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. ;-)

Fun times at the beach and not so fun times at the hospital....

When we left off, the girls were venturing off into the nursery for their first night of sleeping in their cribs - and it went very well! The girls slept through the night with a nice 6 hour stretch! They stirred a couple times, wanting their binkies, so I'd get up and put the binky back in their mouths, and they'd go right back to sleep. I can't say that I slept soundly, but I really don't expect to sleep soundly again until, well, probably never. So it's been a full week now and we're in the routine with sleeping in the nursery. Most nights the girls are sleeping for 6-7 hour stretches. Both Madison and Melia have played a trick here and there, on separate nights of course, demanding food at 3 or 4am - BUT, when they do that, we'll feed them as requested and they'll go right back to sleep for another 5 or 6 hours. There have actually been a couple mornings where I'm awake before the girls!

We still have the girls on the apnea monitors, though truthfully, they don't really need them anymore. Their monitors were downloaded last Tuesday and by Thursday I got the call from the apnea clinic letting us know that the girls could come off the monitors if we (being mommy and daddy) were ready for such a transition. According to the download, the girls have had very few true events in recent weeks and since they are now 4 weeks past their due date, it's considered safe to take them off the monitors. But, enter neurotic mommy and I requested that they stay on them just a bit longer. At the time that I had this conversation, the girls had only been in the nursery for 2 nights and I really needed more time with my apnea monitor security blanket.  So we decided to keep the girls on the monitors (during the night only) for another 2 weeks. The alarms rarely go off - and when they do, it's much more of a pain to jump up and go to the next room rather than just lift my head and check on them right next to me, but having the security of knowing that the alarm will notify me if something is wrong has really helped me with the nursery transition and  it's worth getting up for. I'd rather have them there, than not - I'm just not really to let go of that security blanket yet.

I've been having a serious case of cabin fever lately. Being out of work and literally just staying home with the girls has had me in a place reminiscent of being on bedrest - feeling bored and unable to do the things that I'd like to do. The only things we're really allowed to do with the girls, are take them to outdoor places, but the weather has been so screwy around here that even a trip to the park has been just about impossible. On Friday I insisted that we get out of the house. I really wanted to take the girls outside for some fresh air, since soon enough, we won't even be able to do that. So we decided to take a trip to Point Pleasant and introduce the girls to the beach and boardwalk - it was the perfect day for it. It's amazing how people flock to a couple walking around with twins. I hate this attention. Mike, on the other hand, loves this attention. A wedding party there actually wanted to get their pictures taken with the girls. How random is that? People just love twins! So many people would ask how old they were and when I would say "15 weeks" or "just about 4 months" their reactions were all the same - "oh my God, they're soooo tiny!" - I found myself feeling the need to explain. Finally I decided to just use their adjusted age of 5 weeks, so that the size of my children would make sense to other people and I wouldn't need to explain their story. 

We had lunch outside at the Tiki Bar. As our french fries got cold because the girls decided that they wanted to eat a half hour early - as we sat there feeding them instead of feeding ourselves, we laughed at how much things have changed. This time last year, a trip to the Tiki Bar would've been a completely different experience! After lunch we walked the boardwalk and  took a quick stroll on the beach just to take some pictures. The sun, while it was only about 70 degrees and wasn't very hot, seemed to be bothering the girls eyes - and we didn't want to be out in the sun too long anyway. Mike won some stuffed animals for the girls - a little stuffed dinosaur for Melia and a BIG stuffed pug for Maddie. The pug was fitting for Maddie since her acid reflux always has her sounding congested, and we always say that she breathes like a pug. ;-) Poor little Madster!

And speaking of - the poor little Madster has been keeping things interesting around here. She started giving me problems taking her formula on Sunday. All day long she wouldn't take more than 1 or 2 ounces at a time. She has always been our fussy eater, but on Sunday she took it to a whole new level. I really couldn't figure out what the issue was. As far as I was concerned, she wasn't constipated because she had just pooped that morning, so being "backed up" shouldn't have been an issue that would effect her eating. I started thinking that maybe she needed to be moved to the next stage nipple on her bottle, but then I figured that couldn't be the case because she just went on stage 2 nipples a couple weeks ago and a stage 3 nipple is made for 6+ months - and developmentally, Maddie is still only a 5 week old, so she really shouldn't even be on the stage 2 nipples that are made for 3 month olds. So I talked myself out of the idea that she needed a different nipple and figured maybe she was just having a bad day. But the next morning Mike became concerned about her congestion. I never really get too concerned about her congestion, because like I said before, we never really believe it to be true congestion and we always just chalk it up to her acid reflux. But Mike made the point that her last feeding was at 2am (he stayed up late and fed her as late as possible in an effort to get her hungry before feeding in the hopes that she'd take a full bottle) - and now it was 10am. So 7 hours had passed and she really shouldn't have been having reflux 7 hours after her last feeding. Good point. So, I called the pediatrician and made an appointment for her. I was reluctant to make the appointment because really, she looked fine. But Maddie having feeding issues can lead to weight loss, which would be a significant problem for her. So between that and the fact that at this point I wasn't sure if I could blame her congestion on acid reflux, I figured we were better safe than sorry. When Dr. Luke (the pediatrician) came into the exam room, I told him that we'd probably jumped the gun, but I just wanted her looked at. I was not at all expecting what happened next. He apparently didn't think we'd jumped the gun and felt that her breathing was rapid and labored. That combined with her feeding issues and the fact that he witnessed her spit up a few times while in the office, made him extremely concerned. He feared that she had come down with RSV and sent us straight to the emergency room. I couldn't believe this. I had just spent my morning on the phone with my insurance company regarding the girls' RSV vaccination (they need a vaccine every month from November through April), and here she may already have it. RSV (Respiratory syncytial virus) is a virus that causes infection in the lungs and breathing passages.  In adults, it may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache, cough, fever, and a general feeling of being ill. But in premature babies, who have a lower immune system and premature lungs, RSV infections can lead to other more serious illnesses and even death. Often times, a premature baby with RSV ends up admitted into the hospital and placed back on CPAP or even a ventilator.  So when Dr. Luke expressed concern about a possible RSV infection, my heart dropped, my eyes filled with tears and I was in a complete panic. We went to the ER and after a few hours we found out that her chest xray was clear and her RSV test was negative - PHEW!! So then, what was the issue? At the time that I write this post, 2 days later, still no one knows. The ER doctors weren't concerned with her breathing patterns. They put her on the monitor and she was at 100% oxygen with room air. They believe that her rapid breathing is a result of her prematurity. As the one ER doctor said, if a full term newborn was breathing like that, they'd be concerned - but for a premature baby to breathe like that, it's not very alarming. I wish Dr. Luke had that same reaction! While at the ER they gave her pedialyte and she took it do in record speed. And they gave her a suppository and forced her to poop. Some of the doctors believe that maybe she was "backed up" and wasn't eating due to that. I didn't think this was an issue since she'd pooped Sunday morning, just before the feeding issues began - but they said that unless she's filling a diaper at least once a day, chances are there is still more in there - and due to her prematurity, her intenstines don't move her bowels as well as a full term baby - so constipation for her is a different issue than constipation in a full term baby. We left the ER without any real answers - maybe it's a cold, maybe she's constipated, maybe she's just a fussy eater and is looking for a new type of formula or bottle. So I spent the whole day yesterday experimenting with different things to try to figure out where this new feeding issue is coming from. When we give her pedialyte, she takes it, so I began to wonder if she was getting sick of the nasty tasty of her prescription formula - so I started mixing her prescription formula with her old formula to give it a taste boost - didn't work. I tried to make her poop again - she pooped, but it didn't make her any more likely to eat. The doctor had me giver her Mylanta one hour before eating - didn't work. I tried a totally new type of bottle - didn't work. Finally I went back to the thing that I contemplated trying in the very beginning - I changed her to a stage 3 nipple and VOILA! She took 4oz in no time. Since then I've been switching back and forth between the stage 2 and stage 3 nipples - apparently sometimes she wants to move quickly and other times she wants to take her time. This kid is HIGH MAINTENANCE! So, I'm not really sure what did the trick - the nipple switch seemed to be the last factor when we noticed a difference, but I guess it couldn't been a combination of all of my experiments. Who knows. For now, things are getting back on track. Maddie has been taking all of her formula for the past 5 feedings. Hopefully, she'll stay on track. Today, Melia has been coughing - so I'm pretty sure that even if Maddie is out of the woods, mommy isn't.


The whole Maddie going to the ER thing has been eye-opening.  I make fun of myself for being this neurotic, overbearing, crazy mom that I never thought I'd be. But truthfully, I need to be this way for the safety of my children. People don't get it. And really, unless you too are the mother of a premature baby, I don't think people can or will get it. While the girls are full term and almost 6 weeks past their due date now - and they look like "normal" newborn babies - we have to remember that the mere fact that they were born premature makes them different. Their lungs, intestines and other major organs are still premature. Their immune systems are still very compromised and we have to safe-guard them as much as we can. They require special care. So people can think that I'm neurotic or overbearing, or even crazy - but the fact of the matter is that I'm protecting my children they way that they need to be protected. For those people who don't understand that and still think I'm just over-reacting, I really don't care - you can call me crazy - and I'll call you, ignorant.

Please join and support us...

Many of you have already received this information, but for those of you that follow along and I don't even know it - I wanted to make sure I got this information to as many people as would be willing to read it. Please support this cause in honor of our super baby angels.

On Sunday, October 4th, we will be walking in the 9th annual Miracle Walk at Verona Park in Verona, NJ, to benefit the NICU at Saint Barnabas Medical Center. As you all know, our daughters, Madison and Melia, were born on June 5, 2009 - 11 weeks premature - weighing only 2lbs and 2lbs 12oz respectively. For 8 weeks, Maddie and Lia called the NICU at Saint Barnabas home, as did we. The care that they received was bar none. The doctors and nurses there are the reason that our little girls, our angels, our miracles, are alive and thriving today. We would like to ask you to participate and walk with us to celebrate all the NICU Miracle Babies that are with us, and that are on the way. I am asking that you join us, and the rest of our team, in our efforts. We have joined forces with our good friends, Brian and Angelica Gonor, who are also the parents of their own miracles - their two children were also born premature and were saved by the amazing team of doctors and nurses at the Saint Barnabas NICU.


The money raised is used to buy essential medical supplies and equipment needed to help save the lives of the over 1,200 infants that begin their lives in the NICU at Saint Barnabas Medical Center each year - the same type of supplies and equipment that helped save the lives of Madison and Melia. Premature babies cared for at the Saint Barnabas NICU have a very high survival rate and a very low disability rate compared to the national average. Although technology continues to improve in Neonatology, not every premature baby experiences such an optimal outcome. Our family and hundreds of other families realize that a need exists to raise money for the NICU to help advance medical technology and create the best possible medical and healing environment for babies and their parents. This NICU saved the lives of my children and I am forever indebted to them. You never truly know how important a cause is until it hits you close to your heart and home. This cause is not close to my heart, it is IN my heart. This is so very important to me and my family. I will be forever grateful to those of you who can particpate in the walk with us to help raise the money that is so important to saving the lives of so many premature babies.

This NICU and it's staff helped us go from this...

To this....

Enough said! Please support this cause for all the future babies that deserve the same exceptional care that Madison and Melia received!

Please register to walk with us on October 4th. The first step is to go to the Miracle Walk Website and register online to participate. To join my team directly, please click on my team page link below. If you are unable to walk, we understand - but please consider sponsoring us and making a donation to help us reach our fundraising goal (the hospital is a nonprofit organization and all donations are tax deductible).


To access the Miracle Walk website to obtain more information please click on the link below.


http://www.miraclewalk.com/


To access our team page, to join our team, register or sponsor us with a donation, please click on the link below. Our team name is Preemie Dream Team.


http://www.miraclewalk.com/site/TR/Events/Generalteam_id=6350&pg=team&fr_id=1060


If you plan to walk with us - which we'd LOVE for you to do, you'll need to register. To do this, clink on the "join team" link to the left of the page above where it lists our team members. Register yourself as an individual walker. Registration is free, but the site is designed for every walker to raise funds, so it automatically has a $150 goal listed as an individual fundraising goal. You DO NOT have to donate $150. You can donate any amount that you would like in the "gift amount" tab. You must leave the $150 goal in the "individual fundraising goal" tab in order for your registration to go through, but again, you are not responsible to make a $150 donation - however, if you would like to ask family, friends, co-workers and neighbors of your own to sponsor you as a member of our team to reach that goal, then you are more than welcome to do so!


Please click the link below for walk day specifics.


http://www.miraclewalk.com/site/PageServer?pagename=EventInfo#2

If you are unable to walk with us, but would like to make a donation, please click on the "make a gift" link that you will find underneath the Preemie Dream Team picture on the right side of the webpage.


We hope to see you there on October 4th! Thank you so much!


Love,


Mike, Amanda, Madison and Melia Marcino

A pretty quiet week...

The girls have settled into their formulas (which by the way, my insurance pays for 100% of Melia's formula!! I thought they'd pay the same 90% that they are paying for Madison's, but apparently there is more coverage for a specialty, non-prescription formula - go figure). Madison is taking between 90 and 110ccs, depending on her mood and Melia is taking between 100 and 120ccs, depending on her mood - but she usually takes a whole 120, which is 4oz - I think we'll be moving to bigger bottles with her very shortly. They're both still having reflux episodes here and there. Melia seems to be having more episodes, which is out of the ordinary.  I'm thinking that their Pepcid dosage might need an increase since they've each gained a couple pounds since their last increase. Our next appointment with the specialist is at the end of the month. I'll call him if I need to before that, otherwise, I'll talk to him about it then. I'll see how things go over the next few days.

Now that the formula issue seems to be settled for the time being, of course another issue must arise - constipation. Both girls have been having poop issues. Melia has been having problems for a while now, but Madison always did pretty well in this area - until late last week. Now they're both pooping once every few days - and at times, it gets ugly. I actually had to stimulate her yesterday to get her to go and when she did it hard and she had so much trouble getting it out. So today I gave them both a bit of prune juice in their afternoon bottle. It seems to have worked well for Madison. About 3 hours later she was, um, in a word, explosive! ;-) I haven't seen a change in Melia yet, but we'll see what happens.

Mike has been working more lately, picking up landscaping shifts with a guy from firehouse. So with him gone more and more, I've been flying solo a lot during the days. And naturally, to coincide with my flying solo - the girls have learned to tell time. Ah yes, they are little time-telling geniuses! Every 3 hours, they begin to stir, knowing that feeding time at the Marcino zoo is upon them. With that, and the fact that I only have 2 hands, I've been relying on bottle proppers to help me out. These are like my new best friends these little wonderous creations. A friend of mine who also has twins suggested them to me - she called them a "lifesaver" - so I figured from one twin mom to another, it was worth the $14.95. All I can say is thank you Deana!! When the girls are double teaming me, screaming like they weren't fed 3 hours prior and may never get fed again - I just sit them each on either side of me on their boppies and set them up with these bottle proppers. I watch them to make sure that they don't choke up - and I pick them up for a quick burp as needed - but then I put them right back down and watch the forumla disappear right before my very eyes. Deana, you are correct, these things are lifesavers! I recommend them to twin moms everywhere! I don't use them all the time, because I enjoy the bonding that goes along with holding them close while feeding them - but when the situation calls for it, these things are a dream come true for my ear drums!

In other very exciting news, the girls have slept through the night 3 times in the past week! Not three consecutive nights, but three nights nonetheless. We've been feeding them at 11pm and giving them a few extra ccs to try to fill their tummies to hold them over through the night - sometimes it works and sometimes it doesn't - but it's a start. On three nights we've had 6-7 hour stretches of sleep overnight! WOOHOO!! I forgot what it was like to sleep at night! It's quite refreshing!

Don't get me wrong, there is still some stirring here and there requiring me to reach over into the bassinet and put the binkies in the their mouths, but nothing that requires me to actually get up. They probably won't be on the apnea monitors much longer. The monitor company came to the house yesterday to download the memory off the monitors and they'll send that info to the apnea clinic - once the clinic gets that info I'm guessing I'll get the call that they can come off the monitors because they really haven't had many episodes lately - and the ones that they have had, I don't believe they were true events. So while I still have the security blanket of the apnea monitors, we're going to finally make the transition to the nursery. So tonight is that night. Wish us luck! By the way, Melia says Hi! ;-)

I'll knock on wood before I start this update....

Okay, now I'm ready. It looks like we've found each of the girls magic formulas. Maddie has been doing excellent on the prescription formula for a couple weeks now and Melia's tummy seems to like the Alimentum - and in keeping with the good news, even though Alimentum isn't a prescription formula, it's considered a speciality formula and is covered by my insurance! This is great news considering that it costs $27/can! So now I can get it delivered to my doorstep for about $15 for a case of 6 cans! Melia is demanding more and more formula on a regular basis now. She's up to 100ccs, which is just under 4oz and there are certain feedings that's not satisfying her, so we have to giver her an extra 20-30ccs to calm her down. Maddie is up to 90ccs, not that she's asking for that much - but to keep her weight moving in the right direction, we're forcing it on her. We increase her feedings by 10ccs at the beginning of every week and it seems to be keeping things on track.


We had our first big outing without the girls over the long weekend. Most people leave their kids for maybe 2-3 hours for the first time - maybe hit dinner and a movie - not us, we go for the gusto with a 12 hour stretch and require babysitters in shifts! We always get season tickets to the Rutgers football games and Labor Day was game 1. It was a 4pm kickoff, but we made it an all day event and began our tailgate at 9am - this means we had to leave the house by 8am. So Mike's mom was on the first shift and arrived at our house at 7:30am - then my dad and Rosie came at noon to relieve Mary Lou and they had the girls until we got home at about 8pm. It was a long day for me without the girls. I thought of them often, but resisted the urge to constantly call the house to check in. I knew they were in good hands and figured I'd get a call if something was wrong. So I checked in via text message once per shift - and of course, everything was just fine. I had a great time at the tailgate. It was a day of much needed adult time - but I missed them so much!


While we were out we got a chance to hang out with a lot of our friends - some of which we see on a regular basis and others that we haven't seen since before the girls were born. One question always comes up - "do you feel different?" - Mike always says that having children was the one thing that made him feel "different" - getting engaged didn't make him feel different, getting married didn't make him feel different, buying a house didn't make him feel different - but having kids is that one landmark of his adult life that makes him feel different. I'd have to say that I agree. Having children has made everything come full circle. Having children changes everything and of course, it's a different experience - June 5, 2009 definitely marks the day that things changed . Do I feel different? Yes, I guess I do. I'm still the same person, but my children have made me an enhanced version of myself. My children make me better.

Okay, I may have gone too far....

We had a bbq to go to today and I was so excited about a new dress that the girls received as a gift - I wanted them - no, in my mind, I NEEDED them to wear this dress today. It's super cute and very summery. Today would be the last possible day for them to wear such a dress - it was a gorgeous day - perfect weather for this adorable litte dress - so they just had to wear these dresses today or they'd probably never wear them. So I put them on this afternoon as I'm getting the girls ready to go and I realize that the sleeves (which are spaghetti strap) are too long, so it makes the dress too big. I put an undershirt underneath it, but it took away from the look of the dress. I stood over Melia on the changing table and thought 'if only these sleeves were shorter it would fit perfectly' - then I thought, 'wait, I can totally make them shorter' - and yes, I did, I busted out my sewing kit (which had dust on it and I'm surprised I even knew where it was) and I stood there, running late as it was, sewing four little spaghetti straps to a lower part of the back of the dress to make the sleeves shorter. It worked like a charm, but here's the kicker...we get to the bbq at just after 3pm and at about 3:15pm, the sun went in and was never to be seen or heard from for the rest of the afternoon. It got chilly by 3:30pm and by 3:45pm the girls had their blankets drapped over them and tucked in all around them. About 3 people actually saw the girls in their cute little freshly strap-shortened dresses - and the rest of the time they were completely covered. Haha. It figures!

Oh, and while I was so consumed in sewing these straps, I forgot about the new nipples that I was sterilizing in boiling water downstairs. I had just bought these nipples in the morning - and now, they were half melted and burnt because I boiled them so long that the water evaporated from the pot they were boiling in. I knew I should've just stuck them in the microwave sterilizer! Haha. What a mess! All for my obsession with dressing the girls in this particular dress that no one saw anyway! So, this blog will make everyone see the dress! ;-)

Oh well! They looked adorable while it lasted - and it was worth all the effort! :-)

 **top left picture is Maddie - middle right picture is Melia**
**bottom center - Maddie is on the left and Melia is on the right**
***check out more pictures in the post just before this one***

PICTURES

Maddie in her little bee jammers

Maddie on the left - Lia on the right

Uh oh, looks like Lia is getting hungry - she's gonna eat her sister!

Maddie just hanging out...

Lia checking out the mobile on the swing and just hanging out

Maddie on the left - Lia on the right

The girls sporting their personalized shirts that a friend of mine from work made for them...

I LOVE these shirts! Thanks Dana!!

And this is what I like to call a Maddie face!

Maddie says, "Mommy please quit it with the picture taking!!"

Melia says, "Happy Labor Day Everyone!"

So, where did I leave off?

I know it's been over a week since I've blogged. It was a crazy one with multiple doctors appointments and Mike working almost everyday, picking up landscaping shifts for extra money - so as far as down-time is concerned, there's been little to none.


The girls had their follow up appointment with the gastroenterologist on Tuesday. It was a pretty simple appointment since we've had great success with combatting Madison's acid reflux with her prescription formula (which I can't remember if I mentioned it already, but my insurance is paying 90% of!! phew!) and a small increase in her Pepcid. She's like a totally different baby. She still has her moments, but it's nothing compared to what it was. She'll have maybe one "episode" per day where she chokes up and really struggles with it - and she has maybe one feeding per day that we have trouble getting her to take. She's still spitting up a bit, but it's basically a normal baby spit-up type thing - she's not giving back her whole bottle like she was before. And it's showing in her weight gain - at her previous appointment with Dr. Sunaryo she weighed 5lbs 11oz, and on Tuesday, 10 days later, she weighed 6lbs 10oz!! She gained almost a full pound in 10 days! Dr. Sunaryo was very pleased with this weight gain - and finally, so am I! Just today did I look at Maddie and really notice, saying to myself how big she looks and how nicely she's filling out. It's always been hard to notice her weight gain because next to Melia she looks so small, but I think she has a fighting chance to catch up now! Melia started to spit up more and more throughout last weekend. So I asked Dr. Sunaryo if maybe it was time to switch her formula. She was still on the formula for premature babies, and now that she's over full term, I was wondering if she needed something different. Dr. Sunaryo was reluctant to change her formula without me speaking to Dr. Kamtorn, especially since he wasn't sure that a formula change was really necessary since Melia had a nice weight gain herself over the past 10 days - weighing in at 8lbs 10oz. When I got home I called Dr. Kamtorn's office and spoke to the clinical coordinator of the follow up program. She suggested either Alimentum or Nestle Good Start for Melia. The Alimentum is the $27/can stuff that Madison was on for about a day and a half but hated and was then switched to the prescription formula. I still had some Alimentum left over from Maddie, so I decided to give it a try and sure enough, it's working like a charm. Today I went out and bought the Nestle Good Start. I'm going to try that over the next couple days and I'm hoping that it works as well as the Alimentum for her because it's half the price of the Alimentum. So, time will tell.


On Friday the girls had their first round of immunizations - three shots each, two in one leg and one in the other. One word - HEARTBREAKING! I held Maddie while she got her shots and Mike held Melia for her's. Madison's painful scream threw me right over the edge and as hard as I tried to hold it in, I just couldn't. There I was in the exam room with tears rolling down my face - trying to comfort Madison when I couldn't even comfort myself. Me, Maddie and Lia - three little babies crying in the doctor's office. I knew I'd be sad watching the girls get their shots, but I thought that I'd handle it a little better than I did -  having seen all that I had while they were in the NICU. But I guess the bottom line is that it doesn't matter how many times I've seen it - any time I see the girls in pain, it will effect me.

On Monday I'll be leaving the girls all day to enjoy some time with my friends at the Rutgers opening football game. I haven't left the girls since they've been home (with the exception of leaving Melia for a couple hours when I had to pick up Maddie from the hospital). So we'll see just how much I can enjoy myself. I know they'll be in good hands, being watched by Mike's mom in the morning and my dad in the afternoon, but it's still hard to leave them for a full day and not be there for every little thing they do. And to think, I'm just talking about going away for one day - imagine what a basketcase I'll be when it's time to go back to work!

**Noteable landmarks for the week - Maddie is over 6lbs and Melia is over 8lbs! Madison is officially out of preemie clothes and Melia is officially out of newborn diapers. Both girls are now taking their bottles with stage 2 nipples.

**Notable manipulation for the week - In this story, Maddie manipulates mommy. So Maddie was having one of those days where she just wasn't happy unless she was being held. She had recently pooped so I knew she wasn't constipated - she had eaten about an hour ago so I knew she wasn't hungry - her diaper had just been changed so I knew she didn't need a new diaper. She was just being plain old fussy for no good reason. I put her in the boppy - hysterical. I put her in the bouncer chair with the fun vibrating seat - hysterical. I put her in the swing which is usually great for calming her inner beast - hysterical. She just wouldn't stop. I knew what the problem was - she just wanted to be held. Meanwhile, I was in the middle of cleaning out the garage. I was having one of those motivated moments and I really didn't want to let the moment pass. So I caved. I grabbed the baby carrier, or as I like to call it, the snuggly, and I strapped it on. So here I am with Madison literally strapped to my chest, and the second I strapped her in, she stopped crying. So I went back into the garage and continued my cleaning. Within minutes Maddie was sleeping. Meanwhile, I'm moving like crazy - breaking styrofoam, breaking down boxes, you name it - full garage clean out with this little 6lb baby strapped to me, sound asleep. She totally manipulated me into holding her. I turned to her and told her not to get used to this because I don't plan on making a habit of strapping her to me in order to get my household chores done - for one moment she opened her eyes, just to roll them at me and go back to sleep. This kids knows she has me wrapped around her finger. This is going to be a problem. Haha.

**Notable bad timing story - Melia is good for either not pooping when you want her to, or pooping when you don't want her to. On Tuesday I was supposed to bring stool samples in to Dr. Sunaryo. Of course, I forgot about this until Monday night. Luckily, Madison made her poops in the wee hours of Tuesday morning. Meanwhile, Melia hadn't pooped since early Monday morning and we had no idea when she'd poop again. I tried to stimulate her to go and she just wouldn't. So we went to Dr. Sunaryo without her sample. So he gave me a stool sample test card to bring home and then I had to put her poop on this card and mail it to the doctor. How gross! So of course, she pooped on Tuesday afternoon when we got home from the doctor. That was the last time she pooped all week. She pooped on Tuesday afternoon and didn't poop again until, you guessed it, Friday afternoon - at the pediatrician's office. She didn't poop for days - so why wouldn't she finally poop and put 3 days worth of poop in her diaper while we're in the middle of the pediatrician's waiting room?? Haha. Gotta love it.

***new pictures to follow***

Sleep is for wimps...

The girls went to the opthamologist yesterday. Mike was working so I was flying solo for this appointment. I tried to get an appointment on a day when Mike would be home, but with the doctor's vacation and hospital schedule, we just couldn't work it out. They were supposed to be seen by this doctor the week after they were discharge from the hospital, and now it's week 4 - so I had to take what I could get. And of course, the only appointment that they had available was at 11am - feeding time - so, I adjusted their schedules in the morning so I'd be feeding them an hour later - I fed them at 5:30am instead of 5am and then bumped it further for the next feeding, feeding them at 9am rather than 8am - this way they wouldn't be due to eat until noon. So after I fed them at 9am, I packed them up and got them to the doctor. Of course, the second that I get Lia into her car seat, she pooped - so I had to take her upstairs and change her. Every time I wiped her, more and more poop came out - it was never ending. Finally she's done and I get them in the car. Lia, having just ate and pooped, was in her glory - she went right to sleep. Maddie was awake and alert - and being cute. I watched her in the mirror on the way to the doctors office and she was just looking around, playing with her feet, being super cute. I get to the parking lot, strap them into the stroller and we're off to the office. The second that we enter the doctors office, Maddie starts to lose her mind. Mad Maddie has entered the building people - stand back! She's letting the entire hospital know that she's there! Then, the doctor comes out and says that he wants to put the drops in their eyes now because it takes about 10 mintues to set in (they were having their eyes dilated). So now they're having their eyes held open and having drops put in - in the middle of the waiting room - this didn't go well. So now they're both screaming. But Lia, being the laid back chick that she is, stopped crying almost immediately after it was over. Sir Scream-a-Lot on the other hand (a new nickname for Maddie), was not so easily settled - these drops awoke her inner beast in a whole new way. So I took her out of her car seat to console her. The only way to console her is for me to rock and swing her to an oblivion - so here I am in the middle of this waiting room doing just that. She finally calms down - thankfully Lia is just hanging out not making a peep. When it was time to bring the girls into the exam room, the doctor actually came out and wheeled the stroller into the room so that I wouldn't have to put Maddie down - I guess he was tired of the screams - haha. So we get into the exam room and the doctor starts with Maddie since I'm already holding her. Long story short, Maddie is not a fan of having people hold her eyes open and flash lights in them. But, the good news is - her eyes are complete, all the blood vessels are intact and she doesn't show any signs of vision problems! When she was done I had to put her down and of course, she continued to scream. As I was getting Lia out of her car seat, the doctor was trying to get Maddie to take her binky but she wouldn't take it. He just looked at me and said "she won't even stop with a pacifier" - to which I said, "there's no pacifying this kid - we're just going to have to get through Melia's exam with her screaming in the background - I'm used to it doc, it doesn't bother me if it doesn't bother you" - to which he said "oh, I make babies and kids cry every day, so I'm fine with it" - haha - so that was that - we left Maddie to work out her frustrations and we moved on to Melia. Melia didn't cry once through the entire exam. She's sooooo relaxed this kid. And just like her sister, her eyes were looking perfect - complete and no signs of vision problems! So they don't have to go back to the eye doctor - woohoo! Madison calmed down as we strolled back to the car. I really have no idea what her deal was. Apparently she just hated that office because as soon as walked out, she was fine. I guess she just wanted to make a public performance - how awesome!

So we got home and the afternoon was smooth. I got the girls back on their regular feeding schedule and all was well. Then, at about 7pm - the inner beast was awoken again. Maddie screamed almost non-stop from the hours of 7pm to about 3am. She would stop screaming for a while if I stood up and did the rock/swing move - but the second I sat down she'd cry,even if I continued to rock while sitting. Her comfort apparently depends on my discomfort - more awesomeness! Haha.  But, she had to be put down when I had to feed Melia, so I swaddled her, positioned her on her side (which she prefers over laying on her back) and put her in the swing - I set that bad boy on the highest setting it had and had it swing her until it could swing no more. Eventually, she calmed down and went to sleep - but only for a little while. This routine of either me rocking/swinging her or her being swaddled and swinging in the swing went on for hours. I'd say in an 8 hour period there was about 2 hours of intermittent silence and 1/2 hour of sleep for mommy - and that may be an over-estimation. What made her evenutally stop screaming you ask? She pooped. Since the girls have been off of breast milk and on new formulas I've been keeping track of how often both girls are pooping to make sure that they don't get constipated, and they've both gone from pooping 5-8 times per day to pooping maybe once per day. I knew that Maddie hadn't pooped since late Tuesday night, so I figured that her behavior may have been a result of a bit of constipation - and I guess it was.  So that's something that I need to keep an eye on in the coming days. According to the pediatrician, constipation is only a concern if they haven't pooped in 3 days. THREE DAYS??? She was this upset after not pooping for about 36 hours - I can't even imagine what would happen if she didn't poop for 3 days! I'll talk to the doctor more about this at their appointment next week - unless of course we have a recurring issue with this before then, in that case, the doctor better either let me give her a suppository - or he better come to my house and babysit! ;-P

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Noteable landmark - I think that Maddie has come around and make actually not hate bathtime anymore either. I'm not saying that she likes it - but she didn't scream through it on Tuesday night, so I'll take it.


Noteable Mommy and Daddy exchange - So Mike was working last night and as I've already mentioned, Maddie was in rare form just about all night. So when he got home it was time for me to tag out and go take a nap. I woke up at about 10:30am and Mike had the girls already dressed. Lia was wearing a pink & brown polka dot pants outfit and Maddie was wearing a little yellow dress with an undershirt underneath. At this stage of the game, I'm still having fun dressing the girls alike. I know, I know...they need to have their own identities, blah blah....I'll stop doing this as they get older, but for now, I think it's cute. Even if it's not the same outfit, but different outfits that coordinate with each other, I like that just as much. So anyway, here's what happened...


Mommy: Oh, you got the girls dressed already...great! Thanks.
Daddy: No problem.
Mommy: Why didn't you put them in the same outfit?
Daddy: Because I dressed Lia first and Maddie doesn't fit into that outfit yet - it's too big on her.
Mommy: No it's not, it's just a little loose on her, it would be fine.
Daddy: Your idea of 'a little loose' isn't so accurate.
Mommy: What is that supposed to mean?
Daddy: You're so obsessed with having them dress alike that you make Maddie look ridiculous in some of the outfits you put her in.
Mommy: I DO NOT!! Okay, so one pajama outfit that I put her in was stretching it, I admit that - but other than that, I don't make her look ridiculous.
Daddy: Yeah, you do. I'd rather have her in clothes that fit than clothes that look alike.
Mommy: Oh, so you'd rather her in ridiculous colors that don't match.
Daddy: What do you mean?
Mommy: She's wearing a YELLOW dress with a PINK undershirt!
Daddy: What? Pink and yellow match!
Mommy: WOW!
HAHAHAHAHAH! More fun conversations in the Marcino household. So I dress my kid in oversized clothes like a clown and Mike is colorblind. Good times. :-)

Could it be?

I don't want to jinx it, but this special formula may have done the trick! Madison has been on this new formula for just over 24 hours now and there has been a huge difference! She's still spitting up a bit, but it's nothing compared to what it was - and more importantly, she hasn't been crying in pain! So, I called the medical supply company that will deliver the formula to us and I set up an order for a case of the good stuff (a case being 6 cans which will probably only last about a month or so). They'll contact my insurance company to see how much of it they will cover.

Between Mike working on Saturday night and me having to do all of the night-time feedings solo, and then Madison being up all night on Sunday, I went to bed at 7pm last night and woke up early this morning to do the 5am and 8am feedings - then I took a nap from 9:30am - noon today. I finally feel rested. Just in time for Mike to go back to work tomorrow.


Tomorrow the girls have their follow up eye exams with the pediatric opthamologist. They are full term now gestationally, so their eyes should be complete. Another day, another doctor's appointment! Just when I thought I had a week without an appointment, I remembered that we had this appointment scheduled. Next week we have their follow up with Dr. Sunaryo and they go to the pediatrician for their immunizations. Should be a fun upcoming week!

Boobs, Formula and Missing Pants

So I decided to stop pumping. I struggled with this decision for a while over the guilt that I felt by stopping, but I just had to do it. The pumping had become too much for me. There was no way for me to keep up with the supply that the girls were demanding, and as my surplus supply in the freezer wore down, I became more stressed out about how I was going to handle it all - and with the stress, my milk supply started to diminish even more. So, I made the decision to stop stressing myself out about it. I never wanted to pump. Had the girls been born full term, I wouldn't have. So when I made the decision to pump, because breast milk was the best thing for them while in the NICU, I made it my goal to pump until their due date and then I'd see where my head was at. Well, my due date hit and my head wanted to stop - so I did - and I felt (and still do feel) guilty about it - but to preserve what's left of my sanity, it had to be done. For all you breast feeding loving moms who are outraged that I stopped, don't worry, I was punished accordingly.  I'll say that the milk drying up process is probably the most painful thing I've ever gone through. I'd rather have another c-section than go through that again. My boobs were rock hard, enormous, distorted and throbbing in pain. My sister-in-law put frozen cabbage leafs on her breasts to relieve the pain when she went through it - I got to the point where I'd try anything. So I tried it, but couldn't keep doing it. Once the frozen cabbage leafs made contact with my boobs, they wilted from the heat of my breasts and before long, I was steaming cabbage in my bra. I'm not sure if the cabbage thing is just about putting something cold on your breasts to relieve the pain, or if cabbage itself has some magical power. Regardless, I did it until I couldn't stand my own stench anymore. I can still smell the cabbage on my skin. Gross.


In other news, we took the girls to the pediatric gastroenterologist, Dr. Sunaryo, on Friday to try to get some answers and help with their reflux issues. He listened to my description of their symptoms, then he listened to their chests and tested their stool. After I listed all of Madison's symptoms he was convinced that she did in fact have acid reflux. Once he listened to her chest, he confirmed it. He stated that she may require a stronger medication than the Pepcid that she's already on, but before giving her a stronger medication, he wanted to try some food changes and an increase of the Pepcid. We discussed formula options since the milk that I had stored in the freezer would only last another few days and I had stopped pumping the day prior. He suggested Alimentum, a hypoallergenic formula for babies with colic, food allergies and sensitive stomachs. Melia's issues were of little concern. She spits up and gets irritated after a feeding only here and there. I told the doctor that I couldn't say for certain if Melia even really had reflux or if somethng that I was eating and she was getting through my breast milk was bothering her stomach, since her symptoms seemed so sporatic. Dr. Sunaryo listened to her chest and stated that she does have some level of reflux, but it clearly wasn't as bad as Madison's. He prescribed Pepcid for Melia and said that the formula that I have been using to supplement my breast milk, Neosure, was probably good for her to stay on. He also tested both of the girls stools for traces of blood and they both did have trace amounts of blood in their stool. This could be from the acid reflux irritating their stomachs or it could be an indication of a food allergy, mainly an allergy to dairy or milk-based proteins, which would be found in breast milk regardless of what I was eating. If they are in fact allergic to dairy, then my diet would definitely have an effect on them. I wasn't avoiding dairy by any means. I'd eat cereal in the morning, snack on string cheese during the day, often have dinner that included cheese somewhere in there and sometimes top dinner off with a bowl of ice cream for dessert. So yeah, there was no shortage of dairy in my diet. So as it turns out, changing from breast milk to formula is probably the better thing for them at this point and Dr. Sunaryo told me to start the girls on formula right away and not to use what I had left in the freezer. We were sent home with a new food plan for the girls, Pepcid increase for Maddie and starting it for Melia, and a follow up appointment in 10 days to check their stools again and see where they stand with their reflux symptoms.


On our way home we stopped to get some Alimentum for Maddie. One can of the powdered formula, not even the pre-made stuff, was $27! Wow. I calculated that this would last about 6 days while Maddie is taking only 70mls (a little more than 2 ounces) every 3 hours. Once her feedings get increased to 4, 6, and 8 ounces, we're screwed! But, we gotta do what we gotta do. So we get home and start Maddie up on the Alimentum immediately. We gave her the Alimentum for approximately 12 feedings, about a day and a half. Her feedings got progressively slower, taking upwards of 45 minutes (after 30 minutes, she begins to burn more calories than she is taking in, so a 45 minute feeding takes more from her than she gets out of it). She was refusing to take her bottle and when she would, she'd spit most of it out as she was eating. Taking all of her bottles in full is very important for Madison because we're trying to boost her weight. Late Saturday night, after having to syringe half of her feeding into her mouth because she wouldn't accept the bottle, I said enough is enough. For the next feeding I switched her to the Neosure that Melia is on and she took that bottle in 10 minutes flat - like she was starving! I felt so bad. Here I was giving her this special formula, trying to make things better for her, and it only made things worse. So yesterday and last night she took all of her feedings without a problem - but from 2am on, the aftermath from the feedings were something awful. I was up all night with her, trying to console her. She was screaming and vommiting all night long, with vomit coming out of her nose and everything. It was so sad and so hard to witness her in so much pain. And all last night and this morning it seemed that everytime we had her calmed down after a feeding, it was just about time for the next feeding - and the cycle would start back up all over again. Last night was the worst I've seen her since the first days that she was home. So this morning I called Dr. Sunaryo and he was torn as to whether to just start Maddie on the stronger acid reflux medication, or to try another formula. He decided to try another formala - this time, an even more expensive formula, Elecare, which costs about $65 per can, but can be purchased through and paid for by my insurance. PHEW! It's a partially digested formula which is pre-digested and broken down so much that it's much easier on the stomach. I called one of the social workers from the NICU and she said that they had a can of this formula on hand that they could give me as a sample so I could try it right away and see if she will tolerate it before I order it through my insurance company. So this afternoon I went to the hospital to pick up this new formula and we tried it out for the first time during her 2pm feeding. She took it, but reluctantly - and she was actually pretty good afterwards. The 5pm feeding took a lot of effort to get down, but finally, she took it. She spit some of it up, but she seems to be doing a little bit better than she was doing with the Alimentum, so we'll see what happens as the night goes on. If the night doesn't go well, I'll call Dr. Sunaryo in the morning and see what the next plan of action is. In the meantime, watching Madison go through all this while we find the magic potion of food and medicine for her is pain-staking. 

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**Notable landmark for the weekend - Melia finally took a bath on Saturday night (8/22/09) without screaming through the whole thing. She actually looked like she semi-enjoyed it!


**Notable Mommy and Daddy exchange for the day - here's a recap of a conversation had by me and Mike today. I went to the hospital to get Maddie's new formula and Mike stayed home with the girls. When I got home, it was feeding time. So I picked up Madison and noticed that she was in a onesie with no pants on. This is what happened:


Me: Where are Madison's pants?
Mike: What do you mean?
Me: Oh, they're here - underneath her. Why are Madison's pants off? What happens here when I'm not around?
Mike: I have no idea how her pants came off...she must've taken them off herself.


HAHAHAHAHAHA! I can't stop laughing even as I type this. Mike doesn't think it's so funny - he said that I'm over-tired and delerious, but seriously - my husband just told me that my 11 week old daughter who can barely move somehow managed to take her pants off. That's pretty awesome.