila is having her feedings upped at a faster rate and has been responding well). Being able to hold and cuddle them yesterday was a huge blessing. Karyn and I sat in rocking chairs by their incubators. Karyn held Makaila and I held Faith. We were able to cuddle with them for about an hour and a half and the next time they are stable, we hope to hold them even longer. They are so tiny, warm, and often squirmy, but mostly they were very peaceful and calm resting skin to skin with their Mom and Dad. It was a beautiful moment we will cherish for a long time to come. I took lots of pictures and captured some of the moments on video so I will try to post them when I can.

Please keep Faith and Makaila in your prayers...especially Makaila as she battles this lung ailment. They need God's breath in their little lungs. Thank you for your continued support and prayers.

Blessings,

Graham

Friday, November 10, 2006

A Rude Awakening

Now, while this has been a very traumatic and often difficult journey in the past couple of weeks, there have definitely been some great moments of laughter and so I thought I would share this little story with you that happened this past Tuesday morning when we were staying at Bob and Sally's apartment in Vancouver. So on this particular morning, Karyn got up with Isaiah to feed him breakfast and watch him (watching is all she really can do, because the c-section surgery has left her only able to do limited and slower movements and she can't pick anything up). Now, just "watching" Isaiah is normally all that one needs to do with him in the morning...or so we thought.

As Isaiah's morning pattern has shown has shown us for the past year, he gets up, eats breakfast in the highchair with his PJ's on, gets down, we take his PJ's off, and we change his wet diaper (it's just wet, no yucky stuff). On this particular morning, all was going according to his usual pattern. He got up, ate breakfast, got down from the high chair, Karyn sat on the carpet, and Isaiah walked over to have his PJ's removed and his diaper changed. Karyn manages to get his PJ's off without incident and is about to remove his diaper when Isaiah decides that he would like to take it off himself. Usually we get him to lie down and then we remove it. But he's a big boy (17 months), so Karyn decides to let him try. So Isaiah continues with his attempt to take off his diaper by pulling on the sticky tabs on either side of the front of his diaper. And...Success! The diaper drops to the ground and to Karyn's horror, it's filled with an unexpected load of yucky stuff! To which Isaiah exclaims "Poo!" And then proceeds to plant his left foot squarely in the middle of it! And then run around the living room in circles yelling at the top of his lungs, "Poo! Poo! Poo! Poo! Poo!"

Now this all happens in about 3 seconds flat, so poor immobile Karyn is left just sitting there watching in shocked disbelief as our son runs buck naked in circles, leaving clumps of poo and pooey foot prints on the carpet. Karyn finally comes to her senses and manages to get Isaiah's orbit to come close enough to her so that she can grab him and wipe off his foot. Now that she has him, she needs me to contain him while she cleans up the mess. So she starts yelling my name to get me out of bed to come get Isaiah. The unfortunate thing is that I'm wearing earplugs because part of Isaiah's morning pattern is that he usually likes to yell at the top of his lungs quite randomly and for no apparent reason...so whatever parent gets to sleep in, often sticks earplugs in to get some uninterrupted sleep.

Now, remember the title of this blog entry? "A Rude Awakening". Well, I'm sound asleep when I feel someone shaking me. I wake up and it's Karyn. I'm staring up at her face and her mouth is moving, but no sound is coming out. She sees my puzzled look and proceeds to yank my earplugs out of my ears. "Isaiah stepped in poo and tracked it all over the carpet and I need you to contain him while I clean it up!" Still a little asleep, I find this story a bit puzzling and hard to follow, but the urgency in Karyn's eyes tells me she isn't joking. And then I notice Isaiah standing behind her, completely naked. And then he turns around to leave the bedroom, and I see a hunk of poo protruding from his bum. "Well, now I definitely know she isn't joking," I think to myself . So I get out of bed and go into the living room to survey the carnage. And sure enough there are five significant sized, half lump, half smeared piles of poo on the floor. I guess Karyn had grabbed the "nuggets" before Isaiah had managed to press those into the carpet too.

I grabbed Isaiah, cleaned off his "little friend" he was carrying around with him, and kept him away from the deposits he had left on the floor before he decided to step in them again. I simultaneously got a bucket of hot soapy water and a cloth, gave them to Karyn, and she scrubbed the three contaminated areas of the carpet. It was my job to play goalie with Isaiah while she scrubbed. I was the goalie, he was the puck, and his "deposits" were the goal. Needless to say, I'm a pretty good goalie and I managed a shut out. By the time Karyn was done, the carpet looked as if nothing had happened (though I don't think I would say, "The floor's so clean you could eat off it!") Well, by all accounts you'd never know what had happened that morning if you looked at or smelled the carpet, and I guess that's what counts. At least, I hope that's what counts. Sorry Bob and Sally if that's not what counts! Thanks again for giving us your place for a couple of weeks! Don't worry, we won't let Isaiah change any of his own diapers again! I think it's safe to say we've learned our lesson.

So, I hope our little story brought a smile to your face, as it sure did for us. Because, after a morning like that, and being woken up like that, what else can you really do?!

Update on Faith and Makaila 4

Well, it has been a few days since our last blog entry, and mostly encouraging things have been happening in the little lives of Faith and Makaila. In our last update, I mentioned that Makaila needed a blood transfusion, and she did get one, and since then, so has Faith. Now, as I also said in my last update, this is normal because they aren't "plugged" into Mommy anymore; they simply can't produce enough red blood cells (or other important ingredients contained in their blood) on their own. So they've been getting help, and it's going well.

I also mentioned a short while ago that both Faith and Makaila looked like they were coming down with something. To play it safe, the medical staff started them both on antibiotics, but were able to take them off of them because their blood cultures came back negative! Yay! They should be in the next Bond film, because they dodged that bullet! Payer works! Maybe we could make a movie based on premature twin girls powered by God through prayer that dodge bullets! Maybe not...Anyways, we are encouraged!

Both girls are eating well. Faith is up to 8 ml every 2 hours! Makaila is up to 3 ml every 2 hours! We thought we weren't going to need all the milk Karyn has been pumping, but it turns out these little girls' big appetites will not let any of that milk go to waste. And apparently their plumbing is working great, because they're pooping and peeing up a storm (which is great!...but not a storm I would want to get caught in without an umbrella!).

They took Faith off of the respirator and tried her on the CPAP but she only lasted 20 to 30 minutes. She had several apneas and her oxygen saturation levels are just simply not where they need to be yet so they have put her back on the respirator. We are just fine with that. She gave it her best, but her lungs are just not there yet. Soon enough they will be, so we are good with waiting. Makaila is almost ready to go back onto CPAP as her breathing rates and oxygen saturation have been good. That should probably happen sometime tonight or tomorrow during the day.

Faith had her arterial line taken out of her umbilical cord today, which reduces the risk of infection....and most importantly, it means both she and her sister (Makaila had her arterial line out last week some time) are ready for CUDDLES!!! Yes, that's right, the doctors and nurses encourage skin to skin contact with Mommy (and Daddy too, I think) as soon as the babies are stable enough. This apparently is very soothing for the girls, nurtures their brain development, and even boosts their immune systems!!! The boosting of their immune systems happens in a pretty crazy way! Apparently (now, I'm not the doc, so I hope I get this right), when the girls are in their Mommy's arms, if there are bugs in the air, the mother's body picks up on those and her body starts to automatically produce the antibodies needed to fight those bugs and those antibodies go into the milk she produces and that milk goes into the twins' tummies and it keeps them from getting sick! Wow! God knew what he was doing when he designed the amazing and beautiful bodies of women and the miraculous process of bringing little new lives into the world! Sorry guys, our function in the matter is purely utilitarian.

So needles to say, we are very much looking forward to bringing little Faith and Makaila out of their plastic homes to cuddle skin to skin with Mommy (and hopefully Daddy) tomorrow evening! And I will have my video camera and SLR rolling and clicking away! I will write abut the experience and post the pics as soon as I can! Thank you for continuing to pray for our little ones. They are truly blessed by your love and compassion! They are alive and doing as well as they are because of your faithfulness! We can't thank you enough!

Blessings,

Graham

Tuesday, November 07, 2006

Update on Faith and Makaila 3

Today Faith and Makaila turned one week and it was a better day for both of them. Faith remains stable on the respirator with not much change. She is still eating well, now up to 3 ml every 2 hours. Makaila has settled into being on the respirator again. She isn't on any oxygen which means she is getting enough oxygen into her blood on her own. However, working so hard to breathe on her own while on CPAP this past week has warn her out physically. Between that and the blood tests they have done to check her gases (oxygen and carbon dioxide levels), Makaila needs a blood transfusion. This is apparently very normal, as premature babies born as early as Faith and Makaila have trouble keeping up the production of red blood cells while they grow and develop outside the womb. If they were in the womb, as they should still be, they would have direct lines plugged into them in the form of umbilical cords that would be pumping all the blood with red blood cells they would need. We expect both Faith and Makaila will need multiple blood transfusions so we are not too concerned.

Both Faith and Makaila appear to be coming down with something, but we are waiting for their blood cultures to come back to tell us what they have contracted so it can be treated properly. So far, they are not seriously ill by any means so we hope finding out what they have will lead to a quick treatment before anything does become serious. A day like today after a day like yesterday is apparently the norm. This is the roller coaster reality of having children in the NICU. I guess we get double the ride with two though!

Monday, November 06, 2006

Our Girls' Names and Why

Someone asked in one of the comments what the full names of our girls are. Here's an excerpt from "The Twins' Journey: The Whole Story" which will soon be published on this blog. It explains the names of our girls, Faith Lynne McMahon and Makaila Joy McMahon. We decided to tell people the names and sexes of our girls on the Saturday night before they were born because we wanted them to be able to pray specifically for each twin and the particular challenges they were facing. So here's the excerpt:

"We named Baby A, who was head down and losing amniotic fluid, Faith Lynne McMahon. Faith, because our faith is in God alone, especially when it came to this life who was in distress; Lynne, because this is the name of an amazing godly woman whom Karyn and I both respect who has shown incredible faith and love in very challenging circumstances. Lynne and her husband, Bryan (who passed away of ALS), were and still are the picture of godly marriage Karyn and I base our own marriage on (and a healthy and godly marriage is the best gift Karyn and I feel we can give our children). We named Baby B, Makaila Joy McMahon. Makaila, because it means, "who is like God". It is because of who God is, His character and His promises, that we have hope and faith. Her middle name is Joy because of the unshakeable joy we experienced (and still experience) when we found out we were having twins and the joy we experienced again (and still experience) when we found out they would be girls."

We wanted the twins' names to have meaning, to tell a story of the girls' beginnings, and to point to the hope of their futures. We wanted their names to be constant reminders to them, Karyn and I, and our family and friends, of the God that gives life, sustains it, and gives us faith, hope, love, and joy in all circumstances. We hope this makes sense to you!

Pictures of Faith and Makaila!

I have lots of pictures to add, but it is getting really late, so here is one of Faith and one of Makaila. I will add more later.

This first picture is of Faith, taken on Saturday, November 4th. She's wearing the smallest diaper available, and yet it seems the diaper is wearing her! The tube going into her nose is her feed tube and goes directly into her stomach - this is how she is fed breast milk. The tube going into her mouth is the the tracheotomy tube from the respirator.

This second picture is of Makaila, taken on Sunday, November 5th, just after she crashed. You can see that her face is clear of the CPAP nose tubes and tape (you'll see what that looked like soon) and you can see the "bag" they use to keep her breathing when she's too tired to do breathe on her own. That's Karyn's hand at the bottom of the picture.

Click on the pictures to see the larger versions.

Update on Mom and Dad 3

After you read "Update on Faith and Makaila 2", you will already have an idea of how we are doing. In addition to a day of new challenges faced by Faith and Makaila, neither Karyn nor I had a good sleep Saturday night. In fact, I am not sure if I slept much at all. Though I went to bed sometime after midnight, deep sleep was hard to find. I found myself to be very restless, with visions of tubes and wires and incubators filling my thoughts and dreams. Several times I almost got up to phone the NICU to get a live update on how the girls were doing, but somehow never mustered the gumption to get out of bed. Karyn was too hot last night to sleep well, and had to get up to eat on one occasion and to pump breast milk on another. I got up early with Isaiah (7:30am) and tried to keep up with him until 10:30 when Karyn got up. I went back to bed and crashed for 2 hours of the deepest sleep I'd had in the previous 24 hours.

We spent the better part of the afternoon and early evening in the NICU with the girls and brought in a few guests who came to visit and meet Faith and Makaila. The entire time was particularly emotional for Karyn, and was especially difficult when Makaila crashed (for an explanation of what "crashed" means, see the previous blog entry). It is very difficult to see your very vulnerable infant go through significant physical distress. When they decided that it was time to take her off of CPAP and put her back on the respirator, we decided it was time to go. We stayed long enough to see Makaila's little face free of the cumbersome nose tubes and tape for the first time since her birth. I took a few pictures and then Karyn's brother, Daryl, took us out to Red Robins for dinner (thanks Daryl!), which was a welcome distraction by this time.

Isaiah spent the afternoon and evening with my parents (Terry and Larry) and we met them back at Bob and Sally's apartment after dinner. After Isaiah went to bed, Karyn and I decompressed with my parents for while. The reality of not taking our little girls home has hit Karyn hard. Especially considering it won't be until after February 12th (their original due date) that we will even be able to think about bringing them home. This is especially daunting after difficult days like today. In a particularly emotional and vulnerable moment Karyn expressed in words what was running through her mind, and I don't think she was exaggerating or out of line by saying them: "Living through three and a half more months seems like it will be hell." We are only 6 days into a 105 day journey (at least)...99 more to go.

At times, especially tonight, this is a sobering and discouraging fact. Being honest and expressing how we feel to each other and our family and friends with whatever emotions come with these feelings, has been crucial and life giving during these early parts of this journey. The unconditional love we have received from each other, our families, and friends has been healing and encouraging. Writing this blog is also very therapeutic for me, and your encouraging "comments" have been tangible and much needed blessings for both Karyn and I. We deeply appreciate your love, kindness, grace, encouragement, and prayers.

Blessings,

Graham

Update on Faith and Makaila 2

Today was a rougher day for Faith and Makaila. Their first week up to today has pretty much been a "honeymoon period" with a few little hiccups (jaundice). Today has been the first day that the reality of their very young gestational age has really become apparent. Faith has been running a higher than normal temperature (aka, a fever) and has been getting fluid backing up in her tracheotomy tube (the tube that enters the top of her throat that pushes air into her lungs from the respirator). These are the early signs of an infection, which will most likely end up leading to pneumonia. Once the blood cultures come back and they know for sure, they will immediately start Faith on antibiotics before a serious infection sets in. She is still relying heavily on the respirator and still needs oxygen to keep her going, so it is not looking like she will be going to CPAP any time soon.

Starting last night, Makaila has been having significant apneas (periods of time where her breathing slows down drastically or stops all together), several of which have required the nurses to intervene by bagging her (start manually pushing air into her lungs using a rubber balloon shaped back attached to tube attached to a plastic mask that covers Makaila's mouth and nose) and adding oxygen to her CPAP. During these "crashes", Makaila stops breathing, her heart rate drops from 160 (average) to 40, and her oxygen saturation (the oxygen being brought in and added to her blood by her lungs) drops off quickly. The last time she crashed was around 6:00pm this evening when Karyn, her brother, Daryl, and I were visiting. This is the first time we have seen her crash and it was hard to watch. They poke and prod her and lifted her up to "wake her up" so she starts breathing again. It took a little while for her to respond and it was a pretty weak response at that, so they had to bag her. It was decided after this crash that Makaila needs to come off CPAP and go back on the respirator. Switching her over is quite a process and requires that she be sedated (they remove her nose tubes and then put a tracheotomy tube down the top of her throat - not a pleasant experience I'm sure). When I went back this evening, she was on oxygen and the respirator was set to 50 breathes per minute (which is high and means the respirator is doing a lot of work for her). Makaila was still sedated which probably explains why the oxygen was needed and the breathing rate so high.

While both Faith and Makaila's change in conditions today are hard to watch and take, they are expected. Our nurses and doctors assured us that these are normal and expected setbacks that the vast majority of infants at this gestational age experience. Their immune systems are very weak (if existent at all) and so they cannot fight off a lot of the bugs that you or I would not even notice we had in our systems. So it is very common for them to get sick and need antibiotics. Just as their immune systems are weak, so are their lungs. They are nowhere near developed enough, and their little bodies nowhere near hearty enough to be able to sustain breathing at high enough rates with high enough oxygen saturation for an extended period of time. Makaila has simply worn herself out trying to breathe on her own for so long (5 days). It is amazing that she was able to go onto CPAP as early as she did and last as long as she did. The respirator will give her a much earned Sabbath (time of rest) until she is ready to get back on the CPAP.

Both of our little girls are fighters, but they continue to need our prayers. The medical staff is second to none, the medical equipment they rely on is top notch, but it is God who gives and sustains life. We are confident that He will see Faith and Makaila through these current trials, and the many future trials they will no doubt face. Thank you for your continued vigilance in praying for them!

Saturday, November 04, 2006

Please Feel Free To Interact!

Thanks to everyone who has left comments of prayers, well wishes, and words of encouragement! We really, really, really appreciate them and need them! Please feel free to leave more and to ask any questions you might have because this is probably one of the best ways for us to receive them. It has been difficult for us to get access to email and this way, both Karyn and I can read them any time (rather than having to forward emails to each other). I will do my best to answer your questions in new entries or by adding my own comments. Thanks again!

Update on Mom and Dad 2

Today has been a much better day for Karyn and myself, especially for Karyn. She got a great sleep last night, the best she's had in a week and that has made all the difference. She has been in great spirits and is a "one-woman-milk-factory" (don't tell her I said that!) pumping like crazy so our little ones will be well fed (actually, she's pumping so much that they probably won't need it all...oh well, I guess my morning cereal regimen will benefit!).

We both had some good visits with Faith and Makaila today and hope to be checking out of the hospital tomorrow and moving into Sally and Bob's place just off Oak Street. Tomorrow we'll get to have our son, Isaiah, back as he has spent the week with our great friends Mike and Lyndsay (thank you so much!). Apparently their eldest daughter asked if they could keep him and their son now feels like a big brother after looking out for his adopted (temporarily) little brother. That definitely gives us a lot of peace knowing Isaiah has become so comfortable and safe in his second family...but we do want him back. So we look forward to spending the day with him tomorrow and to taking him into the NICU to see his little sisters for the very first time. You better believe I will have the video camera rolling and the SLR camera taking pictures!

The plan for the next two to three weeks is still unfolding, but so far it is to stay at Sally and Bob's place for as much as possible. Karyn will probably stay there full time with her mom and Isaiah and I will be staying there until Tuesday. I will head back to work in Abbotsford sometime that morning. At some point late in the week, I'll head back out, but we still haven't figured out those exact details yet. The NICU at BC Children's Hospital will be our Sun for the next 3 to 4 months, and our lives, job, and house the planets that rotate around it. Thank you all for your continued support and prayers!

Blessings,

Graham

Update on Faith and Makaila

The twins have had another good day today. Faith continues to increase her ability to consume more breast milk. She started off at 1 ml every 4 hours, increased to 1 ml every 2 hours, and is now consuming 2 ml every 2 hours. While the amount is not particularly important in terms of nutrition (that's what the intravenous fluids are for), breast milk helps her immune system out and trains her for when it becomes her primary source of nutrition a few months down the road. Makaila is still on 1 ml every 4 hours, but they figure that is because of the CPAP that is assisting her breathing. Air sometimes gets into the stomach, making it uncomfortable for her to eat. She's getting enough to get the practice of it, which is really all that matters at this point.

Makaila is doing really well on the CPAP and the PICC line is great. She had some blood work done today and everything looks great. Faith had one of her lines taken out of her umbilical cord and has had a PICC line put in. This is not only to give her a less infection prone sight for the intravenous fluids, but to also prep her for going on the CPAP. Her breathing is getting better, but is not quite there yet. They hope that by tomorrow they will be able to switch her over. Her lungs aren't quite as strong as we would like them to be, so we will be fine if she isn't ready yet, or if she needs to switch back to the respirator after going onto the CPAP. We're not in a hurry and we are so proud of how well she is doing considering her traumatic entry into the world and her very young gestational age. She's our baby slugger!

Friday, November 03, 2006

Update on Mom and Dad

It has been a pretty traumatic week to say the least. Today Karyn and I spoke with a psychiatrist that specializes in pregnancy and postpartum patients. It was good to decompress and share what the last week has been like, to relive some of the moments that were too shocking and overwhelming to even comprehend at the time and walk through them at a slower pace.

Today is "Day 3" for Karyn, the third day after giving birth. With virtually no sleep over the past 6 nights, her hormones in chaos because of her shrinking uterus and her breast milk letting down, recovering from major surgery (the C-section), the craziness of the past week, and her two little daughters in the NICU with whom she has not been able to spend much time with, things have been piling up emotionally. Day 3 is the day that the emotions start to come out. Karyn cried on and off throughout the night and day, has experienced moments of anxiety attacks, and has been generally exhausted.

As we talked through the events between Friday night and the delivery of the twins on Monday with the psychiatrist, Karyn was very clear that at no point was she ever afraid. In fact, she said that throughout the entire time she had this huge sense of peace and calm. She felt God telling her, "My peace I give you, my peace I leave with you". One evening in the delivery ward before the twins were born, she had a vision of a host of angels surrounding her bed dressed in glowing white doctor and nurse uniforms and they were tending to her and the twins within her. After their birth, she continues to have a similar vision, but of the angels surrounding Faith and Makaila in their incubators in the NICU.

What amazes me most about what she shared was how she responded to Faith falling into her underwear (that is literally how she was born). She said that the nurse asked her to walk over to the bed and then she pulled Faith out of her underwear and lay her beside Karyn on the bed she was sitting on. Faith's little arms were flailing around and she was trying to cry, but nothing came. Faith then grew still as the nurse and obstetrician gave her chest compressions. Karyn said she just kept encouraging Faith saying, "Breathe Faith, breathe. You're a fighter, I know you are a fighter, just keep fighting." And again, at no point during this traumatic time did she ever feel afraid. The whole time she felt God's peace and was totally calm. When I went into the OR to be with Karyn after the NICU team had whisked Faith off to stabilize her, Karyn was not upset at all. Later on in the recovery room when I went to see how she was doing, she was sitting in bed, completely calm, completely at peace, so much so that it was somewhat disconcerting. It was as if she had seen the future and saw our twins running and playing and new that what had just transpired was simply the way they chose to enter into this world and nothing more. She knew in her heart of hearts that Faith and Makaila were in God's hands, and that they will be just fine. Karyn's strength, courage, perseverance, and faith absolutely blow me away and challenge and grow my picture of who God is.

While Karyn is still experiencing God's peace, the whole experience of this last week has left both her and I warn out emotionally, mentally, and physically. We will remain in our suite at BC Women's Hospital until she is more stable emotionally and physically, so it looks like we will be here until Saturday. We are both pretty overwhelmed right now so little things like choosing what to eat, or how to get things done like paying bills, or answering the phone have become difficult to do. And our emotions are always very close to the surface. But we know that we will get through this season of this new journey we are on. And as always, we covet your prayers and support. Thank you for how you have so blessed us already.

Blessings to you,

Graham

Baby Makaila Update

Makaila is the more robust of the twins. She was born weighing 813 grams (about 1 pound 14 ounces) and measuring 33.5 centimeters in length. Faith weighed in at 695 grams (about 1 pound 9 ounces) and measured 29.5 centimeters long. Makaila was put on a respirator when she was stabilized but never needed oxygen. She was just fine on room air. On Tuesday they switched her to CPAP (for what CPAP is, see the "Baby Faith Update") and she has done really well so far, breathing on her own.

Today they took our her two umbilical lines. One line was for injecting nutritional fluids and blood transfusions and the other was for drawing blood and measuring her blood pressure. While these lines work well, they are a higher source of infection, so they have inserted a PICC line that enters a major vein in her foot and travels up to just above her diaphragm. This line will deliver her nutritional fluids (like an intravenous).

Makaila was a little jaundice this evening so they have also placed her under the big blue light that helps lower her jaundice levels. They don't expect her to be under it very long. Makaila started receiving breast milk on Tuesday as well, but through a tube that goes through her mouth because of the CPAP. She is not quite up to the same frequency of eating that Faith is, but they expect her to catch up soon. We saw her first poop two nights ago. It looked like a tiny little bit of green tar. If poop can be cute, then that's what I'd call it!

Baby Faith Update

Faith is doing well today. She had another brain scan via ultrasound today and her condition has not changed since Tuesday. Faith has a minor to level 1 hemorrhage which should clear itself up over the next couple of weeks. She was a little jaundice today, so they put her under a big blue light that helps resolve this condition. Faith only needed it for part of today because her jaundice levels have dropped to a level that is no longer a concern.

One of our primary concerns with Faith is her lungs. Because she was born smaller than Makaila and had been without sufficient amniotic fluid, her lungs are a little underdeveloped. On Monday, once she was stabilized after her traumatic delivery, she started off on a respirator without needing Oxygen, which was great. Tuesday evening they began giving her some Oxygen to assist her breathing, but were able to cut her back to room air today. Tomorrow, they hope to switch her to CPAP, a breathing apparatus that allows her to breath completely on her own, but gives her some constant pressure just in case she gets too tired to take full breaths (apnia). It will attach to her nose using two small curved tubes that curl into her nasal cavities.

Faith has been receiving breast milk (pumped from her Mom) through a nose tube since Tuesday and has been able to up the amount she can digest today, which is a very positive sign. She hasn't had her first poop yet, but that's nothing to worry about. The blanket that covers her incubator to keep it dark has a sports theme to it. One of the images on it is of two baseball bats crossing with words arcing over top of them that state, "Baby Slugger". That's exactly what Faith is, our baby slugger.

Thursday, November 02, 2006

Keep Checking Back!

We are currently staying at the BC Women's Hospital in a private suite in a recovery ward while Karyn mends from her C-Section. Faith and Makaila will be in the Neo-Natal Intensive Care Unit (NICU) at the BC Children's Hospital for at least the next two and a half months under the watchful eye of their amazing medical staff. We will be moving out of our suite in the next couple of days to our friends' apartment while they are away on holidays (thanks Sally and Bob) so we can be close to the twins (we're from Abbotsford). Once there, I will be able to post photos, maybe some video footage of the twins, and the full story of their journey into this world. Keep checking back for more updates!

Blessings,

Graham McMahon

Introducing The McMahon Family Blog!

Recently, our family started a new and very unexpected journey. Two months ago we discovered we were having twins, which came as a huge surprise because there is no history of twins in my wife's family, nor in my family. After the initial shock passed, we were looking forward with great excitement and anticipation to the addition of two new children to the one son we already had. We expected them to arrive in late January to early February, but on Monday, October 30th, after a roller coaster weekend, our little twin girls decided to arrive early, only 25 weeks into their gestation, almost 13 weeks early! This Blog will allow you, our family, friends, and community, to journey with us as we, Graham (Dad), Karyn (Mom), Isaiah (Big Brother), Faith (First Born Twin), and Makaila (Second Born Twin), walk through the very early and tumultuous beginnings of being a family of 5 with two very small and premature infant members. We covet your prayers, thoughts, and support in the months ahead!

Blessings,

Graham McMahon