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.