OB Update

I went in today for another appointment. I am further along than I realized! I can't believe sometimes how fast this pregnancy is going, yet it seems to be taking forever for this new little family member to join us because we are so excited. An interesting phenomenon this time around is that I have no clue how far along I am. In every single one of my pregnancies, I have been able to say the exact number of weeks and days (and more than likely minutes and seconds if you really wanted to know!) that I was. Not this time. Now I have to check my e-mail signature. I know my due date, but forget it if you want an answer as to how far along I am. I listened carefully to my doctor and I now know I am 27 weeks pregnant. Wow! It seems amazing to think I am that far! It is also just shocking to me that I do not know how far along I am. I guess my brain just no longer works!

The appointment went, well....so-so. I gained one pound, so that was good. So far, I have just lost weight. I have no protein; yet. Baby's heartbeat was fabulous (168) and moving everywhere. Normally, this baby is very lazy, similar to Nathanial in utero. But when the doppler comes out, watch out. Not a fan, very similar to how Aidan was. I also measured right on for dates. The one teeny-tiny, itty-bitty, smidgen of a problem was my blood pressure. It is rising at a startling rate and was very high yesterday. Not good at all. Dr. H just said 'you can't have toxemia yet...you just can't. You got to 36 weeks with triplets!' And, technically, I do not. I have minimal swelling (I think) and no protein. Still, the blood pressure can be a sticking point for OB's. It was 142/102. Ouch! So I told him it was rather stressful to have to get seven people (kids + "the nanny") to his office on time; I could feel it rising on my way in; it's him making me nervous; it can't possibly be accurate. So he let me "rest" and we chatted about our respective teenagers. Yeah, like that's a good idea to bring the BP down! Not so much, it seems. Or I really am starting to have a problem....but that can't possibly be it. It was the exact same the second time. So now, yippee!, I get to go back in in three weeks so he can keep an eye on it. Yuck. I'm fearful he's going to start the dreaded 24 hour urine again.

Plus, next time, I (joy, joy) get to do the puke-inducing glucose test. He told me not to puke, they'd make me do it again. I told him I learned that lesson with the triplets. Still...it's disgusting. OK, normal people hate it. I despise pop...can't stand the fizz of it, the sugar of it, any part of it. If I am going to have pop because I have to, it has to be Coke or Dr. Pepper. Those are the only two I can even attempt to stomach. Sprite? Orange? No flipping way. Guess what the glucose is?? Extremely bubbly, very sugary, absolutely disgusting "Sprite" or "Orange" flavor. Is it really any wonder I want to hurl?? Not really...

With Aidan and the triplets, I failed the one hour test by a few measly points and ended up doing the three hour. Ohhh...now I get to drink even more nasty crap AND wait three hours. Only to end up passing the three hour with flying colors. I am hoping to pass just so I don't have to drink it again. Sadly, though, I will not be overwhelmingly disappointed if I do not pass it, because that means I get three non-stop hours of reading and vegging...totally uninterrupted! Is that sad?? To get excited to sit in a lab for 3+ hours??? Ah, well. No matter what, I need to pass it though. I cannot get GD this time...I just can't.

So while I had a very nice chat with my wonderful OB and his nurse, all in all, it wasn't a fantastic appointment. Please pray for my blood pressure...I know it sounds stupid to pray for that, but this little person NEEDS to stay put until September!!!

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

Delivery Date Set!!!

We have a date!! We will be delivering the babies on Tuesday (February 6) at 1:30 p.m.!!! I am so excited and scared and just a bundle of emotions right now. I really want everything to be OK with them and I did want to wait until later in the week, but it isn't up to me. It is in God's hands and I trust all will be fine with the babies. I will be 36 weeks and they believe (both the OB and the nurses at the hospital) the babies will be close to 6 pounds by Tuesday. It is just amazing. I am thrilled, also, that we are able to deliver at Allen with our doctor. That is fantastic.My blood pressure and protien were up today, so I do have to go in on Friday afternoon to be sure they don't skyrocket before Tuesday. He said it could, but it is doubtful. But he does want to be sure. I didn't have to do any labs today...hooray!!The nurses on the OB floor today informed me that I am the first set of triplets in 39 years. They will have a pediatrician at the delivery plus lots of extra nurses, so they said it will probably be crowded. They also said that they cannot guarantee that I will get a spinal, it will depend on the anesthesthologist. They said there is one that will only do epidurals. I have had both and I prefer the spinal, but knowing in advance will help me prepare either way.I am just in awe that we have been able to make it this far. This is clearly God's will that we have these babies and that they be born as healthy as possible. We do need prayers for the doctors and nurses and all involved, the babies' health, and that everything goes well. If you could, please say an extra prayer for Austin that he does OK through all of this. He has been very accepting of everything lately and is handling this better, but I know it will still be difficult for him. Also for Aidan who is so excited and doesn't fully understand everything. I will update when I am able with new baby pictures and everything. I also am going to put up new bellyshots, one taken this weekend and I will take another Tuesday morning before we leave.

God is great!!!

OB Appointment

I am so excited! I went to my appointment today and everything with the babies is excellent. My blood pressure is still high (156/86) and didn’t change when I stayed laying down, BUT it isn’t affecting the babies at this point. I get to do yet another 24 hour collection (yippee!!) to make sure everything with me is still functioning. Last week’s results were very borderline, but he didn’t want to change plans yet. Anyway, I am excited because he is letting me go to 36 weeks! Woohoo!!!! This is exactly what I have been wanting and have prayed about. If the labs he does today and the 24 hr come back OK, he will just check bp and heartbeats next week and then the following week will be baby week. It seems so hard to believe that they are almost here! We discussed delivery again and he said he honestly never thought I’d get this far and hasn’t talked to anyone about delivering there. He doesn’t seem to think there will be a problem, but needs to talk to hospital staff and everyone to make sure that it is OK to deliver 3-36 weekers there. He seemed reassuring that they will let him, but again, will have to be sure. I sure hope so because I love our hospital and I REALLY want him to be the one to deliver them. He hasn’t said he won’t be the one to deliver them if we have to go to Iowa City, but common sense tells me he won’t be. The babies are getting really big. Today they measured 4.68 lbs (baby C), 4.52 lbs (baby B), and 5.26 lbs (baby a). Hintz seems to think that it is entirely possible we may be delivering babies over six pounds by the time they come. Unbelievable! He said that I have a “wonderful” uterus. So, that and my cervix are apparently splendid. He said he doesn’t want to wait any longer than 36 weeks due to placenta issues they may face and also following two sections. He said it is entirely possible I may still go into labor on my own before that and if I do, I need to get in immediately because of the risk of the scar rupturing. He said it shouldn’t because it is transverse, but he also said with how “distended” my uterus is, it is a possibility he can’t rule out. So we don’t want to risk that happening. Once again, all the babies were breathing, sucking, moving excellently and umbilical Doppler and brain Doppler was excellent also, along with fluid levels being wonderful. He said all in all, they are each behaving as well as any singleton he has seen at this stage. One of the baby’s has hair he said. He showed me on the ultrasound, but honestly, I couldn’t tell. Austin had a FULL head of hair when he was born and Aidan was bald as a cue ball, so it will be interesting to see how these guys come out.So today’s appointment went well again. I am still on bedrest (he believes it is working) and if something is funky with the labs and/or the protein, then things will be changed, but so far so good! I added pictures under the my pictures link, also.Praise God for how wonderful everything is going!!!

Bedrest

Well, went in for my bp, protien, and weight check today. My OB was more than a little nervous and I am now on bedrest at least until he gets labs back. In less than a week, I gained another four pounds, my bp went up to 150/106, protien was up, and swelling is not coming out even after 10-15 seconds. Good news is that he had me rest on my left side for 1/2 hour (while he entertained Aidan!) and my bp did go down a bit. He is having me do the 24 hour urine today and drew a boatload of labs. If anything is off on any of that, he will reevaluate prior to next week. He said that I am to go to bed and stay there until I either hear from him about the labs or my appointment next week. He also checked their heartbeats, which were still strong and good. He asked about movement. I said the one is still REALLY kicking me and the other two do more shoving than any kicking and I believe that they must have less room than Mr. Transverse. He said that was probably the case. He said if movement decreases, I get ANY headaches, visual disturbances, or anything feels even a little "wierd" he wants me to go in immediately. So, I guess now we are pretty much on a day to day waiting period until about Thursday, then I get to wait until Wednesday and see what will happen. I will be 34 weeks by then, so I feel a tiny bit better about that, but I really want them to stay put just a smidge longer than that. He did say that I am his star patient. He said he hears more bitching from his singleton patients than I have ever done and he's very amazed by it. I told him it doesn't do any good to complain about it...we want this and it will be worth it and it's only a short time of feeling crappy. So, that made me feel better, too.So, I don't really know much more than I did prior to the appointment as far as how long they will stay in there, but at least I didn't have to have them today!