Born too soon: One dad's story of preemie twins

In an instant, the solace of last night's plan disintegrated. As Lori went to get a catheter in her neck, I put on a blue paper gown and hat, and scrubbed my arms. When I joined Lori in the operating room, she was in a drugged stupor.

The boys came out 2 minutes apart. Nobody stopped to show them to me. There was no time.

Two teams of neonatal nurses sprung to action.

I locked in on Baby A — or, rather, the nurse working on him. She squeezed a green oxygen bag, then paused, waiting to see if the air would kick-start his underdeveloped lungs.

She squeezed again. Still nothing.

He remained purple, and she seemed to be losing hope — shaking her head "no'' with such intensity that her brown ponytail brushed shoulder to shoulder across her back.

Jaime Aron / ASSOCIATED PRESS Neonatal intensive care unit nurses adjust 1-month-old Josh Aron's breathing tube on June 20, 2002 at Medical City Hospital in Dallas. He had surgery to close a hole in his heart when he was 3 days old.

Things were going just as poorly for Baby B.

Each minute the babies didn't breathe lowered their chance of surviving.

Of the 4 million births in the U.S. that year, 2002, just 9,510 babies were born before 24 weeks gestation. Nearly half in our boys' weight range (500-749 grams) died; the rate was above 53 percent for twins. Even if they lived, this lack of oxygen made them more likely to become disabled.

These were all the horrible things Dr. Milvenan had talked about the day before. Now, she was walking to me.

"Should we keep trying?'' she said.

This was not one of the scenarios we'd discussed.

"Hell, yes!'' I blurted. Saying no would've meant death, and I wasn't giving up that easily.

But ... what if I'd just sentenced our boys to a lifetime of suffering?

We'd never talked about raising a disabled child, certainly not two. I never brought it up because it scared me. Lori had majored in special education in college, working in classrooms with physically and mentally challenged kids — but this was our family, not a school.

Finally, in his 10th minute, Baby A pinked up. Baby B showed that beautiful color 2 minutes later.

As they were being whisked downstairs to the Neonatal Intensive Care Unit, I couldn't stop staring.

The boys were so tiny, like newly hatched birds, with their eyes fused shut and their skin a creepy, shiny, almost translucent color.

But perfect.

It was as if someone had taken Zac, small as he was at birth, and copied him at a 25 percent setting.

OK under the circumstances
In the NICU, there were monitors to attach, ventilators to start, blood and X-rays to be taken.

And the green oxygen bags came out again.

In the ICU, Lori was still unconscious but OK under the circumstances, doctors said.

On another floor, our family was waiting.

My dad, Lori's parents and her siblings already knew a little. They'd been in the hall outside the operating room and caught a glimpse of the babies. "Like minnows,'' my father muttered.

I told them everything I knew. Their questions made me realize how much I didn't: What are their chances of living? What's being done to them now? And just how small are they?

Then there was another question.

"How are you doing?'' Lori's mom asked me.

Stopping to think about it for the first time, I wept.

Crash course
Dr. Milvenan clipped X-rays of the boys' lungs to a lighted screen on a NICU wall, then began my crash course in neonatology.

"See how white everything is?'' she said. "It's supposed to be dark.''

Our boys were born before their bodies produced a substance called surfactant, which makes it easier for lungs to open and close. They were given an artificial version during delivery, but it would take time to know whether they'd ever be able to inhale, process oxygen and exhale on their own. That is, if the ventilators didn't rip apart their lungs first.

Bleeding in the brain is the other big fear. Babies born this small, this early, strain for each breath — hard enough to rupture blood vessels in the brain. It's usually a question of how many, not if. That test, however, would have to wait about a week.

Their fused eyes eventually would open, but it'd take months to know if they work. Ditto for the ears. And other body parts.

If the boys cleared all those hurdles, another obstacle course awaited. It was filled with conditions they were at high risk for — cerebral palsy, cystic fibrosis, muscular dystrophy ... so many that I lumped them together as "things they have telethons for.''

It all boiled down to this: Could these 1-pound, 2-ounce babies develop "in the real world'' like nature intended them to do in the womb?

Choosing names
On Monday, the boys' third day, the ID cards above their incubators still read "Aron Twin A'' and "Aron Twin B.''

They needed names.

In our families, babies are usually named for a deceased relative. But the boys arrived before we'd picked anyone to honor.

We talked about it briefly in the ICU, when Lori regained consciousness and learned that both boys were alive. We decided to follow a theme: Biblical warriors who overcame long odds.

Rabbi Debra Robbins visited and helped us narrow our list. She also taught us about the concept of renaming babies. Previous generations did this when a child became frighteningly ill, as a way to "trick the angel of death.''

Most of all, she urged us to make a choice.

"The caregivers need names to feel a more personal connection to the babies,'' she said.

We chose Jacob Benjamin and Joshua Caleb.

Jake and Josh.

Bracing for the worst
By Tuesday, Dr. Clair Schwendeman, who usually ran the NICU, was back. With wavy dark hair, a thick beard and a small diamond stud earring, he carried himself like the boss. He also had a great way of explaining things, starting with technical terms, then dumbing it down until I caught on.

Our first big discussion was about everyone being born with a hole in their heart. It closes within 72 hours for most babies. But 23-weekers aren't always that lucky.

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