What's new tonight?

Feeding tubes come in two flavors: oral-gastric (OG) and nasal-gastric (NG).  What distinguishes them is the point of entry.  Up to today, the girls have each had OG tubes; you can see them in all the photos.

The problem with OG tubes is that they interfere with nursing.  You simply can't get a nursing position that's comfortable to the baby when there's a tube in the baby's mouth.  Since we're dedicated to getting the girls used to nursing ASAP even though the nursing is not yet essential to nutrition, the OG tubes have been a bit of a problem.  Evelyn especially has had trouble with "latching," which is essential.  She struggles and makes a kind of quick kissing sound that Ginger likens to the infamous scene in Silence of the Lambs.  Only cuter, I'm assured.  Cute or not, it's not the good, deep latch that will be required later for effective nursing.

So they switched them today to NG tubes.  This happened after I left, so I haven't seen them yet.  Ginger said that installing them looked "uncomfortable."  I'm steeling myself for the sight tomorrow.  Needless to say, I'm looking forward to the point at which they'll get their nutrition from bottles and nursing, and the need for tubes will be entirely eliminated.

What's the story behind their names?

Anna is named for both of her grandmothers -- Mom's middle name, and Ginger's Mom's first name. It's also my sister's middle name and my fraternal grandmother's name. So it was a pretty easy choice, given our rigid adherence to using names in the family. Also, we liked the name. We decided to go with "Anna" rather than "Ann" or "Anne" because choosing one over the other would require choosing between Ginger's family and mine. We're not foreclosing the possibility that "Annie" may stick as a nickname. Or "Anna Banana," although that may be untenable for formal occasions and wedding announcements.

Evelyn is named for my great-aunt on my father's side. She was a very strong and canny woman who played an important role in my father's life. She had no children, but it seemed a shame to let her go unhonored by our little branch of the family. Also, we liked the name, because we're old-fashioned and such. We've been planning to use it for years now, and are relieved we got the chance. There was a movie five or six years ago titled "Evelyn," and we held our breath, hoping against hope that it wouldn't become trendy. Fortunately, the movie bombed, proving that either God loves us and wants us to be happy, or He hates Pierce Brosnan. (Given the recent success of Momma Mia!, it must be the former.) We seem to be calling her "Evie" [rhymes with "TV"] rather than "Evie" [rhymes with "heavy"].

So why the weird middle names? Anna's is my paternal grandmother's maiden name. Evelyn's is Ginger's maternal grandmother's maiden name. (I'm not putting them here because I'm leaving out identifiable surnames, but if you don't know them and are curious, feel free to e-mail me.)

How are the boys handling the changes?

Pretty well, considering.  Patrick is just thrilled.  He asks to go see the girls, and when we're there, asks to hold them and/or pet them.  It's clear he's really enthusiastic about this big brother thing.  More so than the last time around.

Charlie, on the other hand, is having a tougher time.  It's not manifesting in outward hostility -- he also asks to pet the girls, and he'll proudly announce their names to strangers -- but rather in occasionally going on strike.  He'll refuse to get out of the car; he'll refuse to come to the table for dinner; he'll refuse pretty much anything that he used to agree to a matter of course.  Which is worrying.  He's generally such an agreeable guy, it's the contrast with his usual self that's the problem, not the difficulty in an absolute sense.  Patrick on his best day is more contrary than Charlie on his worst.  But not right now.

Charlie's coping mechanisms are quite unique.  He's processing a lot of past events today, and asking me whether I was wearing a belt or a long-sleeved shirt on those days.  I just tell him "yes" to each even when I can't really remember.  A white lie, I know, but I think he needs the assurance that the world hasn't really changed all that much, or not in the important ways.

What's the status on transfer to Peninsula?

Medical readiness? Check.

Insurance approval? Check.

Two spaces available at the same time? Stand by.

They also tell us that Peninsula needs to retain a certain amount of step-down NICU capacity for its own births. Makes sense, but it could cause a guy to resent some other couple's blessed event.

What were their weights?

Anna was born first and weighed 3 lbs 8 oz at birth. Evelyn was second and weighed 4 lbs 4 oz. This turned out to be a good thing because in twin births the risk tends to lie with Baby B. This is so because when Baby A exits the womb and enters the world, she leaves behind a whole lot of abdominal real estate. So even if both babies are presenting head down, when Baby A leaves all bets are off. This is less likely to happen when Baby B is larger -- less room to somersault. So we have Evelyn to thank for not making this difficult, and also for the courtesy of showing up as relatively larger on our last prenatal ultrasound. It gave the perinatologist confidence to proceed as we did.

So what size are they now? People who've had babies know that they tend to lose a bit of weight after delivery, then gradually gain it back, returning to their birth weight after about a week and then surpassing it and never looking back. As the father of two breastfed babies, I'd always assumed this was caused by the inefficiency of nursing in the first five or so days, when the baby is learning how to maximize intake and minimize effort. Surprisingly (at least to me), babies in the NICU also lose weight, even with a feeding tube and dextrose and formula and pumped breastmilk every three hours on the dot.

So we know that the girls have lost some weight. We don't know exactly how much, because the NICU nurses are cautious about sharing this bit of trivia. For a first-time parent, finding out your baby has lost 20% of his birthweight is hard enough. It's downright frightening when you started at less than four, three or two pounds to begin with.