my valentines

One of my darling valentines. If you look closely you can see the other one in the background. Rhys wasn't cooperating with the camera so that's about as good as I could get. They crack me up when they play with each other. Zoe has recently started climbing on top of Rhys, which is only fair I guess since he's been doing the same to her for weeks.

***Disclaimer*** If you continue reading you may find yourself in the middle of TMI. Just so you know.

Last week I had my cerclage. My OB told Cody that I bled a lot during the procedure so I should expect a fair amount of bleeding and clotting. First couple of days weren't so bad, but into Friday afternoon I started bleeding a lot (think heaviest day of your period) and had some pretty sizable clots. I wasn't overly concerned at first since my OB specifically mentioned this could happen, but then it just wouldn't stop. I stayed off my feet all day Saturday, but that didn't help. As afternoon came I really started to panic. I wasn't cramping or hurting, but it was a lot of blood. I called the after hours line and had the doctor on call paged. Luckily it was a doctor in my OB's practice and not a random. She told me bleeding up to a week afterwards was to be expected, especially with a repeat cerclage, and since I wasn't cramping or contracting it sounded fine, but if the clots were that big and I was worried I should go to such and such 24 hour clinic to have them take a look.

Even though the clinic was 35+ minutes away (there aren't any 24 hour clinics around us) I decided to go. By this time it was nearly 10 p.m. so I quickly got dressed and called the clinic to make sure they took my insurance. It may sound ridiculous that I was thinking about insurance, but if they didn't contract with my insurance it would have been considered out-of-network and I'd have to pay everything out of pocket, with nothing going towards my deductible. Sadly, the lady who answered my call didn't know diddly about what insurances they accepted so I decided just to go to the regular ER. But instead of driving to the hospital my OB belongs to, which is 30 minutes away, I opted for the one 6 miles from my house.

Once at the ER I explained my situation to the front desk and the lady quickly jumped on the phone to call the charge nurse in L&D to ask if she should just send me upstairs, since in her mind a cerclage indicated a high risk pregnancy. The charge nurse said no since my OB didn't belong to that particular hospital. Fine, whatever. But then I was (literally) told I should probably go to my OB's hospital next time. Seriously?! I'm a high risk OB patient who is currently 15 weeks pregnant and just explained I'm bleeding and clotting like crazy and you're really going to tell me I didn't choose the right facility? Once in triage the nurse checked my blood pressure and the baby's heart beat, which were both fine, and told me the on call doctor could look at the cerclage stitch to make sure all was well but he wouldn't manipulate it in any way. I was reassured the baby was fine and didn't particularly think digging around down there would be helpful to the situation so I opted to go home and see my OB Monday morning.

I got up early this morning and was at the office before they opened. During an uncomfortable pelvic exam my OB said the stitch was fine, but a polyp had formed. It was on my cervix and that was the cause of all my bleeding. There are several reasons cervical polyps can form, two of which are inflammation of the cervix and clogged cervical blood vessels. He put some medicine on it, which seems to be working thank goodness and the baby looked fine on the ultrasound. I go back Thursday to have him check me again. I'm really hoping this is a freak thing and not a sign of things to come. Just one more thing to add to my catalog of random pregnancy experiences!

updates

Wednesday I had my cerclage put in. Overall, the facility was much less formal than the place I used previously, which made for a much nicer visit. With Zoe I had an IV put in and then had to wait for an entire bag of fluid to drip before I went in for the cerclage. I hate needles and I was anxious anyway, so the entire thing was needlessly long in my opinion. I was expecting a similar experience this time, but man it was so much better! The anesthesiologist put in a tiny IV, painlessly I might add, and we were ready to go. I was immediately brought into the procedure room, they hooked up the "Michael Jackson" drug (PC or not, that is what they called it) and I was out. I woke up completely dressed, sitting in a wheel chair in a small conference room. Cody told me I'd been awake from the moment they wheeled me in, however I wasn't aware of anything until about five minutes before we left. So it seems I was asking questions and making conversation for 10-15 minutes that I don't remember. Actually, Cody told me the anesthesiologist recognized our last name and asked him if we knew so-and-so (who turned out to be Cody's uncle), and I did vaguely remember that being asked, but not until he brought it up. Completely unique experience! So, the cerclage is over and done with. So far so good, but I'll feel better after my next ultrasound to make sure the baby is still doing well.

Rhys has been on baclofen since Monday and holy crow I didn't expect there to be such a good response. This medicine affects the nervous system so it is gradually increased (and also decreased if/when the time comes) as to not shock the body. This also allows for you to determine the best dosage without giving more medication than necessary. If at any time you feel that you've reached the desired result you can hold the medication at that level. We started with half a 10mg pill before bed time and the effects were immediately evident the next morning. The tone in his legs is significantly reduced, and during yesterday's PT session he was standing very nicely in his gait trainer. The dose for Rhys is increased by one-half a pill every week, over the course of eleven weeks, for a max of six pills per day. I am very encouraged by the response, and on so small a dose. Hopefully this will make it easier and less painful for Rhys to break out of the tone pattern and use the muscles as they're meant to be used.

new doctor(s) for Rhys

For the last several months Cody and I have been discussing the need for a more proactive approach to Rhys's CP. Our therapists are great for the most part, and we've seen a lot of progress from Rhys in the last 16+ months. But we still don't have any one person to call the shots, so to speak, in terms of managing Rhys's care. Doctors and therapists alike have commented on how much potential (for lack of a better word) he has, we just need to tap into it. The problem is we know little to nothing in terms of his CP. I mean we know his abilities and disabilities, but how to address everything not so much.

I've long been frustrated with the fact that everyone knows he has CP, but no one wants to discuss it. Of course they will if we bring it up, but I want someone who will look at him and say that's not good enough, we need to... We're increasingly becoming more knowledgeable about things (I've gotten a lot of good info from other blogs), but no matter how much we try to learn the information just isn't readily available. I hate to say it, but several times I've felt that since doctors don't expect much out of micro-preemies they are happy with anything above baseline. And, that's just not going to work for me!

So, in an effort to get as much information as possible we've scheduled with a couple new doctors to check things out. Nothing is wrong, we just want to make sure we've got everything covered. We're not impatient - honestly those of you who know something about this type of thing know there is little sense in being impatient, and that is alot coming from me as I'm the most impatient person I know - it is that there are limited windows of opportunity when these kids are young and we don't want to miss anything.

We have an appointment scheduled with a neurologist in April. I hate that was the first available opening, but hopefully they'll have a cancellation before then. If not, it isn't that critical. I am also thinking of getting a pediatric orthopedic doctor on board just to make sure everything is/stays in alignment, but I'm not sure that is necessary right this second. Lastly, I scheduled with a pediatric physical medicine and rehabilitation doctor. Lucky us, she had an opening yesterday afternoon so I bundled Rhys up and met Cody at their office.

First impression of the office, small and quiet with only one patient in the waiting room. Second impression, we didn't have to wait long after our scheduled appointment time to see the doctor. Third impression, the doctor was very friendly with no scrubs, stethoscope or lab coat and didn't look like she was in a hurry to get out of the room. In fact, we chatted with her for more than forty-five minutes.

In summary, she thinks Rhys looks great for a 23 week preemie and believes he has a lot going for him. He has good range of movement, good head control and a spunky personality that she witnessed first hand. On the flip side he has a somewhat weak torso and tone in his legs that is clearly preventing him from using them properly. To address the leg issue we are starting Rhys on baclofen, which is an overall muscle relaxant. Baclofen works by blocking nerve activity in the part of the brain that controls the contraction and relaxation of the muscles. Hopefully this will allow him to loosen up enough to engage and strengthen his muscles in the proper pattern. And if we can loosen up the leg muscles I'm hoping that will make Rhys be more comfortable in the sitting position. There are a few common side effects possible with this medication. They are minor - sleepiness, irritability, nausea/loss of appetite - but as you can see aren't exactly negotiable so we're hoping he doesn't get any of them or we'll have to switch meds.

The ultimate goal is to identify what exactly needs to be treated and how best to do that. The addition of these new specialities should take care of that and keep us on top of things.

Off to the races!

It seems they are becoming friends :)

table for five

Yes! I am indeed pregnant. It was unexpected and unplanned, but definitely not unwanted. If you think you're shocked, you can not possibly imagine our reaction when we found out. The discovery came just before Christmas. Nice gift, wouldn't you say? Yes, I know where babies come from. But since we needed the help of an RE for the first two, and nothing changed after my pregnancy with R&B (however brief), I never suspected anything would be different after I had Zoe. Our issues were not so severe as far as infertility goes and my RE said it wasn't impossible to occur on its own, just unlikely. So it must have been something about recently giving birth, quitting nursing and just a good ole' fluke that allowed this to happen. We should start playing the lottery. Seriously.

I am nearly 14 weeks, and will be having a cerclage put in next week. I am hoping that goes as well as it did with Zoe, but I am still a bucket of worry. With each pregnancy I learn new things and that kind of knowledge doesn't do me any favors. My mind constantly spins and analyzes. I hate the never ending worry and concern that comes with being pregnant, and I'm not even talking about the potential of preterm labor. Oh to be one of the naive ones who take for granted everything will turn out perfectly. Aside from complete exhaustion I have actually felt great. But the fatigue has finally started to fade and I can now make it through the day without fearing I will fall asleep while my kids are roaming the house.

Our newest addition is due in early August, but we'll do everything precautionary as we did with Zoe to make sure (s)he stays cooking as long as possible. Delivery goal is early July, just before Rhys's birthday. Poor kid, I hate that he's going to have to share his day but it is what it is. Our "sweet" baby is below. The u/s tech at my peri's office gets a little carried away with the sweetness of things. :)

We're very excited about our new little guy or gal, even though we'll be the family circus with three children under three. We've always known we wanted at least one more baby, we just never thought to have all the kids so close together. I know someone is laughing at us and all our plans. You'd think I'd have learned by now that we don't have the final say.

ready, or not

nutrition

Today Rhys's nutritionist came for her every-other-month visit. She's actually been helping us more with Zoe lately by giving us food ideas/timing, because while Rhys's ability to eat has increased his willingness has not. So, it's a waiting game with him and she's mainly tracking his weight to make sure he's staying on target. We can weigh and measure Rhys, but we don't really know what his target is to stay on his curve. Just a couple months back she pointed out he had not grown at all, nor gained any weight, in two months. At that point we had to start supplementing with a calorie additive and today he was back to his normal growth curve. He's 26lb 12oz (~50%) and is 34.25" tall (short side of the scale). We aren't worried about him being plump and chubby, because to be honest that's not his body type. We're just trying to make sure we keep him growing as much as is in our control because kids who don't stand and/or walk don't typically grown as well as those who do. Something to do with weight bearing and the bones and some other stuff I can't accurately explain. Anyway, eating has always been a huge concern with Rhys, and probably will continue to be for quite some time. Oh for the day he wants pizza, or a hamburger or holy cow a bag of M&Ms.

Zoe is 28" tall (~50%) and 22lb 10oz (ahem, 90%). She's continued to gain since beginning to crawl (which she incidentally will do on arms and knees about half the time now) but not at quite the same rate. She loves cheese, toast, cereal bars and surprisingly eats meat just as well as anything else. She's still trying to figure out how to pull herself up to stand, but she's finally making it to her knees easily so getting the feet beneath her isn't far off. I love watching her on the magna doodle and how she only wants to write with her left hand.

Have I mentioned that I hate Blogger? More times than not all my text does random things and has stupid formatting quirks. My favorite? When you insert a line separating paragraphs only to publish the post and see no space! Tonight was a first for me, I inserted a picture and it only allowed my existing text to be centered. Look back through all my posts and not a single stinking post is centered. Normally I'd retype it because it bothers me that much, but tonight I'm too lazy. Yes, I'm a little anal that way. Oh and spell check isn't working either tonight so please excuse any misspelled words.

teeth!

It seems as though I was wrong about Zoe's teeth. No sooner had I posted she had nothing about to pop through and here comes tooth number one! The bottom left tooth is in, with the right one on its way. We'd been checking her gums frequently, but this one snuck up on us. She had hardly any signs at all. A diaper rash (our first ever by the way) that had me suspecting, but Rhys had such a h.o.r.r.i.b.l.e experience with his first two teeth I guess I was looking for something more pronounced. So, the first tooth with no problems, but the second tooth is making her a bear. She's rather clingy and fussy (though I think part of that is just her age), she had a low grade temp this morning and threw up in her crib at midnight last night. Now that is what I was expecting to accompany the teeth, though it is still no where close to Rhys's ordeal.

And, Zoe isn't the only one with new teeth. Rhys is getting his two year molars. Holy moly that kid can be a grump. And speaking of teeth, Rhys's got stained from his antibiotics a few months ago. I'm pretty upset his teeth are no longer pearly white, but the staining has faded somewhat already so I'm hoping it continues.

Rhys and Zoe

Rhys...

Will be two-and-a-half years old next week!

Finally received his equipment! On December 31, with literally only hours to spare, it was delivered by the MIA sales rep and a service technician. Everything was perfect, except we still don't have the tray for his chair. A template was drawn to cut it to size, and the sales rep promised to bring it by last Tuesday, but surprise surprise we never saw or heard from her. I wrote a letter to mail to the company detailing our horrible experience and had decided against sending it, but this changed my mind. As soon as the tray is in our possession and it is processed through insurance, that bad boy is going into the mail with carbon copies to as many executives as I can find addresses for.

Is still army crawling and getting into absolutely everything. I chase him all day long. We recently converted our office into a playroom (I'll post pics later), so that is a baby prison of sorts. It also gets all most of the toys out of our living room. Score!

Seems to be gaining weight. I think he may be 27 pounds finally. I say think because I typically put him on the scale right before his bath, so that isn't the most accurate time for a weight check. He is still beyond stubborn with eating, but his ability to eat is better. That is not to be confused with his willingness to eat.

Seems to be gaining more movement/use in his legs. I think he actually has more range of movement than he uses on a daily basis but I occasionally see glimpses of said movement and get really excited about it.

Has had a twin size bed for a couple months now. One long side is against a wall, with the other "open" side having bed rail. They unfortunately do not make rails that I can find that extend the entire length of the bed. I try to block those gaps as best I can, but a couple times now I have found Rhys wedged between one of the gaps, very close to toppling out of bed and on his head. I believe it is intentional and am worried he's going to succeed one of these days and hurt himself!


Zoe...

Will be 10 months old next week!

Started clapping and pulling herself into a sitting position on Christmas day.

Shakes her head "no" all the time, though she doesn't understand what "no" is.

Is army crawling! Just like Rhys. She doesn't quite understand crawling on hands and knees, but she is close to figuring it out.

Is trying to pull herself up to a standing position. But again, she doesn't quite get the leg part of it. But she's trying!

Has been feeding herself bottles for the last few weeks. We have to prop her on the Boppy because she can't lift the full bottle while in a sitting position, but she's hand's free feeding for the most part.

Is still a great eater, though she is increasingly wanting to do it all herself instead of having us spoon feed her. I have made nearly all Zoe's baby food from day one, so we've more or less increased the texture of that food until it is bite sized pieces for her to grab herself. It is more of a challenge to come up with healthy "finger foods" for a baby her age than I thought it would be.

Is very good at independent play and is using many toys appropriately. I've said it before, but we are constantly amazed at how a child's learning process works. Rhys does everything so out of order that we've never had "average" in this house.

Thinks screaming (and I mean screaming!) is the way to get what she wants. Despite having used basic signs with her for months, she doesn't yet use any of them in return. Except for maybe milk, I think she does use that one sometimes.

Still has no teeth and none that I can see are about to pop through.

Christmas pictures

My mother, brother, us and the kids.

Rhys and Zoe playing at my cousin's house on Christmas Eve.

Rhys is sitting in his new Special Tomato chair, and was anxious to get

onto the ground to wreck havoc with the toys.

My mother and Zoe.

Me and my brother.

My silly boy and his Nilla wafers.