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!