One-Year Adjusted Stats (by Meghan)

***NOTE***  
Meg began writing this post a month and a half ago and we're finally getting some time to finish it.


November 4th marked a very important day for our little ladies.  As of now, they are one year adjusted. At this point last year, we had 11-week-old preemies who were just passing their due dates. Sophie and Maddy were at home and Izzy still had a tough road ahead in the NICU with 1.5 months out of her 4.5 month stay remaining.

Today, you'd almost never know our girls were preemies, except for some delays in milestones. So, let's get down to the stats!




Sophia:
Weight: 23 lbs., 75th percentile
Height: 30.5 in., 85th percentile

Our little spitfire is getting faster each day. She walks everywhere and climbs on everything. Falling off is no problem her her.  Usually, she just gets up and tries again. She says baba, mama, dada and a whole bunch of other sounds. She's learning to sign.  Currently, she waves hello and goodbye, signs "all done" when she's done eating, shows "so big", and holds up her pointer finger when you ask her how old she is. She is also learning the names of many objects.  She knows who dada and mama are as well as the words ball, piggy, kitty, baba, book, and the phrase "turn the page."  Every day brings new learning!



She already loves shoes.  I think I need to find her a new passion, like cleaning the dishes.




Definitely the most jealous of the three, so far


Has huge smiles!



Madelyn:
Weight:  21 1bs., 50th percentile
Height: 30 in.,  80th percentile

Maddy is growing and learning every day, too. The therapists working with Maddy believe she has sensory processing disorder (SPD).  Because sensory processing issues are part of autism spectrum disorders we've been very worried about her.  The pediatrician was also concerned when we shared our observations of her behavior at home.  He advised that if she didn't start "coming out of her world" a bit more by the time she was 18 months adjusted, then we would start to worry about the autism spectrum.  Although kids with autism spectrum disorders have SPD, kids can also have SPD and not be autistic. Preemies with NICU experiences have increased risk of having a sensory disorder.

The great news is that over the last few months since our one-year check-up at the pediatrician, Maddy seems to be doing a lot better. She's not yet communicating with gestures like waving, but she is starting to communicate her needs and wants to us through crying.  She's also showing a much greater interest in being near us. Earlier, she would play for hours and never notice if we were in the room. She wouldn't look when we called her name.  Now if we're in the room, she sees us, drops her toy immediately, and makes a B-line toward our legs. This is great news and leads us to believe she does not have an autism spectrum disorder just a sensory processing issue.

Maddy had her re-evaluation for developmental therapy last week at which time it was determined she could benefit from adding this to her weekly routine. So now she gets speech therapy, occupational therapy, physical therapy, and developmental therapy. As you can imagine we're busy, busy, busy!

Another celebration for Maddy is that she's walking! At just 12 months adjusted, two of our little ladies are walking. I still can't believe it sometimes!  Although she's not as stable as Miss Sophie yet, she's practicing all the time and getting better every day. She is so cute.  I often hear her giggling as she's taking steps and trying to keep her balance. :)

Funny, I thought she was going to have blue eyes


Since they're the only ones walking right now, Maddy and Sophie have a blast playing together, especially when they're playing "I get you!" and chasing each other around the room


By the way, we've since moved up to the big bathtub in our bathroom





Isabelle:
Weight: 20 1bs., 35th percentile
Height: 28 in., 15th percentile

Izzy has made leaps and bounds since our last post. She's crawling, pulling to stand, and cruising on the furniture!  Just a few weeks ago, she wasn't crawling yet and look at her today. Every time she pulls herself up she looks to us for celebration, so now we're clapping all the time.

Although physically she's a bit behind, her cognitive development is right on track.  She's waving hello and goodbye and clapping and she's starting to match words to objects like mama, dada, and kitty.

Such a pretty lady








I can't remember what I said, but it sure was funny




Also, we have had lots of small graduations recently and they're definitely worth celebrating!

1. We packed up the bottles and Sophie and Maddy are using bottles.
2. Izzy is off of oxygen! Yahoo!
3. The cranial bands are done as of this week and they made a huge difference for both girls. 
4. Maddy and Sophie are self-feeding regular table foods.
5. We're down to one nap.
6. Did I say two out of the three are walking already? :)
7. Maddy is done with reflux and reflux medicine!

Until next time...

Time to Learn About ROP

***Warning - There is a post-surgery photo of Izzy's belly (incision site).  So, if that kinda stuff makes you queasy, just stay near the top of the post.***

There's so much to write about, but I'm guessing I have all of about 10 minutes of quiet time before Sophie and Maddy wake up for their next meal.  In fact, Maddy is laying on my chest right now as I try to balance her between my arms while typing.  Who knows, maybe she enjoys the rhythmic sound of my fingers typing on the keypad?

We've had two girls home for two weeks now and we're adjusting.  You don't really have any other choice.  I wish I could say that we were somehow getting more sleep, but with their reflux and needing to be held upright for so long after their feedings, there really isn't a lot of spare time.  It will get better.  It has to.  Right???  I'll write more about Sophie and Maddy later, but I wanted to share some recent pics and a video (only 33 seconds long) of Izzy and let everyone know how she's been progressing after her surgery.

In summary, she's doing very well.  She's lost a lot of the fluid that typically builds up after surgery and she looks less bloated.  She's put on some "real" weight and seems to be hovering between 4 lbs 13 oz and 5 lbs.  It's really incredible to watch.  I still remember what she looked like at 1 lb 7 oz and now she looks more and more like Sophia every day.  It's not like I didn't think she would, I mean, they are identical.  It's just amazing to watch the transition each time we see her.

Having her still in the hospital is really difficult on Meg and me.  With Sophia and Madelyn at home, we're finding it very difficult time to fit everything in.  Usually, Meg and I will take turns on who goes to see Izzy, but it's tough never being able to go together and, frankly, we're just plain tired of the NICU.  Don't get me wrong, we're not ungrateful for the care that they're giving her.  We're just ready to get our girl home with her sisters.

Izzy is making progress on her feedings.  They began giving her milk in small amounts earlier last week.  She was up to about 11 ml every three hours (or 11q3 in NICU speak).  That was until I went to see her last Thursday evening, straight from work with my dress shirt still on.  I tried to bottle feed her, but she wouldn't take it.  After trying for about five minutes and her not giving me any sign that she was going to be cooperating any time soon, the nurse fed it to her through the NG tube.  About 10 minutes later, her bowels decided that they weren't for that volume of food and she let me have it.  I caught most of it, but what I wasn't prepared for was the second round of spit up that contained some bile.  That was her way of telling us that her intestines weren't prepared for that much food yet.  They stopped her feedings overnight (don't worry, she's still getting the TPN) and started up the next day at a lower volume.  It really is a trial and error process in figuring out how much, and in what time frame, she can consume food through her belly.

The other bit of news that was a bit surprising was that she's exhibiting the first signs of ROP (Retinopathy of Prematurity).  I was hoping that I wouldn't have to write about this and that somehow we would escape it, but it seems like we'll have to learn all about another disease.

From the about.com Preemie section (http://preemies.about.com/od/preemiehealthproblems/a/ROP.htm)

What is Retinopathy of Prematurity (ROP)?

During pregnancy, the blood vessels in a baby's eyes begin to develop around 16 weeks gestation. By about the 34th week of pregnancy, the blood vessels in the eye are well developed enough that the retina has a good blood supply. When babies are born early, the blood vessels on the retina are not fully developed. After birth, the vessels may begin to grow so quickly that their growth damages the retina. Retinopathy of prematurity (ROP) is the name for the improper growth of the blood vessels on the retina and the damage caused by that growth.  In most preemies who develop ROP, the growth of the retinal blood vessels will slow down on its own, and vision will develop normally. Some premature babies, though, develop severe ROP.

There are five stages of ROP.  Stage 1 being the mildest and Stage 5 being severe with vision loss.  Stage 3 is where they would most likely consider surgery.  They also specify the location of the abnormal blood vessel growth by zones--either one, two, or three--with zone one being located closest to the center of your eye and potentially the most detrimental to vision and stage three being the most peripheral and least likely to affect vision.

Right now, Izzy is between stages 1 and 2 and is in zone two.  The eye doctor is coming back in a few days for another exam, but we're hopeful that there won't be any long-term damage considering that she's at 41 weeks GA and that she's getting close to being weened off of her oxygen, which can cause the blood vessels to grow abnormally.

Besides all of that, she's seems like a completely content baby.  Watch the video and check it out for yourself!  


Izzy's belly, post-surgery, but with her belly button!


Isabelle, spending some time with my mom before she had to go home




The nurses tell me that she loves the sound coming out of this machine




A quick little video that Meg took last week