Happy Thanksgiving!

This year, like most years, we have much for which to be thankful. Obviously, we are most thankful that all of our girls survived, but we're also so very thankful to everyone who has played a role in getting them through the pregnancy to delivery, through their time in the NICU, and now home with us. Our lives have been changed for the better.  For this, we are forever thankful.  Happy Thanksgiving to you and yours!

Sophia and Madelyn, passed out in turkey-induced comas

Everything Smells Like Spit-Up

I've always thought that babies had a very particular smell to them.  Having given a few baths now, the smell I had stored in my mind was baby shampoo.  Over the last month or so, all I can smell now is spit-up.  Whether it's spit-up, breast milk, or formula, they're all pretty much smell the same to me.  It seems to be everywhere.  You can find it on the girls' clothes, in their cribs, on the sides of their bouncy chairs, or on any one of a hundred burp cloths that litter our floor each day.  Let's not forget my clothes and skin.  The smell has taken over!  All right, so I'm probably being a little over the top, but it's top of mind today.

Meg and Jo Anne went to visit Izzy in the hospital today and I stayed home with Sophia and Madelyn.  If you've been reading for any length of time, you probably know that Maddy's been battling with reflux since she started eating.  Well, today was just one of those days.  Maddy was inconsolable.

On a side note, I'm constantly fighting this internal battle between deciding how much to hold her and how much to let her try and get comfortable.  I'm not going to make it sound easy, because I struggle with it daily.  I know you're not supposed to be able to spoil your baby for the first three months by holding her too much, but it feels like she's training us to pick her up.  Though, choosing not to is just as tough because I literally have a physiological reaction to her crying--she makes me sweat.

Well, I let her cry for a while today.  I put her in the room next to Sophia so she wouldn't wake her up.  After a while, it was apparent that she wasn't going to stop and calm herself down.  It was about feeding time, so I went ahead and gave her a bottle.  She seemed to take it just fine, but during the delicate burping process--more like extremely light rubbing on her back--she projectile vomited all over herself, my arm, and the chair.  I changed her clothes, washed my arm, and wiped down the chair.  I can still smell the spit-up and I don't think that's going to be changing any time soon.

It was a very difficult day for Maddy and me.  I felt bad.  Like I let her down.  She was just so upset and I couldn't find a way to make it better without holding her non-stop.  If she were our only child, it might be easier, but Sophia needs attention too.  In the end, we survived.  Tomorrow, is another day.



Right now, Meg is going with the "I'll hold them whenever I can" approach, as evidenced by the photo below.  Yes, those are little baby footprints from snuggling with mom for a very long time :)  Take a look at that hot belly from a mother who delivered triplets!



The girls are all growing, but Sophia is definitely jumping ahead a little.  As of Friday, Sophia weighed 7 lbs 2 oz, Madelyn weighed 6 lbs 6 oz, and Isabelle weighed 5 lbs 4 oz.  We're feeding Maddy a little bit less than Sophia at each feeding because that's all that she seems to be able to keep down.  When we feed her more, she seems to spit up more, so we're really just trying to find the perfect volume.  She's still growing, just not at the same pace as Sophie.  I'm hoping that as she matures, the reflux will get better and she'll be able to eat and keep down more food.

Isabelle is still progressing very well.  The doctors want to have a meeting with us to talk about when, and in what condition, she might come home.  There's a pretty high probability that she may come home with an NG tube.  She's only taking 11 ml at each feeding and they're only increasing it one ml per day.  She needs to be up in to the upper 30s before they'll take her off of the TPN.  So, coming home with the TPN is also an option.  Lastly, she may come home with oxygen, but she's on the micro-flow at .04 L and it seems like they'll be able to ween her off of that last bit before she would come home.  Other than that, her incision is looking better each day and she's making really good eye contact.  On Friday, she had a follow-up visit with Dr. Davis, her opthamologist, and her ROP doesn't seem to be progressing.  She's in stage 1 in one eye and in stage 1/2 in the other eye.  Both are in zone 2.

The only area where she really needs to improve is her eating.  With all of the surgeries and not being able to eat milk, she seems to be struggling with her sucking and swallowing.  Meg tried to bottle feed her the 11 oz of milk today and it didn't really go that well.  The speech therapist will be working with her to help her get better, she's just a little behind the other girls.  The one area where she's not behind is in the holding department.  Boy, does this little girl love to be held.  Even though we can't be with her all of the time in the NICU, the nurses ensure us they're cuddling with her as much as they possibly can.  NICU nurses, thank you for that.




I thought I'd give you a little preview of my first attempt at taking baby Christmas pictures.  I'll be sure to share the finished products later, but here are a few outtakes.

It's amazing to think this is the same quiet girl asleep in the first photo, above.  Though, I would say it's par for the course when you try to move her at all.

Maddy


Meg had to stand right out of the frame so she could pull out the pacifier when I was ready to take the shot.  I had microseconds before that innocent face turned sad.

Sophie


Sophia had been planning her getaway ever since she heard I was going to be posing her with her butt up in the air.  I have no idea how all of these baby photographers get the kids to "pass out" for the pictures.  If the wind blows in China, my girls wake up.



I know this has been a pretty long post, but it seems like I'm only able to take time about once a week right now to put something together.  About a week and a half ago, I captured a priceless moment when both girls were on Meg's chest.  It's priceless because they're very cute, but also because they're almost too big already to both lay on her chest comfortably any longer.  Enjoy!

Snoring Like Grandpa

Time to Learn About ROP

***Warning - There is a post-surgery photo of Izzy's belly (incision site).  So, if that kinda stuff makes you queasy, just stay near the top of the post.***

There's so much to write about, but I'm guessing I have all of about 10 minutes of quiet time before Sophie and Maddy wake up for their next meal.  In fact, Maddy is laying on my chest right now as I try to balance her between my arms while typing.  Who knows, maybe she enjoys the rhythmic sound of my fingers typing on the keypad?

We've had two girls home for two weeks now and we're adjusting.  You don't really have any other choice.  I wish I could say that we were somehow getting more sleep, but with their reflux and needing to be held upright for so long after their feedings, there really isn't a lot of spare time.  It will get better.  It has to.  Right???  I'll write more about Sophie and Maddy later, but I wanted to share some recent pics and a video (only 33 seconds long) of Izzy and let everyone know how she's been progressing after her surgery.

In summary, she's doing very well.  She's lost a lot of the fluid that typically builds up after surgery and she looks less bloated.  She's put on some "real" weight and seems to be hovering between 4 lbs 13 oz and 5 lbs.  It's really incredible to watch.  I still remember what she looked like at 1 lb 7 oz and now she looks more and more like Sophia every day.  It's not like I didn't think she would, I mean, they are identical.  It's just amazing to watch the transition each time we see her.

Having her still in the hospital is really difficult on Meg and me.  With Sophia and Madelyn at home, we're finding it very difficult time to fit everything in.  Usually, Meg and I will take turns on who goes to see Izzy, but it's tough never being able to go together and, frankly, we're just plain tired of the NICU.  Don't get me wrong, we're not ungrateful for the care that they're giving her.  We're just ready to get our girl home with her sisters.

Izzy is making progress on her feedings.  They began giving her milk in small amounts earlier last week.  She was up to about 11 ml every three hours (or 11q3 in NICU speak).  That was until I went to see her last Thursday evening, straight from work with my dress shirt still on.  I tried to bottle feed her, but she wouldn't take it.  After trying for about five minutes and her not giving me any sign that she was going to be cooperating any time soon, the nurse fed it to her through the NG tube.  About 10 minutes later, her bowels decided that they weren't for that volume of food and she let me have it.  I caught most of it, but what I wasn't prepared for was the second round of spit up that contained some bile.  That was her way of telling us that her intestines weren't prepared for that much food yet.  They stopped her feedings overnight (don't worry, she's still getting the TPN) and started up the next day at a lower volume.  It really is a trial and error process in figuring out how much, and in what time frame, she can consume food through her belly.

The other bit of news that was a bit surprising was that she's exhibiting the first signs of ROP (Retinopathy of Prematurity).  I was hoping that I wouldn't have to write about this and that somehow we would escape it, but it seems like we'll have to learn all about another disease.

From the about.com Preemie section (http://preemies.about.com/od/preemiehealthproblems/a/ROP.htm)

What is Retinopathy of Prematurity (ROP)?

During pregnancy, the blood vessels in a baby's eyes begin to develop around 16 weeks gestation. By about the 34th week of pregnancy, the blood vessels in the eye are well developed enough that the retina has a good blood supply. When babies are born early, the blood vessels on the retina are not fully developed. After birth, the vessels may begin to grow so quickly that their growth damages the retina. Retinopathy of prematurity (ROP) is the name for the improper growth of the blood vessels on the retina and the damage caused by that growth.  In most preemies who develop ROP, the growth of the retinal blood vessels will slow down on its own, and vision will develop normally. Some premature babies, though, develop severe ROP.

There are five stages of ROP.  Stage 1 being the mildest and Stage 5 being severe with vision loss.  Stage 3 is where they would most likely consider surgery.  They also specify the location of the abnormal blood vessel growth by zones--either one, two, or three--with zone one being located closest to the center of your eye and potentially the most detrimental to vision and stage three being the most peripheral and least likely to affect vision.

Right now, Izzy is between stages 1 and 2 and is in zone two.  The eye doctor is coming back in a few days for another exam, but we're hopeful that there won't be any long-term damage considering that she's at 41 weeks GA and that she's getting close to being weened off of her oxygen, which can cause the blood vessels to grow abnormally.

Besides all of that, she's seems like a completely content baby.  Watch the video and check it out for yourself!  


Izzy's belly, post-surgery, but with her belly button!


Isabelle, spending some time with my mom before she had to go home




The nurses tell me that she loves the sound coming out of this machine




A quick little video that Meg took last week

A Gift from a Stranger

If you recall from one of my previous posts, our first go with bath time was by no means, successful.  After that debacle, we decided to migrate from the knee-crushing tile of the bathtub floor, to the more knee-friendly kitchen sink.  At the sink, we used one of the small pink wash basins that we brought home from the NICU.  It worked, but it was definitely a two-person job trying to keep Sophia's head above the water and get her clean.  Could we have continued to muddle through it?  Of course.  If offered a better solution, would we gladly try it?  Absolutely.

Fast forward to this past Thursday.  A box arrived on the doorstep.  I checked with Meg, "Did you order anything?"  Meg, "Nope, did you?"  I hadn't.  While we still continue to receive gifts from our registry from time to time, this package was from 4moms.com, and definitely wasn't from Babies 'R Us.  If you're not familiar with 4moms (and you probably wouldn't be unless you've had a newborn in the last few years), they make the Mamaroo swing.  Apparently, what they also make is a pretty neat bathtub system for the kitchen sink.  Now, I'm not normally a big product promoter, but this tub rocks!  It keeps a constant eye on the water temperature, while always allowing warm water to flow past your baby.  The best feature, in my opinion, because our babies are now notorious for pooping in the tub, is a drain system.  I would summarize it as an in-home water sanitation system for your baby.  It's called the Cleanwater Infant Tub and if you're interested in checking it out, you can find it at http://www.4moms.com/cleanwater_collection

Now, back to the mystery gift giver.  When we opened the box, we fully expected to find some piece of paper or alternative way in which to discover who sent us the king of baby bathtubs.  We found none.  Just a bathtub in a box.  We'd really like to say "thank you."  So, I say, "Come forward and let your generosity be recognized!"  Though, if you prefer to stay anonymous, I completely understand.  For most, the act of generosity is rewarding enough in its own right.   Regardless of whether you decide to reveal your identity, we thank you from the bottom of our heart and want you to know that you seriously made bath time way more enjoyable for us and our girls (even if their faces, below, aren't always screaming "joy!").

The 4moms Cleanwater Infant Tub system


An unexpecting Madelyn, enjoying the soothing sounds and spa-like quality of running sink water


Angry baby rears her head once washrags are introduced


Once the cleaning stops, Happy baby reappears


Sophia is our next victim guest. She seems suspicious of the powers of the new tub...


...and, apparently, for good reason.


Look at that cute hair


After their individual bath experiences, they share notes


The baby whisperer starts to work her magic


And they're...wait for it...


OUT!

Getting Out of the House

Truth be told, Meg and I haven't been for a walk together in months.  When she was about 26 or 27 weeks pregnant, it really started getting difficult to be on her feet for any lengthy period of time.  Well, that was about four months ago.  She has a good excuse.  I, on the other hand, do not.  I like to blame my additional weight gain and overall tiredness/laziness on the fact that I've been sympathetic to Meg's pregnancy.  It sounds good, right?

My good friend, Rob Dunn, who's about my height and was right around my weight, just dropped 44 pounds in 90 days while training for a half-marathon.  Talk about motivation.  Meg and I used to run 10-mile races, so I know it's just a matter of signing up for a race and getting our nutritional house in order.  Let's be realistic here.  I don't think there's any way I'm going to start training for a race as we enter the winter season in Chicago and are, essentially, sleep deprived.  Though, Rob's recent transition is a great reminder that I need to stay healthy for myself and our girls, and that it just takes some stick-to-it-ness to get your energy back.

So, while we're not signing up for any races yet, that it was beautiful outside the other day (~65 degrees) and we decided to take two of our girls for a walk.  We bundled them up and gave them their first breaths of autumn air.  We pushed them all around the neighborhood.  I never realized you could feel each and every single crack in the sidewalk.  It kind of felt like an old wooden roller coaster, but the girls didn't seem to mind.


Sophie, wrapped up and ready to go


Maddy, not so much, but she got there eventually



Meg, Sophie, and Maddy, with the "double" Snap 'n Go


As we were walking through the neighborhood, I noticed someone running behind us.  We had stopped to straighten up one of the girls and I noticed the person who was running closer and closer to us, was running in jeans.  It seemed a little odd until she said, "You must be Kelly's cousin."  We moved in to a very family-oriented neighborhood in suburbia and many of the families have lived here for quite a while.  Meg's cousin, Kelly, lives just a few blocks away and I guess the news of our triplets has spread around to a few folks.  Honestly, it was kind of fun to be noticed in a neighborhood where we really haven't had much opportunity to make new friends.  After introducing herself, she offered to take our picture.



We actually took our walk on Halloween.  I can't say that I've ever seen this before, but I thought it was pretty creative.


Two tired babies after our walk


Meg's new favorite holding position.  She's not sure what she's going to do when Izzy comes home.

Twice the Fun

***Note:  Today, Friday, 11/4/11, was the girls' original due date.  I can't stop smiling when I think about the fact that we've been able to spend almost two and a half extra months with them.  Obviously, I hate the fact that Izzy was born so small and needed to have surgery on her belly, but what an amazing experience we've all shared. ***

This post is a few days late, due to Izzy's big surgery earlier in the week, but I didn't want to miss out on sharing Maddy's check-out day from the Edward NICU.  After spending a whopping 70 days in the NICU, it was time for her to come home.  It was time to make room for other babies in the NICU and time for someone to occupy the space in the crib under the name, "Madelyn."

Picking up a baby for the second time from the NICU almost seemed routine.  It was sort of like, "Oh, you're here to pick up another baby?  Here you go.  Here's your baby."  Relatively, ho-hum if you ask me.  Now, that was what it was like on the surface.  On the inside, we were on the verge of exploding with excitement, knowing that we'd soon have two of our girls home together.

Madelyn left the NICU weighing a hefty 5 lbs 10 oz, a far cry from her original weight of 2 lbs 8 oz.  Also coming home with Maddy, will be prescriptions of both Prevacid and Zantac.  She'll be on very small doses, but it kind of stinks that she still needs prescriptions in the post-NICU era.  They really do help her though.  She has horrible reflux and it's extremely difficult to see her in so much pain after each feeding.  The worst is when the grunting comes with spit up through both the mouth and nose.  It doesn't happen every time, but it's always tough to watch when it happens, knowing that there's nothing you can do.  The nurses tried rice cereal, but its effectiveness wasn't conclusive and one of the docs, who we really trust, told us that recent research shows that it may not make any real difference.

During the last several days at home, she's been doing great!  She spits up from time to time, but she takes her medicine.  We try to keep her still after she eats for at least 30 minutes, and she seems to be thriving.

Maddy, right before she started wailing from being put in the carseat


We decided to try out our new Baby Trend "single" Snap 'n Go. It works great with the car seats we have and provided us with the ability to use the seats we needed for our triplet stroller (Peg Perego Triplette SW), without having to buy the expensive version of the PP individual stroller system.  This Snap 'N Go is pretty much just a frame that fits five or six of the major infant car seat manufacturers.  It's lightweight and is perfect when you have just one baby with you.  We did get the "double" version, too, so we could easily move around if Meg and I didn't want to push around the Peg Perego bus, but wanted to get out together.  These should both be pretty easy to resell on CL, so I kind of think about it like we're paying a rental fee during their use :)



Meg, peeking through the hole in the carrier cover




Buh-Bye NICU!


Our angel, lulled to sleep by the stroller




My aunt Kathy, now a great aunt, came to visit over Halloween weekend. Meg took her to the NICU to see Isabelle and Madelyn over the weekend, then she was able to help out and spend some time with Sophia and Madelyn at home.  "Aunt Kathy, come back whenever you want!"



Sisters - Maddy on the left and Sophie on the right


Meg, with two of her girls on Maddy's first night home

Saving Her Belly Button

Today was life-changing for our Isabelle.
Today was full of "firsts" and "lasts."
Today was her first day with a bowel absent of perforations.
Today was her last day of needing a colostomy bag.
Today was her first day of recovery on her way to being able to eat full feedings.
Today was our last day of wondering when they were going to put our girl back together.
Today, Dr. Liu re-attached Isabelle's intestines.

As far as Dr. Liu was concerned, today's surgery was a success.  By no means are we completely out of the woods, though we can begin the journey of recovery and take the necessary steps to get her home where she belongs.

Watching your daughter being wheeled away for surgery doesn't get easier just because it's the third time.  The pain you feel inside for your child hurts just as much as it did during the first surgery.  For me, the only thing that changed was how well I was able to hold myself together on the outside.  There was no crying today, mostly because of the amount of confidence we placed in Dr. Liu's capable hands and because we knew that our little fighter wasn't going to let anything else get in the way of her coming home to be with her sisters.

It almost seemed routine today, going to the NICU, waiting for Dr. Liu to show up.  Once he arrived and discussed how everything was supposed to go during surgery, they transported Izzy to the OR waiting area where we talked one last time with the anesthesiologist.  We gave our girl kisses goodbye and waiting patiently, with many other families, in the OR waiting room.  After a relatively quick hour and 40 minutes, Dr. Liu emerged from the OR and came to tell us the good news.  Little Izzy was an excellent patient and the surgery went exactly as he had hoped.  He then shared a minor detail with us.  Something so seemingly small that I never once thought about it during any part of this process.  He told us that he was able to save her belly button.  I know.  It's so trivial, especially to me.  I just wanted her to survive.  But, when she gets older and starts getting self-conscious, as all teenagers do, I can only imagine what having something as simple as a belly button will do for her self-confidence.

Thank you Dr. Liu for thinking about that!  Now, it's just something we'll never have to think about again.  We won't have to explain it to her one day and try to rationalize something to a kid who would have just wanted to know where her belly button is.

Lastly, I don't want to oversimplify the impact of today's surgery.  As with all surgeries like this, we're still playing the waiting game.  We have to wait for her swelling to go down.  We have to wait for her intestines to gain its motility again.  We have to hope that the stitching heals correctly and doesn't form a stricture in her intestinal path.  We also have to hope the surgery holds and that nothing leaks at the point where the intestines were re-attached.

For now, we just get to go to the NICU, stand next to her crib, and give her kisses.  It will probably be a while before we can hold her again, as they expect that her stomach will temporarily swell and that she'll be pretty uncomfortable for quite some time.  We'll hold her hand, tell her that we love her, and keep her in our prayers at all times.

Today, our Izzy got her bowels back :)

Izzy, getting some rest ahead of her big day


Getting prepped in the NICU




Traveling with her entourage


Mom, providing a little bit of comfort to her smallest baby




The OR waiting room, in case you've never seen one


Meg, talking to Nurse Pam after the surgery


Our sweet girl, recovering after a long day