Jake & Josh - Getting closer to coming home

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Dear family and friends:

After sending the 9-11 update, we were hoping the next one would include details of Jake & Josh coming home. While we're not quite there yet, we have enough good news -- and a few great pictures - that we decided to put something together anyway.

The most important news is that they're getting very close to leaving the hospital. Only one hurdle remains: Taking eight full feeds a day (we should all be so lucky!).

Josh is up to five and Jake is at four. Neither is able to finish them all.

If they can add one per week, they'll be home shortly before Halloween.

Another interesting target date is Oct. 24 - starting that day, the boys will have been in Medical City longer than they were in the womb.

One thing we're real pleased with is that they're pretty much on the same pace; in fact, Jake had been at five feeds per day, too, but was temporarily bumped down today. Nonetheless, we expect them to come home together, something that didn't seem likely a few weeks ago.

We were mentally prepared to take Jake home first, especially when his latest surgery proved to be only a minor setback. But Josh has taken to the feeds better than Jake - even before this minor setback - and is actually a bit ahead. However, his lungs haven't made the final step needed to be breathing on his own, like Jake is. Josh remains on a low level of oxygen and it's looking like he'll come home on it. Doctors estimate he'll only need it a month or two, if that long.

Still, consider the big picture. At this point, the "worst" of our ordeal is Josh coming him with a little oxygen, a zigzag scar on Jake's tummy and a small, straight scar on Josh's back. While other, hidden obstacles related to their extreme prematurity lurk until their second birthday, we realize each and every day - and Tuesday makes 150 of 'em - how incredibly fortunate we are to have two beautiful babies in such wonderful health.

Some other noteworthy stuff to pass along:

** A little over a month after their due date, the boys are definitely newborn size. Josh is nearly 8.5 pounds and Josh is 7.75 pounds. They've even advanced up the diaper chart all the way to Size 1.

** The boys have been moved to what some nurses call "The Penthouse."

Technically, it's the Intermediate NICU located one floor above the main one. The room is bigger and much quieter. That's a plus for the babies because they won't come home expecting bells and whistles going off around them every few seconds (don't laugh; some babies actually struggle adjusting to the quiet of home). The change isn't as good for us parents as we no longer get to be around the doctors, nurses and others who've become practically family to us over the last four-plus months.

** While there's a natural tendency to lump them together as "boys,"

"twins" or Jake & Josh, we also recognize and appreciate their individuality. Here are some things unique to each:

JAKE - Big, brown eyes dominate his slim face, and lately he's become reluctant to sleep, especially at night, thus the new nickname "Wide-Awake Jake." During those alert times, he prefers being held or rocking in a swing, but sometimes he'll entertain himself by just looking around. He's especially fond of staring at a black grill on the overhead lights. He smiles a lot, even in his sleep, and occasionally giggles. He looks a lot slimmer than Josh, probably because he weighs less and is about an inch longer.

JOSH - His round face features several chins. His eyes, when open, are ice blue, like Zachary's, and he has long eyelashes. His back, neck and leg muscles are very strong; when on his tummy, he'll lift his head and turn it side to side so he can look around. When on his back, he'll squirm around, either sliding down the bed or going toward his brother.

The oxygen tube and the tape holding it down occasionally irritate him, but we're getting more and more smiles out of him - including some during his sleep, too.

One nice footnote: Their cries don't seem to wake each other. So far.

** One of their shared traits is a tendency to arch their backs. Doctors say this was caused by their natural reluctance to having the breathing tube down their throat - they were essentially trying to get away from it. We're trying to break them of that by applying pressure the other direction when they do it. (The flip side, though, is the muscle tone they've developed in their neck and shoulders by all that thrusting backwards. It's part of the reason why both can lift and turn their heads so well.) Another lingering effect from the breathing tube is a ridge that's developed at the top of their mouths. This is a factor in their slow progress with bottle-feeding because it prevents them from getting a good suction on the nipple. It's a bit odd that Josh had the tube in longer and doesn't breathe as well on his own, yet he's the better feeder.

** There's a chance Jake doesn't have a hernia. The problem could be something that corrects itself on its own, although it still could eventually require surgery. Also, Jake's lungs are so good that he no longer has to wear one of the monitors and they've discontinued his breathing treatments.

As usual, Zachary is the star of our big finish.

We recently took him up to see the boys in their new room with the promise that he could hold them. He got Josh in his lap first and squealed with delight when Josh grabbed one of Zac's fingers. Then Zac held Jake and couldn't believe it when Jake put one of Zac's fingers in Jake's mouth. Before Zac could realize what was happening, he had both boys in his lap! (A picture of this sweet scene is below.) Zac loved it and his brothers did, too, as they didn't make a peep. We made a photo album of the visit for Zac to take to school and his teacher reports that he was extremely proud to show it off.

We're pretty proud, too.

Love,

Lori & Jaime