Finn is now two weeks old, has both eyes wide open (at least, when he isn’t spending most of the day sleeping), and is eating more and more each day.

The best news Finn received over the past few days was the result of his cranial ultrasound on Friday, August 5. Preemies are at an increased risk for bleeding in their brains, and substantial hemorrhaging can potentially have some pretty severe impacts on a baby’s later development. Finn had an initial ultrasound back on July 26 that showed just a small amount of bleeding in his left ventricle, a result that the neonatologist said he “would take every time” for a 25-weeker. That remained unchanged in a follow up ultrasound on July 28, and then this more recent follow up confirmed that same trajectory. In terms of big potential problems for micro preemies that Finn has been fortunate to avoid, his relatively clean cranial ultrasound results rank near the top of the list.

While Finn hasn’t had any additional follow up echoes on his heart since the one earlier this week, the nurses, nurse practitioners and neonatologist have been listening for a heart murmur through a stethoscope, and believe the PDA is continuing to close.

His breathing remains about the same, with no changes to his respiratory settings over the past few days — aside from when, at 3:00 am this morning, Finn decided to pull out his breathing tube!  Just yesterday, the nurse had seen Finn with his hand wrapped around his tube and said that he’d eventually be strong enough to pull it out, but not for a little while… though it seems like we once again underestimated Finn’s feistiness.

As of last night, Finn was weighing in at a bit under 1 pound, 13 ounces, and he’s been tolerating his feedings well as they’ve bumped him up slowly from just 1 mL every 3 hours on Wednesday morning to 5.4 mL every 3 hours this afternoon. The more he can eat, the faster he’ll grow — which, the doctor said, can only help his development, particularly that of his lungs.

Finn’s milestones over the past few days include:

• On Friday, August 5, Finn opened his right eye.

Finn is 11 days old today, and continues to make slow but steady progress.

The big news of the day was the result of Finn’s follow up echocardiogram on his heart. The echo shows that the PDA (the open valve that is pushing too much blood into his lungs), while still there, is much smaller than it was before they gave him one round of medicine. So the NICU team here believes the valve is in the process of closing, and they’re confident enough in that diagnosis to start increasing Finn’s meals to 2 mL of breast milk (every 3 hours).

Finn has managed to keep us on our toes over the past few days with his breathing, as he’s had a few “spells” per day where both his heart rate and the oxygen saturation level of his blood drops quickly, and he needs a little help to recover (be it just a friendly nudge or a temporary bump in his oxygen level). Spells are relatively common in premature babies, as their brains aren’t fully developed and often temporarily forget to continue to breathe, but knowing that doesn’t necessarily stop Mom and Dad from worrying each time Finn’s monitor starts beeping like crazy when his heart rate and oxygen numbers suddenly drop. He’s been upgraded a bit from room air (which is 21% oxygen) to closer to the 30% to 35% range over the past couple of days to try to limit his number of spells.

On to happier developments: Finn has, ever so slightly, opened his left eye!  Babies that are very premature often emerge with their eyelids still fused shut, so we’ve been patiently waiting for him to open them and see what’s going on in the world. We’re still waiting on his right eye (which we hope will follow in the next few days). In any event, he can really only distinguish light and dark at this point, so we keep telling him he isn’t missing out on too much.

Finn’s milestones over the past few days include:

• On the night of Monday, August 1, Finn weighed in at 1 pound, 9 ounces — the first time he’s been higher than his birth weight.
• On Wednesday, August 3, Finn opened his left eye.

Finn is 9 days old and already has had more tests, procedures and medicines than some people will ever have in their lifetime.

He finished his treatment for his PDA (the open valve that is pushing too much blood into his lungs) yesterday, Sunday, July 31, at 6:00 am.  After some preliminary tests, they resumed his 1 mL feeds of breast milk.  Today he had another echo to check how he responded to the treatment.  The echo showed that the PDA is still there, but at least for the time being, it looks much smaller than last Friday.  The doctors have decided to hold off on any further treatment right now and will just continue to monitor him over the next few days.  The hope is that it continues to resolve on its own.  Otherwise, he can receive one more round of the medication, and if that doesn’t work and/or things get worse, the last option is surgery.  So now we wait.

Finn’s milestones over the past few days include:

• On Sunday, July 31, he had his first snuggle session with Dad.  A little skin to skin action and only a few of Kev’s chest hairs stuck to the tape from all of his wires!
• Dermot has been saying “Finn” for the past few days.

Lastly, we just wanted to share a quote that stood out to us:

Some twins walk side by side, and sometimes one has wings to fly.

Finn is now a week old, and it has certainly been an eventful last seven days!

Like any micro preemie, Finn has needed a lot of help, from a respirator to blood transfusions to phototherapy lights to countless other little helping hands. There are a million things the NICU team here at Beth Israel is monitoring, with the two most important being Finn’s respiratory system and his cardiovascular system.

The news is generally pretty good on both of those fronts. Finn did actually cry out a tiny bit when he was born, though given his gestational age, he was pretty quickly intubated and put on a respirator. After a day or so, he was switched to a high frequency ventilator — a big, noisy machine that pumped hundreds of breaths a minute into his tiny lungs — to try to stabilize his breathing, and he responded well to it. By Thursday morning, he was back on the regular respirator, and he’s made slow but steady progress since. He’s been weaned down from extra oxygen to regular “room air” at this point, and Finn’s respiratory therapists have slowly pulled back on the automatic breaths per minute that he’s being given as he assumes more of the responsibility himself. It will be quite some time before Finn is ready to breathe fully independently, but the doctors and we are encouraged by the early signs.

As far as Finn’s heart, the doctors are thus far seeing nothing abnormal for a 25 week micro preemie. His heart rate has generally been pretty good, as has his blood pressure. He is being treated with medicine for a patent ductus arteriosus (PDA), which is a blood vessel that is supposed to close after birth, but often does not in premature babies.  We should get follow up results on how that treatment is going in the next few days, but the early indications are generally positive.

Aside from that, things look pretty good considering the circumstances. He started in with meals on Wednesday afternoon, and was enjoying his 1 mL of breastmilk every three hours until they had to hit the pause button yesterday afternoon, just for as long as he’s taking his medicine for the PDA. He is still below his birth weight, which is to be expected — especially because this morning saw his first real poop!  Word is that his older brother Dermot is very proud. Both Dad and Mom have done diaper changes… though Dad has been responsible for more of them!

Mom has now had a chance to hold him three times, and it’s clear that Finn loves snuggling with her. He has a long ways to go before he can graduate from his isolette (his incubator) and be snuggled at any time, so Mom and Dad will take what they can get for now.

Finn’s milestones this week include:

• On Monday, July 25, Dad lifted Finn up and held him for the first time (as his nurses changed his bedding underneath him).
• On Wednesday, July 27, Mom changed her first diaper, and Finn had his first feed.
• On Thursday, July 28, Mom held Finn for the first time, as they did skin to skin for 45 minutes.

Identical twins Emmet Michael O’Brien and Finn Kelly O’Brien were born just after noon on Saturday, July 23. They were just 25 weeks and 2 days gestational age after being diagnosed with twin-to-twin transfusion syndrome only a week-and-a-half prior, and despite all efforts to have them spend more time in utero, the doctors determined that day that our babies would need to be delivered. They joined our family at 12:15 pm and 12:16 pm, respectively, each weighing 1 pound, 8 ounces.

The first hours of their lives were a blur, as doctors rushed to check their respiratory and cardiovascular systems, ensure they had enough nutrients, and undertake the countless complicated tasks needed to care for “micro preemies.”  While Finn was slowly able to stabilize after a blood transfusion and some other help, Emmet was not so fortunate. By 8:30 pm we were urgently rushing from Shannon’s hospital room to the NICU to be with Emmet, and as it slowly became clear that even the world’s best doctors and medicine wouldn’t be able to do anything for him, we were able to spend a precious few minutes holding Dermot and Finn’s brother.  Emmet passed away early Sunday morning surrounded by Shannon, Kevin, and his lifelong companion Finn.

Finn is now exactly one week old, and we are starting this page to provide updates to our family and close friends as Emmet’s brother starts the long process of preparing to come home.

Please feel free to read “Emmet and Finn’s Story” if you’d like the longer, more detailed version of how we got to where we are now.