Praise the Lord!!!

{l-r Hannah at the beginning of the journey in September and Hannah now}

Hannah went back to Iowa City today for another follow up with Dr. A and Dr. V. It was awesome!!! She is just doing amazing.

When she started this journey in September, she was 26.4" long (had not grown in length since June); her head circumference was 16.9" (had not increased since at least April); and her weight was 14 lbs, 2.5 oz (very slow gain, if at all) and her BMI was 14.3. She was well below any percentiles on the chart and, if you are familiar with BMI, that is well below a "healthy" number (normal is at least 18.5 and anything below 19 is underweight). She grew and grew and grew and NOW her numbers are so much better - it is sooo exciting! Her height today was 29.2" (that is almost THREE WHOLE INCHES in four months of the feeding tube!!!!!!!!!) and she is at the 8th percentile for her length compared to SAME AGE toddlers!! Her weight today was 19 lbs, 9.6 oz (that is FIVE and a half POUNDS!!!) and she is almost 3rd percentile....definitely within spitting distance! Her head circumference was 18" - almost TWO INCHES and puts her at the 30th percentile for her AGE!!!!!!!! That was a HUGE jump, especially since her head had not grown - at all - since at least April!! Soooo exciting!! Her BMI today is 16.15, which is still technically 'underweight' but definitely not as alarming. The most exciting part for me is seeing how she is doing on the overall chart...where she lands for her height and weight, irregardless of age (in other words, with peers who are the same length/weight combo as her, but not necessarily the same age) and that was slightly OVER the 25th percentile!!! And she did ALL THIS in only FOUR MONTHS on the feeding tube....God is soooo good. With phenomenal numbers like this, it is impossible to ignore the miracle of the Great Physician's Hands and to Him goes ALL the glory!!!

When we first put the tube in, both Steve and I were under the impression (prior to hospitalization) that it was a very short-term solution and would be completed within 6-8 weeks. We were told something quite differently when we actually were in the hospital and spoke with the doctor and dietitian. They both told us at that point that 6 months was way too optimistic or even realistic of a goal, but we could shoot for it as long as we were not disappointed if it didn't come out then. They both felt that, realistically speaking, she would need the tube for at least twelve months and probably more. We went with that because they are the experts and the ones who deal with these babes all day, every day. So that has been our goal this entire time - get it out in twelve months, but if she wasn't ready for it to come out then, then we would be OK with that. When we got home and I researched it, we found out it was a very real possibility that she would never outgrow the need for supplemental feeding and may eventually need a g-tube (one that goes directly into the tummy). It is super common for babes with reflux and other issues that cause growth problems. I was not willing to accept that for Hannah, but it has always been in the back of my mind. Now, though, we were told that if we wanted to do a trial run without the tube, with the knowledge that if she didn't do well it would go back in, we could try it. Dr. V feels that Hannah has probably recovered all lost weight, length, circumference, but there is a small possibility that Hannah has more growth in her. Because of that and because Hannah is just now starting to really do well feeding orally and on her own, we decided to hold off. So the new plan is to see if we can recover any more growth between now and April 2nd and at that time, wean off the feeding tube completely. That is just astounding to me....that in less than six months, she may be done with it! Again, all glory to God who has healed her!!!

Hannah has done so well through all of this that Dr. V actually uses Hannah in her lectures! She said a lot of the medical community still believes that lack of normal physiological growth (aka failure to thrive) is always due to neglect on the parent's part. She said that she uses Hannah constantly now to prove that when parents are willing to do whatever is necessary medically, are intelligent and on board with doctors, instead of bucking them the entire way, that great things can happen. That is still not to say that all children with LNPG are all products of parents that aren't on board, either. She just said it is much easier to prove that this can happen to normal children in a healthy family and parenting situation and when everyone works together for the good of the child, amazing growth can happen. She said often parents are so angry when it is suggested and refuse to do it, so then DHS ends up getting involved and then parents won't do what is necessary for the child, either, so then they don't end up growing either. She said that she can tell with 100% accuracy that Hannah's issues are completely related to reflux and not at all related to "social issues." It was very vindicating to hear that from a doctor and she kept telling me what a great job I was doing and that I deserved congratulations, also, but I am only doing whatever is in my power to do for Hannah as her mother and praying over the rest of it so that God can restore her health in ways that only He can. It breaks my heart that there are parents so angry at "the system" that they fail to see what is necessary for their child. This was not an easy decision for us to make. This was not easy for me (or Steve) to hear that it was needed. It definitely seemed radical at the time. However, God gave me a great peace about it all when it became obvious that it was needed and He has since showed me over and over that we made the right decision for Hannah. And that's all I wanted...was a little reassurance that we didn't go outside His will through all this and we were doing what was medically needed through the doctors.

I am so excited to see the amazing strides Hannah has made. It just leaves me in awe of what is possible!!

Surgeries....Again.

Nathanial, Ethan, and Noah have been in speech and development therapy for almost a year now (wow!) and so it was time for their bi-annual hearing screens to go with their evaluations for their IFSP's. Nathanial passed his, but was right on the line of a need for a medical referral. The general consensus was, though, that he is hearing well enough to be at a learning level. So he was ultimately not referred on, which was good because he just got a new set of tubes a few months ago. Noah failed his hearing test massively - completely missing entire tones. He did not hear things no matter how loud they got. Ethan failed massively, also, but heard all the tones, just at very loud levels. So they were referred back to Dr. B for an evaluation.

When we went in, it was discovered that Noah's one tube fell completely out, the other was just barely in, and there was a lot of fluid behind both eardrums. Ethan's tubes were both in place, however they were plugged completely, so no longer working. He also had a lot of fluid behind both eardrums. We decided to go ahead with surgery for both of them.

They went in today and Noah knew when we got to the floor just exactly what was going to happen and started sobbing. I was able to distract him with a new blankey and teddy eventually. (I love the hospital that we go to for this - it is very progressive and very comforting for little people, especially considering it's in a town with a population of about 9,000 people.)

Ethan went first, which was a huge help because he doesn't have the propensity for drama that Noah does and he feeds off Noah. He got right in the little wagon and said "bye-bye" to me and was off. He was done in about an hour and Dr. B came in to chat with me. He had a ton of thick mucus behind both eardrums, which was drained and his adenoids were "huge." She feels his speech and hearing should be drastically improved now. His one tube was also fairly buried in his ear, so she had to do a little more "work" to get it out. She said we will probably see more bleeding from that ear than the other three ears and just to know that was why. As soon as they took Noah back, they came and got me for Ethan in the recovery room. He was saying miserably "mommy, mommy, mommy" over and over. Once I started to hold him, he did much better. We got in a lot of cuddle time while Noah was in surgery. Ethan also had/has some breathing congestion now, but they said that should clear up in a few days. He wasn't so bad that he needed a breathing treatment (like Nathanial) which was reassuring; they just heard a lot of "gunk" in his lungs afterward.

Noah went next and because Ethan went without much fanfare, Noah got in the wagon and said "bye-bye" to me, also. Noah had a ton of pus behind both eardrums, so was given iv antibiotics while also being given fluids (Ethan also received iv fluids). Dr B is not sure if he will ever get back some of the tones he totally missed (there was indication of damaged nerves from birth on for those tones), but they are "not tones he really needs." Interesting....

Noah had some dramatics coming out of anesthesia (as always) so one nurse came to cuddle with Ethan while I went back to recovery with Noah. He did better after I got back there and was able to hold him, but still had the little sobbing-breathing problem and would just break into more sobs on occasion.

Ethan drank right away and ate an entire popsicle, but Noah refused. He was not allowed to have the IV pulled until he drank 6 oz of juice and half a popsicle so they could see that he would indeed drink and not vomit when he got home. It took him a good 45 minutes to decide he wanted to go home bad enough to drink anything. As soon as he did, we were GONE.

This afternoon, both are rather hyper and not wanting to rest or nap at all. I believe they may be ramped up on pain killers, but they need to rest. They are recovering well, though, and really don't seem to be in any pain...by now we should be almost out of the effects of the pain meds they had at the hospital!

Hannah's Gaining!!

Hannah had her follow up today in Iowa City with Dr. V and Dr. A. It went AWESOME!!! I have been feeling very defeated and frustrated because it appeared her weight gain was very slow. She has been gaining three ounces a week every week since she was discharged and then she gained eight last week. She gained four ounces this week, according to their scale (it's difficult to say if this is accurate because it is best that she is weighed on the same scale every time at the same time of day in the same place, etc., etc.). So I told the nurse my frustrations. I felt that it should be more, as she is still eating table food, drinking calorie enhanced milk, nursing, and being tube fed. Dr. V came in and was thrilled with her gain. She charted it out for me (below) and said it was an awesome gain overall! Yay!! Five grams per day is maintenance and ten grams per day is weight gain. She was hoping/expecting Hannah G to gain ten grams per day....Hannah is really gaining eighteen grams per day on average!!! WooHoo!!! It made me feel so much better to see it all plotted out. Plus, not only is she gaining, but I'll explain the charts below which were all very encouraging.

Because she has gained weight, we are also going to increase her Pediasure feedings overnight. Now she will be getting 12 ounces over a ten hour period, which will continue to push her weight up, which in turn pushes her length up. Ultimately, she needs her length to be between 30-50th percentile and then her weight to match that somewhere on the chart. Baby steps - and we are getting there quicker than I prayed for!!

Miss Hannah G today - at almost fourteen months {in a few days!}.

The chart above is what Hannah had been doing. As you can see, she dropped drastically, then leveled out. And you are seeing correctly, at 12 months, she was below the number "12." Then, today, at almost 14 months, there was a huge uptake again!!

Above is Hannah's head circumference...from hospitalization on October 9 to today, November 13 (see the increase???).

This is Hannah's length - again, hospitalization to today...another increase!

One of the more exciting ones....Hannah's weight. See how much closer she's getting to the bottom of the chart?!?!?!!! We're almost at 3rd percentile!!! The first "X" is her birth weight percentile for comparison...that's the percentile mark we're shooting for to get her off the tube.

The best one by far....her weight to length comparison. She is now on the chart!! Which means that, proportionately, she is doing super!!! Finally they are matching up somewhere on a chart!!!!

Hannah and Austin and H1N1

Sometimes it seems life gets going and I forget to update...or I can't find two minutes in which to do an update. Last week was a crazy busy week.

Hannah has had her NG tube for over a week now and she is starting to adjust to it. She pulls it regularly at night, but she leaves it be during the day. She no longer has to use her arm restraints during the day and that is a huge relief. We got a lot of looks over that one, but it was the only way to keep the tube in! She started getting smart at night and she will wait until I am out of the room for a while and then remove her arm restraints. She does still wear them at night because otherwise she will pull the tube out. Most of the time she leaves the tube be, even without restraints on, during the night, but if she wakes up in the morning and is left alone, she will pull it. And she's getting very quiet in the morning, so you are never quite sure when she's awake and when she's asleep. My solution to that has been to get her up and out of her room as soon as I wake up. A few nights ago, she got very smart and we still can't figure out how she did it. She pulled her tube out - with both arm restraints on. I have no idea how she managed, but she did. The next night, she pulled it out, with restraints on, at the beginning of her feed. I went in like I usually do and checked her three times. I just checked to be sure it was still attached to her cheek, because she was kind of laying on it. She pulled it and I had no idea. I even went in and checked it again, plus then checked it when I disconnected everything and flushed her line. Steve woke up and went in to get her and her hair was matted to her head and her jammies and sheets were full of Pediasure. I now turn her over when I go in to check on her to be sure it is still in place.

Other than the fights over leaving her tube in place at night, she's doing pretty well. The triplets have not once attempted to pull it out. I am so pleased with that! Noah was checking her out the very first day and I told him "No, that makes owies for Hannah" and he has since left her completely alone. He even told Nathanial "no...owies!" one day just for looking at Hannah! It is so nice to not have that worry!

Austin was home all last week with influenza A. He said he was sick on Monday, but he's been having a lot of anxiety again lately so I assumed it was that sort of sick. I left him be, but he didn't really perk right back up around 9 like he usually does. Monday night, he started sounding awful and went to bed by 6:30! Tuesday he woke up and was just miserable and I knew he couldn't go to school again. So I took him in to the doctor, figuring it was just a cold but I knew we needed an excuse slip if he was going to miss two days. And it wasn't...he tested positive for Influenza A. We've been told that they do not run the H1N1 test because it is so very expensive but that it is too early for the seasonal flu, so we can be relatively positive he had H1N1. He was immediately put on Tamaflu, as was the rest of the family so that we could avoid anyone else getting it.

On Wednesday, I took him back in because he was having a lot of trouble breathing and said it felt like someone was sitting on his chest. The doctor he saw then said to just increase his inhaler use and add Mucinex. I was a little frustrated because he didn't believe me at first when I told him he had tested positive for the flu; then he suddenly thought maybe he should be tested for the flu; then after about 10 minutes he finally understood and looked in his chart. He didn't understand my concerns about his breathing, either, but Austin has asthma, a heart condition, and a neaurological disorder...all of which put him at a much greater risk for complications from the flu. Very frustrating. He did seem a bit perkier for about an hour that afternoon. Thursday he had a few hours of perky-ness and he was back to fighting with me by Friday afternoon. He probably could have gone back on Friday, but I wasn't sure and just figured better to be safe than sorry. Today is his first full day back and he had a ton of homework over the weekend to catch up on. Thankfully, he's a strong student and in some very un-challenging classes so he won't take much to keep up.

Noah, Aidan, Hannah, and I all got colds out of the deal, but none of us came near what Austin had and I think Tamaflu helped keep it not so bad for us! Prayerfully, we will now have healthy winter season!

NG Tube for Hannah

Well, Hannah didn't grow as much as we wanted her to. I took her in on Monday and she was supposed to gain a pound by that point and another one two weeks later. Before the appointment, I was looking at her and thinking her new "diet" seemed to really be working...she looked bigger to me and more filled out. I was sure she had already gained the two pounds. Then I also ran through in my head 'what happens if she's close?' No need to worry - she wasn't. She gained eight ounces, which for her is fantastic, but it is nowhere near where she needs to be to be gaining weight. She can't even maintain at that amount of gain. Upon looking through her appointments in my own notes, I was able to look at exactly what she weighed when and looking at the actual number, instead of just paying attention to the percentiles (because I already know how bad that is), was rather alarming. Way back in March, when she would have been six months old, she weighed 12 pounds exactly and that was alarming way back then. That was when they started talking to us about getting a second opinion about her weight - they started worrying around four months old. Anyway, so she was 12 pounds in March and as of Monday, she was only 14 lbs, 13 oz. That is a gain of less than three pounds. In six months...on a baby! I got it when they went through everything with me in Iowa City and I totally understood why she needed the feeding tube. But since Monday there has been a part of me that has questioned whether she really needed the tube or if maybe we were rushing things too fast. I knew it was going to happen, but I still felt like maybe I was rushing it too prematurely. Now I feel like I haven't done enough sooner and she is greatly paying the price. Now I have the reassurance that we are doing the right thing, which I needed for total peace in this situation. Numbers do not lie.

After Hannah was weighed on Monday, I "discussed" it with the nurse, who royally honked me off insisting that Hannah was "just little," (um, no - it's really a lot more than that) and she "was proportionate," (which is the EXACT problem - she quit growing!!!) and every other manner of denial. Now I am OK with this coming from people who do not understand the entire situation and I am even somewhat OK with me having been in denial for so long because I am not a medical professional who has the entire chart with letters from specialists in it. Why am I explaining this to her??? I am having a hard enough time and I felt like just breaking down right there, but I couldn't, and there I was trying to defend the medical need for an NG Tube being put in my daughter. Like I want this! Like I asked for any of this!

Finally, Dr. B came in (who is awesome, I might add) and we talked about everything and since I did know what was expected, I knew what he was going to tell me. He then made the call to Dr. V (specialist) who then called me back the next morning with her admission plan.

Hannah will be admitted to Iowa City on October 7 at 8 am. She will be on the pediatric pulmonary/cardiac floor (not real sure as to why that is). She will get the NG tube and lots and lots of testing. Testing for CF, Celiacs, and anything else that might be helpful. Then I will need to learn how to reinsert the tube. I have no idea what this process entails, but I am positive it will not be pleasant...but I will do it because I just want my baby girl to gain weight and start to grow. At this time, she will be discharged on October 9.

We have already (per Dr. V's instruction) set up a home health nurse to come in when we get home and developed a preliminary plan of treatment with them. They will come often at first, then depending on possible diagnoses, they will develop a new treatment plan. If it's as simple as this is caused by reflux, then it will be often at first until we are very comfortable and then slow down as we get more confident. She will always have a nurse available on call 24 hours a day throughout this process.

We have no idea how long the tube will stay in and any other plans at this time. Please just keep us in prayers. I am terrified of inserting the NG tube and a little nervous about how the boys (triplets) will handle things. Steve will be staying home with the boys while Hannah and I go down, so prayers for that would also be appreciated. And we'll keep updated on here as often as we are able.

Hannah's Update

I know that I am way behind on blogs and I will continue to update them and let you know when I do, but I also thought that in the meantime, I'll move forward with what's going on now.

Hannah went to Iowa City yesterday for her appointment with a doctor who "specializes" in failure to thrive. Mind you, until last week, I had no idea she had actually been diagnosed as FTT. It was a term that had been used, but I was never actually verbally told that she was definitely FTT. I was a little taken aback, but it also was not a surprise by any means. So we met with a resident first, Dr. A, whom I really liked. She was with us for a while trying to rule out all the common little things that cause weight gain issues. We pretty much did rule them out. Then in came Dr. V (whom I also really liked) and she talked about other things, also, and we went through them and she ruled out a lot of things just by looking at Hannah and her past labs and chart.

First, it is not syndromic. If she had a syndrome - any syndrome - there would be some physical evidence of that and there simply is not. By physical, I mean outward appearance. She is very proportionate (which is why I wasn't concerned, but is the exact reason they are so concerned), petite-looking, normal in appearance. So it isn't syndromic.

It's not hormonal. All of her hormone levels came back well within normal ranges when Dr. B did them a while ago - when she first started showing signs of not growing/slowed growth. Turns out that was an excellent decision also because if we did those same exact tests now it would look like she does have hormonal issues because her body is so lacking. So she is not repeating tests and is going by what was tested four months ago because horomonal things don't change.

It's not social. I "appeared to be intelligent" and "willing to move forward" which are both apparently good signs that this is not our fault. She said a lot of feeding issues are social, but does not feel that Hannah's are a result of that.

She also assured us that Hannah's relatively good growth in the first four months of her life were prenatally driven. In essence, I had really good prenatal nutrition and Hannah benefited from that for the first four months.

There are other things that we are currently trying to rule out as causes. One being that she has been so ingrained from the pain of reflux, that now she is "afraid" to eat. So she is back on the Prevacid so that we can try to rule that out as a possibility. And she has gotten wise to it. She hates it and repeatedly spit it out last night, then left it in her mouth for a while before spitting it out again after I gave her a bit of food. This morning, to avoid this battle, I crushed it up and mixed it with a spoonful of oatmeal - she was none the wiser!

We are to boost her calories even more for the next four weeks in hopes that she gains 1.5-2 pounds. I couldn't imagine trying to do more but we are and she is doing OK with it. She really doesn't eat as much as I thought she was or she's getting fuller quicker because of the calorie and fat laden foods. She is now also getting a glass of milk at the end of her meals which is 8 oz whole milk plus 1/3 c powdered milk. We are also not feeding her during the night if she gets up. Surprisingly, last night she did very well with not nursing. I thought I would get more of a fight out of her. Dr. V believes that she may be "topping off" all the time instead of being really hungry and really full, so now she is on six scheduled meals per day with nothing at all after her last meal.

If she doesn't gain 1.5-2 pounds in the next month, then we go to "phase two," which is already written down as her actual course of treatment because unless there is a HUGE miracle (which we know there can be) she will not gain weight. She will have an NG tube placed in the beginning of October. I say "if," but Dr. V kept saying "when." As in, "when she's admitted, we'll do a,b, and c." Everything was "when." And I know that is more than likely the outcome we will have, but I am praying and believing for a miracle yet. If/When the NG tube is placed, she will be hospitalized (at University of Iowa) until I can learn how to take care of it and then she will go home. We were not given any estimation of how long she would have it....just that it would be in place until she got back up to 30-50th percentile range because that is where they believe (based on early growth curve) she should be.

At first, I had a very hard time accepting it...I mean, seriously, hearing your child is that ill and needs that much of an intervention is very difficult. And I was honest with Dr. V and said that the emotional side of it is VERY hard to digest, but intellectually, I know Hannah needs this and we are willing to do whatever it takes to get her to gain weight.

Right now, Hannah has "Grade 2" malnutrition; which is "moderate" malnutrition. When I saw her length slowing down and her head circumference slowing down in the percentiles, my un-medically-educated self thought that was a good thing and meant that she was supposed to be small. And noone told me differently (not that I pointed that out, because I never did - this all went on in my head). I was informed yesterday that when you stop growing in length that is the first warning sign. And I knew that from Austin - but I didn't know it was the same for babies. I don't know why I wasn't able to generalize in this situation, but I wasn't. The second, and more serious, warning size is a lag in head circumference. It means that her body has totally stopped and said "wait just one minute - when are we going to get some food going on in here??" (or something like that....I may be paraphrasing a bit!) It also can lead to learning disabilities later in life if it isn't turned around NOW. So now is the time to be aggressive.

While she is hospitalized (if), she will be tested for Cystic Fibrosis. Again, I was not a very well informed patient's mama and I hate appearing ignorant (which is why I am always researching stuff). When Noah was little he had a lot of respiratory issues from being a multiple. One pediatrician said maybe he had CF, and another one later on said no because he was tested. Soooo, I assumed that could not be the case with Hannah and did not investigate further. Turns out they only test for the major genetic forms of CF and not the minor ones. So it warrants being tested with this many issues.

Steve and I have, once again, begun our research into causes of this and another thing that sticks out as a possibility (especially the more we research it) is Celiac Disease. One of the first signs of Celiacs is FTT and cranky/clingy-ness, of which she has both. Now I know just because she has some symptoms doesn't mean she has it, but we are going to mention this to Dr. V to get her opinion the next time she sees her. We are also going to continue looking at other things (one thing Steve mentioned - which to me seems out there, but whatever - is a parasite...INteresting...)

So we now have a plan and will have an even better idea if she will need the NG tube when she goes to get weighed in a couple of weeks. We still need to figure out the root cause of it, in my opinion, but for now this has to be good enough. We'll keep leaning on God through all of this praying and believing for a miracle and doing everything we humanly can for her, but ultimately, this is all up to Him and what His will is for Hannah.

Surgery for Thano

We went back to the ENT for Nathanial's recheck. We have decided that it would be best to remove the tubes and start over. Dr. B feels that he has a biofilm (?) on the tubes that is causing continuous, back to back infections. She said that sometimes your body will attack foreign objects and that is what appears to be happening here. So on Wednesday Thano will go in to have the tubes removed, then she will clean all the infection out from everywhere, flush everything with antibiotics, remove his adenoids, and give him IV antibiotics. Between removing and adding new tubes, flushing with antibiotics, giving IV antibiotics, and following up with an antibiotic course, we are hoping to stop this continuous cycle. I hate antibiotics and I definitely feel that in today's society they are way over-used, but in this situation, he needs them. He is growing out 'several' different types of bacteria - "so far." Some of the cultures aren't even back yet! Poor little fella!

Please pray this takes care of everything and he stops having so many infections. Also please pray for Dr. B, a quick surgery, and quick healing.

Hannah's Pediatrician Visit

Hannah went in to see a pediatrician for a second opinion due to her "slow weight gain." He agreed that our doctor did all the labs that he would possibly run to find anything and didn't want to subject her to more. Knowing our family history, he also thinks it is probably just genetics and she will just be petite. He looked at her and said just by observing her, he could tell that she was petite-figured and is going to be petite her entire life. According to him, she is very "busy" and "nosey," both of which could be contributing to her lack of interest in solid foods, along with her reflux. She's too busy to slow down enough to really eat and she's too nosey, so that when she does actually slow down to eat, she has to constantly check out and see what's going on. And she's afraid it will hurt her tummy. Really?? I had no idea....

She is also developing well and is on target for her age. Her one lacking skill is crawling, but she is extremely leery of being on her tummy. In the last couple of weeks, she is getting better and she has been moving backwards. It rather ticks her off, but it's movement. She's hilarious if she wants something. She will work and work to get at it. She also get just irate if her brothers try to take one of her toys. She's been so conditioned by Nathanial that she already starts getting honked off the second he starts coming near her.

Because she is small boned and on target developmentally, the pediatrician wants her to be given three meals everyday and to fortify her food with extra calories. He suggested adding butter and sour cream to everything, but I absolutely refuse to give her zero nutrient foods just to "fatten her up." We discussed it and I told him I have thoroughly researched feeding infants to best maximize nutrition without increasing the risk of obesity later on. I refuse for all of that to go down the drain just to give her extra calories. So we worked together and I will add (whole fat) plain yogurt, nonfat powdered milk, oatmeal (already do this because she needs things thicker), and other nutrient-dense calorie boosters to her meals. She hasn't even noticed the nonfat milk. She was already getting yogurt and loves it, so she's been happy with that, also. The most difficult part is getting her to actually eat three full meals a day. She does not like to eat that much food. It has also slowed down her nursing a bit, but not a lot. He was thrilled that I was still nursing her and encouraged that we continue that. Not a problem. I will do it until she weans herself.

Other than that, he sent us back to Dr. B with no need to go back to him again. He wants Hannah to be seen every month between now and 12 months for weight and development checks to be sure she stays on track and continue with a high calorie diet. I was relieved he didn't tell me to stop nursing - I was so afraid he was going to and I was going to have to refuse. You never know just how educated a doctor is on the benefits of breastmilk, but he was adamant that was the very best thing for her (which I knew). It was a really good appointment and even though I pretty much knew everything that was going to be done (right down to the high calorie diet), I am glad we went, so at least we know there are no underlying issues.

Hannah Update

Hannah had her labs drawn on Friday and she was a trooper. She is so nosy and that paid off big time - she was so fascinated by what he was doing, that she forgot or didn't notice that it was "supposed" to hurt, she didn't even cry. Of course, she had the very best drawing her labs, so that helped immensely, also. He improvised a little baby tourniquet because the regular one was way huge, found a tiny vein, and went for it.

We had the results by Friday afternoon and everything looks fantastic. Even her iron is at a really good level. Now, I would just like to point something out here. The triplets were on iron fortified formula by the time we drew their iron - and their iron was low enough to warrant being on an iron supplement. Hannah is not receiving any vitamins and is only getting breastmilk and her iron was perfect. A few are concerned she is malnourished why??? Actually, I don't think that he thinks she is malnourished at all - I just think he's looking for an underlying cause to her petite-ness (is that a word?) and I really believe it's just genetics. It just felt really good to hear that even her iron was well within normal ranges - I totally expected that to be low.
When the nurse called me to let me know that her labs were fine, I said 'Yes' (because I expected that) and she repeated it. Like I might not totally grasp that I was supposed to be so very relieved. I don't think she understood I was never worried about it and knew they were going to be fine.

We are having some major difficulties getting the urine sample. I have been through three bags - which do not have near enough sticky on them for little girls. It was a task getting it for Austin when he was that age, but at least it was a little easier. Plus, I am learning, girls do not piddle when the cold air hits them. They actually need to go in order to do so. I have also tried letting her hang out with no diaper, cup at the ready, to just try to "catch" it and that's not working. She sits really well for about an hour and a half and then she has had it and wants to be covered up again. Unfortunately, on the occasions I have tried this, I must have just missed a piddle opportunity because we are now on day five and I still have no sample. I was starting to fret, but Dr. B said yesterday to keep trying, but if I can't get it, that's fine. Whew!

She has been taking the Prevacid since Friday. She does not like it. She makes a little noise and shakes from head to toe whenever she is given it. She doesn't spit it out, thankfully. The triplets loved it, so this is surprising to me. So far, it hasn't made a huge difference, but she did sleep for about three hours at night, so maybe it is. I just wish she would sleep more....

Hannah goes back in at the end of the month to be weighed again and then we will see where to go from there, I guess. Hopefully, she'll gain more weight! She still isn't getting food on a regular basis - only about two or three times a week - but Dr. B said that was fine. She loves avocados and sweet potatoes!

Hannah Grace - Six Months

I cannot believe that Hannah is really six months old! Six and a half, actually. She is such a happy baby and is so good. She loves to play and talk to anyone and is so smiley! She recently has enjoyed sitting up. She is a very active little girl. I'm not sure if that will continue as she gets older. Uh-oh. If only she would sleep a little more...

Today we went in for Hannah's six month appointment. It went OK. She has only gained one pound and two ounces in the last couple of months, so Dr. B wants to move forward with labs. He isn't sure which ones to run yet, but will research it so we only have to stick once, hopefully. We will probably not do that until at least Wednesday and I have no idea how long results take or what our next plan of action will be. One step at a time. I'm not as concerned as she is following the exact pattern of growth that Austin did and after three years in the growth clinic at the Children's Hospital, we learned he was fine and just "fine featured." I am willing to do whatever Dr. B wants, though, because we never did run labs or anything with Austin and maybe it will help us avoid problems later on. She does eat...boy does she eat! She nurses every 2 1/2 to 3 hours during the day and at night, she actually eats more, every 1 1/2 - 2 hours. I think it's because it is much quieter at night and there are no distractions. She is at an age where she is highly distractable while eating...and let's face it, our home is highly distractable! She is also eating homemade baby cereal once in a while and we have thrown in sweet potatoes for some variety. Tonight, she gets to try avocados...yummy!

Hannah's length today was 25 1/2 inches (not sure about percentile), weight was 12 pounds exactly (off the bottom of the chart), and head circumference was 16 1/4" (not sure on that, either). She's doing excellent developmentally. She babbles, sits on her own for a few seconds, grabs things (including glasses and hair recently!), reaches for me when she sees me, giggles, and loves to stand.

So that about does it for today. I'll update more on her labs and our next steps when we get that all back. She goes back in a month for a weight check.

Triplet's Two Year Check Up

The triplets had their two year check up today. They are doing well, with really the only concern being their speech. Since we are already taking care of that, everything else seems great. Nathanial has yet another ear infection, so Dr. B (ped) called Dr. B (ENT) to confer about what to do. He is now on an antibiotic and his ears were cultured again and Dr. B (ENT) wants to see him in two weeks for a follow up. I wish spring would hurry up and get here. Incidentally, Noah's left tube is out now. He hasn't had as many infections as the other two, but he's had his share of them for sure.

Nathanial's stats were:

Height: 33" (roughly 15th percentile)

Weight: 25.8 lbs (~ 20th)

Head Circumference: 18.5" (~ 10th)

Ethan's stats were:

Height: 33 1/4" (~15th)

Weight: 26.2 (~25th)

Head Circumference: 18.5" (~10th)

Noah's stats were:

Height: 32" (~3rd)

Weight: 25.2 (~15th)

Head Circumference: 19" (25th)

Nothing real shocking about any of that. Ethan is a brute, and we knew that. Nathanial was a little surprising because he doesn't seem that heavy. Noah Noah is tiny and I knew it. We've affectionately called him "fat boy" since he was itty bitty (because of his cheeks), but in the last six months I've been looking at him and realizing just how petite he really is. We should probably stop, but now it's a term of endearment with him.

We meet with AEA about their speech evaluations next week and will see what they recommend. I still am praying that they qualify somehow.

They also finally got their MMR shots today. They were NOT happy about that. I'm just glad it's over with. They are still sleeping soundly after getting home...guess we should get them up soon!

sick, sick, and more sick

Noah started the sickies in the house last week. I took him in on Friday because he was just miserable. High temp, nasty cough, runny nose - the works. And with him, I always worry about RSV. Dr. B didn't think he had RSV, ran a strep test (negative), and we were sent home to do fever management and see if he got better. If he didn't get better by Monday, we were supposed to take him back in. His fever was down a touch on Monday, so Steve opted to wait until Tuesday. He's gradually gotten better and now seems to be back almost 100%. The biggest sign he was sick? He likes me...he cuddled with me, he loved on me, he wanted me. Pretty good indication he wasn't well. It was nice and he's still actually cuddly with me.

Enter Ethan. Tuesday night, he starts with the nasties. I decided since nothing was different, I wasn't going to take him in. Then, yesterday, his nose had the green nasties. Not cool. Biggest sign he was sick? He was being good.

And now, Hannah. Wednesday, she didn't seem to be doing very well. Then she spiked a fever and was just miserable. Same symptoms, except her nose is clear. She just sleeps and sleeps and isn't nursing well at all.

So, I took them in yesterday. I figured Ethan probably had a sinus infection with the greenies and all and Hannah I was again concerned about RSV. Ethan more than likely has a sinus infection, but we are seeing if his body will fight it on it's own without the introduction of antibiotics. I have a prescription on hold at the pharmacy that I can fill if I need to, but I don't think I will need it.

Hannah has all the symptoms of RSV, so she ran the test. It came back negative. Today Hannah is even worse than she has been - except she has a pretty low grade fever, not real high. But she's wheezing, having massive coughing spells, can't nurse because she can't breath, her nose is so runny - she's just miserable. I feel horrible because there is nothing I can do for her. I keep doing the Tylenol/Motrin thing and she is slathered with Vick's Baby Rub, but she's still very uncomfortable. I guess as long as the test was negative, I'll wait until Monday to call again - but that's rough because I want more than anything to take her in again today.

Nathanial is now also starting to show symptoms - he has a little cough and clear runny nose, plus a low grade fever. Ahh, the joys of having lots of kids!

Please pray everyone gets better, quickly!

The Boys and Their Cake

We had a pretty low-key birthday yesterday. The boys' "real" party won't be until the 21st, but I wanted to celebrate their actual birthday, too. Ethan had a follow up for his ears. Thankfully, there is no more tissue in his ears, so no surgery. Yay! Then they had their first Happy Meals (not first McDonald's - just the first time they each got their own Happy Meal). Then we came home and gave them cake. Not a real healthy day by any means, but we're back on track today.

Noah, Ethan, and Nathanial - trying to get a quick picture of them with their cake.

My battery died, so of course they had to start digging in while waiting. They loved each getting "Happy Birthday" sung just to them. This was Noah's turn. Digging in - yummy!

Hannah is Four Months Old!!

...and a half!! I, personally, cannot believe she is possibly that old already, but she is. That goes without saying, she had her four month check up yesterday. She was 23 1/4" and 10 pounds, 13 oz. The other day someone asked how big she was and I guessed between 10-11 pounds. I was right, it turns out.

Everyone always says she is tiny, and she is. I often think it is unfair, though, to compare an exclusively breastfed baby to, say, a completely formula fed baby - or even one who is breastfed and supplemented with formula. Almost all of the breastfed babies I know tend to be a tad on the tinier side. Of course, they do not make charts that doctors regularly use for this purpose (they make them - most doctors don't use them). I must also say that, in my defense, I was always tiny - until my teens. Even then, I was a "normal" weight and didn't become heavy until I was 23 years old (due to lovely PCOS). She comes by her smallness naturally.

She, of course, like all of my children dropped off the chart. She was 25th percentile or something and now she is down around 5th or so. In her defense, everything dropped...not just her weight. It just seems most doctors are not prepared for that, but all of my children have started out normal to bigger and tend to end up somewhere on the smaller side. Thankfully, our doctor isn't a real nervous type, so he is happy to just wait and see what happens. Her drop on the chart was more dramatic than most of my kids - but it was right in line with what Austin did. He dropped just as drastically, if not more so, between his four and six month appointments. I am hoping that Hannah will now level out and if she follows the pattern of four out of five of her brothers, she will.

Developmentally, she's doing great. She isn't rolling, but I'm not concerned. She flips herself onto her side for everything - sleep included - she just won't take the final little descent into the roll. She smiles at everyone, she is such a happy baby. She talks non-stop. I do not know what we are going to do when both her and Noah are talking...I'm doomed (it's probably pay-back)! She grabs onto her toys and has even started to turn them in her hands and get them into her mouth. She is constantly inspecting her hands, also. She holds her head up fabulously and she is constantly wiggling (probably why she can't keep any weight on!). She's doing everything she's supposed to be except rolling.

I was also told we can start cereal now, if we want, but we will not. I don't like to start anything until 6-8 months. Aidan didn't have anything until almost 9 months. I can't imagine trying to get her to actually eat anything yet - she just doesn't seem like she should be ready for any of that. Although she does like to sit at the dinner table with us and already has her own high chair. The boys have been using the high chairs as chairs (no seat) for the last several months, so we just added a booster seat to the other side of the table. Now they take turns sitting in the booster seat. So far, there have been no fights.

Tomorrow, the AEA is coming to our house for observation number 2 on the boys. I'll update when I know more!

Busy Week and Doctor's Appointments

We've had an incredibly busy week of sick, sick boys. They've had colds for the last few weeks, but nothing too major. Then, on Sunday evening, Noah started producing green gunk out of his eyes. Nathanial and Ethan were a little ornery, but nothing major. All three of them were in bed by 6:30.

Aidan started screaming of ear pain around 5 on Sunday also. We tried the drops we had left over...that didn't help. Tried Tylenol. Nothing. Tried more drops. Still nothing. After four rounds of drops, waiting one and a half hours for the Tylenol to start working, and him howling in pain, I finally took him to the ER. He had a really bad ear infection in his left ear...the ear the tube fell out of.

Monday, Ethan woke up with the green gunk in his eyes. Great, just great. I knew what was coming.

Tuesday, I woke up with very itchy eyes, but I think it's just sympathy pains. Nathanial woke up a little later and he had the green ickies. By now, they also all have nasty noses to go along with everything else. So I called and canceled the flu shots they had scheduled for today.

Today we woke up and Ethan's ears had crusties on them - which only meant one thing...they were draining ickies. Means the tubes are working, but also means he has an infection. So I called the doctor again and asked if he should be seen. I was told to bring him along with Hannah, Austin, and I when we came in.

Poor Ethan has a double ear infection, eye infection, and something in his lungs. So the poor little fella is now on ear drops, eye drops, and an antibiotic. Thankfully, I know that Dr. B is as against antibiotics as I am, so I am comfortable knowing he does in fact need them. The eye drops everyone gets to use and I was given instructions to bring them all in if they weren't any better, soon.

Hannah had her two month appointment. She did very well. She weighed in at 9 lbs, 7 oz (8th percentile) and was 22 1/2 inches (25th percentile) long with a head circumference of 15 1/4" (30th percentile). She's following her curve and growing well, so no problems there. I got the calcium lecture. I have been trying to take it, honestly I have, but it gets difficult to remember. I guess now I'll just take it with every meal. In the long run, nursing should actually help my bone density, but in the short term it does a number on my bones. I made the mistake of having a bone density test done while Aidan was nursing. I'll just be safe and take the calcium supplements this time.

Hannah is also doing great developmentally with no problems whatsoever. Ethan was enthralled with her shots. Poor little guy doesn't know his turn is next.

Speaking of little miss, the calm has worn off, the storm has now set in and I must go search for the Tylenol...

Doctor Visits

Miss Hannah had her two week/four week appointment today. Dr. B was out of the office for her two week check, so we made it four.

She is up to 7 lbs, 14 oz and she was 21 inches long. She's growing! She is still so tiny. I am in awe of how tiny she is and how big the triplets look now. And they're still babies themselves!

Her watery/gunky eye is a clogged tear duct. To me, it already looks like it is clearing up and was near perfect when I asked about it (he probably thought I was insane). Her occasional projectile-vomiting is more than likely due to her eating too fast...which is what I thought. I do not think my body has correctly adjusted to nursing just one baby this time and it still thinks it's producing for three. I am still constantly springing leaks and it seems to be very forceful at let down. When Hannah decides to wait four hours to nurse, instead of her usual three, that's when she tends to spew across the room. OK, not quite that far, but it does make a nice "splat" on the floor behind us when she does it. She doesn't appear uncomfortable, though, as long as she is held upright for about 1/2 hour afterwards. It isn't near to the level Noah was...thankfully!

We are considered a "high risk" family for the flu and since Hannah is less than six months old, everyone else gets to get the flu shot. Yippee! Not. Austin will be getting the mist...no matter what. It will actually be the first time we've done it in a l-o-n-g time.

First Doctor Visit

Hannah went in for her appointment to check for weight gain and jaundice. She was up to 7 pounds - fully clothed. Yay! She also was not looking at all yellow, which was good. She wants us to redraw a final bili on Friday to be positive it's going down, but I know it is. Looks like one more trip to Allen for Hannah and I.

Prayers please

I hesitated to write this entry, but have decided the more prayers we have right now, the better.

Last week, I started spotting. When I went in on Thursday, my doctor thought I was nuts and couldn't find anything. Then, Friday night/Saturday morning, it became extremely heavy with a lot of "cramping." I finally called at what I thought was a more decent hour (5 am) and was told to get to the hospital. Of course, on our way, it slowed way down.

I realize this is my fourth pregnancy and I should know what contractions are, but I really don't. The last time I actually had any to remember was thirteen years ago. With the triplets, they were all in my back and massive, but did no real damage. So, when I had cramping, I thought it was just cramping. When they hooked me up, they realized nope, it really was contractions. I thought they were about 20 minutes apart, turns out they were 3-5 minutes apart. I was told that my doctor wanted to have me monitored for a few hours and some bloodwork, then he would come in to see me.

In the course of the next several hours, the bleeding really, really slowed down and the contractions spread out to every 10-12 minutes. When he came in, he saw the bleeding, but still couldn't find where it was originating. He is sure it is a small tear in the placenta, but he can't find where. I suppose that's a good thing, because it isn't big enough to find.

Because we were able to control the bleeding and the contractions (and my cervix doesn't work), he has decided to wait to deliver. I am only just over 36 weeks, so the longer little Miss can stay put, the better.

Since Saturday, I have had more heavy bleeding every day for several hours a day. When it isn't heavy, it's light, but it's constant. I have called him, like I was instructed to. I am supposed to monitor movement and make sure she is still moving. So far, she is. I go back in tomorrow for another regular check up.

This is very scary to me and I do not like it. It has been very stressful and I am seriously wishing this pregnancy would be over. That is not like me...I love being pregnant and while I am so excited to meet her, I want to meet her healthy and not early. But the stress is getting to me. I have prayed and prayed, leaving it to God, but that is difficult. I would appreciate your prayers for a healthy baby and as uneventful rest of the pregnancy as possible.

18 Month Visit

The boys went in for their 18 month check up. They are all doing great. We discussed their speech...they still do not talk to other people in anything recognizable and I am getting really concerned about the "twin" speak that's going on. Because they just got tubes in last month, we are going to wait another 3-4 months and see how they are doing. If I still have concerns, then we will look into something more. Otherwise, because they weren't hearing for so long, they seem to be doing pretty well. They interact with each other amazingly well and it is fascinating to watch them. They talk to each other and answer each other. They have been comforting each other if someone gets upset about something. They tickle each other...that's hilarious to watch! And they play together really well. Of course, they also fight, bite, push, and hit each other, but I think that's because they have no other way to express anger and frustration. At least I hope so!

As for their stats. Nathanial is, for the first time in a long time, shorter than Ethan. I was noticing in the last couple of weeks that it appeared that way, and I was correct. Nathanial was 32", he weighed 22.8 pounds, and his head was 18". He is about 10th percentile for weight and 20th for height...I think. His head was almost fifth percentile.

Ethan was 32 1/4", and weighed a whopping 23 1/2 pounds, and his head was also 18". He actually went up one growth curve on his weight. I was concerned when I heard that (the boy likes to eat!), but he is still doing fantastic and is not disproportionately heavy. He was almost 5th for head, right around 25th for height, and 15th for weight.

Noah is now the tiniest in weight and in height, but not in head! He was 31 1/2", he weighed 22.6 pounds, and his head was 18 3/4". He was roughly 15th percentile for height and 10th for weight. His head was almost 20th percentile. Still little, but bigger than the other two.

They are doing great with their motor skills and other developmental milestones. Nathanial's third lead level also came back in a normal range, so we are now pretty positive the first high one was a lab error. Nathanial and Ethan's iron levels came back at 10.5 (hemoglobin), so that is also good. They are able to discontinue their iron drops and then we will redraw it in three months. If it stays up, then no more drops. They actually liked them....ewww! At least we didn't have to fight them to get them to take it! They did not receive their MMR vaccine because of the baby. They also do not have to go back in until they are two! That'll be a little odd...going from every three months to six months. I have to admit, it will be nice, also.

Steve and I went on our anniversary date tonight and had a lot of fun. We hit a few garage sales on our way out of town. Didn't really find anything, but it was fun to go without any kids. Then we went to our favorite restaurant, but the wait was almost an hour and we decided not to wait. We went to a BBQ place instead. I am not a huge fan of BBQ, but Steve is. It was OK. I really liked my fries and coleslaw. We both got rib tips. I stupidly (without asking even Steve) assumed that rib tips would be removed from the bone and not have much fat. Wrong. They are still on the bone, just cut into more "manageable" pieces. So I didn't eat a whole lot of them. The portion sizes were huge and we brought home the equivalent of one whole meal. We also got bread pudding and that was really good. Then we went shopping and just generally enjoyed our evening sans children.

All in all, it was a good day for everything!

Physicals for the Big Day

Today I took, all by myself, four of the boys to the doctor. I was very proud of myself for managing it! Nathanial, Ethan, and Noah had their physicals for Monday's tube surgery.

Everyone was great. I thought Noah was starting to look more slender and Ethan more hefty and I was correct. Nathanial weighed in at 21.6 lbs, Noah was 21.8 lbs, and Ethan a whopping 22.4 lbs. He is a very slow eater and he will sit long after everyone else is finished until he is really done, whereas Nathanial hates taking time to eat at all and as soon as Nathanial is finished, so is Noah. I think that's helping him pack on and maintain his weight. All three are so busy, busy, busy it's really no wonder they don't gain very fast.

Aidan was very good and made the visit much easier for me by remaining good.

Aidan has been sick for the last few days. I don't know what is going on with him. He started throwing up Sunday night and Monday, then did OK yesterday for the most part. Today he has had terrible, extremely loose stools. He's sleeping a lot more than usual and isn't really eating, either. Whatever it is, I hope it gets out of his system fast. He isn't really running a fever with it, either. Poor little guy.