Tuesday, June 26, 2012

All Bobby, All the Time

I feel guilty that of late, all my posts seem to be about Bobby, but a quick apnea update - we have an ENT appointment in two weeks and a neurologist appointment in about eight weeks - I was surprised that it was only eight weeks to wait.  I guess it could have been worse.  He had his first dose of Singulair tonight before bed, so I'm hoping that will help.  Apparently there's a chance it could make him hyper, so I'm seriously hoping that doesn't happen!

In other news, James may have broken my nose.  He was sitting in my lap and got all excited about something, reared back, and whacked me in the bridge of the nose with the back of his head.  Now it hurts like no other and is swollen.  So I have an appointment with my ENT tomorrow to check it out....  It's never boring around here!

Monday, June 25, 2012

Two for the Price of One

Bobby's pulmonologist/sleep doctor was able to work us in today, so we didn't have to wait for our scheduled followup on July 2nd.  Although we had to wait almost two hours before we saw her, I'm just grateful we didn't have to wait for the 2nd.  She went over the sleep study results very thoroughly and told us that Bobby has both of the kinds of sleep apnea - obstructive and central.  Basically, obstructive sleep apnea means that something is obstructing the airflow (hence the name), so you have events of decreased (though not totally absent) airflow.  Usually it's tonsils or adenoids that are causing the obstruction, but it really can be anything.  Central sleep apnea means that there is a neurological issue that causes the body to stop breathing, so you have events where there is absolutely no airflow.  Thankfully, Bobby's central events are short - five to fifteen seconds.  While this seems like forever for my baby to be not breathing, the doctor told us that if they'd been using a less sensitive test, these events actually wouldn't have registered - the threshold for the less sensitive machine (the name of which I can't remember) is twenty seconds.  The doctor gave us a prescription for Singulair, in the hopes that at least part of the obstructive sleep apnea is related to swelling due to his congestion.  She said that the x-ray showed his adenoids are actually unusually small, so she doesn't think that's the issue.  She did refer us to an ENT to see if he can determine exactly what the obstruction is.  If they feel it's necessary (and can find an obstruction), obstructive sleep apnea is correctable by surgery.  As far as the central apnea goes, she's referred us to the pediatric neurology department.  Unfortunately, she told us that it will probably take at least a few months to get in to see neurology.  On the bright side, she said that it's fairly common for premature babies to have central sleep apnea, and they usually outgrow it.  While 37 weeks is considered term for twins, Bobby was still technically three weeks early.  We're going to do another sleep study in three or four months (oh joy), and hopefully the central sleep apnea will have resolved itself by then.  In the meantime, hopefully the Singulair will help, and maybe the ENT will see something fixable.  The doctor says Bobby seems to be meeting all his developmental milestones just fine, so she's not really concerned about the neurological front.  Ordinarily, the treatment would be a CPAP machine, but this isn't really an option for an 8 month old!

And now for a couple of cute pictures of Jamesie, since this was all about Bobby...

James enjoying his first tortilla - once he figured out it was food and not a toy!

 James sleeping on the sofa next to Jeremy

Friday, June 22, 2012

A Little (Or Way Too Much) Background...

I wrote the first post on this blog the day before my babies turned eight months old.  I realized I wanted to give some background....  This blog is mainly to serve as a reminder/baby book for me.  I'm ashamed to say that I've already forgotten way too many things; I was working on Bobby's baby book for the first time and couldn't remember exactly when he smiled for the first time (couldn't remember for James either).  Did I write it down somewhere?  Of course not.  I remember it was some time around Christmas, so around 2 months I guess, but I honestly am not sure.  Part of it is that it happened gradually - everyone is always attributing those first smiles to gas, so it's hard to say exactly when his first "social smile" was.  Part of it is that there are two of them; sometimes they do things at the same time, but most of the time they don't.  Developmentally, in fact, James tends to be about three weeks ahead of Bobby.  So this is mainly for me to keep track of all the little things that seem like such a big deal at the time but get swept away into the mists of time way too fast.  If I can share things with my friends and family, and maybe make some new friends along the way, that's great, too!

So, some background:

Peter and I got married December 27, 2007, during the winter break from our second year of graduate school at the University of Chicago.  He was getting his master's in computer science; I was working toward my master's and PhD in Egyptology.  The previous spring, his mom had generously taken us on an engagement trip to Egypt along with seven of her girlfriends.  During that trip, I received (weird word to use, but I can't think of a better one) a severe concussion.  We were sitting in the back row of a mini-bus in front of some precariously piled luggage; the driver stopped suddenly, a suitcase flew forward, and it whacked me in the head.  I knew exactly what had happened because it was unfortunately my third severe concussion (the first two were in college - once I knocked my head on a wall from maybe a foot away and the second time I stood up under some scaffolding when someone called my name).  When we got back to Chicago, it quickly became apparent to me that those concussions had had unfortunate cumulative effects.  I took a medical leave of absence after  I was diagnosed with post-concussion syndrome; I had lost a lot of my medium-term memory (I could make it about halfway through a quarter-long course before I forgot everything from the beginning) and my short-term memory suffered as well.  They warned me that I would never be exactly good as new, and they had no idea how long it would take to recover my faculties or how much I would recover.  I made it through the fall of my second year, but graduate school, especially in a  memorization heavy field (there are five phases of the ancient Egyptian language, and I had to be proficient in all of them, as well as French and German), had become a nightmare.  After our wedding, we decided that when Peter received his master's degree in June, we would move back to Houston - he would work for NASA, and I would work for a needlework shop a few days a week until I could decide if I were capable of going back to school or getting some sort of full-time job.  It was really disappointing to me, as I love academia, but I felt like I had no choice. 

When we got back to Houston, we rented a house in a lovely neighborhood with tree-lined streets.  At that point, we decided that if we got pregnant, that would be great, but we weren't going to rush anything.  However, after a year and a half of trying with no success, I went to the doctor and was diagnosed with polycystic ovarian syndrome (PCOS).  Basically, I was told that my odds of getting pregnant on my own were about 3%.  That's not exactly super.  Along about this point, we also decided to buy a house in what I affectionately (well, maybe not) call the boonies.  Peter's commute down to NASA and back had been anywhere from one to two hours, and it was driving him crazy.  I had no desire to move to Clear Lake (the area nearest NASA), so we compromised and bought a house in Pearland, which is about halfway between the two.  On the bright side, we were able to afford a huge house there with mortgage payments that are actually less than our rent was in town.  On the down side, my family and friends live in town, and there are no big trees out here because relatively recently it was all prairie.  I miss trees.  Along about that time, we started undergoing fertility testing and treatment.  Although it seemed like forever, after a little over a year of treatments, we finally got pregnant using high doses of Clomid, trigger injections, and an IUI.  I have always been open about our fertility problems, as I think so many people, especially younger couples, feel ashamed about fertility treatment.  I can't tell you how many times people told me that I was young and would get pregnant on my own in no time.  Or that they had to do fertility treatment too - one dose of Clomid and they got pregnant.  Well, I'm sorry, that's not actually very helpful.  While that may technically be fertility treatment, it's also just about the best and easiest outcome you could have.  Telling me that when I'm already a year into treatment does not help.  At the same time, I know it could have been so much harder for us.  We could have had to move on to IVF, and we could have ultimately had no success.  Every time I look at my sweet baby boys I know that it was all worth it, and that I can't complain - we have our babies, and while it was expensive (our insurance only pays for $3000 yearly toward fertility treatment, though that's more than many plans), it was nowhere near as expensive as multiple rounds of IVF.  Sadly, judgment about fertility treatment doesn't stop just because you get pregnant - I actually had a relative (who shall remain nameless) tell me that he would love our babies just the same even though they weren't normal babies.  What does that mean? 

Pregnancy was super hard for me - I don't know if it was because of the twin pregnancy, which was considered high risk from the get-go, or what, but I was nauseous from the day I got pregnant.  Then I started throwing up (which is unusual for me - I previously only threw up if my temperature went over 102.5 degrees F) and couldn't keep anything down at all.  I was put on bed rest because I was taking in so few calories that they worried I would expend them all walking around.  I was eventually put in the hospital for four days during my first trimester to feed me via IV.  Ultimately, I lost 40 pounds during the first trimester.  Along about six months, I started feeling slightly better, but it was short-lived - at 30 weeks, I started having contractions and was put on bedrest.  My doctor thought the babies might come at any time, but bedrest did the trick - they didn't arrive until I went to the hospital for my scheduled induction at 37 weeks 3 days!

When we arrived for the induction Thursday evening, they checked me out and were very confused as to why I was there for an induction, as I was already in labor.  Apparently I was already 3 cm and having contractions.  Because I'd been having contractions off and on and in pain of all sorts for so long, it didn't seem any different to me!  They hooked me up to a pitocin drip and told me to get some sleep.  Along about six am, I had them do my epidural, as the contractions were starting to hurt and they told me I had only advanced to about five cm, so I was in for a long day.  We didn't make much progress until late in the afternoon, when, despite the epidural, I was in the worst pain of my life.  It turned out to be because I had gone from 7 cm to 9.5 cm in 20 minutes.  I can't recommend that!  They bumped up my epidural.  After a bit, they took me to the OR to push (they do twin deliveries in the OR just in case they have to do a c-section at any point).  At 8:39 pm, my precious Bobby was born.  The first time I heard him cry was unlike nothing I've ever felt before.  I couldn't pay much attention, though, because I spent the next nine minutes pushing wee James, who was born at 8:48 pm.  It was all worth it - I had my sweet baby boys!

Letting everyone know that we had gotten to the hospital and were going to get things started!

Our first family picture!

Bobby (left) and James (right), in a bassinet together to regulate temperature.  Bobby was six pounds two ounces and 18 inches, and James was five pounds nine ounces and 17.25 inches.

Wednesday, June 20, 2012

Sleep Apnea?

My sweet Bobby was diagnosed with mild obstructive sleep apnea today following his sleep study last week.  I have no idea what this means.  The tech who did the study told me that infant sleep apnea is generally surgically correctable, but I don't know if that applies in this case or if because it's mild we just wait and see?  They're trying to work us in to discuss the results on Monday; otherwise, we won't be seen until our originally scheduled follow-up appointment on July 2.  I know that's only in about a week and a half, but I want my poor boy to sleep better!  I'm terrified of his having to have surgery, but I'm also afraid they're going to tell me to just wait and see.  Not really an option, if you ask me!  I guess we just have to wait for the appointment....

Bobby having a bottle after he was connected to all the wires and sensors for the sleep study.  They put a hat on him and wrapped it with tape (the blue stuff) to keep the electrodes on his head.

You can see the nasal cannula in this close-up.  He did just fine with the attachment of all the electrodes, but he hated the cannula that they put on to measure how much oxygen he took in and how much carbon dioxide he exhaled.  I felt so bad for him.

A little blog about my precious twin boys, James (the monkey) and Bobby (the gorilla)!