Day 293

We thought we would start off this blog with sharing a few photos that the very talented Kelly Linde Photography took for us while Malachi was still in the NICU (about a week before his move to the PICU). We are so grateful to her for generously offering to take these photos for us. We will treasure the beautiful video and the photos, as we can look back and remember the everyday experiences of the NICU life. 

Since our last blog update, we have been very busy with preparing for going home. Between completing our training, ordering equipment, preparing our house, buying the necessary non-medical items we need for Malachi, booking lots of tests and follow up appointments, speaking to lots of different health care professionals, contacting and setting up new outpatient services, and practicing our skills on Malachi (extra trach tube changes, using the rescusitator bag daily, practicing getting him ready for a walk, hooking him up to our own home equipment, etc.)... each day ends up being quite packed with activities. We now have a tentative home date of Thursday September 28th! This date is a moving target, especially since we need to have trained home nurses lined up before we are allowed to go home. We are discovering that this could be difficult to line up in time but we are staying hopeful! We qualify for the maximum amount of covered nursing, which is 5 shifts of 8 hours a week. We are hoping and praying to have these 5 shifts at night, so that we will "only" have to stay up 2 nights a week. 

A trained person has to be awake and watching Malachi 24/7. This is largely why the hospital will not allow us to go home without nursing lined up. We would burnout in a matter of days, since Nathan works full time. This is also why we are currently in the process of hiring a nanny. We need to have 2 adults in the house at all times because one person needs to be watching Malachi and the other two triplets still require a lot of the normal baby attention and care. 

It's overwhelming to think about juggling it all. Sure, there will be times when all 3 babies are sleeping and calm. But there will also be those times where one baby is hungry, the other has a poop explosion and needs a bath, while the other is pulling on his tubing and needs to be distracted with a different toy. (We can't even imagine what it will be like when they start crawling! We will need to be following Malachi constantly with all his machines to make sure he stays connected! Not to mention how Liam and Taylor already try grab at Malachi's tubes and cords and put them in their mouths...) 

It gives us such deep and overflowing joy to think of all 5 of us under the same roof. We can't WAIT to be together and not need to be constantly missing either Malachi or Liam and Taylor or each other. We can't WAIT to relax together instead of always bouncing back and forth between the hospital. We can't WAIT to be alone in our own home and around our own table and in our own bed... (goosebumps just writing about it!) The joy and anticipation is extreme. But just as extreme is the fear and nervousness over taking Malachi home. We are quite confident in his everyday care and even trach changes are getting less scary. But ultimately it's the intense fear of an emergency situation. We are "trained" many different types of emergency scenarios but we have never had to take control in a real emergency. Will we panic and forget everything? Will we be able to remember what to do and when? Will we react quickly enough? Will the ambulance arrive on time? As going home becomes less of a concept and more of a reality, the weight of responsibility feels heavier and heavier. We know Malachi's life is in God's hands ultimately, but we know that his life is medically fragile and dependent on medical equipment and machines. It's our responsibility to ALWAYS be on guard and paying attention. It will be mentally exhausting and draining. 

But he is 1000% worth it all (and that extra zero is not a mistake). 

So on to the updates on each triplet...

Liam: 

Our little man continues to show quite the personality more each day. When he's happy, he lets everyone know it by shrieking loudly and laughing out loud. When he's upset, he lets everyone know it too by complaining and sometimes having very loud meltdowns. He concentrates quite intensely on toys and smiles very easily. He is so fun to play with! This past week he started solids and caught on pretty quickly to it. He's also close to sitting by himself. We haven't had appointments lately with Liam and Taylor because we are trying to book them in with Malachi's appointments shortly after discharge. 

Taylor:

Our sweet princess is still our smiley and happy girl. She smiles with her whole body like she just can't contain her joy! She still loves to whisper but is starting to coo out loud a bit more. She's very quiet and rarely cries. Like Liam she is close to sitting and has also started solids. She's not a fan at all of rice cereal, and we have some great footage of that! 

Malachi:

Our youngest sweetheart has become more and more smiley in the last few weeks. He has huge smiles for us when we come in to his room and it melts our hearts the way he recognizes us. It makes it harder to leave (if that's possible!) now that he knows us. 

He has been very stable and has even come down on some ventilator settings recently again. We are SO thankful! His settings are considered safe for home, but we are still hoping to keep getting them lower before discharge. Once we go home, the "weaning" process will take a lot longer because he does not have 24/7 medical supervision. So every step forward is an extra bonus before home! 

We feel badly about all the practicing we have to do on our sweet boy between all the trach changes and using the rescusitator bag and switching him onto different equipment and circuits... but we know it's for his overall safety in coming home.

A few weeks ago Malachi failed his left ear hearing test for the second time so we will be following up with that. We are also following up on his kidney stones and gallstones before discharge. Eye follow ups will be after discharge. ENT will put a scope down his trach before discharge to check his trachea and top of his lungs. His heart has been monitored already with an echocardiogram this past week that looked improved. We are setting up an occupational therapist, speech therapist, and dietician for home. Half his equipment has been ordered for us to practice on but more will be coming in the next weeks. What else..? We are probably missing things but you get the picture. Lots to do and plan.

When the triplets were first born, the hospital life consumed us and rightly so. All of our energy and attention was dedicated to our triplets and their health. It was so overwhelming and mentally enormous that it was all we could handle (and even then, we couldn't handle it and broke down repeatedly). We could not even listen to the news or hear someone tell us about their average day. It was too much to handle. It was like our brains were "full". We let in some close family but we could not handle visitors or phone calls. Maybe it could be called "survival mode". When something so traumatic and life changing happens, it's all you can handle. 

But over time we have noticed that it has improved. Nathan was forced to overcome it quicker than Jodi because he had to go back to work. That was a hard transition that took multiple attempts before he was back to full time. For Jodi, the hospital life continued full time and still does, and so it is taking longer to be able to handle the normalcy of everyday life outside of the hospital and the triplets. Even things like small talk or hearing the news (there's a world outside the hospital!) or going to church are difficult to do mentally and emotionally, but we are slowly improving. 

It's a hard thing to explain, but talking to others we have found that others have experienced this too. When the church community and family and friends reached out to us, we felt encouraged and uplifted by all the texts and emails and cards, etc. But we also felt badly that we said "no" to so many visitors and did not answer many of the emails and texts and cards. We know that some of you have faithfully prayed for our family and still haven't met the triplets. (Part of that is for germ reasons, too, since we are very careful with having visitors over). So here's our attempt at an explanation as to why we were so closed off. And once again, a heartfelt thank you for all the prayers and the reaching out to us even when it wasn't reciprocated. It was SO appreciated and still is! 

God has truly blessed us with a loving support network that is even bigger than we could have imagined. We couldn't have done without. And it is our prayer too that this experience will be a blessing to us in the future so that we may know better how to support those who are going through a mentally overwhelming and life changing time. 

Nanny Job Posting and 9 Month Update

In the past few weeks, Malachi’s discharge planning has begun. Community resources have been notified, medical supply companies have been contacted, and a schedule is being developed in order to get all things ready for Malachi’s transition home. The estimated timeline is 6-8 weeks from now! While this is exciting it also puts a lot of pressure on us to get the house finished, ensure all community resources are in place, mentally prepare, and find a live-in nanny. The healthcare teams (both in the PICU and the team who will be looking after us when we go home) strongly recommend that we ensure 2 people are home at all times with the triplets. This way one trained person can be solely dedicated to Malachi. We are looking for someone to help us with Liam and Taylor (the two healthy triplets). If you are reading this and know of someone who is looking for this type of position or would be a good fit – please pass it on! The job posting is as follows:

Job Posting for Live-In Nanny:

Requirements:

-          Estimated starting date: end of September 2017

-          Services required for at least 6 months (an extension is likely and can be discussed)

-          Loving, caring, dedicated, and child friendly

-          Hours: Monday to Friday from 7:00am to 6pm

-          Some after hour care may be required in extenuating circumstances

-          Assist in caring for two happy and healthy triplets (Liam & Taylor) - not Malachi

-          Assist with daily housework requirements including laundry, cleaning, shopping, etc.

-          Very germ conscious - especially in the winter season (this may unfortunately restrict some of the nanny’s social activities if sick people will be attending the same activity)

Compensation:

-          Pay to be discussed

-          Free food

-          Housing accommodations

o   Private bedroom

o   Private bathroom

o   Space to have your own time

We recognize that this will be a relationship that will need feedback both ways. We want to welcome you into our home but we also want to respect your need for space and your own time. If you are interested or have questions please email us at: nathan.vanwoudenberg@gmail.com

As parents we are filled with so many different emotions surrounding the discharge planning. We are overjoyed, terrified, impatient, excited, nervous, and filled with a great weight of responsibility. Will we be able to take care of Malachi at home? Will we burnout? Will we be able to react appropriately in an emergency? Will we have a sense of normalcy finally?

In the coming weeks we need to pass a simulation test. After this test we will be allowed to take Malachi for walks around the hospital without needing a nurse or respiratory therapist with us! We can’t wait but it is also daunting. Then Malachi will need to pass the carseat test so that we can start going for car rides with respiratory therapists and healthcare team members to “practice” different emergencies that can happen while driving. We will then need to sleep overnight in the hospital for a few nights without having any help from nurses or healthcare members. In addition to these steps, we need to have all the community resources, insurance, medical equipment, nanny, medical supplies, and nursing lined up before we are allowed to go home. So there is a lot to do and figure out.

Malachi is doing very well. He has been on the same settings for a few weeks and the plan is to not “rock the boat” or challenge him onto lower settings too much before going home. He is getting stronger every day. He loves to be held in a sitting position and he loves to go in his stroller. When the PICU isn’t too busy the nurses and respiratory therapists put him in his stroller and let him hang out with them in the nurse’s station (while his parents can’t be in the PICU). He has lots of smiles for everyone and lots of energy.

First time holding Malachi this way!

We also recently learned how to hold Malachi upright against our chests. Not a big deal to hold a baby against your body? Actually, it takes a lot of practice and some work to ensure that the trach, tubing, and cords are all comfortable and safe! It was an amazing feeling to finally scoop Malachi up and hold him upright on our chests! He loved this position before his trach surgery while he was still on the CPAP mask. These little moments highlight to us over and over that we cannot take each little moment with our babies for granted. The “normal” baby developments and interactions are not always “normal” and they are each precious gifts from God.

Being in the PICU each day also reminds us that good health cannot be taken for granted. Every day we are reminded of sickness and pain and suffering. We constantly hear children crying, see critically ill children with IV lines, casts, breathing support, sedation, etc., hear codes being called on to the hospital intercom, see healthcare teams rush to an emergency or critical situation… We walk into and out of the PICU and see the wheelchairs and hospital beds wheeling down the hallways. We walk into and out of the hospital and see the ambulances and hear their sirens every night. It breaks our hearts again and again. It makes us hug our babies a little longer and a little harder. And it makes us long for the day when God will wipe away every tear and alleviate all suffering.

Tummy time is also quite the process

Loving tummy time and looking at himself in the mirror

Liam and Taylor were baptized on Sunday August 6 with the service led by their Grandpa VanWoudenberg. The Bible text for the sermon was Psalm 139. It was a beautiful (and tiring) afternoon. What a rich blessing to hear God’s promises to our three babies that they are his children!

We will end this blog post with the words from this hymn:

If you but let the Father guide you, relying on His faithfulness,

He will be evermore beside you in all your sorrow and distress.

He who on God Most High depends builds not his house on shifting sands.

Will anxious care or bitter sighing at any time give true relief?

And what avails us our decrying each morning’s evil, trouble, grief?

We only add to grief and stress by discontent and bitterness.

Be still! What God in His good pleasure to you in wisdom may impart

Is given you in perfect measure; thus be content within your heart.

To Him who chose us for His own our needs and wants are surely known.

That last verse speaks about God’s perfect wisdom. It was His plan to bless us with triplets at 25 weeks gestation. All their health complications were in His plan. That Malachi needs to come home on life support is part of His perfect plan too. Sometimes (often, if we are honest) we feel like we can’t handle it. We feel like it is too much for us and we are going to just break under it all. But what a comfort that it is all in God’s plan for us. He is with us, loving us, and caring for us… shaping us, teaching us, growing us. 

Malachi Update and Baptism Plans

It hasn't been too long since our last blog but so much has happened with Malachi that we feel another update is appropriate.

In addition, we wanted to let our family and friends know that we plan to have baptism for Taylor and Liam take place next Sunday on August 6. Please ask us or our immediate family for details. It's going to be very emotionally difficult to do baptism without Malachi and it wasn't easy to come to this decision. We know that once he is discharged from the hospital it will not be wise to take Malachi into a crowd of people. We will most likely need to wait until at least next summer when colds and flus are less and Malachi is stronger and healthier, the Lord willing. And so with the guidance of our church's consistory, we have decided we will baptize Liam and Taylor while it is yet summer and wait a year or so for Malachi.

Superhero Day at the hospital

So what's new with Malachi? Well, a lot actually! This past week Malachi went outside the hospital for the very first time in his life! After 261 days, he was able to feel the sun on his skin and the breeze on his face. He made lots of funny faces when he felt the warm breeze which was quite funny to see. In order to get outside, Malachi took a ride in a stroller which was another first! It is quite the ordeal with lots of equipment to move the little guy anywhere. It's good practice for us for when we go home, though. Wherever Malachi goes he needs to have:

1) the breathing machine (aka ventilator) which is attached to Malachi'a trach via the breathing tubes 

2) enough battery backups for the ventilator 

3) oxygen tank (or more than one if he'll be out for a period of time)

4) suction machine and backup 

5) oximeter (monitor for heart rate and oxygen saturations in the blood)

6) "go bag" which includes all his trach equipment and the emergency equipment needed for if his trach tube ever came out, was blocked, etc. We have a list of items needed in the bag and it's long!

7) rescusitator bag for CPR 

8) his feeding pump and feeding bag

In the hospital we just attach it all to some carts and push and carry half of it. (Our first walk was with four healthcare professionals!) It works to push and carry between multiple people for now, but before we go home we will need a stroller that can safely carry Malachi and all his equipment (plus a diaper bag). This means we will need two strollers to take our triplets anywhere. 

First time outside!

Taking it all in

Daddy took Malachi out another day too!

Another requirement for Malachi to go on walks is to go on to a portable ventilator. There are different types of breathing machines and different modes or ways of breathing that each machine can do. Malachi will be on a portable ventilator 24/7 at home. Therefore we are very excited that Malachi can handle a home ventilator for an hour or so when he goes on walks. Yet another first! Soon, Malachi will be trialled on a portable ventilator (Trilogy) and hopefully stay off of the hospital ventilator (Servo-i). 

Another exciting development is that with smaller tubing and with Malachi's occupational therapy and physiotherapy, we are learning to move Malachi into different positions and to pick him up and hold him by ourselves (without a nurse or respiratory therapist)! This is huge. Imagine Jodi walking into Malachi's room in the morning, seeing that he is crying and just scooping him into her arms and comforting him without needing to call a nurse or respiratory therapist to help. Yep, she cried the first time that happened. It certainly takes practice and work and moving tubing and wires and careful positioning and planning... but we can finally gain some independence as parents. More than that we can give Malachi more cuddles and just have more normal parent-child interactions! 

With all these new developments the doctors are guessing that maybe Malachi can go home in 7-8 weeks! We are overjoyed and terrified and also keeping our hopes down (well, trying to!) as things can change so quickly yet. But we give all glory and thanks to God for all the improvements and miracles He has worked in our precious Malachi!

Happy baby #1

Happy baby #2

Happy baby #3

Our first family walk!

From NICU to PICU

These last few weeks have been very stressful and emotionally exhausting for us. This is because Malachi moved from the NICU to the PICU on July 12. A lot of people have asked us, "Isn't this a step forward for Malachi? Does it mean he is improving?" The answer is not really. The move was mostly due to his size and age. He was moved from the tiny baby intensive care unit to the child and teen intensive care unit. Here, there are children up to 18 years old. The average stay in the PICU is 3 days, whereas the NICU has longer average stays since most of the babies are premature and tiny. However, Malachi was also moved to the PICU with the thought that at some point he will be back in the ICU after he goes home (if/when he gets sick or if he has any complications with his trach). Thus, the PICU wanted to get to know him before his first discharge so that when he ends up back in the hospital they will already know his medical history and ongoing concerns. 

Playing in Malachi's bed

Liam:

Our playful sweet boy is so much fun. He smiles and laughs easily and loves to play with toys. This past week he rolled from his tummy to his back! Both Taylor and Liam can now roll over from their backs and their bellies. Liam's head ultrasound looked normal and his head circumference is also in the normal range, for which we are thankful! The checkups on his brain and head will be ongoing for now, but probably continue to be less frequent. 

Liam also had an appointment with an occupational therapist who was thrilled with his development and head control so far! We often hear healthcare professionals tell us how amazed they are with Liam and Taylor's development. They tell us that they never would have expected 25 weekers to be doing so well. We give all thanks and praise to God for this!

Such a happy little man!

Brothers

Liam in an outfit that his Daddy wore many moons ago

Taylor:

Our happy little girl continues to be smiley and content. She is very social and prefers people over toys. 

This past week Taylor had an appointment with a speech and language therapist. This was because she often whispers instead of cooing. She rarely cries and when she does it is very soft. She also makes wheezing noises often, which is called stridor. At this point they aren't too worried but it could be from having the breathing tube down her airway in her first month of life. This will have to be monitored so that if it gets worse, it will get checked out by ENT (ear nose throat) specialists. There is also some concern that her reflux is irritating her vocal chords. Again, it will be monitored for now. 

Taylor liked the cakes! (Made by Pie in the Sky Bakery)

Malachi:

As previously mentioned, our sweet little man moved to the PICU from the NICU. It was an emotional day. We left a lot of people that we had built relationships with... people who had cared for our babies when we could not. They were the people we entrusted our babies' care to. We saw them every day (except when we were sick) for over 8 months! They let us into the circle of care and educated us and empowered us when we felt helpless and afraid. They saw us go through the hardest times in our lives and they understood when so many others could not. So yes, there were tears that day... and not just our own! Malachi was a big baby compared to the other babies in the NICU which meant he was one of the only interactive and smiley babies. We would often walk into the NICU and see a number of nurses or doctors or other healthcare workers competing for smiles or playing with him. We knew he was well loved even when we couldn't be there. When we brought in Taylor and Liam for visits they had a bit of a "celebrity status" because everyone knew who they were and could remember taking care of them at some point. Taylor and Liam received lots of attention and cuddles whenever they came in! 

We are so deeply thankful to the NICU staff for everything they did for us and our triplets. They truly went above and beyond their job descriptions in many ways. We saw compassion, gentleness, and loving care for our babies. They have left lasting impressions on our hearts. God truly worked miracles through them in saving our triplets' lives!

The move brought many changes and stress for us. We were surprised to discover that there is a whole different philosophy of care in the PICU. Their patient population is very different and so their mentality is also different. It is fast-paced. Within a few hours of being in the PICU we felt the pressure to immediately start making changes for Malachi. In the past 10 days, Malachi has had his first bathtub experience, first tummy time with a trach, first time on the floor/ mat, first time in a bouncy chair, sat up for longer than ever in his life, and has had major changes with his ventilation. He has come off of the NAVA mode of ventilation and onto Pressure Control auto mode. For those

interested his PEEP has come down from 14 to 10 on the NAVA, before switching to Pressure Control with a PEEP of 10 and PC of 16. With all these new changes, our instinct has been to stomp on the brake pedal and slow things down. After all, Malachi has never been challenged like this before... and the PICU staff has only just met him... What if he crashes or collapses a lung..? But as the days have passed, we have started to breathe easier and trust that this team too knows what they are doing. Malachi is at the point where he is ready to be challenged so that we can move towards taking him home. If it is too much for him, then his cues will tell us and the staff. At the same time, we are doing our best to be with Malachi as much as possible and advocating for him so that the team knows him well and makes the best decisions for him. And so, it's been an emotional and draining week!

With all the new changes and steps forward that Malachi has been making, the team has been talking about moving along in planning for home. There is so much involved... tons of medical supplies, applying for some homecare nursing, insurance, applying to all the different medical supply companies for the various equipment Malachi will need, disability pensions, trach training and g-tube training, meeting with the EMS team in our area to briefly educate them on Malachi in the case of an emergency... this all is confusing and a lot of work too! 

Thankfully, Malachi is doing really well. He has been losing weight ever since the transfer but this likely due to all his extra activity. He also is at times crankier and working harder to breathe, but this is part of him working his muscles and getting stronger (again, this is part of the new mindset for his care that we need to get used to). 

Malachi's new chair

First time on the ground

First tub bath (yes, it takes 3 sets of hands!)

Grandma snuggles

Working on neck muscles and sitting

And so, we continue to ask for your prayers. It feels like we are running a marathon at times. Nathan is back to full-time work for the time being and that is harder on both of us as parents. It's hard for Nathan to come home at the end of the day and spend more mental and physical energy at the hospital. It's hard for Jodi to be at the hospital every day alone. And it's hard for both to be apart because we rely on each other for emotional and mental support. 

We are also, of course, thrilled to think about going home potentially in the next months. What a homecoming that will be! Our temporary lodgings are a beautiful gift for which we are forever grateful, but there is no place like home. And there's nothing like being home together as a family. 

With the excitement is deep fear too. We will be taking home a baby on life support! We will need to have all the details and training and organization figured out because it is crucial to his survival. What a daunting task. 

Recently we read from Romans and a text jumped out at us: "Rejoice in hope, be patient in tribulation, be constant in prayer..." (Romans 12:12). It sums up perfectly what we needed to hear. Our God is with us through it all!

Day 236

Another 2 weeks have gone by since our last blog post and as we reflect on the last few weeks, we are thankful that not too much has changed. Except for the fact that our 3 miracles are growing way too fast..! This past week we managed to weigh all 3 of our babies on the same day. Malachi was 15lbs 2oz, Liam was 14lbs 11oz, and Taylor was 13lbs 9oz. They are now in 3-6 month clothing! We are thankful that they are all growing well.

The first picture ever with all of the triplets smiling! 

Liam:
Our handsome little man has been doing great these past few weeks! He is really starting to improve with his head and neck control, although he still does not love his tummy time. He loves to coo to himself (even at random hours in the middle of the night), and laughs easily. In the coming week, Liam has another head ultrasound to monitor the fluid around his brain, as well as a pediatrician appointment for his head circumference.

You talkin' to me?

Posing with our "Malachi Bear" from the organization called Tubie Friends

Taylor:
Our beautiful baby girl has also had a great last few weeks. She is such a strong girl. She can roll from belly to back and can pretty much roll from her back to her belly as well (just gets one arm stuck under her)! She is very curious and loves to look around at any noises or movement that she notices. In the coming week, Taylor has an eye doctor's appointment for follow-up, as well as a pediatrician appointment to monitor her weight gain and ongoing reflux issue.

Sleeping Beauty

Malachi:
Our other handsome little man has probably just had the most comfortable 2 weeks of his life. He is noticeably happier and more relaxed now that the right breathing supports have been figured out for him and he is not fighting any sicknesses or infections. He has way more energy since he is not putting so much energy into struggling to breathe with the ventilator and it's so fun to see him kicking and waving his arms and wiggling all over. He smiles easily and even giggles sometimes (without sound, of course). It is truly a huge blessing to see him breathing so comfortably and happily! It's also a huge weight off of us as parents. We have a more of a spring in our step because we know he is happier and more stable than he has been in so long.
Yet, Malachi's situation is of course still serious. He is still very much dependent on very high settings of life support. There were a few times still these past few weeks when he started turning blue and losing oxygen saturations but none of the incidents were "close calls" in the sense that a Code Pink was not called. (A Code Pink means that an emergency button is pushed and people come running from all directions to help resuscitate a baby who is essentially dying). The few incidents that Malachi had these past few weeks were mostly related to having a lot of secretions in his trach and needing a lot of suctioning to help him breathe again. Suctioning out the trach tube regularly is a normal part of having a trach. A non-trach-ed person is able to clear their throat or cough any mucous or wetness in their trachea. For someone with a trach, they are unable to do this, since the trach tube is in the way. The trach is also in the way of the vocal chords. The air that Malachi breathes in through the trach tube does not go past his vocal chords and therefore he cannot make any noise. It is so hard to watch him silently cry, sneeze, cough, coo, and giggle. We have included a little diagram below to illustrate where the trach goes.

In terms of moving Malachi from the NICU to the PICU, things are still in motion. The right equipment for Malachi is ready, but the respiratory therapists are working on refresher courses on the type of ventilation that he is on (NAVA mode of breathing support).
We are also taking a break from trach training (the course we are taking to train for taking Malachi home on the breathing support). This is because we are too far ahead of Malachi. The next steps are to take him on little walks in the stroller with some members of the healthcare team, and eventually on car rides as well. However, Malachi is not stable enough for this. So the plan is to take a break for a month or two and then start up again once Malachi is ready for the next steps or just to maintain the training we have already learned.
We are excited that Malachi is now allowed to sit up partway for very short periods of time. We as parents are allowed to gently hold him up a little (not all the way sitting) and watch him closely to see if he is tolerating it. So far he can only do short periods before he starts working harder to breathe but it is progress! We are excited for him to have new types of developmental opportunities over time.

Malachi laughing at his Daddy gives us tears of joy and sadness at his silent giggles!

Team Malachi at trach training. SO SO SO thankful for these ladies and their dedication!

We want to thank you all for your continued prayers for us and especially little Malachi. It's a long road and it is hard not to get discouraged and tired. This time of year especially has gotten us feeling a little down as our families and friends go on vacations and take some time on holidays. Yet we strive to remain positive and thankful for the rich triple blessings that we have. And we hold on to our God for the strength and comfort we need each day! As Isaiah 40:30-31 says: "Even youths grow tired and weary and young men stumble and fall; but those who hope in the LORD will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint".

Beyond thankful for Canadian healthcare!