I'm Baaack...

Yes, I know. I've been rather absent. I thought about blogging so many times, but it's hard to be clever at 2am, which is the only time I seem to have. I pledge to do better though and make up for it with a barrage of posts.


So, get your scrolling finger ready and enjoy...

The $134,000 Question

So, the big question...What DOES a stay-at-home mom do all day?? Working men everywhere are dying to know. Recently, "somebody" determined a SAHM's salary would be $134,000 for all she does. Here's how I earn mine on a typical (non-doctor visit) day.

We'll start at just before midnight...

11:45pm - prepare for 12am feed
Pull out bottles and put in water to warm. Draw meds. Tube Abby (worst part). Comfort crying baby. Lay Abby down. Start gavage feed.

12am - 1am Feed girls
Pick up Nat. Give meds. Start bottle and hope she eats. After about 20 minutes, she quits. Put down. Take break. Try again. Repeat as needed. Somewhere during the hour, pause Abby's feed and push her meds.

1am-1:30-45am
Pump, pump, pump while watching shows on DVR. Current favorites: Ramsy's Kitchen Nightmares; Top Chef; America's Iron Chef and America's Next Iron Chef; Meercat Manor; Will and Grace

1:45-2:45am
Variations: continue to watch tv; try to blog; surf net; attempt to do paperwork (bills, thank you notes, etc) and realize I'm too tired; clean bottles, nipples, and kitchen; make bottles for rest of night; try to go to sleep before 3am feed - usally big mistake since I can barely drag myself out of bed.

2:45-4am
repeat 12am feed with the variation of usually falling asleep while holding and trying to feed girls. Also, add extra frustration of Natalie being too sleepy to eat in the middle of the night

4ish - 8:45am
Sleep

8:45am
Try to drag myself out of bed for 9am feeding. Usually fail. Success by 9:30 or 10m.

9am (if lucky) really 10am - 11am
Untube Abby; Prepare bottles, meds, etc. Feed Nat. Nat quits. Put Nat down. Feed Abby. Abby quits. Put Abby down. Feed Nat. Repeat until bottles are finished or one hour passes - whichever comes first.

Day now started, usually an hour behind. Girls awake. I need very much to pump. Put girls on floor - hope they play while pumping for about 30 minutes.

12 NOON - Mommy's favorite time of day. Daddy comes home for lunch!! If on schedule, help feed at 12:00. If off schedule, Daddy plays with girls while mommy pumps (if I haven't been able to). Try to start 12pm feed at 12:30 to get back on schedule. Repeat feeding schedule with Ben's help.

1:30ish - play with girls

2:30ish - probably need to pump again. Girls either went to sleep after lunch and are now up or have fallen asleep and I can pump.

3pm - try to get back on schedule. Prepare bottles, meds, feed Nat; feed abby; feed nat; feed abby, etc.

4ish - 6ish - hopefully find time to play with girls and pump.

5:45 - prepare for 6pm feed.

6pm - Ben walks in to save the day! Feed girls

7ish- 8:45 - play; pump; eat something

8:45pm - prepare for feed

9pm - Feed girls

10pm - Ben to bed; girls to bed;

10ish-11:45pm - Mommy pumps; pretends to do paperwork, but too tired and usually just surfs web; tries to post, but finds it hard to be clever since I'm too tired.

11:45pm - Print girls' schedule (feeds, meds, charts to record amounts taken) for next few days and Start all over.

It's amazing how quickly the two hours pass between the end of one feed and start of another. In fact - it's 11:50pm, and time to start the day...

I'm still waiting for my check...

Feeding update

Feeding continues to be a big issue. *big sigh* I keep reminding myself that it could be much worse. Our girls are so healthy and happy. There are so many children who are so much more sick and require so much more care. At least our girls have throats and stomachs. Some kids doesn't even have that. Still, when trying to feed the girls, it's hard to feel thankful.

Here's the latest...

Abby has not been progressing as hoped. She hates her NG tube. She refuses to eat well when it is in. It had become a Catch-22. She can't get rid of the tube because she isn't eating enough. But, she won't eat enough with the tube in. So, she can't get rid of the tube. You see the dilemma. So we have a new plan.

Currently, we are tubing Abby only at night. She receives a gavage only feeding at 12am, 3am, and 6am. We give her 120mls over 1 hour. If she tolerates that amount, we will increase it to 150mls. After the 6am feed, we will take out the tube and give her a bottle from 9am to 9pm. During the day she needs to average 45mls per feed. If she does this, she will get enough calories and hopefully gain more weight.

This little plan is actually a temporary fix. We have decided to go with the G-tube. If you remember, that will be inserted surgically, directly into her stomach. We will probably follow a similar schedule of oral feedings during the day and gavage at night. The benefit is that the tube will be out of her throat and we won't have to put it in and out - which is a very uncomfortable procedure for Abby and emotionally awful for us. She first has to get a gastric emptying study (looks at how the stomach empties) so she can then be scheduled with the surgeon. We have no idea how long that will be. Hopefully only a week or two more. There is a chance she will improve considerably on the new off days/on nights schedule and we won't have to do it at all. We can only hope.

Now, for Natalie. I had thought Natalie was doing quite well, but when I looked at the data in my nifty little charts, I realized she was falling short about 150mls per day. That's quite a lot. When a pediatrician appointment Tuesday revealed she's only gained a few ounces, we decided to tube her at night as well. We just hated doing it. So did she. I was so worried we'd have to consider a g-tube for her as well. It felt so awful going backwards.

The good news is the doctor today at the Duke Clinic was okay with her weight gain. He said we did not need to tube her at all. Instead, we are adding more Elecare to the breast milk to make it more caloric. Since she's getting more bang for her buck, she can eat less. She still needs to average about 50ml per feed. She should be able to do this. (Abby is also getting the souped up breast milk.) We are hopeful this will keep Natalie heading in the right direction. If we don't feel we have to force her to eat so much, maybe her feedings will be more pleasant and maybe she'll eat more.

Woo - that's a lot of rather technical info about eating. Bottom line: Nat - doing okay. Abby - not as good - getting g-tube soon. Stay tuned for updates...

Gotta Love Grandma

We've been lucky to have a steady stream of grandma's visit in the last few weeks. The girls are so fortunate to have so much love in their life.

In early October, Ben's mom came to stay from Friday to Tuesday. She was great with the girls and they had a wonderful time getting so much attention. Ya-Yai also helped with cooking and cleaning and laundry. Yeah Ya-Yai! She also stayed up late with me to help with feedings. Between feeds, we bonded over cooking shows late into the night!

After Ya-Yai, Nana came for the weekend. It was a wonderful relief since I was having serious issues with my milk (see post below). She also helped with cleaning and laundry and feeding. My mom is also a former infant child developmental specialist. That's a long title for "person who knows lots of stuff about infants and what they should be doing when". Well, maybe that's the short way:-) Nana was very helpful in showing us exercises to work on with the girls and evaluating how they are doing developmentally. It was the first weekend Nana had been able to come in a while and she had a great time. The girls were once again thrilled with all the attention.

Finally, last weekend, Nanny was here for a visit. (Poppy was here too, but we are talking grandma's right now:-)) It had been several weeks since they'd seen the girls and were of course surprised at how big they are now. Nanny is amazing at feeding the girls. I don't know what she does, but the girls eat so well for her. There are several houses for sale in our community...I've been trying to get them to buy one and move in! Of course, the girls were once again entertained, held, and loved all over.

The girls really are lucky to have grandparents so close that they can visit so often. The fact that we could be in Maui right now, is never lost on me. Although paradise would have been amazing, we would have desperately missed our extended family. When I see the grandparents with the girls I am so grateful we are here and the girls will grow up knowing their grandparents. I can only hope they have as close a relationship as I have with my amazing grandmother.

Look Ma - no hands!!

First of all - let's all take a moment and be thankful I didn't post MY picture wearing this contraption.

So - what is that thing, you ask. Well, it's my new time-saving toy. It's a hands-free breast pumping bra. It's wraps around (gotta love Velcro) and the sucker cups go through these littles holes and... Well, you get the picture. It really does work. I can do things with my hands - such as type - as I am right now. Actually, using pump time to blog was part of the reason I bought it. That and trying to not develop carpel tunnel syndrome. I can also play with the babies in a limited way if I need to - at least enough to comfort them.

While on the subject...remember the freezers full of breast milk? ALL GONE. There are two little bags left in my freezer that I'm saving for an emergency. Last week was awful. I've always had a ton of milk, and suddenly, it seemed to disappear. I was freaking out. Not only did I feel guilty for not having pumped more in the weeks before, I was imaging the $500 a month we'd have to spend in formula. It was awful.

Fortunately my mom was here two weekends ago and while she and Ben concentrated on feeding the girls, I pumped all the time. That wasn't much fun either. But it was more fun than running out of milk. The good news is it seemed to do the trick. Things are better now. The children won't starve. This is very good.

What were they thinking...

This is totally unrelated to anything baby but I just couldn't resist. I saw an advertisement for this show...

"The Most Smartest Model"

Seriously. I'm not kidding. I'm not sure if this is irony or what. The goal is for the models, stereotypically not the brightest bunch, to convince the host they are the "most smartest". Who thinks of these things?

So, for those confused as to why I find this hysterical...an English lesson.

One can not be the "most smartest" anything. One is either the "most smart" or the "smartest". To be the "most smartest" is redundant - and terrible grammar. Perhaps the first challenge of the show is for the contestants to figure out the title of the show is grammatically incorrect!

Perhaps the show should be called, "the most smartest copy-editor, producer, or tv executive"!

Schedule/Smedule

So, we've been messing with "the schedule" to try to find what works best for the girls - and for us. There's a fine line between their needs and our sanity. In the end - we all have to survive.

Basically, the girls needs are to consume enough ml of milk each day to gain weight and grow. Abby is supposed to get at least 600ml and Natalie about 480ml.

Our needs include sleep and maintaining our emotional stability. The concern for the later comes from the frustration we experience over their feeding issues. It's just so hard to struggle with them to eat. We worry about them eating enough or not eating at all. We also worry about them spending too many calories while they are eating since it takes so long for them to eat by mouth. It's a balancing act between calorie intake and calorie expenditure. One of our biggest worries is over Abby, her tube and its pros and cons. Obviously, it's good because we can make sure she gets the amount of food she needs. But, it is also really easy for us to be lazy. It much easy to hook her up than struggle with her to eat for half and hour. Plus, I'm not so sure it doesn't make her lazy. Maybe she can figure out that she gets full whether she eats or not. Our biggest concern is whether the tube contributes to her not eating orally. In other words, does the irritation of it make it more uncomfortable to eat therefore reinforcing the oral aversion. The more we have to feed them, the more frustrated we feel.

So...we are trying to work a schedule that allows fewer feedings during the night (sleep) and maybe fewer feeds (7 per day). We are trying to push the night feeding to 4 hours. So, we would feed at 2am so I'm asleep by 3, and then Ben would feed at 6am and could then go to work at a decent hour (instead of 10:30am). I would feed them again somewhere between 9 and 10am.

After all this scheduling, I can understand why people pay my sister the big bucks to do this for them. Maybe I can get a discount:-)

Girl's first colds

Poor little babies. It's really tough being sick when you can't blow your nose. Little Abby developed her first cold starting Monday. She stopped eating by mouth on Tuesday so we had to put the tube back in (see previous post). Natalie started showing signs early Friday morning. She actually even ran a small fever yesterday - just about 99 degrees. I called the nurse line but apparently they don't even consider a fever a fever until it's 102. I really wasn't worried, but since she's a preemie I figured better safe than sorry.

We have saline drops to loosen the mucus and the "buger bulb" to suck it out. The girls hate that. I can't blame them. I wouldn't want someone sucking stuff out of my nose. The cold is worse on Abby since she already has a tube taking up half of one nostril.

The biggest result of their colds is that neither is eating very well. With Abby, of course, we can just feed her the rest in her tube. With Natalie, we just have to hope she's eating enough to maintain through this cold and that her intake will increase once she's better.

The other result - Mommy thinks she's caught Abby's cold. I also started getting a sore throat on Friday. I've felt pretty well today, but tomorrow may start the stuffy phase. I really hope not. The thing is I can't figure out where the girls caught this cold. No one has been sick around the girls except for allergy symptoms. Maybe I picked something up at all those doctor's appointments...

A Poo on Pooh

Abby is up to her old tricks. After spitting up on her 2nd outfit of the day, I was dressing Abby in a cute little Pooh outfit. Ben likes Pooh, so it was for his benefit. Since she has a little cold, I checked her temperature just to keep up with it. In case you didn't know, sticking things in a little kids bottom is often conducive to pooping. So, there was pooping. Thinking she was done, I proceeded to put on the new outfit and diaper. Ben happened to walk in just about then. Suddenly, with her butt up in the air, Abby let one rip - right onto Mommy's hand and her little Pooh outfit. Daddy laughed and laughed and laughed. Abby hadn't pooed Mommy since her blowout in the NICU where she projectile pooped to the end of her isolette. Oh, and if that wasn't enough, as soon as I removed the diaper, she peed all over everything. So, Mommy pulled out the THIRD outfit of the day, and another diaper.

In the words of Pooh,

Oh bother.

When plans fail...

Well, our little tube-less experiment didn't work out so well for Abigail. We went to the pediatrician today for a weight check and she had actually lost weight since Friday. (Natalie had gained two ounces and is now 7lb 1 oz).

Poor little Abby did great for the first three days. She started petering out early this morning. In fact, she completely refused her 9am and 12pm feedings. We left at 3 for the doctor and didn't return until almost 6pm. So, she didn't eat anything for nearly 12 hours. She's also having a pooping problem. The girls that used to poop everywhere each time you changed them are now constipated - and somewhat grumpy. At least Abby is. She hasn't had a decent poop since 12am Sunday morning. I think she's been very uncomfortable and that's why she's not eating. I wouldn't want to eat either if my insides were all full.

So, as soon as we got home, I put her feeding tube back in. It was so sad. She sneezed and shook her head. Her poor little eyes watered. I felt awful. But, she needed to eat, so I set up her feed and she went right to sleep. I want to get her strong again and then we will try again.

It is so frustrating when the girls don't eat. It's by far the worst and most emotionally and physically taxing element of having twins. Honestly, if they ate normally, having twins wouldn't be that hard (so far). I think the hardest thing is not having any control over whether or not they eat and how much. That old proverb about the horse and water takes on new meaning. You really can't make them eat. It's a very helpless feeling. At times it seems like Abby will never get it. I try to remember that Natalie has just been home longer and Abby will get it too. Sometimes, though, it's really hard not to get discouraged.

Come and get it!!!

No - it's not a chow line, but the long awaited for pictures!!! I've just spent hours into the wee morning picking, labeling, and posting pictures for your enjoyment. Click on the link "pictures and videos" and enjoy.

Here She Comes to Save the Day!!

Auntie Kimberly arrived early Saturday afternoon to take control and let us sleep. As an infant/twin specialist, she has lots of tricks and lots of experience.

Her first goal was to get them eating.

Step One: Lose the feeding tube. Natalie has had hers out since her appointment on Tuesday. She has been taking all her feeds orally since then. Natalie, as a big sister should, helped Abigail out by pulling out her tube during a nap. So the tube came out yesterday and has been out since.

Step Two: Choose the right nipple. Kimberly made a trip to Babies R Us and bought $60 worth of bottles and nipples. To that Ben and I both responded with "what!". Hopefully, we'll be taking some of those back. She chose some with shorter nipples with the idea that the longer ones were reaching back to their throats and irritating them or making them gag. It's phenomenal how many different kinds of nipples and bottles there are. Poor breast feed babies only have one choice! Honestly, though, I'd rather the girls just have one choice. Maybe after we get this eating thing down and they are continuing to grow well, we'll try breastfeeding again. However, I digress... back to the nipples.

Step Three: Feed, feed, feed. Now that there are three of us, we can feed both at the same time, which saves a lot of time. Our first attempt was great. They both took their full bottles in about 30 minutes. Since then, we've had varied success trying a variety of nipples and combinations. As always, the first 40ml or so, goes great, then the rest is a struggle.

Current assessment: It's going fairly well. Abby actually seems to be doing better than Natalie overall. She really likes the shorter nipples. We've had a harder time finding the perfect nipple for Natalie.

Prognosis: Looking pretty good. The girls may not be taking all of every feed, but sometimes they are taking more than necessary (especially Natalie). Overall, they are doing quite well. I'm hoping to continue to make progress and go into our appointment on Thursday completely tube-free!

Kimberly also saved us by doing all the 3am and 6 am feeds. Ben slept from 12am to 9am. I slept from 1am to nearly 12pm. Ahhh, pure bliss. Thanks Sister. We sure so love you:-)

Pregnant Women and Babies...

Why does everyone want to touch them?? I never actually had perfect strangers try to touch my stomach when I was pregnant. It was probably because I didn't really start to show until just before the girls were born. I've heard many pregnant women complain of this though. I did have my first stranger reach out of touch my baby.

Natalie and I were at the eye doctor last Wednesday. There we were sitting quietly on the adult side of the office (avoiding the kids on the kids side). Natalie was happy in her car seat and I was filling out paperwork. Along came a little old woman. Well, she wasn't that little, nor that old, but it sounds better. She marched right up to the car seat, ogled the baby, and reached right out and touched her hand. WHY do people do this? I know they are cute and cuddly, and I've been tempted before myself, but I know better. Maybe next time I'll reach out and stroke their face or tummy or rub their head? Hmmmm.

Actually, I have these little signs (courtesy of my sister) that hang from the car seat or stroller. They say "Please wash your hands before touching mine". I did have it on the car seat, but the handle was back and it wasn't visible. So, my next line of defense is little signs I've made and laminated. They read, "Preemie Baby - I have a low immune system, please keep your hands from mine". There's a little smiling face to make it nicer. Ben thinks I need to make a visual sign with hands touching a baby and a line through it - like a no smoking sign. He thinks people won't bother to read my sign. Of course, I've seen people stand right in front of no smoking signs and smoke, so, hey, what can you do? I have taken to keeping a blanket covering the car seat so the babies are hidden. It would take a bold soul to walk over and actually lift up a blanket to see a baby. I'll let you all know when it happens:-)

If wishes were nickels...

I'd hire someone to get up at 5am to feed the girls!!! That 5am feed is a killer. I'm okay until the 2am - since I'm a night owl anyway, but then I am more than ready for bed. The 5am is supposed to be Ben's shift, but sometimes it's just too much. He has to go to bed by 10ish pm to feel good enough to do it, so sometimes, I pitch in. I can't blame him. It's just awful. Who said babies need to eat every 3 hours anyways?? They don't seem to mind. They sleep right on through. As a matter of fact, our schedule was off Saturday and Sunday because feeds took longer than usual. I was trying to get back on schedule and was supposed to get up at 3am Sunday morning so they could eat at 5:30am, and then back on schedule at 8am. Somehow, my alarm didn't go off. Next thing I knew, Ben was waking me at 5am asking me if the girls needed feeding. They never even noticed.

All in all things are still good. We have the most ridiculous schedule of doctor appointments. It seems we are there every other day. It's rather ironic, actually. The whole idea of preemies is to keep them away from everyone. So, we have appointments in hospitals and doctor's offices surrounded by who knows what. To make it worse, it's the Children's Hospital and Pediatrician, so we're surrounded by little kids and all their germs. I'm not sure it's a very good system.

Keeping the girls well, notwithstanding, we are happy to receive visitors: well, not sick hand-washing visitors:-) If you are sick, were just sick, or in the close vicinity of someone who is sick, please come another day. You definately want to call first though. See above rant on doctors' appointments.

I know I've promised pictures. It just takes time to pick them and post them and time is a little short right now. I will get to it - I promise...