Three out of our four quadlings are now in open cribs. When the babies first hit the NICU, they are kept in things called isolettes, which are temperature-controlled beds basically that are closed off to the outside world. It helps keep them warm and snug and almost gives them the privacy they need to adjust to life while such small, delicate little things. During any baby's stay in the NICU, they'll always have a temperature probe, respiratory, heart rate and SPO2 monitor attached to them. The first three are self explanatory, the SPO2 monitor uses a small red light taped to the bottom of their foot to measure the red blood cell count in their oxygen stream, which in turn relays how well they're breathing. This and the heart rate monitor become the most important numbers to watch with preemies, as they'll often experience "desats" when their oxygen level drops (could be that they're holding their breath because they're trying to poop, have dropped their chin or are simply very comfortable and sleepy) and bradys when their heart rate drops.
All three of our girls were given caffeine supplements for the past two weeks or so to help them have less of both of these common issues and Kailey has now been off her caffeine for nearly a week! She has a few desats now and then but has been doing very well. The other two, Logan and Trystan, will occasionally still have a brady but they are becoming fewer and further between so hopefully they can come off their caffeine in the near future. The goal for discharging babies is to reach the point where desats and bradys are no longer occurring, they are digesting all their food, they are feeding well on bottles around the clock, can maintain their temperatures and they've shown sufficient weight gain and growth.
So with the big moves to the cribs, three of our munchkins are doing very well out in the wide open and have been maintaing their temps like rock stars. Harrison, Kailey and Trystan are our crib babies and Logan probably won't be far behind. My little peanut is just a teeny thing so she needs a little more fat on her first! We were very excited, to say the least, to see these guys progress so rapidly yet again. They are only four weeks old today and have already come so far!
Currently, they are all working on bottle feeds. They start out with just one bottle per 24 hours (the rest of their feeds they still get through their feeding tube that's in their nose). It's purely exhausting for them starting out because they've never really used their chin and cheek muscles like this before and the swallowing action is completely new to them. It's common for it to take awhile for them to catch on, especially since they are so small and premature. Normally, bottle feedings are begun around 35 weeks gestational age but ours started a bit early at 34. They are all doing great! Trystan, Kailey and Logan have all managed to finish an entire bottle at least once and Trystan and Kailey now receive two bottle feedings per 24 hours. Harrison has consistently finished about 80% of his bottle feeding each time and I've no doubt he'll be chugging the rest down soon. Apparently he likes to eat with his eyes closed and you can try everything you can to "wake" him up but he simply can't be bothered. That boy is so laid back he cracks me up!
Here's a video of the little guy getting his first bottle feed from dad:
I know the spotlight has been on Harrison quite a bit with all he went through but now he's on an even keel with his sisters. Although it's a not-too-distant memory just yet, we can still quickly recall just how sick he was not long ago.
Our quads have also begun mastering the funniest faces and are pros at the scrunchy face. Here is Trystan (on the left) and Harrison giving it their best shot.
Well, it's time to get to the hospital and feed and love on my babies! Since they are four weeks today we are taking some adorable one month pictures and I can't wait to show y'all. It'll be the first one of all four together!
Well, I've got lots of fun blog posts planned for the coming weeks. There's so much to share, especially the birth story!! I've been working on notes from that for awhile now. It's incredible how quickly the time flies at the moment. The husband and I spend all our extra time at the NICU with the babies, of course. I tend to be up there quite a bit during the day and he comes up after work. And the weekends are dedicated to visiting the NICU then trying to carve out a little time for us to go to dinner, catch a movie or do a few things around the house like set up cradle swings and pack-and-plays, wash baby clothes and organize bottles.
Last night, for instance, we stayed at the Ronald McDonald House down the hall from the NICU. They provide rooms during the day for parents to be able to take naps (perfect for when I'm up there 7-10 hours during a day) and then clean the rooms and reassign them for overnight stays. You put your name on the list and then the charge nurse makes up the final list based first on parents whose babies might be in delicate condition or who are preparing to take them home and then after that it's based on individual situations and needs. Having quads certainly earns us a stay now and then! It was great to be able to stay up late with the babies and we were even able to be right there when they moved Harrison from his isolette into an open crib!! Then we were able to run down and check on them for a second around 1am—Harrison was still doing great and all the girls were sleeping cozily—and then be there first thing in the morning. It enables us to get our visits in early and then head home and still have part of our afternoon left.
We stopped by our local Mexican restaurant for a late lunch and a margarita. Okay, so I had a margarita and a beer... and it may have been one drink too many! I got a little excited and ended up not feeling so hot when we got home. So one drink limit it is, lol. Probably best anyway since I'm currently breast pumping to be sure the babies get milk while they're in the NICU and are so little and young. I have to work pretty hard at it and it pains me to have to pump and dump after a drink (even though sometimes it's worth it!). Pumping has been exhausting and, while I have no intentions of being able to feed four babies and I have no problem with them getting formula, it's just important to me to do what I can for these early, early days.
But back to the BIG news—the babies!! They are doing so incredibly great. Many of you are probably wondering about Harrison and we simply cannot believe how fast he's made a comeback. Two weeks ago, my husband and I were crying our eyes out by his bedside as he dealt with some major lung issues, a brain bleed and a PDA in his heart (a partially closed valve) as well as pulmonary hypertension. You can read all about it in my last post. They are all common issues that preemies often face but poor Harrison kept getting hit with one after the other. At last they got him stabilized and then he really began impressing the socks off everyone. Sunday was his worst day when it all started and by that Thursday, he was off his ventilator!! They put him on a high flow nasal canula, the little tubes that stick in your nose, to help keep his oxygen flowing but it wasn't actually providing him oxygen or working his lungs. He was doing all that very well! Then a few days later, he kept pulling the canula out and sticking it in his mouth so the docs decided to let him try out breathing completely on his own. On top of that, two days ago he got his PICC line removed (a long term IV basically) so now he has no more needles or IV's! Just a feeding tube and his monitors like his sisters! Then last night, they made the big transition from his isolette into an open crib. We were very proud parents to say the least!! He has done so well in it, too, maintaing his body temp with the help of an extra blanket here and there. He'll likely start learning to nipple feed soon, followed by bottles.
We are quite pleased that all the girls topped three pounds within three weeks of birth and they are steadily progressing toward four pounds. Harrison fits perfectly into his preemie outfits and will have to graduate to newborn sizes before long, while the girls have to room to grow in their preemie getup. But they're all so cute and are now wearing clothes every day, I love it! The girls still have some more weight to gain before they can be considered for open cribs but I've no doubt they'll be there soon.
I appreciate each of your prayers and your continued support of our growing "instant" family. I couldn't imagine my life without a single one of these kids. I am so proud of my body for growing these four amazing babies and I'm thankful for a fantastic supportive husband, for our wonderful families and for the privilege God entrusted us with of raising quadruplets. More posts to come, so stay tuned! :)
As the days progressed last week, so did Harrison. He fought back against each and every challenge, continuing to amaze us, the nurses and the doctors with his strength and determination. Even when he was heavily sedated, he could still flutter his eyelids open momentarily and look at you or squeeze my finger when I held his hand. In turn, it squeezed my heart so violently and I never wished more that I could take a sickness away from someone and bear it myself. I hated seeing Harrison struggling so much, his tiny little body was dealing with an immense amount.
As with any beneficial treatment, there are still risks and being on the ventilator did cause some damage to his lungs. He formed blebs, which are air bubbles or pockets, inside the lungs. It's impossible for the doctors to get to these unless the blebs burst, at which point they can then drain them. His was also still dealing with a pneuomthorax (air pocket) outside his lungs on the right side. This is the second pneumo he's had, the previous one was on his left side. To treat this, they insert a tiny tube in the side of chest that slowly drains the air. By late last week, his x-ray's showed the blebs might be decreasing in size and that the pneumo was also reducing. We were thrilled when they took the chest tube out and even more excited when they took him off the ventilator on Thursday and moved him on to a high flow nasal canula!!! This is similar to the little oxygen tubes that stick up your nose a bit. It provides a high flow of oxygen into his lungs but allows him to do the breathing work on his own. He breathes a little hard now and then but he's done very well. And they are not providing him any additional oxygen, his body is processing and inhaling enough on its own. He just needs the air flow to keep things moving. Hopefully in a couple weeks, his lungs will be even stronger and able to accommodate his breathing without any assistance.
With all this improvement, Harrison was able to start feeds again yesterday. If the babies aren't getting milk or formula, they rely on what's called a TPN, an IV that delivers nutrients to the baby so that they aren't going without. He was also receiving lipids, or fat, as well. But now he's on mommy's milk, which he receives through his feeding tube, and I think he's thrilled to be eating. The doctors have even mentioned trying him out on the bottle soon—he loves his pacifier and chomps on it all day long!
In addition to his breathing and keeping an eye on the progression of his lungs, Harrison is working on morphine withdrawals right now, which we hope will pass in a few more days. After two weeks on the medication and varying amounts of doses, his body now has to readjust to living without it. Again, this is part of the "normal" process and that whole "risk versus benefit" balance that NICU babies often face. He gets tremors in his legs and arms from the withdrawals, so they've been giving him either a teeny dose of the sedative he was on or, like last night, a minuscule dose of the morphine to help him along and keep him comfortable as his body re-calibrates. I hate seeing him shake, I know it's exhausting for him. Fortunately, after the single morphine dose they gave him last night he was able to sleep soundly and get some rest. He's been doing really well and I finally got to hold him the other day after waiting 15 days!!! It was the sweetest moment getting to cradle my little boy in my arms at last.
To go from no kids to four kids and then to deal with the thought of losing one within two weeks of having them is something I'll never forget. I'd never felt the kind of sorrow I did last Sunday. My husband and I sat and spoke to the doctor, cried together, stayed by Harrison's bedside hour after hour, met with more doctors and took solace once again in each other as we prayed for our baby boy. Then something amazing happened. I decided to post a status update on Facebook for the family since we were too emotional to make phone calls or answer text messages. Within minutes, that single status update had ignited a powerful prayer chain that spread like wildfire. My family was sharing the status updates that I was posting regularly now to keep everyone informed. In turn, their friends were sharing the news and so were friends of their friends and friends of their friends. Entire offices, churches and more were asked to pray for Harrison's health. My mom updated my blog for me as well, and I began receiving comments and emails that many of you wonderful readers were praying for my son as were friends of yours and friends of those friends. The chain just kept spreading, it was amazing the lengths it was reaching so quickly. Just hours from my first update hundreds of thousands of people were praying for little Harrison. And that's probably about the time we saw a glimmer of hope. Both my husband and I get teary-eyed when we think about all the guardian angels that must have been standing over our baby boy, and all the countless prayer warriors that fervently sought our God's grace and healing power over him. For any of you reading this, thank you from the bottom of our hearts for joining together in prayer and lifting Harrison up. We know he's going to be an incredibly strong and amazing boy!
*dabbing my eyes with Kleenex*
Whew, lots of emotion already! Meanwhile, the girls are simply doing amazing. They continue to make strides every day, increasing their feed amounts, gaining weight, working on their pacifiers and watching everything going on with adorably wide eyes. Kailey has taken the lead on her feed amounts and is up to 28cc I believe, and has also topped three pounds weighing in at 3lb 1oz. Right behind her is Trystan at 2lb 14oz and Logan is about 2lb 10oz. For being a person that wished for three boys and a girl and instead was blessed with three girls and a boy, I sure do love those little gals. They are fireballs!
Now that our babies are here, he's transitioned into the role of a father so wonderfully. He loves his little quad squad. Seeing those girls grab onto his finger so tightly or watching him comfort his son during his moment of need have been such heart throbbing moments for me. I feel privileged to have him as my husband and as the father to my children. He hasn't complained once about continuing to take care of me as I recover and he still drives up to the hospital every day to see his kids. I can't wait until they start coming home and we can enjoy our new "instant family" together!
I am so glad my mom was able to share a post for me yesterday, things got really intense. When we got to the NICU about 11am we were worried Harrison may not even make it. At last his little body began to respond once they started feeding some nitric oxide through the ventilator. This helped open up the blood vessels around his lungs, which had basically clenched up. His lungs are so underdeveloped that they are comparable to those of a 24 weeker, the doc said, despite being born at 29w5d. He's also developed sir pockets inside his lungs, but today they appear to be smaller. And the pneumothorax on his right side (air pocket outside the lung) is slowly decreasing via the chest tube they placed several days ago.
While these are considered "normal" issues for a preemie, he's dealing with a more extreme case of delicate lungs in addition to several other complications. The docs are keeping an eye on the PDA in his heart, a valve that hasn't properly closed. We can hope he grows out of this. And last week, a head ultrasound revealed he had a grade two brain bleed (on a scale where 4 is the highest) on the left side of his brain. Today they check on it and I'm so nervous. High levels of oxygen, trauma and stress can cause these to worsen...all things he's experienced in the past week. My husband and I have been by his bedside since yesterday and are at least glad that he's more stable now. One thing at a time...
Meanwhile, two of the girls had their head ultrasounds and came back negative for brain bleeds. Thank God! The third little gal has hers checked out today. All three are nearing or have passed their birth weights, so now their feeds will be increased based on their weight as they worry about nothing but growing!
The NICU life is certainly a roller coaster. We were prepared for some issues, but definitely not so many and all on one baby. My heart aches for Harrison, I wish I could just scoop him up and take all this away. But he's so strong, even the nurses are amazed. When they had to paralyze for awhile yesterday he was still winking his eyes and scrunching his face. Gosh, I love that little boy...
*UPDATE: Harrison's ECHO showed the PDA in his heart is small and not a primary concern right now. And his brain bleed appears to be resolving, plus all three of the girls are in the CLEAR!!! THANK GOD!
To close, here's a photo of Kailey who wiggled out of her bed and was asleep on her head! It was a good laugh amidst all the stress.
I am going to quote her updates from Facebook strating with the first one this morning:
Just got a call from the doctor, Harrison isn't doing very well. Last night they put him through a lot...his umbilical IV was too close to his liver so they had to take that out and poke him several times to get a PICC line in. Then they had to reintubate him as the ventilator tube was too high. Around 2am he pulled it out. So now he is back on the oscillator and basically being sedated/paralyzed because he is fighting it. I am so worried about him, I am beside myself. Headed to the NICU now...
Basically he wasn't responding to their efforts, but they finally got him somewhat stable on the ventilator. There are lots of variables and several things going on.....bleeding in the lungs, air outside the lungs, brain bleed and heart murmur, possible infection. Everything is related to the lungs so it is a balancing act. Any one of the issues above could be treated individually but all at once is difficult.
Then later this afternoon we had this more encouraging report:
Harrison has finally shown a little improvement after having to hand pump oxygen then switching up ventilators. For some reason he just hadn't responded to anything. But now he has some bleeding in his lungs, which they are assuming is from his heart PDA, a valve that hasn't properly closed due to prematurity. He is no longer having to be paralyzed but is still being kept on morphine. The room is ...quiet and they are trying to keep things calm so he will stabilize. Still has chest tube for the pneumothorax in his right side and he's now accumulated pockets of air in his lungs. He still has a heart murmur and we are hoping none of this has caused his brain bleed to worsen. He's also getting a blood transfusion to make up for all that he's lost from getting it drawn for tests. Tomorrow we find out more about the PDA and they will follow up on the brain bleed with another ultrasound. Thank you SO much for the prayers, we are trusting Him to lead us all through this.
Then at 3:00 this afternoon......
Amber and Mike barely leave the pod. They have a room at the Ronald McDonald House which is right down the hall for tonight. It is a comfort to them to be able to stay close to all the babies but especially Harrison at this time.
'The Husband's' (I love how she refers to Mike in that manner!) brother brought them fresh clothing and some food this evening so they do not have to make a running trip home and back. Thank goodness for family who live in town!
Harrison has an in house team of doctors and his own individual nurse keeping watch. They are doing an amazing job. Of course, Harrison is an amazing baby boy and is a fighter just like his parents!
Amber and Mike are staying strong for their babies and appreciative of the outpouring of support and prayers for their quad squad!
I will close with a picture of them as they took comfort in holding two of their girls.
First, my mom helped me get ready then she took me to lunch at Olive Garden. It was my first time to eat a restaurant or even a real table, for that matter, since Easter weekend! Then we headed to the NICU, where a wonderful surprise was waiting. All the nurses told me happy birthday then directed my attention to the best card ever, made by Casey, my social worker at the hospital. She's really awesome and has been there for me all along my hospital stay—and continues to be as she guides my husband and I through the NICU experience and makes my day with such thoughtful gestures!
Talk about a forever keepsake. That card rocks! And to make things even better, I got to hold two of my girls together today. Trystan and Kailey each took up an arm and the hour I had them passed by so quickly. They would pry their eyes open and stare at me for awhile and I'd stare back at them, telling them all about how adorable they are and how great they're doing. Then they both konked out and slept while I just sat mesmerized by one, then I'd turn my head and admire the other. These kids are truly perfect in every way!
|Holding Trystan and Kailey together for the first time.|
|Kailey all snuggled into her super cute hat that the husband's aunt hand-crocheted.|
|Logan Lee, chilling back under the lights with her shades on.|
|Our strong boy, Harrison, holding my hand.|
It has already been a roller coaster ride and I've been more emotional since getting discharged from the hospital yesterday than I have this entire pregnancy. I truly thought I wouldn't miss any of it but I do miss having the babies in my stomach and I miss having all my wonderful nurses around to take care of me. There was a bit of fear and trepidation about going home after being on bed rest and hospitalized for so long. But I know I need to take the first step toward recovery and that's getting home, getting rested and getting some sense of a normal life back, however fleeting it may be.
|Leaving the hospital and headed home!|
We've already had good days and bad days in the NICU, and I'll get into all the quads current states and updates soon. I'm also working on a post about the birth story—it was an intense experience and a lot of action! Plus, I've got a gazillion photos to share and will try to start posting more regularly... or at least as well as one can when one has four brand new babies in the NICU, a big ol' c-section recovery and a fairly active schedule going to and from the hospital. It's only the beginning. :)