Double Digits

Our big news of the week is that Casey finally made it to the double digits in weight.  Her official number at this week's weigh-in was 10 pounds 8 ounces!! That is over 5 times her lowest weight (she was born at 2 pounds 6.5 ounces, but dropped down to 2 pounds 1 ounce after a couple days).  This is also an 11 ounce gain from last week, which is huge!  I am fairly certain that the weight gain can be attributed mostly to a growth spurt based on the fact that her volume drastically increased, she was finishing some bottles in 15 minutes, and she was even waking up to let us know she was ready to eat before some of her feeds. Well, and all the extra calories from these amazingly rich and delicious Brownie Batter Chocolate Fudge Cupcakes Mommy was devouring last week may have also contributed a bit to her weight gain (and mine!).  Just doing my part to help a little girl out! Seriously, these were so good that my husband, the self-proclaimed "cake hater" had more than one.  We were thrilled that she had such a good week, although her eating has tapered off a bit in the last few days.  This may just be because the growth spurt is over or could be due to the constipation our poor girl has been suffering from which makes eating less than comfortable (she has had some issues with this for a while, but the Dietitian suggested it may be worsening because of the increase in her volume).  We have also noticed that Casey is experiencing more spit-ups which may also be causing her to want to eat less, and bringing up the question we have been debating for months of to medicate or not to medicate for reflux.  I'll spare you the long list of our pros and cons for whether to start her on reflux medication, but it will definitely be one of our major topics of conversation at our next appointment with the pediatrician in a couple of weeks.  Between my daughter's projectile spit-ups and our poor sick dog's vomiting (let me say that the sound of a dog dry heaving and your subconscious screaming "Must.Save.Carpet!" has to be one of the worst ways to be ripped from your sleep), I am pretty sure I have cleaned up my quota of bodily fluids this week! 

That's about all the news I have to report.  It has been a pretty boring week (and that is how we like it!).

And because I know it is what keeps you coming back, here are this week's pictures of our Doodlebug:

 Curled up in her blanket

 Night Night!

 One of a Kind

 Looks like we have a thumb sucker!

 "Paci down, PACI DOWN!!!"

 "Ah, life is good again!"

 This kid's limbs are in constant motion.  It is getting harder and harder to not get a blurry picture.

 Her Serious face

 Little Americans Fan

 It is kinda blurry, but Casey has started giving us the biggest grins and it is the cutest thing ever.

 Return of the giant flower headbands! (and yes, there are lots more to come!)

 I can never figure out how her sock can make that big of a leap???

And just in case you needed a little proof that your prayers are working, here is a video of our girl who has become quite "talkative" since I posted about our goal of getting her to babble and talk more.

And yes, I do realize this is probably only interesting to us, but she does give a few cute smiles that might make it worth watching :)

Observations

I am quickly learning that moms of preemies have to be pretty observant.  Every time someone from ECI (Early Childhood Intervention) comes they like to ask questions such as "Do you notice Casey turning her head more toward the right or the left?" or "When Casey is alert, what percentage of time is she looking at faces and what percentage is she focused on lights or other objects?" To which my response is usually "Hmm, I will try to watch for that next week."  To further complicate things, we have to watch for any skills between newborn and 5 months of age since she is delayed in some areas, on track with her 2 month adjusted age for certain skills, and the hope is that we will start to see some skills closer to her actual age of 5 months.  Despite my lack of knowledge, we did have some great appointments this week, and both our Dietitian and Speech Pathologist were so impressed with her progress that they are already talking about reducing services soon.  For now we are planning to leave services the same and continue to observe and monitor her progress until after I go back to work in a month to make sure she handles the transition well.  She has had a great week feeding wise, and  she is now consistently taking right at 3 ounces at every feed.  Her weight gain has been good, and she was 9 pounds 13 ounces at our weigh in on Wednesday (although the scale kept fluctuating and she was 9 pounds 14.2 ounces just two hours earlier at the doctor's office so I think that weight was a little on the light side). 

We were finally able to get her in for her Synagis shot, and I am definitely not looking forward to witnessing that torture for the next two rounds.  Poor baby! As usual we had to wait over an hour to see the doctor while we watched every person who came in after us be seen first.  It is scary and frustrating to sit huddled in the corner of a germy waiting room wanting to scream "We are supposed to be in isolation!" the entire time, but we are at their mercy.  Hopefully once we get all of her initial patient paperwork and appointments out of the way, the process will start to speed up at these doctor's offices. Since she hasn't had any apnea episodes, I felt comfortable enough to take her to this appointment by myself for the first time (normally Brian or my mom comes so that one of us can sit with her in the back).  She did great in the car, and I only pulled over once to make sure she was still breathing!

Casey did have her final evaluation with ECI for her gross motor skills, and at this time she does not qualify.  The physical therapist noted that her tone seems to be normal, she is often keeping her fists open, and that although her motor skills are more at a 1 month old level, there was nothing overly concerning or that we wouldn't already be working on during Specialized Skills Training (SST).  She will continue to be a consult on Casey's team, and could be called back out if we see anything concerning in the future.  The two things she does want us to keep an eye on are for Casey to start lifting her head without support when we pick her up (she is doing pretty well with head control once in our arms, but lets her head fall back when being picked up) and that one of the indentions on her legs looks more prominent (apparently it is important that your fat rolls be evenly distributed!)  At her bimonthly SST appointment, The Doodle decided to be a complete show off!  She was giving tons of smiles, tracking objects from side to side, gripping things placed in her hands, and lifting her head well for tummy time.  I also learned an infant massage routine which will hopefully help her when she is constipated and gassy (which is getting better but is still pretty frequent). Our specialist told me over and over again how great Casey was looking and how much progress she had already made since her visit two weeks ago. 

Throughout this week we have also noticed Casey picking up quite a few new skills.  She has discovered her hands and loves to put them in her mouth, she has started sticking out her tongue and will sometimes mimic me when I do it, her feet and arms are in almost constant motion when she is awake, and she has started making more cooing and babbling sounds.  Our new goals are to continue working on head and neck strength during tummy time, to encourage more baby talk and noises, and to give her lots of opportunities on the play mat to bat and kick at toys and objects.  Overall we are very encouraged by her progress, and we are loving every minute watching her learn new tricks (and telling her every day that she is the smartest baby in the world!)

Here is the latest Casey cuteness:

 Pretty Kitty!

 Flower Child!

 Sans the ridiculous hat!

She has no idea she is about to go and get an evil shot!

80s baby!

 Tired after her workout in the leg warmers!

 Tuckered out!

 I set her down for two minutes to get her bath ready and she was passed out!

 Pretending to talk on the phone!

 Play time wore her out!

 Pretty girl!

 Mischievous grin!

She loves to suck on her hands!

In other news, I had to show off our latest home project. We finally got the window I painted  a year and a half ago and the coordinating sconces hung.  Nothing like having your in-laws come to town to get a few things moved up the to-do list.  Brian and his dad also worked all afternoon to install our new storm door.  The most exciting part is that now I won't have to wonder every time the wind blows the old door open and sends the dogs into a frenzy if this time there really is an axe murderer at my back door!

 I am pretty proud of my masterpiece!

Also, I neglected to mention a few ago that our third dog is home!  Finn is Brian's Search and Rescue dog and since Border Collies have way too much energy to be cooped up as much as he would have been with us gone all the time, he went to stay with his doggie mom and dad while Casey was in the hospital.  We now know that this smart boy was the first to know I was sick before I delivered, but at the time we could not figure out why he had a sudden interest in cuddling with me all the time.  We are so glad he is home, and now the Inn is officially full again! Thanks Ben and Tiffanie for taking such great care of our boy!  It was no easy feat to get this boy to stand still for a picture, but here is the best I could do.

 Finn boy!

Bliss

Want to know what bliss is? Having three, yes THREE, whole days in a week without any strangers coming into your house! Now let me start by saying it isn't that I don't appreciate all of the advice and helpful tips these visitors provide, it's just that, well...I love my PJs, and when strangers come over I can't stay in said PJs all day. There, I said it!   If you drop by my house unannounced expect to find me in my PJs (you have been warned, so you cannot judge). After spending 130 straight days at the hospital (not in my PJs, unless you count those few nights spent tossing and turning on the not so comfy couch in Special Care), I feel I can justify some quality PJ time (and since it is my maternity leave, I will wear what I want to).  In all seriousness, we had a calm and pretty quiet week this week. Casey has been feeling much better and she has been fever free most of the week! Now that she is over her bug, she has been back to her old happy self and we have loved watching her give us a whole lot more social smiles.  At our weekly weigh-in, Casey's weight was 9 pounds, 7.5 ounces, which means we are quickly having to retire most of her newborn clothes (meaning you can look forward to The Doodle debuting her new 3 month wardrobe on the blog!). At almost an ounce a day, the nutritionist was very happy with her weight gain. We are pretty ecstatic too, because it means we won't need to add back in her 3 am feed (and after a week without it, I am feeling much more human. A human who is not in a constant state of needing of a nap!) Next on the agenda will be eliminating the midnight feed, but I won't get too greedy yet! Our Speech Therapist was also very happy with her progress, and we are having to use less and less "tricks" to try to get her to eat (i.e. chin and cheek support, twisting her bottle, cold stimulation on her lips, and my personal favorite, tapping out a rhythm on the bottle). The most exciting news is that she has even started finishing some feeds in under her 30 minute time limit!

With all this "free time" (yeah right!) on my hands this week, I spent many of  my spare minutes dealing with the nightmare that is scheduling Synagis shots. Casey will get five of these shots throughout RSV season, and at around $2,000 a pop (not our cost thankfully), there are lots of hoops to jump through as far as finding a pulminologist, getting approval from the insurance company, and finding a pharmacy that both the doctor's office and the insurance company will play nice with. After about 1,328,547 calls to all of these places, and my daily calls to the loony toon receptionist at the pulminologist's office whose favorite phrase is "Can you hold please?", I have no doubt that I am now "That Mom" their whole office is taking about.  I am okay with this though if making a nuisance out of myself prevents a trip back to the hospital with a life threatening RSV diagnosis. Our quiet week was nice while it lasted, but this week it comes to an end with at least one appointment or visitor scheduled almost every day. One of these appointments is for her last evaluation with ECI, this time to see if she qualifies for motor development services. Prayers that this evaluation will go well and for her continued progress with feeding are much appreciated.

Here are the pictures from the past week:

 So cute I can hardly stand it!

 She wasn't really feeling picture time today!

 Precious girl

 Rockin' the Mohawk!

 Cuteness

 Mommy does say she is sweet!

" Really lady, you woke me from my slumber to take more pictures!"

 Joy!

I keep telling her it isn't necessary to raise her hand when she has a question, but she insists!

 Little cupcake

 Mommy's Doodlebug

 "Again with the pictures at midnight!" She was not too happy with me as you can see.

She is even cute when she cries!

A Busy Week

We had a busy week filled with follow-up doctors appointments and ECI visits. On Wednesday, Casey had her ECI evaluation with a Registered Dietitian, and she did qualify for Nutrition services. This means we will get weekly weight and growth checks, and she will also be working with us to determine how to best help with her growth and to monitor her calorie intake. We are happy to report that we now have a 9 pound 1 ounce girl! The other good news is that she is now on the charts for her adjusted age, and she is currently in the 25th percentile for weight and just above the 50th percentile for height! She also had her follow-up visits with the surgeon who repaired her hernias and she got the all clear!  Our most exciting news is that after her visit with the eye doctor, he declared her eyes to now be fully developed (no more ROP!!). After waiting over two hours to then watch a doctor pry my child's eyes open with an evil speculum and poke around in them with a sterile paper clip, I was more than overjoyed to learn we won't have to go back (and by her reaction to the torture, I think she is too!).

We also had our first official ECI visits this week, and both of the specialists were impressed with her progress.  I really like our new Speech Pathologist, and after watching her eat she gave us some more helpful tips for further improving feedings.  Overall her daily volume has been pretty good the last few days and we are going to try to wean out her 3 am feeding this week (we are crossing our fingers that she will continue taking enough at the other feeds so that the Sattlers can all enjoy a little more sleep!).  The Early Intervention Specialist that came for our bi-weekly Specialized Skills Training already noticed improvement in her tracking abilities since last week's evaluation, and we too have noticed that Casey is following items and sounds with her eyes and locking in on our faces much more.  She also noted that she seemed much more alert and active, and just this week Casey has started having much more head control and interacting more with us. She provided lots of ideas to try for "homework" before we see her again, which has kept us busy exploring rattles, toys, and her activity mat.

Our Doodlebug did give us a little scare this weekend when she started running a mild fever of 100.4.  I could tell she was feeling pretty bad on Friday when our normally calm and content baby was fussy most of the day and not even her beloved paci seemed to soothe her (I don't know how moms of colicky babies do it every day.  There is nothing more heartbreaking than listening to your baby cry inconsolably). After taking her temperature practically every 15 minutes and speaking with the after hours on call nurse through our pediatrician's office (and reminding myself only about a million times not to freak out), her temperature has remained just slightly above 99 with Tylenol.  We were very relieved to avoid an ER visit, which we were told would have resulted in a full work-up and spinal tap.  Today she has been almost back to her normal happy self, and we are hoping this means she is over the worst of it, but prayers that her symptoms will clear are definitely appreciated.

Yesterday also marked her 5 month birthday, meaning she is now 2 months adjusted.  Enjoy the latest pictures of our girl:

 Preppy girl

All clean!

 Adorable

 Exhausted after her eye exam (and she came up with this pose all on her own)

 Happy Dreams!

 Cuteness Overload

 Can you tell who dressed her today?  (Mommy helped with the bow though!)

 Exploring her activity mat

5 months (where has the time gone?)

Word on the Street

As I was re-organizing Casey's drawers and closets this week to make room for her new Christmas clothes, it became apparent that word on the street is there are a few themes in Casey's life. 

Here is a little hint: 

When we started planning her nursery, Brian's biggest stipulation was he wanted monkeys in the room, so we decided on this wall decal:

  

Knowing that by throwing in a few monkeys I would stand a much better chance of getting to choose the rest of the decor without much objection from him, I was happy to comply! Well, from the looks of things below, he really showed me  :)

 So a couple of monkeys on the wall quickly evolved into a full blown "monkey theme" (I'm still convinced he must have sent out a PSA that Miss Casey would welcome all monkey paraphernalia!).  And before you become concerned about my spending habits (although Brian would probably tell you I do have a bit of a "shopping problem"), I can assure you that most of the things above were gifts from our incredibly generous and amazing friends and family.



And because a girl can't have just one theme, a ladybug wardrobe has also emerged. This theme evolved because my nickname for Casey has been "Doodlebug" from the time I found out we were expecting a girl. (Can you tell which items are a bit harder to find?)

And then walking down the aisles of Target one day we found the perfect compromise to tie our themes together:

The Doodlemonkey!!!!

So a few days before Christmas, our "themes" sparked an idea for a challenge (and my husband never backs down from a challenge).  We were already searching for the perfect ornament for Casey's first Christmas, when I suggested it would be fun if every year we each looked for an ornament to represent our "themes."

Here we have the 2011 editions.  (I think we did pretty good for our first attempts...although we may need to start looking now for next year as this is one tough challenge!)

And because we over-do everything, we also found a couple other ornaments (the carriage for baby's first Christmas and the Scrub-wearing snowman to represent her hospital stay).  The two adorable ones in the back were Christmas presents from family.  I think it is safe to say Casey's ornament collection is off to a good start.

Oh and just for fun, the former fashion design major in me noticed that there must be a cupcake trend in baby clothes this season because she seems to have quite a collection (we could also make a case that she has giraffe and elephant themes going as well, but quite frankly nap time was over I was just ready to get everything back into the closet and drawers so I will save those for another day!)

Well that turned into quite a long post!  Look for a post with her weekly update and pictures later this weekend!