Sunday, February 25, 2007

Three Week Well Baby

We had our three week check up with Dr. Troy on Friday afternoon. The babies are doing great! Noah weighed 6 lbs 15 oz (25th %tile) and was 20 inches long (50th %tile) and his head was 13 3/4” (60th %tile). Nathanial weighed 5 lbs 12 oz (almost 5th %), was 18 ½ inches (~20th %) and his head was 13 ¼” (20th %). Ethan weighed 5 lbs 15 oz (almost 5th %), was 19 ½” inches (~20th %) and his head was 13 ½ (20th %). They all gained about a pound since we last went, which was at one week. They are putting them on a different chart since they are preemies that goes by gestational age and compares them to others at that same age, instead of just a full term baby chart. Which makes me feel better because it seems more accurate. All three have thrush, which I believe started with Ethan about a week ago, but now they all have it. Ethan and Nathanial don’t mind the medicine at all…Noah does not like it one bit. It smells like bananas, so it shouldn’t taste too bad, but Noah makes a horrible little face with it and doesn’t enjoy it at all.They are all eating well. I am no longer nursing any of them…it got to be way too much once we were home with everyone. Nathanial and Ethan have a “preemie suck,” according to the LC, which in my words means they DON’T suck at all. Ethan is especially horrible. He is really slack jawed and won’t even latch onto a bottle. We wanted Ethan and Nathanial to be fed from a bottle because of their weight issues, so we would know exactly what they were getting. It became much easier to pump for all three of them once I quit doing those two, plus it is less frustrating because I know exactly what they are all getting. So now I pump after every feeding, except their 4 am feeding, because Steve takes that one so I can sleep (I take the 1 am feeding). They get about half formula and half breastmilk. I feel extremely guilty about this, but I am reminding myself there are three of them and they are at least getting some breastmilk. And at this point, I am having a hate-hate relationship with the pump, so it is really pretty good that they are getting any breastmilk. I just cherished that relationship with Aidan and I was so sad when it ended, as was he, but I am quickly discovering that bottle feeding is as rewarding if you take the time with each baby AND it has the bonus of other people being able to help with feedings. Which is VERY nice! Nathanial and Ethan still take forever to eat even from a bottle, but Noah downs it pretty quick. Noah makes up for it in that he will not just be put down when he is finished eating…he wants to be held and snuggled. Noah really is our high-maintenance baby. A few nights he has decided that 1 am is the time that he wants to stay awake for a while and has been up until 3 am. Not fun at all. That does not make for a very happy mommy. Nathanial is the one who likes to be with others. He knows the second he is alone in the crib and he will cry if he is. We are concerned about what happens when we move them into their own cribs, but hopefully by then he will be ready for some room of his own. Right now, though, he isn’t. We have been keeping them all on the same schedule. When one wakes up to eat, then we get up the other two to eat as soon as we are finished. Twice now I have had to figure out how to feed three at once, which actually worked better than I thought. None of them would be held off at all and all were screaming to eat at once. As for me, I am doing great. My incision still isn’t healed in a few spots, but it also isn’t infected so that is good. I keep going back to Dr. Hintz for him to check it…I don’t know what he is planning if it doesn’t heal. I am very proud of myself. I am currently down 65 pounds, which means I weigh about 50 pounds less than I did prior to pregnancy! I weigh less now than I did when Steve and I got married! I am so thrilled and so determined to keep this up. I am just waiting for the go-ahead to start exercising and hoping that will help to maintain this weight loss. We have had so much help from everyone at church with meals and people stopping by to help with the babies in the morning after Steve goes to work. Both have been so helpful. We get meals every day of the week, except Wednesday and Thursday…we need some leftover days! Then my MOPS group brought us an entire freezer full of meals. We haven’t touched those yet because we are still getting church meals, but they look so good! Just not having to cook has been immensely helpful! Our neighbors are also still a huge help. Mary comes over on Thursdays to help me with the boys during each feeding, takes Austin to school and picks him up, plus she takes Aidan to the baitshop still and takes him when we have appointments. I do not know what we would have done through the pregnancy, hospital stay, or even now without them. We have been so blessed with all the help we are getting from everyone. It makes it much easier to manage when we don’t have family to help nearby.The newspaper (Sumner) came this week to do an interview for the paper on us. We are interested to see what is printed as she wasn’t here very long and didn’t seem to get a lot of information. I guess we’ll see. We figured enough people have told us they are getting asked in public about us it would be a good idea to do the article and then everyone can see them. I am still trying to get pictures posted. For some reason it is telling me I am trying to post something that isn’t a picture. I will keep trying, but if I can’t, I will set up an account somewhere else to put the pictures. We have gotten some really cute ones of the boys. We got one last night at the 1 am feeding of Noah and Nathanial laying next to each other, with Noah’s arm around Nathanial. It is so cute!

Saturday, February 10, 2007

Nathanial, Ethan, and Noah's Birth Story

I went in to my ob on Wednesday and he wanted me to go back on Friday to make sure that nothing would skyrocket before scheduled delivery day of Tuesday. So, I went in on Friday afternoon expecting that everything would be fine, it was only two days later, and I would just go home. I didn’t even have my bag packed yet!I got to his office and I had gained four pounds in two days, the protein went from a +2 to a +3, and my blood pressure was 158/108 the first time and worse the second. He said that from the last few 24 hour collections, he knew the protein was a lot higher than what was showing up in his office, so he had me go over to the hospital. He was already there, his nurse just called him to let him know where everything stood. He said at that point, I would be in the hospital until Tuesday, if I lasted that long and he maybe would plan on delivery that day. He did two more protein checks in the hospital within about 45 minutes and then came in to see me. He said that my body had definitely become toxic and we needed to deliver that evening. He got staff rounded up and said there were two pediatricians on call and it was up to them who would take on our babies and where we would end up delivering. At that point, both Steve and I became really upset because we really wanted to deliver at our hospital and we all knew it was safe to do so at 35 weeks. He came in and did an ultrasound and the boys still looked pretty good, except who turned out to be Nathanial was not making any breathing movements anymore. He was still active, though and was safe for the time being. The other two babies were fine. Then he left for a while and came back and said he was transferring us to Iowa City. He had talked to the pediatricians on call…one had three babies already in the NICU and didn’t want to take on any more, the other had one baby in the NICU and refused to take on three more. Since we had no idea what kind of care they would need, it became a necessity to be transferred. I know my doctor could see that I was near tears and he wasn’t a whole lot happier. He told us the silver lining was that noone would be transferred and everyone would be left together. He also said if it made me feel any better he felt worse than we did. When I asked him point-blank what kind of lung problems they would experience, he said he had no idea, but it was MUCH safer for them to be out than in. I begged him to let us wait until Tuesday to see if anything would change and they would improve, but he just said that in his opinion, they needed to be delivered immediately. He said Iowa City may differ and do two steroid shots and then deliver on Sunday, but he felt that was riskier than their lung development.

I left that hospital by ambulance and Steve followed us to Iowa City at about 6:15. We arrived in their labor and delivery at 7:05. They hooked us up to monitors, but couldn’t tell if they had all three babies or only one or two (which is why my OB didn’t do monitors and did an u/s instead), so we really had no idea how all the babies were. A ton of different 12 year olds, oh, excuse me, medical interns, residents, and students, came in to tell us different things and an anesthesiologist came in. They told us that they would be doing the c-section around 9:00 and would do a spinal. The anesthesiologist came back in 20 minutes later and said since it was my 3rd sections and there were triplets, they needed to do an epidural because they weren’t sure how much damage there was and how long it would take and he needed access to put in more meds. Then he came back AGAIN and said they were going to do both. At around 10:00 they came in to tell us that we had been bumped because there was a mother whose baby was in distress. Then the teeny bopper came back in, oops, medical resident, and asked me if in the other two pregnancies I had ever needed magnesium sulfate. At that point, I panicked. I said nope, my pressure always went way down within a day or so of delivery. She said she was doing the mag. Finally her chief came in and discussed with me feelings on mag. I said I would rather wait and see than just profalactically do it and she agreed with me. So I was then scheduled for 11:00. At 11:15, they came in again to tell us we had been bumped, again, and we would go at 12:00. Around 10:30, I started to panic and just completely broke down and told Steve there was no way I could do this and I just wanted to go home. I begged him from 10:30 until 12:55 to just take me home and let me just forget about doing this. We were bumped again at 12:00, and then finally around 1:15, they came to take me back. They put in ½ a spinal dosage, and then started the epidural. Apparently my epidural space is really small, though, so the anesthesiologist had a really hard time finding it. Finally something clicked and he got it in. I haven’t seen anything on my back, but Steve said it is black and blue and there are about five different holes that he can see where he attempted to put in the spinal/epidural and couldn’t.

I don’t know when they made the first incision. When I first went into the room, it was just me and two nurses and the anesthesiologist, his chief, and two equipment people. When Steve came in, he looked at me and said there were a ton of people in the room. We knew there were a neonatologist, respiratory therapist, and four NICU nurses per baby, plus all the other doctors and students and nurses and everyone. It was amazing, but I still don’t remember there being that many. There were four doctors/residents just on my stomach alone, two at the top and two at the bottom that I could tell. Steve and I believe the chief ob was the one to actually pull out each baby, but the residents did the incision and all the rest.At 1:54 a.m. Nathanial Steven made his screaming arrival at 4 lbs, 9 oz., and boy was it wonderful to hear him scream!! At 1:55 a.m., Ethan Jacob made *his* screaming arrival at 5 lbs, 3 oz., again tears of joy and relief. At 1:56 a.m., all odds were beat and Noah Robert made *his* screaming arrival at 5 lbs, 12 oz. Apgar scores were 7/9 for Noah, 8/9 for Nathanial, and 9/9 for Ethan. Ethan was taken to a transitional NICU for two hours to observe breathing patterns and then put in the normal baby nursery. Nathanial was sent to Level 3 NICU until Saturday evening due to grunting, but he never had any supplemental oxygen and did just great. Noah was in Level 3 NICU until Sunday night. He had grunting that was severe enough to need a CPAP (a little tube inserted in his nose to provide positive pressure into his airway to help him learn to breath), but that was removed after only six hours and then he was on a nasal canula (normal little nose tube thingy) all of Saturday and they removed all supplemental oxygen on him early Sunday morning. He did well enough Sunday to come to join the other two boys and mommy Sunday around 5:00 p.m.

Nathanial Steven

February 3, 2007

1:54 am
4 lbs, 9 oz
Ethan Jacob
February 3, 2007
1:55 am
5 lbs, 3 oz
Noah Robert
February 3, 2007
1:56 am
5 lbs, 12 oz

The resident in charge decided that she wanted me on the mag immediately after delivery. I was told if I had output of more than 200 for 4 hours straight and my bp decreased, they would remove it. Unfortunately, that never happened and I honestly believed that I would never get off the stuff. Plus because I was a seizure precaution (due to severe Toxemia), I was not allowed anything to eat or drink while I was on the mag. I also had to remain in bed, which meant that I was unable to go see either Noah or Nathanial. Thankfully, Ethan was able to spend much of that time with Steve and I. I never had enough output and my bp stayed way up, so I was on the mag for the full 24 hour course. I did have Steve go take pictures of the boys as soon as possible, but it didn’t really look like them when I actually saw them.
{Austin meets Ethan.}
{Aidan holds Ethan.}

At 2:00 a.m. Sunday morning, I was able to be moved to the mother and baby ward and also go visit Noah and Nathanial. The nice thing about the NICU at that hospital is each baby has his own room and nurse. So they really knew the babies and were really good about answering all of my questions. And they didn’t have ‘visiting hours’ so it was just fine that I showed up at 2 am to see my babies. They would not let me hold Noah, but I was able to hold Nathanial. That was wonderful.
{Mommy holds Noah for the first time}

We had problems with jaundice with all three of them. Nathanial never needed the billi lights, thankfully, but got close. Ethan was the first on the billi lights and he did great, just slept through it. He was on them most of Sunday. Noah was on them Tuesday and he HATED them. He made it known, too. He just sobbed and sobbed and then when I thought he wanted to eat, I took him out, but he didn’t…he just wanted to be held. Poor little guy. I felt so bad. Nathanial then had some trouble keeping his temp up (they all did, but his was the worst), so they had to run a bunch of labs to rule out infection and he was fine.
{Aidan welcomes Nathanial to Mommy's room.}
{Austin bonds with Nathanial.}

We have had a wonderful experience with nursing so far! Since Ethan was the only one in the “regular” nursery, he was the one to first latch and we decided to syringe feed him just in case something didn’t work with the other two. Nathanial was the next to try and he did a great job also. When I knew that Noah had been given bottles for 48 hours, I didn’t expect him to latch and really thought that he would be my trouble nurser. Turns out that he has the best latch and suck of all three of them and he is the one who is almost 100% nursed at this point. While in the hospital during the day, I would nurse all three for every feeding, then pumped. Then at night, they would go to the nursery and get ebm. By Sunday night, all three were exclusively on all breastmilk. Since we have gotten home, I didn’t have a chance to pick up my pump, so we did have to do a little supplementing with formula, but I am back up to stock piling and they shouldn’t need any more formula for a while. I have been super amazed by my production! I am getting between 4-6 ounces at each pumping! It is amazing to me how our bodies provide. And God to make our bodies realize how much it needs. The lactation consultant was thrilled that I was able to show all the nurses and residents and doctors that it is possible to nurse three babies and provide enough ebm for all of them.

We had asked before the section if they would know who were the identical two and they said not without a pathology report. So we went ahead and ordered that. As predicted, the two placentas had fused together and that wasn’t going to tell us anything. However, immediately upon sight, we knew who was who. Nathanial and Ethan look EXACTLY alike…we have yet to find any difference. They both have real dark hair and a lot of it. Noah is very blond and has really short hair. With hats on, you can’t tell any three apart, but without it is easy to tell Noah from the other two. So far we have left bands on and are trying to figure out a way to tell them apart. Someone said fingernail polish or initials on the feet, but that isn’t easy when you have sleepers on. So we are keeping Nathanial in yellow and Ethan in green for now.

Things are going well. We arrived home last night and it feels so good to go home. The boys have their first doctor visit in an hour and I get my staples removed on Monday. So we are still busy.

Austin and Aidan have both been very excited with their new brothers. They fought over who got to hold Ethan on Saturday since he was the only one they could hold. It was easier when we had Nathanial and Ethan with us, so they could each get a baby. Now they both have colds, though, and really want to hold a baby and can’t. I am hoping they are better soon. Aidan has been fascinated with watching the babies nurse and me pump. When he first saw Ethan nurse, he said he used to do that. Then he said that when Ethan was finished, he would have his turn. He actually did well when I told him he couldn’t. Since being home, he loves to sit next to me when I pump and “help” me pump. It actually probably does help some, also, but he is just funny. Then he wanted a taste of the milk I pumped, but settled instead for a sniff. So if he is around, he is my sniff tester to make sure all is well. He has been much needier and had some issues with not wanting to be away from me and wanting us home, but all in all, he’s been excellent. Austin has done so much better than we expected! He is really excited about the babies and has been awesome!

Thank you everyone for all of your prayers….it is such a miracle that they needed such little NICU time, so few interventions and are all home after a week!! God is great!!!

{Our Three Burritos - comfy at home.}
Nathanial, Ethan, Noah