Sunday, January 31, 2010

Typing with a baby on my lap...

Once again, we have been told that Tzelia is coming home.  At this point, I'm not going to believe it until we actually walk into the house with her (and even then, I'll probably be waiting for them to call me to have her returned to the NICU....). The five-day-spell-free period will end, and unless something happened last night (or tonight), she'll be ours after her eye appointment tomorrow.

And the hospital NICU drama will be over.  I'm actually not that excited yet...probably because we've already been told twice before that she'll be coming home, only to have that retracted.  So we'll see...

Our other big concern right now:  Meorah's reflux.  Her reflux has actually gotten a bit worse, in my opinion.  When we lay her down, regardless of how long ago her feeding was, about half the time she will immediately reflux:  milk will come out of her nose and her mouth will get foamy.  She will be in obvious discomfort, and it is very hard to see.  We started putting her more upright in her car bed (car seat for preemies that can lay flat and be at an incline) and that works a little bit, but is not a cure-all.  Unfortunately, she is most comfortable on her stomach, which is pretty typical for reflux.  But, due to SIDS risk, she can't be on her tummy to sleep.  It is somewhat interesting:  the sleeping recommendations for preemies sometime actually recommend tummy-sleeping due to reflux despite the SIDS risk.  It seems to depend on the pediatrician.  I am not comfortable with that, though, and Jason and I were chatting about looking into getting an apnea monitor for the house.  It is possible that our insurance would pay for one, so I will chat with our pediatrician at the appointment next week and see if we can get a prescription for two (one for each).  If that isn't an option, there is a commercially available monitor/pad that detects lack of movement and sets of an alarm after 25 seconds of no movement.  I've seen other preemie mommies with them and the reviews are pretty decent.  But if we can get a real one,I would prefer that.

Personally, things are ok.  We were invited to a house-warming today, and since we can't bring Meorah out in public until April (!!!!!), we tag-teamed so we could both go.  I went alone while Zev was napping, and Jason left with Zev when I came back.  It was very nice to get out of the house and (gasp) be a little social for once.  I feel like I don't have much going on in my life right now, and feel a bit 'boring'...while I have a lot of drama going on, it is all 'baby' drama, which is actually pretty boring.  I'm not going anywhere or really 'doing' anything, and barely have time to read or watch the news.  Hence my day-to-day life is pretty...well...boring.  So being out of the house and doing something fun is a nice change.  I do still get a lot of shocked looks when people see me out of the house; I've been antisocial since October due to the bed rest and now with the girls keeping me home/hospital.  Once the girls are here for a bit, I look forward to having people over again and having more social time/being more up-to-date on how friends are doing.

I also look forward to starting up my hobbies again.  I did start visiting the gym again, and am horrified at how weak I've become in the last four months.  Not surprising of course, but disappointing.  I really do want to try to figure out a good lifting schedule, but will probably have to wait until I have a better idea as to how the weeks are going to go.  Prior to pregnancy, I was going at least 4x/week for lifting, and usually another 1 or 2 for some intervals.  I have no delusions of doing such a thing again (and don't really want to), but I would like to make it in to lift 3x/week for a full-body.  The intervals:  nah.  What I would love to do at some point is take up boxing, but I'm not sure I'd be able to fit that in.  We'll have to see.  Being active keeps me mentally healthy, so it is a high priority for me.  We'll just have to see how it will all come together...

Thursday, January 28, 2010

Zev and Meorah

Everyone keeps asking me:  how is Zev coping with Meorah coming home?

I admit I had initially been worried about that.  How would he react from having 100% of his parents' attention to suddenly having a newcomer (or two) in the house?  I knew he was a very laid back boy, and generally a very happy child, but it was still going to be a big adjustment for him.

Surprise, surprise...he's great with her.  When one of us is holding her, he will come over and say softly, "Hi Moreah".  Note to self:  should have picked a name that was easily pronounceable to a 2-year old.  He will try to bring her a bottle or her pacifier, and when he hears her he will say 'Moreah crying'.  This morning as he was leaving with Nicole, he stopped by her basinet and said quietly 'See you later Moreah'.  It was adorable and very touching, actually.  I guess really shouldn't be surprised:  he's always been such an easy boy.  No signs of jealousy, no real problems.  Just typical 2 year old control-battles that are part of raising a very very active and high-energy boy.

He has been amazing me.  He knows all his letters already and he only just turned 2 the other week.  He also has this inbred fascination with anything with buttons, and can tell if something is electronic:  he will bring it over to me and ask me to 'fix it' if he can't turn it on or the batteries are missing.  Even a toy that I had no idea even HAD batteries.

Tzelia is still in the NICU following a random apnea episode that happened the other night.  Since the rule is five days of no spells...that re-set the clock to zero.  Earliest she can come home is Monday.  But, on the positive side, her feedings are going much better now.  I brought Meorah to see her yesterday and Jason took a picture of the two of them on his iPhone:

It looks like Meorah is smiling.  I'd like to think she is.

I had my post-partum appointment yesterday.  I was finally cleared to 'resume all activity'.  Part of the post-partum appointment is to talk about birth control.  I'm not a fan of hormonal birth control (I have too many hormonal issues as it is), so I did tell him the pill wasn't going to be an option.  And then I got the chat about future pregnancies:

High-risk OB:  "If you plan on having another pregnancy..."
Interrupted by laughter on my part
High-risk OB: "Well, should you become pregnant, you have to call me"
Me: "I figured I would automatically be a high-risk pregnancy"
High-risk OB with a dead-pan serious expression:  "Yes, you need to CALL ME so we can be sure to do something different next time"

Not that I'm jumping to have another baby, but it does make me sad that I probably will not.  (I know my husband reads this, and lets just say his response is:  If you have another baby, it isn't going to be mine).  I like being pregnant (yes, despite my bitching, I actually do), and I enjoy my babies and my son.  But three is probably enough.

Of course, in two years I may be singing another tune.  But then, my bank account will probably convince me otherwise.  Unless we move to bo-dunk no-where, ain't no way....  love living in Boston for all it has to offer...but everything it offers is uber $$$...

Monday, January 25, 2010

Sprinting in the rain

If anyone was on Longwood Avenue this afternoon and saw a crazy lady sprinting down the road in the rain pushing a stroller with a blanket over it...well, that was me.  Of course just as I was heading out to the pediatrician this morning, it started to rain.  I only parked a block or two away, but it down-poured just as I stepped out of the garage.  Ugh.  Of course.

I haven't had a chance to update.  Busy busy busy busy.  I keep meaning to write, but just as I sit...well, damn I just get so tired.  But I do want to try to remember what is going on before my brain really does turn to sleep-deprived mush.

First, Tzelia:  Still in the hospital.  Her reflux is continuing.  They tried switching her to Prilosec, but were less than impressed with the results.  So they also tried thickening her milk with some rice cereal.  Again, the results were not impressive; she continues to have reflux and spells of brady and apnea.  So today she was scheduled for a swallowing study.  I do not have the results yet, but I hope that they are able to find out what is going on.  Swallowing difficulties (and reflux) are not uncommon in preemies, so this isn't too surprising.  I just hope they are able to figure out a way to make it easier for her to eat.  At least she is not on the NG anymore.

Jason and I still try to make it a point to see her daily.  He went back to work this week, so it is a bit easier for him, simply because he is next door.  Granted he is actually 'working', but it is good that he is just a page away should one of us need to go over there.

Meorah:  still home, and we just got back from her pediatric appointment.  She had not gained weight between the first two appointments, but luckily this time she gained 3 ounces and is now 4 lbs 12 oz.  She had been eating better the last few days, and it obviously showed on the scale.  However, yesterday and today her reflux was pretty bad:  not swallowing, showing a lot of pain while she was eating, and not eating a lot at once.  It was painful to watch.  Her pedi decided to up her Zantac dosage, and hopefully that will help her.  She also has had some blood in her diaper and we found another anal fissure, poor thing.  Pain going in, and pain going out...

Zev:  typical 2 year old.  He is starting to press our boundaries, which is probably a combination of being 2 and adjusting to the new home dynamic.  My favorite example so far:  his play computer is sitting on the floor upside down and he is standing on it.

Sarah:  Zev, you shouldn't stand on your computer or you will break it.  Please put it on the table.
Zev:  No table.
Sarah picks it up and puts it on the table.
Zev takes it off the table, turns it upside down, and stands on it again.


He is funny though.  The other night we were telling him he had to go to bed.  Desperate to do anything BUT go to bed, he yelled 'Stop and Shop!!  Stop and Shop!!'  Guess grocery shopping beats going to bed.

I took him to an indoor playground yesterday, just me and him.  I forget how young he is until I see him around other children.  We had a good time, although I was pretty exhausted.  He found every toy that had a button to push and wanted me to 'fix it' (most of the toys were lacking batteries and were 'broken').  And had to point out all the lights that were 'broken' and 'need new light-bulb'.  Very attentive boy.  And (just to brag), we spent some time on his play computer (step-stool) and I have to admit to being pretty impressed that a 2 year old knows all his letters already...

Jason:  started work this week so he could 'save' a week for when both girls are home.  I'm hoping he isn't so exhausted that it becomes torture....  I feel bad that he has to get up in the middle of the night for the feedings now.  Not that I can sleep in either, but at least I don't have to work yet.  Well, I DO work/do things at home, but it ain't trying to cure people from cancer...

Me:  Still tired.  Ulcer still acting up.  My PCP wants to see me in the next week or two.  I'm on Prilosec twice a day and still have pretty bad periods depending on the day.  I'm having a hard time taking a break (big surprise).  Even when I'm home like today, I feel like there are so many things that need to get done while I have the chance...things around the house, people who need to be called, appointments that need to be made/gone to, babies that require attention...

Speaking of which.....

Thursday, January 21, 2010

Still hanging in there

Tzelia had a bit of a set-back the other day.  It seems she has been regressing since Meorah left and ended up needing the NG placed again.  It was only for about two days, and she has it out again thankfully.  But it was so disappointing.  One step forward, one step back.

The nurses think her reflux has gotten worse, so they have prescribed her Prilosec.  Like mother, like daughter.  It will take a few days to work, so we will see if it improves her eating.  She is still sleepy and her O2 is still desaturating while she eats, and only when she eats.  Jason and I went over this morning with Meorah, and we did the double-duty feeding again.  We also think that she just misses us and the routine that we had had when Meorah was still in the hospital; it is too much of a coincidence that her symptoms became worse as soon as Meorah was discharged.  So, hopefully with both the Priolsec and with more consistent visiting/bf'ing, Tzelia will be home in about a week.

Meorah is doing great at home, though.  Eating like a champ.  But, it seems she didn't gain any weight since her pedi appointment a few days ago, so she will have another check-in next Monday.  No appointments until then, thank goodness.  We've been running around almost every day.

My stomach started up again on me today.  After we got back from the pedi, I was just overtaken by intense stomach pains.  Urg.  Its been on/off since then.  I'm going to update my PCP and see what she has to say.  I've been doubling the Prilosec, and while I am definitely better than I had been, I am also definitely not back to normal.  She said she could schedule an endoscopy for me, but I'd really rather not have to have that done...

So still in a holding pattern.  I updated my boss on the situation and told him I'd be back to work some time in mid-March.  He was fine with that and I have a meeting with him scheduled the first week of March to go over end of the year issues and goal-setting.  I am looking forward to going back to work...I still check my work email and see all of these meeting planned and wish I could go and see how things are going.  But soon enough...  I've got enough on my plate right now...

Here's to hoping that Tzelia comes home in the next week.  I think some of my stress is due to just waiting around and stressing about the hospital.  And, I find that I often have flashes of something wrong happening to Meorah now that she's home.  A left-over anxiety?  I don't know, but it really bothers me.  I don't remember feeling this much anxiety over Zev when he was an infant, but maybe I just blocked it out.  I think the NICU experience has just made me hyper-aware of all the bad things that could happen since I keep expecting to hear something....  a PTSD sort of thing.  I hope it goes away...

Tuesday, January 19, 2010

One is better than none

Shortly after I wrote that post, my husband called me and said Meorah was coming home.  Ha.

So now I have one baby at home and the other in the NICU.  Which I suppose has its pros/cons...we are slowly entering the pool rather than diving right in.

We just finished the second night with her.  The first day went quite well, although the actual pick-up was rather drama-filled...more insurance issues regarding the girls' medicines which needed to be picked up resulting in what should have been a 5-minute-errand turning into a 60 minute saga.  But, at least Zev had fun running up and down the aisles at CVS (no sweetie, you do not need a tongue scraper...and please give me back that lip gloss).

But we got her.  I do have to say, the minivan looks much MUCH smaller with three car seats in there.  It is going to be...interesting...when all five of us have to go somewhere.  Jason also ended up going out and getting another combo booster seat for our PT Cruiser for when someone (mainly Nicole right now) goes out with Zev in that car.  Yesterday, Nicole went off with Zev and Jason and I took Meorah to her pedi appointment for the initial visit.  Nothing horribly exciting there, although they do want us to come back on Thursday to pay close attention to her weight and make sure it continues to go up.  Today we have to take her to Mass Eye and Ear for her ROP appointment.  Wed we have the visiting nurse come in to see how things are going.  Busy busy busy.

So far, she is rather easy.  She is sticking to her 3 hour NICU schedule rather well.  There are a few instances where I have woken her up (which seems so contrary: never wake a sleeping baby!!!).  But the rules are different for her, and we want the two girls to be on the same schedule when Tzelia comes home.  The first night, I woke her at 12am, but she woke herself up at 3:03 and then 6:05.  Sometimes she gets up a bit early, but she is also getting more breastfeeding in, and that will go through her much faster (and has less calories than her fortifier).  Our routine right now:  during the day I try to bf her once or twice; we were doing it once in the NICU and I hesitate to do it more right now because she is still a bit weak and it takes more out of her to do so.  Plus, she needs the calories for the fortifier.  I pump after I feed her since she isn't taking that much from me.  Either Jason or I will bottle feed the rest of the day, but during the night Jason bottle feeds while I go and pump...I make a bottle for the 12am feed, and then at 12 am pump for the 3 am feed, at 3 am pump for the 6 am feed, etc.  We did the same thing with Zev, although we will obviously have to modify once Tzelia gets home.

Tzelia is doing ok, just still rather weak.  I visited her yesterday and she took a bottle from me, but with prodding.  She only gained 6 gms over night, and they like a minimum of 15 gms.  Slow, slow, slow.  End of the week, hopefully.  Jason only gets two weeks, so I really hope she comes home soon so he'll be here with both of them.  It was really hard leaving her in the NICU yesterday.  At least with her sister there, she wasn't alone.  I'm going to go back today, probably while Jason and Meorah are at Mass Eye and Ear (the two hospitals are next to each other).  I saw M and T's first ROP exam, and have no desire to see (or hear) it again.

Zev is doing fine.  I am now acutely aware of how loud he is.  Ha.  Luckily babies at this age can sleep through anything and he isn't bothering her.  I'm not going to ask him to be too quiet:  he is a growing boy and needs to run around and be himself.  But I admit to wincing when he yells...which he does a lot when he's happy.  He's a very verbal boy and generally doesn't stop talking, even if it is just repeating whatever sentences he knows ("humidifier upstairs...go back on", "don't touch the space heater; BURN YOU", "Zevy turned lights on", "Zevy funny", "Green means GO!!!", Zevy brush the teeth").  His way of making conversation, I guess.  Funny, though.

I'm more tired than I was before.  I suppose that isn't too surprising, but I wasn't expecting it.  I had already been sleep deprived with the pumping.  Now I'm still sleep deprived but also worrying/caring for one baby.  Will probably be worse with two.  The plan is to return to work in mid-March and I just hope I get into a good enough rhythm before then.  Feel worse for Jason who has to go back after next week....

Sunday, January 17, 2010

And I take that back...

Well, they're still in the NICU.  After all the last minute excitement and rushing around (and rescheduling Zev's birthday party), it was decided that the docs weren't quite as comfortable with the girls' ability to take all of their feeds orally.  They CAN do it, but it takes a lot of encouragement.  Tzelia specifically gets too tired and needs a lot of extra care.  Meorah just downs her feeds, but does have some reflux issues; both girls are now on Zantac for that.

So Jason spent the night with them last night to see how the feeds go.  I was going to go, but honestly the thought of yet another night in the hospital brought on some PTSD-like thoughts.  I felt/feel really badly about not going, although I know Jason has just as much right to go as I do.  I'm just the one with the boobies.  And, this way he gets used to the every-3-hours waking, which I've been doing for the last 6 weeks now.  We exchanged emails at 2am, and it sounded like things were going ok.  Hopefully the girls will be coming home in the next few days.

I am just ready for all of this to be over.  It was a bit of a teaser to be told that it was going to be this weekend, and then have it taken away.  Granted, having a few more days isn't all bad:  they will get their final ROP exam in the hospital rather than in a clinic after discharge (which will save a TON of time for us) and it may be that they will be discharged on the same day, which will also make things easier.  And we have a bit more time to get things ready for them.  But still...ugh.

Some pictures from yesterday when we visited, and the first ones of all five of us:

And after we left:

We did end up having a small party for Zev the night before:

Jason isn't home yet, but we'll see what the docs told him...

Friday, January 15, 2010

Its over


And they're coming home on Saturday.  Yikes.

I was expecting at least another week.  Its going to be a whirlwind day Friday.

We're very excited.  The only disappointing thing:  the timing.  We were having Zev's birthday party this weekend.  Obviously that has to be cancelled.  Instead, a quick dinner tonight with whomever can come by.  We felt way too bad to do nothing and just not do anything.  On his actual birthday we did go out to the Cheesecake Factory.  We told the waiter it was his birthday and we had them sing to him, and he blew out the candle on the strawberry shortcake we ordered him (that was the size of his entire body...the CF portions are just ridiculous).

So while we did celebrate just the three of us, the 'big' party was going to be on Sunday.  Bad timing.  While he won't know the difference, we will.  While it will not be the same, at least he'll get another cake and candle, and some people will be able to enjoy and have a good time.  I'd hate to start out their sibling relationship on a sour note:  "I had to cancel my birthday because of you!!"  In a way, it will be our last chance to enjoy him alone.  Which makes me cry.

He'll be a good big brother.  I know he will.  But I feel bad for him at the same time.  He has no idea what is coming.  I really really really really hope he'll be ok with everything.  It worries me.

And then the rush begins on Saturday.....  Oy.  Excited, nervous, scared...all these things.  It will be fine, but change is always difficult.  Even good ones......

Tuesday, January 12, 2010

Happy Birthday Zev

A day late, I know.

But Zev turned two yesterday.

Happy Birthday Little Man.

Sunday, January 10, 2010

I have twins?

When I found out I was having twins, I did a lot of 'googling' about twin pregnancies and parenting twins.  I read Dr. Luke's book, which is supposed to be the TEXT for twin pregnancy.  I also read various other books pertaining on how to survive that first year with twin babies.  I joined the National Organization of Mothers of Multiples Club, and even made it to one meeting before I was put on bed rest.  It was a good meeting:  the first hour was organized by child's age:  people were divided into different rooms depending upon the age of their twins, and each room had a moderator for discussions.  Since I was pregnant, I was in the 'expecting' room.  While interesting, I actually didn't get a lot of out of it:  everyone else in the room was a first time mom and had general pregnancy questions.

I knew how to be pregnant.  I even knew how to mother a singleton baby.  What I needed help with was how the heck to do it with two babies and a toddler.   So since then, my main concerns have been:

  1. How to tandem breastfeed two babies.  If I can't, I'll be feeding them all hours of the day
  2. How to get them on the same sleeping schedule.  Otherwise, mommy will not be sleeping at all
  3. How to help Zev with the transition.  Welcome Nicole:  a sense of stability for him and help for me.
  4. And most recently:  how parenting preemies differs from parenting typical newborns.  Still working on this one...
Despite the unfortunate circumstance of the NICU, there are some advantages.  The girls are already on a three hour schedule.  If we can keep them on that schedule, we would be very lucky.  And, despite the fact that I am exhausted having to go back and forth to the hospital and that I am getting up twice at night to pump...once they come home I will be even more tired.  I 'parent' them for only a few hours a day, and then leave them with a (very expensive) baby-sitter.  Most of the parenting is not done by me at this point.  So once they get home...things will be even more hectic.  Especially for Jason:  he's sleeping through the night right now.  That is going to change very shortly.

I was over at the hospital twice today:  once with Jason, Zev, and my father, and then a second time alone to do some feedings.  During that second time, I was with Tzelia who is now in a regular portable crib.  I think it was the fact that she was in the crib rather than the isolette:  it made her look more like a 'regular' baby (albeit very skinny and small).  And I thought:  "She's mine.  I really do have three children."  I haven't had that thought as vividly before since I have been leaving so much of their care to the is easy to forget that they are really mine.

And I actually started realizing that they will be coming home soon.  And got a little excited about that.

I've been too tired to really be 'excited' about much, as well as too anxious and worried about how things are going.  But now it seems that they will be coming home in the next few weeks and some of that anxiety is slipping away.  It will be replaced with a different type of anxiety once they are home (having preemies at home is a whole other anxious situation, especially in the winter time:  most parents end up isolating and severely limiting visitors due to the risk of flu and RSV), but the health-related anxieties are starting to fade.

And I'm trying to feel 'normal' again.  But it is very upsetting to always be in pain and not be able to do the things I'd like to do.  I do see my OB on Tuesday and I will see what he has to say.  My ulcer pain comes and goes:  unfortunately while I was with the girls last night, I had a horrible horrible bout of some kind of ulcer/acid attack and it hurt to breath or move.  Which made caring for them difficult.  But we still did ok with the feeding.  It is the last step in their returning home, so I'm trying to do my best to make myself as available as I can for them...  so back to the hospital I go...

Friday, January 8, 2010

Zev pictures

Still in open air cribs!  I admit that I was surprised.  But their temperatures continue to be adequate, so they are staying in the cribs.  In fact, their nurse yesterday said at this point, all they really need to do is learn to eat and they can go home.  It may be as early as two weeks (optimistic) or three (more realistic).  Obviously we want them to come home, but it means so much stuff needs to be done before then!  Most importantly:  I need to recover from this c-section!

I'm still in pain and did take a dilaudid last night before going to bed.  It still hurts.  My six week post-partum check-up is in two weeks, and I really hope I am pain-free by then.  If not, I do wonder what the OB will say.  I'll probably get another lecture on 'taking it easy'.  Ha.

My big concern at the moment:  Zev, and how this is going to affect  him.  Since he is such an easy-going kid (for a two year old), I am hoping he will be ok.  It is a good thing we have Nicole already:  that will give him some stability.  Jason will be home for two weeks as well, so he can spend time with Nicole and Jason and stick to his normal schedule while I try to figure out the girls' routine.  I'm hoping that if we can keep things as stable as possible for him, he will adapt better.

Since I haven't posted pictures of Zev recently:

Jason and Zev visiting Tzelia

Zev after his second favorite thing (the first being 'brush the teeth')

Zev and the 'scary' humidifier


Such a happy boy.  Granted, he has his moments right now.  God forbid you tell him 'no':  instant water-works.  Luckily, he can be distracted quickly and they do not last long.  He really is a special boy:  we're very blessed.

Thursday, January 7, 2010


Back on the dilaudid.

I guess I did a little too much activity the other day.  The girls' dresser came in, and I had been smart:  I ordered one that was already assembled.  However, it did come in a rather large box with lots of styrofoam and cardboard.  Since I really have been wanting to work on their room, I spent a good part of Tuesday evening breaking down the box and then putting away some clothes that I have for the girls.

(as a side-note:  they aren't even home yet and they have quite the wardrobe!  It seems like so much, but since I suppose it is for TWO babies, it isn't as much as it seems.  A lot of people have been lending me clothes, and I also bought a few things myself since not all of Zev's clothes were unisex 'enough' for me)

So that took awhile.  And I also had swept/mopped the floor while I was waiting for the dresser to arrive, organized our pyrex food containers, finished the laundry...  yes, a bit too much.  But honestly, I had been feeling bad that Jason was doing everything.  He inadvertently made me feel bad when we were driving home the other day and had asked me if I had finished the laundry (in a mis-communication, he had thought I was going to do it, while I hadn't actually said I would).  When I said I hadn't had the time, he said that excuse was meaningless to him (he himself has zero time).  Since I was already feeling bad, that made me feel even worse, hence the over-activty of the evening.  He had his own shit to do (unpack a completely different dresser for our TV accessories), and I didn't want him to have to do everything.  But lesson learned:  I was in much more surgery-related pain compared to other days, and I didn't want to take ibuprofen or another OTC that may hurt my stomach.  By the evening I was really hurting:  so I took some dilaudid and felt better.  It has worn off now, but I'm going to wait and see how the day progresses.  I'd prefer to only take it at night if I have to.

The girls:  both are now on open-air cribs, but honestly I expect them to go back to the closed crib.  Their temps were low yesterday while I was there:  they may need a little more time in the heat.  One step at a time.  So far the 26 cals continue to be working for them, thank goodness.  Tzelia gained 2 ounces overnight, and Meorah 1.5.  We did a little bf'ing again, and the girls did quite well.  I'm trying not to worry too much about my supply, although I do want to start taking records of how much I am pumping.  I do not think they are getting much from me (we stopped weighing them since it really doesn't matter at this point how much they take), so I shouldn't have to worry too much about the inaccuracy.  But I do want to have a general idea;  I know I have enough for a single baby, but not enough for twins.  After talking to Susan yesterday, I feel a little better knowing that once I am doing more actual breastfeeding, my supply should catch up with them.  Since I am just pumping, my body doesn't know it needs to make enough for twins.  By putting them to the breast, it should signal to my body that: Hey!  Two babies!!  Make more!!  It is a supply and demand thing, after all.

Plans for today:  not too much, actually.  The first day this week I haven't had something other than just visiting the girls on my agenda.  Which is a good thing.  Again, I haven't been doing well.  As I said to Jason the other day:  I would like ONE pain-free day.  I haven't had one in a month now.

Oh, and I did call my old GI doc to make an appointment.  She has an opening in....two months.  Ugh.  So I'm going to email my PCP and see if she can do something for me other than tell me to see a GI doc. Because I can't take 2 months of this GI stuff.  I'd like to be able to actually eat real food and more than just a few bites at a time, ya know?  I've been living on yogurt, cottage cheese, cereal, fruit, and oatmeal for the last week.  Every time I try something more substantial I end up with a stomach ache.  Not good.

Wednesday, January 6, 2010

And open air crib and breastfeeding updates

A welcoming surprise when I came in this morning:  an open-air crib for Tzelia.  She has been able to regulate her temperature adequately, so we are testing out an open-air crib.  It is still her isolette:  the top is just staying open.  If she continues to do well, they can put her in an actual open-air crib.  Nice progress!!  Hopefully Meorah will be transitioning to the same shortly.

Both girls started their 26 cals/cc and seem to be doing ok so far.  Lets hope they continue to do so.

I spent the morning with Susan, one of the LCs.  We were trying to come up with a feeding plan, since the girls seem more and more ready to take oral feeds.  Since different moms like to do it differently, Susan wanted to see what my thoughts were and watch the girls breastfeed.  She was very impressed with how the girls did, and we had a nice chat about breastfeeding in general.  She agreed that the girls will come home on some form of supplements, so bottles are going to be part of the picture.  Interestingly, she said contrary to popular opinion, it is actually HARDER for the babies to take a bottle than to take a breast:  they have to work to stop the bottle flow but are in complete control of the breast milk flow.  So although the girls do fantastically at the breast, they may have issues with a bottle.  Interesting.  We also chatted about the ways the nurses do their best to keep the bottle flow as natural as possible:  keep the babies laying on their sides, and gently tilt and raise the bottle to mimic the ebb and flow that comes from the breast.  Unlike Linda (another LC) who recommended doing the bottles at night (higher cals = more sleep), she recommended bottles first thing in the morning and right before bed and breastfeeding at night (less bottles to clean, quicker to feed).  Everyone has their own opinion and ways to do things...

What we decided to do:  I am going to do my best to make one (and preferably two) care periods each day and see if the girls are up for feeding.  If they are too sleepy, we can just let them sleep:  part of this will be to learn their feeding cues.  If they show signs of hunger, then we can try breastfeeding but they will continue to get their full supplement feeds via NG right after; if they start to show signs of reflux, we can change that, but for now the extra they get from me isn't really enough to over-fill them.  When I am not around and they show signs of wanting to be fed orally, I gave permission to try bottle feeding.

Unfortunately, it just isn't possible for me to be there the 12-24 hours to do more breastfeeding.  If I didn't have a toddler it may be possible.  But, since I know they will need bottles anyway, we may as well start the oral feedings.  Christine, the nurse yesterday, had mentioned to Jason that they are doing so well and it would be a shame to keep them longer because we were delaying the oral feeds.  I tend to agree:  we obviously want them home and the oral feedings are one of the big check-marks that need to be taken care of.

I do feel badly about the bottle feeding.  Had they been full-term, I would have done what I did with Zev:  exclusively breastfeed to the best of my ability until about 6 weeks and then introduced a bottle (since I am going back to work, a bottle is just necessary).  And, having a bottle option does make it easier for me:  Jason can also feed (as can Nicole) and I am less tied to the couch/girls.  But the guilt complex is high:  this is such a touchy subject for moms.  Breast is best is just rammed into our brains.  Of course, even with the bottles they will be receiving breast milk (just supplemented for extra cals), and I do have to keep that in mind.  Some women chose to exclusively pump for their own personal reasons: baby won't latch, problems with the nipple, or personal reasons to not want to breast feed.  And they will do that for a year plus.  I hope to do it as long as possible, but I am doubtful how long I will last once I go back to work:  with Zev, my supply tanked within a few days of returning to work.  It was just far too stressful to make the time to get to the pumping room, set-up, rush through it, and get back to work.  I ended up lasting a month when I returned to work and by the end I was so stressed that it became a complete chore.  Maybe I'll be lucky this time:  I have a good supply and am even hoping it will increase once the girls are home and I'll be breastfeeding more often rather than pumping all the time.  Here's to hoping.

I met up with someone who had her own preemie a few weeks ago (hi Jurate!!).  It was nice to commiserate about the trials of NICU life.  She is at a different hospital but the concerns are the same.  It sounds like her little boy is doing as well as he could be at this point:  just typical preemie stuff.  It certainly doesn't help the anxiety, though.  At least I knew I'd end up in the NICU for awhile:  it was a complete surprise to her so she had no preparation time.  Regardless, its a stressful journey for everyone, and I hope we are both home with our little ones soon...

Zev is doing wonderfully, as usual.  Typical two year old (I can't believe he will be two next week).  I don't know where he gets all his energy...  his favorite activity right now is running up and down the couch and throwing himself onto the cushions.  Great.  And I love how his key word for going to bed is now:  'Brush the teeth?' Yes, he is obsessed with brushing his teeth.  Hey, whatever works.  He and Nicole will be coming to the NICU this morning:  Zev's third time and Nicole's first time.  She has been really wanting to come in, but we had to wait until his cold was over.  Now that it is, they will drop by for a bit and she will see the girls for the first time.  It will be nice if she could make it over a few times in the next few weeks...after all, she will be caring for the girls as well when they come home.

Tuesday, January 5, 2010

Q-tip fun yesterday; no sign of ROP!

Another trip to the doctor for me...

My incision:  it was determined that it is granulation tissue, which is a type of connective tissue that forms during wound repair.  If it over-grows, it is called 'proud flesh' (I'm proud of it?) and can protrude.  Lucky me.  Treatment is to try to shrink it down by trimming it down or silver nitrate.  The physician I saw yesterday wanted to make sure it wasn't infected, so I had tons of fun while he poked and prodded in my incision with a Q-tip making sure it actually wasn't a deep hole.  Ewwww....  But:  no infection, no deep hole, and just granulation tissue.  So he cut it (yikes!) and put some silver nitrate on it, and I get to have it looked at again in a week.

yay.  At least I know what it is.

But lets have another medical complication just for shits and giggles:  since I can't sleep on my stomach, I have been sleeping in weird positions.  That, plus the non-stop pumping and poor body posture that accompanies it, means my entire upper back has been in spasm since 11am yesterday.  Of course I don't want to take anything for it because...I probably still have an ulcer.  Which reminds me:  I need to call for an appointment...

One thing taken care of, and another thing crops up...

Yesterday I had to wait at home for the girls' dresser to be dropped off.  I was told it would come between 12-4.  Hence, I was anticipating a knock on the door sometime around 3:45.  I was spending my morning trying to organize some things when the doorbell rang at 11:50am.  NO WAY.  Exactly WHEN do things be delivered EARLY????  Kick-ass.  Hence, I was actually able to get to the hospital yesterday (and see that doctor who got his kicks digging around in my incision).

Coincidentally, I made it just in time to watch the girls' ROP assessment.  For anyone who has a preemie who has to have this done...I wouldn't watch it.  I actually didn't see the assessment itself (I have a 'thing' about eyes and hate having my own checked) but listening to the girls scream was not my cup of tea.  It didn't hurt, but who the heck enjoys having their eyes poked and prodded?  Poor things succombed to the best coping mechanism there is:  sleep.  They both dropped off less than a minute after the exam.  Way too much stimulation for their poor brains to handle.

Two things I was told by the nurse:

  1. I am not allowed to bring in breast milk anymore because I am taking over their freezer.  Despite all the health issues I'm having, I seem to be a lactating machine.  So Jason and I have to buy a second freezer for my stash.  Good times.
  2. I was asked if I wanted the girls to be started on bottles when I am not around.  At this point, it isn't necessary but I was given the option.  
Bottle feeding:  I said no.  While I know the girls will probably come home on bottles (since they need fortified breast milk), I'd rather not introduce them until it really becomes necessary.  It does mean I'll have to try to be there more regularly, which until all this health stuff happened, I was doing anyway.  They are still too weak to get much through oral feeds, so this would just be a continued 'training' for them.  My goal is to be there for at least one of their care periods, if not two, and get them taking milk orally more often.  I asked what women who wanted to exclusively breastfeed did, and the nurse said they usually stayed all day/spent the night, or did their best to stay as much as they could.  If they were going to EBF, they had to stay over night so the docs could make sure the baby still gained weight.  With Zev, I don't want to do that and I know I can't EBF anyway, but I still would rather hold off on the bottles as long as possible.

I'll have to do another post on this....  the whole 'bottle vs breast' is such an issue for moms and everyone has their own opinion....

Sunday, January 3, 2010

Pregnancy and body image

I've been thinking about this topic for a few days...

When I was pregnant, I would post occasionally on pregnancy message boards and forums.  It was always nice to chat with women around your same due-date and complain compare symptoms, thoughts, funny stories, etc.  Regardless of the site, there would always be a thread or two about body image issues.  The world likes to think that pregnant women are community property and seem to have no qualms about commenting on a pregnant woman's size.

And it didn't even matter what size the woman was.  Someone would always think she was too big or small regardless of her size.  And there would be the inevitable touching of the belly by complete strangers (boundaries!!!!!).  I got a few comments this pregnancy, but luckily escaped many of them since I was locked away for the last two months of my pregnancy.  I got some comments while pregnant with Zev, but I do not remember too many of them.  I am one of those women who carry completely in front, so most comments would have to do with that.  I suppose many people think that is the 'best' way to carry (less gain in the face, butt, thighs, etc).  Honestly, it ain't that great:  too much stress on the abs leads to pretty bad post-partum results.  I had a rather severe diastisis after having Zev, which never healed completely.  But honestly, it didn't bother me all that much:  it is part of having a baby.

Now that I'm post-partum again, I still browse message boards.  I do not find much comfort in them honestly, because having a preemie is quite different from having a newborn.  And the majority of the posters are first-time moms with first-time mom anxieties; I'm hardly going to worry about which style bumper is the cutest when I'm busy worrying about when the girls are going to be able to be off the NG tube and in an open air bassinet.

There are still threads about post-partum body recovery.  So many women are freaked out about when they can return to their pre-pregnancy bodies, how they can get their abs back, how they can diet off that "baby weight", etc.  And granted, it is a valid concern for a lot of women...  but am I weird that I don't share their concern?

There is actually an excellent site:  Shape of a Mother.  I came across it while pregnant with Zev.  A beautiful site where women upload pictures of themselves and show what post-partum can look like.  Most of it is anonymous and while it isn't something I would ever do, it is nice to see the support people offer.  A post-partum body is beautiful, regardless of stretch marks, sagging breasts, and c-section scars.

Going back to me (it is all about me, after all): I don't have these anxieties.  Maybe because I actually bounced back quickly after Zev and the girls?  Or because I don't think I have that many post-partum body issues to deal with?  Maybe if I HAD stretch marks or a lot of sagging skin I would be singing a different tune.  But I really don't think so.

In my 'former life' (i.e., before bed rest and while not pregnant) I was a rather active person.  My hobby is weight lifting, and over the course of many years I have learned a lot about fitness, nutrition, and how to take care of your body.  I know what to do if I felt I needed to 'do' something, and have confidence in my ability to do it.  So how I look right  Doesn't really concern me all that much.  Interestingly, for a gym person, I was never after some body-type ideal:  I like working out for the endorphin rush, for making new strength goals, and for the structure it provides in my life.  I don't really care about making my booty smaller (god forbid), getting a six-pack (had a four-pack once...didn't change my life that much), or any other physique goals.  The number on a scale is pretty meaningless to me as well:  I don't give gravity that much power and know too much about the factors that affect body weight that are out of my control.

Which is why I think I'm weird.  I just roll my eyes at the fitness magazines:  they are full of misinformation and fitness myths and are just made to make money rather than disseminate information.  This time of year, people are making their annual 'lose 20 lb' goal, and I just don't have the interest or time to even consider such a thing.  What I am interested in is regaining some of the strength I have lost over these two months of disability, maybe getting into a new hobby (boxing?) should I have the opportunity, and simply enjoying being physical again.

How my body responds to that is secondary.  If I walk away with washboard abs, great.  But I ain't holding my breath, and given that there are only two people who would regularly see them...who the heck cares anyway?

Saturday, January 2, 2010

Will I ever be well?

Warning:  vent ahead.

I am very very tired of being incapacitated.  I was put on bed rest on 10/2.  Felt fine, but couldn't DO anything and had to spend my time in bed or on the couch.  Went into the hospital at week 24 for a few days for steroid shots.  Went into the hospital AGAIN at week 26 for preterm labor and had all the joys of magnesium sulfate thrown at me.  Stayed for two weeks.  Went into the hospital AGAIN at week 30 for preterm labor and once again had mag sulfate thrown at me, but at a much higher dose that made me extremely ill.  Yet it didn't stop the labor, and hence my beautiful girls were born.

Ok.  In between that, I had oral surgery somewhere around week 27 for a mucocelle.  Which actually didn't go away completely, so the week after the girls were born, I went back and had it done again.  Each time consisted of a few days of subsiding on yogurt and taking too much pain meds while trying not to rip open the stitches in my mouth.  Lovely.

Lets not forget I had a c-section.  And, since the girls are still in the hospital, I can't just rest on the couch and breast feed:  I am up and about and going to the hospital, trying to spend time with my son (who I barely got to see during those 10 weeks of bed rest) and sitting at that pump every 3 hours.  I ended up taking too much percocet, so I was given dilaudid.  Fine.  Weaned myself off the dilaudid, but continued to take the prescription strength Motrin every 5 hours or so.  I have been on some form of pain medicine for about four weeks now.  At least the horrible edema that caused pain whenever I laid down is gone.

A few days ago, I felt some GI problems and chaulked it up to some fenugreek I had started.  So I stopped the fenugreek.  But, the GI cramping is still occurring.  Every time I eat, I end up in intense pain.  Well, what could that be?  I have my incision looked at again because part of it looks like it isn't healing properly and I'm wondering if it is related.  No, not related, just a coincidence, but I still need to follow-up on that incision because it isn't healing correctly and have another appointment in another week.  Ok.  But what is causing all this GI pain?

Enter google.  "possible causes for abdominal pain"

Well, a cause for abdominal pain happens to be an ulcer.  And what are risk factors for an ulcer?

  1. Surgery
  2. Stress
  3. Caffeine
  4. Oh, and taking too much NSAIDs, of which Motrin happens to be.
Well, Christ.  

So I'm on a series of omeprozole OTC, hoping that will help.  It should take a few days.  If it isn't better by Monday, I should probably call my GI doctor and be looked at.

But really?  Can't I just catch a break already?  Three months of being an invalid?  I feel like a hypochondriac:  every time I turn around, something is wrong with me.  

I really should change my name to Job.

Friday, January 1, 2010

Happy New Year

I missed Dick Clark and all the party-ing.

I am not a NY person anyway, so I'm not crying about it.  I was asleep when 2010 finally rolled in.  Long day yesterday.

The visit with the girls went well.  We did more nutritive feeds:  Tzelia ended up taking in 6 cc's from me, and Meorah took 10.  Not bad.  They both fell asleep only after a few minutes of trying:  it takes up so much of their energy to try to feed orally that we actually have to make sure they don't stat LOSING weight while doing this.  They can end up burning more calories trying to breastfeed than they are actually taking in.  But, both girls were able to suck-swallow-breath without problems, so that is a good sign.

Unfortunately I am still not feeling well.  I ended up back at the doctors today:  even though I am off that fenugreek I am still 'under the weather' and not feeling 100%.  When I took a look at my c-section incision, it did not look good yesterday morning:  parts of it were red and it seemed like the seal wasn't completely closed.  So off to the doc I went.  She said the incision was closed, it just wasn't sealing straight, so she used some silver nitrate to 'even it out' a bit.  Ouch.  And the GI was unrelated, although she told me to call if it got worse.  I told her I was still on pain meds, and she said that was fine given all my activity...I was going to be healing much more slowly.  And, yet again, I got a very nice lecture talk about how I should be taking it easy:  I just had major abdominal surgery and it would be ok to NOT go to the hospital every day...


I ended up getting home later than I had planned, which threw off my pumping schedule.  What can you do.  Nicole and Zev came home early because of the snow, and Jason was also somewhat early having come back from an eye appointment.  So we built a fire and relaxed for awhile.  I pumped again and after sitting with Jason and Zev for a bit after Nicole left, I just had to lay down.  And fell asleep.  Woke up for my 9pm pumping, then crashed again until 1:30am for my next pumping.  And hence, missed the New Year.

No resolutions this year.  I thought about that last night, but I'm still in 'one day at a time' mode, so I can't even begin to think about goals for next year.  I have no idea what things are going to look like once the girls come home.  Maybe just 'survival with sanity intact' would be a good goal for the next year....