Moving Day

I am moving blogs.
Yep, I've got brand new digs...
You can find us here (www.tripletmama.blogspot.com)

Poopsicle

(Or lack thereof...)

See, I mentioned yesterday that Emery's discharge was delayed due to a need to test her poop. (I am branching out as David astutely pointed out that I have mastered the use of the word "stool" by using it as both a noun AND a verb. I will eschew the term "bowel movement" for the more popular "poop". Yes... my medical school education at work. Oh, but I digress...). What I didn't bother to complain about is that she COULD HAVE come home yesterday. See, the black poop she has was not tested as the Nurse Practitioner whom the nurses called Wednesday night didn't believe it was necessary (had it been tested and come up negative as I believe it will, she still could have come home yesterday). I didn't make a big deal out of it although I was VERY ready to have her home. There was nothing left to do but wait for her to poop again (not such an simple proposition as they are receiving mostly special iron-containing formula and a small amount of breast milk. Quite the constipating brew. Just ask Parker. Oh, but I digress... again). AND SHE DID! This morning. Which means we should have been carting her home right about now.

Ummmmm. No.
See, the nurse this morning dutifully sent the poop down to the lab with the appropriate paperwork to have it checked for blood and C. Difficile toxin. But she forgot one thing... to test for the toxin the poop has to be put on ice.

It wasn't (grrrrrrr).
No poopsicle = no toxin test = no discharge.
*sigh*

In case anyone is keeping track (and I can only imagine that you are keeping copious notes...) Emery's discharge has been delayed by Emery three times. But the trained staff at the hospital are hot on her tail by delaying her discharge twice... in two days... a much more embarassing figure if you ask me :-).

So once again we wait with baited breath for our only daughter to poop.

And what pray tell, you must be asking, could be the silver lining in this Keystone Cops charade? Well, there is a possiblity that Isaac and Emery will be discharged together... probably Monday.

That is... if they have no more episodes AND someone sends a poopsicle.
What do you think are the odds? :-)

Still Flying Solo

Flying solo.
Yep, Parker is still the only one who has escaped the confines of the NICU.

Emery was to come home today (for, I do believe, the FOURTH time!) and yet, she is still hanging in the hospital (one of these days I will grab the two of them and make a break for it :) ). But for once she switched it up a bit. Her discharge was delayed this time not for a bradycardic or desat event. No, this time it was due to a black stool she had last night. Unfortunately we now have to wait for her to stool again so it can be checked for blood and infection and THEN she can come home. At least Isaac and Emery seem quite cozy...



Since I posted last, both Emery and Isaac had sleep studies. I happened to be there when Isaac was being wired up... Can you say "Mad Scientist"?


Neither study showed anything worrisome, but both will be coming home on Pulse oximetry monitors so that we know if their heart rate or oxygen saturations drop too low.

For now, we are enjoying having Parker at home... and enjoying the extra sleep which we won't be getting once the entire brood has made a break for it.

While we wait for the other two to slip the surly bonds of the NICU, here is a bit of entertainment. Parker was kind enough to humor his mother as she snapped a few pictures. The photo shoot came to an abrupt halt when he peed while naked.




And while we wait for Emery... talk amongst yourselves...

Discharge Delayed

Hard for me to believe... but Isaac and Emery are still in the hospital.
Three times now they have had bradycardic events less than 24 hours before their scheduled discharges.
The episodes aren't serious, but every time they occur, the discharge clock is reset for another 5 days.

As a result, they are both having sleep studies done this weekend and we anticipate they will be coming home this next week on monitors so that we will know if they brady or desat. I'm not actually complaining... we would much rather have them stay in the hospital until they are good and ready to be safely at home. As Matt is fond of saying, "We will have them for 18 years, what's another few days?". In actuality they are still ahead of their projected 40 week discharge date. Otherwise they are both doing great. Isaac is by far the best eater of the bunch and also appears to have the most mellow nature (although Emery may not agree as when I walked into the NICU this morning, he was pummeling her in the head... payback perhaps for the times she has pulled his head around after getting ahold of his oxygen tubing?????).

They are all growing like weeds and currently range around 5 lbs 5 oz. In fact, in a sort of major milestone, they have all officially grown out of their preemie onesies!

Parker seems to have settled into his crib... and his "only baby home" status. He has a particular affinity for his father, being walked, having the word "swish" whispered repeatedly in his ear, being worn in the wrap sling, the cool vibrating crib mattress Matt found, and waking well over an hour before his next feeding.

I drove Mom to the airport this morning :(.
Her help has been invaluable for so many reasons and we are grateful to have had her here for so long. As Dad is serving as mission president, it is not easy for her to be away for so long from their responsibilities. Thanks, Dad for lending us Mom for two weeks! :-)

Sharon arrives tomorrow to help us for a week. We are so lucky! Between Mom and Sharon I hope to have a clue as to what I am doing with these babies by the end of the month.

39 weeks today!

Parker In Da House

Time has flown and I only today realized it has been a week since I posted.

I picked up Parker from the hospital last Monday as planned (complicated only by my neighbor informing me an hour before that I had water gushing down my front lawn--- a broken irrigation valve--- timing is everything, isn't it?). Here Parker is during his "car seat challenge" where they ensured that his oxygen levels would not drop while sitting.



Only in a picture like this do I realize how small he is! For those car seat safety savvy amongst you, I do not use the padded insert while driving him around...

We got a quick pic of the three together before Parker set off on his own, leaving his brother and sister to keep each other company.


Between taking care of Parker at home, exercising every day (Yay endorphins!), continuing to pump and of course running back and forth to the hospital to see Isaac and Emery twice a day as well as attempting to single handedly prop up the economy by shopping for large quantities of baby supples... it has been a very busy week. Because we didn't have enough going on... Matt started a trial the morning after Parker came home which meant that he worked extremely long hours the remainder of the week. How did we survive you may ask? My mother! She is out here for a few weeks and has not only helped me adjust to caring for a newborn, but she watches Parker so I can visit the other two babies. Matt's trial ended on Friday (he won!)and it was great to have him around all weekend. Matt and Parker bonded on Saturday as you can see...



Parker is doing very well, and his parents are learning :-). We love having him home and enjoy staring at him for hours a day.

He had two medical appointments on Friday-- one of which was a four hour round trip ordeal which I get to repeat every week for another 6 weeks... eventually with all three (Oh Goody!). At least now I know what to expect.

Isaac and Emery are doing well in the hospital. Both have had a few more bradycardic events so are not yet cleared to come home. Barring any new events, Emery should be home in another few days. Isaac shouldn't be more than a week behind her. He doesn't require oxygen while sleeping, but still needs it during feeds and when he (rarely) gets upset.

Take Home Message? Things are going well and we are SO grateful to be on this side of the journey :-).

D-day

"D" as in "discharge.
Parker is coming home in a few hours!
Emery was to join him, but a few bradycardic episodes in the last 24 hours means she will be in for another 4-5 days and will most likely be receiving another blood transfusion. The nurses think Emery is just a nurturing sister and doesn't want to leave Isaac alone at the hospital. You know, the whole "Leave no man behind..." thing :-)

Isaac has made remarkable (and I do mean remarkable!) progress over the last week and is now on the lowest possible oxygen setting known to man (0.1 liter). He is eating well and should be ready to come home in the next week (with or without oxygen). The nurses at the last NICU promised us he would most likely catch up to his brother and sister quickly... but I wasn't expecting this. What a champ!

Now anyone who knows me well can only imagine my last week. I have been shopping like a mad woman... not only for baby stuff (although that is clearly the most FUN shopping), but also food, household stuffs, etc. I have no delusions that I will be getting anything done besides taking care of Parker and visiting with Emery and Isaac. We have been putting together cribs, decorating the nursery (thanks Jen!) and doing more loads of laundry a day than I would like to admit. Oh, and lets just say we have been filling the garbage cans...

Graduation Day

Yep, kind of like graduation from kindergarten... only more expensive.
Yesterday the babies "graduated" from the Level III NICU and were transferred to a Level II much closer to home.

Road Trip!!!!

Here is a picture of their wheels... the "baby limo"...



There is talk of Parker and Emery going home Monday... which means I am have much shopping to do :-).

Bye Bye Ampho

Dear Amphotericin B,

I appreciate the fact that you fought and bested the nasty fungus which rudely took up residence in my cute little body. But we have had quite the lengthy relationship (20 days now) and while I am eternally grateful for your assistance, I am no longer in need of your services. Lately your presence has become more and more inconvenient. To accomodate you, I have been required to maintain a PICC line (central IV line) which placed me at continued risk of other serious infections. When the PICC line failed four days ago, I then had to keep a peripheral IV line in place... a daunting task considering my new found penchant for moving around. As a result I have undergone multiple needle sticks a day. This requirement has become burdensome to say the least.

So in summary-- I appreciate your services... but good riddance!

Sincerely,
Isaac

Two Peas In A Crib

Emery and Parker have been sprung from their isolettes!
They are now "co-bedding" in an open crib.
The nurse this morning said she already had to break up a few fights.
And the fun begins :-)
A purely tangential bonus is that I can now start bringing my own blankets in for them. When you are a NICU mom, it is the little things :-).





We wish that Isaac could join them now, but it appears that will be happening soon enough. After about a week of stability but not much improvement, he seems to have turned a corner. His oxygen and flow requirements have decreased significantly over the last two days and he looks great! We are very proud of our little fighter.

Ringing In My Ears

One thing that can be said of NICUs is that it is often a noisy place.

There are numerous machines with numerous alarms... per child.

After 6 weeks, Matt and I know exactly what each alarm means. Is the feeding tube pump finished or is the child's heart rate or saturation dangerously low? We can tell immediately. It has gotten so bad that we hear alarms even when we aren't in the hospital (or is that just my psychosis kicking in? :) )

But over the last few days it has grown strangely quiet in our corner of the NICU.

It used to be that if one of the saturation or heart rate alarms sounded... it was one of our children. Now? Chances are that it is another child over the half-wall that separates our corner from the rest of the back room. What a relief! (I am aware that may sound a bit callous since it means someone else's child is alarming)

Don't get me wrong... when the serious alarms sound, I automatically scan the machines attached to our three rugrats just to be sure. It has become habit. But more often than not they are behaving themselves.

This change of events was strangely disconcerting for the first 24 hours. I wondered at times if the monitors were plugged in correctly :-). Now I revel in the fact that our kids are outgrowing the A's and B's of prematurity.

Speaking of the kids... they are all growing well. Isaac is stable again and as long as he remains infection-free (fingers crossed!) he should just continue to improve. I have been able to kangaroo with him the last few days which makes for a very happy mother. Parker and Emery are on autopilot. They are sporting their preemie clothes and at least Parker technically could be moved to a crib anyday because he is controlling his temperature without a problem. They are all now over 4 lbs! We anticipate they will be moved to the Level 2 NICU much closer to our home sometime soon (pending available beds). We have had a couple good days in a row now... dare I say "momentum"?

Matt and I with Emery (please excuse my bad "bang day")



Another picture of Isaac will be forthcoming... I am hoping to get a good one of him with his eyes open today.

Mr. Personality

Because of a little setback with Isaac on Monday (nothing too serious, after a stint on CPAP again he is back on nasal cannula...) I didn't manage to get pictures posted as planned.

So here are a few of Parker...

His hair looks reddish in this picture but it is actually brown.



Parker is "Mr. Personality" as he makes us all laugh with his constant facial expressions. You know exactly how happy or sad Parker is at any minute. He is controlling his temperature so well that they are no longer heating his isolette, but he won't be able to move to a crib until he has grown a bit more. He hit four pounds today... a reflection of the fact that he is a voracious eater.

I will try to get more pictures posted in the next day or two.

Momentum

Isaac has tolerated being out of the Oxy Hood for two days now.

He is still requiring significant amounts of oxygen (usually 35-40%), but the doctor yesterday said he is doing "amazingly well". He has very little reserve so they have to increase his oxygen whenever he gets restless or is stimulated at all. This afternoon his oxygen was down to 32%. Yay! Go Isaac!

What he needs is some good momentum. In the past, each time he has started to improve, Isaac got hit with another complication. At least he is headed in the right direction again and now all we can do is be patient and wait. Because he he is out of the Oxy Hood we are able to hold him, which we did twice yesterday and then I kangarooed with him today. After several days of only being able to look at him or touch him, the ability to hold him again is such a treat.

Parker and Emery are now taking significant portions of their feedings using a bottle. They are also doing well at controlling their temperature. So much so that as of today they are being dressed in clothes (hospital snap shirts that are much too big) and swaddled in their isolettes. Why is this important? It means that I finally get to dress them in their preemie clothes! I am headed over to the hospital tonight bearing clothes for them. They will most likely be out of the isolettes in the next few days and Isaac should be right behind them.

So it just hit me yesterday that they will be coming home soon (relatively-- in another three weeks or so). As a result I have shifted into overdrive. There are so many things I would like to have ready and projects I would like to complete before they come home (I am under no delusion that I will actually accomplish ANYTHING besides diapering, feeding and doctors' appointments for the first few months). So now I am taking all that nervous energy from the last few weeks and directing it towards my lists. And they are long! But I am so enjoying the anticipation of having them come home. One of my projects is to organize my pictures... the hundreds of pictures we have taken so far and not reviewed. I promise to have a few to post tomorrow.

Leaving Da Hood

I suppose it won't surprise anyone when I say the last week has been intensely stressful.

I became admittedly obsessive about watching Isaac's monitors.  Each time his saturation numbers dropped slightly, my heart rate would rise.  On Thursday, Matt insisted that I spend less time at the hospital.  I knew he was right.

So I went shopping.

When Jennifer asked what I went shopping for, my answer was, "My mental health".

And I found some.

Three hours of running errands did me wonders.

Of course, it helped that Isaac was improving.

Over the last few days, the doctors have been weaning down Isaac's oxygen.  He has done very well.   The doctors have been surprised with how quickly the PIE and pneumo has resolved and currently there is no evidence of PIE on his CXR.  Yesterday I was able to hold him for the first time in over a week.  We wrapped him up and I held oxygen near his face while they changed his bed .

When I spoke to the night nurse early this morning, she informed me that orders had been written to take Isaac out of the hood and place him on nasal cannula.  We are grateful he is doing well enough to be tried on the cannula, but we are also nervous about taking him out of the Oxy Hood since he has been doing so well the last few days.  He remains tachypneic (breathes too fast) much of the time, and has a lower saturation rate when he isn't on his stomach.  But his blood gases have been good and he is now on a low level of oxygen (35% compared to the previous 100%).

We are very grateful for all of the positive thoughts and prayers that have been sent our way.  I know that it has made a difference for Isaac and we can only hope that the current positive trend continues.

Parker and Emery both had their first real baths on Thursday night.  Emery was not a fan.  Parker looked stunned throughout the entire event.  Luckily Tami was there to help us document the process so we have great video and pictures.  They are both getting better at controlling their temperature and once they come out of the isolettes I will be able to start dressing them in the preemie clothes we received at the shower.

And as I mentioned to my parents, isn't that what having babies is all about? :-)

Day Of Rest

Isaac:

He has tolerated a lower percentage of oxygen (70%-- which really translates to an inhaled percentage of about 50) in da 'hood for over 24 hours now.  Turns out, not only did he have a pneumothorax (which is almost completely resolved), but he also had a recurrence of PIE (Pulmonary Intersititial Emphysema-- a serious condition which he had at 3 days old but which at that time resolved after 3 days on the jet ventilator).  The CXRs over the last few days again show resolution of the PIE, although with some chronic changes which may lead to him requiring oxygen for up to 6 months.  

They decided to give him another day of rest on the current oxygen level before attempting to wean down the level tomorrow.  See, my theory is that Isaac is a curious lad.  He apparently aspired to try out every oxygen delivery system available in the NICU: jet ventilator, regular ventilator, CPAP, SiPAP, Oxy Hood, high-flow nasal cannula.  Now the only one he has yet to trial is the low-flow nasal cannula (which with any luck he will be sampling in a few days).  See, he's just got his dad's curiosity, that's all :-).

On the infection front, it appears the medication is taking care of those nasty yeast (David, feel free to cease your protest... which, by the way, Isaac wholeheartedly endorsed).  Isaac will need the "Amphoterrible" for another two weeks, but at least we know the infection is responding.  Also, he doesn't have pneumonia (Yay! One infection that he HASN'T actually picked up!).  He is growing like a champ.  He weighs half a pound more than the other two rugrats... he is now over 4 lbs!

Emery and Parker:

What more can I say?  They are doing fabulous.  Emery has been off all oxygen for a few days, so the two of them are flying on "room air".  They are learning to "feed".  When you are still less than 35 weeks, the whole suck-swallow-and-breathe-at-the-same-time thing can be a bit confusing (a fact which both of them clearly show on their faces).  But they are learning quickly. 

We are hoping for more good news tomorrow...

So About That Roller Coaster...

Ummmmm.

Remember what I said yesterday about this journey being like The Desperado?

Well, we took a bit of a loop today.

This morning when I arrived at the NICU, Isaac wasn't on the vent again.

He also wasn't on SIPAP like yesterday.

No, he was now in an Oxy Hood.

He now has a pneumothorax (because really PIE, bacterial sepsis and fungal sepsis clearly isn't enough for a 5 week old premature newborn to go through... *rolls eyes*).

Let me explain. 

For those not in the medical field, a pneumothorax essentially means that air has "leaked" out of the lung into the space around the lung.  

Not good.

Luckily it is very, very small. 

But see, the pressure used to help him breathe on the SIPAP machine had, even over just 24 hours, made the pneumo grow slightly.  To prevent the more dangerous complications of having a significant pneumo, he needed not only to be taken off of SIPAP, but needs to be treated with 100% O2.  Leaving him on any device which used pressure to help him breathe would be likely to cause the pneumo to expand to a dangerous level.

Now there are advantages to having him in the Oxy Hood.

In particular, we can see his face again without multiple tubes (he only has a feeding tube now).

The disadvantage?

The high levels of oxygen leave him at more risk of retinopathy.

But his lungs must take priority over his eyes.

So Oxy Hood it is.

He seems quite comfortable in the hood... or "da hood" as I like to think of it :-).

Best case scenario is that the pneumo resolves overnight and they are able to wean him to nasal cannula with oxygen.

Fingers are crossed.

At the risk of sounding like a broken record...

Emery and Parker are doing great.  They have graduated to being "Feeders and Growers"... essentially they are healthy, they just need to learn to feed better and get bigger.

I promise more pictures will be forthcoming...

Look Ma, No Tube!

There is, south of Las Vegas, a particularly thrilling roller coaster.

It is categorized as a "hypercoaster" characterized by the lack of loops or inversions, but known for steep  drops and high speeds.  I am not a fan of heights, but I would go on the Desperado over and over as a challenge... to scare myself to death and prove to myself that I could manage the fear.

Now I understand why Dr. R warned us that our NICU course would be a roller coaster.

As of today, I feel like we are on the Desperado... only in slow motion.

Sunday morning Matt and I went over to the hospital for what we thought would be a quick visit for a few hours prior to heading back to our side of town for church.  But when we arrived, Isaac was not doing well.  His respiratory status had worsened, he had a significant increase in secretions requiring frequent suctioning which is VERY uncomfortable for him,  and his CXR (chest x-ray) was "cruddy" per Dr. R causing concern that he had a bacterial pneumonia on top of the Candidiasis sepsis.  Needless to say, we never made it to church.  In fact I was on the verge of tears all day.

***As an aside, I do anything possible NOT to cry in the NICU.

I kept telling myself, "There is no crying in NICU!!!!"

Think Tom H.anks in A League of Their Own ("Crying?  There's no crying in baseball!")***

Just before we left on Sunday, they started a new respiratory treatment which helped significantly and they were able to suction a very large amount of secretions out of his lungs.  He was resting more comfortably and oxygenating better when we left to go home.

It was with trepidation that I entered the NICU this morning (for I never really know what I will be faced with)... to find out that our little buddha had extubated (removed the ventilator tube) himself this morning.  And go figure... he was tolerating being on SiPAP (a step down from the vent-- a machine which supports his breathing but doesn't require a tube down his throat).  We are waiting on some culture results as he still may have a bacterial pneumonia.  We should also know tomorrow whether or not the medication is eradicating the yeast or if he has a resistant strain.  Despite the continued questions regarding his infections, he was still doing ok off of the ventilator when we left the hospital tonight.  Not sure what tomorrow will bring, but so far so good.

Emery and Parker continue to progress.  They are very entertaining!  Parker especially is very expressive and alert.  I hope to post new pictures of them in the next few days. 

One Month

And oh, what a month it has been!

The triplets are one month old today

Isaac Update:

As of this morning, his lab values either stabilized or improved.  After three days of waiting, worrying and hoping, it is the first concrete sign that he is turning the corner.  In addition, he started trying to suck on the ventilator tubing and is in general more active and alert today.  His respiratory status has yet to improve but I can be patient :-).  

Isaac reminds us of a little buddha.  Partly due to his appearance... his wide set eyes and oval face.  But mostly because he has been since birth mellow, calm and deliberate (remind you of anyone?  Ummmm...... maybe his father???).  We see these qualities in his eyes, even now.    Of course, the comparison of Isaac to a buddha is particularly interesting considering that one of the main tenants of the Buddhist religion is that suffering is an inherent part of existence...

Parker and Emery are still eating like champs (now a few feedings each day from the bottle or breast) and are steadily gaining weight.  They are now both approximately 3.5 lbs (Isaac is nearing 4 lbs).  Parker has been able to stay off all oxygen but Emery is back on a small amount.  Now that they are nearing 34 weeks, we have been able to handle them more, something we are truly enjoying. 

We are back to having our own little area of the NICU to ourselves... the "Triplet Suite".  Very nice for privacy (such as it is in a NICU), but it also affords us a chance to spread out and get comfortable when we are in what has now become our second home.

A Fungus Among Us...

... But we are hoping that we now have the upper hand.

Isaac is slightly more active today and the full-body rash he developed two days ago is now gone.

He remains on the vent and Dr. R says we can't expect any significant improvement for at least 24 more hours.  The waiting is truly the hardest part.

More good news on the Isaac front...

There is no evidence of local involvement (i.e., "fungal balls") in his heart, eyes or kidneys.  This makes his treatment less complicated.  It is hard to see him on the vent, clearly still lethargic and slow to respond.  But we are relieved to not only know what the problem is, but also to have the treatment already underway.  We are grateful for the great nurses and doctors who caught the infection early and sent blood cultures right away.

Good news on all three...

They all passed their first "Retinopathy of Prematurity" eye exams today.  Yay!  They will have them weekly for approximately 10 weeks.  Besides brain bleeds, retinopathy is the other dreaded complication of significant prematurity because it can lead to blindness.  We are pretty much out of the woods when it comes to brain bleeds.  So far so good when it comes to retinopathy.

The Culprit

Now I love yeast.

Or at least I love the baked goods that require yeast to make them rise.

Where I don't like yeast?

In our son's blood.

I mentioned yesterday that it appeared Isaac had another infection (on top of the other one he is still on Vancomycin for).  He does.  Only it is a generalized yeast infection (in preemies this young EVERY infection becomes generalized).  Not what we were expecting, but not entirely surprising considering he has been on hefty antibiotics for the last 9 days.  He has remained stable on the vent but is clearly a very sick boy.  They have to check his heart (done today and it looks fine), his eyes and his kidneys to look for evidence of localized involvement.  They started him on the medication... which in medicine is nicknamed "Amphoterrible" because of the nasty side effects.  We should see some improvement in about 48 hours.

Just so glad that he won't remember any of this...

On a brighter note....

Parker is now off all oxygen, which is a very good thing since he has become particularly proficient as of late at pulling the cannula out of his nose so that he is oxygenating his... cheek.    Emery is nipping at his heels and was also taken off oxygen today but had an episode of bradycardia and severe desaturation so she is sporting the cannula again.  The other big news is that I was able to feed both of them from a bottle today.  Impressive considering they are not yet supposed to be able to coordinate the suck-swallow-breathe thing yet.  Apparently all that practice they have been getting on the pacifier has served them well:-).

Caller ID

When you have babies in the NICU, there is one number that you never want to see on your caller ID--- the NICU.  Believe me, they are never calling to tell you the babies are doing fabulous.  A call from the NICU always means something has gone downhill.

Last night it was clear that Isaac was having more respiratory problems.  He started having long and frequent apneic episodes.    The nurse suctioned him out well and by the time we left he seemed to be doing better.  I called about midnight and wasn't surprised to hear he had been placed back on CPAP.  We had been expecting this may happen for a few days as he had started having some chest retractions and his oxygenation was borderline.

When the NICU called this morning, my heart started racing.  It was about Isaac.  This morning his apnea and oxygenation worsened significantly and he was intubated--- meaning he is now back on a ventilator.  Dr. R was on and explained what had happened and the tests he planned on running.  He started another antibiotic-- which, it turns out was a good thing.  It appears from the lab work that Isaac has another infection.   

Isaac is doing better on the vent and is resting comfortably.  We can only hope that the infection will improve in the next 48 hours.  Luckily, Isaac is a little fighter and for now he seems stable.

As for me, I will just be glad when the NICU has no cause to show up on my caller ID.

Out Of Snappy Title Ideas

Things are going well.

They are 33w1d today.

Isaac is doing great.  He has gained quite a bit of weight and to our skewed eyes looks downright chunky :-).   He managed to wiggle out of his "nest" the other night and I found his feet hanging off the bottom of his bed.

Parker has particularly expressive facial expressions and LOVES his pacifier.

Emery is eating like a champ and if this continues,  she will be giving her teenage brothers a run for their money.  Like her brother Isaac, she manages to squirm her way out of her bed on a regular basis.

They are all still having "As and Bs" but they seem to be less frequent and a bit less severe than in the past.   We still have a few weeks before they grow out of these episodes all together.   

Yesterday I held all three (kangarooed with Isaac and Emery and held a swaddled Parker)... in my view...  the definition of a "good day".  

34 weeks here we come!

Mostly Quiet On The NICU Front

3 weeks 1 day old

So time for another update.
Things are going well.
Isaac is much improved and Emery and Parker are holding their own.
All three are growing well.
Matt and I will be very, very glad when they grow out of having A's and B's (another three weeks). Isaac was already asleep when we arrived tonight, but I got a few pictures of Matt with Parker and Emery (added at the bottom).

Emery


What I can't explain is how a little girl (3 lbs 3 oz) has a double chin...

Parker



Isaac




Parker and Matt (or at least Matt's finger...)



Parker and Matt



Emery and Catherine's Hand



Matt in action with Emery

Upswing

I am happy to report that Isaac is doing much better.

In fact yesterday he was taken back off CPAP and as of late last night was tolerating the change well. He has a generalized infection in his blood which appears to have responded to the antibiotics they started as soon as he became unstable on Thursday (the final culture results are expected early this morning). Some follow up tests are scheduled, but so far things are looking good.

Emery and Parker are doing well with the more mundane and expected ups and downs.

Mundane.
We like mundane.

A's and B's for C

It is excruciating to watch your child's chest fall silent.

I spent way too much time yesterday staring at Isaac's ribcage, attempting to get him to breathe by the sheer force of my will. He seemed to have improved about 3 days ago and then started having severe apneic (where he stops breathing) and bradycardic (low heart rate) episodes the day before yesterday. These episodes (known in NICU terms as A's and B's) are expected in such premature infants and all three have had at least some mild ones. But there were times that Isaac actually turned a dusky color before they were able to get his oxygen level back up. We are hoping that the treatments they instituted yesterday will make for a better day today.

I suppose these last few days fall into the "Not So Good Day" category.

On the other hand, Emery and Parker still seem to be engaged in an all out competition to see who can progress faster. They have both started tolerating milk through the feeding tube (a VERY small "OG" tube that goes from their mouth to their stomach) so well that their TPN (Total Parenteral Nutrition-- nutrition they had been receiving through their veins) has been discontinued and their IV fluids will probably also be stopped in the next day or two. When that happens, their central IV line can be removed which is a potential source of infection.

They would have been 32 weeks today.

Good Days And Bad Days

Some days are great when all babies are doing well.
Some days are very stressful when one or more takes at least one step back in their progress. It is difficult to leave the hospital on those nights.
Dr. R (Neonatologist) told us yesterday to fully enjoy the good days. And on the bad days... look for the good days.

Emery and Isaac have both been put back on the CPAP machine (for respiratory support) in the last few days.
Luckily, they are requiring very little oxygen.
Parker is hanging in there just on nasal cannula.
They have all gained significant weight, but both Parker and Emery have some swelling in their feet, hands and face, so some of their gain is water weight.
They are all receiving the nutrition they need through TPN (Total Parental Nutrition) which is infused into their veins, but Parker and Emery have also been tolerating increasing "trickle feeds" of milk.

Isaac was seen by a Pediatric Gastroenterologist yesterday because they were concerned about bowel obstruction... but considering the two very dirty diapers Matt changed last night... looks like that isn't an issue anymore :-).

I was able to hold Isaac and Emery each for an hour yesterday which, of course, made their mother very, very happy :-).

So overall things are going well. Every day that they get older, gain weight and are free of infection is a step in the right direction and brings us closer to the time when they will be more stable. My mom is here until tomorrow and last night she was able to hold a few of the babies while they were being weighed. Matt and Mom also took a series of pictures of Isaac next to a dollar bill, quarter, etc in order to better represent their size. I will post a few more pictures in the next day or two.

One more day down...

A Triplet By Any Other Name

So we did it.
We named the triplets.


Baby Girl A = Emery Grace



She is easily riled up and definitely feisty. One of the nurses calls her "Princess" since she has a big attitude for someone just over 2 lbs. Although she is the smallest, Emery leads the pack in terms of her progress since delivery. She is gaining weight, is off all oxygen, has started small feedings through a tube, loves her pacifier and has started to open her eyes frequently on days that she isn't under the bilirubin lights (in which case she is sporting her "cool" sunglasses). I have been able to "kangaroo" (hold her against my upper chest while she is tucked inside my shirt or a robe) with her twice.

Baby Boy B = Parker Robert



Now this boy has a temper. And it is serving him well. At one point it took 3 full-grown adults to hook him back up to a CPAP when he had an episode of bronchospasms and it was believed he would require some respiratory support overnight. He arched up so high that only his hands and lower legs were touching his bed. By the way, Parker won. The doctor decided that if he was doing well enough to throw such a fit that his respiratory status must be more stable than initially thought :-). Parker is also gaining weight, tolerating small feedings and is off all oxygen but has a nasal cannula that gives him a minute amount of humidified air. I have also been able to kangaroo with him. In this picture he had been given a new hairstyle by one of the nurses. Very Chic!


Baby Boy C = Isaac Matthew



Isaac has had the most medical problems since delivery. But he is a fighter and has made very significant progress. At this point he is only getting a small amount of oxygen through nasal cannula although he has been off and on CPAP for the last few days. He truly dislikes being forced to lay on his back. Only in the last few days has he figured out what to do with a pacifier... and it appears we may have created a monster :-). At one point the other night, either Matt, Jennifer (my sister) or I had to hold his paci for nearly 2 hours to keep him calm. He is receiving IV caffeine (which helps with his respiratory and cardiac status) and one nurse calls herself "Nurse S.tarbucks" as she hooks him up at night.


I am doing a little better every day. Despite a daily discussion with myself that I will take it easy and get lots of rest... I find myself overdoing it on a constant basis. But it feels so fabulous to be home and able to move... albeit slowly... often while teetering like a drunk :-). Jennifer arrived just as I was discharged from the hospital and has been a great help. She drives me around and does her best to get me to rest. We have been having a lot of fun and she has done much to get the baby clothes and supplies organized and washed.

So far so good.

Long Time, No Post

All right.
So I have been horribly neglectful in posting.
And in returning emails, voice mails and text messages.
Would it matter if I said I had been terribly sick and thus much more wrapped up in attempting to survive this postpartum period than in blogging about my woes?

So today is Tuesday.
Friday evening I was put back on the Mag.
Yes, that would be the Medication From Hell.
The one that I was talking smack about in my last post.
But see my blood pressure became uncontrolled (194/108) and I was hyperreflexic and "twitchy", putting me at risk for seizure.
So I did another stint on Mag.
Seeing as no bamboo was handy, I did so without sawing off my arms :-).

I remained quite ill with blood pressures that were anything but well-controlled despite high doses of multiple medications.
That is until late last night.
Dr. Peri tried a different combination.
And... well... my body seems to agree.

So much so that I am leaving Room 304 (*sigh of nostalgia*) for good tonight.
Yep, I am being discharged.
Well ain't I the bomb?

I have a serious stint of recuperation ahead of me as not only the pregnancy, but the long episode of bed rest and the complicated post-severe-preeclampsia-post-partum course has left me significantly drained.

But enough about me...
Let's talk about the babies.

No, we have not officially named them.
Yes, we get asked that all the time.
We have names.
But have been wanting to take our time so as not to regret the decision later.

So for today at least, they remain Alpha, Beta and Charlie

In short, they are all doing well.
Charlie has had the most complicated course, developing a serious pulmonary complication which required a fancy-dancy-jet ventilator.
But a mini-miracle later... and he is not only off the ventilator, but the condition has completely resolved on x-ray.
What a super star.

They are all currently on room air.
Requiring absolutely no supplemental oxygen.
So far so good.

Really we couldn't ask for anything better for their gestational age.
So now we wait.
Wait for them to grow.
Wait for their GI tracts to mature so they can tolerate more feedings.
Wait for them to stop the disconcerting periodic apneic and bradycardic episodes.

Now that I am on the mend, I will update with some good pictures in the next few days.

The Triplets Have Landed!

I will write the "birth story".
But I don't have the energy to finish it today, and considering there is a line forming to decapitate me for lack of updates, here is the short version of the story...
My blood pressure worsened (from an already precariously bad state).
And it was decided that the risk of stroke and seizure for me outweighed the risk to the babies even at their very premature state of 29.5 weeks.

So the babies were born soon after 9 pm on August 12th.
Baby A (girl): 2 lb 6 oz, 14 inches long (per NICU nurses, remains in constant movement. Really? I could have told you that...)
Baby B (boy): 2 lb 7oz, 14 inches long (per NICU nurses, VERY feisty. Again... this is not news, people...)
Baby C (boy): 2 lb 7oz, 14 inches long (per NICU nurses... very sneaky. He managed to extubate himself....)

Those with observational skills of... well... a slug will notice that I am nothing if not consistent in my gestating.
Those aren't typos.... the babies weights were nearly identical and their lengths were. Identical... keep up with me here :-).

Dr. Peri then proceeded to squander all good will I had for him by putting me on an evil drug called Magnesium.
It is used in severe preeclampsia to prevent seizures.
Sounds all right.
But that's 'cuz you haven't had it coursing through your veins for 24 hours.
It is evil.
With a capital E.
I won't go into the details, they would just get me all upset.
Just trust me when I say that I would have chosen to commit suicide by sawing through my arms with blunt bamboo rather than stay on the medication for another 24 hours.

Then add on multiple liters per minute of dry oxygen to some seriously congested sinuses and what do you get?
A face and head that feels like cement PLUS a woman sawing through her arms with bamboo.
I think you are getting the picture here.

I was able to see the babies once the Medication From Hell was turned off late last night which was fabulous.
Matt has posted some of the pictures he has taken.
You will find them here.

I feel much better today (nearing human status, actually) and expect to be discharged in another few days when they can improve my blood pressure control.
In the mean time we are enjoying having the NICU right down the hall.

So there you have it.
All babies are currently off the ventilators (although C may be headed back to Vent-ville soon) and are doing well for their age.

More updates will be forthcoming.

Here We Go!

So things changed quickly.
As you may see on Twitter- we are heading in for a c-section tonight.

Happy Birthday Babies!

One Big Winded Swollen Pest

(29w2d, Hospital Day 17)




I feel like a cockroach.
You know, the kind you just can't kill.
Don't get me wrong, in this case that isn't a bad thing.
Both my liver and kidney functions improved and/or stabilized.
Again.

Which means I escaped delivery one more time.

Dr. Peri walked into my room shaking his head.
"I just cannot believe you are still here!"
Obviously it won't last forever.
Everything has started to take a toll on my body as I mentioned yesterday.
I have been living on borrowed time since they started the labetalol exactly one week ago.
And we are grateful for every day.

Dr. Peri says the babies look great on monitoring.
He did a growth ultrasound today and estimated the babies range from 1030 to 1170 gm (2.2 to 2.5lb). Smaller than we would like, but consistent with expectations in light of the preeclampsia and the treatment for my blood pressure which can also worsen growth restriction. But they are growing. And at this point gestational age is more important than size.

I may be a cockroach flailing away on my back...
But I'm not dead yet!

Three Lights

(29w1d, Hospital Day 16)

Per Dr. M, I am a superstar (I can't help but think jazz-hands).
He clearly seems surprised that I made it through his weekend call without cause for delivery.
"You've got a very strong wife", he told Matt.
But really I am just a passenger on this roller coaster.

This morning both my liver and kidney tests bumped (again).
Nothing catastrophic.
But clearly trending in the wrong direction.
Clearly.

My swelling has gotten a whole lot worse... but I can't complain since it has been quite mild to this point.
The really pitiful part?
I get out of breath turning over in the bed.
Not exactly half-marathon material :-).

My labs will be repeated in the morning and Dr. Peri will be in to see me at some point tomorrow.

I found this video on a woman's infertility blog about a year ago.
Always feel better after listening to this song, so I have been doing so every morning.
Some days aren't easy for me and in general I am quite uncomfortable at this point.
It is becoming clear to me that my body is struggling.
So a little pick-me-up is exactly what I need every morning...

It is by a Christian rock group called Third Day and the name of the song is Tunnel

The Chorus:
There's a light at the end of this tunnel.
There's a light at the end of this tunnel for you.
For you.
There's a light at the end of this tunnel.
Shining bright at the end of this tunnel for you.
For you.
So keep holding on.




There's a light at the end of the tunnel, indeed.
Make that THREE lights at the end of this tunnel

As an aside, I added a Twitter feed to the sidebar. I started using Twitter to keep Matt informed as things changed during the day (i.e., my blood pressure, doctor's visits, etc.) I am adding the link here since some of you get anxious when I haven't posted :-).

Broken Record

(29w0d, Hospital Day 15)
Yes, I am still here
Yes, the babies are still in Womb-Thing.
Yes, it is day to day and I seem to still be teetering on the edge of a c-section every morning.
I am surprised you are all still reading, since frankly, I am starting to bore myself.

Things got a little exciting as my blood pressure was higher than the parameters all night (when it tends to run lower) and then my kidney functions came back worse this morning on blood work. I was thinking I was done for. But then late this morning my blood pressure decreased to within the acceptable range (luckily BEFORE Dr. M arrived). And he didn't seem overly concerned about my kidneys for now and will watch to see what they do tomorrow. Phew!
Escaped by the skin of my teeth.
Again.

The most exciting thing today?
I actually left my room.
See, it has been two full weeks since crossing the threshold out into the hallway (thankfully I have an enormous window with a breathtaking view--- makes the whole bed rest thing a little easier to swallow).
Now I BARELY left the room today... only to get on a fat-person scale that my nurse had managed to wheel to my doorway.
But there was something sweetly rebellious about the whole experience :-).

The other thing I am disproportionately thankful for?
The Olympics.
I have always had Olympic fever.
And what could be better for a woman on hospital bed rest than to have upwards of 14 hours of Olympic broadcast to watch every day?
Not much (besides all the snacks Matt brought in for me today, that is)
I even got some serious crocheting done.
I have become the "Source Of All Olympic Knowledge" for the unit and a few of my fave nurses occasionally stick their heads in to get updates throughout the day.

As always, we will see what excitement tomorrow brings!

Still Alive And (They Are) Kicking

(28w6d, Hospital Day 14)

Ummmmmm. Still here.
And still in the game.
And judging by my lab work it appears I am... well... becoming MORE stable.
Huh?
Yes, if anything my blood work actually improved a bit today.

Womb-Thing started acting up last night.
And then this morning by the end of monitoring I was contracting every 2 minutes.
Not exactly conducive to stretching (sorry... REALLY bad pun) out this pregnancy.
So they increased my P.rocardia a bit (now on max dose) which should also help a bit with my blood pressure.

Call it the battle of the doctors.
Dr. Peri now thinks I will make it to the middle of next week (all of the sudden he is Mr. Positive).
Dr. M (who is on call for their practice this weekend) has been anticipating the need to deliver this weekend, including discussing with me that he may need to do a vertical uterine incision in order to decrease trauma to the triplets (I was relieved to discover that the skin incision will still be low horizontal-- not that I will be sporting any bikinis in the near... or any future.) Of course, Dr. M is also the one who believed at the beginning of this week there was no way that I would make it to today without delivery. He comes in every day expressing amazement I am still here.

And yet, I am.
I should get the two of them to back their medical opinions up with a little bet...
Or at least some baked goods :-)

Rumor is that I have become the talk of the hospital.
Periodically someone from lab, housekeeping, food service, etc will be in my room and ask if I am having a boy or a girl.
"Well," I tell them, "two boys and a girl".
Their face suddenly changes.... "Oh, so YOU are the one with triplets!"
The Neonatologist who came to check on on me today mentioned that discussion over the last few days regarding my possible impending delivery (the hospital's first triplets) has the NICU and L&D wards a-buzz.

I'm starting to think this may really go on for at least a few more days.
But I'm trying not get too ahead of myself.
As for now... we are breathlessly close to 29 weeks

And The Beat Goes On

(28w5d, Hospital Day 13)
Quite the rollercoaster we have going on here.
Looks like this actually may go on for a bit longer than we would have guessed a few days ago.

My blood pressure has stabilized on the medication and my blood work is rock solid.
Go figure.
I am feeling good, and as the babies looked stellar on monitoring this morning, I am expecting to still be tucked into my comfy antepartum bed tomorrow (and maybe the day after *gasp* should I dare hope???).

The babies appear to be growing well and estimates put them around 1 kilo (2.0-2.5 lbs). Their kicking has gotten stronger and I periodically find a foot or hand sticking straight out of my belly.

One important thing about making it until tomorrow is that I will receive another steroid dose. Recently research has shown that a "booster" steroid injection (given if the woman hasn't delivered 2 weeks after the initial steroid doses) can improve outcomes. Right on. We will take any help we can get at this point.

btw... I did get a big smile from Dr. Peri for getting to 28 weeks. But he said he wouldn't be REALLY happy unless I get to 29 weeks. Talk about moving my cheese :).
(at 29 weeks not only is survivability >95%, but the rates of retinopathy and brain bleeds decrease significantly. Sign me up!)

I have survived to gestate another day...

P.S. I have great nurses! Last week I had J three days in a row. Then she was off for three days and when she returned two days ago (the day after things looked like they were tanking), she walked into my room first thing in the morning and asked, "Who broke my patient????". Well, it appears she got me "fixed" again :-).

Too Much Of A (Not So) Good Thing

(28w4d, Hospital Day 12)
I remain on the antepartum unit.
And the triplets remain inside Womb-Thing.
But OOOOOEEEEEE, was it a close one this morning.

My repeat 24 hour urine showed severe proteinuria (7gm) which was approximately 20 times worse than when I was admitted last week. Dr. M walked in this morning clearly stating he was looking for a reason to deliver me today. If he found one other reason besides the proteinuria, it would be Happy Birthday to the triplets. The only reason I have yet to go under the knife is that everything else is stable.

So stable the doctors seem a bit perplexed.
Clearly they don't know me well :-). I am not known for following the "expected" path.
With proteinuria this severe developing over such a short time, I would be expected have much more edema, worsening kidney function and worsening blood pressure along with possibly worsening liver function and decreased platelets. But... ummmm... I don't.

My systolic blood pressure remains in the 150's on the labetalol.

And the babies? They are thriving like champs. They look good on monitoring and on ultrasound all three have great amniotic levels (if low, it would indicate the placentas were not perfusing properly).

So where are we?
As soon as my blood pressure creeps back up into the 160's, the babies show any evidence of distress, or my morning labs show dropping platelets or worsening liver or kidney function... the jig is up.

Everyday counts!

High Pressure Situation

(28w3d, Hospital Day 11)

Looks like we will be meeting our babies.
Soon.

My blood pressure started inching up about 24 hours ago and by early yesterday evening I was regularly hitting 170s/100. Not exactly what we were hoping for. Stat labs (amazingly!) weren't bad... only mildly sub par kidney function. Oh, and 3+ protein on urine dipstick. Since my platelets, liver and uric acid were cooperative, they agreed to treat my blood pressure with labetalol (at least temporarily) while a 24 hour urine is repeated and labs could be done again this morning. The NICU was put on alert, and a delivery for tomorrow was expected.

But then my labs were stable this morning.
And my pressure has shown some improvement on the labetalol(at least it has returned back below the "danger zone").
So I am in a holding pattern.
Whether or not I will be delivered will literally be a day-by-day decision from now on.

Obviously we would like to keep them in as long as possible, but I appreciate that the doctors are concerned about my health. As Dr. M said yesterday, "Taking the babies a day or two early at this point won't make an enormous difference for them, but taking them a day or two late could have huge consequences for you." Point well taken.

Feeling not so much like my fab self today, so signing off for nap time, but will try to update daily.

A Day In The Life

(28w2d, Hospital Day 10)
My life right now is very exciting (*snort*)

5:30-6:00 am Wake up on my own or by someone in a white coat shoving a large needle in my arm (you know, either way... whatever); medications. Start watching local, national and international news.
6:00-7:00 am more news watching, occasionally punctuated by a text to Matt and periodic quick naps; shift change
8:00 am Breakfast arrives (hey, these are big events one looks forward to with baited breath and an empty stomach); medications
9:00-11:00 am (approx) monitoring starts. Four monitors, one belly, 2 hrs laying flat. Need I say more? Watching TV. Occasional discussion with nurse and housekeeper regarding Oprah's topic of the day.
11:00 am (if I am lucky... if the Wiggly Ones don't cooperate, make that 11:30) the highlight of my pitifully simple day.... SHOWER!
11:30 am I pour my non-makeup-ed, non-blow-dried but now squeaky clean body back into my bed with crisp new sheets; medications
12:00 am Lunch. No really... nothing like food to break up the monotony
1:00-5:00 pm Nap on and off (which I desperately need), watch TV, read, chat up the nurses, return phone calls and snack
5:00 pm Dinner arrives, but as I have most likely eaten a snack or two, I hold the tray to be warmed later when Matt arrives
5:30-6:00pm Matt calls to say he is on his way to the hospital. What do I want to eat?; medications
6:30 ish pm Matt arrives and we get some time to chat
7:00 pm Shift change
9:00 pm Another round of monitoring; medications
10:00-11:00 pm Matt heads home
11:00 pm - 5:30 am Episodes of deep sleep (thank you, A.mbien!) punctuated by bathroom breaks (think hourly...), blood pressure measurements and medications (midnight and 4am).


Major Decisions I Make Every Day
Forget the life-or-death decisions I used to make in the hospital. This is where the REAL decisions are made:

1) What time do I want my monitoring done in the morning? What time at night?
2) When do I want my shower?
3) What will I eat for a snack in the afternoon?
4) What do I want to order off the menu for tomorrow?

But the most important recurrent, vital decision that I make on a daily basis?
5) Now that I am back in bed from the bathroom... do I want to lay down on my left or right side????? I have to admit this one sometimes stumps me sometimes for a few minutes :-).

So there you have it. A day in my life.
Don't get me wrong, I'm not complaining.
Although a bit monotonous, it is the life of a human incubator.
And every day they spent in THIS incubator is 2-3 days they won't spend in the NICU incubator.
Still hoping this life-distilled-down-to-basics schedule continues for at least another week or two.

Of (False) Decels and Nannies

(28w1d)

So as my recent frequency of posting may tend to indicate, two things have changed.
1) I have successfully discerned the best way to use the internet here at the hospital
2) I now feel well enough most days to jot a little post down

Get this...
As of this morning, my liver and kidney functions have completely normalized.
Even my uric acid is "normal", just a little higher than they would want.
The doctors seem a bit perplexed.
Apparently they often see a slight improvement after hospitalization and steroid administration. But to have everything normalize and remain stable for a week is... well... quite unusual. I gather they didn't get the memo that I don't exactly follow the expected route of... well... ANYTHING when it comes to this pregnancy.
What a fabulous way to buck the trend!

During monitoring this morning, there was some concern that Alpha was having decels (a substantial decrease in her heart rate which can indicate low oxygen/distress). But because she wasn't showing up well, it was unclear if they were true decels or just artifact from the monitoring.

Dr W showed up and was concerned enough to pull out the ultrasound machine. Apparently if the decels are "true", Alpha will be sluggish due to the build up of lactic acid. He needed to count her movements. From the minute the ultrasound probe hit my belly the screen was filled up by a whirling dervish. Make that three of them.

They usually spend 30 minutes counting fetal movements.
All three of mine passed in the first minute :-).
Dr. W believes the tracing pattern is due to Alpha's position (VERY low and near my large vessels), and her... ummm.... maniacal activity:-)
Phew!
One more bullet dodged.

In other news... it appears that Matt and I will certainly be getting at least some sleep once all the babies are home.
No, dear readers, I am not in the throes of acute hospital-induced delirium.
No, my friends... we have found a night nanny!
She is about 60 years old and has extensive experience taking care of multiples.
And likes working at night.
Could we be any luckier?
Skipping a feeding or two a night (at least five nights a week) should do me wonders.

That's all for now...
One more day down!

Let Me See Those Pearly Whites

(28w0d, Hospital Day 8)

First of all, I feel like I am back in Mrs. J.orgenson's third grade class.
When Dr. W (a partner of Dr. Peri) showed up yesterday and said all of the partners (apparently they discuss treatment plans on Dr. Peri's hospitalized patients as a group every day) are not only pleasantly surprised that I made it this long, but also impressed that things actually looked better for me yesterday than at any point since I was admitted, I couldn't help but be proud (as if my falling liver tests are a direct result of good study habits.)

Well stick a gold star on my forehead :-).


Today is 28 weeks!
We made it!
Slap me silly and call me Martha.

Let's see.
I'm most definitely going to celebrate.
Hmmmm......
Maybe by eating one extra baked goody? (*gasp*)
Or, if I am feeling truly rebellious, making my way OUTSIDE my room down two doors to get some cranberry juice (think T.he V.illage, T.ruman Show, etc). Yep, a wild child, I am :-).
Ooooo, ooooo, I know (hand waving wildly waiting for teacher to call on me), Stuffed crust pizza for dinner? (Now we're talking!)
Matt is running a few errands for me today... Among other things... new shampoo and conditioner. MOUTHWASH (ahhhhh.... I can't wait!) and he will be bringing my shaving supplies from home as another week like this and S.asquatch won't have anything on me.


The Mother of All Headaches is gone.
Completely.
Ahhhhhh. Can't tell you how NOT sorry I am about this.
One never truly appreciates the lack of one's head being split in two by a hatchet until... well... it stops.
This also marks the beginning of hospital week 2.
All sorts of things to celebrate today!

I can tell the babies are growing because of how they move (well, and I suppose the fact I am teetering on the edge of belly button out-y-ness is also a clue). And I'm not talking about the 6-footed, 6-handed, log-rolling frenzy that often erupts when monitoring starts. No, I'm talking about the occasional foot that stretches out the top of my uterus. This conscious stretching activity is new. Estimates roughly put them at approximately 2 lbs right now if we are lucky (soaking wet, of course). New goal? 2.5 lbs... no, make that 3 lbs... it is O.lympic season, might as well dream big, no?

It is an awful good thing I made it this far.
See, I have an ulterior motive.
Dr. Peri should be in on Moday.
And I am SOOOOOO waiting to give him a bad time about putting me in the hospital and then leaving the country the next day to go SCUBA DIVING... WITHOUT TELLING ME. I am so going to raz him.
Besides, he has been telling me for several weeks that he won't be smiling until we get to 28 weeks.
Where is that smile, Dr. Peri???????

Now clawing our way towards 29 weeks...

A Pain In The... Head

(27w6d)

... But also a pain in my always-ample-now-jumbo-jet-sized tush.

Technically and geographically the pain is actually above my shoulders.

Yes, I had a migraine starting yesterday morning.

No, not just a run-of-the-mill migraine.

No, as S.addam H.ussein would have said-- the Mother of All Migraines.

As my normal pre-pregnancy migraine medication (which, btw works so well that I would kiss the feet of the researcher that developed it... No really, I would... barefoot...) is off limits for now I am left with older meds that have luckily worked wonders during my pregnancy... until now.

Not exactly great timing as those in the know will understand that a persistent headache resistant to treatment is an indication for delivery in preeclamptics.

Even at 27w6d.

As a bonus... such a severe headache is bound to make one's blood pressure... well... less than desirable.

Fabulous.

I eventually took four doses of the older medication with very little effect.

Not reassuring.

And even I started becoming concerned since this was so unusual.

After being called a "ticking time bomb" (tick, tock, tick, tock) by Dr. Peri's partner  ("Don't even consider thinking about being able to leave this hospital until you deliver these babies" he warned me), he threw the proverbial pregnancy-friendly pharmacy book at me in an attempt to prove this was actually a migraine-run-amok and not my neurologic system preparing for mass destruction.

Eventually it worked.

Hallelujah!

And I got a full three hours sleep (something I fully intend to rectify this afternoon by turning off my phone and turning my TV to the golf channel.

As of this morning, I am the proud owner of a respectable (ummm... at least for Pregnancy-Induced Hypertension standards) blood pressure, decent labs and an after-severe-migraine fog.

Besides feeling like I have been run over by a M.ack truck (fighting a migraine for 12 hours will do that to a person), I am feeling good today.

And I couldn't be happier.

Talk about a rollercoaster!

So far August (at least the first 12 hours of it) is treating me very, very well.

Oh, I almost forgot.  A family friend sent over their caterer to bring me dinner a few nights ago.  Complete with a cloth napkin, placemat and table cloth.  Pink and yellow lentil soup (Yum!), salad, salmon with risotto and roasted beets were served.  A great surprise, tres generous and tres tasty!

P.S. In case you aren't aware (not that you would like to be... ) one of the benefits of an ever-growing front section is that even the most generous back side begins to look... well, relatively flat.  Believe me.

On Hold

(27w4d)

Ok, time for an update.

Unfortunately blogging while in the hospital has been frustratingly difficult.

The wireless internet card I would normally use gets spotty reception at best here in the hospital.

And although I am grateful that I can access the internet through the TV in my room, the type is so small from y bed that I can't read enough of what I am attempting to write in order to make it worth worthwhile.

To boot,  I have been exhausted the last few days, without energy to even crochet or read my book.

Shortly after I last posted (on Sunday) the Neonatologist and a NICU nurse arrived at our room to discuss what to expect when the triplets are born early.  

Turns out, we know both of them.

Dr. Neo is a kind, mellow and very good neonatologist who Matt did some contract work for several years ago.  When I worked at U.MC, Dr. Neo always went out of his way to chat with me in the hallways.  Turns out he now runs the Level III NICU here at the hospital where I am.  As I mentioned in my last post the NICU here only gained Level III status in the last year.    What we didn't know is that they ONLY care for Level III babies here.  Once they are stable enough for Level II, the babies will be transferred to a hospital within the same system that is very near our house.  I find it reassuring that the nurses and physicians here specialize in only the smallest and most acute babies.

As for the nurse-- she used to date Matt's brother in high school.  It has great to see her again.

I see all of this as a good omen.

We may be their first triplets, but we are in familiar and reassuring hands.

Until yesterday my blood work was still trending slowly in the wrong direction.  It appeared that my liver was becoming involved and the MD filling in for Dr. Peri seemed more concerned.  She was talking about possibly needing to deliver the babies by the end of this week.  But my lab tests have improved and stabilized over the last two days.  My blood pressure has also stabilized (being on hospital bed rest will do that to a woman!)  I attribute this turn around not only to hospital bed rest, but also to the thoughts and prayers of family and friends.

So at least for today, things are going all right and it appears (knock on wood) that we will at least make it to 28 weeks.

The babies are still doing well.  They put all the monitors on my belly for 2-3 hours every nursing shift (which means every twelve hours).  Because of the difficulty finding and keeping the babies on the monitors, I have to essentially lay completely still, often basically on my back, for the whole time.  As you may imagine, this is anything but comfortable... especially when one's bladder is being bashed either by Baby A or by a contraction.

But at times it is quite entertaining.  The babies seem to resent the monitoring as an intrusion into their world and often start kicking and moving.  A lot.  It is reassuring to hear their heartbeats and feel them moving around.

In summary, I am feeling better than a few days ago and all signs point to this being a longer-rather-than-shorter hospitalization.  We are grateful for every day that I remain on the Antepartum instead of Postpartum unit.

Just taking it one day at a time.

This Patient is Forever

(27w1d)

I have been classified as a "forever" patient.

Meaning I will be here in the hospital until the babies are born ... no matter how long that is.

Dr. G was covering for Dr. Peri last night... who is out of town for the next week.  Nice, Dr. Peri... dump me in the hospital and run off to some tropical location :-).

When Dr. G arrived it was clear there was no chance I would be heading home to sleep in my bed and swim in my pool.  My pressures fluctuated between 150s-160s/90s (highest being 164/98).

While on bed rest.

Laying down.

On my left side.

High enough by itself to classify me as preeclamptic.

In addition, I am spilling significant amounts of protein, my kidney function was sub par and my uric acid was a bit high.  All in all not great news.  BUT that babies seem to be doing well and although they keep calling my Womb-Thing "highly irritable" (What you talkin' about, Willis?), I am only having a few "real" contraction an hour.

I attended the baby shower yesterday via video conferencing that Matt set up.

Not ideal, but quite fun nevertheless.

Afterwards, some people came over and hauled all the presents into my hospital room (much to the delight of the nursing staff who thought I should have had the shower here).  I gleefully spent a few hours opening all the gifts for the babies.

I am overwhelmed by the amount of concern and love that our friends and family have shown to us and the babies.

Marsha, Natalie and Tami pulled out all the stops for the shower (I know since I got to sample the food later!)

I will post some pictures and more about the shower in the next few days.

Jennifer and Diana were here for the weekend and among other very important things both gave my tired, swollen feet a good rub.

My digs here are great.  I am in a fairly new hospital and I have an enormous (and I mean ENORMOUS) private room.  The nurses have been fabulous.  And get this... even the food is tasty (or maybe that is the result of having little variety in my diet since being on home bed rest?)  There are really only two drawbacks to being at this particular hospital...

1) It is quite a ways from our house.  Our first choice of hospital no longer has a contract with our insurance company.  The two hospitals with Level III NICUs that were closer were completely full when Dr. Peri admitted me on Friday.  So he called the fourth and last hospital in town with a Level III NICU and they had a room (if not, apparently my insurance would have had to pay for me to be treated at our first choice hospital since they also had a room).  As the freeway between the hospital and our house is undergoing construction and parts will be closed in the evenings for the next month, the commute will be even more painful than normal for Matt.

2) This hospital has had Level III NICU status here for just under a year.  Rumor is that they run a great NICU, but as far as I can tell (judging by comments from several nurses), we are their first set of triplets.  The good news is that the neonatologist who will be caring for the babies (per Dr. Peri and per reputation), is fabulous.

So there you have it.

I am getting settled into what will hopefully be a long hospital stay.

Every day the babies remain inside is a blessing at this point.

Signing off from Room 304

Out Of Luck

(26w6d)
So my luck ran out.

I am currently blogging from a hospital room while sporting a hiney-baring gown complete with three heart rate monitors and one tocometer straped to my belly. Quite a site, I assure you.

In short (since I am exhausted and attempting to type this using a tv screen across the room which i cannot reliably see well), my blood pressure was 160/100 and my kidneys (despite the strict talking-to they received just prior to their moment in the sun) started spilling protein.

Yep, game over.

Luckily, since being in the hospital, my blood pressure has improved and my labs came back fairly normal, thus I was able to avoid the pre-third trimester emergency delivery. But attempting to monitor three VERY wiggly little ones on the monitor all at the sme time proved nearly more than the antepartum staff could manage. Luckily, all babies look good and healthy.

Since I have been such a "good patient" and things are looking ok, there is a slim possibility that I will be set free tomorrow.

Considering the lecture I received from Dr. Peri this morning, (a la... you will be in the hospital until these babies come out whether that is tomorrow or 6 weeks from now)... I'm not holding my breath.

More tomorrow....

A Wee Whinge

(26w0d)

It has been a while since I posted.

To be honest, I was in quite a foul mood on a few days this week and just couldn’t bear to write about it.
Let’s just say this pregnancy is hard.
I have good days and bad days.
And I had my share of bad ones this week.


For starters, my abdomen became very sore to the touch and I felt as if my abdominal muscles were slowly being ripped apart (ummmm… I believe that was exactly what was/is happening), throw in a good measure of food coming up into my throat hours after eating if I had the gall to eat a normal meal portion, plus a dash of swelling which included gaining an average of one pound a day for the last two weeks culminating in me now eerily resembling the M.ichelin M.an….


EXHIBIT 1



Who wouldn’t want to do this for another 8 weeks?

Dr. Peri keeps referencing my “preeclampsia” although he concedes that technically I don’t fit the criteria since my kidneys are not spilling protein. He seems to consider this purely a formality and an inevitable occurrence. He emphasizes to me at every chance that I should expect to be hospitalized any day. I, on the other hand, gleefully point out at every possible opportunity any minute detail that may indicate I will be proving him wrong when he says, “I don’t expect to be delivering you in the next week or so, but I doubt you will make it much beyond that”.

That is a challenge if I have ever heard one.
And anyone that knows me knows I am a sucker for a challenge.
Now, if I can only get my kidneys on board…

But I am proud to say that I managed to avoid wearing gowns that close in the back with my hiney hanging out for at least another three days. A small success for sure.

Our growth ultrasound yesterday was great in that the babies still appear to be developing well anatomically. All of their parts seem to be functioning well and appear to be in the right place. The one glaring exception? They continue to be small. Very small. Small even for triplets (and believe me…. that is small!). The computer estimates them to weigh approximately 1.5 lbs, but he seems to think that is a stretch (Dr. Peri points out this is another sign of my preeclampsia).

But as Dr. Peri concedes… there is nothing that I can do at this point but wait, hope, pray, continue to lay on the couch... and monitor my blood pressure and kidneys twice a week. I will continue to see him every week as well.

Every week from here on out is a blessing.
Dr. Peri says he won’t start smiling until I hit 28 weeks.

And believe me… I REALLY want to make him smile :-).


P.S. After reading this post it occurs to me that I paint Dr. Peri in a very pessimistic light. To be fair, he is just very blunt. He did have me schedule appointments out four weeks in advance. Perhaps an unintentional positive impulse he couldn't fully squash? Hmmmmm.