A Chubby New Year

Happy holidays to all. Maddy and Milo spent their first Christmas hanging out with Mom and Dad at home opening gifts and watching the Christmas Story marathon. We're betting things will get more exciting next year when the kids can travel and will generally be more excitable.

This year the twins have given us the early gift of sleep. We've definitely lucked out on that front. Most nights Maddy sleeps through until about 6:30 or 7:00. Milo usually wakes up once around 4:00 or so, but every now and then goes straight through too. Of late, their doing pretty well at getting themselves back to sleep when they wake up (usually after a particularly big fart).

Bugged-eyed Milo - 12/27/08

The kids visited their pediatrician for their check-up on the 30th. The latest numbers look good! Milo weighed at 11 lbs 8 ozs and was nearly 24 inches long.

Maddy and Mom - 12/27/08

Maddy is still way ahead of Milo on weight - she's a rubenesque 12 lbs 14 ozs and was 24 inches long exactly.

Along with the normal poking and prodding, the babies were treated to three shots, which they just loved of course. In other big news, the doctor suggested we give the babies their first sample of solid foods. Well, barely solid - we're talking rice mush or oatmeal. It will be more for recreation purposes than sustenance, but a solid food source will be nice. We had stock piled a roomy deep freeze with mom milk while the babies were in the NICU and it's nearly empty. Pretty amazing how fast they've gone through it. Add to that the fact that Milo suddenly started eating about 30% more than usual in the course of one day. It was amazing - like someone just flipped a switch! The kid was eating about 700 ml of milk each day, then he suddenly started eating 1000 this past Sunday. That's one liter or a little more than a quart.

By the way, we're still waiting for a surgery date for Milo's hernia. We expect the operation to happen sometime in January.

A Night Out and Other Big Happenings

First off, big thanks this week to Nurse Janet who was kind enough to bless us with the gift of a full night of baby sitting. Elaine and I took the chance to enjoy a meal out and a movie for the first time in many months. I'm not sure what a night of childcare by a fully qualified NICU nurse normally runs, but I seem to recall that it was pretty pricey. It was the first time we've both been away from the babies since they came home, and, although we were tempted to hop a plane to Mexico, we returned to find the babies better than we left them, i.e., asleep. Thanks so much Janet!

We were also able to bring the babies by the NICU on the 15th for their first visit back since discharge. It was great reunite and show off all the great progress the babies have made. Unfortunately, we missed out on seeing several of our favorites nurses (Sandra, Annette, Cheryl, Terri, Dana, Donna, Laura, Hilda, Christie) who weren't working that night, but we promise to get the babies back by soon.

Caitlin & Milo

As most of you know, Elaine and I have been fortunate to have the assistance of Caitlin to help out with the care of M&M while Dad is at work during the day. Unfortunately, Caitlin is returning home to Montana in the coming weeks, and, what with the unrealistic commute, Elaine and I are on the search for another mother's helper. Caitlin did a great job and we're hoping to find another who will be as kind and loving with the twins. Needless to say, Caitlin will be missed!

Uncle Nate & Milo

The good news this week is that we got a visit from Elaine's brother Nathan. Nate's in town for 5 days to see the kids and change a few poopy diapers.

Maddy

As promised, we finally had the chance to take a few shots of the babies with Mr. Bear. Maddy definitely looks like she could take him in a fight.

Milo

To really see the comparison in growth, check out the September post here http://miloandmadeline.blogspot.com/2008/09/three-months.html back when the babies were 3 months old. Or go back to the very first pictures of the twins with Mr. Bear in August: http://miloandmadeline.blogspot.com/2008/08/long-march-to-september.html.

The Six Month Retrospective

Tomorrow marks six months since M&M's birth, and we thought it might be interesting to take a look back at all their progress. I'm going to start from the most recent photos and work back in roughly two week increments. Just a heads-up: some of the early photos are a bit scary. Still, it's amazing to see how far they've come! For those of you NICU parents with micro-preemies, I hope this gives you some hope about just what is possible.

Milo - aka "Stiles 1" or "Baby A"

Taken yesterday, December 13, 2008. As of December 12, Milo was 10 lbs, 14 ozs -- roughly 9 pounds over his birth weight.

Milo came home October, 17. I took the shot above on the 23rd.

Less than a couple weeks before, he still used a gavage tube for feeding and (apparently) he wasn't very happy about it.

Milo was on a nasal cannula on August 15, when I took the above shot.

Above: July 28 - Milo is intubated to prepare for his PDA surgery.

Above: July 19 - Milo on Si-PAP.

Milo struggles his way into the world at 25 weeks, 2 days gestation. He weighed 2 lbs and was 13.5 inches long. The shot above was taken a day or two after his birth on June 15, 2008.

I won't list here all the complications and challenges that Milo faced (feel free to review the early blog entries), suffice to say the little boy pushed through an awful lot. To look at him now, you'd never know.

Maddy - aka "Stiles 2" or "Baby B"

Above: Taken December 13, 2008, shortly after our return from our (semi) daily walk. On December 12, Maddy weighed in at 11 lbs 14 ozs -- a full pound bigger than Milo! She has gained 10 lbs since birth.

Maddy proudly sports the tulip hat Aunt Heather gave her. Shot above taken on October 23.

Maddy rests during her first week at home. She was discharged from the NICU on October 4th. The above shot was taken a few days later.

Above: "Roar." Maddy does her best convincing dragon impression. Picture taken August 31 during Maddy's weigh-in.

Above: "What the heck is that thing?" Maddy notices something attached to her wrist. Picture taken July 29. Poor Maddy's nose was all smooshed from the Si-PAP (see just below); it's rebounded nicely since then.

Above: Maddy recovers from her PDA ligation. She was the very first baby at Alta Bates to receive the procedure at the bed side. Picture taken July 4th.

Scary small. Maddy fights her way into the world at 1 lb 14 ozs, and believe it or not that's pretty big for a 25 weeker. Many preemies born that early are around 1/3 to 1/2 a pound lighter than that. I took this shot just a day or two after her birth.

As with Milo, I'm not going to list all the challenges Maddy faced, but suffice to say, the little girl's got moxie. Little known fact: Moxie was very nearly Maddy's middle name but we chickened out. Could there be a name change coming?

Obviously the kids have made much progress in the last six months and much more to come. Stay tuned! Tomorrow (or the day after) we'll post their growth pictures with Mr. Bear.

Peace on Earth, Good Will Toward Men

Maddy & Milo wishing you and yours a happy holiday ;)

Like all new parents, we decided to take cutesy pictures of the babies for Christmas cards this years. It only took about 40 shots (thank God for digital cameras), but we did finally come up with a usable photo. No, not the one above -- that one was one of the two dozen or so throw-aways. Believe it or not, they did settle down and even smile a little.

Maddy just seems to get bigger and bigger. Tomorrow we have to bring the kids in for another Synagis shot and they'll get weighed in then. I'm gambling that Maddy is pushing 13 lbs. She has already out grown her newborn size clothing and she's getting a bit big for the the 3-month-0ld sizes too. In the picture above, she's wearing a 3-6 month old size.

Milo's getting bigger too, but his sister is definitely the heavy weight of the two. Milo is probably in the 11 lb range somewhere. We'll see tomorrow. Milo is developing well otherwise. He has great head control and - as you can see - can lift himself up pretty well and even roll over from his tummy to his back.

Maddy's pretty strong too -- she's just more portly. But in a good way.

Elaine's First "Mom" Birthday & Other News

What big plans did I make to celebrate Elaine's first birthday as a mom? I basically blew it. Instead of planning a grand gesture, poor Elaine settled for eating out at a restaurant for the first time since the babies came home. OK, it wasn't a restaurant so much as a coffee/lunch counter, but there was seating, and they did carry our food out to us when it was ready. That's pretty close, and at least I didn't have to tip ;). We're not really supposed to take the kids to crowded public places - so that puts a lot of limitations on where we can eat. Basically, we need to be able to maneuver the stroller into a spot where the yokels can't breath or paw at the kids, and luckily there's a nice little place near the house that allows just such an arrangement.

Elaine feeds Maddy after a nice birthday breakfast.

Maddy - girl of leisure.

The following day we headed out for a walk along the Alameda shoreline.

Milo recovers after a tummy time workout.

Milo - cooing and smirking.

In other news, the kids had their first visit with the pulminologist on Monday at Children's Hospital. The news was basically good. Maddy is now 11 lbs 4 ozs, which means she put on 3/4 of a pound in a week. Very impressive. Milo weighed in at a hefty 10 lbs 6 ozs, but trailing little sister by a wide gap. The babies' pulminologist, Dr. Hsia, was generally impressed with Maddy's progress, but the little girl's voice is still very hoarse. It's possible that it's just taking some extra time for her to heal from all her intubation, but there a few other potential complications that could stem from her PDA surgery way back in July. To determine the exact problem, Maddy will need to return for a bronchoscopy.

Milo is also doing very well generally. (Most doctors are pretty impressed when they see the kids, especially if all they've seen thus far are their medical records.) Milo is still laboring to breath a little, which is evident from the fact that his adomen retracts a little with each breath -- not a lot, but enough to raise an eyebrow. Milo is also having a little trouble with eating. He tends to choke and sputter a bit during feeds and is generally a "disorganized" feeder. Dr. Hsia is having Milo complete a feeding study to determine whether he might be aspirating (breathing in) some of his milk. Continued aspiration can harm his lungs, so we'll need to get that resolved fairly soon. Luckily, the treatment is probably just a matter of adding some thickener to his feeds.

This all means more appointments, but it will be good to get these issues resolved. Milo is also due for his surgical counsel in another week or two to repair the hernia, so stay tuned.

What the &%$# is that thing on Maddy's head?

By now most of you have seen what I like to refer to as the cherry on top of our Maddy sundae. What is it? It's called a hemangioma. Hemangiomas occur in about 1 in 10 Caucasian births, and are three times more common in females. I've also read that premature babies have a higher incidence of these little buggers. Maddy's hemangioma is the superficial variety, which is often referred to as a "strawberry hemangioma." It doesn't cause her any pain, it doesn't interfere with her development, and I'm pretty confident she doesn't even know it's there. Maddy's strawberry appears to be at the peak of its growth cycle, more or less, and we know this because its got a pinkish-grey tint (and because it doesn't seem to be getting any bigger). You'll notice in some of the links above that hemangiomas can get big and gruesome, but that's a pretty unlikely scenario for Maddy. Her hair will be growing in pretty soon and will cover it up -- it will probably be gone by time she's 2 or 3. It's rare to treat a superficial hemangioma unless it interferes with vision or causes some other problem. Given how much the babies have been through, we're not inclined to do much more than let it run its course and resolve on its own.

I suppose I could photoshop all of Maddy's pictures to get rid of the hemangioma, but that wouldn't be quite authentic. It's part of the whole great package. That said, we'll probably stick a hat on her -- not because we care so much -- but in order to avoid some the inevitable rude questions. As luck would have it, Maddy can be pretty finicky about wearing hats. Actually, Maddy can be pretty finicky period. On the flip side, I thought about putting it to good use on Halloween by drawing a little eyeball around it and making it the pupil. Elaine wasn't so hip on that idea and I guess it's not a good idea to draw on a baby with a Sharpie. Maybe next year...

Lookin' Pretty Good!

Today we headed to the Regional Center of the East Bay for the latest in a long series of assessments and medical visits for the kids. I think we average about one of these visits a week these days, and, on the plus side, it means getting the chance to read selections from the stack of old People magazines that always populate doctors' waiting rooms. Today was no different and we got the chance to catch up on all the happenings with Madonna and Guy Ritchie before getting called in. Can you believe Madonna is 50? Anyway...

The good news is that M&M are developmentally on target so far. They're able to track objects with their eyes, bring their hands together, comfort themselves (somewhat), lift their heads and upper bodies, and a bunch of other things that "normal" babies their age do. They've even got a few bonus features. For example, the kids have repeatedly demonstrated the ability to roll from their belly to their back -- something that Milo just started doing today, but Maddy's been doing for a while. Milo has the added bonus of liking to stick his big tongue out a lot --- like all the time. Problem? Apparently not yet. I guess Gene Simmons made an entire career of having a long tongue so maybe Milo can front a Kiss cover band one day.

Maddy was on her best behavior during the assessment. She slept mostly, then woke up and looked around and smirked. Unfortunately this was a rare moment of calm for her. Over the last week, she seems to have fallen back into a lot of the behaviors we associated with reflux. We thought the medicine cleared things up, but more adjustments may be in order. That will probably come at the next doctors visit which is (surprise!) early next week. Hopefully we'll get her back on track soon, because right now the poor girl seems to only have a few moods: hungry, asleep, and frantic crying while stiffening her body completely. We still think it's reflux, but bad gas can't be ruled out. Every so often the pixie wakes up, lifts both her legs, and cuts a huge fart. It would be pretty funny if it didn't make her cry.

On the bright side, Maddy got weighed on Monday and she has broken the 10 lb mark! We suspect that Milo is about the same or maybe a touch more, but we'll find out when he gets weighed next week. To hear them pass gas, you'd guess they weighed ten times that amount.

A quick shout out to all the great folks at Alta Bates for helping the kids to become so big and healthy. Thanks all so much! We're hoping to come by for a visit some time soon.

5 Months

Mom here, taking over from Dad on a posting. Both kids are currently napping, and I saw my opportunity. My plan when I got to do a blog post was to put up as many pix of Rob in his boxers, bathrobe, and socks as he's put on of me in my glasses and jammies, but the man seems to avoid the camera at every opportune moment. However, kind readers, I am currently showered, wearing my contacts, and just ate lunch, so look out world.

Mom slightly less bleary-eyed with Milo.

It's been a good couple of days here at Stiles central. The babies went in for their monthly Synagis shot on Friday and were weighed for dosing. Wouldn't you know it the little buggers gained almost half a pound this week. Both weighed in at 9lbs, 12 oz. That means they should hit the double digit pound mark this week - the big 1-0. Go babies, go!

Maddy looking coy during tummy time.

Blue-eyed girl.

Mom and Dad have also been treated to lengthy sleeps the past two nights, culminating last night in a full 8 hours of sleep for the first time since October 4 when Maddy came home. We had one stint of about 5 hours, and another stint of 2.5-3 hours after a 4 am feed. We also managed to cook and eat a simple dinner last night AND watch an episode of 6 Feet Under on DVD. Our cup runneth over. It probably won't last, but as long as we get a little treat like that once in a while, I think we'll make it.

Milo well-rested and sporting his Red Sox colors (thanks Jeff and Michelle!). Milo knows all about the Sox losing to the D-Rays, but daddy didn't raise no fair-weather fan.

Tomorrow, Milo goes for another eye exam related to his retinopathy. These are never fun, as it's a pretty tough exam which basically involves holding Milo down while the doctor jabs a steel instrument in his eye. Mom is not looking forward to it -- let the screaming of bloody murder begin. Both babies also go in on Friday to the Regional Center of the East Bay to have an initial developmental assessment. The Regional Center assists families in getting services for any physical or developmental disabilities or delays the babies may have as a result of being premature. As you may remember, both babies are at higher risk for cerebal palsy and some cognitive issues because they were born so early. Based on what we've read, both babies seem to be on target for their developmental corrected age (7 weeks), so we're hopeful all will continue to go well.

And in closing, Saturday was Maddy and Milo's 5 month birthday based on their calendar birth date. As usual, Dad took some photos of the babies with their bear and ducky for size comparison. You can see how they've grown by looking at posts on or around the 15th of the month over the past several months. You'll be glad to see that both babies are now (finally!) substantially larger than Mr. Bear!

Milo, Mr. Bear, Maddy & Mr. Duck. Maddy's pants are a bit high, and she appears to be sporting a little J in the T.

Maddy at 5 months.

Milo at 5 months.