Moving right along...

I've been a very bad blogger lately...

I've started and stopped this entry a few times, and thus (because things change so fast) I've had to start over each time. I'll go "long story short" and say that overall, the girls are doing well. It's hard to believe that they are two months old today--or roughly 35 weeks gestational age.

They are both getting close to four pounds. They are both slowly becoming more able to maintain their temperature. They're both getting at least one feed a day via bottle. They've grown so much and they're definitely starting to settle into their little personalities.

This is Elena taking a bottle...

...and Amelia.

Momma and her babies.

Elena sleeping without her feeding tube.

So, they're doing well, their mommy and daddy are doing well. We're so excited about the idea of going home, but we're not allowing ourselves to get our hopes up yet. Their original due date was July 24th, so realistically, we've still got a ways to go. In the meantime, Crissie and I enjoy bathing them, changing their diapers, getting them dressed, and holding them when we can. Our NICU nurses and doctors continue to be awesome.

Time is flying by so fast and Crissie and I often joke that we'll be sending them off to college before we know it. Stay tuned...

Trying not to jinx it... (D-Day + 31)

So, our early NICU experience was so up and down that we've developed a phobia of admitting when they're doing well for fear of jinxing it. It's funny, if you so much as mention the "Q" word (quiet) in the presence of nurses, you're sure to see them diving for cover expecting the ceiling to cave in. It's a surprisingly superstitious place. When the girls are doing well, I feel like we're all in the dugout in the 8th inning with a pitcher who's got a perfect game going. Nobody say anything...

Well, it's been a few days and at the risk of tempting the fates, we have to report that the last week has been pretty good in general. Maybe we're getting desensitized to the little blips, but it sure feels like they're progressing well of late.

Amelia (little Miss Consistent) is up to 6.5 mL of continuous feeding which is pretty much the maximum for her weight (which is roughly 2 pounds 4 ounces). She's tolerating her feeds really well and is growing pretty steadily. She's back down to 2 liters on the Vapotherm and she bounces around between 30 to 60% oxygen levels to maintain her saturations. No IVs or PICC lines. Overall, she's in good shape. She has the usual ups and downs--the occasional apnea or bradycardia, but she usually recovers well unassisted.

Elena (our Drama Queen) is up to 6.0 mL of continuous feeding which is good too and she's also weighing in around 2 pounds 4 ounces. She's tolerating her foods really well and seems to be stooling and urinating regularly. I only mention it because early on it was an issue. Her breathing is improving although she had a setback since our last update. Her carbon dioxide levels in her gas samples were coming back high. She was reintubated, then got upgraded to CPAP. She's now back down to the lowest rate on the CPAP and we're hoping she'll get moved back to Vapotherm soon. She looks like an underwater samurai--which is to say, uncomfortable (as any samurai who's spent time underwater will attest). No IVs or PICC lines. She just finished up some antibiotics for a little infection in the PICC line, but all seems to be better now.

On another note, we have received more thoughts, prayers, words of support, and genuine love from friends and family than we can ever possibly acknowledge. So many of our close friends, blog-followers, long-lost pals, distant families, buddies on facebook, current and former co-workers, and many complete strangers have reached out to us to show how much they care for us in this time of emotional awkwardness. To know how many people are out there cheering us on is truly touching. We still have our "dark and twisty" moments, but they get fewer and fewer as the days tick away. It's hard to think too much about "what might have been" when "what actually is" is altogether precious and awe-inspiring.

We can't possibly be more grateful for this tsunami of support we've received. It's meant more to us than many of you will ever know. Though we haven't been able to respond to many of you lately, know that your messages were received, they were appreciated, and they helped. Blasting this to the world via blog seems a wholly insubstantial way to communicate our appreciation, but we're having to make trade-offs for the sake of efficiency. We are sincerely thankful that each of you are a part of our lives.

THANK YOU!

NICU Update (D-Day + 17)

By the time I put the period on this sentence, what I think I know about the condition about our daughters will be old news.

Seriously, it changes that fast.

First their PDAs are open. Then they're closed. Then one's open again. Got that fixed. The other one's open. Now it's closed. Check that...

Feedings? Yep, they're both feeding. No they're not. One of them is. Not anymore. One's not pooping. Now she's pooping. Starting feeds. Stopping feeds. Why? PDAs open. Crap!

How's their breathing? Great! Extubated after a couple of days. Now on Vapotherm. One's three liters. One's two liters. One's on high-flow canulas. One's on low-flow canulas. Room air trials (maybe)? Blood gases acidic. Reintubated. Oxygen 74%. Oxygen 100%. Back to Vapotherm. Doing good. Sleeping comfortably. Her PDAs open? Reintubated--do not pass Go, do not collect $200.

If this sounds familiar, then you've either worked in, or had multiples in the NICU.

As I re-read the above, I continue to be marvelled that it's not an exaggeration at all. This has become our life. People will ask me how they're doing and I'll give them the latest. Then, they'll ask me again three hours later at which point I'll tell them that whatever we were worried about earlier is now fine, but now there's three more things we're concerned about. People must think we have some sort of hyperactive "Munchausen syndrome by proxy."

I'm just going to start telling people that they're slowly turning into sea turtles.

So, here's the real latest scoop.

Amelia is doing pretty well. She was down to low-flow canulas at room air, but then her PDA re-opened up, so they moved her back to 2-liters Vapotherm and they gave her the 3 rounds of drugs to close it. They think it worked, so they resumed feeds and she seems to be doing fine. Her blood gases are checking out okay. She has some minor swelling, but she's peeing well enough, so they aren't overly concerned.

Elena is more of a challenge. At 10 days, she wasn't pooping. A couple of enemas and some Muco-mist later (I can't wait for her friends to read this one day), we got some poop. So we started some feeds. Then, her blood started getting acidic and she stopped peeing. So they stopped feeds and reintubated her. Now her gases look better and she's peeing. She's intubated at room air for the moment. She's struggling with ventilation even though her oxygenation is doing well. The doctors think she's worn herself out for the moment. So, we wait a little while and regroup.

Honestly, don't you just want some pictures already???

Amelia, the laid-back one.

Crissie and I spend a lot of time seeing each other like this. (Amelia's isolette)

Elena says "hello."

Taking a noonie.

That's all for now. You can be sure that anything you now know about how they're doing has since changed. It's the only thing that seems to be consistent for now.

The Wheelock Quads are Born (Part 1)

We thought we were prepared for this.

Saturday was a day that started like so many others since our stay at Woman's Hospital began. I was on my cot and Crissie on her bed. My "uniform" that day was my Mississippi State hooded sweatshirt, my Mississippi State shorts, and my Mississippi State fluffy slippers that look like clown shoes. Something about being in Baton Rouge makes me feel the need to exaggerate my "Maroon-ness." Plus, I'm kinda' known around the hospital for those ridiculous slippers and I have a reputation to uphold. Our plan was to watch movies, Law & Order, and mostly vegetate all day.

Crissie was feeling uncomfortable. Of course, her belly was big, she hadn't had a night of uninterrupted sleep in over a week, and the straps on the uterine and heart monitors were irritating to the point of exhaustion. She'd been off antibiotics since early Friday morning and all indications were that they had done their job. The constant worry about Garrison's leaking amniotic fluid hung like a dark cloud over our situation, but there wasn't much we could do about it beyond hope.

My brother came to visit late in the afternoon because he was in the area and we hung out for about an hour. He left because he could tell Crissie wasn't feeling well. Around 5:00, Crissie started to get really uncomfortable, so we took off the monitors. It was about this point that she started getting the chills. We were still on high-alert for fevers, so we immediately started doing temperature checks. She was running about 99.9 so we called in Rachel, our nurse who was assigned to us for the first time (bless her heart).

Crissie and I immediately assumed the same thing: An infection was taking hold. We'd heard how quickly infections could wipe out a pregnancy if left unchecked, but even we were surprised with the speed and ferocity of this illness. Within two hours of the onset of her symptoms, her fever was 102 degrees. The decision to get the babies out was made quickly. By the time Crissie was on the operating table, she had vomited, was convulsing, and shivering so hard it was painful to watch. I was truly scared for her life at that point. However, they got her on the table a little over 3 hours from the onset of symptoms--pretty impressive considering the complex issues in play.

At 8:38 pm on April 17th, Amelia Frances (Baby B) was born first at 1 pound, 7.5 ounces. At 8:39 came Elena Marie (Baby C) at 1 pound 15.8 ounces, followed by Garrison Thomas (Baby A) at 8:40 also weighing 1 pound 15.8 ounces. At 8:41, Lillian Brooks was born sleeping.

Drs. St. Amant and Diket performed the C-Section and were assisted by a myriad of neonatologists, respiratory therapists, NICU nurses, and surgical assistants. Three of our "Top 4" nurses were able to make it in time for the surgery. Jami, Tanyl, and Tracy raced to the hospital and pitched in on their own time for which we can't thank them enough. We wish that Jennifer J. would have been able to make it too, but she was out of town and couldn't be reached.

A special thank you is reserved for Dr. St. Amant who gave us a 'bat-signal' to be able to reach him in the event of emergency. We found him at the first sign of fever and he was at the hospital within an hour or so--even though he wasn't on call and it was a Saturday night.

Crissie got loaded up with antibiotics and pain meds, while three teams worked on intubating and stabilizing Amelia, Elena, and Garrison. Our families stood by in the waiting room--my dad and brother, and Crissie's parents and sister, along with various other friends and loved ones.

Nurse Tracy took care of Lillian. She had the difficult duty of bathing and dressing her. Once Crissie was stabilized, she and I had an opportunity to hold Lillian's hand and say our good-byes, despite knowing that she was already in heaven. It was an emotional end to an emotional day and we appreciated the nurses who took such loving care of us by looking after her.

We got moved from our room in Labor and Delivery up to the part of the hospital known as "Mother/Baby." It was a much smaller room, and after nearly a month, we'd accumulated a lot of stuff. Most of that stuff got sent home with Crissie's parents. Dr. St. Amant helped us get rid of some of our remaining foodstuffs. Since we deprived him of his dinner, his preoperative meal consisted of peanuts from our "snack table."

Once settled into the new room for the dénouement, we were left with a few visitors, but mostly left to ourselves. It had been a day filled with the most intense emotions we'd ever experienced--fear, love, sadness, hope--we were exhausted. Not long after our last visitor left, we collapsed into what we'd hoped would be long, well-earned sleep...

It was not to be.  

The Wheelock Quads are Born (Part 2)

After falling asleep sometime after midnight, Crissie awoke around 3:30 in the morning with an intuition that something was wrong. Thirty minutes later, we got a phone call from the NICU asking permission to transfuse blood for Garrison. Of course, Crissie granted that permission without hesitation. We really didn't know what was going on with him at that point, and we certainly weren't thinking that a blood transfusion was out of the ordinary, but a 4am phone call from the NICU definitely had our already frazzled nerves on edge.

Thirty minutes later, we got a phone call from Phillip (the charge nurse in the NICU that night and a personal friend) that we needed to come down immediately. Considering that Crissie was eight hours removed from major surgery, still on a catheter, and had yet to be moved post-operatively in a wheelchair--this was a serious request. Though we wouldn't say it aloud, we were pretty sure they wouldn't call us down to the NICU unless there was dire need.

Much of the following was a blur because of our exhaustion, delerium, and (for Crissie) pain medications. But first, I need to back up a little bit...

When Garrison was delivered, he was bruised from head to toe. His membrane had ruptured and he had virtually no fluids in his sac at delivery, so the belief was that he had suffered external bruising as a result of the other membranes crashing down on him. Thus, Garrison's body was darker than we expected--it wasn't quite "black and blue," but it was close.

When we approached Garrison in Pod 8 of the NICU, he was being attended by as many as 6 or 7 different nurses, doctors, and therapists. His incubator was wide open and one nurse was doing chest compressions while another worked a breathing bag. He was being given epinephrine shots at a regular interval. It wasn't good.

The doctor in charge of Garrison explained that the infection that spiked Crissie's fever had attacked Garrison too. Having a ruptured membrane meant that he had very little defence against the infection. It wreaked havoc on his delicate lungs and cardiovascular system. He had crashed once already and they were able to bring him back, but from this last crash, he wasn't recovering. We were asked if we wanted them to continue, but the answer was already clearly written on the faces of everyone working on him. Garrison wasn't going to make it to his first sunrise.

I still don't know how long we stood there in silence watching everyone work. I do know that I felt my heart was literally being ripped in two--so much so that I thought was having a heart attack. Crissie sat and cried while I stood. We were completely devastated.

We continued to wait for a miracle that wouldn't come. They stopped chest compressions and he was shortly thereafter pronounced dead. He lived outside the womb for less than nine hours.

We were given a chance to bathe him. Crissie could only get up close enough in her wheelchair to rub lotion on his left arm and leg and I tried to help, but I was struggling to hold it together so I left it to the nurse. They dressed him and brought him to us so that we could spend a few quiet moments alone with him. We both held him and cried all the tears we had left. A priest came to baptize him. We finally left Garrison to check on Elena and Amelia (more on them later). We were led back to our room to collapse again in utter exhaustion. Heartbroken, overwhelmed, and afraid, we slept fitfully--wondering what the next phone call might bring.

We'll always wonder what kind of man Garrison would have grown up to be. We'll always wonder what kind of brother, son, or father he would have become. I can say with all honesty that we'd trade all of our worldly possessions to have him back. Everything... without question.

When Lillian passed, I was sure she was up in heaven, safe and sound, holding hands with my mom. I was so hopeful that it happened for a reason and that we would one day understand. With Garrison's passing, my hope is that they're all together and that Lillian will have a big brother to pass the time with until we can all be together again. It sounds nice to write that down--I just hope one day I find peace in believing that's how it works. Right now, there's no peace.

My faith has been shaken.

And, there's two other girls who still need us to believe in miracles.

The Wheelock Quads are Born (Part 3)

The NICU roller coaster begins.

We need to mourn our losses, but that time is not now. Now, we have to turn all of our attention to our two perfect little babies--Amelia and Elena.

For the most part, they are doing well. They're both on Vapotherm at the moment (which is a step down from CPAP--their noses are too small for CPAP!). They were both extubated (taken off the ventilator) rather quickly, and other than a short re-intubation of Amelia for an apnea, they're doing well with their breathing. Their oxygen saturations are in the mid to high 20s or low 30s. Room air is 21%, so this is pretty good.

The big news this week was that the PDA (Patent Ductus Arteriosus) in their hearts closed with medication and no surgery will be necessary. This meant that they could start with feedings. Mommy has been pumping away, so we're hoping our little ones will start packing on some weight before long.

As expected, Elena is the wild one. She came out kicking and screaming and she continues to do so today. We constantly catch her yanking on her feeding tube and she's squirmy for sure. She looks quiet in this picture, but don't be fooled.

She's blue because she's undergoing phototherapy for high bilirubin levels (jaundice)--pretty normal for preemies. She's the bigger baby for now, and her numbers have been pretty consistent despite the occasional bradycardia. She also cries when we bother her too much, though it sounds like the squeak of a mouse.

Amelia is our little calm baby. She just hangs out.

She's a little behind Elena on her breathing, but not much. She was the first to get off phototherapy--even though she eventually had to go back on. She seems perfectly at home in her isolette (incubator). We've heard some peeps out of her, but not much seems to bother her. She really likes it when I sing to her. I know because she told me--she's very smart.

In general, Crissie and I are doing okay. We definitely have our moments, but we're so thankful for our beautiful girls. We're home today, and walking into their bedroom with four beds was hard. Seeing all the embroidered baby boy gear in the closet was more than either of us could handle. We definitely planned to bring all four home, and looking back, we wouldn't have done it any different.

The doctors keep telling us that Crissie has to heal from her c-section before we focus on assisting with caring for the babies (her incision is infected, btw--just thought I'd mention that). Well, the truth is, we both have to heal from our emotional wounds before we can give all of hearts to Amelia and Elena. At times, we're depressed, we're angry, we're hopeless, we're inconsolable. Then we walk into the NICU and it all goes away when we're with our girls.

Our hope is that there will be a joyous homecoming for our girls in the months to come. But until then, we ride the roller coaster that is 'life in the NICU' and we deal with our emotional baggage in the space between.

Thoughts and prayers are still welcomed. The four of us all have a lot of healing to do, and a little peace would be a nice change too...

News from Today's Ultrasound

Following a pretty tough weekend, we had a lot of lingering questions that remained unanswered. However, there was really only one question that we needed answered that would affect an outcome.

We still didn't really know whose water broke.

We assumed it was Lillian's. Seemed like a fair assumption and most of the doctors and nurses agreed. Certainly made sense at the time. We gotta' give Dr. Stedman credit where it's due, though. He was the only one who ventured a guess that ended up being correct--even though we weren't thrilled when he first postulated the notion.

Crissie's cervix is funneling and Garrison is at the bottom of the uterus. Think of it as a regular funnel with a water balloon in it. If you piled a few more water balloons on top of that first balloon, you'd basically have Crissie's uterus. The weak point from a pressure standpoint is Garrison's balloon at the point directly over that void above the cervix, or the open tip of the funnel cone.

So, that was Dr. Stedman's theory and the ultrasound today proved him right. Lillian's sac appears to still be intact (which is actually good news) and Garrison's is ruptured and continues to leak.

This isn't ideal, but it's not the end of the world either. It's been almost 6 days since the sac ruptured and the biggest threat was infection that usually strikes in the first 3 days. Crissie's been non-symptomatic and the babies' heartbeats have been looking really good. If we can avoid stuff like chorioamnionitis, there's hope that we can hang in there as long as Crissie and the kiddos continue to put up good numbers. Garrison continues to produce amniotic fluid and that fluid does continue to accumulate in his ruptured sac, but it also seeps out from time to time.

We're getting close to 26 weeks. This is an important time in their development. Certainly, there are plenty of healthy people walking this earth who've been born that prematurely, but we continue to fight for every day, every hour, every minute. We have to give them the best possible chance.

We're determined to bring all three home healthy.

Thanks for all the thoughts and prayers. Please keep 'em coming...