Every baby gets scraped and bumped during the development years.  Every baby falls.  We all earned those scratches and black and blue marks, hopefully none of them permanent.  With twins, Ari and I have found that a mark on one often comes from the other.  Our daughters are often pulling and poking each other to tears.  But at least they keep it fair:  they are equally the victim as well as the bully.  And so it was on Friday, early in the morning, that Julia achieved her first black eye.  After a long night of crying and sick babies, Julia had come to our bed at about 3 am screaming for attention.  Once she was in our bed, she was ready for a party, crawling all over our pillows and heads, flailing her arms in excitement, and bonking her head into the wall (still haven’t figured out what that’s about).  Throughout the night, she managed to shove her fingers up Ari’s nose, kicked Ari’s hand into her mouth, and inserted all of her fingers into my left eye.  As the sun rose, Julia stepped it up a bit in her bonkersness.  Ari sat her up in the bed, while I tried to catch one quick wink before getting up for work.  Then it happened.  Julia flailed her arms like a conductor, sending herself backwards into a fall.  Her rock solid skull careened downward and landed hard onto the only thing in its path.  My left eye.  At first it was a little bump, then a decent sized mouse under my eye, and finally a full-fledged shiner.  So, there ya go.  Accidents happen, complete with scrapes, bruises, and sometimes a black eye.  I’m so happy that I could be there for Julia’s first.

Respiratory Syncytial (sinsish'ul) Virus, or RSV, is a very common cause of respiratory infections in infants, children, and even adults. It is so prevalent that by the age of five, almost all children have been infected at least once.  It infects half of all children during their first year of life and, by age five, all children will have been infected at least once.

 For most children, RSV is usually no worse than a bad cold, but in children born prematurely or who have lung problems, the RSV infection can be severe and life threatening. Up to half of these infected infants need to be hospitalized for breathing difficulty and are given oxygen, intravenous fluids, feeding tubes, and medication. No treatment is available to eliminate the virus and antibiotics are ineffective. 

RSV is highly contagious and is usually spread from to hand to hand contact.

There is no vaccine to prevent a Respiratory Syncytial Virus infection. However, a medication is available to prevent severe RSV from developing in high-risk babies and children. Full-term babies get antibodies from their mothers during pregnancy, but babies born prematurely often do not get enough of these antibodies.  The medication is called Synagis^®  and it is available only by prescription. It works by providing high-risk children with virus-fighting antibodies specifically designed to attack the RSV virus. Each dose of Synagis gives a high-risk baby enough RSV-specific antibodies to help fight RSV infection for a whole month.  Therefore, a new injection is needed every 28 days during the RSV season (October to April) to give full protection to the baby.  

Synagis is given as a shot into the leg muscle and the dose is based on weight.  Only a small amount of medicine can be injected into each leg so often the child needs multiple injections.

Julia and Marayla have been receiving Synagis since October.  The medication costs our insurance company about $3,000/injection.  Right now we don’t have a co-pay – and that is wonderful!  Our old insurance company charged us about $34/injection, but had we stayed with this company our 2008 monthly total for Synagis (including doctor’s co-pays) would be about $300—yikes!  Thank goodness for choices. 

I was shocked when we were told that Marayla had RSV, however at every follow up visit the doctor (it was a nurse practitioner that gave her the initial diagnosis) kept calling it a cold and nothing more.  Maybe RSV is subjective.  Since it doesn’t require a test to determine (like Strep), some doctors or nurses may call a cold RSV. 

Arianne coined this term recently when she was talking about how we’ve been feeling for the past two weeks.  It refers to that state of exhaustion we felt when the girls first came home from the NICU, when we were feeding every three hours, when we had countless doctors’ appointments getting in the way of our napping schedule, when we didn’t have the energy to feed ourselves or clean the apartment.  We’ve been living in a state of déjà vu.  Only this go-around, Ari and I got to experience what the girls were going through, firsthand, because we got sick too.

I can trace the origins of our current state of existence all the way back to November.  That was when we kicked off a marathon of parties, holidays, visits, visitors, events, reunions, outings, and business trips that lasted until just after New Year’s.  These were all wonderful experiences, and we welcomed them all with open arms.  We knew that they would disrupt the girls’ schedule, and over stimulate them at times., but we are not going to stop living our lives and be ruled by "the nap."  The chaotic schedule left us in a whirlwind.  The oh so welcome nights of the girls sleeping 12 hours straight during the autumn months ceased to exist; they were waking up almost every night yelling for food, or comfort, or something yet to be determined.   The girls’ reflux seemed to intensify.  And day by day, Arianne and I felt the familiar drain of poor and/or little sleep.  This packed schedule left us looking forward to January to recuperate and return to some normalcy in the New Year.  Silly us, we failed to remember that normalcy mixes with babies like oil and water.

For numerous positive reasons, Arianne gets together with a few different play groups of multiples, giving the girls an opportunity to socialize with other babies and giving Arianne an opportunity to socialize with other adults during the day.  The one minor risk of taking part in play groups is the exposure to sick parents and kids – eventually, your kids get sick, too.  And so it was last week, that Marayla contracted a virus that attacked her sinuses and lungs.  Ari was told that it looked like RSV, despite the fact that the girls are receiving monthly injections of Synagis.  Couple this with Marayla having an ear infection complete with fever.  The first trip to the pediatrician yielded us another antibiotic (in addition to the one she’s on already) as well as a new toy:  the nebulizer.  To combat the early signs of RSV, Marayla needed to inhale the medication into her lungs to help her breathe better and rid her lungs of the congestion.  She has to have a tiny little mask over her face for 10-15 minutes and breathe in the gas, while the nebulizer hums loudly a foot away.  Over the course of a few treatments, she has grown accustomed to the procedure.  She is quite the trooper, and expert on many medical practices.

Marayla’s illness, like anyone’s affliction, worsened during the nighttime hours, so we were up at least twice each night with her, if not with both BTs. They would cry hysterically, trying to breathe out of their noses.  They would try to suck on their fingers to soothe themselves to sleep, but due to their congestion, this was near impossible for them.  Naturally, they were quite frustrated.  We would wrestle them down to give them nose drops (which they hate), and to suction their noses with the shnooker (which they REALLY hate).  We had three trips to the pediatrician in one week, through the newly fallen snow, uphill both ways.  One of these visits was supposed to be just Marayla, but, naturally, Julia started showing signs of sickness and eventually joined her sister (no fever, thankfully).  So, both girls were miserable, and not their fun-loving smiley selves.  They were challenging to hold and comfort.  They weren’t eating well, as the formula probably hurt going down their throats.  But, in the end, the sleep factor was the main hurdle.  In order for the girls to get better, they needed their rest; unfortunately, the virus kept them from getting that rest easily.

And this caused Arianne and I to lose sleep, and make our systems vulnerable to any viruses in the air.  So it happened like that:  all four of us were sick as dogs together.  Arianne and I had swollen glands, sore throats, congestion, sinus pressure, headaches, nausea.  All we wanted was to catch up on sleep to recuperate so we could get our girls back on track.  We had to sneak naps in whenever possible (although naps are packed with anxiety that the girls will wake up once we fall asleep).  We had to scrape easy meals together for us and for the girls.  So, Arianne described it to a friend in that way, saying that we were so tired, “back in the day tired.”

Note:  This entry was under construction for days.  I apologize for the lag in entries.  To update all readers – the whole family is doing much better now, and looking forward to getting on with the New Year!