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.