Monday, September 28, 2009

Getting back on track....



So it's been a week since the Maddie being taken to the ER fiasco and I THINK we've managed to get her back on track. I'm still not sure exactly what her issue was, but it seems that a suppository here & there and a stage 3 nipple here & there have done the trick. Also, my mother suggested that I switch the girls to an every 4 hour feeding schedule, so I threw that into the mix as well - and all things combined seem to have created the cocktail that Maddie needed. Now that she's waiting 4 hours to be fed, she's much more hungry and takes her bottle much easier than before. I guess she really wasn't hungry every 3 hours anymore. And for those feedings where she still gives me trouble, I'll start her off with a stage 2 nipple and switch over to a stage 3 if she gets tired towards the end of the bottle. I talked to my pediatrician and the nurse coordinator at St. Barnabas about this and they both say that while it's a bit of a strange request for Madison to make, it's worth the inconvenience if it makes her willing to finish her bottles. I'm giving her suppositories every few days and that is definitely making a difference in her general disposition. Maddie would do a lot of grunting throughout the day. In the NICU they called it the "preemie grunts" - but Melia stopped doing this about a month ago and Maddie just kept on growling at us, as I called it. I guess this was a result of her trying to move her bowels, because ever since I started the suppositories she's been growling a lot less, hardly at all actually, and her herniated belly button has gone down drastically. My pediatrician still isn't a big fan of me using the suppositories, but the doctors and nurses at the hospital not only suggested it, but recommend it, if Maddie isn't pooping every day - and by pooping, they mean filling a diaper. It's hard to figure out what the right thing is to do when you have so many doctors with different ways of doing things in the mix. So I'm taking all of the suggestions and figuring out what's best by trial and error. What we're doing now is working, so I'm sticking to it until it doesn't work anymore.

The girls had their first high risk infant follow up appointment at St. Barnabas today. This follow up is designed for babies that are expected to have delayed milestones. Madison was put into this high risk category due to her birth weight, and while Melia missed the cut-off to be officially classified as high risk, she's been put into this category anyway based on the fact that she's a twin. The clinic doesn't like to break up twins, so they'll follow them both for the next 2 years to make sure that they are meeting milestones at an appropriate stage in regard to their adjusted age. So today was their first appointment and we weren't really sure what to expect. First they weighed and measured them (just like they used to do at the apnea clinic - and I'll get to the apnea monitors in a minute) - Madison is weighing in at 8lbs 5oz and 21 3/4inches - Melia is weighing in at 9lbs 10oz and 22 inches. I'm surprised that Melia isn't over 10lbs, but it's okay because it's helping Madison catch up! Maddie is now only 1lb 5oz and 1/4 inch behind Melia! For the first time on Saturday Mike was taking pictures and he said that he really felt like they looked similar in size as they were side by side. So our little Maddie is moving on up! After being weighed and measured, Dr. Kamtorn gave both girls a quick exam and was very happy with how big and healthy they are. Then we met the occupational therapist, Kim. She put each of the girls on a mat on the floor and moved their arms, legs and heads to test their muscle strength. She put the girl on their tummies to see how well they hold up and control their heads. She laid them on their backs and had them track audio and visual targets with their eyes. Kim was very happy with where both girls are and said that they are exactly where they are supposed to be for their adjusted developmental age. She gave us some homework - over the next few months we have to work with the girls doing certain things to help the girls along developmentally and keep things moving in the right direction. Our next appointment isn't until January, so hopefully they'll meet all of the requirements for their adjusted age at that point and do as well as they did today.

While we were there, we had their apnea monitors downloaded and reviewed. Melia's download was free of any true events - so we decided that it's a good time to take her off of the monitor - so the monitor company should be contacting me in the next day or so to come pick up her monitor. This makes me nervous, I'm not going to lie. But she hasn't had an event in over 3 weeks, so to keep her on it wouldn't make much sense. I have to let go of the monitors eventually, so, I suppose there's no time like the present. Don't get me wrong though, even though she's technically supposed to be off of the monitor as of today, I will use it for the next couple of nights until they come pick it up. Madison, on the other hand, in true Maddie fashion continues to keep things interesting. According to the download, she didn't have a true event in 2 weeks - until THIS MORNING! This morning, at 6:21am, sure enough she had a true apnea episode. What are the odds? Maybe Maddie realized that mommy wouldn't be able to handle both girls coming off of the monitors at the same time. So she gave me 2 more weeks of that security blanket with her, so I can adjust to Melia being monitor free. Madison will have her monitor downloaded again on October 13th - and provided that she doesn't have any events between now and then, she'll be taken off of the monitor at that point.


Madison says, "Mommy, no pictures please!" and Melia, as usual will try to eat anything near her mouth!

**noteable milestones - Melia has landed on her first developmental milestone! She has developed her social smile! She's not doing it all the time, but when she does, her smile lights up the room! I had noticed her smiling here and there lately, but wasn't quite sure if I could classify it as her social smile, but Dr. Kamtorn noticed it while she was doing her exam on Melia today and after a few cute smiles from Melia, Dr. Kamtorn confirmed that these smiles were the real deal. And, the girls are officially sleeping through the night - always going a nice 6-7 hour stretch, so as long as we put them down after a late night feeding (10-11pm), they'll sleep until about 7am, sometimes even later. At this point, they rarely stir in the middle of the night, so I don't even have to get up and give them their binkies. We're talking 6-7 hours of solid, uninterrupted sleep. It's a beautiful thing!

**noteable poop story - So Mike took Melia upstairs for a diaper change before her afternoon feeding and after he was up there for a little over 5 minutes, he yells down the stairs and asks me where the changing pad covers are - so I know that something fun must've happened. So I went upstairs to get the scoop. Sure enough, she had pooped and made a sloppy mess of herself - but that wasn't the issue. Mid-diaper change she started to spit up and choke a little bit, so as Mike moved his attention to her upper body to help her work through that and then clean up that aftermath, she started to pee - and of course, this was minus a diaper under her butt since daddy didn't have time to put one under her as she was choking and needed his help elsewhere. So now she's pooped, puked and peed all over the changing pad and all over herself - the changing pad cover needed to be changed, and so did her outfit - and daddy's hands needed a good, long scrubbing. ;-)