As Soon As You Figure Something Out, It Changes

While the meaning of the title of this post is pretty widely accepted and agreed upon, it's never been more true in my life until we had babies.  Already, I can't tell you how many times we thought we figured out exactly...

• how much food to give the girls to keep the full, yet not make them puke
• at what time to give Maddy her Prevacid and Zantac in between feedings to reduce the pain of the reflux
• what position they like best to rest and sleep
• how long or short they can stretch between feedings
• how to keep on a schedule
• how many feedings per day they'll take

...just to have it all change the next day or work well one day, then not the next.  At this age, there is no "set it and forget it" process that allows your brain to relax, not even for a moment.  Having triplets truly is taxing on the body AND mind.

If we're fortunate, next week, we'll get to throw another big variable in to our daily equation.  A variable that's invariably as cute as the others-Isabelle.  For the last week and a half, the docs and nurses at Edward NICU have been preparing her to come home after a way-too-long four-month stay.  They've continued to look for any explanation of why she may be having difficulty eating and have been practicing with a new feeding schedule.

I think I mentioned before that her ENT exam showed there was nothing anatomically wrong that would cause her to have difficulties eating, swallowing, or breathing. 

Also, the results from the MRI came back negative, too, which we were ultra excited to hear. 

Her direct billirubin numbers are also way back down, close to the normal range.  Hers was up near 4.0 and is now back down to 2.2.  2.0, and below, is considered normal.  We were expecting this to happen once she was off of the TPN and she's right on schedule!

Feeding-wise, they've been consistently sticking with a 9pm-6am continuous feed through her NG tube.  This gives her, and will hopefully give us, the most rest possible when she gets home so she can grow and we can try to keep our sanity.  She'll get four bottle-feedings per day at 9am, 12pm, 3pm, and 6pm.  We're expecting that she'll eat some by bottle, hopefully more over time, and then we'll have to finish the feed through the NG tube.

Meg and I have already received some training on the medical equipment we'll have at home for Izzy, but still have another session this Friday.  I'll write another post on that topic later, when I have some photos to go with it.  For now, I'll leave you with some pics from the last week, including Izzy's first captured-on-camera smile.  Enjoy!

Meg and Izzy, practicing with her bottle-feeding


This is the first photo I have of Izzy smiling.  I can't stop looking at it :)


No paparazzi (aka Dad)!  It's odd that I now have a shot of each of our girls in this pose.  Did they not know, in utero, that they were being born in to a photographically-focused family???


Meg's mom, Sharon, came to stay with us for a week.  She hadn't seen the girls since they were first born and was so excited to see her "big" girls.  She helped Meg and me out a ton and even managed to dress up some of our windows while she was here.  "Thanks Grandma Sharon!"



After many, many suggestions to try it, we are now on the Moby bandwagon.  This thing rocks and is Maddy-appoved!  It truly does have mystical powers that can lull even the crankiest of babies to sleep.


Madelyn, catching some Z's after a big bottle


Sophia, getting some tummy-time on the mat.  "Hey kid!  Why don't you try lifting that head up?"


Before we can bring Izzy home, her primary caregivers need to graduate from the NICU with training on how to feed her, as well as how to insert and remove her NG tube.  I stopped by the NICU today, but forgot to let them know I was coming and I missed my window.  I didn't even get to hold her because she fell asleep while she was eating and was completely knocked out!  Nurse Erin told me she hasn't been sleeping exceptionally well during the day.  There was no doubt that she was off somewhere in la-la land and I wasn't about to bring her back from that trip.  Erin had to hold her there for an hour like this!  I love our nurses :)

Leaps and Bounds

Where to begin?  How about the fact that weeks go by like days used to.  The girls have made so much progress over the last week, I almost feel like I'm cheating everyone by only sharing the most recent updates.  Every day brings a new surprise or an accomplishment.  I'm just going to tell you where they stand today.  Just know that Meg and I felt as excited each and every day with their progress, as we do today.

Also, I know I've mentioned this in the past, but we really do appreciate all of the attention, love, and prayers that we and our girls receive.  Meg and I snuck away for 24 hours to Sarah and Zac's wedding (separate blog post forthcoming) in Washington D.C. on Saturday.  So many people came up to us at the wedding and asked about our girls.  We were told on several occasions that people had their churches and prayer groups praying for us.  We want to say "thank you" from the bottom of our heart and, whatever you're doing, keep doing it!

This past Friday marked 36 weeks GA and they're seven weeks old today.  Sophia is up to 4 lbs 15 oz, Madelyn is up to 4 lbs 11 oz, and Isabelle is up to 3 lbs 2 oz.

Let's start with Isabelle since we probably put a scare into everyone during our last update.  If you recall, the docs tried to start up the trophic feeds without success.  After a few days, they tried again and our little fighter's intestines finally woke up!  In fact, today, she took three of her feeds from the bottle.  She's only getting around 8ml per feeding right now, but she's doing so well with it.  The stool that's coming from the stoma is exactly what they would expect from a breastfed baby--yellow and seedy.

Today also marks the four week anniversary of her surgery.  At this point, the surgeon could decide at any point to reconnect the two ends of the intestines that are currently healing above the surface of the skin.  What will most likely dictate how much longer he allows Isabelle to heal before her next surgery will be when she begins dumping.  I'm pretty sure your mind just started envisioning what I could possibly mean by dumping.  Yes, it's probably what you're thinking it is.  Basically, she's able to digest her current volume of feeding with the length of intestine between her stomach and her stoma.  We'll know she's not able to keep up when it looks the same going in as does coming out.  The docs will keep increasing her volume until it's apparent that she needs more intestine, i.e. the food needs to have a longer visit inside, to help digest the food.

Besides that, her lungs seem to be doing very well and she doesn't appear to be letting anything else hold her back.

Meg loves her skin-to-skin time with Izzy


Mom soothing a fussy Isabelle


Letting gravity do the work during one of Isabelle's feeding


She sure is one tough cookie, but even cookies need to rest


...more resting...


I sure do wish I knew how to make these babies smile on demand. For now, I'll just continue to wait patiently with my finger on the shutter release button and the auto-focus mark set on their eyes.  These girls are really helping me out though.  For no apparent reason, they just start smiling.  You really just have to be there to see it.  It cracks me up.  All kidding aside, I laugh a little every time one of them smiles.  Seriously, just looking at the pics below leaves me snickering.

Madelyn


Sophia


I was recently told that as your children grow, you'll go back and forth over who they look like the most.  Meg and I both agree that, for now, Maddy definitely looks like a DeBauche baby, while Sophie and Izzy definitely have some Carrick genes.

Look at that double chin! She does look like me!


Maddy is doing great! She's still on the nasal cannula and they have been trying to ween her off of it for several days now. She was slightly anemic a week ago which is what precipitated her needing the extra oxygen. Her blood tests looked much better this past Friday, so it's just a matter of time before they can remove that pesky tape from her face. She, like Sophia, is going gangbusters with their feedings.

Her only real issue at the moment, besides needing the oxygen, is some really bad diaper rash.  I'm talking so bad that the nurses actually use a concoction, stronger than Desitin, that I fondly refer to as "butt plaster."  Strange, I know, but you have to see this stuff.  I really think you could patch your walls with it.  It's a mix of Desitin, stoma powder, and a third magical ingredient which is escaping me at the moment.  What's worse is that Maddy's elimination system seems to get stimulated when you apply the plaster, so much so that she literally pooped on my hand as I was applying the paste.  Of course I struggled with what to do with a recently-changed, semi-clean, full-of-plaster baby while one of my hands held her legs high and the other, well, it was a mess and doing nothing.  I eventually worked it out, but it does remind me of my episode with Sophia's diaper-changing that took as long as a Jeopardy episode to get through.

I'm sure she'll get me back for this one day, but since she's so small now and I'm the dad, I'll share a precious moment, caught on disk, of how the nurses help treat the diaper rash by letting her air it out.  Yes, that's my girl on her side, getting a fresh breeze on her dairy aire.



Sophia still seems like she's in the lead to make it home first.  She had an "episode" today while taking her vitamins, though I have to believe that most adults, too, would have an "episode" with that stuff.  It looks bad and smells worse.  Once she goes seven days without a sleeping episode and five days without an eating episode, she'll be taking her first of many rides in our triplet transporter (aka. Nissan Armada).  I told her the good news and she was so excited.  Look for yourself!



She is eating all of her feedings now from either the bottle or breast. In fact, they just moved her from the green nipple (slow flow) to the blue nipple (faster flow). She didn't skip a beat. Maddy is actually on this nipple, too.



The more weight they gain, the bigger their cheeks get. Case in point. Look at these cheeks hanging over my fingers while she's getting burped. I'm sure they'll get much larger, but for us, these girls seem like little porkers right now. They look so healthy.



After the burping comes another nap.



Actually, these last four images are pretty indicative of all of their sleeping and eating cycles. First, they wake up and are full of energy. We prep them for their feedings. They eat. They look amazingly cute as they get burped. They pass out until their next feeding. What a life :)