We got the go-ahead today to put Nate to breast once a day and see how he does!! And as soon as Mitch and Eli get their breathing under control (couple more days on the breathing treatments) they can try too!! I can't begin to tell you how excited I am for this milestone...
What a wild and crazy week its been for the triplets! Yesterday marked 5 weeks wince they were born. This last week has been an eventful one! It started with being able to hold all three boys at once one night. Then they all gained enough weight to hold their own temperature without assistance from the incubator which allowed them to start wearing clothes. Then Eli, our little chunker, reached the 4lb milestone! Nate and Mitch are not too far behind.Nate is 3lbs 9oz and Mitch is 3lbs 12oz. Yesterday, when I went in Eli had been moved out of the incubator altogether into an open crib! And Nate was moved into Eli's room. Today, all three are being moved into one room. All this means they are that much closer to coming home!
Today Mitchell and Elias both had lung xrays because they are still on quite a bit of oxygen assistance and the doctor wanted to see if they had an issue with fluid building up in the lungs. Fortunately, that is not the case. They simply are being a little slower with their lung development and both have some swelling (like baby asthma). They are now being treated with lung treatments (a steroid to help with the swelling and albuterol to open the airways) and hopefully this will relieve some pressue, allow them to come off the oxygen assistance and give their lungs a chance to mature.
This week Nathaniel had another head ultrasound and we finally got some good news! The blood is starting to disappate! Its minor still but progress none-the-less. His hydrocephalus is stable and not showing signs of worsening. Unfortunately, there is no cure for hydrocephalus. There is treatment when the condition is progressive, but luckily Nate's is not progressive at this time. However, he will have to be cautious his whole life as the condition could become progressive at any point. Basically he will have to be limited in what sports he can play (baseball but no football!) and minor bumps to the head (like any little boy is prone to) will have to followed up with a visit to his neurologist. But overall, it will be manageable, assuming it stays stable until that blood completely disappates. Here are some pictures of Nathaniel from week 5:
One day this week I accidently left my camera at the NICU. The nurses that night apparently thought they would take advantage of that and gave Eli his first bath and documented it! Here are some photos of Eli including the mystery bath photos.
And here are some photos of Mitch in his new digs and hanging out with his big brother:
The boys are officially one month old! (33 weeks gestational) They are looking great. Eli is up to 3lbs 10oz and is maintaining his own body temperature! Go Eli, Go! Mitch is 3lbs 6oz and Nate is 3lbs 3oz. Recently, we were able to get the boys together for the first time!! Check it out!
We officially have 3-pounders! Eli is weighing in at 3lb 7oz, Mitch at 3lb 2oz and Nathaniel is a few grams away from 3lb 1oz. They are looking bigger too! Their skin is pink and healthy looking, not that transparent bluish tint that they were born with. Its so good to see them mature and grow.
All the boys had their first eye exams this week and everything came back normal for their age, meaning they have immature blood vessels but that is normal for their gestational age. They will continue to have eye exams every week until they come home. Preemies often have vision troubles, especially in thier first few years, because of the oxygen assistance they receive. If they are over-saturated with oxygen it can cause their retinas to detach- a condition called Retinopathy of Prematurity (ROP) and so they will continue to have exams to watch for this condition. But so far, so good.
Nathaniel had a bad day after his eye exam. Apparently the exam stressed him out (I understand- I hate having my eyes dialted and I'm full grown!) and so he was desatting (drops in his oxygen saturation). After 2 weeks of no oxygen assistance they put him back on the cannula for the night. By morning though, he was back to breathing on his own.
Also this week all the boys had head ultrasounds again. Mitchell and Elias both are still showing normal (no bleeding) and Nate's situation hasn't worsened. However, they informed us that the first person who evaluated Nate's situation had mis-categorized the grade of his bleed. Originally we were told he had a grade 1 on the left and a grade 4 on the right. Well now they are saying the grade 1 is actually a grade 3 because of the fluid that is present. And we were told that he officially does have hydrocephalus. Originally we were under the impression that it was just the hemorrhage and had yet to form hydrocephalus but apparently he's had hydrocephalus all along. The good news is that it is stable and not getting worse. At this point there is no need to consider a shunt. His head is growing at a normal rate. However, before he comes home he will have to have an MRI and be evaluated by a neurologist. This means he'll have to transfer to another hospital in downtown Tampa for a couple days. Because he is not able to be still on his own for an MRI, they will have to put him under general anesthetic for the procedure, which in and of itself is kind of dangerous. So please continue to pray for him. We are not out of the woods yet and I truly believe the reason it hasn't gotten worse is due to the tremendous prayer support we've received thus far.
Mitchell and Eli are still reliant on the oxygen assistance and both have had issues the last few days with finding a level they are comfortable at. If they nurses turn up the oxygen just a little, they tend to saturate too high but if they turn the level down just a little, they desat. And little Mitchell is working so hard all the time. You can see his little chest thrusting up and down as he struggles to regulate his breathing. The doc says this is still normal for their age and they will outgrow it eventually. Its hard to watch though, especially because their desat alarm seems to be constantly going off. Those alarms stress me out!!
This week I started back to work. Call me crazy but it's really the best option. If I take the full 8 weeks allowed to me by FMLA I would be going back to work about the same time the babies are coming home. That didn't seem to make much sense to me. So I am going back now, getting caught up, and when the boys come home I will take my vacation time. That way I am not stressing over being behind in my work AND I get my full paycheck AND I get time with the boys when they come home at full pay as well.
My company has been so good to me through this. Because a large portion of my job is driving they provide a company vehicle. When I found out we were having triplets I realised my Subaru Forrester was WAY too small! So my company arranged for me to get a mini-van which was just incredible of them. As of last week I now drive a Chrysler Town and Country which I surprisingly love! Its big and heavy and slow, but I love it. Its spacious and will work perfectly for toting around 3 infants, and 8 yr old and a ton of work gear.
I am feeling quite well physically. I've been back in my size 6 jeans for almost a week now! Woo Hoo go me! :) I'm still producing milk at a good rate, though I've had some problems with pain. I've tried a bunch of different things and currently am treating myself for what is possibly a slight yeast infection in the breast. The boys are not showing any signs of yeast infection (no thrush or diaper rash) so as of now, if that's what the problem is, I'm not throwing out my milk. If they start to react though, I'll have to throw out two weeks worth of milk. Ugh... breaks my heart to think of all that hard work gone to waste. On the upside, my boobs are absolutely HUGE! LOL... In fact, I don't know if its a compliment or a curse, but yesterday the Lactation Nurse- a woman who looks at boobs for a living!- said something that just cracked me up... I pull up my shirt and she exclaims, "Wow those are big!" and then embarrased she says, "Oh I'm sorry I shouldn't have said that out loud. Its just your frame is so small and I've never seen someone so small with breasts so large!" LMAO! I have to say though, bra shopping sucks right now. I've been fitted as a size 34E or even a 34F and they just don't make bras that size unless I special order them on the internet. I can find plenty of bras that cup size, but finding the size 34 is the problem. Most start on 36 minimum which just doesn't fit right. Ok enough about my boobs. Sorry if that got too personal...
The NICU stay is taking its toll emotionally. I've done considerably well with it thus far, but every day it gets a little more difficult to not be able to take the boys home. I physically miss them when I'm not with them. I know I should be appreciating this "eye of the storm" lull and taking advantage of it bu relaxing and whatnot, but it just doesn't make sense to me. So I stay busy and visit the NICU whenever I can. Its hard to imagine 4 more weeks of this.
Today, if I was still pregnant, the boys would have been 32 weeks gestation. That was my goal. Part of me feels guilty for not making it this far, even though I know its not my fault. I had to unsubscribe from email lists that I had signed up for that give me weekly updates on my pregnancy. It was painful to get emails about pregnancy milestones that I would never make. Its hard to read how big the boys would be if they were still inside. But alas, they are doing well for being born when they were. As of today Nate is 2lbs 12oz, Eli is a full 3lbs, and Mitch is 2lbs 13oz! Although Elias and Mitchell have been on and off the cannula oxygen, that is still normal for this stage and may be the case for the next couple weeks. Nathaniel however is my little champion breather and has been without oxygen assistance for well over a week!
Nathaniel had his weekly head ultrasound and it showed no changes still. This means there has been no build up of fluid thus far, but it also means nothing has disappated. His head circumference is still being measured every other day but it is growing at a normal rate and there's no apparent swelling in his fontanelles all of which is a good sign that all is well thus far.
Elias is due for another lung xray today to follow-up on his PIE situation. The swelling has gone down and he's breathing well with the oxygen just above room air concentration so I suspect the xray will show much improvement. There's a chance he could come home still needing oxygen, but it's still too soon to tell.
Mitchell is just plugging along as usual. All the boys have gone up in their feeds and have vitamins being added to their breast milk to fortify it and help them grow better. I am very proud of them all and the progress they have made thus far. Its really amazing they don't have more issues and I know its thanks to all the prayers out there.
Here are some photos of Nathaniel from week 3: (double click on photos to open larger and see captions)
Here are some of Elias:
Last but not least, Mitchell's week 3 photos:
Mitchell was wide awake and wanted to say hello to everyone :)
I am long over-due for an update. This week has flown by! Matt went back to work and Jordan went back to school and I was left to my own devices at home, not working but also not having babies home to take care of. So I found myself sleeping a lot at home and spending my waking hours at the NICU. Each day this last week I spent 4-6 hours with the boys. It was great because I spent a lot of time kangarooing them and taking turn with their hands-on care. Sometimes I just sat in their rooms looking at them. Its given me an opportunity to get to know their personailities and nuances. Honestly, when I'm at home I find myself wishing I was at the hospital. I just love being with them and seeing them make progress, being there when they cry and being able to comfort them to some extent, and being there to learn and help with their medical needs. It helps to not feel so disconnected from them.
The boys are each making such great progress. As of today all three are off IV's completely, all PICC lines removed, and all supplemental nutrition is now being added to the breastmilk instead of being given intraveinously. This is such a positive step because it means the docs have confidence in the stability of their situations.
Eli is my little champion this week. We got a new doctor (they rotate in and out every week so we get a new one every 5-6 days or so) and this new doctor decided to make some aggressive steps in Eli's care. He rapidly moved him off the oscillator and in the same day off the intubated ventilator to the CPAP machine. He spent one day on CPAP and then was moved to the high-flow nasal cannula which is where he is now and is doing great on it. The last lung xray showed improvement in his condition which is very encouraging. Elias is also the biggest of the 3 and at the last weigh in was 2lbs 11oz!! Almost 3lbs! Also this week I got to hold him for the first time. It was precious. He cried at first and his cry was so weak and hoarse from having that tube in his throat for so long, but after about 10 minutes I was able to comfort him and the rest of the time he just slept peacefully on my chest. I'll admit I shed a tear of happiness and completeness being able to hold my third baby. Here are some recent pics of Elias... (double click on photos for bigger image and caption)
Mitchell is making progress slow and steady as usual. His current weight is 2lbs 9oz. He was taken off oxygen for a couple days but put back on due to drops in his oxygen saturation. The nurses assured us this is a normal back and forth process. Apparently when they increase the amount of food they are intaking, it increases the size of their stomach thereby putting pressure on the lungs causing the oxygen level to drop. Here are some photos of Mitchell from this last week... (double click on photos for bigger image and caption)
Nathaniel looks great. He is currently weighing in at 2lbs 7oz. He has been off the oxygen for quite some time now and is doing really well without it. He desats from time to time (meaning his oxygen level drops) and he's had a few bradys but has continued to self-recover. Earlier this week, before his IV was removed, we were given quite a surprise when we went into his room only to find his IV had been moved to the top of his head! It looked awful and uncomfortable and we were worried it would interfere with the monitoring of his brain bleed situation. It did in fact delay his head ultrasound one day before it was removed and a PICC line was finally put in. The ultrasound showed no visible changes, which at this point in the game is good news. However, we were notified this morning that his head circumference, which is measured every other day, is growing at a faster rate than they would like, indicating a possible fluid retention problem. PLEASE continue to pray for him. He is still in critical condition even though you would never know it to look at him.
A couple days ago the hospital asked me to be part of a photo shoot they were doing to update their website and make it look friendlier. Nate and I got to pose for the NICU page. Nate wore the hat a new friend made for us - so cute. (Thanks Kristine!!) He's a little celebrity already! :) Here are some pictures of Nathaniel from this last week... (double click on photos for bigger image and caption)
Well, its been 11 days since the triplets were born. My recovery is going well. I have lost about 25 lbs and my incision is healing nicely. My pain is diminishing and I have stopped taking pain pills. This means I can drive again which is good since Matt has to go back to work tomorrow. I have to say, as my bloated belly goes down I find myself grateful for the lack of damage that's been done. I was anticipating something like THIS WOMAN... but luckily all I have so far is a few more stretch marks. I guess if I had gone 36 weeks I'd have a different story, but having only gone 28 I didn't get stretched out too far and for that I am grateful.
The boys continue to make progress. Nathaniel is now breathing on his own with absolutely no assistance or extra oxygen. He has had 2 bradys since removing the cannula, but he recovered on his own without assistance which is a good sign. If he's capable of doing that he will stay off the oxygen. In efforts to watch for signs of swelling due to his brain bleed they are measuring his head every three days and his last measurement actually showed that it had shrunk 1/2 cm. That's awesome! Not only is that a sign that his bleeding isn't building fluid, but it also means his original problematic swelling is still going down as well. He is due for another head ultrasound in a couple days. Matt had the opportunity to Kangaroo Nate a couple nights ago and that stinker pooped his diaper while Daddy was holding him and was fussy the whole time.
Elias is still struggling with his lung issue. Today the nurse explained his condition in detail for us. He has what is called Pulminary Interstitial Emphysema (PIE) in his left lung. There are 3 layers to the lung and PIE means he has a tear in the first inner layer, allowing air to leak inbetween the next 2 layers. Because he is so active he is fighting against the machine that is trying to relax that lung and its not allowing it to heal. In the last 24 hours that lung became enlarged. They are making adjustments to his treatments several times throughout the day based on the level of oxygen and CO2 in his blood. At his second xray today the lung showed improvement in size and also in lung matter meaning the tear is healing. But he is not out of the woods yet and will probably go back and forth with progress and problems for the next several weeks. Long term effects to him are susceptibility to chest colds and congestion and possibility of asthma in early childhood. There's also a good chance he will require use of oxygen for the first couple months he comes home. I have to admit, it is hard to see Eli struggling when his brothers are making such tremendous strides and improvements. Tonight he was crying and they were working on him and all I could do was watch. Every maternal instinct in my body kicked in and I wanted to just scoop him up and hold him close and tell him it would be ok. It broke my heart that I couldn't.
Mitchell is slow and steadily making progress. Last night they moved him to the high flow cannula (tube in his nose) and he is doing well on it. He has had no bradys at all since making the switch. I got to Kangaroo Mitchell for the first time 2 days ago and got to again last night. He is so funny. He doesn't fuss much but he starts to cry as they are getting him ready to Kangaroo. But the minute his head hits my chest he quiets down and is the happiest baby you will ever see! I love it. :) I can't wait to have these little guys home with me.