Nathaniel and Mitchell are doing so well that the nurses are having us help with their hands-on time. This means we change diapers, take their temperature and help weigh them. Here is a video of Matt helping to weigh Nathaniel...
In my overwhelming concern for Nathaniel I feel like I have neglected the needs of my other two triplets! They too need your prayer. Mitchell is doing great. His progess is slow but steady. He is my quiet one. His CO2 levels are still a little high and until they come down he won't be able to move off the ventilator and back onto CPAP. Elias is still struggling with his lungs. He has a tear in his left lung and he is such a active child that he is fighting against the breathing machine causing the tear to not be able to heal properly. The doctors are considering purposely collapsing his lung in order to give it a chance to heal. He amazes me really. I'm glad that he's a fighter and strong enough to be active even though he is sedated 24hrs a day and on an oscialator that shakes him constantly. I just need him to relax long enough to heal his lung!
Last night, after a stressful day getting the bad news about Nathaniel, we went back to the NICU for a visit. To my surprise and utter joy they let me Kangaroo Nate! (For those who don't know, Kangaroo care is holding the baby skin to skin using your own body temperature to regulate his). I got to hold him for an entire hour and it was the most amazing feeling in the world. I can't wait to hold the other two now! The Kangaroo care can only help Nate at this point so it is perfect timing. Hopefully Matt will be able to hold him soon too. What a great way to end such a devastating day.
Thanks for all the prayers and support. I can't begin to tell you how much we appreciate it. I feel like I end every blog entry this way, but I can't stress enough how important the prayers are to us.
Here are some pics of Nate from yesterday...
Here are a couple pics of Mitchell...
Unfortunately, I don't have any good pics of Eli to post. He is still constantly under the Bili-lights and on the shaking machine so its tough to get a good picture. As soon as I have some I will post them.
Despite common challenges of prematurity the triplets have done considerably well thus
far. However, we were most concerned about Nathaniel who was born with fluid in
his abdomen and around his heart and major swelling of his head. Seven days
later his swelling has gone down to almost nothing and the fluid is rapidly
dissipating. His lung function has been so good that, of all three boys, he is
having the most success breathing unassisted. However, after a brain ultrasound
of all three babies we got the devastating news that while Elias and Mitchell
were free and clear of any brain issues, Nathaniel has a brain bleed.
There are 4 stages of brain bleeds and it is a common problem among preemies
born before 34 weeks gestation. Stages 1 and 2 typically resolve on their own
and cause no long term effects. Stages 3 and 4 are more severe and can lead to
major complications and have long term side effects. Nathaniel has been
diagnosed with a stage 1 bleed on his left side of his brain and a stage 4 on
the right side of his brain. A stage 4 bleed affects actual brain matter and
damages it permanently.
The next 4-8 weeks are critical for Nathaniel. Worse-case scenario could be that
the bleeding continues to get worse and further damages his brain tissue causing
more and more problems and possibly even death. Best-case scenario is that the
bleeding has stopped and won't get worse. If it has stopped the blood will
reabsorb into his body. However, if while it is reabsorbing any clots form they
could get caught up and cause what is called hydrocephalus in which fluid builds
up and causes his brain to swell. If this happens it could mean he would need a
shunt (a drainage tube) in his brain for the rest of his life.
The damage that has already been done is concerning too because brain tissue
does not regenerate. Long-term effects of the bleed as it stands right now could
mean anything from mental retardation to cerebral palsy. On the positive side of
things, it could also mean absolutely nothing. The brain of a preemie is
extremely resilient and still developing and although parts are damaged, the
other side of his brain could pick up the slack for the damaged areas. The good news
is that Nathaniel has already shown great strength and the stability of his
health at this moment in time gives him a greater chance of overcoming this.
Please pray for Nathaniel. The next few weeks will determine how he will live
the rest of his life. Please pray that the bleeding has stopped, that no clots
form, and that he is able to overcome any long-term effects of the damage that
has already been done. Please forward this blog to anyone you think may spend
time praying for Nathaniel. He needs all the love and prayers he can get and so
Thank-you from the bottom of our hearts,
Christina and Matthew
Five days old and the triplets are doing great. The doctors keep telling us that for 28-weekers they are REALLY healthy! Here's where things are with each of them...
Nathaniel- for a little guy who was on the verge of not surviving childbirth just 5 days ago, he is doing awesome!! His swelling has gone down tremendously and the fluid level inside of him is diminishing as well. He had a 2nd echo-cardiogram (ultrasound of the heart) and it showed that there is no more fluid directly around his heart, that the valves that are supposed to be closed are, and that it is getting stronger. He spent a couple days under the bilirubin lights to help with his jaundice, then one full day without. He is back under them as of today. He started out on an oscilator breathing machine, moved to ventilator a couple days later and as of late last night he got moved to the CPAP machine! I can hardly believe he's progressed so well! They attempted to put in his PICC line today but were unsucessful. As soon as they get that line in and can remove his umbilical line, assuming he's still doing well on CPAP, I'll be able to kangaroo him! I can't wait. I'd give anything to hold these little boys in my arms...
Mitchell- although Mitch had to be taken off CPAP and put back on the ventilator due to his carbon dioxide levels being too high, he seems to be doing well with it. He spent 24 hours off the bilirubin lights and was put back under them this evening. The nurse was able to successfully place his PICC line and so his umbilical line was removed. This is great news! As soon as he is back on a stable CPAP we can kangaroo him too. He had his first heart ultrasound which showed only a small opening which should close on its own and does not need medical intervention.
Elias- this little guy is our stinker! He is super active and curious. He was doing well breathing room air oxygen but due to his excitability he was risking damage to his lungs so they put him on an oscilator and have kept him sedated. Even through his sedation he responds to our voices and touch. His heart ultrasound was like Mitchell's- small hole still but its normal for his age and will resolve on its own. He too was off the bili-light but is now back on. We can expect that back and forth with the bili-lights to continue for the duration of their stay.
All three boys are getting head scans tomorrow to look for possible brain bleeds- standard procedure for preemies this age. Also all three boys have been introduced to my breast milk. They are getting 2-3 ml 3 times a day. In addition they are receiving mouth care with my breast milk to help fight infections that can occur in the mouth.
We took Jordan to visit his little brothers today and it went well. He got to touch Mitchell and hold his hand and foot. He seems so excited about being a big brother.
My breast pumping is gong extremely well too. I am averaging a total of 60-110 mls each pumping session. The nurses have said that most moms are only producing 20-30 mls at 5 days post-partum. I guess my body knows it has to produce 3x as much!! :)
Well that's where things stand today. As we are learning, things can change quickly in the NICU. But overall progress is being made and the boys are doing well. Thank-you for continuing to pray for them- it's so comforting to know that God is watching over them.
Today my beautiful little boys are 2 days old! It's impossible to keep up with every little detail of their care in the NICU especially because it changes almost hourly, but I can say they are each making progress in their own way.
Nathaniel is responding positively to the treatments for his swelling and excess fluid. They took him off the oscilator today and onto a regular ventilator and he is doing well with the transition. I got to see him open his eyes today for the first time when he heard my voice. It was precious!
Elias lost a couple oz of weight from yesterday to today but that is normal. He pulled his tube out and didn't tolerate breathing very well without it so they had to reinsert it. They attempted to insert a PICC line for him today too and did not succeed. He had a rough day. But he responded to my touch and calmed down when I had my hands-on time with him. I also got to help change his little tiny diaper and help weigh him.
Mitchell is still our strongest at the moment it seems. He pulled his tube out today too and did so well without it that they now have him on the CPAP machine with no tube. He spends his day under the bilirubin light which all three are now under. Because he has no tube down his throat I actually heard him cry today. It was a little tiny meowing kitten noise.
Tomorrow we will be dismissed from the hospital which I am both looking forward to and nervous about. Luckily we live so close that I'll be able to come back and visit the boys in the NICU as much as I want.
Matt has been such an absolute rock for me these last few days. He spent the day, Christmas Eve, running around getting me breast-pump supplies and even now as I write this he is out getting me Papa Johns pizza because I can't fathom one more night of this hospital food! lol... He bought the boys Christmas gifts today- little winnie the pooh stuffed rattles and a sheriff woody doll especially for our sick Nate. So sweet. He has been by my side and I am so grateful for his love. He is an amazing daddy already and I love watching him interact with the boys. I am a lucky woman to have found such a great man.
As for me, I am healing ok from the surgery. More pain today than yesterday, but holding up. I have been diligent about using the breast pump every 2-3 hours and my hard work is paying off. I'm already producing 30-40mls per session. That milk is like liquid gold to the health of my baby boys and I'm really looking forward to the being able to take it.
I miss Jordan though and am looking forward to spending time with him this coming week. We are delaying our Christmas present opening to Monday but I guess that makes it more special. He called me today and it absolutely made my day. He is such a great kid. I'm a lucky mom. And on that note, a tired one. Thanks for all the prayers and I will continue to update as I can.
Merry Christmas to you all!
Let me start by saying, "The babies are here!!" Surprise! Everything happened so fast...
Our last doc appointment was Friday the 17th. At that appointment we knew that Baby B, our Nathaniel, had a cord issue where the pressure was a little high. The docs wanted to keep an eye on it but we were told that it was probably not a big deal in the scheme of things. So on Friday when we saw our regular OB he checked out my cervix and said it was strong. He put me on the contraction monitor and saw that I was having minor contractions (so minor I had no idea thats what they were until I saw them on the machine!). He sent us home and basically told us not to worry. He said if the contractions got stronger to give them a call. So over the weekend I did notice that the contractions seemed stronger but I thought maybe it was because I knew what I was feeling now that I'd seem them on the monitor. But I tried to take it easy and rest. Monday night, or I guess early Tuesday morning, I got up for a routine bathroom run at about 3am. On my way back to bed I felt a gush and hurried back to the bathroom. I immediately knew that I just passed my mucus plug. Which meant that my cervix was no longer strong. Big change in just 3 days.
First thing in the morning Tuesday we called the doc office and told them what happened. They had us come in and found that I was indeed dialated 1cm and contracting pretty strong every 5 minutes. After a quick in-office ultrasound to check on the babies' heart rates, we were sent directly to the hospital with instructions to administer drugs to stop labor. So we got the hospital and they gave me a steroid shot to help mature the boys' lungs and put me on magnesium sulfate which let me tell you, SUCKED. It made me so uncomfortable and hot and nauseus. But the contractions slowed and a few hours later when they checked I was still only 1.5cm dialated. But they wanted to do a more thorough ultrasound for the babies to check their cord flow and weights and see how they were holding up against the pre-term labor I was experiencing. Well what they found was quite a shock. First, Nate's cord issue had gotten worse to the point of almost absent flow. Not the regurgitation that we had feared yet but getting close to it. And on top of that he showed fluid collecting in his abdomen. That was a huge red flag. So immediately the talk went away from stopping labor and into how many days can we keep these babies in there before Nate's issue forced us to deliver. We thought we may have anywhere from 48 hours to a week at first. The problem is that it had accelerated so fast we didn't know if that rate of acceleration would continue. And if it got worse it could potentially kill him. And worse yet, if it killed him, because he shared a placenta with Eli it would put Eli in immediate danger as well with anything from neurological damage to killing him too. So the potential of losing two of our precious boys suddenly was upon us. Wednesday morning, early at 1am, they administered a second shot of steroids to me. At this point we knew delivery was imminent but we weren't sure how close. We wanted the steroids to have time to work but we didn't want to wait too long to deliver for the fluid issue to become even more serious.
Wednesday mid morning we had another ultrasound to check on the progress of the issue and found it had gotten worse. The cord flow to Nate was now completely absent, Eli's cord was showing stress, and Nate's collecting fluid level had gone up. The doc took one look at the report and said, "We've got to take these babies out now. Be ready in two hours for surgery." And that's exactly what happened. At 2pm on Wednesday 12/22/2010 we started the c-section procedure. Within the hour our boys here here!
First out was one of our twin pair - Nathaniel Robert. He went from being our smallest baby just a week earlier to our largest baby because of the extra fluid he was carrying. He was born at 2:50pm weighing 2lbs 11oz and his length was 14 1/2 in.
Second out was twin #2 - Elias Matthew. He arrived into this world at 2:51pm weighing 2lbs 9oz and his length was 15 1/4 in.
Lastly, our "singleton" Mitchell Henry at 2:52pm weighing 2lbs 4oz and length of 14 inches.
The last 32 hours have been quite the rollercoaster ride. The boys were taken away at the surgery before I even got to see them. Matt was able to watch them be born and he got to go to the NICU a couple hours after their birth, but I was recovering from the surgery was wasn't able to see them until this morning, the next day. Mitchell so far seems to be our strongest little guy. He's been on and off the ventilator a couple times when he's been strong enough to breath room-air. Elias is doing ok too and already receiving fluids intravenously for nurishment.
Nathaniel is still struggling and has a bigger battle to fight at the moment. He is slowly eliminating the extra fluid from his body but its a slow progress. He's also showing swelling in his head but the doctors have assured us that this is not part of the extra fluid, rather normal skin swelling as a direct result of the extra fluid in the belly. It is scary to see him, and all three of them really, hooked up to all these wires and machines that are helping them to breathe and stay alive. And we've been told that the NICU ride is full of ups and downs that can change from hour to hour. Overall however, the news with them all has been positive. While Nate is struggling with his blood pressure, the good news is that the medicine they're giving him to correct it is doing an excellent job and the docs seem to think his fluid should be elminated within the next 24-36 hours. Mitchell spent some time under bilirubin lights this afternoon to fight jaundice but he's already seeing improvement. Elias looks so strong and has opened his eyes the last two times we've been in there. He grips everything and also spent some time breathing room-air today. So overall the progress and outlook for all three babies is good.
Here are some photos of the boys thus far...
Well we're in our 28th week and things are getting tougher physically. Everything hurts. Sleeping is near impossible because I am so uncomfortable no matter how I position myself. Rolling over from one side to the other and getting off the couch (which is where I am most comfortable sleeping these days) are such monumental tasks. My hips and shoulders are sore from being on my side so often. Breathing is difficult, especially as my heart rate is constantly at around 100bpm. My acid reflux is so bad that my throat hurts all the time now, not just when I lay down, despite the many Tums and acid reducer pills I take. My midback spasms all the time and there is no relief for that, whether I am sitting or laying down. My hands feel like I have arthritis and my feet swell anytime I am not laying down. And one of the boys, I think its Elias, has a part of his body crammed into my ribcage on the right side which now feels like a cracked rib. It hurts to take a deep breath or to lay on that side. There are some nights when I am so tired and uncomfortable I just wish this pregnancy would be over. But then I check myself and say a little prayer and ask God to help me get through it because these little babies need time to grow! Every day they can stay in the womb makes a difference for them at this point.
At 28 weeks I am now 44.5 inches around and my fundal height is full term. I have gained just over 30lbs and it is ALL in my tummy. At my last OB appointment they put me on the NST monitor and it showed that the pains I've been having the last couple weeks are indeed contractions. But the good news is that the contractions haven't affected my cervix. It is still strong with no signs of thinning yet. I passed my glucose test with no sign of gestational diabetes and my blood pressure continues to be normal. The babies at this point should all be over 2lbs but we'll have an official measurement at our perinatologist appointment tomorrow. Although I still am getting bumps and jabs, the babies' movements have slowed down a LOT. I can tell they are getting crowded in there. And Baby A is getting harder to detect because he is tucked so far under the other two. As much as the movement can be bothersome at times, I hate that its slowed down because now I worry constantly about losing one of them in utero.
So yeah, this time in the pregnancy has proven to be quite stressful and uncomfortable but I know the reward in having these three precious boys is just around the corner! To end on a positive note, here are some recent photos of me...
So we went back on Monday for another measurement of the babies. This time we measured only their fluid level and dopplers. Baby A and Baby C are doing great! They are right on target for weight and fluid and blood flow. Baby B, our little guy, is showing some stress in his umbilical cord. That means that the cord itself is constricting the blood flow to the baby. The analogy the doctor gave us was like a pinch in a hose... if you do so the water pressure goes up. Right now that pressure, while elevated, is not too severe. Now this could stay at this level for weeks or it could deteriorate quickly. We go back for another measurement Tuesday the 21st. If it has gotten significantly worse they will put me in the hospital to monitor him more closely. If they see any sign of regurgitation, where the blood flow is actually forced backwards, they will probably deliver these guys. The trick is to find the "sweet spot" where they are not in the womb so long that one or more of them suffers, but also not deliver them so early that they suffer too many prematurity issues with their brains, hearts and lungs. The good news is that I'm far enough along now (28 weeks tomorrow) that if they should be delivered now they would make it. It would be a tough road with many weeks in the NICU but they would make it. That being said, please send up a prayer that this cord issue does not progress to something worse and they can continue to cook safely! I would love to carry them until the end of January!
Well we've made it to 27 weeks! I can hardly believe how fast the time has gone. The boys will most likely be here just next month! My goal is 32-34 weeks and that puts me in the last two weeks of January.
This week we went to our perinatalogist. The last appointment we had there things were going so well that they didn't have us come back for 3 weeks instead of the normal 2 so it had been awhile since we'd had pictures and measurements of the boys. Well this appointment dealt us our first true worry. It seems Baby B, our Nathaniel, has slowed his growth rate compared to his brothers. He's always been the small one and he's not THAT far behind but the doctor wants to watch him closely. We go back on Monday for another measurement and weekly after that to plot his progress. Because he shares a placenta with Baby C, Elias, its ultra important to catch any major discrepancies in growth so it doesn't adversely affect the other twin. The good news is that the fluid levels on all the babies looks good and thats a sign that they are all getting enough nourishment. Its actually normal in multiple pregnancy for the growth rate to slow down about this time.
So I've been put on bedrest, albeit not STRICT bedrest merely rest as much as possible with no major activity. I'm working hard to eat and drink as much water as I can get down. Matt's parents put together a bunch of meals for us and brought them over today so I don't have to worry about cooking anything. And Matt has been really great about making sure I'm taken care of. I feel very blessed to have such support!
One of the boys, not sure if it was Mitchell or Elias, got the hiccups last night. It was the first time I've felt that with this pregnancy and it was so cool! Although it seemed to go on for a long time (like 20 min) so I started to feel bad for the little guy. I'd hate to have the hiccups for that long! Anyway, it was just a wonderful reminder that I'm growing real live little people in there. :)