Tuesday, March 20, 2012

Kiss Me, I'm Irish!

While this St. Patty's day was a little more tame than those of pre-triplet life, we did manage to relax, have a drink, and get out of the house to see some of the neighborhood fam.  The girls had received St. Patrick's day shirts and bibs as gifts, so it was definitely a good excuse to break out the camera for some lasting memories.  In total, our celebration probably lasted about 30 minutes in Steve and Kelly's backyard, but it was a celebration nonetheless.

Plus, we look for any excuse possible to get out of the house and take a stroll through the neighborhood.  The weather in Chicago was perfect (aka. unseasonably warm and enjoyable for this time of year).  The girls soaked up the warmer weather (but not the sun).  Dressing them up in their St. Patrick's day garb also served as a good excuse to break free from the sleeper slums.  I wrote a post a little while back about how these girls lived in their sleepers 24x7.  Now, the weather is turning warmer and mom's got a closet full of fashion in store for these girls this season.  I think they were pretty excited to let their chubby little arms and legs hang out.  Also, to show their excitement, they waited until the very last minute, right after we got them dressed, to start spitting up and drooling all over their new clothes.  I realize that's what babies do after all, but c'mon.

A St. Patty's Day family portrait

Kelly and Steve with Maddy and Sophie

Meg and Izzy


Izzy, smiling (and drooling)


The DeBauche Babies!  Just finishing up a round of solids and getting ready for a walk.

Which one do you like better, the color or the black & white?

Also, it wouldn't be normal around here if someone didn't visit the hospital this week.  I'll tell you who, but it's not who you would expect.  No babies this time around.

Meg and I decided that we wanted to start running again.  When we lived in DC, we used to run together quite often and ran a few 10-milers together.  Life's been a little hectic the past year and we kinda let it go.  The girls are getting bigger (and so am I), the weather's getting nicer, and there's no excuse not to get back outside.

Now, Meg and I can't go running at the same time (at least not yet), so I went early in the morning.  She decided to sneak out while the babies were napping (yes, someone was here with them).  She got about a mile away from home and, wouldn't you know it, a piece of sidewalk jumped up and bit her.  She wiped out, scraping up one hand and both knees, as well as putting a nice little crack down the middle of her new iPhone.  Worst of all, she broke her elbow.

Meghan, patiently waiting to see if she'll be getting a cast or if they'll tell her she's being a sissy.

The nurse, removing the soft cast they gave her at the ER last night.

Meghan and the doc, moments after he injected a needle into her elbow to remove some blood that was pooling and causing.  She was a trooper!

The silver lining here is that she won't require a cast and should start feeling better within the next few weeks.  This does mean that dad will be pulling triple duty in the evenings as Meg can't hold anyone for a while.  Fortunately, Jo Anne is coming to our rescue this evening and will be staying with us for the next couple of weeks. We couldn't do this without family and friends!

Friday, March 16, 2012

It's Good To See Old Friends

A couple of weeks ago, I wrote a post about a letter we (the girls) received from Hudson, the son of some very good friends of ours, Laurie and Errick.  Errick has been battling cancer for over a year now and he's one of the strongest people I know.  He just celebrated his 34th birthday.  So, me and a few of his oldest friends, traveled to Grand Rapids to spend the weekend with him and celebrate another year of his life.

It was also a great opportunity to catch up with Laurie, get some updated pics of Hudson, and check out the house they just built.  Not to mention, a perfect way to catch up with friends that I only get to see about once (sometimes twice) per year.  Play a little cards.  Have a few drinks.  Re-live stories that we've told time and time again that never get old or any less funny.

Errick, we sure are glad you're here buddy.

Hudson, navigating his iPad like a pro.  No joke, it's definitely a learning tool, too.

Showing mom where California is on the map.

He knows the name and location of every state, though I can foresee an argument with a teacher coming when she tries to tell him that Alaska isn't an island SW of California.

...and athletic, too!

Conquering the stairs.

Stealing a hug from dad.

Rob, getting loosened up for a vigorous round of poker.

Rob and Wes, trying equally hard to figure out what each other have.

A disinterested Nelson, eagerly searching for the latest version of Angry Birds.

Chin up Steve. Chin up.

Everyone rallying for a night on the town

Thursday, March 15, 2012

Medical Critic Working Overtime (by Meghan)

There are food critics and movie critics. Sometimes I think Izzy's teaching us to be medical field critics. There was a time in my life when I knew absolutely nothing about the medical field. Those days are long gone as terms like tachypnic, diaphoretic, PO, and FIO2 have become part of my daily conversations. There's a nurse-in-training working with our nurse here who came in to get vitals and I showed her how to use the monitor to start the blood pressure cuff. I really thought as a stay at home mom I wouldn't feel intellectual stimulation and the only things I'd be able to talk about would be poop, spit-up, breast feeding, and sleep schedules. Thanks to Izzy, my life will never be that dull. :)

Now, for the info you've been waiting for. The 10 days Izzy was at home after being released from Edward were awesome. When she first came home she wasn't tolerating her full volume and she also needed a little extra oxygen. Within the fist week we weaned her back to her baseline of 0.2 liters and she was doing great. We were able to increase her volume with each feeding and she was eating everything by mouth during the day. This was new for us. We had at least four days where there was nothing left at the end of her feedings to put in through the NG tube. She was taking her full bottle by mouth and looking good doing it. She was coordinating her sucking, swallowing, and breathing beautifully. The speech and physical therapists were both very impressed. So, as you know we attempted to let her keep her NG tube out.

Unfortunately, on Tuesday, she gradually went downhill. Feedings started becoming longer and longer and she looked less and less coordinated. By her first nighttime feeding she wasn't able to eat more than an ounce. I noticed she was breathing very fast. Her respirations were at 80 breaths per minute, which is much higher than the average 40-60 breaths per minute she should be breathing. In the NICU, the nurses won't feed babies unless they're under 60 because there is fear of aspiration. They told us it's like trying to chug a bunch of water down after you're exhausted from running a race and breathing very fast. Any of us would throw up with that scenario and that's what happens to Izzy, too.

Because it was such a drastic change, we reinserted the NG tube and came to see Dr. Andrews in the morning. She decided to keep Izzy overnight for observation. After they increased her oxygen, she started finishing her bottles again and looking much better. Her work of breathing is better and she's smiling, which is always great to see.

So far we give our new hospital and medical team a 5 out of 5 star rating. The nurses, doctors, residents, check-in staff, and even security guards have all been wonderful. The best part about being here is there is a huge team of doctors looking at her an collaborating. It's not just a world renowned pulmonologist, but also all of her residents. The pulmonology team is working with Dr. Andrews (the neonatologist). There is also a speech therapist and a dietician involved. They're all collaborating to make the best plan for Izzy.

Here's what I know so far. The dietician thinks she should be on 120 cal/kilo diet instead of 108 cal/kilo so she recommended increasing her volume. She said we really need to grow her lungs and she'll need the higher calories/day in order to do that. She said Izzy should get chubby before she gets long so we should expect that and not worry. (Jeremy I'm talking to you who thinks Sophie may need a diet already.) Dr. Andrews and the pulmonologist, Dr. Lester, are worried that the diuretics are dehydrating Izzy so they're going to have us add a water flush between her feedings to help keep her hydrated. We'll go home on 0.5 liters of oxygen and turn it up to 1 liter during feeds. They're still deciding whether to add some additional medications or not. It looks like we'll be here one more day so they can solidify all the parts of the plan and send us home with just the right amount of breathing support for her to be able to bottle feed.

Although coming to the hospital may seem to you like a step back it's actually a huge step forward. Over the last week Izzy has shown us she can eat all of her feedings by mouth. We never knew that before. And, now that we're downtown, all of her care will be coordinated and overseen by Dr. Andrews. We had a pulmonologist before, but he was working in isolation as were all the other key players.

So, here's my big review on the medical profession: It's just like education! Collaboration is the key. The best schools operate as a professional learning community in which the classroom teacher, reading specialist, math specialist, speech therapist, guidance counselor, special education teachers, and administrators, etc. collaborate together to make the best plan for each student who is struggling. In my mind the pediatrician is like the classroom teacher, able to take care of most of the kids with great results. Izzy is like the student who is struggling with the typical amount of support. She needs more. More intervention, more support to meet her potential. She needs time, extra time to grow and catch up. Before coming here it felt like she had a different teacher for each subject and, since she was struggling in everything, they were all telling us what we should do to help her. Each teacher had a different opinion based on their background and the only way they were aware of each other was when I told them what the other said. No one was collaborating. So, we, the parents, were left in charge of deciding who to listen to and deducting what the real problems were based on all the opinions we heard. That is an extremely overwhelming and stressful burden to carry.

Here, it's different. The docs are communicating with each other in real time, before sending us home, and they're setting a collaborative plan for where we're headed next. It feels like it did in the NICU and it's a huge load of stress and worry off of our shoulders. Thank goodness for Dr. Andrews and thank goodness we were able to keep looking to find great care for Izzy yet again. I am really looking forward to watching her grow over the next few months and seeing her wow us with her progress. We'll keep you posted!

Monday, March 12, 2012

What Happened To Your NG Tube?

Sorry to leave everyone hanging in suspense.  Via my facebook posts, most of you probably already know that Izzy came home a week ago.  It's been so great over the last week to have Meg and all of the girls back at home, together again.  Izzy probably could've stayed in the hospital for a couple more days, but they moved her from a very nice room, down to the dark, no-window dungeon on the basement floor.  At that point, the nursing care is much more sparse and Meg would've been taking care of most of Izzy's needs anyway.  So, we just decided we could do that at home.

So far, she's been doing great!  We continued the breathing treatments for a few days, but weaned her pretty quickly.  What's more impressive is that, since last Thursday, she's finished almost every bottle by mouth without the need for the NG tube!  Plus, her reflux, or lack thereof, has been improving as she's been recovering from her bout with RSV.  I know it's not completely gone, but she hasn't been spitting up either, which is a great sign that her lower esophageal sphincter (LES) is regaining some tone and helping to keep her food down.

This morning, we woke up to a clean-faced Izzy, which if you've been reading this blog for any length of time, isn't a good thing.  The little escape artist wiggled one of her tiny infant arms from what must have been a very poor swaddling job and pulled everything off.  Her NG tube was laying on the ground next to her, as was the nasal cannula with tape attached.  What was she doing?  Smiling, of course.  We were a little flustered at first, but we decided it was actually for the best.  We had been looking for an excuse to try without the NG for a couple of days.  We wanted to see if having it out might actually help a little with her reflux, as one of our docs previously described it as "acting like a wick" in her belly, providing a path for the food (and acid) to follow up alongside of.  Also, before we taped her cannula back to her face, I measured her oxygen saturation.  She was actually doing quite well from a pure saturation perspective, but her respiratory rate was up and her retractions were definitely a little deeper than normal.  Basically, if she had to survive without oxygen, she probably could have, but it makes her so much more comfortable and has definitely helped her to relax and enjoy life a little more.  By far, the biggest impact it's had has been on her eating.  So, we're keeping it for a little while longer.

Right now, Meg's driving us down to Comer Children's Hospital downtown.  Izzy's sleeping in the back after finishing another big bottle of formula.  By the way, Neocate is freakin' expensive, especially as Izzy gets larger and starts consuming more volume.  We're on our way to see Dr. Andrews for a follow-up visit.  We were worried that we wouldn't have much to report since she was doing so poorly after first coming home from the hospital.  Now, she's like this completely different baby, except for the huge ear-to-ear smile she tosses out frequently--that never changed :)

All right, so we just left Comer and I get to be chauffeured around in my own car for another hour.  It's nice to not be the one driving sometimes, though I have to admit, Meg's driving scares me a little (a.k.a. "Distracted Driver").  Dr. Andrews agreed with our plans to try it for a couple of days with no NG.  It will most likely mean that we'll have to get up in the middle of the night 1-2 times to help her make up the lost volume from the nighttime continuous NG feed, but if it can help us avoid another surgery (the G tube), then we'll do what it takes to slowly increase her volume the "normal" way.

We also met with one of the GI docs that works with Dr. Andrews, Dr. Sentongo.  I can't remember whether I wrote about our experience with the last GI doc we saw (not. nice. at. all.), but Dr. Sentongo's bedside/patient manner was worlds apart and we left feeling so much better about our next steps.

To sum it up, for now, we're going to try to see if we can make it without the NG tube.  She's going to stay on a very low volume of oxygen.  We're going to gradually, but intentionally, increase her food volume to slowly stretch her stomach, but also to test how well her LES is maturing and see if it will allow her to handle more volume without spitting up.  We'll go back in a few weeks to discuss her progress and next steps, but for now, she's just as every baby should be--happy!

The other girls are doing so well and getting so big very quickly, too.  Right now, all is good in la casa de DeBauche.

Friday, March 2, 2012

How To Grow Smart Babies

How do you grow smart babies?  You water them with words, of course.  A couple of months ago, two-year-old Hudson, the son of some very close friends of ours, Laurie and Errick, took the time to write a letter to our girls.  He may have had a little help from his mom, but I think he probably could've done it completely on his own.  He also sent over some books and cd's for the girls, which we are very thankful for having received.  I decided that I wanted to make sure the girls know that one of their first friends, even one they haven't met yet, was already thinking about their education.  Below, is his letter with some pics of this really cute kid.

Dearest Izzy, Maddy, and Sophie,

Rumor has it that your 'rents think I'm pretty intelligent!  They asked my folks what "they" did to make me such a smarty pants, but let me tell you the truth...I was born that way, babies.  Kidding....Of course my parents helped out!  I took them shopping to pick out some of my fave books because books make you smart, right?  I was reading from birth.  They also scooped a few music CD's to help calm you in cars (or just at home) and debated for hours on which Einstein DVD's to get you...because they all rock.  I could watch them on repeat, so I'm guessing you'll be able to, too!  There are SEVERAL more if you find they hit the spot.  (Baby Beethoven & World Animals are great ones!)
Some other helpful hints include:
  • Sign Language (I still sign, even though I can actually say "please," "thank you," "more," etc.)
  • Flashcards (Tell your parents don't be afraid to make animal sounds & sing songs)
  • Puzzles (Melissa & Doug brand are the best)
  • Peek-a-boo books...or just Peek-a-boo (seriously calmed me down if I was in a tizzy)
  • iPad (Duh! I'm a techie, but any kid loves Duck Duck Moose apps)
  • Baby Bjorn Bouncer...(get 3, helps with reflux after feedings, well worth the money)
  • Sensory activities (go outside and touch the snow, the tree trunks, the dirt...hehe)
  • My mommy is always talking to me, telling me how many there are of everything and what color everything is...She sings songs a lot and even makes up her own songs.  What a silly goose.
  • Action Songs: Itsy Bitsy Spider, Wheels on the Bus, If You're Happy and You Know It, etc.
  • Exersaucers are fantastic and a Jumparoo is a must-have (the rainforest one was a blast!)
  • LeapFrog Learn & Groove Musical Table (you can put it on the floor or take two legs off to prop it up on an angle to help promote sitting)
  • LeapFrog Chat & Count cell phone (in violet, of course) & My Own Leaptop (also in violet)
  • Bright Starts Hop Along Carrier Toy Bar (what a joy when I finally could "push da buttons")
  • Bright Starts Lots of Links or Sassy Ring O' Links (rattles rule, especially with skinny handles)
  • Don't do the squirty bath toys, they will eventually collect moldy water - try Sassy Count & Spell Bath Appliques and stackable cups and/or rings (also good on dry land...)
  • When I was as young as you ladies, my mommy and daddy rigged an activity mat with those crossing beams (big mobile of sorts) so that a rattling giraffe was at my feet and I could kick, kick, kick, to my heart's delight (we called it the "kick drum," ever seen "The Breakup?")
  • All time favorite toy when I was "little": LeapFrog Baby Counting Pal (it's a counting, singing, colored caterpillar...brilliant!)
I know there's so much more, but your own mommy and daddy will come to know what makes each of you "tick."  Having ONE baby is the steepest learning curve on the planet, let alone THREE!  We'll offer more suggestions as time goes by, but you don't need to know that Color Wonders are ingenious just yet :)

Much love to all of you beautiful gals.  Can't wait to meet you and tell your parents to remember to take a breath here and there...

- Hudson

Hudson is now two.  He really is a smarty pants.  We haven't been over to visit with Errick, Laurie, and Hudson in about a year and a half, but I'm hoping to get over there next week.  These pics are the last ones I took of him when he was a wee bit smaller.  His mom posts pics of him all of the time on facebook and he's still just as handsome :)