Family Resemblance

The top picture is Grandma holding Jamesie, and the next one is Grandma holding baby Melanie. (And then for comparison, there's me holding Jamesie, from Halloween.) I think James takes after his mama!

You'll be sad to hear that we missed out on our Thanksgiving photo opportunity -- we were in such a hurry to get the turkey into the oven in the morning and on to the table in the afternoon that we didn't remember to pose the babies next to the turkey for size comparison. (This year, the turkey wins -- it was around 17 lbs, and James and Mattie are in the 11-13 lb range.) Oh well, I don't think there's going to be any shortage of baby photos of either one of them!

We had a wonderful and relaxing Thanksgiving weekend, and all our company made it home safe and sound. Since Uncle Adrian managed to catch Cousin Daniel's cold, we didn't get to see them. We were disappointed, but fortunately we'll see them for Christmas.

Saturday, James "talking"

James is beginning to "talk" more often than he used to. We try to encourage this by praising him when he makes sounds, but it is hard to know if he connects our hugs and smiles at that moment to his vocalization since he receives so many hugs and smiles anyway no matter what he is doing.

Happy Nov 28th

We have a very happy household today (and the day has just begun). The sun is out and the boys are enjoying the extra staffing over the holiday weekend. We haven't told them that aunt Erin and uncle Isaac are leaving this afternoon.

So Very Thankful

We have so much to be thankful for this Thanksgiving. I started to make a list in my head, and it was so long that it would take up an entire blog page! We are thankful to have our two precious boys at home, and thankful to the amazing nurses and doctors who took such wonderful care of them (and saved their lives) in the NICU. We are thankful for all of you -- our friends and family who have been so fantastic in so many ways.

We hope you have having a wonderful holiday! We have been enjoying good food and good company. (In fact, I fell asleep on the couch this afternoon, and when I woke up, the table was set, the potatoes were mashed, and the turkey was coming out of the oven! Best guests ever!)

Getting Ready

We're getting ready for the arrival of family for Thanksgiving. We're so excited to see everyone! (And hopefully the cuteness of the babies will distract people so they don't notice that the house is messier than usual.)

There's been a wrench thrown into our original plans, though. Cousin Daniel has a cold. (This is his first time in daycare, so he's had an illness of one sort or another pretty much constantly all fall, but this one started this weekend.) Our pediatrician did not think it was a good idea to expose the babies to cold germs, so Aunt Nora and family are delaying their arrival to see if they can get past the most contagious and runny-nose stage. Hopefully it will work out -- it won't feel like Thanksgiving without them here! (I think Nora would not approve of my just misting Daniel with Lysol every time he walks by.)

Of course we couldn't escape without some type of medical appointment this week. Matthew's blood pressure was up a little bit, so we had to pop by the pediatrician's office to get it checked again. It's still a bit higher than they'd like, so they've upped his medicine a little bit.

Hope you are all doing well heading into the holiday weekend!

A Tale of Two Mornings

Yesterday morning we woke up to discovered that James had had an ostomy bag "malfunction" -- yuck! It's no more disgusting than a poopy diaper blowout, but it does take longer to deal with!

But this morning we had the boys down under their activity gym, and they were smiling at each other! So cute!! They each seem very happy to have a brother.

Also this morning, Matthew slept until 8 AM! (Of course, he fell asleep later last night than usual, but hey, I'll take those extra hours in the morning.) He usually wakes up at 4 or 5 AM for his first breakfast (and then goes back to sleep for a couple hours before second breakfast), so this was quite a pleasant change.

Rest in Peace, Aunt Jeanne

Aunt Jeanne passed away this morning, at home, surrounded by her loving family. Rest in peace, Jeanne -- we will miss you.

Saturday morning photos

It is a beautiful bright day here in Chapel Hill. And I think Melanie and the boys are looking particularly happy and cute this morning so I thought I would share the feeling.

Good Eating

Jamesie continues to do well with his bottles --yesterday he had some 40 and 50 ml ones interspersed with his 20 and 25 mls ones, and same thing today. We are very happy -- it's so much more pleasant to feed him during the day without the pump, and to have the flexibility to be out and about without a feeding deadline every three hours! (Of course, James sets his own "deadlines" by crying when he wants to be fed!)

It's hard to tell what he's hearing and what he isn't; sometimes he seems to respond to relatively soft sounds, and other times he doesn't seem to hear loud ones. It didn't seem like he was responding to much sound today, but then when our friend was visiting and made some clicking noises behind James's head, it seemed to soothe him. (Time will tell, but it's hard not to try to figure it out in the meantime.)

Mattie was laughing up a storm this morning -- baby laughter is awesome!

We Love You, Aunt Jeanne

Our thoughts this week are with Mike's Aunt Jeanne, who is being released from the hospital into hospice care tomorrow. She has beaten cancer before, but sadly, it has returned and can no longer be treated.

Most of you have not had the privilege of knowing Jeanne, but she is a truly amazing person -- one of the kindest and most cheerful people I've ever met. She organized her town's 100th anniversary celebration, she sends out the family calendars so that the rest of us can remember birthdays and anniversaries, she has a smile for everyone. And throughout her illness she has always been upbeat and never stopped taking care of those around her. She is truly a model of grace, strength, and courage.

Jeanne and Mike's Uncle Don celebrated 50 years of marriage this summer, not long after the babies were born. It's too bad there wasn't a way to teleport between North Dakota and North Carolina so that we could have celebrated with them and they could have met the boys. (The bottom photo is from a few years ago, when they celebrated Thanksgiving with us in Philadelphia.)

We love you, Aunt Jeanne. We wish we could be there to see you. You are in our thoughts and hearts today and always.

Rings

James is starting his training early for his Olympic gymnastics debut. (I think having the pacifier will be a deduction, though.)


James did fine with the larger overnight feeds, and he also did fairly well with his bottles yesterday. He only drank around 20-25 mls at a time, but he'd do that two or three times over the course of an hour, so he ended up exceeding the goal of 200 ml in daytime feedings. Of course, it seemed like we were feeding him every time we turned around! It's okay for now, and it was really nice not to have to deal with the pump during the day, but we're hoping that he'll consolidate those little feedings into fewer larger ones. He was also awake and happy a lot during the day, so at least this approach seems to be reducing his tummy discomfort.

Practically Normal

The GI doctor called first thing this morning with James's blood results, and he was very pleased -- James's direct bilirubin is down to .6, which as the doctor said is "practically normal." (The normal range is 0 to 0.3.) His other liver enzymes looked good as well. Hooray!! Everyone had been saying how good James's color looked, so we thought we might be getting good news (but didn't want to get our hopes up). It was a nice way to start the day!

This afternoon the teacher from the hearing Early Intervention program came to the house. (The plan is that we'll be seeing her twice a month while James is still little, and then more frequently as he gets older -- after about six months adjusted age.) There are several different approaches to teaching communication to kids with hearing loss or deafness, and this person uses the Auditory-Verbal approach.

Apparently we're doing things in a slightly unusual order. There are two Early Intervention programs for hearing loss. One provides teaching for parents and kids, and the other, called Beginnings, is more of a support program to make sure families are aware of the resources available and are connected to the appropriate agencies and so on. Part of the Beginnings program is explaining all the different approaches to communication teaching, so that parents can make a more informed decision about how to proceed (for example, focusing on sign language versus speech). But we're not meeting with the person from Beginnings until next week, so we don't know much about the different options yet -- though we get the sense that people feel very strongly about the one they choose! Usually this meeting takes place before a referral to a teacher. But that's okay; I think we'll be happy with the current person, and if we decide an alternative approach would be more helpful for James, I'm sure we can switch.

The first part of the meeting was her getting a sense of where James is developmentally (by asking us questions about what kinds of things he's doing or not doing) and auditorially (I'm not sure if this is actually a word, but you know what I mean). Our impression was that she was very encouraged by the kinds of things he was doing and the fact that he does seem to be responding to some sounds. And her experience has been that more often than not, kids with auditory neuropathy do well with hearing aids. It was nice to hear that from someone with actual experience working with kids with this condition.

As we understand it, the goal of Auditory-Verbal approach at this stage is to help James pay attention to sounds. So, we're supposed to pay attention to when he seems to be responding to sound, and draw his attention to it by pointing to our ear, making an excited face, and saying, "You heard that!" We're also supposed to talk to him as much as we can in a regular voice, but close to his ear. This makes it more likely for him to hear what we're saying, but doesn't distort sounds as much as raised voices do -- and of course, it's also a much more natural way to talk to a baby! As the weeks go on, she's going to be giving us additional exercises to do. She's also going to be doing some evaluation herself of how much James is hearing or not, and is going to do some activities with him that will help prepare him for the more formal behavioral hearing test. (Her overall goal will be to have him at an appropriate age level with language by the time he turns three, when the Infant-Toddler program ends. If needed, he'd transition to the next level of EI program after that.)

I don't think I fully understand the basis of the A-V approach yet (and I'd be interested to see what the research says about it), but it seems like a reasonable starting point.

For feeding, we tried the "bottles during the day" approach. He did several 20 ml bottles, which isn't as good as he'd been doing over the weekend. However, he was alert and happy a lot today -- he wasn't dealing with as much digestive discomfort. We'll see tonight whether we can give him enough food overnight to make up for the lighter meals during the day.

Good Thing They're Cute

The day started off well. We had an appointment with the speech/feeding therapist at the hospital around lunchtime. She was glad to hear that things had improved with the new formula. Since James is doing well at night (no spit-ups, not waking up in pain), she suggested trying to give more volume with his continuous feeds (for example, running the continuous feeds for nine or ten hours instead of seven, and going to a slightly faster rate), and then trying to just do bottle feeding during the day when he acts hungry, with a goal of 200 mls during the day (or five feedings of 40 ml each). If that works, it would be great, because dealing with all the pump stuff during the day is really time-consuming. It would also give us a little more freedom if we have to be out and about; right now we only have about a two-hour window between feedings.

I'd fed James a little bit (25 mls) before we left because he was acting hungry. He was sleeping when we were there, and he didn't want to eat when I tried to feed him. But then he woke up a little more, and ate 50 ml for Mike with no problems! That's the best he's done in a while. We weighed him, and he's continuing to gain weight (he was 11 lbs, 8 oz on their scale). So, it was a good visit.

She suggested going up from the slow-flow nipples on their bottles to the regular flow ones, since neither James nor Matthew seems to have trouble any more with drinking too fast and choking. We tried it with Matthew tonight and he did just fine with it.

We also had to do blood work, but the orders for it weren't at the desk, so we had to wait around for a while for them, and then had to wait at the lab, so it ended up being a long afternoon. In fact, I had to leave to go to a meeting at work, so poor Mike had to manage both of the little guys for the last part of the visit. Fortunately, they both slept, so it was a bit easier for him!

This evening wasn't so much fun. James was pretty fussy with his feedings, and at his 9 o'clock feeding, he didn't really want the bottle at all, and then ended up having a small spit-up afterwards. Matthew was a little fussy as well, so between the two of them, they kept us both busy more or less non-stop. Mike was trying to meet a deadline for work, and I just wanted to do a few little things like put a couple dishes in the dishwasher and pay a bill, but it was not to be! The babies are both asleep, finally.

Six Months

I can't believe the boys are six months old today! Half a year -- wow. They're such wonderful little guys. We're so happy to have them.

We had sun today for the first time in four days, so we took the babies out for a walk by our neighborhood lake. (There's a little gravel path down to the lake, and it turns out our strollers really aren't good for off-roading -- they made it, but it wasn't a smooth ride!) Stanley was happy to get out of the house, too!

James had a good day today with his bottles. He was drinking 35-40 ml per feeding, which is still not his best, but it's an improvement from where he's been recently. We just went up to the 24 calorie version of the formula, and he seemed to be doing well with it until the evening, when he had a bit of a spit-up and seemed a bit more uncomfortable. So, we'll see how things go.

Matthew has been having great fun grabbing things recently (mainly toys hanging from his activity gym, although watch out if you have long hair); his coordination has improved so that he's actually able to grab things on purpose instead of just randomly. He was fussing a little bit the other day while he was playing, and I think it may have been because he was frustrated because one of the toys was hanging just a little too high for him to reach. I wonder if this is the start of a new phase. Up until now, if he's crying, it's almost always for one of three reasons -- he's hungry, he has gas, or something has hurt him (scratching himself, getting a shot, etc.). But today he was fussing a little and then smiled when we came over, and started fussing again when we left -- so maybe he's now going to start expressing himself about some other needs as well as just the basic ones.

We had a really nice evening -- one wonderful friend came by bearing dinner (and immunizations), and another (also wonderful) friend came over later to watch some football with us. Hooray for adult company!

Friday Fun

We went to a friend's birthday party tonight. Getting out with the boys is an effort, but it was definitely worth it -- we had a great time seeing our friends and meeting new folks, even if we did have to divide our attention between socializing and baby wrangling. The babies were both asleep when we arrived, but that didn't last too long. After he had some milk, Matthew was happy to be passed around and smile at people, but James was a little more high maintenance.

The other kids there (all boys!) were all a few years older than our little guys, so we had a preview of the future. (It turns out that the future is cute, but also very noisy.)