32 Weeks Gestation

The triplets are 32 weeks gestation today or almost 7 weeks old. 32 weeks is the average gestational age that triplets are born at, so this is around the time when we were actually expecting our triplets to be born. Obviously, God had other plans for our little ones.

Since our last blog, we have been unable to visit or even see our triplets in the NICU. This is because on Wednesday morning, Jodi came down with the flu and is still fighting it. Nathan was staying out of the NICU as well to be safe, and he recently came down with the flu as well. Once we are symptom-free, we will still have to wait a full 48 hours to be able to go into the NICU. It is so difficult to not be able to see our little miracles. Every day that passes makes us more anxious and frustrated and upset... especially since Nathan has some time off of work for the holidays. We miss our babies so badly! However, we know that it would be very serious if one of our triplets were to get the flu, and so we take comfort knowing that we are still being "good parents" by staying away. We have been calling the NICU often to get updates on our babies and some nurses have been sending us pictures as well.

Liam:
In our last blog about a week ago, Liam was just getting over an infection and the doctors were watching him so that once he was well enough he could go for heart surgery. Liam was kept on an antibiotic to fight a potential yeast infection since his tests for an infection had all come back negative. He had been doing much better except for some mucous in his stools. A sample was sent off for testing a few days ago and a few tests still need to come back. However, the test for the flu came back negative, for which we are very thankful.
Since Liam had this one symptom, the doctors were holding off with talk of surgery until they knew he was not sick. Just this morning, however, Liam's standard blood work came back with infection markers yet again. Once again, all of the tests are being sent off to try to determine the type of infection he has. The nurses have been speculating that this infection is not new but something that he has been fighting for awhile. This is because Liam has been on weeks and weeks of antibiotics and just keeps getting sick. We hope and pray that the source can be determined and our little man can be fully healed and well enough for surgery. When Liam gets sick, he needs more breathing support and the impact of the open duct (PDA) is very evident. Today, the nurses noticed that his lungs are very wet (one of the effects of the open PDA), and that Liam is retaining a lot of water. They have given him lasix to help him get rid of some of the excess fluid. The boys have been on lasix more than once in the past already, so this is not very new. Liam also received yet another blood transfusion this morning.
Today was also the day that our triplets were signed up for eye exams. When babies are born very early as ours were, the risk of eye complications is high. The exams today gave the eye doctors a baseline from which they will continue to monitor every week or so for the next few months. We are told that eye disease usually manifests around the weeks 34-36 and especially in babies who have been on higher amounts of oxygen support. This means our boys are at higher risk than Taylor, who has been on much lower breathing support than her brothers.

Taylor:
Last Wednesday, the healthcare team tried to extubate our little girl and get her back on CPAP. This was unsuccessful since Taylor did not tolerate it well and still needed the extra support. She also had some swelling in her throat and vocal chords from the tube. The team put her tube back in and gave her a few days to rest and recover. On Friday, they tried again since Taylor's breathing settings and oxygen requirements were very low (which is a good thing). This time, they gave her steroids to help with the settings. Taylor tolerated this very well and remains on CPAP again. As of today, she is doing very well. She is not having any bradychardias or spells where she forgets to breathe. Most of the time, she is able to breathe room air at 21% oxygen, without needing extra oxygen. This doesn't mean that the CPAP machine is not supporting her, since she is still receiving pressures and volumes to help inflate her lungs and given a set number of breaths. Last week, Taylor's echocardiogram showed that her PDA has closed significantly. While the PDA was not impacting Taylor a lot, it still needed to be closed eventually and so we are very happy with this bit of news!
As for her sickness, Taylor seems to be over whatever type of infection or sickness that she had. She is still not at 3 pounds, but is slowly but surely continuing to grow.

Malachi:
Last week, Malachi had vomited a few times and been tested for an infection. Since then, he has been doing well and has not had any more vomiting or symptoms. Today, he came off of his general antibiotics and so had his IV taken out. Because he was a bit sick, he had been taken off of his food but this has been slowly increased again. Malachi is not having full feeds still, however, because his sodium levels have been too low. Thus, he has been kept on a lower amount of breast milk so that his sodium levels can catch up (with the help of supplements).
In terms of breathing support, Malachi has remained at roughly the same amounts of support, which is relatively high. He needs to keep growing and getting stronger, which he has been doing quite well at. Yesterday, the nurse weighed him to be 1500 grams, which is well over 3 pounds! Another great bit of news came from Malachi's echocardiogram last week which showed that his PDA has also closed significantly. This takes heart surgery off the table for Malachi. This is very good news, yet the PDA does have the potential to open again for Taylor or Malachi in the future if they were to get a significant infection or sickness.

Although we have been mostly sick during the holiday season, we have been witnessing some of the generosity of the people at McMaster Hospital and at the Ronald McDonald House. There have been so many people donating so much to make the holidays enjoyable for sick children and their families. Between the food, well-wishes, events, and presents, we have been feeling quite blessed. We are also so thankful for the NICU team who has been very understanding and helpful to us while we are unable to be with our babies. We desperately hope and pray that now that we have had colds and the flu that we will be healthy and sick-free for a long time in order to care for our little miracles!

42 Days

We had a very hectic weekend here at the NICU, but things have been starting to settle down for a bit. 

Liam Josiah:

Since last Wednesday night (when our little sweetheart became very sick), Liam has been responding well to his antibiotics. The doctors told us that they had been very worried about him, and it really sunk in emotionally a few days later- especially when the other two triplets started having issues as well. The blood cultures never showed what the infection exactly was so Liam was prescribed a week of general antibiotics which seemed to have done the trick. The reason why the blood cultures and tests were inconclusive may have been because he was already on a different type of antibiotic for his last infection and meningitis. We were very thankful that his lumbar puncture came back negative. On Sunday night, Liam needed a blood transfusion to bring up his hemoglobin and we again noticed an improvement in his physical appearance.

As for the PDA heart surgery, Liam needs to be entirely infection free and well again before a date will be scheduled. We continue to wait in the next few days to see when the doctors deem him well enough for surgery. 

Looking at our little man, we can see huge improvements from Wednesday and Thursday especially. He opens his eyes more and moves around more. We are also very excited that our oldest and biggest triplet is now 3 whole pounds! 

Taylor Joy:

Our baby girl has been having a great last few weeks and we almost started getting too used to it. On Sunday evening, she started acting a bit unlike herself and having a lot of dips on heart rate and oxygen saturations. Some blood work and preliminary test results indicated she might have had an infection and so she was started on general antibiotics. At 2 in the morning, we received a phone call that they were taking Taylor off her CPAP and inserting a breathing tube to better support her breathing needs. On Monday, we received a phone call for consent to do a lumbar puncture as well. Similar to her brother Liam, Taylor's blood cultures did not show what kind of infection it was. However, x-rays of her lungs and stomach seem to show an infection in the intestines or bowels around her stomach. As a result, her belly was really round and not allowing her lungs to expand adequately. In addition to this infection, Taylor was having a lot of nose secretions that might be indicative of a small cold. Nose and lung secretions are normal for babies who have a breathing tube in because the body is trying to fight the foreign object in its nose, throat, and lungs. However, the colour of Taylor's secretions might indicate she is a sick and unable to get enough air in through the CPAP. As of Tuesday evening, Taylor is still considered sick but is doing much better. She is way more active and spunky. She has started getting small amounts of breast milk again and this will slowly go up to full feeds over the next number of hours. The healthcare team believes that she will be ready to be extubated tomorrow or the day after, if she continues to do well! 

While CPAP is way better for the babies, we have really enjoyed seeing Taylor's sweet little face and head these past few days. It was a really strange feeling seeing her face without the CPAP hat and mask for the first time in weeks. It hardly even felt like it was our baby girl! Being able to see her face has rekindled all sorts of paternal and maternal feelings in us, and we are falling in love with her all over again!

Malachi John:

Our youngest little man has also had a busy weekend. On Sunday afternoon, Jodi was holding Malachi while Nathan was sitting beside the chair when we heard Malachi's voice make some little noises for the first time. In any other situation we would have been overjoyed to finally hear his little voice, but since he is intubated we knew it was not a good thing. The respiratory therapists immediately took him back into his incubator and assessed him to figure out what was going on. It turns out that Malachi has a small leak around his breathing tube in his throat. In certain positions, some air can leak out and cause him to lose the pressures the machine is giving him. It also allows some space between his vocal chords so they can vibrate and make noise. The next size breathing tube is too big for him, so the healthcare team has to be careful with how they position him. 

As if that wasn't enough excitement for one day, Malachi started vomiting three or four times on Sunday evening and through to Monday. He was tested for an infection and again nothing yet has showed up in the blood work. He hasn't been vomiting any more, but he also hasn't been having very much milk. An IV was started on Monday when they stopped feeding him entirely. On Monday evening they started him on 4 mL of milk and on Tuesday 5mL. A full feed for Malachi is arojnd 16 mL so they are just taking it slowly. Malachi has an echocardiogram scheduled for Wednesday because the doctors suspect that his PDA might be impacting his breathing needs more. Thus, heart surgery is staying on the table.

We continue to covet your prayers. We have learned again this week to never take anything for granted. It is so up and down in the NICU that we need to rely on our Father one day at a time for His grace. 

Friday December 16

We have had a pretty busy and stressful week. The NICU life is certainly exhausting and emotionally draining at times. On Wednesday, we met with the neonatologist and a few other healthcare professionals to discuss each of our triplets. We had to make a few decisions during this meeting. It is so difficult to try to learn about what is going on with each baby from a medical perspective, try to understand and process it all, and then have to collaborate on what we have just learned.

Liam:
As mentioned in our last posts, Liam's PDA (a duct which brings oxygenated blood between the placenta and the heart while the baby is in the womb) is still open and remains a cause for concern. It is clear from the many chest x-rays that the PDA is impacting Liam's lungs. After four rounds of medication, the doctors indicated that the medication options were exhausted. Because Liam's breathing support needs are so high, the medical team strongly recommended to us that Liam needed heart surgery. As parents, we listened to the risks and benefits and decided to go ahead with the heart surgery. We were told that Liam would be a priority case because of the severity of his situation, and that the surgery would happen within a week's time. On Wednesday night, we made the rare decision to go to bed early rather than spending the evening at the hospital. When we called the NICU to check in before bed, the receptionist told us we were unable to speak to Liam's nurse because he was in a procedure. Naturally, we sort of panicked and Nathan ran over to the hospital to check it out. Liam had started showing signs of infection early in the evening. His health had been deteriorating so quickly that the healthcare team had not been able to update us. They had run a number of tests on him, taken blood cultures, and performed a lumbar puncture. They put a catheter in to help him urinate and put him on medication to bring his blood pressure down. They also put him on general antibiotics because preliminary tests strongly indicated a blood infection.
As of Friday night, Liam is doing much better. He is much less lethargic and he looks much better. However, the blood cultures have not indicated what type of infection Liam has. The hypothesis is that Liam's PICC line had a blood clot on the end of it which is a source of bacteria collection and potential infection. The PICC line is out and a temporary IV line put in. In the meantime, heart surgery has been postponed for at least a week until the signs of infection are gone and a course of antibiotics has been finished. We will also need to reconsider heart surgery entirely once he is well enough, as there is the possibility that the situation will have changed.

Our sick little man

Taylor:
We don't have too much to report for Taylor as she is still doing quite well. She is not quite ready for the lowest type of CPAP yet but is doing well for her gestational age and size. She still has spells where her heart rate drops quickly and/or her oxygen saturation levels drop. However, overall she is having less that she has in the past. We still enjoy lots of cuddles from our little girl because she is almost always well enough to come out of her incubator.

Little princess

A nice surprise from the nurses

Malachi:
At our meeting on Wednesday, the neonatologist discussed how coming off of steroids can cause a baby to do a little bit worse for a few days before improving. This did happen but in the past few days his breathing support needs have been fairly consistent. The doctors are hoping that he can continue to stay the same so that as he gets bigger and stronger he will be able to improve. We were told that 4.5 lbs is the goal before his lungs will begin to improve to come off of the breathing tube. Right now, he is about 2.6 lbs (1210 grams). Today, Malachi's ventilator machine was switched to one that has more settings and can therefore provide more consistent pressures in his lungs. The healthcare team has indicated that heart surgery is not off the table for Malachi but there are no definite plans for him yet. We continue to wait and pray that his lungs can improve as he grows and gets stronger.

Our baby boy all snuggled up

As parents, it is hard to watch our babies go through so much. All of the pokes for bloodwork, IV lines, tubes pushed down their noses and throats, medication... it seems to never end and most likely won't for a long time yet. We sometimes half-joke that we will have full-blown anxiety disorders by the time we are able to take our babies home from the hospital. Perhaps it is not a very funny joke though, because we hope and pray that the LORD God will continue to strengthen our faith and trust in Him. "The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus." (Philippians 4:5-7). May His peace be with each of you, also during this holiday season.

30 Weeks Gestation

Maybe we have said it more than once, but we never know what the day will bring in the NICU! 

Liam Josiah:

After hearing about how Liam's lung disease was significantly impacting him last week, we were extremely surprised to come into the NICU on Friday and hear that the plan was to extubate our oldest baby boy. The doctors and respiratory therapists explained that they wanted to give CPAP a try even though there was a possibility that Liam was maybe not quite ready. "The baby is the boss" is the saying we have heard more than once. Liam would show us if he was ready or not. So at 2 in the afternoon they took his tube out and put him on CPAP. After 20 hours of repositioning his little body and changing many different settings on the ventilator, Liam was reintubated. Although we were disappointed, we were happy that physically appeared well throughout it all. We are back to square one and the doctors have given Liam a few days to rest before a new plan is drafted. The healthcare professionals will decide whether Liam's PDA needs to be surgically fixed or whether a round of steroids might be an option. While they are the professionals, as parents we also have to weigh in on the decisions and give our consent. This is because of all the risks that either option entails. Right now, they are leaning heavily towards heart surgery within the coming week.

On Sunday, Jodi finally had a successful snuggle with our precious baby boy. He continues to grow well.

Taylor Joy: 

Our little sweetie continues to do well. Her oxygen levels hover in the 20s (remember that 21% is what you and I are breathing). She has been having more of the pressures and settings weaned down as well. It's still a ways in the future, but after CPAP there are still a few other forms of breathing support that babies generally still need. 

Taylor has also been giving her parents some great cuddles lately. She is still the smallest but growing well!

Malachi John:

As you may recall, Malachi started his second round of steroids to improve his lungs this past week. As of Monday night, he is nearly finished the steroids. While he is nowhere near coming off his breathing tube, he has definitely improved from the steroids. As parents we were disappointed that he was not near being extubated but the healthcare team assured us that the steroids improved Malachi's lungs pretty much as they were expecting. We will be meeting with the doctors in the next few days to decide on what the next steps for Malachi might be. We are very hesitant to put him on a third dose of steroids but there are not many options for our little man in terms of interventions that can improve his lungs. 

In the meantime, coming off of his steroids will hopefully mean that Malachi can start to grow more quickly again. Growing bigger for all of our triplets means developing and getting stronger because their breast milk is being fortified with lots of good stuff like protein, vitamins, and minerals to help them develop. We love to watch them and see the changes in each of our babies. Looking back on the pictures of their sticky red skin and bony little bodies, we are thankful to see the improvements they have made so far.

We want to again express our thanks to everyone for their cards, emails, texts, messages, care packages, and comments. We feel so uplifted by the communion of saints. 

Romans 15:13: "May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope."

4 Weeks (and 1 Day)

The triplets are now over 4 weeks old and have passed the milestone of 29 weeks gestation.

Liam: 

In terms of progress, we don't have too much to report for our little Liam besides growth. His latest weight is over 1200 grams! 

However, Liam's lungs have been getting worse in the past while. As we have mentioned before, being intubated does not help with lung growth and healing and babies can become more and more dependant on the ventilator for breathing support. A chest X-ray on Wednesday afternoon showed that Liam's lungs are significantly impacted by what the doctors call "chronic lung disease". We have heard this term many times with Malachi and it simply means to hat the lungs are underdeveloped (which is unsurprising due to how early the triplets were born). Because of the chronic lung disease, the doctors may consider steroids as a medication to help improve his lungs to be able to get the tube out of his throat and onto the less invasive CPAP machine.

In the meantime, Liam is on his fourth dose of medication to try to close the PDA by his heart. As you may remember, the open duct causes complications due to breathing and so treating the PDA often helps lower the breathing support babies need. However, using medication to treat a PDA is generally only effective for the first month of life, after which it doesn't usually work.  So, the doctors have indicated that they are not optimistic this will work. Surgery to close the PDA is not definite at this point, but will be something the doctors will consider in the coming days or weeks.

We have not been able to hold our Liam very often because of his breathing difficulties. His tube is very positional which means that if it is moved a certain way, his heart rate or oxygen requirements might change quickly. (This could mean that the tube is hitting a spot in his throat or trachea that is uncomfortable or that the tube is going too deeply or too far out of his lungs). Another issue is that being intubated causes lots of secretions (which is like thick saliva) in the lungs, throat, and mouth. Both Liam and Malachi need to have this suctioned every few hours or so. These issues have made it hard to be able to safely hold Liam without his heart rate dropping or oxygen support needs going way up. Nathan and Jodi have both experienced attempts to hold him this past week where he needed to be put back in his bed in an emergency situation. Not only is his scary but it's also so disappointing to have to helplessly watch our baby boy without being able to hold him. We try to do as many diaper changes and assist in his care as much as we can.

Liam also continues to finish his antibiotic course via his PICC line although we don't see traces of the infection in his physical appearance. He has needed two blood transfusions in the past few days for his hemoglobin levels and his skin looks a healthy pink colour again. He still loves to lay on his belly (as do his siblings) and suck on his soother. We have also been noticing that our babies are getting better at focusing their eyes on our faces when we talk to them.

Taylor:

The healthcare teams continue to call our little girl "feisty" and we love to hear that. Taylor remains on CPAP and is doing much better than her brothers in terms of breathing support needs. She has not been having nearly as many bradys (drops in heart rate and oxygen saturation) these last few days for which we are. very thankful! Although her PDA remains open, it does not seem to be impacting her lungs as much as her brothers and so the doctors plan to leave it and monitor it, in hopes that it will eventually close on its own.

Taylor has finished her antibiotic dosage. (As you might recall, all her tests came back negative for infection but she was put on antibiotics just to be safe). Because she is done her antibiotic course and is now getting her milk fortified, she no longer needs her IV and had it pulled out on Wednesday. Another small step forward! She looks to be pretty much recovered from whatever sickness or infection she had.

We have been able to hold our baby girl pretty much every day lately and she generally does very well, although sometimes needs to be put back early because of her breathing support requirements go up. We are told this is normal for such premature and little babies. 

Taylor is now past 2 lbs/ 900 grams! She has finally started fortified feeds as well. 

Malachi:

For the first time ever and after 4 weeks of waiting, Nathan was finally able to hold Malachi on Wednesday evening! What a blessing! 

The doctors tell us that Malachi remains our sickest baby- particularly in terms of his lungs. He is on quite high support and oxygen levels and the team has not been able to wean him down. Thus, on Tuesday we gave our consent to start him on a second round of steroids which will be a slightly different kind and a slightly higher dosage. This will hopefully lead to his lungs improving enough to be able to get him back on CPAP. 

Malachi's PDA is also still open and impacting his lungs, yet the doctors feel as though his lungs are so sick that they take priority to treat before addressing the PDA. 

Although his lungs are not developing and improving, we still have opportunities to hold Malachi because he is quite stable in his support levels. He is also growing well and pretty close to his brother's weight. His PICC line also remains in (like Liam) so that he can finish his antibiotics, which will be mid-December.

With all the discussions around lung development and breathing support, we have learned this week that our babies will be behind their peers in their development for a number of years. Thankfully, lung tissue can continue to grow and develop during the first few years (we've heard until around 5 - 8 years of age). However, this means that once our babies are able to come home, as parents we will need to take a lot of precautions and measures to protect their weaker immune systems and especially their respiratory systems. It will also likely mean a lot of extra sicknesses (especially respiratory illnesses) and extra trips or stays at the hospital. Obviously it is rather early to be thinking about going home but this was all a surprise to us. 

Another lesson we have been working on this week is thankfulness to God. We were given the devotional called "One Thousand Gifts" by Ann Voskamp which focuses on finding everyday graces. On Wednesday night as Nathan was holding Malachi, the baby girl across from us was passing away. Our hearts ache for them and we pray for that family. At the same time we are able to reflect on how thankful we are for these 4 weeks with our precious triplets and the small improvements that they make each day. It hasn't been an easy road and yet it is a road filled with everyday grace from our Heavenly Father.

Day 23 - 25

It seems to be getting more difficult to write these blogs. The triplets often have similar or reoccurring issues and sometimes it's hard to keep track of each baby. It also often feels like the days are running into the each other to the point that we often forget which day it is!

Liam:
This little sweetheart is still intubated and it seems he will be for at least a little longer. He is not able to come down on any of his settings and stays in the same oxygen requirements as well, which indicates he is not ready for CPAP again. The doctors suspect that a lot of this has to do with his PDA which is again open and again being treated. This is his third treatment and so we are really praying this will work and stick so he can avoid heart surgery. On Monday he will receive another echocardiogram to see if the duct has closed or not. Because he has been swinging in his oxygen needs a bit and having some rougher nights in terms of breathing, we haven't been able to hold him for awhile.
In the meantime, Liam continues to finish his antibiotics but physically seems to be over his infection. He is growing and we can definitely tell by looking at him! His cheeks are starting to get chubbier and we even notice a bit of fat on his little feet! The nurses tell us that this is in part due to the fortifiers they put in his milk.

Taylor:
Our little girl's tests for infection have all come back negative. This includes her blood cultures, her kidney/renal ultrasounds, and her urine sample. However, the doctors were not satisfied with these results as she was showing strong symptoms of an infection. They decided to treat her as though she has one. Early Friday, Taylor spit up some blood mixed with her milk and the doctors decided to do a head ultrasound and a lumbar puncture to check for infection in her cerebral spinal fluid. As of Saturday, we don't yet have results.
In terms of breathing, Taylor is still on CPAP but not doing nearly as well as before she was sick. The doctors warned us multiple times that she may be intubated but so far she has stuck it out. The doctors suspect that her sickness and/or her PDA (which has reopened) may be impacting her breathing. This fits with her chest X-rays that show her lungs have not been able to fully inflate lately. Taylor is on her second round of treatment for her PDA. She continues to have bradycardias, although lately a chin strap to keep her mouth shut has helped a bit. This lets the CPAP get more air and pressure into her lungs via her nose mask. Compared to her brothers who only have two tubes on their faces, she looks so sad with her face mask pulled tight on her tiny face, her feeding tube taped across her chin, her CPAP hat covering her hair, and her chinstrap encircling her head. The face mask really squishes her face because she is so small and it needs to be as air tight as possible.
We also haven't noticed an ounce of fat on our princess yet. She is much smaller than her brothers, especially because she doesn't get fortified milk or full feeds yet due to her being sick. We have been able to hold her twice this week though, which we are very thankful for.

Malachi:

Our youngest sweetheart also remains intubated without being able to be weaned down on his breathing support. He is still being treated for his bladder infection although physically he seems well. Malachi's lumbar puncture did not go as planned since the healthcare professionals did not collect enough fluid. This meant that they were unable to run all the tests they wanted to. The one test they could run was negative but the infection team strongly felt as though this was inconclusive. They told us that all the other signs and blood work indicated that Malachi was much sicker than just a bladder infection and thus decided to treat him for meningitis instead of doing another invasive lumbar puncture which would also take more time to wait for results. Malachi received a new PICC line and will be on antibiotics until the middle of December.
On a lighter note, Malachi is visibly growing like his brother and is also still in fortified milk. Both boys have passed 1000 grams while Taylor is at 860 grams. Malachi's hair is also visibly growing on his head and quite a bit on his arms too! (This is normal for preemie babies). We got to hold him once this week as well.

As parents we are able to more and more become involved in our babies' care and are becoming more comfortable with things like diaper changes. Unfortunately it is cold and flu season, and Nathan picked up a small cold this week which meant he could not see our babies for a number of long days. It's obviously very difficult to be unable to see your own babies and we are praying that we can both stay healthy in the coming months! While we aren't letting in visitors into the NICU besides immediate family, as parents we do enjoy visits from friends and family who do not have any sicknesses or sick family members. We hope you can understand.

We continue to covet your prayers to our Heavenly Father who is the Creator and Sustainer of life!

28 Weeks and 2 Days Gestation

Today the triplets are 28 weeks and 2 days gestation, or 22 days old. In general, they had a busy Monday, quiet and stable Tuesday, and busy Wednesday.

Liam:
Our oldest little triplet is still the heaviest of the three. Both Liam and Malachi are over 2 lbs and continuing to gain weight. Taylor is not yet 2 lbs and needs to gain another 60 grams to get there. Sunday night and Monday, Liam had a rougher go. His oxygen saturation levels (how well his oxygen is being taken into his blood) kept swinging up and down. As he is just recovering from his infections, the nurses believed that a lot of it had to with Liam feeling unwell. Liam started to do better over the last few days and looks like he is feeling better as well. Liam's feeds are back up to 12 mm which is a full feed for him! He still has a PICC line because he is still on antibiotics for his infections.
On Tuesday, Liam had a head ultrasound which showed that the bleeding has not gotten worse. We are thankful for this! Next week he will have another head ultrasound to monitor it.
The healthcare professionals can also hear the PDA in Liam's heart and an echocardiogram done Tuesday shows he will need a third dosage to treat it.
On Wednesday morning, the plan was to extubate our little boy but the plan changed when Liam showed that he could not handle it yet. The respiratory therapists will wait 48 hours and reassess. This is somewhat disappointing as Liam was doing so well on the CPAP before.
On Wednesday afternoon, Liam needed a blood transfusion as his hemoglobin levels were dropping and he looks quite pale.

Taylor:
Our little girl has had a few ups and downs the last few days. Because she looked pale and lethargic, the doctors had done blood tests for an infection over the weekend and started antibiotics. However, the results did not show an infection. It's possible the antibiotics caught the infection early or Taylor was sick from something else. On Monday, the doctors did a blood transfusion to raise her hemoglobin and Taylor looked more pink and is was more active. She remains on CPAP but has been having a lot of bradys where her heart rate drops and her oxygen saturation levels also drop. Some bradys she can come out of herself, but others require the nurse to stimulate her so she will recover. The healthcare team has been changing her settings on her CPAP machine and changing Taylor's position and trying different things to prevent the bradys.
On Wednesday morning, the healthcare team determined that Taylor was again looking sick. As of Wednesday afternoon, the concerns include: 1) a possible infection for which they have taken blood tests and sent them off, 2) kidney problems because she is not urinating enough and for which they have done an ultrasound and await results, and 3) possible PDA issues again for which she received an echo in the early afternoon. None of these issues are certain but are being monitored to try figure it out. Taylor received another blood transfusion Wednesday afternoon to raise her hemoglobin again. She is also now on general antibiotics to start treating the possible infection. Thankfully, Taylor is finally back to full feeds which means all the triplets are getting the amount of breast milk that matches their sizes. This is great considering all the benefits that come from getting their mom's milk.

Malachi:
Our youngest triplet had concerns of possible pneumonia but it was determined that it was a bladder infection instead. It is likely that the infection was making him feel unwell overall and therefore impacting his breathing and lungs as well. He is on specific antibiotics (just like his siblings) to treat the infection. A lumbar puncture was also done on Tuesday afternoon to check if there was an infection in his cerebral spinal fluid. We don't have results for that yet.
Malachi also received an echo Wednesday as his PDA is audible like his siblings. Again we will receive results likely tomorrow.
In terms of his lungs, Malachi is still intubated like Liam and on higher settings and oxygen than his brother. Hopefully treating the infection and possibly the PDA can help this little guy improve and get onto CPAP so that his lungs can  improve.

We again want to express that we are so thankful for the encouraging emails, texts, cards, messages, etc. Thank you for your prayers! We are starting to get to know more parents and nurses in the NICU and at Ronald McDonald and some of the stories are encouraging, while others really scare us. Yet we are also able to see differences because while many parents put their trust and hope in their doctors, nurses, and healthcare teams, we take comfort in knowing the Greater Power. Our God is in control, also over the healthcare professionals.

"The steadfast love of the Lord never ceases; His mercies never come to an end. They are new every morning; great is Your faithfulness..." Lamentations 3:22-23.

November 25-27

As parents, we have really been noticing specific preferences and differences between each of our precious triplets. We love to marvel at their little personalities and differences.
For example, Malachi loves to stretch out his tiny body no matter how his nurse positions him. When we walk up to his little bed, we often first see a little arm or foot waving in the air. Malachi doesn't like being laid on his left side.
Another example is how Taylor will use up lots of energy when a nurse is handling her (changing her diaper, putting in an IV, weighing her, etc.). She will cry her tiny cry with all her might, wave her arms, and kick her legs so that by the time the nurse is done she is very tired and sleeps soundly.
Liam has also shown a mind of his own. He loves to have his hands up around his face. Even if the nurse tucks his arms in by his side, he always manages to squirm them out and up by his face.
All three love to suck on soothers. All three love to lay on their tummies all wrapped up. They are little people who have been created by the awesome Creator!

Liam Josiah:
Liam's infection seems to be much better. The second blood culture came back negative which most likely means the antibiotics are working. His skin color is improved and he has more energy. The doctors decided to leave Liam intubated over the weekend and reassess Monday for when he might go back on CPAP. He has been doing quite well intubated in the meantime. He is also tolerating more and more breast milk, as he had not been getting any while he was feeling sicker. He is almost up to full feeds again. A lot of our babies' tests (head ultrasounds and echocardiograms) have been postponed to next week so we don't have any updates in that department. Liam is also growing and is over 2 lbs!

Liam intubated and trying hard to focus on Mommy's face

Taylor Joy:

Taylor has been also looking better than the past few days although she is still fairly pale. Her blood culture came back negative but the doctors are quite sure she had or still has some sickness or infection. She is being kept on a general antibiotic and monitored. In the meantime she has also restarted a small amount of breast milk but has been throwing up a fair amount. She continues to get supplements and antibiotics through an IV, but they have not put a PICC (permanent IV) back in yet, as they hope she will be back to full feeds soon. Taylor has lost weight the last few days as well which is not very alarming considering she is not feeling well. Thankfully, Taylor has remained on CPAP (Continuous Positive Air Pressure) and is breathing room air oxygen (21%, which is what you and I are breathing), However, we have been learning a lot about the different types of CPAP and the different settings that can be applied. The number of puffs of air given as a reminder to breathe, the pressures applied to keep the lungs open, the percentage of oxygen given... there are many different settings and our baby girl has a long way to go before breathing on her own. Because the triplets are so little, they would not be able to grow or develop if they were even able to breathe on their own since all their energy would go into breathing.

Taylor with her CPAP sleeping in her favourite position

Malachi John:

On Friday at midnight we received a phone call (which we were more or less expecting) that Malachi was again being intubated because his lungs were again starting to collapse. Malachi's breathing support is quite higher than it has been this past week. In particular, his CO2 levels in the blood have been higher than they should be. The doctors are continuing to monitor and change settings on the ventilator to find out what is best for our little boy. We are very thankful, however, that Malachi continues to be on full feeds of 11.5 mm of breast milk with the added supplements that used to be given through the IV. This is obviously important for him to grow and get stronger! On this Sunday morning we learned that Malachi's lungs had collapsed partially again overnight. When we came to his bed this afternoon, we were excited to learn that Malachi was being transferred into the same pod (area) as Taylor and Malachi. This will make visiting easier as we divide our time between our three little ones. Shortly after being moved, the new healthcare team assessed Malachi and strongly suspect that he has pneumonia. This would explain his collapsing lungs and how he has been needing higher breathing support. The initial tests seem to really point towards pneumonia but the official blood culture results will take up to 48 hours. The doctor working today decided to start treating Malachi with specific antibiotics as if he has pneumonia, since all signs seem to be pointing to it. As parents we are of course very disappointed and worried to hear of yet another sickness for our triplets. The nurses have assured us that pneumonia is a fairly common risk when babies need to be intubated in the NICU, yet it is serious that our little baby is sick.

Malachi intubated again and wiggling onto his back from his side

Isaiah 40:11 has been sent to us by a number of people: "He will tend his flock like a shepherd; he will gather the lambs in his arms; he will carry them in his bosom, and gently lead those that are with young." We take comfort knowing that our Shepherd tenderly loves our precious triplets who are His covenant children.

Days 15 and 16

It seems we've had more downs than ups these past few days on the NICU rollercoaster.

Liam:
The doctors have been treating Liam's blood infection with specific antibiotics targeted at the infection, which they now strongly believe is from the sore on his belly he has had since Day 1. Liam seems less lethargic but we are now waiting for a second blood culture test to determine if the antibiotics are working. On Thursday morning, he was taken off the CPAP and intubated again as it seemed too much for his little body. He is doing very well being intubated and hopefully this is short term. On Wednesday, Liam also received a lumbar puncture to determine if the infection had spread into his cerebral spinal fluid (which is around the spinal cord and brain). The results came back late this Thursday afternoon and they were positive. The infection team believes that Liam had or still has meningitis which is an infection on the brains membrane. The healthcare professionals explained to us that what this means for Liam's long-term outcomes and development will be seen in the future and cannot be determined anytime soon. We are trying hard not to worry about this because we know it's in our Father's hands. In the meantime we are waiting for our sick little guy to overcome the infection and get stronger.
We are thankful to report that Liam's PDA causing a heart murmur is no longer heard by the nurses. We pray that the PDA will remain closed permanently and avoid the heart surgery. Liam also had a head ultrasound Thursday morning and we await the results on the bleeding in his brain.

Taylor:
Taylor was having a pretty good week aside from some bradys and swinging in her oxygen requirements and heart rate. On Wednesday she started spitting up more than normal and slowly over Wednesday night the nurses started thinking something was up with our baby girl. Seeing her on Thursday morning, we can tell she is not herself as she is lethargic and paler than normal. Currently, we are waiting for test results to determine if Taylor now has an infection. Doctors believe it's very likely and have already started her on antibiotics. Before the red flags started going up, the healthcare team decided to pull out her PICC line and feed her IV nutrients through her oral feeds. This is now unfortunate as Taylor's feeds have been suspended and she has needed another IV put in to give her nutrients. A new PICC line may need to be put in. Again, we commend our sick baby into our Father's hands. Taylor's heart murmur has gotten worse the last few days and an echiocardiogram will be repeated to determine if she should go back on a second dose of medication to treat the PDA.

Malachi:
This little cutie doesn't seem to have an infection but he had a busy Thursday as well since doctors decided to extubate him and try him on CPAP. As of Thursday evening he is doing extremely well. He may have his PICC line taken out Thursday night or Friday morning. He is our only baby on full feeds now (11.5 milliliters), since the infections set back the other two. Malachi's heat murmer is still audible but the doctors feel it is not strong enough to be of concern. They will wait to see if it will resolve on its own.
Malachi has had a better few days than his siblings, yet we continue to fervently pray for him too as we know that the situation can change quickly.

Thanks for your continued prayers.

2 Weeks Old

They say that every day in the NICU is a rollercoaster and we certainly can understand that saying... multiplied by three! The past few days seemed to have had a lot of dips and loops for our little babes.

Liam:
Our little guy has had a tough few days. On Sunday night, Liam's heart rate was high and he was not acting like himself. Blood work was done and by Monday it was confirmed that our baby has a blood infection. This could be from any of the needles, IVs, PICC lines, or the open sores he got from the sanitizing products that his skin reacted to. The healthcare team is monitoring Liam closely. He is being treated with antibiotics and some Tylenol to help him settle. Liam also has had a lumbar puncture (needle which goes into his spine and extracts some cerebral spinal fluid) to see if the infection has spread to his brain. We are waiting for the results and praying this is not the case. In the meantime, he seems to have more energy on Tuesday.

All three babies have come off the humidity in their incubators since they are now 14 days. Their skin is much better looking- not as red and see through. All the babies are also getting a millimeter more of breast milk each day and are almost at full feeds. To give an idea of what a full feed is: Malachi is 885 grams (900 grams = 2 lbs) and so 11 milliliters is a full feed for him. This evening he is at 10 milliliters. Once a baby is at a full feed, they will try fortify the breast milk with the nutrients that are currently going into their bodies through the PICC line (permanent IV). If the baby tolerates everything orally, they can take the PICCs out. Hopefully all three triplets can have this in the next few days.

Taylor:
Our baby girl has had better days than her brothers recently. However, she has still been swinging up and down in her oxygen requirements. The nurses and respiratory therapists have been playing with her CPAP settings and even had her on an oscillator for a while. As of Tuesday evening she is on fairly good oxygen levels. Another issue Taylor is facing is mucous and secretions in her nose and mouth (Liam and Malachi have also been having this to a lesser degree). This really impacts her ability to breathe properly and so she needs to be suctioned often.

Malachi:
On Sunday night, our Malachi was having some intensified breathing difficulties. The healthcare team finally determined his breathing machine was faulty and replaced it with a whole new unit. In the meantime, for whatever reason, his right lung partially collapsed. By late Monday morning, his lung was resolved but both lungs had a lot of fluid in them that needed to be emptied. The turn of events was especially disappointing because Monday was the day that the doctors planned to extubate Malachi and try him on the less invasive CPAP machine. Everyone is anxious to get him off the breathing tube because it is harmful and hard to get off the longer it is in. The doctors are now assessing him daily to determine when they will try extubate.

We are told and are also experiencing that every day and even every hour can fluctuate. Infections unfortunately happen to almost every baby in the NICU. Babies improve and regress and improve again and regress again all the time. It's nerve-racking to walk into the NICU each time, wondering what news we'll hear this time and how each baby will be.
We cannot express enough how thankful we are for the support we receive and for all the prayers to God for our precious miracles. Please continue to pray for these little babies. We remember our wedding text from Proverbs 3:5-6: "Trust in the LORD with all your heart and do not lean on your own understanding. In all your ways acknowledge Him and He will make straight your paths."

12 Days Old

We have learned so much these past 12 days. We have learned many new medical terms, how to read the many numbers and graphs on the monitor screens, the different types of care our babies need, etc. While it often feels overwhelming, we are thankful that the doctors and nurses take the time to answer all our questions and update us often on our babies. Each baby usually has a one-on-one nurse for a 12 hour shift. Sometimes when the babies have been stable in the last few days the nurse will have 2 babies at a time per shift. We are allowed to visit anytime and call at any time for updates. The NICU calls us if there are serious issues. We also meet with our babies' neonatologists and a social worker once a week to go over everything thoroughly. On Thursday we had one of these meetings.

Liam Josiah:
We were fairly optimistic going into the meeting about our oldest triplet. However, the doctors talked about some issues in a greater depth than our nurses and discussed 2 fairly big challenges Liam is facing. First, his PDA (valve in his heart which channels blood to the placenta) was opened too far again. The first round of medication for the PDA had worked initially but then reopened. The doctor discussed how this also causes Liam's lungs to get very wet and therefore makes breathing very difficult. This explained the higher breathing support and dips in oxygen we had been seeing for Liam. The doctors will try 2 more rounds of medication before performing heart surgery on our little boy. While the second round of medication given on Friday has improved Liam's breathing so far, it's too early to tell if it will be a long term fix. By next week Monday (not tomorrow) we will likely know if surgery is necessary. The second big challenge for Liam is that the bleeding in his brain has worsened. Initially it had been in the fluid filled ventricles, but it has progressed outside the ventricles which is called a flare effect. It's too early to know if it will worsen or even if it will have implications for Liam. However, bleeding in the brain scares us and it's hard not to worry about this issue.
In the past few days, we have been able to hold Liam every day (twice on Saturday!) and he does very well. Because of the PDA medication, his feeds are behind his siblings at 5mm and he has also been on phototherapy often because of the medication side effects. On Saturday evening, Liam was nearly at his birth weight of 900 grams.

Taylor Joy:
Our baby girl has been doing quite well in comparison to her brothers. The bleeding in her brain is the same as the last time and doctors are optimistic about this, since most bleeds happen in the first 3 days of life. Her PDA has nearly closed from the medication and the doctors feel it should close all the way in the near future without medication. Taylor has been doing well on the CPAP but does have dips and swings in her oxygen and heart rates. Sometimes she stops breathing while sleeping (especially after she tires herself out with all her moving around during handling) and needs stimulation to revive. All the babies remain on caffeine through IVs since preemies often have this issue. Taylor has passed her birth weight and is very close to her brothers' weights! We have also been able to hold Taylor every day these past few days. On Friday she enjoyed a snuggle with Jodi at the same time as her brother Liam. On Saturday morning Taylor's other eye opened. Now we are just waiting for Malachi to open his little eyes.

Malachi John:  

Our youngest triplet's biggest challenge remains his lungs. At the family meeting, Malachi's neonatologist expressed that he was unhappy with how Malachi's lungs were not progressing. He is on a fairly high level of support and remains intubated through his nose and down to his lungs. Babies should not be intubated for long because of the damage it does to their lungs. The longer a baby is intubated, the longer the baby will continue to be dependant on it. The neonatologist asked us as parents to make a decision whether or not to start Malachi on steroids to help the development. After talking through the benefits and risks with him, we decided to go forward with the steroids. It will be a 10 day course with the goal to heal and develop his lungs and get him stable enough for CPAP. Malachi was 5 grams below his birth weight on Saturday evening! He has been tolerating his mom's breast milk better than his siblings without reflux and is at 7 milliliters a feed every 2 hours.  On Saturday evening Jodi was finally able to hold Malachi for the first time! He seemed to love it, even though the process of getting him out and in is even longer than that of his siblings.

As parents we have been grappling with many questions. What can we do for our babies? How can we best support them? What does it mean to be "good parents" in this situation? How do we divide our time and energy? What will the coming days and weeks look like? How can we protect such vulnerable human beings? As we work through all these questions, emotions, and challenges, we remember Romans 8:28 which says, "And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Thanks again to everyone for all the many texts, emails, messages, and comments. We don't always respond but we do read them and feel uplifted by all your prayers to our Heavenly Father who is working for our good and for His glory. 

The Triplets are 8 Days Old

Its so hard for us to believe that a week ago this whirlwind started! It feels like yesterday we were feeling terrified in the operating room...

On Tuesday, Liam had a fairly good day. Since he has been on his CPAP machine, he has been having periods where his heart slows down significantly. He often needs stimulation to get his heart rate up again. His oxygen levels are also a bit higher but have remained stable. Liam has been spitting up and "pushing up" his food through the feeding tube lately. Jodi was able to hold Liam for the first time Tuesday afternoon and he responded extremely well. Nathan was able to hold our firstborn on Wednesday and the same results occurred. The nurses were very impressed with how Liam's oxygen levels improved during the snuggles, he settled down (he often is waving a little arm or a little leg in the air), and the fact that he had zero bradys while being held! Unfortunately he went back to bradys after the skin to skin care but his oxygen remained a bit better.
God's design for human life amazes us. For example, how a parent snuggling his/her baby has great health benefits for the baby. Another example is how a mother's breast milk has incredible benefits for the baby including protecting against infections and sicknesses. We often find ourselves marvelling at the triplets' tiny fingers, ears, noses, toes... and thinking, "What an amazing Creator!"

All three babies had echocardiograms on Tuesday and it was determined that Liam and Taylor both have murmers persisting and thus need another round of medication. However, the official results on Wednesday demonstrated that all three babies are improved and therefore they will wait in giving more medication.

Taylor had her PICC line (permanent IV that goes all the way up to the top of the heart) put in Tuesday. The burn mark on her other arm where the other PICC line was had some pus which is always a cause for concern since infection is very dangerous for such little babies. However, the tests have come back negative for infection and she will likely come off antibiotics soon. Doctors had been hoping Taylor could come off her breathing tube and onto the less invasive CPAP soon and on Wednesday afternoon they went ahead with the procedure. As of Wednesday evening, Taylor is doing extremely well. Her oxygen levels remain very stable and at the same level she was on with the breathing tube. This is incredible, especially compared to her brother Liam who is on much higher oxygen support and continues to swing up and down in his breathing support needs. Taylor can partly open one eye so hopefully she can open both soon! Liam can open both his eyes but Malachi's remain fused.

Malachi has been much stabler these past few days and we are so thankful for this. His chest tube was removed on Tuesday after x-rays showed the air between his lungs and chest were gone for a long enough period. Malachi is still on an oscillator (which shakes his lungs gently to help him breathe) and is still intubated. However, his oxygen levels have been much better (though still quite high) and he is able to get more rest. When the nurses try to wean his oxygen levels down, he reacts very poorly.The doctors do not think he will be coming off of the breathing tube and oscillator anytime soon. Malachi has also been successfully weaned off the pain medications from the chest tube.

Both Nathan and Jodi have had opportunities to help change diapers, take temperatures, hold feeding tubes, and hold our babies' hands (although touching their skin requires a lot of care since their skin is so sensitive and thin). These opportunities make us so thankful that we can interact with our babies and relieve some of the helpless feelings we are experiencing. We are very thankful for the healthcare professionals who have been very kind and compassionate towards us and especially towards our babies. It's crazy how much we need to trust them with our little ones, yet we know that ultimately they are in our Father's care! Our pastor sent us this text the other day: "Be still and know that I am God..." (Psalm 46:10). We admit that its difficult to be at peace and still, yet we know and trust that He is in control.

Days 5 and 6

On Sunday morning, Jodi was discharged from the hospital and Nathan and Jodi were able to move into the Ronald McDonald House. We are extremely thankful for this opportunity which makes commuting and meals so much easier. At the same time, it was immensely difficult to leave our precious little babies at the hospital and it made for another emotionally draining day.

All three triplets have had ups and downs the past few days.

Liam:
On Sunday, the healthcare team in the NICU decided to try put Liam back on to the CPAP machine since he was breathing so well with his intubation. This means Liam has to do more work breathing on his own. It has been much harder for our little guy to breathe and there have been a number of adjustments and changes to try help him out. However, as of Monday evening, he is still on the CPAP being monitored closely. The breathing tube that was pulled out (which the other two triplets still have) goes down the throat, between the vocal chords, and to the top of the lungs, the babies are unable to make noise. On Sunday evening we first heard Liam's tiny voice when he started to cry (which made us cry too). Like his siblings, Liam has gone up to 2 milliliters of breast milk every 2 hours through his feeding tube. Liam has also gone off and on phototherapy for jaundice these past few days. Because he has been struggling with his new CPAP machine, we have still been unable to hold our baby boy.

Taylor:
Nathan was able to hold Taylor for the first time on Sunday afternoon which was an incredible moment. Both Nathan and Jodi have been able to help with Taylor's (tiny!) diaper changes as well. Taylor has been having breathing issues where she gets too tired and forgets to breathe. For this reason, doctors have decided not to "upgrade" to the CPAP machine yet and she remains intubated like Malachi. On Monday afternoon, the nurses felt confident that Jodi could hold Taylor again. However, she had a fairly serious episode during the skin to skin where she stopped breathing and needed a team of healthcare professionals to intervene. Needless to say it was a very intense time. It was determined that some secretions in her lungs had caused a blockage when she was moved from a horizontal to more vertical position. Thankfully she was stabilized and is again doing well. Like her brother Liam, Taylor has needed a blood transfusion for low hemoglobin levels. Another obstacle Taylor faced this Sunday was another skin reaction causing a burn mark on her arm where the PICC line was inserted. The PICC line was removed and antibiotics started in case of infection. A temporary IV is now in her hand and another in the top of her head. All the poke marks, IVs, burn marks, and lines on her tiny body are so sad to see. Happily, Taylor has started to gain a few grams (as you probably know, babies always lose weight after birth).

Malachi:
While our youngest triplet has been mostly stable these past days, he has had some difficulties persist. The chest tube to empty the air between his lungs and ribs remains in although it has been clamped closed. This will be monitored with more x-rays in the next day to try remove as soon as possible. He still requires a lot more oxygen and breathing support than his siblings. On Monday afternoon, a PICC line was finally put in to replace the temporary IVs. It hadn't been done yet because Malachi had not been stable enough for the doctors to feel comfortable to do this. All three triplets have had three doses of medication to treat the PDA which causes a heart murmur. The nurses on Monday afternoon heard murmers still in Liam and Taylor (which could still resolve) but not in Malachi (although it could still be there).

We continue to covet your prayers especially as we start to come to terms with the long-term plans and implications. At this point, the doctors have told us that we can expect our babies to be in the hospital until at least their original due date which is February 20th, 2017. We praise the LORD that He continues to preserve life and allows our babies to be doing relatively well for their gestational age, which is 26  weeks. May He answer our fervent prayers! Thanks also to everyone for their support and prayers.

The Triplets are Born

This blog is intended to keep our family, friends, and church family updated on our little triplets, as it is very difficult to keep everyone update regularly. As you can imagine, many changes and updates happen daily and even hourly with each baby, so will try to stay as concise in our updates.

On November 9, 2016 our triplets were born at 25 weeks and 2 days. We were aware of the higher risks of preterm labour with triplets throughout the pregnancy. Jodi was also put on hospital bedrest on October 31 due to a shortened cervix. However, their arrival was still very much a surprise but our Heavenly Father in His perfect wisdom determined it was time. At 8:00 am, Jodi started feeling some pains. By 10:00 am it was determined that she was in labour and Nathan arrived at the hospital quickly from work. At 11:00 am the doctors decided it was time to do a c-secttion.

At 12:56 pm, Liam Josiah was born weighing 1 lb 15 oz. At 12:57 pm Taylor Joy was born weighing 1 lb 10 oz. At 12:59 pm, Malachi John was born weighing 1 lb 14 oz.

Each baby was immediately whisked away by a team of doctors and health care professionals. They were all intubated and put on breathing support, and put on special IVs through their umbilical cords. Many monitors and probes were attached to their tiny bodies to monitor different things like heart rates, temperatures, oxygen levels, etc. They were then taken to the NICU (neonatal intensive care unit) once they were stable. Thank the LORD that each of them were able to be stabilized by the late afternoon, though many challenges are faced by these little ones each day.

We will try to give a summary of each baby from their birth on Wednesday afternoon until the time of writing on Saturday evening.

Liam:
Our biggest baby boy has the easiest time breathing out of the triplets, yet still requires much support for his underdeveloped lungs. The doctors tried to take out his breathing tube and put him on a different support called CPAP, but Liam needed to be intubated again when his little body couldn't handle the lesser support. He has been given two doses of surfactant, which help his lungs to breathe. His skin reacted to some sanitization around his umbilical cord shortly after birth, and as a result he still has a fairly large burn but that is starting to heal nicely. On Thursday, a head ultrasound of the brain showed a small amount of bleeding in the brain which the doctors will continue to monitor. However, they are fairly optimistic it can resolve on its own. On Friday, the IV in his umbilical cord was replaced with a more permanent IV called a PICC line. On Saturday, Liam was given medication for his heart for something called a PDA which results in a heart murmer. Liam has also been treated with phototherapy for jaundice, which is very common for babies. The doctors have started Liam on 1 milliliter of breast milk - through a feeding tube, yet he does not always take well to it with his tiny stomach which was not developed for food yet.

Taylor:
Our baby girl is the smallest of the triplets yet has proven to be quite feisty. Her journey has been quite similar to Liam's journey including  two doses of surfactant, a small burn on her skin as well, a small amount of bleeding in her brain, a new PICC line to replace the umbilical IVs, medication for a PDA as well, and treatment for jaundice. On Wednesday, the doctors had to take out one of the umbilical IVs when her foot started to turn colour due to lack of oxygen. The extra handling that all of this took made for a rough first night for our baby but she pulled through. Taylor has also been having drops in her heart rate for which the doctors and nurses have been changing her breathing support settings to try resolve the issue. On Saturday afternoon, Taylor was stable enough that Jodi was able to hold our baby for the first time and she responded well with improved oxygen levels. Taylor has also been started on 1 millileter of breast milk every few hours.

Malachi:
Our smaller baby boy has had a difficult time with his tiny lungs. The doctors have often had to turn up his oxygen support levels moreso than the other two babies which have made for some rough patches. On Thursday, it was determined that Malachi had air between his lungs and rib cage. The doctors put in a tiny needle in the side of his chest cavity to drain the air. The air remained a problem on Friday as well. It is the hope that the hole or multiple holes in his lung can heal quickly and the chest tube removed, as it is invasive and painful. On Friday, Malachi's left lung partially collapsed. Thankfully, the lung has been improving as of Saturday night, although it is still not up to full inflation. Malachi is not yet ready for a PICC line although it is the hope in the future. Malachi also needs to be treated for PDA yet as of Saturday evening, the doctors weren't confident he was stable enough for the medication. We are also thankful that Malachi has not shown any bleeding in the brain, though doctors will continue to monitor this as well.

Through all these ups and downs, we trust in our Heavenly Father to watch over and be with our tiny little blessings. As parents, we feel so helpless yet we know that our God is in control of these precious lives. We are so thankful for the many prayers that have gone up and continue to go up for our babies. We covet your prayers! Many people have sent us Psalm 139 as encouragement: "For you formed my inward parts; you knitted me together in my mother's womb. I praise you for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. My frame was not hidden from you, when I was being made in secret, woven in the depths of the earth. Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them" (verses 13-16).

Many of you have been asking about visiting. As of yet, we have not been having many visitors due to the overwhelming emotions and exhaustion we have been facing and business of meetings with various medical professionals. As things settle down we are happy to have visitors for Nathan and Jodi. However, we will not be allowing everyone into the NICU to visit our babies. There are many sick little babies in the NICU and there are many rules to control for germs. Our babies too are very fragile and cannot be exposed to many different people. We hope you can understand.