Feb 14th Valentines Day

Today we made time to celebrate Valentines day. It turns out that Barbara's secret mission last week was actually to buy me a Valentines gift, a new pair of cargo pants. Despite all the wonderful flowers you have sent us, I got her some very pretty roses.

Valeria dropped by with a food parcel from Molinari's, famous traditional San Francisco Italian food. She brought us some of their famous hand made Ravioli. mmm mmm mmm.


Barbara cooked one her special meals and we celebrated a dinner together despite a few interruptions.

We have had a few delicious food parcels dropped off from our friends and we enjoy each one of them. Barbara's body can demand food suddenly as a result of the breast feeding and it is great to have something ready to eat.

The bambini are not sleeping so much and in a 4 hour period we are lucky to get 30 mins to do something else. As we get back into the flow of work, it is taking a toll.

We are learning how to manage time. Feeding both at once if possible and consolidating essential chores. We are told we have three months of this until they can sleep through the night. It's going to be a long journey to summer.

We have been watching the British series "behind the seems" where a group of 20 something's go to India to work in the sweat shops and cotton fields that fuel the garment industry. They earn about 60c per hour ($5/day) and have to rent a place to live.

We have every modern convenience, from heating and food to bathrooms with running hot water, an unknown luxury in working India. I cannot imagine how hard it must be to raise children without these things.

I wanted to thank one of the nurses at the hospital, so I used Valentines day to take her some roses from Nico and Luca. If she did not have a Valentines bouquet before, she does now... and from two men. Judging by the smile on her face, I don't think she cared too much if they were only two weeks old.

I took the trouble to express our particular thanks for her healing work. In this culture, and particularly in a hospital built on the practice of medical science, there is not much validation for a real healer.

What was particularly interesting was her story of how she got assigned to us. Some of the nurses could not understand my explanations of the importance of being with the children in their first hours outside the womb, so they asked Vesna to try and figure out what we were talking about. She got it immediately and, and even offered more advise about keeping the children with us when we sleep.

We were told in the newborns class that it is not a good idea to sleep with babies because you can roll over and crush them. Vesna disputed this and said that mothers are acutely aware of where their babies are even when sleeping. She said that the reports of women crushing their babies are from women that went to sleep drunk.

She explained how to teach them to accept the breast even after the easy flow of the bottle and gave me my first lesson in introducing them to milk with a syringe and a tiny tube attached to my finger for them to suck on.

The weekends are when I take a look at the items on the "honey do" list stuck to the fridge. We have agreed that she will not bug me about anything if I do at least one item per weekend. This weekend it was a shelf.

A shelf sounds simple enough unless it comes from Ikea. This $45 item came with instructions, a bag of hardware and four pieces of wood. After a half hour of assembling the $2 worth of components (is there any industry that has a higher markup than furniture?) I had to locate the studs in the wall to hang the shelf. What a pain this "simple" task became
.

Thursday

From Bambini

Its only been a week since we left club Kaiser, but it feels like a month. Luca is gaining weight very fast and Nico is a little behind. Luca was bigger in the womb and is probably just going to be big.

So far we have been lucky in that we have been able to stagger their feeding. Today they managed to align themsleves despite out best efforts. At about 4 in the morning they are both licking their lips at the same time. Its like looking at a Tsunami approaching the beach you are sitting on realizing that a lot of life threatening activity is in your imminent future.

Necessity became the mother of invention today as I devised a simple but effective solution to the need for four hands, as you can see in the picture above.

The last few days I have been exhausted. It seems adjusting to being a father isn't just about feeding bottles and daipers. The concept is a lot more daunting than it first seems.

Barbara rented a more powerful breast pump today because the bambini were sucking much stronger than the first pump. She is doing better with the breast feeding. During the day, they start on her breast and then finish with the bottle.

We were warned by several nurses that because the bottle delivers a lot of milk with little effort, they might not do well on the breast if they get used to the bottle. So far this has not been the case.

Barbara seems to be back at work despite hopes that she would make more time for the babies. The clients are relentless and she is hard to replace. The nanny is here in the morning to help while I sleep.

She has cut down the pain medication to 1/2 of the dose and seems to be doing better. The feet swelling is going down and she is much more mobile.

Wednesday - Pregnancy

From Baby Shower

Another day another daiper... or 5. How can babies make so much? They eat every 2.5 hrs.
I have developed about five different ways to remove diapers without causing a screaming fit. Luca in particular had a very big problem with daiper changes but he seems to be handling it better now.

His favorite trick is to pee everywhere. The daipers are virtually useless if the pee does not run straight down into the absorbing part. I seem to remember someone telling us that no daipers are leak proof, so we just hope they pee in the right position.

We weighed them today to make sure they are gaining weight.
Luca - 5lb 5.5oz
Nico - 4lb 14.5oz

If you weigh them after feeding they weigh 2oz more. I don't know why I find that so hilarious, but their food intake is a significant portion of their body weight.

Talking of body weight, Barbara emerged from the bathroom this morning and annouced; I shrunk! After spending many months blown up with babies, it has got to be a good feeling. I was just relieved that I was unlikely to hear that question that all men dread, "Do I look fat?"

I seem to be getting more fatigued. I sleep eight hours and wake up tired. I am feeling the pressure to get back to my business, but with this schedule I cannot make any significant progress. I decided to take some of Barbara's birth control pills to change my hormone levels to see if that would help. I didn't feel any better, but I did change my shirt color three times.

Today Barbara announced she was going on a secret mission with her girlfriend. This is usually code for a "munch munch munch, blah blah blah" session at some new restaurant. I am really happy she can have this part of her life back, it scratches and itch that runs as deep within her.

We got some pictures from my Brothers family today and enjoyed them very much. Nico and Luca have two cousins, Danny and Charlotte. Charlotte is two years old (picture above - there are also some pictures from the baby shower)

We received many many useful gifts at the baby shower. Thank you all so much. It has made a huge difference.

Barbara has said that she enjoyed the pregnancy despite the limitations, and watching her own the transition was never more fun than last xmas when I took some pictures of her glowing

Tuesday - Athena

From Bambini

Today the Bambini had their first visitor, our wonderful Dulla, Bendicte. To celebrate, Luca's umbilical cord stub fell off! As soon as I gave her Nico, he immediately recognized her and had an expression I just about caught in this picture.

Dulla is a Greek word for birth helper and describes someone who is present to support a woman giving birth. Bendicte worked with Barbara during labor, birth and while coming off the medication to help her with these difficult transitions. Each time she comes, the effect is clear.

During the first seven days we have tried to protect the bambini from any virus like flu and especially H1N1. I asked the nurse that taught our newborn class how concerned we should be about this and she recounted the story of her recent birth in which family members flew from South America to see her. She would not let them in the hospital for 48hrs until they were sure they had no symptoms. Which brings me to Athena.

One of my consultants daughter has moved out of ICU finally. Her name is Athena and she has a daughter. Athena is one of the unlucky people that caught H1N1 which rapidly developed into a life threatening condition in October last year. She has been in ICU in critical condition for FOUR MONTHS!

At this point, her right lung is destroyed and needs to be removed and she has difficulty breathing on her own. She has been on a feeding tube most of this this time and is so weak from the strongest anti-biotics know to man, that she cannot withstand the trauma of the operation needed to remove the right lung.

Her father John, estimates the cost so far at over $3m of which the insurance only pays a small part. By the time this is over they will all be financially ruined.

John has been blogging about her progress for months, which gave me the idea for this blog. At the end of December, Athena had the following to say:

• I feel like I just experienced a drug overdose that put me in a unconscious neurological state.
• My body feels broken and I can’t communicate with anyone how I feel.
• With the amount of blood samples taken from me on a daily basis, my body is having a hard time healing and allowing me to build up my energy. Remember, I’m sick and haven’t moved in months so my ability to do anything is limited.
• Please go easy removing/reducing the medication your using for my issues. I’m very sensitive to slight changes as my body is frail and so is my mind.
• I’m really scared as I have been places no one should have to go. When I’m able to communicate again, I will redefine the meaning of fear for you.
• I want to hold my little girl!

H1N1 kills 970 people PER WEEK world wide. After Athena and Alfie, the little boy living next door to us makes three people we know personally that have contracted this virus.

It was made very clear to us that pregnant women were at the highest risk for death because their immune system is compromised.

During this pregnancy, I was particularly concerned about this threat. The building we used to live in, had one door to the elevator for the whole building and everyone touched it everyday. The building was 10 minutes from one of the busiest airports in the world.

We began to listen to the health experts that advised people to use hand sanitizer frequently, especially after touching door handles, ATM machines, supermarket trolleys, menu's and money.

Once Barbara was pregnant and flu season began, we sanitized cell phones, keys, purse handles, credit cards anything that other people had touched.

During the later months, we cut down on visits, restaurants where we could not see the food prepared, and cinemas with lots of people.

I insisted that everyone use the hand sanitizer when visiting and while most people were more than happy, this did rub a few people the wrong way.


Last year (2007/2208), Barbara and I went out for dinner at christmas before we went up to Mammoth for a few days. We went to a nice restaurant in the Marina. The next day we both came down with a nasty cold. It was clear that someone in that kitchen had given us their cold. It's that easy.

If that had been this year, and that person gave her H1N1, the probability is very high that she would die like this poor woman.

It has been suggested once or twice that I might have exaggerated my concern and my efforts to reduce the risk. I suspect if I asked John, he would say; do anything in your power to protect your family. I sure tried.

Monday - Reflections

The nanny helped us wash clothes for the bambini and all kinds of other chores while Barbara attempted to to perform business email triage.

We have everything we need for most of the day to day events, now we are trying to catch up with our lives between feedings.

The bambini are obviously experiencing the expansion of their digestive system as they drink a lot more and have pronounced hiccups followed by facial expressions that you or i would have if we swallowed a chicken whole.

It takes me about 30 Min's after a feeding to get them sleeping. If things go well, they are staggered so that you can focus on one while the other is sleeping. This had been working well for me so far, but today Barbara got into a synchronized feeding frenzy.

When I got home from the store, she had both Bambini in car seats, bottles in both hands and a look on her face that said "I need another pair of hands" I have a plan for this eventuality. I believe you can buy "doggy downers" at the pet store that have a very sedative effect on children. (just my dark humor in case family members are concerned)

I did however find what I thought was the perfect "push present" at the store today. Barbara has had sciatic nerve pain since the back contractions of labor. I occasionally get lower back pain when I exert myself to much so I thought a back massager would a good idea.

I found one that is like a chair, but not a full chair. I think it can be put on the sofa or a platform. Anyway It doesn't matter because it never made it past the unwrapping stage, let alone reading the manual.

Furniture decisions in this house are a complex mix of random mood, fen shui color co-ordination and about 25 other mysterious factors that can neither be codified or understood by any man. Moving furniture is a tortuous process that consists of me slowly trying every conceivable position and then finally settling on the first choice with much face scrunching and labored breathing in between.

This process is about as much fun as a root canal and if i make a suggestion, the response is equivalent to what I would expect if I had suggested we set fire to kittens after dinner. Judging by the time I have spent in several of my motorcycle buddies man caves over the years as a result of similar offenses they have committed, this is not a unique phenomena! To add to the disaster, she announces that she knows what she wants for a push present!!

I can only assume this is one of those situations where us men are supposed to guess what you women want (even though you already know, but refuse to tell us) and thus run all over the map failing pathetically for a suitable period of time before you do tell us. This particular type of torture is akin to pulling the legs out of a spider for us.

Needless to say, I was not happy, especially since i had to unpack the massage chair in the parking lot in the rain because the box would not fit in the car. I had to collapse all the packing materials in case it did work and we needed to return it.

So the good news is I can return the chair (after I have had a few good massages) and the bad news is i still have no idea exactly what I am supposed to buy. While this new development in our communication is a change from nine months of "pregnancy brain" it is certainly not what I hoped for.


I probably shouldn't complain. This process has been very demanding on Barbara's body, let alone the huge hormonal changes and physical trauma she has endured. It all began with a process called IVF - Invitro Fertilization. We elected to use this technology after many months of trying because it was becoming no fun trying.

Getting pregnant is a process that can become complicated with disappointment and expectation very easily. After years of taking every precaution not to become pregnant, the assumption is that as soon as you stop, you will succeed in becoming pregnant. This is not necessarily so.

We did quite a bit of healing work to help with the emotions that come up for Barbara during this difficult time. More than once Barbara said she was convinced her body was not going to co-operate. She worked through a meditation course and many healings to release all these pictures of impossibility and open to the possibility that it could happen.

After a while, little by little, the process became a little less serious and intense. After a year, she picked a date to begin the IVF process so that she would not be traveling or stressed with work.

It begins by stimulating the generation of egg follicles followed by the extraction of eggs laproscopically. These eggs can be frozen and used at any time, but for the first attempt, you evaluate which ones are most likely to accept fertilization.

We had then had to decide how many to implant. If you only use one egg, the probability of failure is higher. If you use two or three, you risk a multiple pregnancy. We elected to use three to ensure we got at least one pregnancy, and if we got three, we would have to consider a reduction so as not to risk Barbara's health.

The second part of the IVF procedure is to fertilize the eggs and implant them. To help this succeed, the hormone level is supplemented by injection. This meant that every day for a couple of months, before and after the implant, I had to inject her (in the butt) with hormones.

Luckily I don't have a big problem with this, but for Barbara, injections are filled with terror. Just getting blood drawn is difficult from her, and the few times I have been present when she had it done, I realized how tough it was for her. All sense of fun goes out of the window when a needle is pulled out.

Despite this, she stepped up to the challenge of daily injections. I made it as fun as I could and after many weeks, the associated terror began to subside a little, even if the discomfort did not. After the fertilization, there were a few weeks where we just had to wait and see.

On a trip in Peru I noticed a small sweater in a street vendors store. It was Bambino size. I had been looking for one for Barbara, but this just caught my attention.

I remembered that she had bought a passport holder for me when my US Citizenship had fallen between the cracks of some bureaucrat's desk for years. I remembered how certain she was that it was going to resolve itself and I would get a passport to fill that holder. She let me know a couple of times that she had something for when I got my passport, and the certainly she expressed through that simple act was enormous.

I decided in that small village in Peru, that I would return the favor. I bought that sweater thinking we would end up with one baby, and I held it until the day the Doctor confirmed she was pregnant. At first we didn't know it was twins.

When I pulled it out, her eyes filled with tears and we had a very quite moment that celebrated the culmination of the long and difficult journey to pregnancy.

Today, she pulled out that sweater. I have no idea how she kept track of it through all the chaos of the move and so forth, but she held it up as proud as any mother who has conquered her fears and endured what must be endured to realize this dream.

Sunday - Week 1

From Bambini

Nico and Luca were born a week ago at 8:10am. Today they celebrated their first week birthday by taking a stroll and starting a new album of pictures.

We decided to break out the "snap and go" collapsible engineering marvel and use the car seats for this adventure to our little town's main street. We originally thought we would buy new car seats and stroller, but the quality of the used items in this area is very high.

We joined an online mommy's group recommended by Chiara, through which we found a pair of used car seats with four bases and the "snap and go" for $55.

Since the seat and base are essentially a simple injection moulded plastic piece, they should last a hundred years without a problem. I inspected them before we bought them and rapidly realized that it made no sense to indulge babiesRus in their 200% markup of these items. They are only going to last for a short while anyway, and it makes more sense to put the money toward toddler seats.

I was expecting some complex installation of the seats, but they adjusted to the car easily and worked first time beautifully. Barbara washed the covers and I installed a very soft wrap around the belt where their faces are to preventing chaffing. They even have a curved base so you can rock them.

As you can see from the pictures, the bambini are still small and almost dissappear into the seats. The snaps and buckles do not intrude and I have to say I love these things. They are well made and well designed.

Los Altos (the tall one's in spanish) is a small town in the foothills of the small mountain range separating Silicon Valley from the coast. It is a charming low key little town that has a sparse number of visitors yet has many nice restaurants. Traffic is minimal and the people are friendly.

We got as far as the french bakery at which point they both went unconscious. I can only assume that even at one week, the few drops of English blood they have, understood how disconcerting it can be approaching the French... and they have not even been to Paris yet! I only mention this because some very old friends in the UK have joined the blog, and no self respecting Brit Blog would be complete without at least one insult to the French.

Barbara and I visited the UK in 2008 but did not get a chance to meet all of you. The pictures in this Blog are all of pregnancy and childbirth so i thought it might be appropriate to show you some pictures from Barbara's brother Alfonso and Enrica's wedding in the Bahama's a couple of years ago.

Barbara and Alfonso are very close. I can always tell when they call, Barbara has a smile all day. It was an absolute joy to part of their very private wedding on a small island. Since then they have had a baby boy, so Luca and Nico have an Italian cousin.

Barbara got a good nights sleep last night and read this blog for the first time. It got approved even thought there are some very unflattering pictures here.

This evening we grilled a bunch of meat and had dinner while feeding babies. They seem really hungry until they get onto Mama's boob, then they just flop there and immediatly go to sleep. It is very obvious they feel comfortable in her energy. Its like watching them float in a sea of tranquility. They just go limp.

We began with the idea that they would be close to us from Birth. We believe they can sense us and feel safe when we are around. When we were transferred into the recovery room, I immediately noticed that it was cool. This was probably a comfortable temperature for the hospital staff, but it was way too cold for the newborns.

I turned the thermostat all the way up but after a couple of hours it was still cold. When they took the babies temperature, it was falling and they offered us the option of putting them next to our skin (one each) to warm them up or taking to the impersonal stainless steel nursery for heat lamp torture.

I took Nico and Barbara took Luca. After an hour their temperatiure had stabilized, but was not going up. I asked them how we could get the temperature in the room up? They explained that it is set somewhere else and they would need to call maintenance to make an adjustment.

Since the reason we are all there is because of the newborns, it seemed to make sense to have the room set to support their requirements. Can I have been the first person to have thought of this? Once we realized that we would be going without babies if they did not put on weight, it became very important that not waste calories heating their bodies that could be used to store fat.

The nurses were very helpful with the collection and marking of the cord blood. This is a booming industry that is based on the possible benefits of treatments requiring stem cells. The liklihood of using cord blood in private banks has rested mostly on the odds that the donor child or a family member will require a stem cell transplant. In the United States, the overall odds of undergoing any stem cell transplant is 1 in 217. These figures are based on actual transplant rates in 2001-2003. Barbara was certain she wanted to do it, so we did it.

This evening we spoke to my Brother and his wife for the first time. They have been following along and waiting patiently but were very eager to talk to us and see the babies. The first two weeks are very important and almost no one is visiting them, especially not in flu season. Every time I glance at the commercials in a movie we are watching, all I see is cold remedies. Considering the cost of a 30 second spot these days, i am sure they do careful market research to determine if there actually are sick people to sell this stuff too on the day the commercial airs.

Throughout the day Barbara has been going through emails and preparing for the coming week of work. After dinner she announced that she was down to 100 emails in her inbox so we decided to give them their first bath. Chiara and Jean Luca have given us a very nice baby bath. It is baby size and padded to provide the perfect bath.

Chiara has helped in preparing for these children guiding us in many ways and hosting the baby shower. The last few days have gone smoothly thanks to her help preparations.

They didn't like having their back or chest washed, probably because the water conducts heat 25x faster than air. Once we wrapped their upper body they loved the lower body bath. They get this funny expression on their face that looks like "oooh, what's this all about?"

The latest development in their feeding is that they both get hiccups now. We are told this is normal, but I find it amazing that their little bodies can deal with such violent events after only a few days.

Tomorrow the nanny is coming to help in the mornings so Barbara can get some work done while I sleep after staying up all night. She will also help with the laundry and stuff so that we have less to do. What a luxury.

Saturday - Family Day #1

From Birth

Sleep is a wonderful thing. We both managed to get about 8 hrs Friday night, and today we took some time to enjoy the bambini. Luca and Nico made Barbara laugh a few times today with their expressions and noises. It fills my heart to see her dream realized and the joy the she gets from this.

So far they are very easy to manage. They lick their lips when they want food, cry when the daiper is full and sleep when they have had enough to eat. I don't find babies that cute, but as my friends told me, it is different when they are yours. They were right, it is different. I am enjoying them very much.

We can just about see where the horns are going to break through on their scalp (either side of the "666" marking on the crown) so I suspect we only have weeks before the campaign of terror begins.

Today they are eating 30 m/l of supplement each time they they are hungry. This is a good amount, and they gulp it down like an Irish peat digger downign a pint of ale in the pub. This is a very long way from the first night when I had a small tube attached to my finger and a syringe. That was Monday night while Barbara was recovering. It took 45 minutes to get 10 m/l into Luca and it was his first meal.

It's an odd feeling to give someone their first meal. I had no idea how important it was in the transition from the womb to the world. The pediatrician that was summoned to the O/R (when Nico's chest was heaving because his airway was semi blocked) made a quip about fattening them up from here on. I had no idea how significant that was at the time.

Tomorrow marks the end of their first week on earth and they are doing great. Nico celebrated early by peeing in Barbara's face. I guess it's a guy thing. I was very proud, She could not stop laughing.

In the first 10 minutes after they were born, I was struck by how odd it was to see a mini version of me, even though it seems obvious. I had become so detached from the whole event in order to manage the huge number of things happening in that hospital at once, all of which required a great deal of decisions that somewhere along the way i forgot that this was the birth of my children.

Today we remedied that with some quality family time. Barbara was much more relaxed after sleeping, and the pain did not seem to be so bad. Her mobility is getting much better, but the ankles are still quite swollen. I gave her a 30 min princess massage (where i worship at her feet - which she loves) and today I managed a few more minutes while she breast fed.

Her mission today was to engineer a hands free breast pumping system. I got concerned when the scissors disappeared and 10 minutes went by in the bathroom. She emerged with a severely modified pregnancy belt and two suction cups protruding from it over her breasts. We laughed for a while at that, but I was very impressed with the ingenuity.

next she disappeared into the bedroom closet to create version 2, because the velcro on the belt didn't quite line up correctly. After a little while she emerged with a bright blue bikini top modified to hold the suction cups in place. This not only met the utility requirements, but more importantly the fashion statement! Thats two expensive Bikins sacrificed to the cause.

After this statement of intent, i have been relegated to second feeder. She has taken over some of the bottle feeding as well as the breast feeding and pumping obviously. Apparently she intends to work and breast pump at the same time. I think I will have to turn off the camera on the laptop so she does not accidentally end freaking out clients on Skype.

We also opened the baby closet today to dig out all the wonderful gifts that we got from the baby shower. There are things in there that I can't even guess at their function. I washed all the feeding bottles and plugged in the wipe warmer my brother gave us. Then I bought a baby scale to weight them and track their weight gain.

We would like to thank everyone for their gift, and for the help we got from mommies in figuring out what we needed. We have the nursery set up the way Barbara wants it although I still have not put up the curtains.

As soon as the subject came up today I had a major attack of lethargy. It was so bad that even the thought of opening the chocolates that we had been given seemed like too much effort for the reward, and so that's how we spent the day. It was nice to take a day off.

Finally I would like some suggestions from Barbara's girlfriends for a "push present". She pushed for three hours with all her strength and even though the bambini came out courtesy of a surgeon, she did her bit. Having been there and witnesses this heroic effort. Nothing I think of seems to commemorate the event. Please email me any ideas you have.

Friday - Spag bog

From Birth

For those of you joining us for the first time, welcome.

Today Barbara cracked open the laptop and began working for the first time in almost a week. Judging by the expression of horror on her face, the inbox was more than a little full. She wanted to make sure everyone got a link to this blog so that you can follow the adventure if you want.

I have written this at breakneck speed so far, with no attention on spelling or grammar. I figured you would rather have something bad now than something perfect two weeks from now.

Many of you have sent flowers. They are all over our house, and everywhere she goes she is reminded that a very special event has ocured... I have to cook and do house work for a while now it seems. Barbara has made a special request that if you have the desire to send any more flowers, they should be timed to arrive on Feb 14, and the card should read "To barbara, Love Mike"

Since we started living together, Barbara has refused to allow me to cook. If start insisting, she gets that Italian "kick your ass" look and tells me to leave the kitchen.

For years now, every time she does this, i threaten to cook my amazing Spag Bog for her one day. This is a dish I learned to cook in college.

When I threaten to serve this at a dinner party for her friends, her reaction could not be worse if i told her all her friends just died. Despite its abreviated name, its really only Spaghetti Bolognese.

This week, amongst the 100 other things going on at the hospitakl, I prepared this dish and last night i had it ready to go just at the moment when her body started demanding food again. By the look on her face when I announced the news, I suspect she was expecting something the flavor of Marmite, but the aroma did its magic and she was so hungry she agreed to try it.

I wanted to serve it on Spaghetti of course but she was so hungry she could not wait, so I offered her the high speed version; Bog on Toast. For Brits this is no surprise. Any nation that puts cheese on toast and has the audacity to call it Welsh rabbit, would have no problem with Bog on toast. Needless to say, she said it was delicious and early this morning she microwaved some more.

Barbara is having a very hard time taking it easy. She is walking around most of the day and if I suggest she take it easy and let me do everything, she asks me to stop telling her what to do. The doctor said that she should walk, but her ankles are swollen and she has a bad pain in her back which she thinks is a trapped nerve. It just doesn't seem like standing for hours would be such a good idea, but I know better than to insist on this one.

We went to the "mommys club" at the hospital today for a check up, breast feeding and weighing. There machine is so accurate that is detected .6 of a gram change in weight. Her breast milk is beginning slowly because it was required five weeks ahead of schedule. She has little patience for this logic and is frustrated with her body and breatfeeding in general.

Her local friends Kiara and Jean Luca have lent us their breast pump (amongst many other items) which she is using to jump start lactation. She is not convinced that this is going to happen despite the assurances of a stream of lactation consultants in the hospital.

The hospital was filled with sick kids couging everywhere. We had to run a gauntlet of them to get to the "mommy's club". While I get the idea, it just seems like this should held in venue where the healthy people go, not the sick ones in the middle of flu season.

In the first two weeks, the bambini have to fill many diapers. This process allows the billi-rubin to be excreted until their livers start working. If they get a cold and stop eating, the jaundice will escalate requiring re-admission to the hospital and being take away from us. Having read a good deal more than I ever wanted to about this over the last few days, 60% of re-admissions are due to this reason alone.

On the way out I was approached by a hospital volunteer and the guilt of my wicked intentions with her lovingly made pink and green woolly hat overcame me. As we had our conversation (in slow motion), I began making a list of relatives in my head, that i could give this to next xmas, thereby relieving me of any and all guilt.

We valet parked the car. When I offered the valet guy five bucks because he ran (literally) to get the car and smiled constantly, he told me they cant take tips.

Moving up here has been such a welcome change from Los Angeles where even going to dinner is a stressful experience filled with traffic, parking waiting and attitude issues. If you don't tip 20% or more there, you don't even get a thank you.

The people here are much nicer to each other in general and driving on the 280 freeway is always moving well. It was so refreshing to have a nice valet guy that I finally forced the tip into his had so that no one could see.

I will try to upload a couple more shots in the nursery taken tonite. It is coming together slowly. Almost everything is done, but I have failed miserably on a couple of items. We had the nanny come by so we could see how she interacted with the bambini, and Barbara was happy.

Last night Barbara made it through until about 4am when the pain medication wore off and she came to get the mild pain medication she has. The main pain medication is Norco which takes the edge of nicely, but she did not allow me to pick those up yesterday. She is determined not to be "handicapped" by the state of her body and I suspect a good dose of old fashioned Italian Catholic guilt.

I have the night shift right now, and i can usually make it until 6am. She then takes over and sleeps on the sofa bed in the nursery. She really wanted some "me" time today and settled on a pampering and "blah blah blah" session at the hairdresser. She loves this. I got up early to make sure she could go before we had to leave for the hospital, but we still ran late.

The idea was to pick her up on the way.

Finally today, just to add to the fun, I managed to upset one of Barbara's hypersensitive aunties. She doesn't speak English and I don't speak Italian so we settled on bad Spanish which I know a little of. When I told her that Barbara was at the hairdresser she thought I was making up excuses not to put her on the phone because she was about to die. It really went down hill from there.

The last time we called her was back when she had just had the operation and she sounded like mental patient due to the drugs. Now I was telling her she was at the hairdresser. it was just too much. I explained that in times like these, the small details of like like her cell phone charger was forgotten and calls don't get made.

I think the low point was when I suggested she go to an internet cafe (to read this blog) like all of our friends. She reminded me that she was family, not "friends" and she could not wait in the internet cafe for us to call. Yes, in retrospect that was probably a bad idea. Finally she made sure I understood that she was not happy.

It's just hard to explain how impossible "touch base" phone calls are at a time like this unless you have been through it. We appreciate you patience and will call each one of you in the coming days.

Tursday night

What a relief to be home and quiet after all the people that kept coming through the door for the last five days on top of breast feeding and dealing with a body recovering from a very serious operation.

We brought all the flowers home and she keeps looking at them. Luckily we had prepared and washed everything, so the bambini moved right in. We have tons of baby stuff thanks to all of you and the baby shower. We tried out the bottles tonight, which flow a lot more supplement than the syringes we were using in the hospital. The problem is they get used to receiving a lot of milk for little effort. On the breast, it is much more work.

We have contacted a nanny that was recomended to us to see if she can come over tomorrow evening so we can both get a full nights sleep. It may take an evening or two to get comfortable enough with her to be able to relax and sleep. Barbara says she has been able to keep going because she is so wired.

The bambini are eating more and more and the last weighing we did confirmed they have stopped loosing weight and actually gained weight.

We have decided to take this weekend to try to recover from the chaos of the week. We are going to focus on getting everything set up for the bambini and catching up on sleep. We hope to call each one of you over the course of next week and spend a
little time catching up.

Thursday - Kaiser Check out

The car seat trials were a full on clinical test with heartrate monitor, pulse oximeter, and two other electrodes. Of course the pulse oximeter (taped to the foot) worked about half the time setting off a loud alarm when it fell below the threshold. Because I chose to do this at 4am, the babies were asleep for most of the test, which was of course the whole point.To avoid this alarm waking up the baby I had to hold the sensor for the entire hour. I was in an akward stanging position and my arm went to sleep frequently. It was torture.

I negotiated this quite room and a 4am start time for these trials. I certainly did not want to strap them into the car seat and have them scream for an hour. My plan was to feed them and let them sleep their way through the trial.

This Kaiser test came out of a couple of pre-term ride home deaths where the baby's head fell forward suffocating the baby. I can only imagine what the Kaiser lawyers said after that. It is utterly idiotic to make both our babies go through this torture, but rather than argue that we only live 15mins away and there is no law requiring this, I figured I might as well play along if I could.

Nico went first. He seems to be a little more difficult to get settled, but he was off to sleep in a second. At that time the nurses are relaxed and willing to make small talk which I used to relax everyone and nicely ask them to shhhh occasionally. The nursery door had the loudest electronic door solenoid I have ever heard. It was like a sack of potatoes being dropped on the floor every time a nurse swiped her card to get entry. I don't know what geniuses designed this nursery, but clearly they were not 3 days old!

Our nurse Irma was very nice and let me remove Luca after only 45 minutes. By 7am, a hospital is in full swing with sleepy eyed, monday morning, get it done workers. It is not the lazy quite of the small hours.

Luca responded perfectly and with a little rocking of the car seat, was pushing out zzzzzzz before I knew it.

Passing this test was critical to a smooth departure with happy smiles from the Kaiser procedure enforcers. Having made a significant issue out of the needle heel stick, passing this test would make any further interaction with the head pediatrician much easier. If we didn't pass, the babies would be asked to stay in the "nursery" without Mom or dad. We definately didn't want that!

Luca passed the test at 6am, and when i got back to the room i realized i needed to get a least a little sleep so I could deal with any last minute burocratic nonsense involved in checking out. I turned out the light and finally slept at 7am.

I was woken up at 9am. There were two satisfaction representatives going over something with Barbara. After they left she said it had been non stop since 7am and she was really looking forward to going home.

The nurse told us that the head pediatrician was coming by to do the final examination for jaundice by eye, just like the nurses in the outpatient area we will be visiting tomorrow. To do this you take the babies into daylight and observe their color. What a concept!

There are possibly two reasons why all the babies are not evaluated this way, first they do not get paid for the time it takes to walk outside and hold a baby up to the light, and second, its far faster for a doctor to scan down a column of numbers at 7am than taking 20 babies outside. I tried to explain this to Nico, but he fell asleep when I got the part about the bean counters.

The head pediatrician, is a very nice middle aged women who's visit we really enjoyed today. She said that it was obvious to her even under the neon lights that the babies had no signs of jaundice and then hung out holding them both while I fed them. She was clearly enjoying this part of the job.

The rental Biliblankets arrived and so did the duty nurse assigned to discharge us with a three inch stack of paperwork. I decided to sit in the rocking chair fearing I might snore too loudly otherwise. We signed here, here and here, listened patiently to cautions about this that and the other thing they might get sued over and finally compared wrist tags of babies to parents. The last step of this process is possibly the most painful.

This hospital has an army of volunteers. These are very pleasant older folk that obviously have nothing to do and love interacting with people and being of help. We were informed that the wheelchair would be pushed by one of them who would also give us a special cap. I assumed that they sit at home at night knitting these things, but I didnt ask as i coulndt deal with the guilt of the final destination of these works of love.

The worst part about this, is that right at the moment you want to move as fast as possible, you have to walk at a snails pace behind this well meaning OAP shuffling along with a satisfied grin as everyone admires your babies in slow motion. It was an exercise in patience.

Once we got out of the parking lot, it became very emotional as we realized we were now a family. I had so much attention on dealing with Kaiser, that I had not really been experiencing my feelings, and it caught me by surprise to realize how significant this moment was. We had finally begun OUR journey together.

Wed - New Pictures

From Birth

I have uploaded some new pictures to the album.

today we discovered that there is a device called a bilirubinometer. This is actually used clinically all over the world to dertemine which babies might be jaundiced and thus draw blood from.

Since our concern was with Kaisers routine drawing of blood, a lot of blood and the extreme stress caused to the 3 day old pre-term babies, we were very excited to learn that Kaiser in fact poseses one!

I waited all night for the pedaitric doctor to come by at 7am to tell us the good news. Unfortunately he never showed up. Instead the head nurse brought it in and told us that there was no battery and it needed to be calibrated! Not a good start.

it went downhill from there. The doctor finally came by at 11am, obviously she was in no hurry to be the bearer of bad news. She walked in with a mask on and introduced herself with "Hello im Dr Ross and I have a cold today and I'm going to do an examination of the babies now"!!.

I leaped out my chair and blocked her from getting near the babies while trying to gently point out that we would not like that at all because of the risk of infecting premature babies with the virus. Rather than leave she decided to ask Barabara a series of questions about her recovery.

After waiting patiently for several minutes, I asked her if we could talk outside. It was very akward trying to explain to a DOCTOR that it is inappropriate to be any where near 3 day old children with a streaming cold. She explained; "I have a mask". The akwardness was compounded by the fact that she was an African American woman and I a white man.

I tried my best to let her know how many precautions we had taken to protect Barbara from swine flu. Pregnant womem are the most likely to DIE from it. The doctor said it wasn't swine flu, but I was not sure if she knew that for sure.

This didn't bode well for the news on the bilirubinometer. Needless to say with little discussion the answer was "its not going to happen". After the nurses introduction i figured that Kaiser was going to not going to change there procedures for us, so I asked who could make such a decision and was referred to the head of pediatrics.

Next a very nice male doctor showed up (without a cold) to do the examination. We talked at length about using the bilirubinometer (which you just press against the skin) instead of blood draw to monitor levels of Bilirubin (that causes Jaundice) in pre-term babies. He said it was a reasonable request and he in fact used to use such a device. When he left I felt we might still have a chance. Since I suspect he would be talking to the head of Pedatrics, I mentioned that we might simply find a pediatrician that did use this device for the first five weeks of development. He understood that this was not a trivial issue for us.

Next the nurse says the head of Pedatrics is coming in to talk to us about this. At 5pm she shows up and says she has some choices that she can offer us but the bilirubinometer is in fact not accurate and her "admitting" nurses do a better job of asesing jaundiced babies than this device! She referred to it as "junk".

So we talked at length about how well the babies had been doing over the last 36 hours. She had obviously studied the charts and agreed, She said that it wouldn't be a big problem to cancel the order for blood draw tomorrow morning if we used the big blue light box overnight.

This box is a stronger form of the blue light than the pad they have been on and is the best treatment for billirubin in the blood when exposed to skin. The problem is that even though babies have a natural reflex of closing their eyes when exposed to the blue light, Kaiser requires that they wear "goggles".

As you may imagine, 3day olds dont quite get the concept of goggles, and the ensuing battle between nurses doing a job and babies who are strongly protesting gets ugly in a hurry. This is why we did not do it in the first place!

she then started explaining some elaborate set up where we would hold the babies and shield there eyes while the light shon on their backs as way around the goggles. I agreed to stay up all night to administer that to both babies and she would then feel comfortable about not doing a blood draw in the morning.

She also said that the follow up nurses are very good at spotting any problems and when they ask for a blood draw they are usually right. We agreed that if they thought it was necessary we would draw blood to determine if there is any risk to babies.

When the blue lights arrived, the nurses set them up as though we were going to use goggles but instead suggested that I make use of the blanket to protect their eyes. This means I will have to watch them all night in between the feedings I do, but when Nico looked at me yesterday with an expression of "how could you let them do this to me?" i realized this is a small price to pay.
This blog should be called the sleep deprivation project.

The head pediatrician also said that she would write an order for us to get a pair of the bilirubin light pads so that we can continue the low level therapy at home for the first critical week. This was great news.

The room we have is very well designed and has just enough space and everything you need. Even the food is good.

The final issue was the car seat test. They have to be taken to the nursery and strapped into the car seats and left for an hour! Yes 3 day old babies strapped into a car seat for an hour! The nursery is like San Quentin on riot day. Babies are being circumsized and weighed and diaper changing. They scream endlessly.

I suggested that we do the test in our room, but they need to hook up an EKG! on a 3day old!! I suggested a small room off to the side and chose 3am to do this ridiculous test that has more to do with the hospital not getting sued because a baby died in a car seat onthe way home from a neglectful, sellp deprived parent. I picked 3am so there will probably be no one in there and no noise. That's we are going next.

Barabara is doing much better. She feels very handicapped. Today Natalie visited and they went for a little stroll around the ward. We have received some very nice flowers that cheer her up and we will take them home tomorrow if all goes well.

Wed morning

after speaking with my very good friend, a surgeon, I realized just how dangerous the C-Section was on Sunday morning. It was terrifying to watch 2 surgeons, 2 assists, 4 nurses and the anesthesiologist circling her preparing to eviscerate her. I can only imagine how scary it must have been for her lying there exhausted in anticipation.

I did not watch the operation, we had heard that it is hard to see your wife in the same way after, so I was under strict instructions not to look at anything. although she was awake, her entire lower body was numb and this made her feel totally incapacitated. They had used velcro to hold her arms out so she looked like she was about to be crucified.

during the operation, her body had a reaction to the surgery and she vomited. this is extremely dangerous because she was on her back. my friend explained that if they choke on their vomit, patients get a nasty infection in the airway. apart from that, they will be unable to move and choking!

WHile I was observing her, I noticed that she was about to vomit. The anesthesiologist was watchign many things and had not noticed. I told him that i thought she was going to vomit. He sprang into action and had tube in her mouth within two seconds. This had A powerfull suction and removed everything - thank goodness he was fast.

she had turned her head to one side as an automatic reaction (which was correct) and even though she retched 5 or 6 times, luckily she did not choke. When i got home that night and started thinking about that moment, i stood in the shower shaking for minutes. it was terrifying.

Aftewards, I asked the anesthesiologist why she threw up and he quipped that the surgeons were the problem, to which they laughed and blamed the anesthesiologist. The joking relived the tension, but could not mask the stark reality that we just stared into the teeth of a very serious problem and escaped unscathed.

I attribute this to the strength in Barbaras body. Most high risk pregnancies like this get bed rest for many months.

One of the (many) criteria for finding a new place to live was proximity to a pool so she could swim. We also wanted a pool without chlorine. I found the condo in three very stresfull days of searching and chose it over a place in the hills I preferred because there was a local health club with a small pool and ozonated water (no chemical treatments). It is walking distance from where we live and served as a great exercise for her during pregnancy.

Tuesday night

typing with one hand (bambino in the other)
returned to a very different room. Our wonderful dulla had come by and done some healing work with Barbara. she got very relaxed and fell asleep for a few hours.

our evening nurse teaches healing for the hospital (it is now recognized as a treatment by Kaiser) and so the two of them were in hog heaven for a few hours. she is also very good at helping me get the babies to eat. This has become very important if we want to go home this week. They are five weeks premature so must gain weight and not be at risk for jaundice - which is also tied to their weight gain.

jaundice can be treated with blue light, so we now have little pads that go against their backs that emit blue light. They look like ET in the cribs!

The best news is that our nurse knew of a machine that will read the level of jaundice by using a photo sensor on the skin. this is excellent news, because we can monitor progress without needing to stick the babies and squeeze blood out of their foot. she said they have located one in the hospital and in the morning they will dig it out.

doctors dont like it so much because it is not as precise as blood test, but then the standard procedure here is to give vitamin k by injection!

we have made it very clear that we want minimal invasive procedures at least for the first few weeks, but especialyl in the first few hours and days. They are slowly accomodating us.

babara tonight is a different person. she is no longer out of it, but very very tired. she is enjoying the babies and learing how to breast feed. I am using a technique of a small tube taped to my finger to deliver formula until her breast milk kicks in.

the babies are very well behaved only crying to let us know when they are hungry or need to change daipers.

I have a few more pictures that i hope to add to the set soon.

its now 2.30 am and next feeding is in 1 hour. feeding babies takes a lot of time!

Tuesday2

We apologize for not calling anyone, there is just too much going on. Every spare minute is spent working on something. Also Barbara has not had full nights sleep in four days and it is taking a toll.

Tuesday

I rapidly realized that Barbara cannot cope with all the nurses and doctors and her own revoering body and feed the babies at night, so I stayed and managed to give them both their first feedings. One lasted 45mins.

Today they are scheduled for a blood screening test that covers about 40 different things and a blood draw to test for jaundice. I knew this was going to be the most invasive procedure yet so I postponed it while Mom and babies were sleeping so they could get a little rest.

They arrived at 9am. Nico was screaming a lot and Luca started off that way but seemed to reluctantly give in after a little while.

They prick the heel and then proceed to squeeze the hell out of it to get enough blood to fill a small vile and soak 5 circles on a paper. It was torture for them... and us!

I wanted to stay a little while so that Barbara could use a stroller to get a little walking exercise. Then the doctors descended on us. First the OBGYN and then the Peadiatrician.

The Jaundice results are borderline (which is common in premature babies because liver function is not well developed. Therapy consists of blue lamps and they must gain weight (one of the risk factors.

I left at noon with two nurses and a lactation consultant feeding the babies to get the milk into them. We have to reduce the risk of Jaundice.

Barbara is on a mild pain medication, but still very out of it. There are big decisions I havve to make almost every day, with little sleep, it is hard and stressful.

Monday - Recovery

Barbara has had very little sleep again. Each 8 hours sees a change of nursing teams and inevitably they want to examine the babies for themselves waking them up and waking Barbara up. The babies must be weighed regualarly and have their temperature taken which they don't like.

They use a heel stik to extract blood to determine their blood sugar, which they really hate.

The first 24 hours they did not eat at all, and the lactation nurse came to show us how to breast feed and feed using a finger with a small tube attached to a syringe with formula.

We had a couple of visitors and our Dulla, Benedicta came by to enjoy the babies and give Barbara a healing. Our nurse is also a healer and hung out in the room for hours after everyone left talking and working with Barbara. She is exhausted, but "wired".

Sunday - 8am Birth

From Birth

at about 4am we went down to the Operating Room to begin the pushing stage. After 3Hrs of exhausting trying, Nico who was lined up first, was not coming out.

We realized we were only left with a C-Section to deliver babies. Barbara was bitterly dissappointed.

Babies arrived quickly after procedure began at 8.10am. Nico had fluid in his lungs and was heaving until they sucked it out.

In keeping with our minimal invasive philosophy, we have been questioning every thing that they want to do to the babies in this delicate first few hours.

The Vitamin K injection it turns out, can be given orally, but is given as an injection because it is faster. We asked for the oral version which one of the wonderful nurses gave in five minutes.

After 36 non stop hours I went home to sleep

Saturday - Labor Begins

Arrived at 2pm to check if Barbara's water broke. It had, so we began the labor