Nora's Second Birthday

I had a grand idea for Nora's birthday - have it at the local park!  I got really excited, sent out playground-themed invitations and reserved a pavilion.

Then, Mother Nature laughed.

It snowed, snowed, snowed, rained, snowed, rained, snowed, you get the idea.  As if I didn't get the message that Mother Nature was trying to send me on Friday, there were Flash Flood warnings before her Saturday party.

Needless to say, I canceled the pavilion reservation and moved the 75-person party to our house.  That's right, 75 people.  Our Nora sure is loved.  Her Mommy was not very prepared.  The cake was set to serve 30 and my house was not ready.  But, thanks to my awesome family and sweet neighbors, the house was quickly set up for the party.

I was worried that the party would be "boring" since it wasn't at a park.  We solved that by setting up last year's ball pit in the den, booking a balloon animal guy and buying an indoor slide.  The kids had so much fun!

Drinks

Kites were the party favor, which would have been adorable at the park;)

Being a toddler, Nora LOVES to snack, so we had all her favorite snacks.

The cake that was supposed to serve 30 somehow stretched to serve the whole crowd!

Side view of the slide and tree theme cake - again, would have been perfect for the playground!

James was so happy at the party.  His party favor?  Pink eye!

Nora wanted Emma and I to take her outside to see the balloons.

Magic Mr. Nick, balloon animal expert. He was great considering how much the kids were climbing all over him.

Lila demonstrating something to Mr. Nick

Harlan, Emma and Lila watching with fascination.

Emily proudly showing off her new balloon animal to Steven and Daniel.

I think Emma had Mr. Nick make her quite a few animals;)

Preston trying to taste test the cake;)

I think Nora was a little overwhelmed.

Nora, Eli and her Uncle Clint

Eli and Megan

Our girl is a leftie!

Eli loves snacks just like his cousin:)

Eli patiently waited until the end of the party for an animal.

Cutie pie.

Nora's favorite part of the day was her new slide.  When we rolled up her pants she could go a lot faster:)

Emma proving that you can never be too old for a slide.

Losing Our 'Three Under the Age of Two' Status

You may have noticed a steep decline in blog posts - but I have a good reason.  Three reasons to be exact, and they are all under the age of two.  I'll admit, it's been fun to tell people that we have three children under the age of two, and watch them mentally try to do the math.  When I explain that two of our babies are twins, it usually garners a sympathetic response.

Honestly, it's been hard.  But it could have been harder, so so much harder.  We don't have colicky babies, their general health is good (once we got past October!), and I'm blessed to have a such a wonderful husband and partner to experience this craziness by my side.  He is Johnny-on-the-spot with diaper changes, sleep training, toddler pleasing and daycare shuffling.

As Nora approaches her second birthday, I feel like we have hit a milestone.  No, she isn't potty trained and has yet to spout off full sentences expressing her desires, but changes are coming.  She loves her baby brothers and they smile when she plays with them.  This weekend, we will graduate to 'three under the age of three' status as we celebrate Nora's birthday.  Our little family of five is learning everyday how to survive and thrive with such young children, and we appreciate all of you who check in on us and offer to help!  It truly takes a village, and when you have your own village at home, it takes a stadium of people to make it work.

Three Months in the Books!

We celebrated three months (Jan. 15) with major milestones - switching to a four hour feeding schedule and booting the boys out of our room!

Happy 3 Months!  Simon left, James Right

The new feeding schedule transition was a fairly smooth one - the boys had been sleeping past their feeding times anyway so it wasn't a stretch.  However, since they barely made it on the growth chart at their two month appointment (tenth percentile for premature boys), I will nurse them earlier than the next scheduled feeding based on their hunger cues if they act anxious instead of waiting on the clock.  I've discovered I'm less regimented the second time around - I don't track feedings, diapers, anything really.  It's a good day when I can consistently refer to the boys by name without switching them.  I don't even carry a diaper bag anymore - I just throw a few diapers in my purse when I leave the house.  I recently told a friend that if running errands with the twins involves more than a diaper change, I'm just going home!

My most favorite milestone was moving the boys out of our room!  They are such good, but noisy sleepers.  James is a snorer and he does this 'scream-cough' sometimes at night when he is asleep.  Scares me to death.  Simon had a cold a few weeks ago.  If he couldn't breathe while he was sleeping, he would wake himself up by wailing….then immediately fall back asleep.  It was ridiculous.  For now, the boys are in the office next to our bedroom.  I still nurse them once or twice during the night.  When they start sleeping through the night, I will move them upstairs to their room.

The next big goal is to weigh ten pounds by their four month check up.  At their three month weigh-in, James was 8.10 and Simon was 8.14.  I nurse them six times a day.  At night, I nurse and bottle feed now to help them sleep longer.  It's really made a difference this past week since starting the new routine.  They are starting to outgrow their newborn clothes and a few 3 months outfits actually fit them, so I don't feel that they are that far behind in development.  Size one diapers should fit them for a while.

Unlike Nora, these babies miraculously don't have any orthopedic issues.  I was told after her hip dysplasia and torticollis that there was a high likelihood of any future children having the same issues.  When we found out I was having multiples, I was told it was a 'definite' thing that the babies would need orthopedic intervention.  Every time we go to the pediatrician, I have her check out their hips and necks - everything looks perfect!  Even Nora's pediatric ortho can't believe our luck.

A few pictures:

 'Spit-Up' Simon left, James right.  They aren't excited about tummy time, but do like to lay on their backs and kick their feet a lot.

Simon left, James right laughing at me.  I was probably trying to sing.

James is such an easy baby.  I took this picture while Nora was throwing a temper tantrum and Simon was crying.  James was just relaxing with his hands behind his head (a frequent position for him).

JD snoozing with the boys - Simon left, James right

Sleepy Simon

Simon smiling left, James right

JD trying to prove how much he looks like James

James left, Simon right on their first Sunday at church.  We call James 'Jovial James' because he never stops smiling.  Simon could be crying in the middle of the night, I'll look over at James and he is just smiling away.  He even smiles with the pacifier in his mouth.  He and Nora were both easy babies.  Simon probably isn't that fussy of a baby, but compared to Nora and James he is more work.  JD says Simon is more like me;)

Happy BIRTHday, James & Simon!

Seeing as how the babies are approaching the three month mark, I knew it was important to write this post before my new mommy brain completely forgot this very special day: October 15, 2014.

PRE-BIRTH

I had downplayed generally every little concern for this pregnancy - don't get me wrong, I was taking care of myself physically, but I didn't turn to Google for every hiccup like I did for Nora.  I just prayed that it would all work out and felt mostly calm about the process of being pregnant with twins.  With as many appointments as I had with the high risk group and my OB, the chances of anything going horribly awry between ultrasounds were slim considering my track record of a previously healthy pregnancy.

Around 26 weeks, James "Baby A" turned breech.  With a multiples pregnancy, so long as the first baby is head down, a natural birth can be attempted even if Baby B is breech.  When James flipped - I instantly knew it.  His kicks were too low to be head down.  When confirmed by ultrasound, I started the process of doing everything I could to flip that baby back around - spinning babies exercises, Webster-certified chiropractor, handstands in the pool in September, hopping on one foot while clucking like a chicken - not really, but you get the idea.  I did NOT want a c section.  Yet, every week, there was Baby A nicely snuggled in his new position.  While we never knew the genders, this is when I began saying that Baby A had to be a boy because he was trouble already!

Five weeks before the boys were born

BIRTH DAY

On the morning of October 15, I had been up all night with a cough.  I knew I was sick but didn't want to go to the doctor between prenatal check ups.  I messaged a birth group I was in on FaceBook - one that focuses on all natural approaches to birth.  I was looking for homeopathic remedies to my symptoms when a physicians assistant warned that I could be in preterm labor.  That's when I realized that my back was cramping up the same as when I was in back labor with Nora.  I decided to call the doctor about a Z pack and thought I would just mention the back issue.

Dr. Mullenix (with MOGA) had me come in at nine and listened to my lungs.  That's when I mentioned my back.  He looked alarmed and asked to conduct a pelvic exam.  Afterwards, he calmly stood up and announced that I was "probably 6 cm and I just felt Baby A's butt in your birth canal."  I jumped off the table and promptly accused him of lying.  I just couldn't believe it.  The nurses started flurrying around to book an OR at the hospital next door.  It was a busy morning for L&D, and they couldn't get an OR ready for me for at least another hour.  Dr. Mullenix barked at one of the nurses, "tell them she can have her babies in their lobby or she can have them in an OR, but it's their choice!"  That nurse quickly returned with the news that they were ready for me next door and I walked over to L&D.

Poor JD was en route to Oxford, MS when I called him to turn around.  Physically, I felt fine, but I knew this was going to happen very soon.  He drove over 80 mph through Memphis streets to get to the hospital on time and ran up five flights of stairs.  I think he should have been given oxygen when he got to L&D because he almost couldn't talk.  When I got to L&D, a nurse checked me and said I was 8 cm (!), and the monitors said I was contracting every minute.  I felt like I was in a twilight zone because I still felt completely fine.  No pain other than being hugely pregnant.

There were a million healthcare staff in the OR - when a woman comes in at 35.5 it's considered preterm labor.  When it's twins they get pretty fussy about it all;)

I was very worried that the anesthesia wouldn't "take".  I asked for an epidural with Nora and it never worked.  I had a d&c last Christmas for a maintenance issue and I woke up in the middle of the surgery and tried to get off the table.  So far, my track record wasn't great for anesthesia.  Luckily, the anesthesiologist did a good job and I felt very little of my surgery.

Feeling pretty good from the anesthesia;)

Dr. M did a great job of keeping me relaxed and the surgical tech had a good sense of humor that kept things light in the OR.  When they pulled out the first baby and announced, "it's a boy" - I was excited but not terribly surprised given my prediction for this breech baby.  When they pulled out the second baby and announced that it, too, was a boy - we were SHOCKED.  Excited, but I swore that baby was a girl.  That's why it is so fun to not find out the genders.  We truly didn't care what the genders were, but it was fun to guess along the way.  I still remember how much we laughed when the second baby was a boy.

James David III, Baby "A", born at 11:15 am

Simon William, Baby "B", born at 11:17 am

We stayed in the OR for a long time doing skin-to-skin with the babies.  JD was great about holding them up for me, but it was obvious that Simon was having trouble breathing.  The neonatologist wanted to keep Simon in the OR for a while in case he could come out of it, but it became clear after a while that Simon was headed to the NICU.  James was borderline.  His breathing was labored as well, but not as severe as Simon's.  Both babies were around five pounds each and received high APGAR scores of nines both times.

First family photo with the boys.  I'm starting to get a little puffy from all the fluids.

They took the babies to be assessed while I was in recovery and it was a few hours before I heard anything about Simon.  I knew he wasn't critical, but I was frustrated that it was taking so long to hear.  James was in recovery with me and we were contacting family about the last minute news.

Skin-to-skin with my sweet James

When I was moved up to a room, I accidentally disconnected my IV.  It was a minute before I realized what happened, and then I saw blood all over one side of my sheets and the more I moved my hands to talk (yes I'm a girl - it's what we do), the more I kept flinging blood all over the place, walls, TV remote, etc.  I told JD to call a nurse to let them know - keep in mind, I am totally relaxed, calm, and laughing at the mess - he hit the 'Staff Assist' button.  Well, the 'Staff Assist' button is an all-hands-on-deck emergency button so all these nurses came running into my room that looked like a murder scene with blood on the walls, yet I was sitting up in bed swearing I was fine.  We all had a good laugh about it, and they took out my hep lock so it wouldn't happen again.

POST-PARTUM

We sent James back to the nursery and we took our first of many trips down to the NICU.  Simon looked pitiful in his incubator down there.  I couldn't nurse him or hold him just yet.  They hadn't administered any medication for his lungs yet because they were waiting to see if he could overcome his breathing issues  Surfactant has a few side effects that aren't pleasant, but we were lucky in that when the NICU staff did decide to administer this medication, Simon had no side effects and his breathing quickly improved.  Then we were able to hold him and I could nurse him.  However, he continued to languish for a few days before being weaned to room air, and even longer before he started to gain weight.

Simon in the incubator in the NICU

Seeing Simon in the NICU for the first time a few hours after the c section.  I couldn't hold him yet because of the monitors.

Upstairs, James began to have issues over the next few days.  He had problems regulating his body temperature.  They put him in an incubator in the well baby nursery to warm him up.  I practiced a lot of skin to skin with him.  The doctors were concerned that his low body temp meant he was about to get an infection right before my discharge.  They administered an antibiotic that required a 48 hour hospital stay- one extra day than I had in the hospital.

James, Jr. and James III

First time I got to hold Simon in the NICU

This was when I started to get upset - I couldn't believe I was going to have to leave the hospital without either one of my babies.  I had begun to accept that Simon needed his time in the NICU, but James too?  JD and I discussed paying for an extra night when one of the nurses did the kindest favor for us.  She made a few calls and found out that most of our floor was about to be discharged.  She requested permission to let us stay an extra night - for free - off the books.  Her request was granted and we were responsible for my meals and medications, but could otherwise stay another night, close to James and Simon.  When she came to my room to tell me what she had done - I'm not going to lie - I cried.  It was so sweet of her to do that for us - and we were able to leave that next day with James.

The boys are starting to do consistently well with their growth and development.  Their two-month check-up was really the first time they had consistently gained weight. Since birth, they have been great sleepers and I feed them every three hours during the day.  Nighttime, I stretch out their feedings to whenever they wake me up.

I still can't believe I am a momma to two boys, and how much I love having boys!   This was a scary time for us, but we felt loved by all of you who prayed for us, fed us and constantly checked on our well-being.  We have the best family and friends!

James left, Simon right

Holy October!

Never has November been such a welcome sight for our family.  October was a difficult, joyous, crazy month for the Graffams.  Here's our month in a nutshell:

Sept. 28 - JD goes upstairs to get Nora ready for church.  He sets her down on the floor of her room, and she crumples over.  She stopped walking.  After talking to a nurse, we decide to take her to Methodist Germantown.  They run a bunch of tests and take x-rays and determined that they weren't equipped to handle her case.

After loading Nora into an ambulance, she is transferred to LeBonheur Children's hospital downtown.  For the record - seeing my sweet little 19 month old on a stretcher in an ambulance is about the worst thing I've had to witness so far in my adult life.  LeBonheur decides that Nora has toxic synovitis - a virus leftover from an ear infection is attacking her hip - and recommends a daily regimen of ibuprofen until it passes.  No big deal right?  We take her home and hope for the best.

A few days later, Nora is running around, back to normal.  The Methodist ER doctor calls to report that her blood culture was positive for a bacteria.  Based on the fact that Nora seems to have recovered, the doctors at Methodist and LeBonheur decide the bacteria must have been a skin contaminant and dismiss the idea that she was misdiagnosed.

For the next two weeks, Nora relapses and recovers every few days.  Her mobility varies from not being able to walk, to limping, to running.  JD takes her in to every pediatrician in the pediatric group - our regular pediatrician is on leave.  They all observe the limp but tell us to wait it out.

Oct. 14 - JD and I go to dinner and a movie.  My mother babysits Nora so we can have a date night.  I have trouble sleeping.  I can't stop coughing.  I've had this lingering chest congestion for a week, but it was worse.  All night, I pace the house because my back hurts from coughing so much (so I thought).  I have to empty my bladder every 5-7 minutes.  I knew I was sick but I didn't want to call my OB.  That week was my last week 'off' as the next week would start twice a week pre-natal visits for the twins.  The babies were moving like crazy.  By morning, I was exhausted.

Oct. 15 - I call my OB's nurse to see if he will call in a Z pack.  The nurse says that Dr. Mullenix wants to see me at 9 am.  I really don't want to waste my last week off going in, but I also want to stop coughing.  After listening to my lungs and hearing my symptoms, Dr. M asks if he can examine me.  Sure enough, I am 6 cm dilated and Baby A was already in the birth canal.  This is not a good thing as I have to deliver these babies by c section, which was initially scheduled for Nov. 1.  Baby A was complete breech, and the risk of a prolapsed cord was too great to attempt a natural delivery.  Less than an hour later, we meet our sons.  I'll do a longer post about this later.

A few hours after my c section while I am in recovery, the day care calls about Nora.  The director is worried about her leg again.  I call the pediatrician again to find out that Nora's regular doctor is finally back and wants to see her.

Oct. 17 - Nora finally sees her regular pediatrician.  On top of her leg issues, Nora's oxygen level is so low that it takes three breathing treatments in the office before Dr. Hussain will let her leave.  An appointment is set up with Nora's pediatric ortho to look at the leg.

Oct. 20 - We leave the hospital with James.  Simon must stay behind in the NICU.

Oct. 21 - Dr. Beaty at Campbell's Clinic observes Nora.  He says if six weeks passes of symptoms, they would step up her treatment.  He schedules a follow-up appointment for next week.  Nora's leg continues to get worse.

Oct. 25 - JD takes Nora in to Campbell's after hours clinic.  The ortho who observes her is sympathetic, but recommends waiting for our next check-up.  I get a call from the NICU - Simon is coming home!  We are so excited to have everyone home!

Oct. 26 - Nora's leg pain is so bad today that she can't stop crying.  This is the first time when she has had an episode where she won't let us touch her leg.  JD takes her back to LeBonheur.  He calls me close to midnight to say they have admitted Nora and have ordered an MRI for the next morning.  My mom quickly comes over to watch the boys so I can stay the night at the hospital.

Oct. 27 - When Nora is in recovery from the MRI, her nurse is the same nurse she had earlier in the summer for a different issue.  Unlike last time, the nurse isn't hinting around that Nora's MRI was normal, and keeps asking questions about hot spots, inflammation, etc.  She says to wait in Nora's room for the results from the radiologist.  She says if Nora is an emergency case, the radiologist will see us sooner rather than later in case they need to operate right away.  I take this as a bad sign.  When we get upstairs to her room, her floor nurse calls the radiologist to see if Nora can have a snack as she has been NPO since midnight.  The floor nurse quickly returns to say Nora can't have anything to eat or drink, and the radiologist was on his way.  Soon after, the radiologist, pediatrician, anesthesiologist and nurse practitioner come to Nora's room.  Two things popped up in her MRI - excessive fluid behind her left knee and a possible bone infection in her left shin.  They need to wash out her knee first and test the fluid, and put her on IV antibiotics for the bone infection.

As soon as the operation gets underway, the nurse calls JD to say that the fluid looked infected and they had to open up Nora's knee more than anticipated - but that was explained to us as a possibility beforehand.  Her white blood cell count confirmed the infection, and a few hours later we have a sweet, groggy toddler in the recovery room.  I stay a little longer, but then go home to be with the boys.  JD stays with Nora.

Oct. 29 - Nora was supposed to have a second surgery to washout her knee again, but the surgeons were confident that all the fluid is gone.  They still have no idea what type of infection she has in her knee, and this is causing a problem for treatment.  They send out for an infection diseases (ID) consult.

Oct. 30 - The ID doctors spend a lot of time interviewing JD and looking at Nora's chart, which leads them to diagnose her bacteria infection as Kingella Kingae bacteria - a bacteria that can grow out of mouth sores.  Nora has had hand, foot and mouth several times this year - and recently had mouth sores.  Once the ID doctors make this diagnosis, we are relieved because the treatment is easy.  Just oral antibiotics at home.

Oct. 31 - Nora finishes her IV antibiotics for the bone infection (not the bacteria infection), and they discharge our little girl.  We are finally all back together!

It was a hectic month with Nora's leg issues.  It was joyous with the birth of our sons.  Through it all, we felt incredibly supported, prayed over and well-fed (!) by our family, friends, neighbors and fellow church members.  'October' might be a dirty word in our house for a few years, but surely we will look back at the insanity one day and laugh, right???