We Survived

Well, we survived Mommy's first week back to work! Casey did really well with my mom, I made it through every day without any tears, and I even managed to get dinner on the table each night (not gonna lie, I was pretty bummed I cashed in our occasional pizza delivery night the week before because this mama was tired!).  It took some adjusting, but I think we are all figuring out our new schedule  (if only it didn't have to start at 5 am!).  I will admit that I was in bed before 9 pm on at least one night last week, and by lunchtime I was really missing my usual morning nap, but I think I did pretty well all things considered.  It was great to see my students, and I was ready for a routine that didn't revolve around feeding, sleeping, pumping, and crappy daytime tv.  Casey ate well for my mom (which was my biggest worry), and I have already come to the conclusion that Gigi is way more fun than I am.  I got tons of texts throughout the day of all the exciting things they were doing (which definitely made the days easier knowing she was happy and entertained).  At her Nutrition appointment we were very encouraged that she gained 7 ounces in 6 days, and her weight is now 11 pounds 13 ounces!  This was a huge relief after she only gained 6 ounces combined in the previous two weeks.  Our Speech Therapist came to work with my mom and showed her a few things to try when Casey fights the bottle (which is still a pretty frequent problem). Unfortunately, we have yet to see any major improvement from the reflux meds we started, and she is still having several big spit ups a week, which is pretty frustrating when you have just worked so hard to get the ounces down her.  We are encouraged though that the constipation problem has been much better recently, and we haven't needed to use prune juice in over a week.  This week she will have her next SST appointment, and even though she hasn't quite rolled over on her own yet, she is getting closer and closer!

As always, here are the latest pictures of our Doodlebug:

Loaded up for her first day with Gigi!

 I wanted to be sure you all got the full effect of what the previous picture didn't show. This is what I got to pack up in the car just to survive our first day (thankfully this is NOT what I have to take on a normal basis)

 Gorgeous girl!

The happiest baby in the world!

 "What's that you say?  I get to go to Gigi's house again today?  Happy Dance!"

 Check out those almost 12 pounder rolls!

 The best part of every morning is seeing this sweet smile!

 "Mom, why did you wake me up so early?"

 Big grins

 Good morning!

 One guess who dressed her in this ensemble today.  When questioned, Daddy said "What, yellow and blue go together." Umm, in this case I beg to differ babe!

 Check out that head control!

Casey's new favorite thing is to wiggle into the corner of her bed as quickly as possible.  No matter how many times we try to reposition her to the middle, this is the spot she always ends up in again.

Things I Learned on Maternity Leave

It has been a relatively slow week around the Sattler house.  We had our SST appointment where we set some new goals for Casey.  Within the next few months we will be working intensely on helping her to roll over and we are hopeful that she will also be able to sit up with support by her next evaluation date.   Casey weighed in at 11 pounds 6 ounces, which is a bit disappointing because it means that she again did not have a great weight gain as she is only up 2.5 ounces.  We have not noticed much of a difference from her reflux medicine yet, and due to the stall with her weight gain, our Dietitian suggested we try to take out her midnight feed, allowing her to get more rest at night, but it means we will need to feed more frequently during the day to make up the difference when she does not take full feeds.  For babies with reflux, the trend seems to be that discomfort starts after they take in about 2 ounces, and for Casey this is definitely true.  We have to carefully weigh whether it is worth pushing her to take more and risk having her spit-up (causing her to not gain weight in the short-term) and possibly develop an oral aversion (long-term disadvantage).  These are  both things that we are working closely with our Speech Therapist to help us avoid. After trying the new schedule for a few days, we are concerned she is still not taking a large enough volume, and since we don't want to risk another week of poor weight gain, we may have to wait a bit longer to wean her off that late night feed.  Casey also had another round of Synagis (RSV shot) this week, and we are hoping she will get one more shot in March (insurance may or may not approve it based on whether RSV season is declining). We are still keeping her very much isolated, especially considering what a terrible RSV season this has been, but watch out world, because The Doodle hopes to make her public debut sometime in April when the warmer weather has killed off all these nasty germs.

We will be making some major adjustments in our world this week as I return to work.  While I am definitely excited to get back into the classroom  and see my kiddos (and go somewhere more exciting than the grocery store), it is going to be very hard to leave my girl.  We are so fortunate that my mom will be taking over for me during the days to watch Casey and that her therapists will continue to work with her at mom's house.  My mom has been busy practicing bottle feeds and learning all the techniques to encourage Casey to eat, and mom's house has now been transformed into Baby Central.  Please pray that the transition goes smoothly for all of us, and that feedings with my mom continue to be successful.  In honor of my return to work, I give you my list of things I've learned on Maternity Leave:

1. Whether working or staying at home, there will never be enough hours in a day, ever!
2. Changing the channel with my foot never goes well, yet I still seem to forget this about once a day and continue to try.
3. It is not a good idea to put on eyeliner while holding a baby.
4. I have decided it is pretty much impossible to get all those snaps right on a baby's clothes on the first try.  I am pretty sure someone designed them just to torture tired mommies and daddies
5. We are going to be in for a rude, rude awakening if our next child doesn't sleep through the night.
6. Even if your child does sleep through the night, if you are pumping, you don't get that luxury.  I am going on almost 7 months of no more than 5 consecutive hours of sleep, and eagerly looking forward to the day when my pump and I can finally have our "break-up"
7. After a blow out diaper, sometimes it is just better to throw that outfit away.  You will never look at it the same again.
8. Preparation times on recipes are only a suggestion (and when you have a baby whose fussy time is any time you decide to cook, you should just plan on doubling that prep time)
9. No matter how many times your child's apnea monitor false alarms, it will still send you running (even when dripping wet from the shower)
10. Someone who weighs 11 pounds can more than double you week's laundry loads, easily!
11. It is nearly impossible to keep both socks on a baby's feet at the same time
12. Nothing can clear our animals out of a room faster than a crying baby...or a vacuum
13. My child's goal in life must be to work her feet out of socks, blankets, or the footie part of her pajamas as fast as possible.
14. Daytime television really stinks.  On a related note, Alexandra of the Dr. Phil Family has had TWO more kids and is now in rehab. I have never wanted to jump through a television and shake someone more than her!
15. Every day I can have the same thought "No, THIS is the cutest outfit I have ever seen," hence my philosophy that you can never have too many pictures of your child
16. There is no better feeling in the entire world than when your sweet baby snuggles into your neck (except for maybe every single time that sweet baby looks up at you with her adorable grin)
17. Despite swearing that I would never be one if those wives that didn't puts on makeup or dry my hair when I was staying home, I am now having to eat my words...big time.
18. Work clocks and home clocks cannot possibly operate at the same speed.  Three hours at home goes by in an instant, and there are moments at work that seem like hours
19. Television, specifically Grey's Anatomy, does not give an even remotely accurate picture of prematurity. They had yet another opportunity this past week to address it, and I was fuming at the portrayal! I also get mad every time they show Callie and Arizona's 23 weeker and never once mention any issues she might have faced. Ugh! Some day I WILL write them a letter!
20.  It bothered me so much to only have 19 things in this list that I had to create a 20th just to tell you how much it bothered me (and they said I would let the little things go when I became a mom. Ha! Still holding strong to my OCD tendencies)

On that note, here are the latest pictures of our adorable 26 weeker:

Cuteness

Pretty in purple

Completely zonked

"Everybody clap your hands!"

Sweet Doodlegirl

Taking a load over to her new home away from home.  Ready or not Gigi, here she comes!

Isn't she the cutest?

Sweet dreams

Our Little Valentine

I know, I know, two posts in two days, but Casey didn't want you to miss out on her Valentine's Day wardrobe!  Here are a few pics from Casey's first Valentine's Day. You can see we have quite the heart collection of clothing going on:

 Rockin' the leg warmers, a gift from our favorite RRT before we left the hospital

 Mommy and Daddy got to go on our second date since Casey came home (and where else would we go but to an Americans hockey game).  Thanks Gigi and Granddaddy for baby-sitting!

 Our Little Valentine

 This is the Valentine's card that Casey sent all of her grandparents and great-grandparents with pictures we just got from her newborn photo session (and yes I promise I will post them for all to see soon)

Here is what Casey made Daddy for Valentine's Day (isn't she talented!) Let me tell you it was quite the accomplishment to get as many decent footprints of this active child as I was able to get, but I was looking for a good excuse to put my new Gazelle (die cut machine) that I got for Christmas to work,  so eventually I prevailed.

We hope everyone had a great Valentine's Day with the ones they love!

6 Month Check Up

In many ways it is hard to believe that it has already been 6 months since Casey's dramatic entrance into the world, and at other times it seems like it has been so much longer. She had her six month check-up with the pediatrician last week, and he was very impressed with her progress. He thinks her weight gain has been excellent, and he expects she may even be on the charts for height for her ACTUAL age when he sees her again in three months. He also noticed that her teeth roots are in, which explains all the drooling of late, and said we could start seeing teeth any time in the next couple of months. We also discussed her recent increase in spit-ups and reluctance to finish feeds, and we did decide to start reflux medicine. For now, her prescription is for every other day as we monitor whether it improves her feedings. Developmentally he was very encouraging about the milestones she has already hit (many beyond her adjusted age), and the only biggie she still has not accomplished yet is rolling over, but just this past week we are making some progress there! The major news from our visit is that we got the go ahead to take her off her apnea monitor, and not a moment too soon as her back-up leads stopped working this week. We had only been using it at night for the last few weeks, and although it is a little scary to not have the reassurance that she is indeed breathing while we are asleep, it is a huge step that she no longer needs it (and it means we no longer have to ask each other "Did you plug in the baby?").

No more Apnea monitor!

Our other appointments last week included a follow-up visit with the Audiologist to check Casey's hearing. Even though she passed her initial newborn hearing screen, the doctors at the hospital were concerned that one of the infections Casey had in the NICU can cause hearing loss and they wanted her to be checked again. The follow-up showed that her cochlea is functioning normally and we don't expect to need another test unless we see start to see some evidence of hearing loss down the road. We also had our weekly weigh-in at our Nutrition appointment, and Casey's current weight is 11 pounds 3.5 ounces. Although she only gained a little over three ounces last week, we aren't too concerned as this week's main goal was working on her constipation issues. The juice remedy has started working (maybe a little too well) and this may be a contributing factor to the week's poor weight gain, along with having three weeks of pretty huge gains in a row.  Her feedings continued to be hit or miss last week, but overall her total daily volume has been somewhat improved, and the spit-ups have not been quite as frequent (or huge) so we are hoping this week she will have a better number on the scale.  Our speech therapist also continues to work with us weekly, and it is such a relief to have someone to encourage us and give us suggestions when what we are doing is no longer working.  While Casey's feedings have improved so much from when we left the hospital two months ago, we expect feedings will probably continue to be an issue for some time, and it will be a whole new ball game when we start introducing solids (the pediatrician gave us the go ahead to start introducing her to rice cereal in two more months).  I also had my six month check-up at the Endocrinologist, and she was very happy with how I have controlled my blood sugar and A1c level. She sent me home with lots of information to look at and think about, although I am still very much undecided about committing to an insulin pump.

Casey has been batting at her toys like crazy, has most definitely discovered her hands (our goal from the previous week) and her newest tricks are grabbing onto anything and everything!  Her favorite thing to grab these days is my face (unfortunately for me she has razor sharp little talon nails no matter how often I try to clip them), but it is so cute that I withstand the pain.

I will leave you with the Doodle's latest pictures:

She looks like such a big girl in her hoodie

Getting cleaned up!

Notice the missing sock again

She is fascinated by the spinning birds above her swing.

"Hi!"

 Just lounging

 So sweet

Much more interested in chewing on her hand than smiling for a picture

 Too cute for words

Got a little smile!

And since I got so many comments that everyone loved the last video, here is a new one of Casey playing with her toys:

Defying Gravity

You know the saying "What goes up must come down?" Well our child has decided to defy gravity and reverse that saying this week. In our world it has been more "what goes down, must immediately come back up." Spit-ups have pretty much been our theme of the week, and by "spit-ups" I mean we all need a bath after she eats. Not pleasant at all!  We had a long discussion at our Nutrition appointment this week, and our first order of business is to address the constipation problem that has persisted. Our plan is to give her a couple ounces of apple or prune juice every day to try to regulate her, and then we will see if that helps with the discomfort as she eats or if it truly is just reflux that we need to address with medication. Casey has her 6 month check up with the pediatrician this week, and based on how the past couple weeks have gone, I suspect medicating will probably be the route we take for a while. Despite the spit-ups and a decrease in volume, she did still manage to have an above average weight gain of 8 ounces over the past week, and her weight is now 11 pounds even. Her spit-ups have worsened over the days since the weigh-in, so we are hopeful that our pediatrician will have some advice for us so that she can continue gaining weight and getting the nutrition that she needs.

Our Speech Pathologist had some advice as well to help with her decrease in feeds, and we are having to bring out many of the old "tricks" again to help her eat. One of the things we are trying now when Casey starts to get uncomfortable during a feed is distracting her, and she loves the new Look Baby app that our speech therapist showed us. Now if only I had a third hand to hold the bottle, the iPad, and support Casey as she eats! One of our other big goals in Speech right now is for my mom to feel comfortable with all the tricks of Casey's feeds since she will be taking over three feeds a day in just a couple more weeks when I go back to work. In addition to Speech and Nutrition, we also had our SST appointment this week, and Casey has continued to make great progress developmentally. She was particularly impressed with how well Casey is holding up her head up during tummy time. We will be setting new goals at our next appointment since Casey has far surpassed the ones we set at our initial evaluation. The things she is hoping to see next time are that Casey has started to watch and focus on her hands (she has been bringing them to her mouth for a couple of weeks, but doesn't  necessarily look at them yet), and that we continue to work with her on batting at her toys.

We have a busy week ahead with not only our pediatrician appointment, but also a more in-depth follow-up with an Audiologist to make sure there are no complications that the original hearing screen at the hospital did not indicate. I also have my six month appointment with the Endocrinologist where the discussion will probably include the possibility of transitioning to an insulin pump and what the next steps will be in treating my Diabetes.  Our prayer needs now are for these appointments to go well and for Casey to have some relief from the spit-ups so that she can keep down the calories she needs for healthy growth.

And of course, here are all the latest pictures:

 So stinkin' cute

 I adore this happy girl!

 I'm pretty sure we should be the ones wearing this shirt, since most of the time it is actually us waking her up to eat.

 They don't know it yet, but these two are going to be best friends.

 Porter is always hanging out nearby

 We have been working on saying our prayers

 And we have mastered the pouty lip

Looking cute in her giraffe jammies

 "Is picture time over yet?"

 When Casey gets really tickled at something she gets a huge grin and turns her head completely to the side.  It is absolutely precious, and I was finally able to catch a picture of it.

 Smiley girl

 "No, I'm a really good babysitter Mom, honest!"

Time for bed!