Therapy Thursday: To Sip or Not to Sip (3 for 21, Day 4)

There has been a lot of controversy and discussion around self-feeding, especially when it comes to bottles and "sippy cups".  I myself am smack dab in the middle of this with my twins at the moment.  On one hand, we have to do what is right for them and their individual development.  On the other, we have the needs of the family.  What's right?  What's wrong?  More importantly in terms of my kids, what am I going to do?

First, consult the experts.  According to several (including our own OT and pediatrician), the following is recommended:

• Introduce a cup a month or so after introducing spoon feeds (6+ months)
• Use thickened liquids at first to help with swallowing

How to teach your baby to use a cup:

• Ensure the baby is sitting up and well supported.
• Using a small cup, place the rim on the child's lower lip
• Let a small amount of the liquid flow slowly into the front of the mouth.  (Do not pour it in!)
• Ensure the tongue is above the rim of the cup
• If your child has difficulty closing their mouth when swallowing, provide some jaw stability with your thumb and forefinger by placing them around the chin
• As time goes on and the baby gets better at it, leave the cup on the bottom lip and allow the child to take small sips on their own

Regular spout sippy cups are not advised as:

• they encourage a poor latch-style mouth shape, 
• they encourage jaw protrusion
• they encourage chewing on the stem
• there is a high incidence of dental cavities among children who use or have used sippy cups.
• they encourage an "open bite" (misaligned teeth)

Several sources recommend:

• a "coffee style" or recessed hole opening cup (as it helps keep good posture and a good mouth shape).  This is favoured by our OT.
• the "Doidy" cup (a slanted handled cup available in the UK),
• a cup with a nose cut out (??),
• Mr. Juice Bear, 
• juice boxes as you can squeeze juice into the straw to aid with sucking

That, in a nutshell, is it.

However, what I am about to say may shock a few people:  this is not exactly what I am doing.

Before the pitchforks and torches arrive however, I would like to preface my personal choice for Wyatt with a little refresher on his back story. My twins are preemies, delivered by emergency C-Section at 34 weeks, 4 days.  They were six weeks early and every single development has had to be adjusted accordingly.  Every age given to a physician or specialist since they have been born has had six weeks subtracted from their age and the suffix "6 weeks corrected" added to the answer.  It doesn't sound like much until you consider that they are almost 2 months behind full term babies born on the same day.  When you look at Wyatt, you add a little more time as he is a boy (who, statistically take longer to develop than girls).  You can also add a little more time for his extra 21st chromosome and even more time as he was born with a hole in his heart.  I can't really guess at his developmental age (and I shouldn't be either);  what I can say is that he is right on with some things and a little behind in others.  In terms of motor skills he's about where his neurotypical older brother and younger sister were at about 10 or 11 months or so.  The twins will be two in February.   There is a developmental gap in this house, that is true.  Most of the time, it really isn't an issue except when it comes to feeding.

Feeding them is an especially tender topic as I had to teach them to eat when they were born.  Most babies come out with rooting and sucking instincts, my little people did not.  Also, being so tiny and early (Zoe was 4 lbs, 1oz and Wyatt was 4 lbs, 13oz), if they attempted to eat, it would have exhausted them.  Zoe was tube fed for most of the first two weeks of her life and Wyatt for the first month of his.  I had to patiently teach them both to suck.  You can read more of that here.  Once they were able to latch properly and breast feed, they did, with top-up bottles afterwards to help them gain weight.  Zoe, with her strong latch, preferred Avent, while Wyatt, with his unusual latch, did better with the Medela bottles.  Feeding time around here is a huge issue; if you think keeping track of what one baby is eating and doing, try doing it with two babies.  And a six year old.  Also, you will probably be alone as I will be at work.  Things get interesting for my husband and I.

Right now, they are eating pretty much the same things.  He has smaller chunks than her, takes longer and we have to make sure he isn't over stuffing his mouth.  He "chews" with his back gums and moves food around in his mouth like a pro.  They've been off puree for a very long time now;  they've been self feeding the same amount of time.  Unless we sneak in an applesauce or pureed fruit dessert, we rarely use the spoons any more.  Most of the time, we let them play with them, to get used to handling them. 

We have tried various shapes and sizes of covered drinking cups with Wyatt as we have a stack of them left over from our first son, Quinn.  We loaded up many different designs over a couple of days to see what kind of reaction they would get.  Zoe had little or no problem with anything except one of the new straw models as the straw was too small in diameter.  Our Wy guy, however, was totally overwhelmed and would cry and cry when he saw the sippy cup or straw or what-have-you.  The straw would poke him in his palate, the others would pour down the front or he would choke.  His oral muscles are not as big of a problem as you may think as he and his sister were breastfed for 17 and a half months.  Trust me, dude can eat. I'm also not totally anti-sippy cup for two other reasons:  one, we do not let our kids run around with anything other than water.  They have milk or juice at meals and milk only before bed.  Which, is still in a big bottle and fed to them individually before putting them down as bedtime is also a big production (no, we don't put them down with bottles in their beds...).  Sippy cups aren't to blame for the increase in pediatric cavities:  parents and constant access to sugary drinks are (the sippy cup is just the mode of delivery... like they say, don't shoot the messenger).  I've got a mouth full of "why you don't walk around drinking acidic things off and on all day long at your leisure when you are already dental compromised".  Even when my kids do get juice, it's 1/3 strength (so, juice boxes are on the no bueno list for the wee ones as well).  Two:  I'm sorry, but no matter how cute and useful Mr. Juice Bear is, I will never be able to look at my darling child using it without thinking that he is drinking out of a bong.  I was also having difficulty rationalizing spending almost ten dollars on one cup with one straw that looks like it is just a re-vamped honey bottle.  I am assured that it isn't.  In fact, one of my dearest friends recommends it highly as it helped her daughter transition to drinking after the NG.  Her testimonial is enough for me;  Mr. Bear gets the official seal of "Awesome".  However, she's in agreement with me:  it still looks like a bong.

There were two versions of drinking cups that Wyatt did manage to use with some success.  We found an Avent sippy cup with a soft Nuby like protrusion on the top that wasn't exactly nipple like and not exactly a spout.  The other, my first choice, was a Nuby cup with a soft straw like top.  Sadly, I was afraid he was going to chew it off and the cup itself was so large he had to tip it back to drink out of it.  We went with the Avent with the soft spout and I had a chat with my OT and pediatrician.  Our pediatrician is a hard core old fashioned cup advocate, however we can't practice with cups safely (and sanely) with both of them unless both of us are here.  What I decided to do, for the best of everyone was to slowly wean him to an open cup and my secret weapon. The soft nipple went away after a few weeks and was replaced by the medium one.  It is soon to be replaced with a hard, smaller one, once he gets used to the valve not being there (as I have removed it to simulate more of a cup)  He will then go to some kind of straw.  In the meantime, when I am home, we will do proper cups.  Once we get the hang of that, we break out the secret no spill weapon which, in the absence of the "coffee cup" type covered cup, has gotten the thumbs up from Wyatt's team.  It's this:

Say hello to my little friend...

This is the Advent "Natural feeding cup" which has a valve only to stop the liquid from pouring out once either one of them throws them on the floor (as, if you read yesterday's post, they do multiple times a day each).  The top is indented to allow for the nose and by indenting the middle circle on one side (as the top lip naturally would, with the jaw in alignment and not thrust forward and the tongue where it should be), the liquid easily flows out.  Stop pressing, liquid stops.  It's elegant in it's design.  You drink out of it like you would a proper cup.  If you don't, it doesn't work. It also has handles. 

So far he hates it.

However, two wait patiently in the kitchen, one for each of them. 

I wouldn't recommend doing what I am.  However, I would recommend doing what is right for you, your child and your family.  Not everyone has my circumstances, that is true.  However, for those that do, you may want to rethink a few things.  But, and I can't stress this enough, run it past your team first.  Perhaps there is a way to incorporate good practice for your family that fits into your life.  You won't know until you ask.

No matter which method you choose, raise your cups high.  Salut!

Perez, Jennifer, and Gwenyth Gorlin. "Feeding & Swallowing in Children with Down Syndrome." Lecture. Allen C. Crocker Family Lecture Series on Down Syndrome. Children’s Hospital Boston Feeding & Swallowing Program. 24 May 2010. Boston Children's Hospital. Web. <http://childrenshospital.org/>.


VanVuren, Marinet. "Developing Good Drinking Skills in Children with Down Syndrome." DownSyndromeCentre: Information and Services for Parents of Children with Down Syndrome. DownsyndromeCentre, 27 Feb. 2009. Web. <http://www.downsyndromecentre.ie/>.

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Defending the Boob

I'll start off right now by saying this post isn't for everyone.  It has boobs in it. 

Lactating ones.

I realize that half of you stopped reading after the last line, but to be fair, I've probably gained a few weird fetish dudes by now so I'm sure it all balances out somehow. 

In any event:  My name is Jen and I am an extended breastfeeding Mom.

As their biological mother, I chose to breastfeed all three of my kids.   I did this as I believe this is the best start that I can give them. I am not here to make you feel bad if you didn't;  we are fortunate enough to live in an area of the world that allows us options.   However, it's my blog and right now we are all about the boobies. 

It's sad in this day and age that you have to defend your choices as a mother, no matter what direction you take.   I am very lucky to have been able to breastfeed my twins up until now.  I struggled with my eldest for 6 months before giving up and switching him to formula. I wish I had known then what I know now (and had gotten a decent pump!)  The babies are now almost 14 months old and we are still going strong.   When Wyatt was born, I was open to any an all options for him in particular;  if it turned out that he needed to be tube or bottle fed pumped milk, then I would have done that.  We were very pleased when he was able to breast feed; not only would it provide the best dietary option and boost his immunity, but the increased resistance would give his oral-facial muscles a better start. 

As part of the 31 for 21 Blogging Challenge that I participated in last October, I put out this Factoid Friday:  7 Good Reasons to Breastfeed Your Baby with Down syndrome.  Babies with Down syndrome commonly have feeding problems;  I came across a study from Italy where 57% of babies with DS born in the four university hospitals were bottle fed (Pisacane, etc, 2003)  Depression and frustration were two of the most common cited reasons.  Feeding difficulties was the most common.  Only 30% of the children admitted to the NICU were breastfed.  I've run into similar studies from South America.  My advice to any new DS parent facing their options would be to do the research.  If you can do it, do it for the 7 Reasons that I've listed.

Now that the babies are 13+ months, I've now moved into very uncharted waters.  I'm now part of a new category:  the extended breastfeeder.  I have had (mostly well meaning) folks ask me "how long are you going to keep that up?" and the like.  (Also, "why are you still feeding both of them?", like I can pick one of them?) The stereotype, of course, is the "crunchy" mom who breastfeeds until the kid is in middle school... and yes, I have been asked that as well. Both Wyatt and Zoe are eating a variety of solid foods.  When I am at home, they continue to receive breast milk (they are supplemented with homogenized milk when I am working and there is not enough pumped milk in the fridge).  Why am I still doing this?

Really, it's more like: why the hell wouldn't I be?

There is no medical explanation as why I should cease breastfeeding my twins;  those 7 reasons still apply.  Between my insane work schedule and, well, life, any close, quiet snuggle time I get with the babies is important.  So what is the issue then, other than a vague societal idea that it is somehow weird and unnecessary?

To be honest, I did think about quitting.  It would be easier in some respects.  Pumping at work can be a drag, when all I want to do on my break is close my eyes for a few minutes or possibly eat something at a comfortable pace.  I might also want a glass of wine or two (or three) some evening at home. Then there is Zoe, who now has a mouthful of teeth.  Sharp, needle-like teeth.  I probably don't need to expound on that one. 

Ultimately, for me, it comes down to Wyatt.  Yes, he is eating solids, well above what is "expected" of a child with Down syndrome at his age.  However, is solid food and cow's milk the best I can do for him and his special needs?

It is true that after 6 months, with any baby, supplementary feeding is recommended.  However, that does not mean that breast milk ceases to be of any nutritional value.  In fact, once you are over the year point, it is the exact opposite.  In 2005, Mandel determined that milk from mothers who had been breastfeeding for over a year showed "significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods."  To further expound on this, Dewey (2001) found that "Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins."  In fact, when analyzed, 448 ml of breast milk (in ages 12-23 months) provides (of the daily requirement):

• 29% of energy
• 43% of protein
• 36% of calcium
• 75% of vitamin A
• 76% of folate
• 94% of vitamin B12
• 60% of vitamin C

After the first year then, breast milk continues to be a valid form of nutrition for a toddler.  What else can it do?  Building on our previous 7 reasons:


"1)  Breastfeeding provides antibodies and protection from illness"

After the first year, breast milk continues to provide immunity and fight infection.  In fact, it has been shown that breast fed toddlers have less infections and a reduced severity of illness (Gulick, 1986). Also, breast milk has an increased amount of antibodies in the second year (Goldman, Goldblum, Garza, 1983) which increases even further at the time of weaning (Goldman, 1983).  It would seem that extended breastfeeding is a beneficial practice for the health of any child, especially one who is statistically prone to infection and illness due to his genetic make up.

"2)  Breastfeeding improves mouth and tongue co-ordination which will aid in speech and language development"
  
Breastfeeding provides a variety of "positive effects on the development of an infant's oral cavity, including improved shaping of the hard palate resulting in proper alignment of teeth and fewer problems with malocclusions." (Palmer, 1983). In terms of both motor skills and early language development, another study found "The proportion of infants who mastered the specific milestones increased consistently with increasing duration of breastfeeding." (Vestergaard, etc,1999).  Therefore, extended breastfeeding would only continue to enhance speech and language development.

"3)  Breastfeeding promotes increased brain growth due to DHA, a fatty acid that is not found in most formulas or cow's milk." 

Extensive research in this area has shown that there is a direct relationship between breastfeeding and cognitive ability.  Of particular note is a study from 2002, whereby "a significant positive association between duration of breastfeeding and intelligence was observed in 2 independent samples of young adults, assessed with 2 different intelligence tests." (Mortenson, etc, 2002).  Extended breastfeeding then, would further aid any child's cognitive development;  ostensibly providing a boost to one who was developmentally delayed.

"4)  Breastfeeding provides the opportunity for extra sensory stimulation as there is more skin to skin contact"

Many studies have shown that breastfeeding enhances motor skills and overall development.  In fact, "The psychomotor and social development of breast-fed babies clearly differs from that of bottle-fed ones and leads at the age of 12 months to significant developmental advantages of the psychomotor and social capabilities." (Baumgartner, 1984).  As the senses develop the more they are stimulated, it would be easy to infer that the more one is breastfed, the more developed the senses would become.  It is obvious how this would be helpful to a child with Down syndrome.

"5)  Breastfeeding fosters closeness"
and
 "6)  Breastfeeding enhances mothering skills"

I think this quote says it best;

"A major reason for practicing sustained breastfeeding in industrialized countries in the face of social disapproval has been the belief that it provides a closer bond between mother and child. These children are often said to be more secure and more independent. They continue to remember this close bond and their mothers believe that it continues in some sense, even into adolescence, easing the difficulties in the mother-child relationship during this period." (Grenier, 1995)  

The strong bonds created with breastfeeding appear to last well into childhood, at least by our perceptions.  Ferguson found "significant associations between the duration of breastfeeding and maternal and teacher ratings of conduct disorder obtained at six, seven and eight years" (Ferguson, et al, 1987). 
 
"7)  Breastfeeding reduces the risk of Type 2 diabetes"

Breastfeeding your child reduces his or her chances of developing Type 2 diabetes.  What is not commonly known is that extended breastfeeding decreases the mother's chance of developing Type 2 DM as well.  According to the Journal of the American Medical Association:  "increased duration of breastfeeding was associated with reduced risk of type 2 diabetes".  In fact, for each year of lactation, a woman decreases her chances by 15%.  (Stuebe, etc, 2005).  With that in mind, if a woman has two children and breastfeeds them both for two years, she has reduced her chances of developing Type 2 diabetes by 60%.  Other diabetes related finds of note:  suppressed lactation actually increases the chances of diabetes. Also: "lactation was associated with improved glucose tolerance, fasting glucose, and total area under the glucose tolerance curve. In an analysis stratified by use of insulin during pregnancy, fasting glucose levels were significantly lower in the lactating group." (Stuebe, etc, 2005)

As it turns out there is also some evidence that extended breastfeeding reduces the mother's risk of certain cancers, rheumatoid arthritis, and osteoporosis.


Contrary to popular belief then, extended breastfeeding (past the first year) has valid benefits for both mother and baby. I must admit, although it can be tricky (mainly due to other people), it provides a quiet time that I can spend with both my babies at once.  They make eye contact with me, they make eye contact with each other.  Occasionally, one will poke at the other, but that is the story with any siblings.  It's also easy and free, which scores bonus points as well.  I won't know for sure if it will make the difference between Wyatt taking this course or another in high school.  I will know that when I do get a chance to cool it for a bit, I can rest easy knowing that I did my very best for him and his sister.  Which is all any of us aspire to do, really.

Long live the boobies.  To my twins at least, they're like no udder. 



---------------------------------
Baumgartner, C. Psychomotor and social development of breastfed and bottle-fed babies during their first year of life. Acta Paediatrica Hungarica 1984; 25(4):409-17. 

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).

Ferguson, D. M. et al. Breastfeeding and subsequent social adjustment in six- to eight-year-old children. J Child Psychology and Psychiatry 1987; 28:378-86.

Gulick EE. The effects of breastfeeding on toddler health. Pediatr Nurs. 1986 Jan-Feb;12(1):51-4.

Goldman AS et al. Immunologic components in human milk during weaning. Acta Paediatr Scand. 1983 Jan;72(1):133-4.

Goldman AS, Goldblum RM, Garza C. Immunologic components in human milk during the second year of lactation. Acta Paediatr Scand. 1983 May;72(3):461-2.


Mandel D, Lubetzky R, Dollberg S, Barak S, Mimouni FB. Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation. Pediatrics. 2005 Sept; 116(3):e432-e435.

Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The Association Between Duration of Breastfeeding and Adult Intelligence. JAMA. 2002;287:2365-2371.

Nursing Beyond One Year by Sally Kneidel, NEW BEGINNINGS, Vol. 6 No. 4, July-August 1990, pp. 99-103.

Palmer, B. The Influence of Breastfeeding on the Development of the Oral Cavity: A Commentary. Journal of Human Lactation. 1998;14(2):93-98

Pisacane A, Toscano E, Pirri I, Continisio P, Andria G, Zoli B, Strisciuglio P, Concolino D, Piccione M, Lo Giudice C, Vicari S.  Down syndrome and breastfeeding.  Acta Paediatr. 2003;Dec;92(12):1479-81.

Stuebe A., Rich-Edwards J., Willett W,  Manson J, Michels M, Duration of Lactation and Incidence of Type 2 Diabetes.  JAMA 2005;294(20):2601-2610.

Sustained breastfeeding, complementation, and care by Ted Greiner, Food and Nutrition Bulletin, 16(4):313-319, 1995

Vestergaard M, Obel C, Henriksen TB, Sorensen HT, Skajaa E, Ostergaard J. Duration of breastfeeding and developmental milestones during the latter half of infancy. Acta Paediatr. 1999 Dec;88(12):1327-32.

Makin' Progress

Busy, busy...

It has been such a busy week with Team Logan.  We have updates, we have birthdays, we have goals.  We have cupcakes.  What's better than cupcakes?

Wyatt went for his one year hearing test a week ago and did very well on all accounts.  As yours truly was working, Sean had to take both babies by himself.  Wyatt did not have to be asleep for this test (thankfully); I think that would have been almost impossible to achieve. You may remember from the last audiologist appointment that Zoe screamed loud enough to be heard inside a soundproof room.  She stayed true to form and did not disappoint this visit either.  However, despite the not-so-ambient noise from my daughter, the audiologist felt that Wyatt's hearing was within normal limits except for one small area which was inconclusive.  She was unsure as it could have been Zoe's interference and distracting abilities or just Wyatt deciding not to respond to the sound.  Regardless, we took it as good news.

The very next day was their first birthday.  Although I did blog a bit of a retrospective in the morning, the afternoon and evening were spent with the babies.  Lots of pictures were taken and vids were shot.  Both Wyatt and Zoe loved their first taste of cake, which wasn't anything fancy.  For Quinn's first birthday I went all out and made a special no added sugar, no egg thing that tasted vaguely like raisin bread.  This time around I didn't have time (or the desire, frankly) to make anything like that, so instead we opted for angel food cake cupcakes (with confetti sprinkles) and whipped cream.  Naturally, they loved them. 

Babies Eating Cupcakes.  YUM!

Saturday was their birthday party.  Unfortunately, we woke up to a blanket of snow.  That meant that most of our party guests (who were coming from out of town) were unable to make it as they were pretty socked in.  It's February.  In Canada.  What can you do?  We still had a great time with the few that did come and the babies were thoroughly fêted.   

Aside from cake, they've explored quite a few new foods and textures lately.  Both are crazy about cheese (cottage and cheddar) and were treated recently to their version of mac n' cheese (just don't tell them it has pureed cauliflower in it).  They've attempted very small pieces of cooked broccoli;  Zoe was nonplussed while Wyatt thoroughly enjoyed it.  That is, until I discovered that he was just stashing it in his high palate.  Pancakes, raspberries, watermelon... and the list goes on.  The biggest change in their diet this week has been switching them from formula to homogenized milk.  They are still breastfed most of the time, but their diet was supplemented with formula when I was at work and with a small "top up" at night.  That has been switched out to milk and thankfully, everything is well so far.  Next up:  eggs.

At our session this morning, we discussed future goals with Wyatt's therapists.  At six months, we hoped that by this time Wyatt would be sitting independently (while bracing himself), propping himself up on his hands while on his tummy, pivoting while in that position and starting to commando crawl.  As of this morning, he can sit up independently while braced for 5 minutes (and without bracing for a short period of time).  He props himself up on his hands while on his stomach and can pivot slightly less than 90 degrees.  His rolling has improved to the point where he can log roll non-stop and in both directions.  He is not crawling, although he did demonstrate a little "going backward" today when he was trying to reach for a toy (and was able to "push off" of his worker's hand and slide forward to reach his goal).  Everyone is pleased with his progress overall.  Today we set new goals:  Hands free sitting, pivoting 90 degrees, backwards or forwards commando crawling and feeding himself more independently.  The last is a bit of a tricky one as he is quite content to grab a handful of my hair or another foreign object and put it in his mouth but not food.  He picks his solid food up, plays with it, but if he eats it, generally it is because we are putting it in his mouth.  I think it's just a matter of proper motivation, as I turned my back for a second on Saturday to help a party guest with something and turned back to find this:

Wyatt's Ninja Noms

No one can resist a cupcake.  No one.

Slowly and carefully, Wyatt is developing, albeit at his own speed.  He is strong and healthy and continues to delight anyone in his presence.  At one year in, we know we are still new at this;  it will probably get a lot harder as he grows older.  Right now we are progressing and that deserves to be celebrated.  Quite possibly with cupcakes.

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I've also done a guest spot on "Life with Penis People" this week.  Stop by, say hi to Danielle and read my post "A Little Longer and a Little Different".  You won't be disappointed.

Sittin' Pretty

Life has been kicking my ass lately.  Stress is high, motivation is low.  Haters gotta hate.  Between appointments and bookings and weekly therapy and work and the never ending train of things going by, I've found myself impatiently waiting for sight of that caboose.  Thankfully here is a break in our schedule, this train has finally passed and the crossing bar is going up.  I'm off for a few now and I could almost hear the engine revving in my head to get the hell out of Dodge. Which I did, as soon as the lights stopped flashing.  Zoom!

Team Logan has been hitting the milestones hard in the last while;  there have been quite a few "firsts" and realizations with our little brood.  For example, we seem to have a finite amount of teeth in this house.  Zoe has sprouted three little pearly daggers, while her big brother Quinn has lost two and is possibly working on a third. The first one to fall came out by accident;  Quinn was running around the living room and slipped and bumped his mouth on the couch.  There was blood... lots of it.  He was pretty freaked out at first until I explained a few things.  1) the bleeding would stop eventually and 2) his hysterics at the sight of blood would have nothing to do with [this weeks goal of] becoming a doctor.  Thanks, Wonderful World of Psychiatry. 

His second tooth came out a few days ago as I "accidentally" popped it out as I was "assessing" it.  His two adult incisors are growing in at a furious rate and the baby tooth had fallen over and had started to imbed itself sideways in the gum.  After the initial shock and surprise (and less freakout as there was less blood), it lay in it's jewelry box totally forgotten about for two days.  He finally remembered to put it under his pillow last night and was rewarded with a dollar.  He added it to the five dollars he got for his first tooth and is [quote] a happy miser [end-quote]. 

Zoe's latest kick is shouting.  I don't mean yelling as she is hungry/tired/hurt, but rather shouting for shouting's sake.  She'd make a great Vogon guard.  Her babbling just seems to be set on 11 at all times and when not exploring the endless permutations of "Dada", "Daddy", "Bob" and "Bop", (complete with wild hand gestures) she works on her version of The Who/CSI Yeeeeaaaaah!.  At all hours. At random intervals.  It's especially charming after a couple of night shifts. *shiver*.

She's also almost walking.  The cruising is one handed at best and every object that she can roll or shove across the floor is an assistive device.  This includes (and is by no means inclusive of):  Wyatt's "Bean", the Bumbo chairs,  the musical table, and a 10 lb basket of toys.  She'd roll Wyatt along if she could.  I'm not kidding.  She's a bulldozer.  You have been warned.

We've added a few things to the babies' diet as well.  The pediatrician was shocked that we had Wyatt on more than a simple puree.  We've been slowly bringing more texture/less moisture to their food for some time now.   Zoe should be eating a lot of finger foods, but it is hard to have two completely different meal textures on hand at all times.  Instead, we've reached a happy medium.  Our homemade oatmeal has more lumps, as does the barley.  They eat rice shaped pastina:  mixed into their food, in clumps with melted cheese, and individually if they want.  If they have a pureed banana with their cereal in the morning, we set some aside and cut it up into tiny little bits for them to work on.  Zoe works on her pincer grasp with Cheerios, Rice Krispies and Special K, while Wyatt works on his tongue muscles and synchronizing his chewing and swallowing.  You may have to feed the pieces of cereal to him, but you also have to count your fingers afterwards. Recently, we've added cottage cheese, mashed textures and tiny chunks of cooked fruit.  It's been successful all over.  I haven't quite introduced them to their Momma's famous homemade mac and cheese yet, but after some pretty frustrating months, it looks like we will get there.

The best news all week was Mr. Wyatt's sitting progress.  He's been improving slowly in this area for the last little while.  We've been working on his core, improving his posture and putting him in a sitting position as much as possible.  Our perseverance paid off yesterday as he managed to sit, unassisted for over a minute!  It was amazing! 

Look what I can do! We managed to get him to do it again, at least long enough to take the above picture.  He's tired... you can tell as he is starting to list to port.

We've found lately that putting one of the smaller nursing pillows around him while he sits gives him a tiny bit of support (and a handy crash pad).

Sittin' and a' grinnin'

Life with Team Logan is never dull.  But, that's life with special needs.  Sometimes you need a helmet, sometimes it feels like your heart is about to burst.  Big girl panties are a must and we don't have any positions open for part time people.  Somehow though, it all works.  It isn't easy to get out of bed some days, but we are getting there, one milestone at a time.  We may not be rich or have the best of things, we may be short on sleep... but we are sure sittin' pretty. 

Yes.

Factoid Friday: 7 Good Reasons to Breastfeed Your Baby With Down Syndrome

It may be difficult to breastfeed your child with Down Syndrome in the beginning.  I had to train Wyatt to latch properly and then how to eat without either choking or exhausting himself.   I was asked many times by (mainly) well meaning friends why I would bother.  I would mumble in my sleep deprived haze about antibodies and future weight issues.  Today's Factoids, now that I am a little more coherent, are good reasons why you should breastfeed your baby with DS.

1)  Breastfeeding provides antibodies and protection from illness.  Children with Down Syndrome are susceptible to bowel and respiratory issues.  Breast milk provides antibodies to fight infection and is easier to digest than formula.

2)  Breastfeeding improves mouth and tongue co-ordination which will aid in speech and language development.

3)  Breastfeeding promotes increased brain growth due to DHA, a fatty acid that is not found in most formulas or cow's milk.  Breastfed children score higher on IQ tests than those raised on formula;  this brain stimulation is particularly important in learning disabilities such as Down Syndrome

4)  Breastfeeding provides the opportunity for extra sensory stimulation as there is more skin to skin contact.

5)  Breastfeeding fosters closeness.  It offers more time to cuddle and spend time and get to know a special needs baby better.  It also boosts the mother's self esteem by providing a way that she can do something meaningful for her child and their health.

6)  Breastfeeding enhances mothering skills.  The patience, encouragement, coaxing and teaching used to help the baby learn to breastfeed will be employed over their lifespan to help them reach their goals.

(Becky Flora, BSed, IBCLC, 2001)

Finally, Number 7 is on me...

7)  Breastfeeding reduces the risk of Type 2 diabetes.  People with Down Syndrome are prone to Type 2 Diabetes for many reasons, including increased insulin resistance, reduced lean muscle mass, increased weight and fat storage. 

And, that's the facts, Jack.  Happy Friday.

Day of Rest?

Ahh Sunday.  So we meet again.

Sundays start out with that promise of sacred time.  I'm not talking in the religious sense; it always starts out feeling like stolen time for you and your kids.  You may get to sleep in a bit.  Breakfast will be involved.  Coffee will be savoured.  Fun things will be planned for the afternoon. These things rarely come to fruition however as the illusion of Sunday morning is usually shattered by 10:30.  By crying.  Sometimes it's actually the kids doing that. 

I'm often asked questions like "how do you manage" or "where do you find the time?".  Other than my usual stunned look, I often answer with "I don't know" or "when I figure it out, I'll tell you?".  The truth is, time is pretty finite in the waking hours.  When I am off (and not actually sleeping after my night shifts), I have a limited amount of time to get everything [read: anything] done.  Period.

Our 'day of rest' usually goes something like this:

Assuming one of us isn't already up by 6, Quinn gets up around 7-7:30 ish.  There is usually quiet cereal and TV.  The babies wake up somewhere around 8:30 or nine and the feeding commences.  Two babies get their bums changed, two babies get dressed and brought downstairs for some floor time (they spend a lot of time on the floor to build their muscles).  There is a "Medela moment".  We are now somewhere around 10:00 or 11:00.

Lunch is discussed and then abandoned as a topic as we are inevitably interrupted by one of/all of the kids or in a forgetful stupor one of us decides to wander away to try and complete at least one simple task (ie, throw in a load of laundry, unload and reload the dishwasher, fold a load of laundry, what have you).  We usually opt for brunch at this point as quiet cereal and TV were some time ago.  We haven't eaten yet (or Sean has eaten lightly) and Quinn is now ravenous and screechy.  Sean either makes something lovely or "quick and dirty".  I wolf my food in between separating/rescuing/soothing/cleaning/redirecting at least one baby.  Quinn has resorted to making "crafts" out of everything in sight.  Small bits of paper are removed from Zoe's hand/gaze/throat.  Wyatt is either asleep on his tummy or quietly watching everything.  They usually start shouting around now and it is time to feed them again.  Which we do, including real food.  Babies are changed again as we have to hose them both and the kitchen down.  There is another Medela moment.

Then it is nap time.

Naps are a real bone of contention around here.  I'm all for them.  I am pro-nap.  I would rather we all have a little siesta in the afternoon and go to bed a little bit later then have the alternative which involves a lot of screaming, crying and general carry-on.  Quinn napped right up until last year when his daycare provider "helpfully broke him of the habit" [translation:  felt it was stupid and since she drove around all afternoon ferrying various children hither and yon, it was an easier for her].  If anyone needs a nap around here in the afternoon (other than me, of course) it is him.  If he doesn't sleep, he is an absolute terror by suppertime and most of that time will be spent on the stairs in "time out".  A nap for Wyatt and Zoe will be attempted.  They both may nap for a few moments initially, but that will end.  Especially if Quinn is actually asleep as we can only have two out of the three napping at the same time.  One will wake up, (usually Zoe) and be screechy.  Assuming she won't go back to sleep after her soother is found and replaced and hasn't woken up her twin, she'll be brought down to the living room to play.  Where she will until she passes out an hour later, at which time Wyatt wakes up hollering.  If Wyatt wakes up first I can bring him down and plunk him in the swing and he will sleep, but this only happens if Quinn is awake.  Confused yet?  All of this boils down to NO NAP FOR MOMMY.  None.  Dee-nied.

Now it is somewhere around 3 or 3:30.  My eyes are closing now whether I like them to or not.  I hit the Tassimo.  It is short lived as I seem to be able to metabolize caffeine very fast.  I am even more tired 45 mins later. Sean may stumble off to have a nap or have one downstairs as he is entertaining Quinn.  Babies are changed post-nap and put on the floor again.  I may scatter toys around and let Indiana Zoe discover them or lay on the floor and play with them.  One of them will have a "problem" (fussy) so as one parent goes off to do whatever project they had to do for the day, the other entertains kids (usually me). Now there is talk of dinner.  Sean goes off to make that/set up the baby food as I start feeding the babies.  More highchair time.  More hosing.  More diaper changes.  Another Medela moment. 

Dinner is prepared and scarfed down in record time as there is usually at least one member of the family crying or having an issue.  Dishes are attempted, but usually abandoned in the sink.  Issues are addressed and babies are played with as Quinn putters around us, interacting with some or all of us.  It is somehow around 8 now (I am surprised each and every time).  Babies are taken upstairs and if it is a bath night, that ritual is begun.  One of us (we alternate when I am home) is in charge of undressing, un-diapering, towel wrapping, towel unwrapping, drying off, diapering and jam-ifying.  The other is in charge of bathing.  We started out each washing a baby with two tubs but we found that an assembly line type operation works better.  One of us nips off to make up their bedtime "top up bottle" (of EBM) and then its more feeding.  One of us each gives a bottle (we alternate), snuggles and then they are put to bed.  It is now somewhere between 8:30 and 9:30.  Quinn's needs are now met (he bathes opposite to the babies... it was a compromise that makes our evenings not drag on forever) and he is put to bed, usually by Sean as I am having another Medela moment.

Depending on what Monday morning will bring, we either have a few moments to ourselves or one of us is doing laundry or escaping for some alone time.  Or collapsing in a heap in front of the TV.   If I'm working the next day, I'm off to bed.  G'bye Sunday, we hardly knew ye.

So, to answer the question "How do you find time to do it all", the answer really is "I don't".  I also don't even try any more.  "Fires" are put out and we do the bare minimum.  Larger cleaning projects are tackled just like that:  as a large project that takes up a block of time.  Despite all the multitasking and my ability to do just about anything while holding a baby (including write this) , it doesn't get done.  Oh well.  It used to drive me nuts, but I've come to terms with it.  It will all get done... eventually.

Our "day of rest", like any other parents, is a joke.  We have to do two loads of baby laundry a day to keep up with them.  I still wouldn't trade it for the world. Quinn, when not being "Dynamo:  The Kid Dramatic" is really freaking funny and his younger siblings are completely edibly adorable.  I know I have said this before, but Sean and I are incredibly lucky to have each other.  It works.  It gets done.  I don't know how, but it does.  Much like this blog entry, which has taken a ridiculous amount of time to write (and is probably poorly edited).

Happy Sunday.  Enjoy your day of "rest", whatever form it may take.

Added to the 'Define Normal' Blog Hop! Find out more @ Just Bring the Chocolate

Learn to Speak "Therapist " in a Few Easy Steps

Down syndrome, like most things, flourishes with the right attention.  In terms of therapy, this includes a multidisciplinary approach.  As each of these Allied Health specialties has their roots in medicine, it may seem to the uninitiated that they have their own language.  For our second Therapy Thursday I thought I'd define some of the most common terms that one would run into.  It always helps to know the language of the place you are visiting.

First, there are the disciplines:

Occupational Therapy:  Promotes the learning and strengthening of specific skills that aid an individual with the activities of daily living.  

Recreational Therapy:   Promotes well-being and the reduction of stress and anxiety by providing recreational activities.  This also promotes socialization.

Physical Therapy (or Physiotherapy):   Promotes optimum physical movement and co-ordination with a focus on preventative care.

Speech Therapy:   Promotes clearer, more expressive and understandable speech

Some important terms relating to Down syndrome and their relevance:

Hypotonia:  Weak or low muscle tone. The muscles also have reduced endurance.
Impact:  Infants with hypotonia have difficulty learning to breast or bottle feed as they are unable to maintain a proper latch and tire easily.  Later there will be a delay in both gross and fine motor skills as well as significant delays in holding the head up (for example) and the ability to sit, crawl, stand, etc.  Hypotonia also has an impact on learning to eat and swallow solids as well as learning to speak. It is important that those with hypotonia learn to use the correct muscles for movement as compensation often occurs (by using other muscles instead), leading to chronic discomfort and the underdevelopment of key muscle groups.

Hypermobility or Hyperflexablility:  joints that bend farther than normal.
Impact:  Much like weak muscles, the ligaments are tend to be looser in those with Down syndrome which creates joints that flex farther than normal. Hypermobile joints tend to interfere with the normal physical development and can cause chronic pain later in life.

Macroglossia:  an "enlarged" tongue.
Impact:  An enlarged tongue interferes with all aspects of eating, swallowing and speech acquisition.  It can also interfere with sleep and with enlarged tonsils and hypotonia, contribute to sleep apnea.

Receptive Language:  The ability for an individual to comprehend the language that is spoken or signed to them
Impact:  This can cause difficulties in learning, social interactions and communication.

Expressive Language:  The ability for an individual to express their thoughts and feelings in a verbal, sign or written form.
Impact:  This can cause disturbances in learning patterns, limit social interactions, communication and is frequently a source of frustration for the individual.

Oral-Motor:  That pertaining to the functionality of the anatomy and muscles of the mouth, lips, tongue and face.
Impact:  Many aspects of life, including speech and eating.

Gross Motor Skills:  The ability to use the larger groups of muscles.  This starts with the development of posture and continues on to include sitting, standing and walking.
Impact:  Improper use of these muscle groups will affect movement and comfort for the individual for the duration of their life. 

Fine Motor Skills:  The ability to use the smaller groups of muscles, mainly those in the hand in tandem with eye movements.
Impact:  Any motion or skill that requires successfully grasping and/or picking up an object

Activities of Daily Living (ADL's):  Everyday self care activities such as feeding one's self, brushing teeth, getting dressed, etc.
Impact:  Directly dictates the level of independence an individual has.

Range of Motion:  The extent a limb or joint can comfortably move.  Active Range of Motion is the extent that the person can move themselves, while Passive Range of Motion is the extent of movement when it is manipulated by another person.
Impact:  This directly impacts levels of movement and comfort.

Bon Appétit!

We're on day four of The New World Order here at Team Logan and there have already been quite a few changes.  The kitchen is getting overhauled.  The laundry is no longer "Mount Logan" but rather resembles a large burial mound (hopefully not mine).  Everyone is a little more relaxed and Wyatt and Zoe are now eating solid food.

Last week I mentioned that I was leery of starting the babies on cereal;  I was concerned that Wyatt's head was still a little unstable.  My hope was to wait another two weeks to be well beyond the "six weeks corrected" grace period that each of their milestones is given.  That grand plan lasted until Saturday afternoon after observing both of them watching me eat.  After trying to take food away from me (not a wise move for anyone, even my own offspring) they sat there salivating as I ate my brunch.  Their little eyes bored into me, their jaws were moving in time to mine.  Their little pink tongues were darting out of their half open mouths over seemingly parched lips.  It was creepy.  It was time.  It was more than time.  These babies were hungry!

I hadn't dug out our high chair yet so they were each plunked into a Bumbo.  Wyatt still has trouble sitting up straight in the Bumbo for periods of time, so we were on the clock (I have since set up the high chair for him in the kitchen that works much better).  I mixed up a batch of runny rice cereal according to the directions for  "first feeding" and went to town.

Not surprising, my babies like to eat.

I love this and you Mom!

Rice?  More like awesomesauce!

I couldn't remember any of the first feeding guidelines so I had to consult 'the experts' beforehand.  According to a few places, a baby's first feed should be somewhere around a tablespoon or two.  These two polished off 1/4 cup (or more) each and were upset that I wouldn't give them more.

Please Mom... can I have some more?

I swear, I had to count my fingers afterwards as I was afraid that I had lost a few.  They were snapping at the spoons like little sharks.  According to the aforementioned 'experts', I was also supposed to keep food to once a day.  It was apparent by the end of day two that 2 "solid food" meals were going to be needed as they were starving (they still start out with a full breastfeeding session prior).  Can we say "growth spurt"?  Now they get BF 4 times a day, 4 hours apart and at lunch and dinner they get solid food and a "top up" bottle at bedtime.

I had been looking everywhere for first feeding instructions for kids with DS and found little that was useful.  There's a reason for that;  the instructions are no different than any other baby.  The main concerns are still head/neck development and swallowing ability.  Although Wyatt pushes a little food out with his tongue at times (because he is actually giving me his patented "raspberry of approval", not because of his glossal co-ordination), he has still taken to food pretty well.  He requires a little more "shaving" than his sister, but that is typical of a boy.  They like to wear their food.

We also have a new secret weapon this time:  Sean brought home The Baby Bullet.   I was skeptical at first, in fact the first time I saw the ads I remember thinking "how superfluous is that stupid thing?" (I used to have a vocabulary BT or "Before Twins").  I have a blender... yes it was a wedding present and therefore almost 14 years old, but it's still practically new (right?).  Except for the cereals, I made all of Quinn's baby food with it.  I would cook huge batches of things that were pureed according to his texture tolerance and frozen in ice cube trays (which I would then empty into labeled freezer bags).  It was a good system, it was healthy, it was cheaper... and it was a helluva mess.  I think I finally threw out the last of it a year ago.  This time I can make up one thing at a time, quickly and efficiently.  What really sold me on it was the milling head.  It never occurred to me to make my own cereals.  So I did.  This afternoon, I started with 1/2 a cup of brown rice and ended up 20 minutes later with enough ready made rice cereal to last us a week (if they ate at every meal).  I filled four of those wee containers (2 oz each) for the fridge and filled our freezer container (which is half the size of the one shown) and froze it for later.  It is awesome.  I still have a box of baby oatmeal cereal to start them on in a couple of days, but after that we are totally making everything ourselves. 

I could only be happier if I were full of squished sweet potatoes

I even used it to make the banana puree this afternoon.  We'll give it another chance, but thus far the verdict is split:  Wyatt is of the mind that I should immediately switch to having it "on tap" instead, while after a few bites Zoe decided that it was worthy of her best yucky face.  I'll mix it with a little rice cereal and maybe a bit of what is currently on tap and see what she thinks then.

Overall, both twins are doing well.  At their doctor visit yesterday they weighted in at 13 lbs 9.5 oz for Zoe and 13 lbs even for Wyatt.  That differential can totally be attributed to Zoe's muscle mass which continues to astounds me.  She is faster, stronger and way more agile than full-term Quinn at this age.  Wyatt is much improved as he is much less "floppy" than he used to be.  In fact, when we lift him up high into the air he is not as ragdoll like and more like superman.  He will also stand on his legs when held in a standing position, something that Quinn was totally against for a very long time.  To quote one of my girlfriends, Quinn's take was "Legs?  What are they good for?"  Wyatt seems to have his own way about things which is very much a delight to watch.

There was a chill in the air this morning;  I can almost smell winter coming.  The babies will be 7 months old tomorrow and I go back to work a week later.   Time is marching on.  With each new thing I am reminded that they will not be babies forever and this special time will be over for us soon.  As bittersweet as that is, it also represents all the new things headed our way.  New things that will be done first one way, then repeated slightly slower and differently. Done differently, done in the Down syndrome way.  Wyatt's little extra brings a whole new flavour to our family table. One that many, incuding us, have never experienced before but are enjoying immensely.

Bon appétit!

Changing of the Guard

There are some big changes for Team Logan in the next few weeks.  Some are welcome, some not.  Some have been a long time coming.  In the next little while, we will be completely overhauling our lives, starting with our roles in this family.  It may seem a bit drastic or a bit weird or awkward to some, but I think it will all work out just fine for everyone involved.

Sean and I have always had to work;  it was never an option otherwise.  After we had Quinn I was hoping to drop to part time but unfortunately the gap in our wages is too far.  That is no slam against Sean, who does really well as a "Team Lead" or "Specialist" or whatever you call a supervisor today without actually calling them a supervisor (and therefore, do not have to pay them as a supervisor).  That's a sign of the times.  Companies want the most out of people for the least amount of reward.  It makes me very sad.  However, four years ago we stuck the boy in daycare and returned to our working lives.  Now we have two more little ones and I have to return to work early.

It really stinks that something so personal as time with your babies should come down to money, but it does.  I know I am not alone here, either.  "Family first", as they say... unfortunately that means "work your ass off and pay others to raise them for you or starve".  At the very least it won't be as bad as the last time;  I was a complete wreck when I went back to work after Quinn. At the time, we chose an in-home daycare option as it was a) cheaper and b) decreased the sample size in the petri dish.  His initial caregiver (he would go through 4 in 3 years) was a very nice lady who took very good care of him.  That didn't stop my husband and I from clinging to each other in the driveway of her house after we dropped him off on the first day. He was inside, probably finger painting his little heart out and we were outside carrying on like we had abandoned him to the elements.

This time is different as Sean will be taking the rest of the parental leave.  Instead of trying to pay for three kids in daycare, he is gong to stay home and spend the time with them.  I did not know until recently that he regretted not taking any time with Quinn, but this is something that he has certainly wanted to do.  I don't even know where to start with how much happier I am with this decision. Wyatt and Zoe will hopefully never know what it feels like to be woken up before 6 am, hastily eat and then be shoved first into a starfish shaped snowsuit, then into a cold car to be dumped at someone else's doorstep for the day. I'm sure this is just my mother paranoia kicking in but it is hard enough finding quality daycare for one child, never mind twins.  Never mind twins where one of them has special needs.

It also means no more late-night writing out of cheques and schedules, only to be told that I have hopelessly fouled them up a week later.  Oh sure, I can calm a maniacal hummingbird and soothe the most savage of beasts at 4 am, but apparently simple banking is beyond my skillset.  I used to have to make out calendars for everyone as well;  two for daycare (one for the provider and one for the agency) and one for Quinn's teacher so that she would know which days were "bus" days and which days his caregiver would pick him up.  As per my contract with the agency, I had to send him a minimum of 3 days a week.  I worked continental shifts (2 on, 2 off, three on, two off, two on, three off, switch to opposite end of clock).  In the interests of saving money, I would have to pull at least one "Iron Mom" a month where I would work all night and then stay up all day with him. When Sean's work moved from a comfy 6 minutes away to a mind-boggling 45 mins, the Iron Moms became up all day and then work all night.  Not recommended... but, every parent in my line of work has had to do it at some point in their career.  Thankfully the woman who ran the agency is a sweetheart and after politely pointing out my error would accept my fumbling excuses, make up checks and new schedules graciously.

Quinn was also a year old mind you, when I went back to work the first time.  This time the babies are a little over 6 months old.  As of right now they are still not taking any solids as Wyatt's head is still just a touch too unsteady to start cereal.  I'm sure he would be fine, but I am not taking the risk of aspiration as pneumonia could very quickly set in with his DS immune system and with his AVSD... well, I'm not going to even go there.  In any event, I am still their chief food source and I will have to take my trusty Medela with me when I return.  It should be interesting trying to find a quiet spot three times a shift, but it can and will be done.

Although most of me is sad and a little bit melancholy about returning to work, I cannot deny there is a tiny part of me that is doing her happy freedom dance.  Let's face it, I'm terrible at the stay at home Mom thing.  I don't know how other Moms do it, frankly.  I could have stayed off forever with Quinn, but now I find myself a little too eager to go back sometimes.  Maybe it's the constant screaming... maybe it's the constant laundry or the dishes or the little pieces of paper, glue, Popsicle sticks and other random craft supplies that my 5 year old leaves in a trail behind him... but part of me has had enough.  Part of me is willing to go back to the world where insanity comes in all flavours, shapes and sizes and there is never enough coffee, Sani-Gel or Jack Daniels to clean it all off. It is a small, crazy part, but it exists nevertheless.  I guess I need a balance and a sense of order which has totally broken down around here since I went off after Christmas.  [Un]fortunately, it is time for my shift to be finished and my relief to take over.

We were trying to explain to Quinn that shortly after he returned to school, Mommy was going back to work.  He asked if he was going back to his last caregiver and was quite concerned when he was told no.  I carefully explained that Daddy would be leaving work and staying home, at least for a little while and doing all the things that Mommy would normally do.  He looked really confused for a moment and when I asked him why, he asked "Is Daddy going to pump?"  I must have looked confused then because he continued with "...pump milk for the babies?"  When I had stopped choking on my own saliva, I explained how that was impossible.  We all had a good laugh about it and now it has become a family joke "Daddy's gonna stay home and PUMP!  Bwahahaha!"  What Daddy IS going to do however, is sort out quite a few problems around here... and he is welcome to them.  If he totally wants to reorganize the kitchen to his liking, so be it.  Do whatever you like, as long as it is consistent.

Please don't think I'm just going to throw him into the kitchen and shout "Bye!" as the door slams behind me.  We've arranged it so that we have almost two weeks together to transition.  There are a few appointments in there so I can familiarize him with a few specialists and clue him in on how each of their offices operate (I know I shouldn't have to, but it really does help to know all the tricks).   We can also have a block of time together where we can plan out a few things. Things like meals and swimming lessons and "what to do with the mudroom" and "where the hell are we going to put all this crap" and "how the frick am I going to sleep in the day with two babies in the house"... and so on.

There is a new shift to go back to;  tours of four 12 hour shifts (2 days and 2 nights) followed by five days off (with the occasional "red shift" thrown in for sh☠ts and giggles). The kids will most certainly benefit the most from Sean being home as they will have consistency, structure and at least one ready parent at all times.  I will most certainly benefit as I will have consistency, structure and one ready responsible adult at all times.  Which is very important, especially after the last night shift where I am probably sporting a new set of bruises and my brain has assumed a consistency not unlike tapioca pudding.

Weekends off will be scarce, but we will all have days off during the week where we can go do something.  Wyatt will have his needs met and then some;  a parent at home means he will do whatever exercises and skill practice he will have to do to be the best that he can be.  It also means that at least one of us can attend any of the daytime groups that ICDSP offers. Sean benefits as he becomes the family MVP, which pays less than his current employer, but the perks and swag are awesomesauce. 

Going back this time feels weird.  I went back to work the last time and retained my Mommy crown.  Now, I feel like I'm passing it on.  It's freeing and scary all at the same time. Overall I think I'm getting a pretty good deal as I get to reclaim some of my sanity, have meals planned and cooked for me and I can concentrate on my career and on being a Mom when I am home.  I can also do all of this without worry as I know they are in excellent hands and well cared for.  It's not for forever, it's for the time being and it's going to be pretty good.  It will also free up some time where I can actually write without having at least one child crying in the background while I reach around the Medela.  It might also be nice to eat a meal where I'm not acting like a prisoner:  hunched over, shoveling in the food and ready to shank the first bitch that looks at me the wrong way. 

It may not be mainstream, it may not be hip and it may not be what some would deem appropriate for a guy, but my guy is going to be a stay-at-home-Dad.  It may not be what all the rest of the cool Daddies are doing, but it's a lot more than what many fathers do:  he is doing what is best for his family.  Which is more "man-up" than a lot of men are capable of giving.  He's our new hero and we will be toasting his new position tomorrow afternoon, as a family, with celebratory smoothies.

Go Team Logan, Go.  We may be switching up the roster a bit, but our eyes are still collectively on the prize.

Mom, Dad, Boy, Twins.

DS.

We are down wit dat.

Completely.

"...Eyes, Ears, Mouth and Nose."

I can't believe it's been over 15 weeks.  I don't know where the time went.

Well, that's not true.  I do know where the time has gone:  it's been a haze of feeding, bottling, diaper changing, dishes, laundry and doctor's appointments.  It's really the amount of time that has passed that is a bit staggering.  Another astonishing fact is that in the space of just under four months they have almost tripled their weight and gone from swimming in the preemie clothes to filling out 0-3 mos sizes nicely.  Amazing.

They've had a little help along the way tho'.  My enormous appetite and unquenchable thirst has guaranteed that they continue to get pints of Mommy's Finest at mealtime.  I'm still pumping afterwards for the "top up";  after they feed, they get a bottle of EBM with a bit of formula powder added in for extra calories.  The recipe is supposed to be 5ml of the powder in 90ml of EBM which gives them an extra 20kCal.  The top up bottles are currently 60ml, so you can see that the math does not easily line up.  Having a "mixed" bottle of extra in the fridge is just another step in the "kitchen chemistry" that takes up time and energy that can be spent somewhere else.   That's another mixer bottle to wash and sterilize and keep track of (as the mixture is only good for 24 hours, ergo, so is the bottle, no matter how young the leftovers in it are).  Instead, when I'm pouring each of the 60ml bottles, I throw in 2.5ml (or less) of the powder.  They are getting less formula than prescribed, but as you can see, they are not missing anything.

My little chubsters. Thanks to Penny for zapping out that annoying tag and making my babies even more beautiful.  Love, love, love it!

The top up is an annoying practice that my pediatrician has insisted that I keep up.  I realized the other day that (another) one of the reasons that I felt so remote from the babies is the lack of snuggle time after a feed.  Normally it's the perfect time to cuddle and yes, even doze off.  Not this Mama... I have to finish up with them and then put them down to have a Medela Moment.  It's one of those million little things that contribute to a big thing.  I'll be glad when I no longer have to force feed my little Strasbourg geese.

Wyatt is still holding on strong.  Other than chilly feet and hands (his feet are usually mottled to blueish) he remains mainly asymptomatic from his AVSD.  He's usually a bit mottled all over as well, so I just make sure that he is a little more warmly dressed than his sister.  We've added two new doctors to his roster as well;  last week we saw the ENT and Friday we met his Opthomologist.

Now, the ENT has been described to me as "gorgeous" (and by that alone, I fear I have given his identity away), and he is man-pretty... if you are into thin metrosexuals, which I am not.  He did however use an iPad the entire time, which I thought was pretty cool and very forward thinking of him.  Among the countless little differences that Trisomy 21 offers up are tiny ear canals.  Even with the smallest pediatric head on the otoscope, he couldn't visualize the ear drums to see if Wyatt has any fluid built up (DS kids commonly end up with tubes in their ears due to this).  All that flaky skin on the outside of Wyatt's head lives inside his canals too;  even with his fancy extraction machine and thrilling headgear, the ENT couldn't clear the canals enough to get down there. We have to go back in two weeks after I goop Wy's ears with mineral oil every day.  He doesn't totally hate it, which I guess is a good thing.

I had no idea what was in store for Wyatt at the ophthalmologists.  Many DS kids have eye problems including (but not totalling) strabismus, hypermetropia, myopia, astigmatism, weak accommodation, nystagmus, cataracts, glaucoma, keratoconus, blepharitis, presbyopia, watering eyes and frequent eye infections.  Since I am myopic with a bad astigmatism and have been such since childhood, I'm not too worried about him wearing glasses in this family.  However, I had no idea how they were going to test a baby.  First they dilated his eyes with Cyclopentolate (I asked as I wanted to make sure they were not giving him atropine with his heart issues).  The orthoptist first used a series of blinking lights, toys and cards to check for muscular abnormalities.  I was happy to hear that at this point there are none, but he should be frequently monitored.  The opthomologist used her own brand of thrilling head gear and saw that he did not have cataracts (my pediatrician seemed to think he did, although she did not voice this to us) and that he did not have retinoblastoma.  The latter not being prevanlent in the DS community; the babies in our family are routinely tested as our 2-D Cousin was diagnosed at a young age.  Hers probably wasn't the genetic type, but you can never be too cautious. Happy results all around, we'll be back in 6 months to follow up.  Since the pediatrician only referred ONE of my twins, I have to ask to have Zoe checked. Poor Zoe, always the bridesmaid...

My Baby blues are good to go!

I shouldn't really say that as Zoe ends up getting more face time than Wyatt.  As the puker and screamer of the duo, she spends a great deal of not-so-quality time with dear old Mom and Dad.  It still astounds me a) how much she can throw up and still gain weight and b) how LOUD she is.  Recently, she's managed to connect her hand to her mouth and we thought "oh good, now she can calm herself that way".  No, sorry.  She's managed to find a way to put her hand in her mouth and make herself EVEN LOUDER.  Apparently that was what she was missing;  amplification.  I guess to offset that (and to ensure we didn't leave her in a basket on the neighbour's doorstep) she learned how to giggle this morning.  A cute little "hee hee hee" that goes with her face-splitting grin.  She is cute, I'll give her that.

Is that a smile? Not the full one, but one nevertheless...

Developmentally, they both seem to be right in the "six weeks adjustment" area.  There are certain things that she is better at, and certain things that he is better at.  He babbles and coos more often while she is better with the eye contact and specific noises.  I'm trying to get them both to grasp at toys and I'm encouraging them to spend more "tummy time" and lift themselves up.  Wyatt seems to be the one closest to rolling over at present and is spending more and more time awake, which is fantastic.  I can't tell you how encouraging it is to have his sweet little eyes locked on me for minutes at a time as we interact with one another. 

I'm doing much better these days as well.  We're getting a little more sleep on the whole as they can push that 1am feed to 2 or 3am on average and to 5am on a good day (they generally eat around 9 or 10 before bed).  The days that they sleep through the night are few and far between, but they are there, which means there is a light at the end of the tunnel for all of us.  Well, until they start teething... (shudder).  The hormones are still horrendous, but I think I've figured out how to ride them out for the most part.  Thankfully, caffeine has been put back on the menu (along with the occasional beer) in small, yet well timed doses.  I'm not sure if it's a side effect of the hormones or what but I can enjoy a little treat without the fear of PVC's.  Even the tiniest bit of caffeine, chocolate or alcohol would get my heart tripping up, but for now it seems ok.  I'd like to think my organs got together and lifted the sanctions on the holy trinity.  "Dood!  We have to give her something!"  I kind of overdid it on the chocolate a few weeks ago... my weight started to creep up again as I was self-medicating with the lovely stuff.  I am happy to report with the advent of more sleep (and getting out to Mother Goose), we are back on track and down to our pre-pregnancy weight again.  Yay!  It's nice to hear things like "I think you've lost weight since this morning".  :)

Now the trick becomes getting as much time and effort into them before I have to go back to work.  I would love to take the full year off with them but unfortunately I have to disagree with Jessie J here... it is all about the money.  Hubby will thankfully take the second half as I return in September.  At least I get to start them on some cereal and get Quinn back to school first.  Should be interesting as I will have to take a Medela break every four hours...

"Head and shoulders,  knees and toes..."   Right now I think we have all these things under control.  (Until the next crisis, that is.)  For now tho', I'll just keep plugging on.  Even the bad days have their good points; a little smile here, a little development there.  The laundry will always be there, the dishes will always need doing and the floor will always need to be swept. Our time together is flowing past at an alarming rate... You'll forgive me then, if I choose instead to gaze into two little sets of eyes; one blue and one brown, and listen to two little sweet voices babble and coo.  Eyes, ears, mouth and nose.

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 Part of the "Define Normal" Blog Hop at:  http://www.justbringthechocolate.com/define-normal/

Checking In

[Note:  This is one of the series of letters that I posted to my friends and family on Facebook between January and May of 2011.  They are rough, raw, painful in spots and are completely representative of the level of understanding I had about Down syndrome at the time (read: precious little).  Despite ump-teen years of nursing, I had very little understanding of what Intellectual Disabilities were and how deep my own ignorance ran. 

This one in particular is our "NICU story", full of preemie babies, twins, post-C section stuff, firm diagnoses, post partum blues and overall NICU stuff. -Jxox]    

I will admit that it has been a long time since our last twin update. I will also admit that I am not sure what day it is or what my phone number is (which is scary as I've had it since '93). Wyatt and Zoe were born on February 16 and other than a few highlights that I can string together out of the haze, the days have flown by. I can't believe they are now 6 weeks old (and now officially "full term").

Preemies face many obstacles that most people don't even think of. This whole experience has been a giant learning/refresher curve for me as well. Born at 34 weeks and 4 days, the babies were unable to eat; although they do come equipped with a sucking reflex, they were too small and weak to actually draw milk from a bottle or breast and when they did, they tired easily. Both babies were a pretty good size, which allowed them to play catch up rather quickly, but it still meant tube feedings via nasogastric tube for most of their first few weeks.

My experience with the NICU, although positive (those girls are fantastic and have the sweetest gig up there!), is slowly receding into the realms of bad dreams. For the first two weeks, it was awkward but relatively easy; basically I had two babies by emergency C section... and then went back to work. At least it felt that way. I was only a patient in the hospital from the Wednesday night until Saturday morning (the only reason I got to stay Friday night was the fact that I was an RN on staff). Starting Sunday morning, I spent at least 7 hours a day, every day, in the NICU with the babies. The first week was pretty awful with the fresh C section, as the walk from ER seemed to be never ending. I actually had to use a wheelchair as I was either in too much pain or completely exhausted by the time I got anywhere. Simple things like getting in and out of the van were torture. After about 10 days or so, the pain had dampened from "excruciating" to "annoying" and was only there when going from a stand to a sit. I was still sleeping in my big leather armchair as lying flat and rolling over were impossible, but I was managing (I finally got back into my bed last week). I would spend all day with the babies, slowly assuming their care, trying to teach them to latch and holding them while a tube filled their tiny bellies with at first preemie formula, then some feeds of colostrum and then finally milk that I pumped and left for them. Every morning I would arrive between 9 and 10 with a cooler bag and make a deposit in the fridge--and when that was full, started on the freezer.  Usually I arrived during rounds and could eavesdrop a bit on report and start the day.

The babies were fed every three hours, one hour apart. Zoe would start at 1100, Wyatt then at 1200, Zoe again at 1400 and then Wyatt again at 1500. By the end of the 3 o'clock feed I was usually tired and needed to sleep... that is if I hadn't already passed out with a baby in my arms at least once during the afternoon. Rest came when I got home; when not pumping or eating I was sleeping and I needed it. I'm not a good sleeper to begin with but September was the last time I can remember getting more than 3 hours in a row. You can imagine my surprise when I was now clocking 6 or seven hours. Heaven! Then I would get up and do it all over again.

Sean was home for the first two weeks which made things pretty simple. We would take Quinn to school and then he would drop me at the hospital. The boys would come by for a visit later and then pick me up. It was difficult keeping Quinn occupied as he is a busy little guy, so we tried to keep his visits short. He would draw pictures and we decorated the babies rooms with them, much to the delight of the nurses. Still, it was very hard for him. We always reward good behaviour with a high-five around here... Quinn has added a "Go Team Logan" at the end which is just adorable. He flips back and forth between desperately wanting to help and being upset. It's all normal and it's improving, the closer we get to our "new normal" over here.

The staff, as I mentioned earlier, were fabulous. Organized, knowledgeable and very instinctive. They knew when to push and when to not with me, which I appreciated. They also made a point of appearing to keep their distance at times, even though I knew they were keeping a close eye on us.

Finding out that you have a child with special needs is hard, that I know from both sides now. I felt bad for the social worker who was obligated to stop and talk to [read: assess] me, because she knew who I was and where I worked. I've had a few staff through my area; it's hard to assess the "assess-er" sometimes. She too was very nice. We talked about a few things, resources that were to be set up... but also my level of coping. I would be a complete fraud if I didn't mention the crying spells here, so there you have it. For the first two weeks, until Zoe came home, I would have my little moments at random. Partially hormonally fueled, but also 'grieving' the loss of my 'perfect' baby. It sounds a bit weird as I have a healthy baby, but during pregnancy, you have a fantasy baby (or babies, in my case) in your mind which is rarely what you get, but nevertheless it is there.

Having a son with Down syndrome was not my fantasy by far and I had acknowledge that and accept it. Sounds very clinical now, doesn't it? It was, simply because the little psych nurse never left my shoulder,  so I could rationally think my way through the crap if I just took a breath. It was like a whirlwind of pain as I mourned the perceived loss of my fantasy football/scientist/rock star (or whatever) son and feared what the future would hold for him and what it would take to get him to whatever level he could achieve. I also cried for my own selfishness and for my own guilt, which you mothers out there will certainly comprehend. I cried silently while holding my son at the hospital and wiped my tears off his face while he slept. I sobbed uncontrollably in the shower. Once this all had started, I wouldn't have to think of anything at all and the tears would come on their own. Like in the grocery store. Or while waiting in line in the cafeteria. I also cried when I had to leave them every day, holding each one tight and kissing their tiny faces and hands. Part of me whispers "pathetic" as I write this, but it is dreadfully hard to leave your children behind. You truly don't know love until you become a parent. I know I am going to piss a few people off with that statement, but it is true. You may have pets, you may love your significant other, but you cannot comprehend the overwhelmingly pervasive feelings you get until you have children of your own. I'm sorry, but the cats and dogs just don't cut it. Each and every day, I felt as if I cut parts of myself away and left them behind. I couldn't stay and I dreaded coming back in the morning. It was hell.

I tried to contain it all when talking to family and friends, especially Quinn. There was one day when my Mom called and caught me off guard and got the brunt of it, but that was about it. I tried to stay up, to stay clinically focused as that provided some relief from the rawness, but the cracks would form and the tears would seep through. My pain--both physical and mental--coupled with hormones, mixed with worry for the twins and guilt for ignoring Quinn really made things pretty toxic. Thankfully I have wonderful friends who would take Quinn for an afternoon on the weekends, which certainly helped and gave Sean and I some time to talk. I was just starting to come out of it when my one nurse told me that Zoe could go home the next day. Naturally, I burst into tears.

With each and every feed that I was there, we had been working on teaching the kids how to eat. Both had a strong suck, yet Wyatt's mouth shape led towards an unusual latch. The NICU rule was that they had to be NG feed free for 48 hours before they could go home and I was determined to make sure that happened. After I started bringing my "home cooking" in for them, we started "test weighing" them. Each time they fed, they would be weighed before and after to see what they had gotten off the breast and then "topped up" with either a bottle or a 'tube. Zoe progressed slowly but steadily from the start. Even when the kids were separated in their own isolettes, you knew just knew Zoe was the stronger one. Our little mighty Micro-Me pushed herself and did a little more every day. It was frustrating as these were preemie "baby steps", but you could see the progression with her daily. Wyatt was another story. He would feed from the bottle once a day, would have a freak feed once in a while, then fall back asleep and have to be tubed for a day and a half. I was delighted that the OT was a girl I had worked with at Etobicoke and together we worked on Wyatt, trying this technique and that on a bottle and analyzing the results. I had to teach him to pace himself as he would forget to breathe and choke or exhaust himself completely. We tried different holds, different nipples. The lactation consultant was also helpful, popping by daily with different holds and some words of encouragement. When he wasn't feeding, I held him and had him work on a soother to try and strengthen his facial muscles. Zoe's weight, after the initial loss, steadily climbed while Wyatt's rose and fell, seemingly at random. They were assessed by the dietitian and the EBM (expressed breast milk) that they were getting had to be fortified with some formula to add extra calories. I generally equate formula to chips or some kind of ready made frozen entree, so you can understand how underwhelmed I was by this. Sure, it may have started out with good ingredients, but it's pretty much crap that puts weight on babies. In this instance, we're using it like protein powder to put weight on my preemies. To this day we are still using it and I look forward to when it is no longer needed. Not only is it expensive, but it's hard on their little tummies.

Sometime during the second week they began rooming together and shared a crib, which was nice for everyone as they were back together again. I also didn't have to sit helpless as I held one baby and heard my other crying from a room away. We were plugging along when I went in one day and our nurse told me that Zoe had been tube free for 24 hours. I wasn't going to get my hopes up as she was still quite small and I wasn't sure that they were going to let a four pound baby go home in a car seat, but it was still good news. The next day we had passed our mark and I was told she could go home if she passed her car seat test. Which, naturally, she did with flying colours. Two weeks to the day after she was born, we brought our baby girl home. Then the real work started.

My trips to "work" now became "take your kids to work day" as I lugged Zoe back and forth from home to the hospital. With Sean's return to work it made our lives more difficult as we tried and schedule visits to the NICU and still take into account things like Quinn going to school. Luckily, Sean's Dad came down for a week and looked after Quinn while I shuttled back and forth between Wyatt and home. Having one twin with me at home and one in the hospital was exhausting; I had to keep Zoe on the same schedule and was up most of the night with her and then had to pull my "shift" with Wyatt. Every feed that I was with Wyatt, he was learning and adapting and getting a little bit better. Unfortunately, with me being there for only 2-3 feeds a day, it was going to be a long drawn out process. By Tuesday of Wyatt's third week, I was getting frantic.

Although that morning he had completed a full bottle (causing the staff to have a "Go Wyatt" happy dance, so they tell me) it was going to be a long haul if I didn't step things up. Zoe and I would have to start doing 'round the clock stints with him in order to get him off his damn feeding tube. So, that Wednesday, we moved into one of the courtesy rooms. They are small, uncomfortable and almost impossible to sleep in, but it sufficed. I was there for over 32 hours and missed only one feed (the night nurse let me sleep as I guess I was pretty zombified by then). By the time I left I was exhausted and completely discouraged as there had been no sign of improvement at all. I was crying in the van as I told Sean my fears that our little guy might be in hospital for weeks, maybe even months at this rate. I went home and slept and then took Friday morning for Zoe and I. Up until that point, Zoe and I had not had a morning where we could just feed and rest and spend time other than in preparations/travel. Quinn was also going to his Grandpa's for a March Break after school that morning, so I wanted to be there to see him off and say goodbye. We had our morning, I got some sleep, I (tearfully!) saw Quinn off on his vacation adventure and I called the NICU to let them know that I would be in later. The nurse mentioned casually that Wyatt had been tube free since just after I had left. It was early, but it was a tiny bit of hope.

With our little seed of hope starting to sprout, Sean and I went to visit him in the evening for his 2100 feed. Still no tube! I talked to our nurse who told us to go ahead and bring in the car seat just in case as she felt this was the beginning of the end of the NG. She was so confident, in fact, that she had taken it out already. By the time we returned in the morning with the car seat, Wyatt had surpassed his 48 hours. I swear, it was as if someone had kicked the knees out from under me as I could barely stand with a mixture of joy and relief (and simple exhaustion).

We agreed to bring him home Monday as we needed to make sure all his follow up appointments had been take care of and links to community resources had been started. I went up with Zoe, just like every other day and hung out until Sean got of work and could bring us home. Again, RHIP as I'm sure they would have booted us out earlier if they had wanted to. It felt so good to bring them home together. It just felt... complete to tuck them into their bassinet that night, almost a month after I didn't make it to dinner.

Since then, we've been trying to find our stride. Having most of a week with just the babies helped as I could putter around their schedule as best I could. I also had to try and get them on the SAME schedule as the hour apart thing was unworkable at home. That part was easy, as was changing them to four hours just this past weekend.

Now the challenge will be to keep up with the appointments. Both have been seen by the family doctor and the pediatrician. Last week, during our routine pediatrician appointment, we were pleased to hear that she felt that the kids were doing well and gaining weight. Since Wyatt had only averaged 12 g per day since discharge, we have to continue with our formula top up for a while. Wyatt's AVSD seems to be quite balanced at the moment as well, so it is not posing any problems right now. The visit wasn't all good news however, as she found that Zoe had an inguinal hernia which had been totally missed up until that point. She reduced it in the office, but let us know that our little girl would need surgery too and probably sooner rather than later. We didn't treat it like a big deal, but it is just one more thing. We see the surgeon at McMaster on Monday (right in the middle of the hospital change over! It will be hell) and we see the cardiologist on Tuesday for Wyatt for his echo and to find out more about his surgery. I'm sure I'll have dates and whatnot by Wednesday, so I will update if there is anything.

The babies themselves are just darling and each has their own distinct personality. Zoe is colicky, loud and a laundry generator. Her eyes are the colour of hematite and are just as bright and shiny. She also ensures that no one gets any sleep around here. Wyatt is laid back, cries only in short bursts and is easy on the laundry. He is still very sleepy, but this morning he was wide awake and it was nice to sit with him as I got my Tassimo on. He gazed around with his dark blue eyes and focused on various things around the room like any other newborn. He can also hold his head up for a few seconds and has excellent muscle tone for a newborn with Trisomy 21. We still don't know what the future will hold for him, but he seems to be pretty good with most things.
 
Right now they are chillin' in their swings, bellies full. I'm going to try and get some shut eye as I am only averaging about 3-5 hours total a day. That will get better, but for now, we soldier on. When you have twins you really learn your limits: how little sleep you can get, how little you can eat or drink, how much you can do with one hand or possibly a foot... How long it takes you to notice that it's been a while since the last shower.  Which brings me to the next limit: memory. I don't have one. I don't know if I will every have one again, but for now, it's gone, baby. I have a book and a board I rely on; I would be completely messed up without either of them. The board is a cheapo whiteboard from the dollar store with "Mommy's Brain" written on it. It is stuck to the front of the fridge. On there I add any sort of random thought that I come across that need to be remembered. Right now, in random comic balloons, there are entries like "Bottles: 60ml". There are mini shopping lists: "Batteries, pop, toilet brush, mayo". There are memos like "Call ___________" and the most important one "Last Shower: ______". The book is different. It is a 3 column ledger that keeps track of when they fed, who pooped, who took how much top up, who slept. It sounds ridiculous to parents of singletons, I'm sure, but it has to be done. Any sort of trend can be monitored as I have raw data; any sort of question any of the doctors may have about the day to day stuff, I have it at my fingertips ('cause it ain't stored upstairs). Both are invaluable tools that I would recommend to any new parent. Especially if they have or are having multiples.

Once again, thanks to all for the kind comments and emails. They have meant a lot to us over the last month and have given us fuel when we were running on empty. This is not easy and is getting harder with each new thing that crops up, but we can do this. We have to.

Go Team Logan, go.