Babies Coleman

One step forward, two steps back...the same ol' dance

2009-09-30T07:07:00.000-04:00

It's the same dance we learned back at the NICU that Tom has been practicing ever since.

Tom has made good progress overall since we've been back in South Bend. The docs have made several tweaks to his vent settings and have successfully weened him down on both is rate and his oxygen. Today, he's at 35% oxygen and at a rate of 25 breaths per minute. This is actually huge progress considering the setback we had last week.

On Wednesday, we had a "care conference" for Tom. All the major players in his care got together with us to discuss the necessary steps to Tom's discharge and to set a target date to bring him home. The PICU intensivist (doctor), primary nurse, social work, home nursing, pediatrician, etc. each brought to the table the goals or requirements that needed to be met before their piece of the puzzle would be ready for Tom's arrival at home. October 6 is the magical date. We should have our training done (including nursing-type care and understanding all of his gear), the home care folks should have nurses lined up and Tom should have time to get down a bit on his settings. How exciting - thrilling, actually. The thought of not having to split our time between home and hospital, of being able to spend time together as a family and of Tommy finally getting to see his brothers again made me giddy. Light at the end of the tunnel at last. Sure, we know the date isn't set in stone; there are a number of stars that need to align. But having a date to aim for - that's a huge step closer to home.

The next day was a big day for Tom's brothers. Henry, Sam and Joe had their 6-month check-up with the pediatrician. Our friend Gretchen from the NICU stayed with Tommy at the hospital while Aunt Bonnie and I loaded up the other 3 hooligans in the van and took them to the doctor's office. All three checked out just fine - and took their immunizations like champs. Henry and Sammy did their fair share of crying and screaming, but I have to say that Joe is the one that really took it like a champ. Their current weights are very impressive, especially considering their tiny beginnings just over 6 months ago: Joe is the lightest of the 3 boys at home, weighing in at 13 pounds 4 ounces. Sam is 13 lbs 7 oz and Hank the Tank is a whopping 13 lbs 13 oz! Tommy's weight as of tonight is just about 13 pounds even. Huge!

Anyway, on my drive back to the hospital, Tommy's nurse called me to tell me he'd had a particularly rough morning. His oxygen saturations kept dropping, his CO2 was particularly high (even higher than when we first came to the PICU here at the end of July), and he was very uncomfortable. They'd tried a number of different settings on his home vent and needed to be moved back to the hospital vent. (For reference, the home vent could be compared to a Chevette and the hospital vent a DeVille. They both get the job done, but one of them has much better ride and handling.) Needless to say, I was upset. I was very concerned about Tommy. I felt awful that poor Gretchen was there in the middle of the mess. And I was sad at the big step backward. We had just been riding so high after the care conference the day before - and here we were, back on the hospital vent.

Come to find out, Tom had "tracheitis" (sp?). Because there is always mucus/secretions sitting in Tom's trach (as there typically is with any trach patient), its an ideal environment for bacteria and other "bugs" to hang out. Usually they hang out in a nice balance, but every now and then one of them gets unruly and causes a stir. Tom had been experiencing more secretions than normal and they were turning cloudy and slightly yellow - indicating a possible infection. We tested the mucus and voila - tracheitis. Luckily we caught it before it spread beyond his throat and with antibiotics he seemed to quickly shake the infection and has been doing very well ever since. In fact, they put him on his new home vent (a newer model than what he had before) Sunday morning. And since then we've made reductions in his settings - getting him down to the numbers I mentioned above. And the best part is that we're still targeting October 6 for discharge. We couldn't be happier - or more relieved that he's recovered so well.

In other news, Tim took a short business trip to Pittsburgh and we were able to recruit enough help to keep things rolling at the house while I stayed with Tommy. In fact, we've had a wonderful succession of helpers to help us manage our crazy world. We honestly couldn't possibly thank each of you enough. We'll be searching for some steady help - perhaps in the form of a nanny or nursing student - to stand in for Becca and Aunt Bonnie as our steady helpers. Plus, this will allow time for me to focus on work. (Yes, I started back to work last week. Our checking account will certainly appreciate not sending those payments to Cobra any more. It's been a challenge to keep my head in the game, but hopefully it will get easier to find that balance between work and family.)

The helper of the year award, however, goes to Aunt Bonnie. Wow. What a trooper. Bonnie has spent over 5 weeks with us already - and after a well-deserved vacation next week, she's coming back for 2 more weeks with "her boys". Incredible. Amazing. She's been the glue that's held us all together - and has done it seemingly effortlessly. Simply put - as she typically does - "I just felt like I needed to be here." Bonnie told me she's prayed that the right helpers would find their way to us - that the right nurses, doctors, etc. would enter our world and help to make things better for all of us. But I think the helper that's had the most imact is Bonnie. You've been a guardian angel and fairy godmother to our boys and for that you'll always have a very special place in our hearts - and theirs.

Another guardian angel for us has been our neighbor Julie. Not only has she been a wonderful help with caring for the boys at home, she's also volunteered to be trained to care for Tommy when he comes home. She also offered to stay the night at the hospital with Tommy on Friday night. Not only did this give her more experience and training with Tom, but also gave Tim and me our first real date night in ... hell, in I don't remember how long. We attended McDazzle Friday night. That's the annual fund raiser for South Bend's Ronald McDonald Family Room at Memorial Hospital. If you've read our blog at all, you know how much we support and appreicate this wonderful service. The director of the RMFR asked us to be guest speakers and to share our story. We were happy to do so; anything in support of such a good cause. We had a great time at the event and got to see several familiar faces: many of the NICU doctors were there. :) Doctors Okanlami (from NICU and PICU), Dr. White and Vitaliy with his wife Anna were there. Julie also arranged for us to have a room for the night at the Inn at St. Mary's. What a treat. Not only did Tim and I get to spend so much time together, but we also got to have some solid sleep. Both I'm sure were very helpful to us in so many ways.

On Sunday we attended the annual NICU reunion. It takes place at a children's museum in South Bend and NICU "graduates" and their families attend. We happened to be there when a news crew came through and asked to interview us. Sure! So we made it on the news. We've got it recorded on our DVR and - thanks to Kevin for this suggestion - I'm going to try using my digital recorder to capture the show on the TV so I can post it here or on youtube or something. More to come on that. If anything, we'll at least have some photos to share - of this event and a shot of Tim and me with Ronald McDonald Friday night.

We're making progress on our training in prep for Tom's return home and should have all those ducks in a row by the end of the weekend. We did our 24-hour shift here at the hospital with Tommy from 9pm last night until 9pm tonight. It all went very well. We were responsible for all of Tommy's care. The 24-hour requirement is intended as a sort of dry run for when we get home with Tom. Thankfully, we've got the experience of having him home for 2 weeks in July with his NG tube feedings and oxygen gear. Sure, his gear is more intense and complicated now, but if we could do that before, we can certainly do this now. Plus, since one of us is here all the time, we've already gotten so much experience with his feedings and other care.

Well, I think that covers things from our end of the world. Plus, I need to stop typing so I can get some sleep. Hopefully Tommy is on the same page and also feels that I should get some rest tonight. :) We'll post some pictures soon. And we'll certainly keep you posted on our October 6 target date for discharge. Thank you for your continued love, prayers and support!

Lots of love,
Kristin, Tim, Tommy, Henry, Sam and Joe

South Bend Tribune article

2009-09-13T11:37:00.002-04:00

Here's the URL for the South Bend Tribune article: http://www.southbendtribune.com/article/20090913/News01/909130369/1130

If this doesn't work, go to www.southbendtribune.com and there should be a link to our article on the right side of the screen. In the printed format, we're again on the front page. (That just cracks me up.) Anyway, once you get to the article online, there's an option to view more photos and a link to the slide show. There is supposed to be audio on the slide show, but it doesn't seem to be working on our home computer. Let me know if you have any luck with it.

Kev, I'll save a copy for framing...hoping we can cash in on your employee discount. :)

Again, if you live locally and get the paper, please save your copy for us. Enjoy!

Love,
Kristin, Tim and the boys

Almost home

2009-09-12T09:19:00.004-04:00

Hi everyone! Here's Tommy waving to you from his new bed in South Bend.

Unfortunately, I can't figure out how to edit photos on this computer, so the shot is a little dark. Don't be fooled: his room is actually very bright with a huge east-facing window.

Tommy is starting his third morning here at South Bend Memorial Hospital. He is settling in pretty well. It is so nice to be back "home" and surrounded by familiar faces. Tom has been visited by no fewer than a half dozen people from the NICU already. His primary nurse Jugenia even offered to babysit for a while last night so Tim and I could go out for a bite to eat together. What a nice treat. Tommy really seemed to enjoy the time with his friend Jugenia and Tim and I loved the opportunity to catch up and just be with each other for a couple hours. Thank you Jugenia!!

We had some issues initially with Tom's ventillator when we arrived on Wednesday afternoon: they didn't have the LTV (home vent) here for him and they put him on the vent he was on before the LTV at Riley. Though this would probably not affect his overall time in the hospital, I couldn't help but see this as a step backward. He had to be stable on the LTV for a week before we could transfer him here. So what good could come of putting him back on the other vent? (especially since they were constantly tweaking his vent settings) Anyway, its all a moot point now. Later that night, we were able to get the LTV set up and running. He's back on the same settings as when he arrived, but doesn't quite seem to have found his groove yet. They say that each machine has it's own slight variations on how it manages the air flow - and these variations may feel different to Tom. His respiration rate has been unusually high - especially when he's at rest - but all of his numbers are sitting right where they were before we left Riley. So there's no real reason for concern. We'll wait it out for a bit and see how he does.

We met Mary on Wednesday night. She's our trainer from the home medical company. She already did a home assessment on Thursday and has scheduled the first vent training session for Tuesday at our house. My mom and our neighbor Julie will start the training with me. Tim will be out of town next week, but will jump into the training sessions when he gets back. It'll take a couple weeks to complete all of the sessions, so we know Tom will be at Memorial for at least that long.

Our insurance company has approved Tom for nursing assistance at home when he's discharged. Once we get Tom home and settled in, we'll have nursing support for his care 12 hours a day. We'll start working with the prospective nurses at the hospital so they can get to know Tom and his gear and so we can get to know them.

At home, Henry, Joe and Sam are all doing very well - and are as cute as ever. They've started taking turns sleeping alone in a crib, as space was getting a little too tight any more to keep all 3 in the same crib together. Hopefully this will make the transition to their own cribs a little smoother when the time comes.

We also received some bittersweet news this week: our nurse/babysitter extraordinaire Becca has been offered a job at Riley's PICU. She has, of course, accepted the position and will start work there on Sept 28. We'll certainly miss her and her consistent, dependable help. Over the last few months she has become a part of our family and it will be difficult to see her go. We knew at the beginning that we couldn't keep her here forever (if we could only provide benefits...), but it's still sad to see her go. We'd like to invite all of you that have met and "worked" with Becca to send a note of thanks. Please snail mail a card to our home or email something to my email address and I'll collect them to present to her before she leaves. Thank you!

We met twice more with the photographer from the South Bend Tribune this week. He captured a few more photos at home and some sound bites to include on their website with our story. He also came to the hospital on Friday to get some shots of us with Tommy. I spoke with the journalist to confirm a few facts in the story and she promised that it will run on Sunday. If you live in the South Bend area and get the paper, please save your copy for us. And regardless of where you live, be sure to check out the newspaper's website for the photos and audio clips. As soon as I get the link from their website Sunday morning, I'll post it here on the blog.

Well, I think that covers it from our little corner of the world. Thanks again to all of the helpers at the house and to everyone for your continued love and support.

GO BLUE!
Kristin, Tim and the boys

South Bend, here we come!

2009-09-08T21:30:00.002-04:00

It's official - we've got written pre-approval from the insurance company and the folks in the PICU at Memorial Hospital are expecting us: Tommy's headed back to South Bend tomorrow. If home weren't so far away from Riley, we'd certainly be open to the idea of staying here until Tommy's ready to go home. The move to South Bend, however, will likely make life substantially less complicated for all of us. We've made some fast friends here in Indy and hope to keep in touch with them - even if only through our blog.

Tommy's ride (the ambulance) is scheduled to arrive at Riley to pick him up at 10am. For the ride to South Bend, I'll follow behind in the van, like Tim did on the way here 34 days ago (yeah - that's right - THIRTY-FOUR days). We're not sure yet how long to expect Tom to be at Memorial - we'll figure that out once we get there.

We know we need to wean Tom down on his resp rate on the ventillator (he's at 30 now and should be in the mid-20's before he were to be discharged), but his other vent settings are all perfectly acceptable for home. The other requirement to consider before his discharge is our training - and training for the other folks that will be taking care of him regularly at home.

Well, I need to get all our stuff packed up tonight. Tomorrow morning will be a bit crazy before we leave at 10am. Breathing treatments, feedings, loading the car, etc. We'll let everyone know how things are in South Bend once we get settled in.

Love Kristin & Tommy

A couple more pics

2009-09-07T00:30:00.003-04:00

I forgot that Aunt Jules sent me a couple photos that she took while visiting last weekend. But this doesn't mean Amy is off the hook for sending me the shots she took last week. :)

In the stripes, Sam is on the left, Joe in the middle and Henry on the right. My best guess on the activity mat photo is Joe, Sam, Henry from left to right. Jules, do you remember?

Baby steps

2009-09-06T23:06:00.016-04:00

Hi everyone

In the last couple weeks, Tommy has been making progress. He's been switched over to the home ventilator system - the LTV - and has been doing well on this vent. His CO2 levels haven't gone down as much as we had hoped, but they're at least holding steady. Tom has been gaining weight and tolerating his feedings very well. He's active and interactive with the nurses, physical therapists and (of course) his parents. He chomps on his pacifier and LOVES his mobile. (Looks like we'll be buying one for his crib at home just like the one he's got here in the Infant ICU...)

Tom's progress has impressed the docs so much that they've approved a transfer back to Memorial Hospital in South Bend. Our insurance company has also approved this - something very unusual in the world of private insurance. But considering the circumstances around Tom (3 brothers at home, the 3+ hour drive for his parents, and the others that need to get trach/vent training), they have agreed that the move back to South Bend is the best for all involved. Tom is scheduled to make the move on Wednesday; it was originally scheduled for Tuesday, but the folks at Memorial needed one more day to get things ready for Tom's arrival. Having him only 25 minutes from home should make life a bit easier for all of us. We don't know yet how long Tom will be at Memorial, but it is one baby step closer to home.

So I'll finish out our stay in Indy with Tom. Tim went home to enjoy the rest of the holiday weekend on Sunday afternoon. In the time he spent with Tom this weekend and last, Tim was able to accomplish a lot of training with Tom's trach. Tim attended a trach class, performed "trach care" (cleaning and changing the dressing around Tom's trach), and quite successfully completed 3 trach changes. One of those changes was a practice run on an "emergency trach change" where he performed a typically 2-man process by himself. What a pro. I've gotten much of the same training under my belt, but only 1 trach change so far. I guess I'm just not as brave as Tim is ... yet. I'm sure that will come in time...baby steps, right?...

At home we've had a continued string of wonderful helpers. Aunt Bonnie has been incredible and the boys have really taken to her. Last weekend "Aunt Jules" came to visit and help out. Then last week Aunt Rosie, cousin Amy and Grant hung out with the boys. We had to frisk Rosie before she left to make sure she wasn't trying to smuggle Henry, Joe or Sam out the door. :) This weekend Tim's parents are in town and with them is Uncle Tom. He's not only visiting the boys, but also Aunt Bonnie! There are no words to express our gratitude for their help - and the help of all those signed up to help in the coming weeks. We know we couldn't get thru this crazy time without you.

As we get closer to Tom's arrival at home, there are several things we need to implement at home and to consider for those that come to help - particularly those that will help out regularly with the boys. Among them are:

- Flu season: It will be particularly important for each visitor to be tuned in to his/her own health and exposure to those that are sick. Even a cold can turn into something much more serious for any of the boys - particularly Tom. If you're a regular helper, we'd like you to consider getting a flu shot.

- Inhaled irritants: Since Tom doesn't breathe through his nose or mouth, his air bypasses the natural filters built into our respiratory systems. We need to take extra steps to make sure particles and fumes in the air around Tommy are strictly limited. We will not be able to dust or vacuum when he's in the room. Aerosols are a big no-no; as are cleaners with chemical fumes and perfumes/colognes. Please refrain from wearing perfume or cologne when visiting.

As we learn more about what Tommy will need at home, we'll be sure to let everyone know. We'll want it to be as smooth a transition as possible - and we certainly appreciate your continued support to help make that happen. In the meantime, please enjoy the photos below... oh - and speaking of photos...

Alicia Gallegos, the journalist from the South Bend Tribune that interviewed us a few weeks after the boys were born, contacted me last week regarding a follow-up story. She and a photographer visited the house on Thursday to interview Tim before he came back to Indy. Then they came back on Friday to interview me. Alicia was hoping to get the story in the paper on Sunday, but weren't sure they had the resources over the weekend to set up the online slide show they hoped to incorporate. So watch for it online and in the paper on Monday. If for some reason the story doesn't make it into Monday's paper, I'll call Alicia on Tuesday to get the details and will let you know when the story will run.

Take care everyone - and thanks again for all your love and support. Please enjoy the photos below...

Love,
Kristin, Tim and the boys

This was taken a couple weeks ago when Papa Don and Uncle Mike came to visit Tommy before his trach surgery.

Shortly after Tom's trach surgery...Mr. No-neck...

The first day I got to hold Tommy since his g-tube surgery and after his trach surgery.

A couple shots of the fellas at home. Henry is in orange, Joe in blue and Sam in green. Too cute for words, eh? I'll have more cute photos of these 3 hooligans soon. (REMINDER to cousin Amy to send me those pics...)

Tommy last week with his physical therapist.

Mr. Sweetie Face

Daddy and Tommy - probably watching Sports Center...

Tommy loves his bouncy seat and mobile.

Mommy and Tommy

Another pic

2009-08-28T00:50:00.007-04:00

I just had to share photo of Kate and the gang. I'm not sure how she kept her sanity...

Another update

2009-08-27T23:02:00.006-04:00

First - I had started a "thank you" post to all our helpers a couple weeks ago. I finally finished it and posted it tonight. But it was posted under the original date. To read it, please go to the Aug 14 post "To all our helpers".

Since my last post, Tom has been doing pretty well - as have his brothers. And as for Tim and me, we're hanging in there.

I was finally able to hold Tom last Thursday. It had been nearly 2 weeks since the last time we got to hold him - before his g-tube/nissan surgery. I held him once in the morning and once in the afternoon. In the afternoon, he smiled at me. It was wonderful.

Tim took over in Indy for a long weekend on Thursday. Tom's ventillator settings and CO2 levels yo-yo'd all weekend and through this week so far. Overall, Tom has been stable. We've just been trying to find that "sweet spot" in ventillator settings that would bring down his CO2 levels - and keep them down. No such luck so far. He had his first trach change on Monday. We can now use some special rubberbands to help keep his ventillator tubing attached to the trach - thereby greatly reducing the risk of his chubby cheeks knocking the tube loose. In addition to the rubberbands, Tom also sports a trach holder or trach ties around the back of his neck, fastened to the "wings" on the trach. (Thank you to Tim's cousin Sue for the trach holder samples!) Unfortunately, the trach ties and the trach itself have created some very tender areas on his neck, but the nurses assure me these will heal and in time Tom will sport his new accessory without any discomfort. Tom was moved to the Infant ICU on Monday night. This is a specialized 6-bed unit where all the patients are infants on trachs. The focus here is development and training - for the patients and their parents. This is definitely the right place for Tom to be.

Before I forget, I also wanted to mention that a couple of the staff here at Riley have definitely earned a shout-out here on the blog. Will is a respiratory therapist that was assigned to Tom before his trach surgery. He went out of his way to get Tom the newer model ventillator that he's currently on. Since then, I've run into Will a few times in the halls of the hospital. Not only has he remembered who I am, but has even remembered Tom's name. He caught me in the hall the other day while I was nose-down in my BlackBerry: "Hey, how's Thomas doing?" Will had only taken care of Tom for one day, but he still remembered him and wanted to know how he was. That's pretty special, if you ask me.

Another person who's earned a special mention is Ann - one of the nurses in the PICU. She was assigned to Tom a couple times, then asked us if it were okay if she requested to be one of his primary nurses. We love Ann. She knows her stuff, is very pleasant, gets things done - and does them on time, and most importantly she spoils Tom. We were sad to leave the PICU because Ann had gone out of her way to get mobiles, music and all sorts of stuff for Tommy. I'm sure Tom misses all of her sweet talk and attention too!

So anyway... Late last week, we got some great news from our insurance company: They've approved a back-transfer to South Bend. This is something that is typically never approved. Once Tom gets on the home vent system (they call it the LTV - short for "laptop vent" because of it's relative size) and is stable for about a week, he can be transferred. This will make things easier on many fronts. Obviously, it'll be easier for Tim and me to split our time between hospital and home when the hospital is only 25 minutes away - instead of over 3 hours away. But more important for the long term, moving Tom back to South Bend will enable our ventillator/home care training to take place in South Bend and anyone else that we'd like to have the same training can participate in South Bend - instead of making the trek down to Indy.

As of this afternoon, the plan for Tom is to make one more change to his vent settings tomorrow morning. The new settings can be replicated on the LTV, so hopefully he'll tolerate the change well. If all goes well, we'll keep him on these settings thru the weekend then on Monday or Tuesday we'll make an attempt at changing over to the LTV. In the meantime, since the variations in vent settings over the last week haven't had much of an impact on his CO2, we're doing one more short course of steroids. The docs aren't convinced they'll make much of a change, but feel it is definitely worth the attempt. He'll be back on "the juice" for 5 days. Hopefully this won't add too much more volume to his already way-too-fluffy cheeks. :)

Though Tom's lungs are among the worst these docs have seen, the docs have all reassured us that he will outgrow much of this. It's just going to take time.

Tim will come down tomorrow to take over for a few days. I'll head home to help Bonnie manage the three hooligans at home, then we'll make the swap again early next week. And so goes our "new normal".

Finally, here are a few pics. Our camera is at home, so I hope to get some more recent photos on the blog this weekend. In the meantime, please enjoy these:

Intubated Tom - pre-trach surgery

Tim & Kristin next to Tommy's bed in the PICU at Riley

Proud Papa Don with Tommy

This is the doll that Tim has affectionately named Patty Picu, due to it's androgenous appearance. Tom's nurse Ann lent us this doll so we could get familiar with how Tom's trach would look and work.

Well, it's very late. Tom is asleep - so I should be too. More to come soon. Thanks for all your positive thoughts and prayers!

Lots of love, Tim & Kristin

New Photos!

2009-08-19T22:07:00.009-04:00

Hi! It's Katie, just thought I would post some pictures of the boys here at home. Hopefully we can post some of Tommy tomorrow!

A Good Day for Tommy

2009-08-18T21:08:00.002-04:00

Tom had a good day today. When the surgeon stopped by this morning, we talked about what the doc called Tom's "short neck". I told him "short" would be a generous description. :) Tom had some good awake time (during which we "danced" to his Baby Einstein tunes and reintroduced his pacifier - which he LOVES) and some good sleep time. He seems to be recovering well and adjusting to his new contraption. It's just so nice to see him in a good mood. He's even been making eyes and smiling at some of the nurses...he prefers blondes.

We're weaning him gradually on the ventillator. He was at 80% oxygen last night and is down to 60% tonight. We're watching his blood gases closely and using them as a guide to make adjustments on the ventillator. He's still holding steady at 30 breaths per minute, but hopefully yet this week we can take that down a couple notches too.

The docs want to get a solid 48 hours of recovery in before we try to hold Tommy - so maybe as early as late tomorrow afternoon, I'll be able to hold him. We'll see how his day goes tomorrow.

All of your comments are so caring and thoughtful. Thanks for all your support. We'll be in touch again soon.

Lots of love from Indy,
Kristin & Tommy

P.S. I talked to Tim last night after he got home to Henry, Joe & Sam. It had been 2 weeks since he last saw them. Tim's reaction: "They're huge!" :) They're so huge that the pediatrician has approved for us to try a 6-hour stretch at night between feedings. We'll see how it goes...Good luck tonight, Tim and Katie!!

The Trach is In

2009-08-17T21:02:00.002-04:00

This update will be short and sweet. My computer took a crap today, so I'm using the "public" computer in the PICU parent lounge. Tim went home today to see the Henry, Joe and Sam and to spend a little time at the office. Since it's just me and Tommy down here in Indy, I don't want to be away from him for very long if I can avoid it.

Anyway, this morning we discovered that Tom's hemoglobin was pretty low, so he received blood before surgery. He also got bumped further down the surgical schedule, so his 11am surgery didn't happen until around 3pm.

The procedure took about an hour and went very well. He has a "cuffed" trach tube - meaning it has an inflatable cuff at the bottom of the tube. This cuff can be inflated to hold the tube in place and to secure or close off the airway around the tube - keeping the important oxygen flowing in the direction it needs to be flowing. Right now, the cuff itself - in its deflated state - is enough to secure the airway and tighten up any air leaks.

His huge cheeks, multiple chins and lack of neck make it look a little uncomfortable, but he seems to handle it pretty well. He just has to turn his head to the side so his chin doesn't run into the tubing that attaches to the ventillator. When he gets feisty and starts moving around, the little bugger actually knocks the tube loose. Bells and whistles go off and people come running, but all it takes is a gentle push to put the tubing back together. We've run that drill twice already and the trach is only a few hours old. :) It could be a long night...

Thank you to everyone for all your prayers and positive vibes. They are certainly paying off so far. Tom asked me to send a special shout out to his brothers at home and to ask them to save a spot for him in the tubby time lineup. He also wants to say "hey" to his peeps at the Memorial NICU. Thanks for all you did to make him healthy and strong - he's tapping into those resources this week for sure.

Photos coming soon...stay tuned...

Lots of love, Kristin, Tim and Tommy

More Surgery

2009-08-15T12:13:00.003-04:00

Well, Tom has been pretty stable for a couple days now. His ventillator support hasn't really changed much. His blood gases have been pretty consistent. And for the most part, he seems to be comfortable (except, of course, when he coughs up the mucus in his chest and throat caused by the irritation of the ventillator tube).

We started the full dose of the "viagra" meds today - it's actually called sildenofil. Tom's blood pressure has been gradually getting lower, but is still in a good range to continue this medication. It doesn't seem to be having a profound effect on his pulmonary hypertension, but is at least helping.

Each morning we're invited to participate in rounds with the doctors and other PICU staff. Some days I think they regret inviting me to join in. :) I'm sure those of you that know me best - and those from the NICU at Memorial - can imagine the scene: notebook in hand, pen poised and a list of questions at the ready. I have to say that I'm thankful for the opportunity to get in front of them to ask my questions. I've been able to affect change in Tom's care and have brought issues to their attention. Let's just hope I don't annoy them too much before we move out of the PICU. I don't want to become one of "those" parents...

Twice a week, Tom will spend time each with physical therapists and occupational therapists. They'll work with him on movement, flexibility, developmental milestones, etc. This will help make sure he doesn't get too far behind in his overall development while in the hospital. A dietician even stopped by this week. She took some measurements and made some changes to Tom's feedings to ensure he gets enough calories to support healthy growth and development.

Yesterday (Friday) we met with Dr. Ackerman and a couple other folks on her team. We discussed our options for Tom's long-term plan and agreed the best option is the tracheostomy (or trach) and ventillator. This will give Tom the best opportunity to be the healthiest he can be.

A tracheostomy is an opening in the front of his neck that lets air move from the outside (he'll have a ventillator to do this) into the trachea (windpipe) and lungs. A trach tube is put in the opening thru the skin and into the trachea. The procedure is scheduled for 11:00am on Monday. It should take about an hour. The same surgeon that did his nissan and put in his G-tube will also do this surgery.

Following surgery, Tom will need to stay in the hospital for about 4 weeks - give or take, depending on a number of different things. The trach tube will remain in place with stitches for the first week so the channel to the trachea can heal. This is much like getting your ears pierced - the channel thru your ear lobe heals so the post of your earring goes thru it without any pain or discomfort. He'll be hooked up to a ventillator coming out of surgery and will eventually be switched over to the ventillator system that he'll use at home. After the first week, we'll begin to get training on how to care for Tom, his trach and his ventillator. Once we get to that point, we will look into the possibility of transferring him back to South Bend to complete his recovery and our training. If our insurance company doesn't like that idea, however, we'll do all of this in Indy.

When Tom comes out of recovery from surgery, he'll come back to his room in the PICU. Once a bed opens up (one is scheduled to open August 24) in the Infant ICU, we'll move there. This is a 6-bed unit filled with infants on trachs and ventillators. We visited the unit earlier this week and the babies seem very well cared for - and loved. We met a boy not much older than Tom that was happy, mobile and obviously loved his nurse. This is where we'll spend the rest of Tom's time in the hospital.

So we've still got a long road ahead - even after we bring Tom home from the hospital. He'll have the trach and ventillator for quite some time. It's difficult to estimate, but most kids like Tom have their trachs 18-24 months. Let's hope it's not that long for Tom. But even if it is, at least he'll be mobile and able to play (with limitations, of course). He won't be stuck in a bed like he is now with a regular ventillator tube in his throat. We'll be able to take him out - with some additional gear and extra effort. And most importantly, he'll be able to interact and play with his brothers.

We're moving tonight to another room in the PICU - a little quieter and a better location for nursing assignments. We don't have a phone in our room and we're not supposed to use our cell phones in the unit. So if you need to get in touch with us in a hurry, call the unit directly and ask to speak to Tom's family. The number is (317) 274-2871. Otherwise, continue to call the house, call our cell phones or email us as needed. We'll be in touch!

Thank you to everyone for your continued support and prayers.
Kristin, Tim and Tommy

Updated Pictures!

2009-08-15T11:56:00.010-04:00

Hi! It's Katie :)

Addie and I came down on Wednesday to help out with the boys. I have enjoyed spending time with them and of course have staged several photo shoots already :) Hopefully I can figure out how to get them posted and get their names right too!

Enjoy!

Henry, Addie and Joey

Addie and Joey

Joey

Sammy

Henry

All 3 boys asleep in their bed :)

Sammy, Joey and Henry (I think in that order), sending a message out to Tommy :) (this was Becca's idea, isn't it cute?!)

To all our helpers

2009-08-14T11:15:00.011-04:00

In our recent posts, we've neglected to mention all the wonderful help we've had for the boys at home.

At a moment's notice, my mom was able to get a week off work and was here the night Tom was moved to Riley. With the help of Becca, our nurse/babysitter/lifesaver they held down the fort for the first week. When mom had to head back home, our sister-in-law Katie took over as our "home base" person. The glue that held it all together our first 12 or so days in Indy is Don, Tim's dad. What a trooper! Pat, Tim's mom, has been down a couple times during Tom's stint in the hospital and Natalie, our 13-year-old neighbor and baby-slinging prodigy, has been amazing. Before school started, she stayed the night at our house several nights to make sure someone else got a chance to sleep. Now, Tim's Aunt Bonnie is at the helm and plans to stay until we "kick her out". As I understand it, she runs a very tight ship - which is exactly what we need!

In addition to all of these "home base" helpers, we've had a constant procession of other helpers at all hours of the day and night. These helpers include friends and neighbors from the area - and even from hours away. We can't thank you enough - all of you. We certainly couldn't divide our time between home and Indy without each and every one of you.

Since Tim and I are spending so much time away from the three boys at home, we've instituted a sort of guest book. When/if you come to help us out, please write a little note in our guest book. Be sure to include the date and time that you hung out with Henry, Joe and Sam. Tell us how well the boys ate or what fun things they did to entertain you. Our hope is that we won't feel quite as removed from their daily lives if we can share your experiences with them.

They say it takes a village to raise a child...well, I guess you could say we've recruited an entire city's worth of people to raise ours. And we couldn't be more grateful.

All our love and appreciation,
Tim, Kristin & the boys

112 Days...and more

2009-08-13T15:54:00.007-04:00

Hi everyone. This post is long overdue. As you can imagine life at Chez Coleman is a little busy and as my brother mentioned in a comment a couple posts ago, typing is not high on the priority list when there are diapers to change, mouths to feed and babies to cuddle. Before I get into Tommy's current status, I want to fill you in on some of the story that got us where we are today.

So, as you may recall, Tom was on his own in the NICU at Memorial as of May 31 when we brought Joey home. The nurses and other staff were very generous with their love and attention for Tom - and we thank them for that. It made it easier to leave him "alone" knowing he would get plenty of lovin' from the folks there. During his solo weeks in the NICU, Tom faced a lot of challenges and toughed it out like the strongest of fighters.

The week Joe came home, Tom had gone back on CPAP - again. The treatment this time: diuretics, steroids & a VERY gradual weaning of his oxygen/air flow support. The diuretics help to get rid of excess fluid in his lungs - which is part of the process with chronic lung disease (or BPD: broncho pulmonary displasia). About a month before, we tried a very low dose, short course of steroids to help stimulate lung growth and development to fight his BPD, but didn't see any remarkable results. This time we increased the dose and the length of treatment - and were fortunate to see some decent results. We were able to very slowly take him from CPAP, to high flow cannula, to "off the wall" oxygen - similar to the system we have for him at home.

During that time, Vitale explained pulmonary hypertension to us, as this is a typical by-product of BPD. If Tom had pulmonary hypertension at the time, it seemed to be mild at most according to the echo of his heart. So they raised his oxygen saturation limits to keep his oxygenation higher. (Oxygen helps dilate blood vessels, which helps with the hypertension.) The docs didn't feel that Tom needed to go on any meds to treat it at this time. Though he did start medication to treat systemic hypertension (your run-of-the-mill high blood pressure).

In the midst of all this, Tom underwent a couple swallow studies. They confirmed that he has reflux and is indeed aspirating when swallowing - meaning, when he swallows, some of his food goes down his windpipe into his lungs. He unfortunately wasn't even coughing to get the milk out. Not a good thing for many reasons, but mostly because his lungs are already at a disadvantage with BPD. We did the study twice 3 weeks apart - and saw the same results both times. When he was finally discharged from the NICU last month, it was still too dangerous for him to take feedings by mouth, so he came home with the nasal gavage (NG) feeding tube as he had in the NICU.

A few days after Tom's second swallow study, we did what Vitale called a "milk study" to check for aspirating during reflux. Tom was given a feeding through his NG tube with some sort of radio active material added to the breast milk. Four hours later, they took a picture that captured all the traces of radioactive particles where the milk had gone in his body. That test did not confirm that he was aspirating when he refluxed and we were happy to hopefully rule out reflux as a contributor to his lung issues. In hindsight, our elation and relief were a bit premature.

Prior to discharge, we had lengthy discussions with Vitale and a handful of the NICU nurses regarding the option to have a couple surgical procedures done on Tom. First would be to put in a "G tube". This feeding tube provides a direct line to the stomach thru his belly, eliminating the need for the somewhat invasive NG tube down his throat. The second procedure would be a nissan - which uses the top of the stomach to sort of cinch-up the valve between the stomach and esophogus. These procedures would help with both reflux and swallowing - 2 issues Tom faces. Knowing he would most likely outgrow these issues, we opted to wait on the surgery for now. The stress of a surgical procedure and the risks involved outweighed the potential benefits...at the time.

After 112 days, we brought Tommy home from the NICU on Thursday, July 9. In addition to his NG tube, and nasal cannula with 3/4 liter of oxygen, he came home with a variety of medications. Needless to say, it was overwhelming to manage Tom and his needs on top of the requirements of his three brothers. The first few days were very stressful, but then we began to find our groove and it began to feel like our "new normal".

The night of July 21 and morning of July 22 Tom was having a rough time with coughing/choking spells at home. We took him to see the pediatrician. She made some changes to his medications and we seemed to see an improvement on the 23rd and 24th. On the 25th, his coughing got worse and the pediatrician decided to admit Tom to the pediatric unit at Memorial. Unfortunately, this cancelled Tim's trip to Indy with our neighbor Dave to the Brickyard NASCAR race. Instead we began a 5-day hospital stay with Tom. The level of care is certainly much different in Peds vs. the NICU. We agreed early on that one of us would stay by Tom's side for his entire stay. At the end of 5 days, Tom's oxygen requirements came down to where he was at home and his coughing fits seemed to be subsiding. There really wasn't much more the docs were prepared to do for him, so Tom was discharged and he continued to hold his own for a couple more days. On Thursday, July 30, Tom had his final appointment with the eye specialist and handled the exam like a champ. But when we got home, I noticed that he was very pale. I chalked it up to the stress of the eye exam and being late for his feeding. So we fed him and waited for his color to improve, but it didn't. I called the pediatrician and made arrangements to take him to the after hours clinic - luckily our doctor was on duty that night.

When we arrived at the clinic, Tom's oxygen saturation was very low - and even after 2 Albuterol breathing treatments it only got into the low 80s (it should be in the high 90s). That, in addition to his poor coloring, encouraged the doctor to admit him. This time we went to the Peds ICU (PICU). Upon admission, the nurses drew blood gases on Tom. His numbers were alarming enough to prompt a 2nd draw. His CO2 should have been in the 50s or even as high as the 60s but was at 128. They put him on 3 liters of high flow support at 100% oxygen. And he stayed at that level of support for a day or 2 before we were able to wean it down at all.

Call us naive - or just ignorant to the ins and outs of BPD - but we still believed that Tom would recover, get back to his 3/4 liter oxygen level and we'd take him home in a few days. Perhaps the doctors' words fell on our deaf (read: optimistic) ears. Or perhaps even they didn't catch on to just how serious Tom's condition was (and still is). We had discussions about BPD, pulmonary hypertension and other issues - but it still never settled in that our little guy was fighting much harder than we thought.

The PICU doctors raised the question again about the surgical procedures to address Tom's reflux problems. Taking reflux and risk of aspiration out of the mix could not only make Tom much more comfortable, but could give his lungs a better chance of "fixing themselves" faster and enable him to grow faster and healthier. By merely looking at the mechanics of it: Tom's NG tube was running thru his throat and down into his stomach. He's got issues with swallowing and keeping the valve between his esophogus and stomach closed. Taking the tube out of the mix would enable better swallowing and lessen reflux. So we agreed to do them both, but we knew the best place to get them done is at Riley Children's Hospital in Indianapolis. Tom's PICU doctor made a couple calls and on Wednesday, August 5 Tom was transported by ambulance from South Bend to Indy. Tim followed behind in our car and I came down the next day.

Tom was admitted to Riley's Infant Unit. On August 6 Tom got an upper GI in prep for his surgeries. Everything looked good, so he was slated for surgery on the 7th. Tim and I stayed in his hospital room the night before surgery and I was able to carry him in my arms to the surgical prep area before the procedure.

Surgery went well - though it took a bit longer than average. They were able to avoid a large incision and instead did the procedure lapriscopically (sp?). Given Tom's lung issues, it took a bit of extra effort on the surgeon's part, but he was able to successfuly perform both procedures without any complications. The complications came up AFTER surgery...

At first, Tom was resistant to waking up from the anesthesia. Then he was showing a marked resistance to weaning off the ventillator used for the procedure. A few hours later, they made room for us in the PICU and set Tom up for the night. We hoped to gradually wean him off the vent and get him back on high flow or regular nasal cannula by the following day...but no such luck. Tim and I were very frustrated, feeling that if these docs would only give our tough guy a chance, he could show them just how strong he is. We'd seen him bounce back so many times before - in the NICU and since discharge - and we honestly believed he could do it again.

Then Monday morning Dr. Ackerman came on duty in the NICU. She is on staff and is the woman in charge this week. She just happens to have 20+ years with kids that have severe BPD and pulmonary hypertension. Days later and with several tests to confirm and frank chats - we now know that's exactly what Tom has. Thanks to Dr. Ackerman's direct approach and years of experience to draw upon, we're now understanding just how tough our little fighter is.

Six days post-surgery, Tom's still on the ventillator. We've discovered that his CO2 has continued to be higher than the acceptable range. We're monitoring his CO2 levels via blood draws thru his PIC line every 4 hours and using that information to determine if we can wean him off the ventillator support gradually. We've introduced meds (the same ingredient in Viagra actually - it's a great blood vessel dilator) to address his hypertension and help with this exchange of CO2 for O2. The doc is hopeful but not optimistic that the meds alone will have much of an impact. We'll discuss it further with the doc tomorrow, but the best option for Tom may be a trachea tube and ventillator. This is the most aggressive approach to managing his BPD, but it would give him the best chance to develop as normally as possible over the next year. No guarantees, but the hope is that he would be off the ventilator and trachea tube in 18 to 24 months. At that point, we would have a healthy little boy. If we decide to go with the trachea tube and ventilator option, Tom would be in the hospital for another month. Needless to say, we got much more than we bargained for when we brought Tom down for a simple acid relux and feeding tube procedure. But, we find comfort in knowing that Riley Children's Hospital is the best place for us. Until we write, and you read, again, please remember - Never give up, don't ever give up!

Monday update....

2009-08-10T18:21:00.002-04:00

Hello again....Jules here. Kristin, Tim & Tommy are still all down in Indianapolis. Tom is, unfortunately, still on the vent and they are working very hard to get him off. He had some test done today and also an echo. As far as the surgery, he is healing nicely. His discharge date is very unknown at this point. A schedule is being created right now for coverage with Henry, Joe and Sam back at their home. If anyone is able to offer some help, please contact Katie at: starrsindc@msn.com Please continue to keep the Coleman Family in your thoughts and prayers!! Thanks!

Surgery update.....

2009-08-08T09:33:00.002-04:00

Hello again....Jules here! Kristin sent me an e-mail this morning about Tommy and his surgery, here is what she had to say: The surgery went very well, the doctors were able to do it laproscopically (sp?). He is still on the vent though. His CO2 is pretty high, so they want to increase his O2 on the vent for awhile longer before trying to extubate him. Kristin stayed in the PICU with Tom last night and he'll be in there till after they extubate him and then he'll move to the infant unit. I will keep you posted as I get more information.........

August update

2009-08-06T21:44:00.003-04:00

Hello everyone! This is Tim & Kristin's friend, Julie Rees updating their blog. As you can imagine, they all have been very busy with the boys! Sam, Joe and Henry have all been doing very well at home since their discharge date and have been growing/eating/smiling like crazy! Unfortunately, Tom has been in/out of the hospital a couple times the last month. Most recently he was admitted on Thursday, July 30th. Since last Thursday the good news, Tom's oxygen support has gone back down where it was when he left the NICU. But, since Tommy still has other issues - reflux and aspirating when swallowing - Tim and Kristin have decided to have a couple procedures performed on Tommy. Last night, Wednesday August 5th, Tommy was transported to a hospital in Indianapolis to have the two procedures done. The doctor will install a G tube, a direct line to Tom's stomach. This will allow the feeding tube that goes up his nose and down into his throat to be removed - which will hopefully make swallowing easier. The other procedure they will perform is called a nissan. The doctors will "cinch up" the top of Tom's stomach to tighten the valve between his stomach and esophogus. This will hopefully resolve his reflux issues!! Tim will be staying in Indy with Tom until he can come home. Kristin drove down today (Thursday) and will stay a few days. Kristin and Tim have great help at home right now with the other 3 boys. Please keep all of them in your thoughts/prayers, I know they appreciate it so much. ~ Jules

Photo Updates

2009-06-25T09:39:00.007-04:00

As I'm sure you can imagine, life with three babies at home and one at the hospital has been crazy busy - but so rewarding and fun too. Here are a few shots and some quick updates from the last couple weeks.

Henry's first try at the bouncy seat. It didn't last too long, but he did like the looks of that giraffe.

Sammy in a silly hat made by Nana (my mom). The look on his face says it all, doesn't it? :)

Three peas on the activity mat. They had as much fun reaching for (and hitting) each other as they did playing with the toys.

Two of our most favorite helpers: Jen and her mom Lynne. We certainly couldn't have made it through the first couple weeks without their help! For reference: Jen is holding Sam, Lynne has Henry ("the champ") and I've got Joe.

Tim wanted to join the fun on activity mat. I'm not sure how much the boys enjoyed Dad invading their space, but Tim had a blast!

Henry really enjoys taking tubbies. Here he is enjoying his post-bath snuggle in his towel.

Here it is the Fabulous Feeder 2009 or "The Contraption" as I like to call it. (though there have been a number of different names under consideration...not all suitable for print...) Tim made this out of PVC and velcro - pretty clever, if you ask me. The goal: to shave time off our feedings - particularly the night time feedings. So far, we've had good success with it.

Well, I need to run. I'll post updates on each of the boys - particularly on Tom's progress - very soon. Take care!

Love,
Tim, Kristin & the boys

Welcome home Joe!

2009-06-12T11:40:00.003-04:00

As many of you know, we welcomed Joey home on Sunday, May 31. And although we are thrilled with his recovery and progress since his abscess, it was bittersweet to bring him home. In fact, I bawled at the NICU before we left with Joe - at the thought of leaving Tom "alone". I know he's in wonderful, caring hands with the staff at the NICU, but I hate that he's there now without his brothers.

Anyway, we've got three healthy boys at home now and we're so very thankful. It's been pretty crazy around here - as I'm sure you can imagine. Mom was here for Joe's first night home and Jen is still here in the trenches with us. I'm not sure how we're going to make it all work (especially the night time feedings) once Jen goes home!

Here are a few highlights from Joe's homecoming:

Joe in his car seat before leaving the NICU: "Wait! Isn't Tommy coming with us?"

Joe and his proud parents (with mom's tears wiped away). Valisa took this photo (since Henry wasn't with us this time). She was Joe's primary nurse and brought him into the NICU from delivery, so it was perfectly appropriate to have her there to wheel him out.

It seems to be Coleman boy tradition to fall asleep in the car seat on the way to or from the hospital. Don't you just want to eat this little peanut up?

Three peas in a pod. And just for the record: It's definitely Sam in the middle, but even their mother can't tell which one is Joe or Henry in this photo...

Lots more photos and a list of things we could use help with (thank you to those that have offered!) to come soon. Also, a big thanks to our neighbors and friends in the bunco group for their generosity in brining meals to us. We've been overwhelmed with all the love, help and support from our extended family here in Indiana. Thank you!!

Lots of love,
Tim, Kristin & the boys

Welcome home Sam!!

2009-05-30T22:50:00.003-04:00

Two down, two to go! Sam came home from the NICU on Wednesday, May 27. So far, he and his brother Henry have taken it easy on us and not caused too much trouble. :) We've been fortunate to have the generous help of my mom and best friend Jen (who arrived Thursday from Amsterdam) to get us through the feedings - and to keep us fed!

Here's a shot of Sam and his proud parents just before leaving the NICU. Henry was there with us that day and actually took this shot for us. :) He's very advanced.

Getting all those car seats in and out of the new minivan isn't as easy as one might think...

Sam snoozed on the way home - once he got settled into his car seat.

Our next exciting news is that Joe will be coming home tomorrow (Sunday)! We are thrilled to have three of our boys at home, but will certainly find it difficult to leave Tom at the NICU without the company of his brothers. The nurses, nurse practioners and doctors have assured me that Tom will get plenty of extra TLC in his brothers' absence. And I'm holding them to it!

More homecoming photos to come soon!
Lots of love,
Kristin, Tim and the boys

Welcome Home Henry!!

2009-05-25T11:56:00.015-04:00

As many of you may have already heard, we brought Henry home from the hospital on Friday!! We're all adjusting pretty well, though it's still difficult for me to grasp the notion that we're now fully responsible for him! :) He seems happy and to be adjusting well - though I'm sure he misses his brothers. :) We go to see Dr. Rougeau (pediatrician) tomorrow for his baseline check-up. I honestly can't believe the "fun" is offically starting after 9 weeks. He's already made one trip back to see his brothers in the NICU - and will probably make a few more before any of his brothers make their journey home. The nurses have even set up a small crib for Henry to hang out in - right next to the big crib his 3 brothers are sharing. We're still working out the feedings (who's getting up at what time to feed him) and how Henry's schedule will adapt to work for all the boys once they come home. It was certainly helpful to have my mom here this weekend. Three adults to one baby is a great ratio. Too bad we can't maintain that... :) Here are a few photos of Henry's big weekend:

He slept through his car seat test.

How can Henry and Joey NOT be the identical twins?! (sorry Valisa!)

Henry and his proud parents upon their departure from the NICU. The nurses all said "goodbye and good luck". We said "thanks! we'll see you tomorrow!" :)

(Henry had a great first night home, but we couldn't keep him out of his dad's beer fridge. (I take no responsibility for this photo.)

Here's a quick recap on the other boys and a few photos too...

On Tuesday, Joe and Sam got their circumcisions. Both of them handled it like champs - though Sam was certainly more vocal about it - no surprise there. On Thursday, Joe, Sam and Henry got their 2-month vaccinations. I'm not sure if Tom has gotten his yet...I need to find out. That evening, all 4 had their bi-weekly eye exams. Their eyes are still "immature", but nearing maturity - and the good news is that there are no indications of any eye issues. The bad news is that they'll all need another eye exam in 2 weeks.

Joe came off oxygen this week - except during feedings - and has been doing very well. Just this morning, they removed his oxygen monitor and will not give him oxygen unless he demonstrates a need for it. He's been eating very well and gaining weight: he's finally joined the FIVE POUND club with his brothers! Here's a shot of Joe getting his bath on Thursday evening - after eye exams.

Tom came off CPAP on Thursday - yippee!! He started out on 7 liters of air flow in his cannula, but is now down to 5 liters. Tom has been getting albuterol treatments all week (just stopped them today) and they definitely seem to be helping. When at rest, he is breathing easier and not working quite so hard - which is a step in the right direction. He took his first bottle yesterday with Dad. We're allowed to bottle feed him once a day, as long as he seems up for it. He took 18 cc's, but we're thrilled to have him truly eating again. This is a sleepy Tom after his eye exam on Thursday - with his CPAP-free face!

The nurses have informed us that Sam is a bed hog! He manages to shimmy closer and closer to Joe - eventually crowding out him and Tom. :) Sam had been hanging on to his 25 cc trickle of oxygen for a while now and we've finally been able to take his oxygen off. Like Joe, they've also removed his oxygen monitor. We'll watch his heart rate and color cues to see if he needs oxygen support. When he and Joe make it 2 days without oxygen help, they'll be able to come home. So right now that could mean Wednesday...we'll keep you posted! (Mom - are you on stand-by for an emergency trip down here mid-week?) Sam, the most expressive of the group, let us know his feelings about being bothered after his eye exam on Thursday:

Just a couple more shots from Henry's first visit back to the NICU on Saturday. I took the first photo in the car on the way to the hospital - so sweet. And the second photo is of Henry's 3 brothers in their shared crib with their pacifiers.

Gotta run! We've got babies to feed in the NICU. I'll be posting another update soon with information/rules for visitors and some options for those of you that have offered to help us out. Stay tuned!

Lots of love and hugs,
Kristin, Tim and the boys

Photos to go with last week's post

2009-05-25T11:19:00.006-04:00

I don't know where the time goes, but I can't believe it's already been a week since my last post. Anyway - here are the photos I intended to include with that post:

These are the photos the boys gave to Dad for his desk on his birthday - one of each boy:

Henry getting a bath (okay, this was staged, but he just had a major blow-out and needed some serious cleaning).

Sam testing out his car seat.

A peaceful shot of Tom sleeping (on high flow cannula, between sessions on CPAP).

Joe smiling - as always.

Decorations for Tim's birthday party at the NICU.

Our new digs in the NICU - back out into the main room.

The gang on Mothers Day at Yesterdays, one of our favorite restaurants in the area.

More updates and photos to come... Love, Tim, Kristin and the boys

The Week in Review

2009-05-19T11:43:00.003-04:00

Hi everyone! It's been a busy week (okay, 10 days) since I last posted an update. Here are the highlights:

My mom and Tim's parents came to visit for Mothers Day weekend. We all attended CPR training at the NICU and the grandparents got some training on bottle feeding our preemies. Since they'll be helping us quite a bit once the boys come home, they all need to have this important training and information. Plus, it was nice to have our moms here for Mothers Day - and for them to spend time with four of their grandsons.

I met with another pediatrician last week (I've "interviewed" three of them) and have decided to go with Dr. Rougeau. She impressed me right off the bat when she brought a note pad into the room to take notes on each of the boys. :) I think I'll get along very well with her!

The final chapter of the milk saga has been written and gone to print - so to speak. Bronson milk bank pasturized my milk last week and shipped it to me just this morning. We now have 140 bottles of milk in our freezer - plus all the bags that I add to the collection every day. (Thank you again to Uncle Tim & Aunt Sarah for that chest freezer!)

Tim's birthday was the 14th and the boys wanted to throw a little birthday party for him. Valisa helped decorate our room at the NICU to celebrate. We put up a photo of each of the boys and a bunch of streamers. The boys gave Tim some photos of them to keep on his desk at work.

The 15th was a big day: We ALL tested negative for MRSA!!! Since this was our second negative result, we're no longer in isolation. No more gowns and gloves!! Yippee!! On Saturday, the nurses offered to move us out of our tiny room and back into the main part of the unit - in the room we started in. So we've got our new digs set up where there's plenty of natural light and space for us to move around. It's so nice to not feel like the local lepers any more! AND - the best part is that I've been able to start nursing again. I'm only doing it once or twice a day, but the boys are doing very well with it.

Jim & Carrie MacCaughan visited the boys on Saturday. It was great to see them and the boys were so happy to finally meet Uncle Jimmy and Aunt Carrie. :) I'm sure our boys seemed so incredibly small to them - since "little" Jimmy Walter is pushing 18 pounds already!

Joey has been doing amazingly well! Since our last post, the flow on his nasal cannula had been reduced gradually. As of Sunday, he is off the high-flow cannula and just getting a trickle of oxygen (25 cc's). We hope to ween (sp?) him off oxygen completely over the next week. He's doing well with his feedings - and has had his feeding tube removed on Sunday as well. That means he's bottle-feeding or nursing for all his feedings now. If he falls asleep during a feeding, he'll wake up hungry the next time around. "Tough love", as Dr. Vitale puts it. :) Joe is weighing in at 4 lbs 12 2/3 oz - my little peanut.

Tom started getting steroids on Mothers Day. His oxygen requirements had been going back up and he seemed to be working harder to breathe. On Tuesday, they put him back on CPAP. That was not a good day for Mom, let me tell you. Its clear to me that Tom is so uncomfortable on CPAP and it's so hard to see him unhappy. But I guess the alternatives are much worse. He received a full dose of steroids on Monday and Tuesday, but has been weening since. I'm not sure Dr. Vitale has seen the results he'd hoped for with the steroids, as Tom is still on CPAP. They've reduced his flow from 6 to 5 and hope to move him back to the high-flow nasal cannula in the next few days. He does continue to gain weight (he's getting all feedings thru his tube, as he can't bottle feed while on CPAP) and is currently 5 lbs 6 1/3 oz.

Sam, like Joe, is at 25 cc's of oxygen - and dangerously close to coming off oxygen all together. On Tim's birthday, Sam's feeding tube was removed - more "tough love". He's doing very well with his feedings and gets just over 2 ounces in his bottles. We've nicknamed Sam the Spokesperson for the group. He's definitely the most vocal and doesn't shy away from telling you exactly how he feels. :) Sam is one of the "big boys" weighing in at 5 pounds 8 2/3 oz.

Henry is HOMEWARD BOUND!! Last Monday Henry was moved to just 50cc's of oxygen, then weened until his oxygen was removed on Sunday. He's doing very well without any oxygen support - and it's so nice to see his face without anything going up his nose or taped to his cheeks. :) He's been eating like a champ: losing his feeding tube and eating 2 ounces just like Sam. Right now we're targeting Friday (yes THIS Friday) for Henry to come home. He's got a busy week ahead of him, so we'll see how he fares. We may need to wait until the weekend to bring him home, depending on how he handles his circumcision (this morning - he did very well), vaccinations (tomorrow) and eye exams (Thursday). (All the boys will get vaccinations and eye exams this week.) We also need to test him in his car seat to make sure he fits and that he can maintain proper oxygenation while seated in that position.

Sam and Joe won't be too far behind Henry - potentially heading home next week. We'll see how well we can ween them off oxygen and how well they do with their feedings.

The toughest part of our journey may be yet to come: dividing our time between Tom at the hospital and the other three at home. Tom is in for the long haul and probably has another 3-4 weeks ahead of him at the NICU. We'll be recruiting all sorts of help to care for the three at home so I can spend ample time with Tom - who will certainly need some TLC in the coming weeks.

I really wanted to post some photos with this update, but I've run out of time. I have to get to the hospital to feed the boys. I've got photos of the boys, our new digs, Tim's birthday party, Mothers Day and more. I'll get them out here soon - I promise! Gotta run. Thanks for all your prayers and support. We couldn't do it without you!

Lots of love,
Tim, Kristin and the boys

Henry's stats

2009-05-09T12:15:00.002-04:00

I neglected to include Henry's weight and length in the new post: He's the heaviest of the group, weighing in at a whopping 5 lbs 3 oz. And he's a bit shorter than Sam at 17" long.

The generosity of strangers (and those we know)

2009-05-09T10:34:00.006-04:00

Hi everyone! Thank you for your patience (or for not expressing your impatience) in waiting for a new post on our blog. I'm happy to report that we have a lot of good news to share in this update. Unfortunately, I left the camera at the hospital last night, so I don't have any new pictures to include today. Hopefully tomorrow.

Joey is recovering wonderfully from his MRSA abscess. His incision is healing nicely and he's been eating like a champ. He's down to 2.5 liters on his high flow cannula and not too high on his oxygen requirements. Joe is a whopping 4 lbs 6 oz and 16 1/4" long. He's the smallest of the gang, believe it or not!

Tom was put back on CPAP last Friday night, but has since been put back on high-flow cannula. Tim and I are thrilled about that - but I think Tom is even happier. He really didn't seem to like it at all. He's still pretty high on his airflow/oxygen requirements (5 liters & 50-50% oxygen) and is getting breathing treatments. We thought he might have pneumonia, but now it looks like he's got chronic lung disease. He's got a fairly long road ahead of him (3-4 more weeks at least). He's a little behind the other boys with respect to bottle feedings because when the others first had their bottles, he wasn't eating due to his urinary tract infection. Then he was taken off bottles again while on CPAP. Hopefully we'll start him back on bottles in the next couple days, but but since his oxygen requirements are higher, bottle feeding may be tougher for him than the other guys. Tom will most likely be the last to come home from the NICU - and is expected to come home on oxygen. But we'll cross those bridges when we get there. Tom weighs in at 4 lbs 12 oz and measures 16 1/2" long.

Sam has had a good week - not much to report (and in this case, no news is good news). He's still off the high-flow air and on minimal oxygen support (75-100 cc's). Sam does really well (most of the time) with his feedings - eating his entire feeding a lot of the time. He may be the first to come home - in 10-14 days. He and Henry are running neck & neck. Sam weighs in at 5 lbs 1 oz and 17 1/2" long. We tested Sam in a car seat this week. (I've got great photos of that.) His shoulders are just below the height of the straps, so hopefully he'll grow just enough in the next couple weeks to come home in the car seats we've already got.

Henry has been a bit of a yo-yo with respect to his oxygen and airflow support. Last Friday, he went down to 1 liter of flow, but had to come back up to 2 liters a couple days later. Fortunately, he's gotten back down to 1 liter again - just on Thursday - and so far he's doing pretty well. If he continues to do well, we'll take him off the high flow support next week and put him on the same oxygen system as Sam (which is one step closer to going home). Henry is also very good with his feedinigs and has finished all bottles in a 24-hour period. Most of the time he's a little more hit-or-miss, but just as good as Sam. He may be able to go home with Sam in 10-14 days.

The breast milk saga continues...but thankfully with a very happy ending. I contacted the milk bank in Kalamazoo (where South Bend Memorial gets their donor breast milk) to see if they could pasteurize my MRSA-positive milk. They can do it - but the prices they quoted me were cost-prohibitive. One of the many reasons I'm such an advocate of breast feeding is because it's FREE. Its hard to rationalize spending hundreds of dollars to use the approx 11 gallons of milk we have stored. I spoke with Dr. Vitale about it earlier this week and he suggested finding a "sponsor" to cover the costs for us. Before I could make any calls to places like the South Bend Tribune, he made some calls at Memorial. I'm not sure who he sweet-talked or what he said, but he was able to secure funding from the hospital to cover the cost for pasturizing my milk!! (THANK YOU VITALE!!) Someone that we'd never met was generous and kind enough to help us. That was, of course, wonderful news that we certainly didn't expect.

Vitale also spoke with Cindy, the manager of the milk bank. We've got it set up for her to pick up the milk from our house tomorrow. As luck would have it, she'll be in the area to visit family. She offered to bring coolers with her and pick up all our milk on her way back to Kalamazoo. We certainly could have driven the milk to K-zoo ourselves, but Cindy was generous enough to offer to do this herself. Amazingly generous.

Thursday, the results came back on the 2nd culture of my breast milk: NEGATIVE!!! That afternoon, the boys were off formula and back on breast milk. Yippee!! At the NICU, a couple visitors came to see us: the pastor and his wife from Michiana Community Church of God. We've never been to the church and probably don't know any of its members - but someone at the church saw our story in the paper and "just wanted to do something nice" for us. They came bearing gifts: diapers, clothes, crib sheets, etc. What a wonderful - and completely unexpected - surprise. Thank you!

Later that day, the boys had their bi-weekly eye exams. All are still immature with no issues evident yet. (That's exactly the result we wanted to get.)

On Friday, we got the 2nd culture results on the boys: NEGATIVE for MRSA! Fabulous news! If we get another negative result next week, they'll be able to stop the isolation procedures in the NICU (gowns, gloves, etc.).

Obviously, our lives are on quite a roller coaster ride. The issues that came up last week have all changed and progressed and we're on to more issues already. The staff at the NICU - the nurses (Kiam, the boys' primary nurses: Valisa, Jugenia, Gretchen, Robyn and Kathy...who am I forgetting?), Karen the social worker, Bonnie the parent relations person and of course Dr. Vitale - have been incredibly supportive. In addition to the spectacular care they provide 24-7 for the boys, they've also taken care of us. Thank you to all of you for going above and beyond! Seven weeks (and more) in the NICU is an incredibly intense and stressful experience for any parent. We can't thank you guys enough for doing all you do to make it as smooth and easy for us as possible. Thank you to all our friends and family for all your love and support. The events last week were definitely the proverbial straw that broke our back - and I'm sure that will happen again before all the boys come home. We find comfort in knowing that you'll all be there to support us when that happens. We're sending big hugs to all of you!!!

Lots of love,
Tim, Kristin, Sam, Henry, Tom & Joe

An Emotional Week

2009-05-01T11:15:00.002-04:00

I intended to post a lengthy update to the blog today, but just don't have it in me. It's been a long week - but I do want to give you all a quick update. Here goes:

Joey's abscess came to a head on Wednesday and it was lanced by the same ENT that did Sam's. Due to the location of the head, he was able to put the incision in a much less conspicuous spot, so hopefully he won't have any visible scars. He's back to his charming self and will be moved back into the room with his brothers today. We're very relieved.

Since it is more than a coincidence that 2 of our boys developed the same abscess in the same spot, the NICU staff - particularly Dr. Vitale - has done some research and consulted with several MRSA experts. We ended up testing my breast milk for MRSA - and it has come back positive. ALL of it - even the GALLONS stored in the NICU freezer. (I'm guessing we have about 10-15 gallons of frozen breast milk that may have to be thrown away.) The experts say that the milk should be sterile unless I have an internal infection (for which I have no symptoms) - so the most likely cause is that I have MRSA on my skin. We're all undergoing treatment to de-colonize MRSA(antibiotic ointment in our noses, oral antibiotics and an antibacterial wash for Tim and I to use in the shower). We'll test my milk again next week to see if the treatments have had any effect. In the meantime, I feel defeated. The ONE thing I can provide for our kids while they're in the NICU has made them sick and it can't be used. We're looking into pastuerization, but I'm not hopeful that this will pan out. Its so hard to see all my hard work and emotional investment go down the drain.

Some very good news: Sam may be ready to come home the week after next - and Henry shouldn't be far behind. Tom and Joe will require more time in the NICU. Tom's chest x-rays and oxygen requirements are pointing toward Chronic Lung Disease. I need to find out more info on that. Preemies that have this tend to have issues with asthma and other pulmonary issues down the road. He's getting breathing treatments (started yesterday) for that and we'll see how he responds. Since Joey was on similar oxygen support before this mess with his abscess, he may also have chronic lung disease, but we'll need more time to determine this, as he just got off the ventillator yesterday.

So given that Sam and Henry are close to being ready for discharge, we've started the ball rolling with the discharge nurse in the NICU. We met with her for 2 hours this week and have made plans for CPR training with Mom, Pat & Don since they will be helping us out when we bring the kids home. (Jen Morris - do you have CPR training? We might be able to hook you up when you get here...I'll have to investigate...)

Anyway, to say the least, it's been a hell of an emotional week. Sure, the breast milk thing isn't life threatening like so many of the issues the boys have faced. But after 6 weeks of life in the NICU with 4 babies and all the stress we've dealt with so far, this was the proverbial straw that broke my back this week. We'll get through this, I'm sure. But - wow - it's amazing just how much one family can be tested, isn't it? I have to remind myself that we're only given what we can handle...and that I need to live up to the "handling" end of that deal. Thanks everyone for all your love and support!

Love,
Tim, Kristin & the boys

Quick update: Here we go again...

2009-04-28T10:29:00.002-04:00

Sorry for not posting in a while. I've got lots of info to share, but not much time right now to share it. The boys have made great progress and are probably only a few weeks from coming home. But Sunday night, we got word from the NICU that Joey seems to have the same infection/absess that Sam had a couple weeks ago. It has presented in the same way: apnea and bradicardia (heart rate drop) episodes, requiring increased oxygen, etc. until they spotted the swelling on his neck. So, they've put Joe on a ventillator and on a warmer (his temp had dropped with the infection). They started him on antibiotics right away and took blood for cultures to make sure we know exactly what we're dealing with (though the doc is 99% sure it's the same infection Sam had). We should have those culture results today or tomorrow. The kicker is that they had moved the boys into a smaller room last week and that room can't support (nor does it have room for) a ventillator and a warmer. So Joe is in a separate room by himself. This has made things fairly complicated with all the precautionary procedures (gowns, gloves, etc.). Even though I understand all the policies the NICU staff has to follow, I certainly feel like we're all outcasts and not welcome there. The staff has been great and I'm not saying it's anything they're doing personally. It's just the procedures they have to follow.

Needless to say, it's been a pretty intense couple days. I stayed at Ronald McDonald House last night and will probably stay here again tonight. Joe is stable, but still seems pretty uncomfortable with the swelling on his face and neck - just like his brother Sam. The other boys are all doing well. We'll keep you posted as soon as I can find time to post more info. And once things settle down a bit, I'll catch you up on everything else the boys are up to. In the meantime, your positive thoughts and prayers are much appreciated!

Love, Kristin, Tim & the boys

A Few More Photos

2009-04-22T08:57:00.004-04:00

These were just too cute not to post...

Tommy

Sammy

Joey's first burp with a bottle

Joey

Henry

Bottles, Cribs and 1-month Birthday!

2009-04-22T08:21:00.005-04:00

Happy One Month Birthday, Boys! Gretchen and Jugenia (I hope I spelled that right) helped me stage this shot on the boys' one-month birthday. The hats came from a sweet girl that works at the salon where I got regular prenatal massages thru the winter. Aren't they adorable? And the boys wear them so well. :)

Things have been going pretty smoothly since our last post (knock on wood!). Henry, Sam and Joe have each been doing well on their bottles - and have each taken a turn at actually finishing an entire feeding by bottle (though they're not very consistent yet). They've done so well, in fact, that on Sunday I was able to start nursing each of them once a day. Henry and Sam have been the most successful at that, but Joey certainly does his best. They just need to grow a bit more and get some more practice. They'll all be pros at this suck-swallow-breathe coordination thing soon enough!

Henry's first bottle

Sam's first bottle (his IV was in his head and he has gauze under his chin from the absess drainage after it was lanced - and even with all that going on, he still ate like a champ!)

Joe's first bottle

Hopefully we'll be able to start bottles and nursing with Tom very soon. His feedings started on Sunday and he's ramping back up; he should be on full feedings later today.

As I think I mentioned in one of my last posts, Sam and Henry have moved into a crib together and have really seemed to be enjoying hanging out together. Check out their new digs:

Yesterday, Tom moved out of his isolette and is now sharing a crib with Joey. I left last night without taking a picture of their new digs, so I'll snap a shot today and include it with our next post.

We found out over the weekend that the cause of Tom's issues late last week can be attributed to a urinary tract infection. I guess this is fairly common with preemie boys. So he'll finish up antibiotics later this week to make sure the infection is gone. He's definitely back to being himself and seems much more comfortable.

Joe and Henry got another head ultrasound (just a routine check) yesterday and everything looked great. Sam and Tom will get theirs today (they still had IVs in their heads yesterday). Dr. Vitale has stopped Sam's caffeine and will stop it with the other boys over the next week or so. The caffeine is used to help avoid apnea. Since they're all coming down on their oxygen support, the caffeine won't be needed much longer. This is yet another sign that they're getting closer to coming home. In fact, the doc is targeting another 3-4 weeks for discharge. Pressure's on! We need to get our poop in a group and make sure we're as ready as we can be for these boys to come home. (...lord help us...)

I had another follow-up appointment with Dr. Donald on Monday. My blood pressure was back to normal (118/72) so I no longer have to take the medication. I'll go back in 4 weeks for my final follow-up.

Here are their current weights as of last night (unless otherwise noted). They're getting so big!

Sam: 3 lbs 11 2/3 oz (as of Monday night)
Tom: 3 lbs 6 2/3 oz
Henry: 3 lbs 12 oz
Joe: 3 lbs 10 oz

I think that covers it for now. We'll post again soon!

Lots of love,
Tim, Kristin and the boys

A Long Week

2009-04-18T10:51:00.003-04:00

Well, we've made progress - and hit a few stumbling blocks this week. In summary:

On Tuesday morning, Henry had a bad episode of drop in heart rate and oxygen level in his blood. He's totally fine otherwise and has been great since. I guess he just didn't want Sam to get all the attention. :) We discovered later in the week that his hemoglobin had dropped down to 6.4 (normal is around 12 - I think). So he received some of Dad's blood on Thursday and some more on Friday to get his hemoglobin back up into the normal range. We tried a bottle feeding with Henry on Tuesday and he drank a whopping 5 cc's before falling sound asleep. Not too shabby for his first time out. We're working with the nurses to attempt bottles at pretty much every feeding and he's doing pretty well.

Sam had a big day on Wednesday: the infection on his chin and cheek finally absessed and formed 2 "heads" - one on his left cheek and one under his chin. The swelling was very pronounced in those 2 areas, but much of the swelling and redness over the rest of his face and neck had decreased substantially. So at 1:30pm on Wednesday, an ENT came to lance the absesses. Come to find out, it was actually all one big absess - with a channel deep under the skin connecting the 2 "heads". Crazy. The ENT actually commented several times about the "impressive amount of fluid" that came out of the little guy. Almost immediately, he seemed to feel so much better. And even thru the worst of his swelling, he really took to his pacifier. (If you're familiar with The Simpsons cartoon, imagine Maggie Simpson sucking on her pacifier.) So we tried a bottle with Sam on Thursday and he did really well. Like Henry, we're trying bottles with almost every feeding. One of the nurses even got him to finish an entire 30cc feeding by bottle the other night. Go Sam! What a trooper - especially after the week he's had.

We both stayed at home Wednesday night. Since Sam was doing so much better, I felt more comfortable leaving the hospital and sleeping in our own space. Foolishly, I came into the NICU Thursday morning expecting and "easy" day since Sam was on the upswing after his infection. Then I saw 2 nurses working with Tom and knew this couldn't be good news. Wednesday morning, Tom had a bad heart rate and oxygen drop episode (like Henry's earlier this week). That wasn't a very big deal - until he did it again (a couple times) Thursday morning. So the doctor ordered antibiotics for Tom and several blood tests and cultures to figure out what was causing the problems. Tom's abdomen was distended, so the doc feared he might have NEC (I don't remember what the acronym stands for, but its something to do with the digestive system and can get very bad very quickly). So they're holding Tom's feedings until Monday at the earliest. In the meantime, he's getting nutrition via IV. They gave Tom some of Dad's blood, as his hemoglobin was low and that seemed to help perk him up. His blood tests indicated a possible infection, so we're watching him closely. He had a pretty good day Friday and I was able to get some good one-on-one time with him in the afternoon. His abdomen came down substantially in size, so we're hoping that's a good sign. We stayed at the hospital Thursday night, but since Tom was stable on Friday, we stayed at home last night.

Joey has had a few episodes of low heart rate and apnea, but nothing as serious as Tom or Hank. He's really holding his own very well. We also started bottle feedings with Joe. Tim gave him his first bottle and he did very well. When the nurse fed him by bottle over night, he finished an entire 30cc feeding! Quite impressive for our little peanut!

Sam's absess tested positive for MRSA, so they swabbed the other boys' noses and skin to test them. We know Henry and Joe have also come back positive. I haven't heard yet about Tom, but expect that he'll have it too. Much of the general population has MRSA on their skin. It's not a serious threat to most people - but can be very serious to those that have compromised or weak immune systems - like premature babies. So, we will remain in isolation in the NICU until the boys are discharged. This is a preventative measure to reduce risk of infection to any other babies in the unit. Our nurses put on clean gowns over their scrubs and clean gloves when they come into our area to care for the boys - and they change into clean gowns and gloves if they move from one baby to another. Tim and I are not required to wear gowns, but we do if we've held one baby and want to hold another - as the MRSA bacteria can be transferred on clothes. For any visitors, we'd like you to wear gowns as well when you visit. And if you touch anything (the cribs or isolettes, their blankets, etc.), you need to wash your hands thoroughly. There is no serious threat to you - this is merely a precautionary measure to keep from spreading the bacteria.

On a lighter note, we have made progress this week (in addition to the bottle feedings). Three of the boys have been moved out of their isolettes and into cribs. Sam and Henry are actually sharing a large crib together. And Joey is in a small crib next to Tom. Because Tom is still not quite himself, we're keeping him in his isolette until sometime next week. Once he's ready, he and Joe will share a crib like their brothers. It's strange to see them "out in the open", but it shows how much they're growing and getting stronger.

By the way - we're all convinced that Tom & Joe are NOT the twins. It appears that Joe & Henry are. The nurses - and even Tim - agree. Time will tell - and perhaps a pathology report on the placentas that my Dr. Donald should have... We'll keep you posted on any developments on that... :)

I really wanted to include some photos, as I've taken quite a few this week. But I'm on my laptop and don't have the photos downloaded to this computer. And it's getting late...I want to get back to my boys at the hospital! We'll post pics soon - hopefully yet this weekend.

Tim is on his way to the dealership now to buy a mini van. He brought it home last night so I could see it and so we could test it out with all of our baby gear. It's a 2008 silver Chrysler Town & Country. Not too shabby. Tim thinks it'll look a lot better once we add the flames on the sides... We'll turn in Tim's truck and keep my Vibe for Tim to drive. I still can't believe I'll be driving a minivan...

Current weights are listed below. Please note that they are ALL OVER 3 POUNDS!

Sam: 3 lbs 7 2/3 oz
Joe: 3 lbs 4 1/3 oz
Tom: 3 lbs 4 oz
Henry: 3 lbs 8 1/3 oz

Well, I'm off to the hospital. Thanks for all your thoughts and prayers - and for your posts. We love to hear from you. By the way - Stacey: The picture in the newspaper doesn't show all the baby weight I'm still carrying. Very clever of me to use that pillow on my lap to rest the babies on, eh? :) Oh, and Brooksie, I'm so glad you enjoyed the head measurements. I should have known you'd get a kick out of that!

Lots of love,
Tim, Kristin, Tom, Joe, Sam & Henry

What a weekend...

2009-04-13T23:08:00.002-04:00

Well, Friday's doctor visit had mixed results. My incision has healed very well - but my blood pressure is still very high. So I'm now on medication to get that back under control. I'll follow up again with Dr. Donald on the 20th.

Sam came off the high flow air on Friday - and went back to regular flow. For a few hours all 4 boys were on regular flow...but after a few apnea/heart rate drop episodes that day, Henry went back on high flow. They did a CBC to check for infection and it came back negative, so that's good.

Also on Friday, Tim double-kangaroo'd Sam and Joe and I held Henry & Tom. Sam & Tom loved their exercises - but Joey didn't do too well. He's always been more comfortable on his tummy than on his back, so his oxygen kept dropping when we had him on his back to do the exercises. We'll try them next time on his side and see how he does. I loved watching Tim do the exercises with the boys. He adds sound effects and talks to him just like a personal trainer encouraging his trainee through a tough workout.

Overnight they put all 4 boys on air temp control in their isolettes vs. skin temp control. This means they're all getting closer to managing their own body temperature. Another step in the right direction!

On Saturday, I kangaroo'd Sam & Joe together and also Tom & Henry. Our McKay cousins Mike, Mandy, John & Julie came by Saturday afternoon to meet the boys. It was a very nice visit and the boys were on their best behavior. :)

Throughout the day, there was a lot of talk about Sam's new double chin. Since he's one of the biggest of the 4 boys, we all assumed (the nurse too) that he was simply gaining weight and showing it in his chin. Then, after a great day with the boys, we got a phone call at home from the doctor in the NICU around 8-9PM. Sam's double chin was actually the beginning of an infection. The nurses on the night shift picked up on some redness and puffiness on his cheek, chin and neck and they acted very quickly to get antibiotics running. Because this type of infection is usually some sort of staph infection and can be contagious, they moved all 4 boys into 2 small rooms at the back of the unit to isolate them from the other babies and reduce the risk of spreading the infection. As an additional precaution, the nurses put on clean gloves and gowns every time they come into our rooms to care for the boys - and a new gown and gloves when they move from one baby to another.

Later that night, they put Sam on a ventilator. This was partly a precautionary measure - if the swelling spread and increased, they feared his airway would be blocked. Sam was also becoming very lethargic and lazy with his breathing. The vent would make breathing easier for him, so his energy could go toward fighting the infection instead. They've also started holding his feedings and giving him nutrition via IV so he doesn't have to use his energy to digest food.

The infection probably feels like a bad toothache for Sam. So the nurses have given him pain medication - in addition to his antibiotics - to make sure he's as comfortable as possible. They gave him some blood today (unfortunately we don't have an approved O negative donor yet on our directed donor list, so we used blood from the general blood bank). The doctors feel that he's through the worst of the infection and we just need to give the antibiotics time to fight it. They did a spinal tap to confirm the infection has not spread to his brain - and it came back negative (whew!). His blood cultures also came back negative, so the infection is localized and has not spread so far. This is very good news. Even knowing that, it's still so hard to see him like this. He's just not himself. Hopefully in the next couple days, we'll be able to tell everyone that he's feeling better and definitely on the upward swing. In the meantime, please continue to send your positive vibes, thoughts and prayers Sam's way.

One other new development for Joey: It seems that he's developed an allergy or sensitivity to the tape they use to hold his feeding tube in his mouth. The nurse last night took off the tape he had so she could re-position the tube and discovered some tiny blisters on his skin under the tape. They seem to be healing pretty well and they're using as little tape as possible on his skin.

Tom's lungs are showing improvement, but his hemoglobin (and Henry's) is borderline - meaning they'll both probably need blood in the next few days. Luckily, Tim's blood has been approved on our direct donor list, so they can both receive his blood. (The other A positive friends and family that have donated were not approved.)

Here are the current weights and measurements. I've included the length and head size for those that might be interested (particularly the McKay fat heads). :)

Tom: 3 lbs 3 oz; 15 1/4" long; head 11"
Henry: 3 lbs 5 1/3 oz; 16" long; head 11 1/2"
Sam: 3 lbs 7 oz; 16" long; head 11 1/2"
Joe: 2 lbs 15 oz; 15 1/2" long; head 11"

Well, that's it for now. Tim and I stayed at the hospital last night and I'm here again tonight. I'm just more comfortable being right here with Sam and the other boys. We'll post another update soon.

Love,
Kristin & Tim

Three-Week Update

2009-04-10T08:51:00.002-04:00

Just a quick update this morning. I need to get over to the hospital for one more check-up with Dr. Donald before visiting with the boys.

The boys are all doing great. In rounds yesterday, the doctor said they're "awesome". They're all on only 1 liter of air flow with minimal oxygen support. They're tolerating their feedings well and are increasing the amount of milk per feeding. They're also gaining weight. The numbers below may not be 100% accurate as of last night, but they're close:

Sam: 3 lbs 4 oz; feedings are up to 29cc's
Joe: 2 lbs 13 oz; 25cc's
Henry: 3 lbs even; 28cc's
Tom: 2 lbs 13 oz; 26cc's

We're starting to work with the nurses to do a physical activity program with all of the boys. We'll use flexion, extension and compression on each of their shoulder, elbow, wrist, hip, knee and ankle joints to help mineralize their bones. They would normally have gotten to do this on their own by pushing and kicking against their placentas and my uterus walls in the womb, so we'll make up for what they're missing. Studies have also shown that this activity is most beneficial when the parents do it with the babies. So we'll be their personal trainers for a while!

We've got another busy weekend with lots of visitors expected. The McKays will be in town for Easter and many of them would like to come by to meet the boys. We're always happy to show them off! We'll also have Easter dinner at Terry and Kay's Sunday afternoon. It'll be nice to see everyone.

We'll update again soon - and will let you know how the boys' daily exercises are going. :)

Lots of love,
Tim, Kristin, Sam, Henry, Tom & Joe

South Bend Tribune interview

2009-04-07T10:03:00.004-04:00

As I mentioned in my last post, yesterday was going to be a busy day - and it proved a little busier than expected! Not only were Aunt Honey and Aunt Dorothy in town, but Aunt Molly and Uncle Craig also stopped by on their way home from Wisconsin. They were all able to stay for our interview with the South Bend Tribune too. Then, Tim took them over to the lab so Honey and Molly could have their blood drawn and tested for a match with the boys. Thank you!! We found out that Tim is a match so far - and he can give to 3 of the boys. It's good to have a few names on stand-by for when the boys need blood, so we'll keep looking for more volunteers. Unfortunately, blood donations need to be made locally and collected by the blood bank here in our area. But thank you to all of you that have offered to donate in other states. We really appreciate your generosity!

The interview went really well. Our boys' nurses figured out a plan to move all 4 babies together so we could hold them for photo ops. :) Tim held Sam and Henry; I held Tom and Joe. (I'm not entirely sure that Tom and Joe are really the identical twins...they look very different to me and having them so close together for the first time didn't convince me...)

The story will be printed in Wednesday's paper. You can also access it online at www.southbendtribune.com. The writer's name is Alicia Gallegos - just in case you need that to search for the story. Alicia asked if they could do follow-up stories on us when the boys come home, when they come back to the NICU for the annual "reunion", etc. We think it's a great idea and are happy to share our story.

After the interview and all the aunts and uncles went home, our friends Mark and Julie came by to see the boys. We love to have visitors and to show off the progress the boys have made.

The boys have all gained a little weight since yesterday's post:

Joe: 2 lbs 9 1/3 oz
Henry: 2 lbs 13 2/3 oz
Tom: 2 lbs 9 1/3 oz
Sam: a whopping 3 lbs 1/3 oz!!! We've got a 3-pounder!

I'm heading over to the hospital a bit later today and plan to stay into the evening to help with the boys' baths and the rest of their evening routine. We'll do that a few times a week so we can get involved with as much of their care as possible.

Every time I log in and read the comments posted by our blog followers, I'm touched - and sometimes overwhelmed - at the response. And to see a post from a fellow quad parent is awesome. No doubt we'll be reaching out to that family for all sorts of help and advice! Thank you for posting a comment, Brad! I'll be in touch soon!

Thanks everyone for your continued love and support. We couldn't do it without you.

Lots of love,
Tim, Kristin, Sam, Henry, Tom & Joe

Can you believe it's been over 2 weeks already?

2009-04-06T08:19:00.003-04:00

Wow, time flies.

I met with our neonatologist and the NICU social worker on Friday to discuss the boys' status and our long-term plans for child care, etc. The boys are all in the category of what they call "growers and feeders" now. As of this weekend, Joey's nutritional IV came off - so now all 4 are getting all they need from breastmilk. Gestationally, they are just over 30 weeks old, so we've got a few weeks yet before they will instinctually learn to swallow (that usually happens around 32-34 weeks). At that time, we'll start trying to introduce bottle feedings. Until then, the doctor said we shouldn't anticipate any major changes in their conditions or their care. This is all good news.

Of course, having said all that, we're not completely out of the woods. They'll still be watching the boys very closely for any digestive or breathing issues that are out of the ordinary. So far, everything is going very well (as Henry's monsterously poopy diaper last nigh would prove). Tom & Sam's lungs are still showing improvement and will most likely "fix" themselves over time. Two of the boys are on regular flow cannulas and two are on high flow with varying levels of oxygen support - all within the normal or expected range. The boys' feedings are all gradually increasing and Joey is slowly catching up with the others. (The pressure is on Mommy to produce lots and lots for them to eat!) Here are their current weights:

Tom: 2 lbs 8 1/3 oz
Henry: 2 lbs 11 2/3 oz
Sam: 2 lbs 14 oz
Joe: 2 lbs 7 1/3 oz

Later this week, we'll start working with the nurses to put the boys thru a physical activity program. It's all about massage and movement to help them with their physical development. I'm looking forward to getting a little more "hands on" time with them.

On Thursday night, a leak developed in the skylight in our room in the NICU. So on Friday afternoon, they moved all the babies from that room to other spots in the unit so the drywall and paint repairs could be made. We're now in a smaller room without much space to maneuver. But on Saturday, our nurses found a way to make the most of our tight quarters. The boys' isolettes are paired up across the aisle from each other. And each pair shares a common pole for their oxygen support. That means each pair can be taken out of their isolettes for DOUBLE KANGAROO (skin-on-skin) holding between their isolettes. We loved being able to re-introduce them to their brothers (though they all pretty much slept thru it) - and really enjoyed being able to hold 2 at the same time. Here are a few pictures of some serious kangaroo action over the weekend:

Sam with his arm around Joey in my arms. (Their nurse Valisa had the clever idea for the arm bit. Too cute!)

Sam with Daddy. Both Sam and Joey sneezed when they first encountered Dad's hair chest. :)

Henry and Tom hanging out with Mommy.

Joey hiding in Daddy's shirt.

Henry and Tom with Daddy.

We've got a busy week ahead of us. Today Great Aunts Honey and Dorothy are coming to meet the boys and this afternoon Mom and Dad have an interview with the South Bend Tribune. Daddy will be busy with telecommuting and spending some time at the office and Mommy will be busy with catching up with phone calls, making some appointments and having lunch with family and friends throughout the week. But most importantly, much of our time will be with our boys in the NICU. That's definitely where we want to be!

Oh - how could I forget? A big warm thank you goes out to Mike & Kate for their help this week. While Tim was out of town for work, Mike & Kate (with the help of the kids) were my "babysitters". Thanks for carting me around town and for helping out around the house. Thanks, too, to Pat and Don for their help this weekend. And thanks to "uncle" Ed Donnellon for stopping by to meet the boys over the weekend. And thank you to all of you for your continued support and prayers.

Lots of love,
Kristin & Tim

Quick update - with photos!

2009-04-02T09:42:00.005-04:00

Here are a few shots that Kate took when she came to the hospital with me yesterday (some of you may have already seen these). Please note that we can now see all 4 boys' faces! Thomas came off CPap yesterday and has been doing very well on the cannula.

NICU - our home away from home. Please note the blankets crocheted by Nana on top of their isolettes.

Henry

Joey

Sammy

Tommy

I had grand plans to post a very cool picture that one of the NICU nurses printed for us yesterday. She used the digital camera there in the NICU and put a photo of each boy on a single page. I tried to scan it this morning, but my scanner is not working and I don't have the time (okay, the patience) to troubleshoot it this morning. Maybe I'll be able to figure it out tonight when I get home from the hospital. Hopefully these will be enough to hold you over until I can get all of our photos on a snapfish site.

We'll be in touch again soon!
Love,
Kristin & Tim

Mid-Week Update

2009-04-01T09:14:00.002-04:00

Hi everyone! It's been a pretty good week so far - here are the highlights:

All four boys had head ultrasounds Monday morning. This is a routine test for preemies. As you may recall, Sam had a small "grade 1" bleed on each side of his head a while back. He's down to just one grade 1 bleed now and doing very well. This is very common and the doctor is not concerned. The other 3 boys' ultrasounds came back clear. Great news!

Tom continues to show improvement - though still has a long way to go for his lungs. But the doctor felt he was ready to come off the ventillator yesterday! He's back on CPap - which is a step in the right direction. They're giving him extra oxygen, but that is expected coming off the jet vent. We'll miss seeing his face for a while (hidden under all that CPap headgear), but are very happy to have him off the ventillator. He's up to 2 lbs 5 1/3 oz. I've been able to get some good quality time with Tom (and all the boys) over the last couple days too. They say it helps in their recovery and growth, so I try to spend time with each boy every day.

Sam has joined Henry with losing his IVs for supplemental nutrition. He's taking in enough breastmilk to provide all the nutrition he needs. That's 2 boys that can now wear shirts since their IVs are gone! I've brought in a couple shirts for them to hang out in. Sam is weighing in at a whopping 2 lbs 9 oz!

On Monday, Joey was taken off the ventillator too! He's on the cannula like Sam and Henry. He's still been struggling with bouts of low heart rate, sometimes coupled with apnea. They're watching him closely. They've begun feedings again and is at 4 cc's (he hasn't had any breastmilk since Thursday). He's not consistent with digesting everything yet, but hopefully in time he'll get the hang of it again. The doc is watching Joe's hemoglobin levels (and the other boys' too). He's up to 2 lbs 5 oz.

As they draw blood for lab tests, etc., each baby's blood volume goes down a bit. They can only replace so much blood in a given time, so at some point all 4 will probably need blood. The local blood bank has a directed donor program - meaning, if you'd like to direct your blood to a particular recipient (i.e. our boys), we can submit your name and you can donate locally. Sam is O negative and the other 3 boys are A positive. If you're interested in donating, let us know. And just so you know - blood type and Rh factor are not the only factors used to determine if you're a match. They test for a variety of things - as there are certain viruses, etc. that can't be present in order for the blood to work for the babies.

Henry, as mentioned above, is off his IVs and can wear shirts. His feedings are up to 17cc's and he's doing very well. He's up to 2 lbs 7 oz.

We swapped out the blankets on top of each of their isolettes. The ones they'd been using needed to be washed, so I brought in the ones that Nana made - which coordinate with the little hats & ID bracelets she made. We also added some Easter decor to each isolette by taping the bunnies their Uncle Kevin gave us. Finally - we're adding some personality to their space.

Tim is out of town through Friday afternoon. So Mike, Kate and the kids are staying here with me for a few days. While Kate is here, I'm hoping to get her help with posting our pictures. Thanks for your patience!

Have a great day, everyone. Thank you for your continued support!

Love,
Kristin & Tim

Weekend Update

2009-03-30T09:36:00.002-04:00

First - let me address the photo situation. I know many of you are anxious to see updated pics of the boys. We've taken so many, I've decided to post them on snapfish or one of those sites. I'll publish the link in one of our next updates. Hopefully I'll get to that tonight. (By the time I get home from the hospital each day, I run out of steam pretty quickly...)

Now - on to the update for each boy from yesterday and last night.

Tommy continues to show improvement with his lungs. In fact, yesterday afternoon they dialed down the jet vent from 350 to 300 (which is a good thing). He was scheduled for another chest x-ray and blood gas check this morning, so we'll be able to post that info in our next update. Because they've limited his positions to his right side and his back (dividing the time equally), his nurse put him on a big fluffy "pillow" last night so he'd be more comfortable. He's at 8cc's with his feedings and still has some residuals here and there, but overall doing pretty well. They keep a close eye on tummy measurements - to make sure all the food is passing thru and not running into issues in their bellies. Tom's belly measurement has been a bit high, but is not raising any major concerns yet. I didn't get his weight last night when I called in to check on the boys, but as of yesterday morning, he weighed in at 2 lbs 6 2/3 oz. I got to hold Tom kangaroo style twice this weekend. I'll just keep working my way down the row to get as much "bonding" time with each one as I can.

Sammy is doing very well; we really don't have too much to report on him. They put him on a nasal cannula and took him off CPap earlier in the weekend and he's doing wonderfully on room air (no additional oxygen support). He's up to 10 cc's for his feedings (if Tim and I remember correctly...). His tummy measurements have also been a bit high, so they're watching that closely too - like Tom. Sam has gained a lot (relatively speaking) and is up to 2 lbs 7 1/3 oz as of last night.

Joey didn't receive any feedings over the weekend - as they want to conserve his energy for fighting the staph infection he's got. They believe this infection is what caused his apnea episodes last week that put him on a ventilator. He is scheduled for a scan of his belly this morning to make sure everything looks good before introducing the breast milk again. Hopefully he'll be back to eating today. He's also scheduled for an "echo". He may have the same issue with the duct from his heart that goes around his lungs not yet closing on its own (this presents as a murmur). So, like his brother Tom, he may need to go on some meds to close that duct, but the echo will tell us more. He's still doing well on room air with the vent and they turned the rate down from 30 to 25 yesterday afternoon (a good thing). His weight is up to 2 lbs 4 2/3 oz.

Henry is our champion eater - his feedings are up to 13 cc's! They actually removed the 2 nutrient IVs yesterday because he's getting all he needs from the breast milk. He is, however, demonstrating some apnea issues. He had a handful of low heart rate episodes yesterday - which required mild stimulation to "remind" him to breathe. They did some blood tests to check for infection (like with Joey) to nip this in the bud before it gets much worse. Those test results came back okay yesterday afternoon, but they're going to run the test again this morning to be on the safe side. Hank is still doing well on room air with his cannula - though when his heart rate has dropped, they bump him up to 24-25% oxygen for a few minutes to help him recover. He weighs the same as Joey: 2 lbs 4 2/3 oz.

All 4 boys are scheduled for routine head ultrasounds this morning. This is to check for any bleeds - which are typical for preemies. We'll have those results later today.

Mom was here this weekend and was able to get some serious bonding time with 3 of the 4 boys. She'll alternate weekends down here with Pat & Don. We also had a couple visitors at the hospital: Jen L. stopped by on Saturday and Cindy S. came by yesterday. Dana and Megan were on duty over in Special Care yesterday afternoon (my first room at the hospital) and came by for a short visit too. We love to have visitors - so if you'd like to meet the boys (or see them again), just let us know.

Tim drove to Michigan on Saturday. He picked up a freezer and a bunch of food from my Uncle Tim and Aunt Sarah (THANK YOU!). He also picked up a high chair and some toys from a buddy he knows from Chrysler. AND he moved my Granny's old dresser from Mom's place to Pat & Don's. Don does a wonderful job refinishing furniture and has agreed to work on this dresser for the 2nd nursery. Thank you everyone for your generosity!

I'm still sleeping at home at night (since Friday) - and it gets a little easier each day to leave the hospital. Though I hate being so far away from the boys, it is nice to be in "my own space" and I seem to rest better. I need to find that balance between taking care of the boys and taking care of myself, but it's certainly not easy. Once we get into a routine, I think it'll be easier for me to manage. Until then, we'll take it a day at a time.

Thank you to everyone that has been following our blog. It's a little overwhelming to think about the number of people that visit this site - many of whom we've never even met. All your positive thoughts and prayers have certainly helped our boys so far - we can't thank you enough for that.

Love
Kristin & Tim

Sunday update.......

2009-03-29T08:09:00.002-04:00

Hello everyone ~ Julie here again. I received a few text messages from Kristin last night with updates. Here goes! ~~~~~~~The boys are doing well. Tom is showing improvement on his chest x-ray and also gained 3 ounces! Joey is doing well, has a staph infection, but should be thru the worst of it and also gained an ounce. Henry's feedings have been increased to 10cc's. Sam is off the bili light and is going to get a scan of his belly to make sure everything is working properly. Doesn't seem to be a major concern, we'll see what the scan says. Again, Tim & Kris thank you all for your thoughts and prayers!!!!

2 steps forward, 1 step back...

2009-03-28T08:53:00.004-04:00

Hi everyone, this update is coming straight from the source. I thought I'd give Jules a break and post a quick update myself.

Thursday we had such a great report at the end of the day, but it turned out to be a rough night for Joey. I happened to be in the NICU to drop off some milk when Joey was in the middle of an apnea (sp?) episode. Apnea (when a baby "forgets" to breathe) is very common and typically happens in very short, momentary episodes. The episode I witnessed lasted several minutes. Needless to say, I think it was as hard on me than it was on Joey. One of the docs had been paged in to receive a new preemie to the unit and they also notified him of Joey's condition. As you may recall, Joey has been on CPap since he arrived in the NICU. Well, he had yet another longer episode of apnea about an hour or so later. So the doc had him put on a ventillator. Yesterday was a "rest day" for Joey. They held his milk feedings and provided nutrition only thru his IV and we didn't take him out of his isolette in order to avoid any unnecessary stress. We're anxious to see how he's doing today. We didn't like having to take the "step back" to put him on the ventillator, but we have faith that he'll be back on CPap soon.

One other "step back" was with Tom late Thursday night/Friday morning. Due to an over-expanded right lung, he's had to go back on the jet ventillator. He's laying on his right side to get more air in and out of his left lung and to keep the right one slightly compressed. He was due for another chest xray early this morning, so we'll know more about him shortly.

The boys have all lost weight - which is totally normal for any baby. Here are their current weights, as of yesterday afternoon:

Tom 2 lbs 3 1/3 oz
Sam 2 lbs 5 1/3 oz
Joe 2 lbs 1 2/3 oz
Henry 2 lbs 3 1/3 oz

I spent my first night at home last night. I can't even describe how difficult it was to leave the hospital, knowing I'd be away from our boys for so long. I of course called the NICU last night to get an update and I'm too anxious to call yet this morning. In fact, I'm going to end this update so I can get out the door! Mom is here for the weekend and we'll be spending most of the day at the hospital. Tim is on his way to Detroit this morning to pick up a freezer and some food from my Uncle Tim and Aunt Sarah (thank you!!!) and to run a couple other errands. Hopefully he'll get back from his day in Michigan in time to visit the boys. I'm sure he misses them as much as I do.

Thanks again for all your help, love and support. Hopefully we'll make time this weekend while we're home to get some more photos posted - we've got so many to share!

Love
Kristin & Tim

Thursday Update!!

2009-03-26T20:23:00.003-04:00

Hello all! Kristin e-mailed me today with the update, I will just copy and paste what she wrote below. Enjoy.~~~~~~~~~ Tom: has been the best and most consistent with digesting his feedings - 5cc's at each feeding. He is off the jet vent and doing really well. Will prob stay on the reg vent for a while, but will eventually get on cpap. The medication to close the duct from his heart to bypass his lungs (used in the womb when I'm pumping blood for him) seems to have worked after one round. This is what allowed him to come off the jet. I held Tom "kangaroo" style today - skin on skin. It was wonderful! Words can't describe. He did really well the rest of the day - the doc and nurses attribute it to my time with him this morning. Sam: doing very well on cpap. Pretty well on feedings - he's been "giving a lot back" (not digesting some or most of his food). I also held him kangaroo style this afternoon. His oxygen level kept dropping and we couldn't figure out why and tried just about everything. Then a nurse peeked under my shirt to find his feet - since his blood oxygen monitor was on one of his feet. He was laying on his foot and it had probably fallen asleep. :) after we figured that out, the rest of our time together was wonderful. Joey: up to 7cc's per feeding and doing pretty well digesting it all. He's holding his own on room air on cpap. Dad held him this morning. He is still having problems with apnea - he "forgets" to breathe. All 4 boys are on caffeine to help avoid that, but Joe still struggles with it every now and then. Henry: the nursing staff likes to call him Hank - and I think he likes that. He came off cpap today and is now on just a small nose piece. We finally got to see him without all that gear on his head. And just as we suspected, he is very handsome! Like Joey - though usually a litle better - he gives back some of his feedings. He's also on 7cc's per feeding. Dad also held held Hank this morning. I'm doing well - today is the first day I haven't relied on a wheelchair to get around. Much less pain. I go see Dr. Donald tomorrow morning to get my staples removed. I'm sure he'll be interested in my blood pressure too. Hopefully the meds he put me on for that are working. Tim is taking me out for a bit tonight to visit friends and to get me some fresh air. Thanks again to Jules for managing these updates. And to everyone for their continued prayers and support. I know we say that all the time, but we just can't seem to say it enough. Love Kris & Tim

Wednesday Update!!

2009-03-25T19:48:00.003-04:00

Hello everyone! I am updating for Kristin again....(this is Julie): Kristin stayed in the parent room at the NICU last night. She said there isn't a shower, but a nice private bedroom with a half bath. Very convenient to the NICU to drop off milk as she pumped. They took Sam off the vent last night, his numbers were still good this morning, so they extubated him and put him on CPap. He's still doing pretty well - but may need to go back on the vent. They will see how he does over the next day or so. All 4 babies have had successful feedings ~ when they do digest all or almost all of their food. They've each also had some not so good feedings, but that is to be expected. Tom is still on the jet vent and the doctor said that Sam is trying to set a good example for Tom to follow suit! :) Tim and Kris are staying tonight at the Ronald McDonald house at the hospital. A very nice facility and more space than the parents rooms in the NICU. Kristin would like to let everyone know that if you're interested in making donations to the Ronald McDonald house (money, gift cards, pop tabs, food, household items, personal care items) all are welcome. She will get the details to me soon to post. Kristin is doing well, has a friend visiting now and Tim ran home for a bit. She's really tired today, but happy to have the many opportunites to visit with the boys!

Monday Morning Update!

2009-03-23T10:32:00.003-04:00

Hello everyone! Julie again, Kristin sent me an e-mail this morning (as I'm back in Ohio now) with details for a blog update! Kristin's doctor is keeping her in the hospital for one more day (discharge now Tuesday). Her blood pressure is still a little high, so they're now giving her a new medication to help get rid of the excess fluid, which is possibly causing the high blood pressure. Kristin's lost over 20 pounds, but still 40 pounds from her pre-pregnancy weight, so if the Dr. likes the results from today, she'll be discharged tomorrow. The NICU doctor came by this morning with an update. Joey and Henry continue to be very active and are progressing well. They're going to increase their feedings to 4cc's today. Sam is making progress and will begin smaller feedings today - his first! He is still on the "jet" ventilator. Tom has been on a ventilator, but is now on the jet, like Sam. The doc doesn't see this as a setback for Tom, but more of a "bump". Overall, they're all progressing well. Tim even held Joey yesterday - and changed another diaper. :) Kristin held Tommy and Henry, but let Sam rest. It can be a little stressful moving them out of their isolettes, so we wanted to avoid the additional stress for him. Kristin and Tim say thanks again for all your love and support! Its been a whirlwind since Thursday - and they're not sure how we could have gotten thru it all without you!

Sunday Morning Update!

2009-03-22T09:37:00.009-04:00

Hello everyone! Thought I would update again this morning. Happy to report that all 4 babies did very well during the night. Sam will get some more blood today and is on the vent still. But, his head scan report from yesterday showed that everything is normal. Henry and Joey are still on the CPap but receiving less oxygen. Tommy is still on the vent as well. Kristin is doing very well and will move to a regular mother/baby room today. Tim came home last night to get some much needed rest and gave me their camera to post these wonderful pictures! Check out Mommy holding her 4 precious babies!! Enjoy! ~ Julie~~~~~~~ Mommy and Tommy

Mommy and Sam

Mommy and Joey

Mommy and Henry

Saturday evening update!

2009-03-21T21:33:00.005-04:00

Hello everyone! Thought I'd update the blog again this evening. Katie and I were able to go to the hospital this evening and visit with Tim & Kris and the babies. Here is an update on how they're all doing: Kristin ~ doing much better this afternoon and evening. Off all IV's and taking pain meds every 4 hours. Was able to get a shower, eat some regular food and get some rest. And.....the best news.....she was able to HOLD all 4 babies!!!! So exciting for all of them. Sam ~ his hemoglobin level is still low, so they'll probably give him more blood. They have not started the nitric oxide. Sam is on a high-frequency vent. Henry ~ on a CPap. Thomas ~ on a regular vent. Joey ~ on a CPap. All 4 babies are receiving nurishment also. The NICU is amazing, such GREAT nurses and Dr.'s in there. The 4 boys are in terrific hands. Kristin and Tim thank everyone for their love, thoughts and prayers!! ~ Julie & Katie

Saturday morning update

2009-03-21T09:27:00.002-04:00

Hello everyone! Julie again. I have an update from Kristin & Tim about the boys. Both Sam & Tom have been intubated, but Sam isn't responding as well. They're going to do a heart scan today to see if there's anything else going on. The neonatologist came to their room not to long ago and said that Sam has pulmonary hypertension. The vessels that carry the blood from the heart to the lungs are very small. So, even though they've been able to get his lungs to expand with the help of the ventilator, the blood volume going through the lungs isn't enough to keep him well oxygenated. They're putting him on nitric oxide to try to dilate those vessels. Please ~ start those prayers going ~ little Sam (and the rest of the family) can use all the thoughts and prayers. I will keep you all updated as soon as I hear more. We're communicating via text messages ~ as I'm still at Kristin & Tim's house getting things organized here. With the help of Kristin's Mom, Brian and the girls! ~ Julie

Welcome Coleman Babies!!

2009-03-20T17:51:00.007-04:00

The Coleman babies have arrived!!!!! I was able to get pictures ~ welcome sweet baby boys!!! Everyone seems to be doing just fine. Kristin is back in her room and resting. She and Tim thank everyone for their wonderful thoughts and prayers, they are working!!! ~ Julie~~~~ Sam 15.2 inches, 2 pounds 10 ounces, born at 11:38am Henry 14.75 inches, 2 pounds 8 ounces born at 11:39am

Tommy 14.5 inches, 2 pounds 7 ounces born at 11:41am

Joey 14.5 inches, 2 pounds 3 ounces born at 11:41am

Update #3

2009-03-20T09:55:00.002-04:00

Hello again ~ I haven't heard back from Tim or Kristin yet with the scheduled C-section time. I am going to head to South Bend now, so there probably won't be another update on their blog 'till later today. I will keep you posted! ~ Julie

Update #2

2009-03-20T07:55:00.002-04:00

Hello again........I just talked with Kristin and Tim ~ they need to deliver the babies today. Kristin's platelets dropped another 2 points. So, they need to come. As soon as I know the scheduled C-section time, I will update again. Please keep the 6 of them in your thoughts & prayers!!!!!! ~ Julie

Update

2009-03-20T07:18:00.004-04:00

Hello everyone ~ this is Julie, Tim & Kristin's friend. She has asked me to update her blog for her. Yesterday, (March 19th) Kristin was admitted to the hospital with "mild-preeclampsia." Her blood pressure was a little high at 146/90 and her platelets are dropping instead of going up. She is having more blood drawn this morning (Friday, March 20th) to check her platelet level again. If the blood work comes back and shows that her platelet level is continuing to go down, the Dr.'s will need to deliver the babies. As of last night when I talked with her, her blood pressure had gone down and she and Tim were starting to relax comfortably in their hospital room. They wanted me to also mention that the concern and support from their friends and family is greatly appreciated!!! They do not have internet access, but Kristin does have her cell phone and can receive/send text messages. Please continue to keep them all in your thoughts/prayers and I will update again when I know more. ~ Julie

Almost 28 Weeks

2009-03-17T21:24:00.003-04:00

Our appointment with Dr. Donald today was good overall - and eventful...

I weighed in a whopping 17 pounds heavier since our last appointment - which was only 2 weeks ago. This raised a huge red flag in our constant watch for symptoms of preeclampsia. The cause of preeclampsia (also called toxemia) is unknown. What is known, however, is that women expecting multiples are more likely to develop this condition than those with singletons. Its related to high blood pressure, fluid retention/swelling, and liver/kidneys not functioning properly. There are several symptoms - and aside from my sudden weigh gain (tied to the fluid retention/swelling), nothing else by itself would point to preeclampsia. But with a moderately high blood pressure and slightly elevated protein levels in my urine, Dr. Donald is concerned...and, of course, so are we.

Following our appointment, Dr. Donald sent us to the lab to have blood drawn. These tests would tell us how well my kidneys and liver are functioning. Unfortunately, the results came back late this afternoon with "slightly elevated" numbers - meaning my kidneys and/or liver aren't quite performing up to par. The Doc is not panicked over all this - but definitely concerned. So, here's where we stand right now:

I have been firmly directed to lay on my side at all times (well, except when I have to go to the restroom, of course). I'll call the Doc's office Wednesday morning to schedule an appointment on Thursday. Dr. Donald wants to see me again and repeat the same lab tests. He told me on the phone today that I should simply plan on being admitted to the hospital Thursday. In theory, if all my test results come back with better numbers (as rest and lots of fluids can lessen or reverse some preeclampsia symptoms), the Doc could send me home in a couple days. BUT - knowing Dr. Donald and his typically conservative approach, he will most likely keep me in the hospital until after I deliver the babies.

Speaking of delivering the babies... If my symptoms worsen over time, and my health becomes a concern, the only "cure" for preeclampsia is to deliver the babies - regardless of how far along we are. That is not the best situation, but obviously, Dr. Donald is responsible for my health, as well as that of the babies - and we have to consider the situation from all angles. This is the main reason the Doc wants me to be in the hospital; as all 5 of us can be more closely monitored.

Having said all this - I really do need to share the good news from our appointment. I'm not showing any signs of preterm labor. All 4 babies are doing well. They're all active and growing! Like last time, the numbers below are estimates based on a variety of measurements. The "ages" are +/- 15 days and the weights are +/- 5 ounces.

Baby A: 28 weeks 2 days / 2 lbs 9 oz
Baby B: 27 weeks 2 days / 2 lbs 7 oz
Tommy: 27 weeks 5 days / 2 lbs 10 oz
Joey: 27 weeks 0 days / 2 lbs 6 oz

Well, one of us will update everyone after our appointment on Thursday. Please keep us in your thoughts and prayers.

Lots of love,
Kristin & Tim

26-27 Week Update

2009-03-12T08:55:00.004-04:00

Last weekend, my mother-in-law Pat was kind enough to snap a few pictures of Tim, me and my belly. (Thank you Pat!) The amazing part is that she didn't even need a wide angle lens...but we're getting close, as you can see.

The "mandatory" profile shot...our boys are definitely growing!

My new digs: We put a twin bed in the living room, as it is more comfortable and a little higher, so it's much easier for me to move to a standing position. Thankfully the nifty laptop table Kevin & Nikki gave me for Christmas does go one level higher than this, so I can pull it up closer and avoid the need to grow longer arms - though it doesn't go high enough to get over my belly. Go figure... Now that I've officially been on leave from work for just over a week, the monotony of bed rest is starting to kick in. Please give me a call at home or email me if you get a chance. It certainly helps break up the day!

We've got a busy weekend planned: Pat will arrive sometime on Friday and stay thru the weekend. My brother Kevin and his family Nikki, Aaron and our new neice Sophia will arrive mid-day on Saturday and stay thru Sunday morning. Don (my father-in-law) will be at a tractor auction in near-by Shipshewana, IN. Tim will spend the day with him there on Saturday, then bring him home to stay the night and ride home with Pat Sunday afternoon. Something tells me I'll be on my twin bed in the livingroom watching all the activity from a safe distance...

One more item to note: The women in my Bunco group have offered to start bringing over meals to us twice a week. Its difficult for me to spend much time on my feet - and I'm supposed to be laying down as much as possible - which makes it a bit difficult to cook a meal. We can't thank you girls enough for doing this for us. The generosity of our new friends here in Indiana is almost overwhelming.

We hit the 27 week mark on Wednesday - and I'm so thankful to still be at home. As you may recall, our next appointment with Dr. Donald is Tuesday the 17th. We'll be sure to post an update shortly after that. Hopefully I'll be posting that update from home, but he may have me admitted to the hospital if he feels that would be safer for the babies and me. We'll definitely keep you posted!

Thanks again for all your thoughts and prayers!
Love,
Tim & Kristin

Check-up at 25 Weeks 6 Days

2009-03-05T09:28:00.002-05:00

Well, believe it or not, I'm still at home. With each appointment, the likelihood of being admitted to the hospital increases...but so far we're still beating the odds.

Our appointment on Tuesday went really well. My blood pressure was almost back down to normal (well, normal for me anyway) at 100 over 72. The babies' heart rates were all great. Lori even noted that the babies are all active...I could have told her that. :)

Then the moment of truth - they measured my cervix and as crazy as it sounds, it's still holding strong at 5cm! When Dr. Donald saw it on the screen he just smiled, shook his head and said "Would you look at that..." He thinks we should call Energizer and tell them to ditch the Bunny...we've got a new mascot for them. I just keep going and going and going... At least we hope so.

I officially started my leave from work on Tuesday (the day of our appointment), though I just finished my last project this morning for our big event next week in Vegas. I told Dr. Donald that I'd be spending most of my time laying around and he was happy to hear that. We scheduled the next appointment for 2 weeks out (St. Patty's Day, actually). If I remember correctly, they'll measure the growth of the babies again at that appointment. Then I'll go back a week later, when they'll measure my cervix. This plan assumes, of course, that I don't run into any problems that require me to be admitted between now and then. (Keep your fingers crossed!)

I'm so incredibly thankful to still be at home this far into the pregnancy. There are still a lot of things we'd like to get done around the house before I'm admitted - and we're very happy to have the time to get them done. To help us, Pat and Don (Tim's folks) will come down this weekend and again next weekend. The following weekend, our good friends Brian & Jules will come with their girls. One thing I want to accomplish this weekend is to get some photos taken of Tim and me (and my belly) to post on the blog. (Keep your fingers crossed on that one too!)

Thanks again for all of your thoughts, prayers and support.
Love,
Tim & Kristin

Update at (almost) 25 weeks

2009-03-02T18:44:00.003-05:00

This update (though a week late) will be short and sweet. Last Tuesday we went back to see Dr. Donald. They did a pretty thorough ultrasound to measure the growth of the babies - and I'm happy to report all are right on track. The tech (Lori) measured various body parts (head, abdomen, arm, leg) and used those numbers to estimate each baby's weight and "age". These are, of course, estimates and the margins of error are +/- 2 weeks and +/- 4 ounces:

Baby A: 25 weeks 0 days, 1 lb 12 oz
Baby B: 25 weeks 0 days, 1 lb 14 oz
Tommy: 24 weeks 4 days, 1 lb 8 oz
Joey: 23 weeks 5 days, 1 lb 6 oz

The photos at the top are all shots of the babies' faces. It's difficult to see, but the shots of A & B are profiles and Tommy & Joey are looking into the camera (though Tommy's left hand is partially covering his face).

My blood pressure is still running high (for me anyway), but hasn't raised any red flags for Dr. Donald. In fact, he told me that at this stage of the game, he's "looking for an excuse to admit me to the hospital". Thankfully, I haven't given him one yet. He sent me home with orders to get more rest and to keep eating a lot. :) We go back to see him tomorrow (just one week between appointments this time). They'll just check heartbeats on the babies and measure my cervix again. I anticipate that he'll either admit me to the hospital or put me on full-time bed rest at home. So, I've made plans to begin my leave from work starting tomorrow. I'll still help out with a couple small projects for the next week or so, as we've got a huge event in Vegas next week. Once that's over, I'll be done with work completely. It's kind of strange to think about not working, but it will certainly be a relief to remove that stress.

So I've been getting more time laying on my side - though this weekend proved to be pretty busy. Mike (Tim's brother), Kate, Chase, Jack & Addelyn came for a visit Friday night. We were so happy to finally meet Addelyn (just 2 weeks old) and to see the family. It was a short visit, but we are so happy they made the trip.

As they were heading out, my mom arrived. Mom stayed the night and helped us out with hemming some pants and some other stuff around the house. With her, she brought a car load of stuff for the babies. Thank you (you know who you are) to everyone that sent items down with her. While Mom was here, she even took me to the mall, where she pushed me from store to store in a rented wheelchair. The wheelchair was kind of a strange experience from my perspective, but it was so nice to get out and run some errands without the exhaustion & discomfort that walking and standing bring me these days.

Also this weekend, my brother Kevin called to tell us that our other neice was born: Sophia Elizabeth. His wife Nikki had been struggling for some time with on-and-off contractions and bed rest - and little Sophia waited until the day before her due date to make her appearance. We're looking forward to meeting Sophia sometime soon too.

Well, I wanted to include some belly shots to show all of you how big the babies are growing, but I haven't gotten anyone to take my photo yet. Hopefully soon. We'll have another update to post after tomorrow's doctor appointment - so I'll try to add a belly shot to that post. In the meantime, please keep sending us your positive thoughts and prayers - they really seem to be working!

Love,
Tim & Kris

The Latest on the Nurseries and Other Baby Stuff

2009-02-22T10:08:00.007-05:00

This weekend, with the help of our friend Kurt, Tim made some serious progress on the nurseries. They moved the bed and dressers out of the second nursery and into the room across the hall. This will remain our guestroom for quite a while.

The bed that was in that room is now in the second nursery - just temporarily. With all the visitors we anticipate until long after the babies come home from the hospital, it just didn't make sense to take down this guest bed until we need to.

Tim & Kurt also assembled the last 3 cribs. We are fortunate to have been able to use cribs and other pieces offered to us by friends and family. The furniture in each room isn't yet arranged in its final place, but we thought a few "in progress" photos might be fun to share.

This is the first crib that Dana and I assembled last week. I included this close-up shot so you could get a better look at the bumper pad and coordinating crib sheet.

These are the cribs and dresser that are in the first nursery. (Even the dresser came from friends!) The changing table will come from our neighbors or we'll use the one I got from Freecycle - both are an oak color, like the furniture already in the room. We'll start the babies in this room - two to a crib - when they first come home. They'll be tiny enough to share the space - and may be used to the companionship of their brothers.

These are the cribs in the second nursery. The crib on the right came from friends with a coordinating changing table. We'll also have my Granny's dresser in this room. Tim's dad is going to refinish it for us and have it ready in the spring. We're certainly not in any hurry for it, as the boys won't be in this room for a while. But at least we're getting everything in place.

I've also spent some time working on the "inventory" that Leza and I started a couple weeks ago. We're trying to determine what we still need, and which items we need to have before the babies come. To fill some of the holes, Dana and I went to Babies R Us yesterday to take advantage of some sales and coupons. We still have holes left to fill, but thanks to the generosity at our showers and all the wonderful hand-me-downs we've received, we're a lot further along than we expected.

We're looking forward to my mom's visit next weekend (hopefully the weather isn't like this weekend!). And perhaps the week after that, Tim's brother Mike and his family will come down for a visit too. They just had a baby girl and we're very anxious to meet our new neice Addelyn Rose. Then the weekend of the 14th, Tim's parents will be in town. We're always happy to have visitors and depending on my activity level - I'm sure I'll be anxious for the company.

I think that wraps it up for now. Everything else is good here. Tim's out shoveling the driveway - we're up to about a foot of snow for the weekend. I should wrap this up and get comfortable on my side for a little while. Take care, everyone! Talk to you soon!
Love Tim & Kristin

Week 24 Update

2009-02-22T09:03:00.003-05:00

Well, as some of you may have heard, we had our first little "scare" on Tuesday. I had been experiencing some intermittent pain during the day, so I called the doctor's office in the early afternoon. I explained the symptoms to the nurse - and she called me back after speaking with the doctor. They asked me to come in later that afternoon - just to check things out.

Being at 23 weeks 6 days, I had a feeling Dr. Donald might want to admit me to the hospital - depending on what he saw. So I called Tim, packed an overnight bag just in case and headed over to the doctor's office.

My blood pressure was a little high - but not high enough for concern. I'm sure a lot of that was from my thoughts of being admitted to the hospital. But the ultrasound showed that the babies are all doing fine and that my cervix (a.k.a. Super Cervix) is still holding strong at 4.7cm. Dr. Donald actually seemed surprised when he saw the measurement on the screen and said, "Well, there's no reason to admit you."

Above are a few pictures of the babies...though as they get bigger and more crowded in my belly, I find it more difficult to decipher the images from the ultrasound. Each shot above shows at least part of each baby's face - or so says Lori the ultrasound tech. :)

As a preventative measure, Dr. Donald sent me home with steroids to stimulate lung development for the babies. At 24 weeks, it's not uncommon to administer steroids for multiples. The chances of carrying the babies full-term for their lungs to develop on their own are slim to none - so administering the steroids now, gives them a better starting point in the NICU when they arrive.

Dr. Donald also explained that the pain I was experiencing was most likely due to pressure on my cervix. I am full-term size now and gravity takes its toll. He's instructed me to spend more time laying on my side during the day. Since I hadn't been laying down at all during the day, its definitely a reasonable request. :) So I've found ways to work on my laptop while laying on the couch at least 1-2 hours per side every day. I won't lie - it is certainly cumbersome. But so far, it's working out pretty well.

Well, because I saw the doctor on Tuesday, we moved our scheduled Friday appointment to this coming Tuesday - Feb 24. They'll measure the growth of the babies (which should each be well over 1 pound by now) and probably my cervix again - just to make sure things are still secure. I'm anticipating more restrictions to my activities and perhaps some "official" bed rest as of this next appointment - but to make it to 24 weeks as well as we have is truly a blessing.

Our neighbor and friend (and former pediatrician) Julie has made some calls to a couple people she knows in the NICU. We're hoping to set up a meeting with some NICU staff to ask a few questions and take a short tour of the NICU after our appointment with Dr. Donald on Tuesday. I'm sure it's a place that can be very overwhelming the first time you see it. I'd rather get that out of the way now - and be able to simply focus on our babies and their health when the time comes. We'll fill you in on that on Tuesday.

We're coming up on the most difficult part of the journey so far and will certainly continue to rely on our family and "extended family" for your love and support. Thank you!!

Love

Kristin & Tim

22 Weeks

2009-02-05T18:17:00.002-05:00

We had another successful appointment today!

The babies' heart rates are all well within the normal range - between 141 -160. They were all active and mobile - gearing up for their tag team wrestling matches, I'm sure. :) Space is at a premium in there, which makes it difficult to get good photos. We came home with a handful, but it's very difficult to tell what's what - even after the tech explained what we were seeing.

After the ultrasound tech (her name is Lori) did what she needed to do, she turned the screen so Tim and I could watch the action for a minute. We got to watch one of the boys give a good kick on the screen - while seeing the same movement in my belly. Way cool. We all said "Did you see that?!" And Tim added, "He gave you a good one!" :) He certainly did! It was amazing to see what they're doing in there to make those movements visible from the outside.

My glucose test for gestational diabetes came back normal - so that's good news. I don't have to give up chocolate or Ben & Jerry's ice cream. :) Dr. Donald did say that my hemoglobin is low, so he's added an iron supplement to my regimen. Evidently, when your blood supply doubles to provide for 4 babies, your hemoglobin gets dilluted in the additional blood volume. So taking the supplement will boost the level back up where it should be.

Dr. Donald also asked if I had experienced any contractions. I admitted that over the last 2 weeks, I've noted 3. Each of them happened after doing something I shouldn't have been doing in the first place - like pushing a 30-lb box on a shelf or bending over repeatedly to get clothes out of the dryer. So I've added those activities to the growing list of things I won't do any more. But because the contractions were few and far between - and each had a specific reason for happening - the doctor wasn't concerned. He encouraged more fluids and rest - as these will help avoid any further contractions. And he of course agreed that I shouldn't do those things any more. :)

So given all this, and even considering the fact that I'm inching ever closer to full-term size, I've been granted another "2-week pass"! No bed rest yet. More fluids, more rest, avoid any strenuous (read: stupid) activities and keep eating. We go back in about 2 weeks - on February 20. At that appointment, they'll measure my cervical length and also measure the babies' growth. We should have over 4 pounds of baby by then!

Thank you again to everyone for all your prayers and support!
Love,
Kristin & Tim

Houser/McKay Shower - January 24

2009-02-02T19:23:00.009-05:00

My aunts on the Houser side (Mom's sisters) threw this shower for us. My long-time close friend Julie "Jules" Rees co-hosted with them. It was a very nice party, girls - thank you! I handed my camera to Jules when she arrived to take photos for me. Here's a selection of the shots she took - starting with the cake Jules brought (above). Above is a gift-opening shot featuring the bumper pad for the cribs (thank you Mom!). This was where I got my inspiration for the border on the walls in the nursery. Molly Rees, Ruby Huermann and Emma Rees. Too stinkin' cute, aren't they? This is what happens when you hand the camera over to Jules...this is not the only "belly" shot she took when I wasn't paying attention... The next generation of McKay girls: Taylor, Meghan (holding Sabrina) and Lauren. The older girls here - along with their older sister Morgan and their mom Julie - have volunteered to help out with our babies when they come home. They are certainly naturals. Thanks to everyone that was able to attend the party - and thank you so much for your generous gifts. We're certainly well on our way to gathering all the necessities for our boys when they come home in the spring. Love, Kristin & Tim

Coleman/Sasse Baby Shower - January 17

2009-02-02T19:02:00.004-05:00

Well, now that Leza gave me a tutorial on downloading and modifying photos from our new camera, I can post a few shots from the baby showers.

Here are some photos from the Coleman/Sasse (Tim's family) shower. My sister-in-law Katie hosted the shower at her home (Katie and I are belly-to-belly in the shot above; she was at about 31 weeks at the time; and I was at about 19). My mother-in-law Pat and long-time close friend Leza Rebera were co-hosts. Thank you girls for putting on such a nice event. I'm sorry Leza couldn't attend - she and most of her family came down with a nasty cold just a day or 2 before the shower. But with SIX pregnant women and a gaggle of little girls present, she took the hit for the team to not be there. We missed you! :)

This pic shows some of the darling decorations the girls put out for the shower. I just loved this clothesline over the fireplace.

Look at all the pregnant women! (ranging from 12 weeks to almost 39 weeks) The other women at the shower were afraid to drink the water - for fear it was a contagious condition...

Our nephew Jack was my assistant gift-opener. He did a wonderful job!

I just had to share this shot - if you know me, you know I try to be "green". My fellow tree hugger Theresa LaVeck "wrapped" her gift in this handy reusable bag. I love it!!

While the shower was going on, the guys held a "diaper party" for Tim at the neighbor's house. All guys that wished to come play cards, eat and hang out with Tim had to bring a pack of diapers. We certainly got a good start on our diaper collection - thanks guys!

Thank you to everyone who braved the elements to attend the parties. We certainly missed those that were snowed-in. It was a great day. Thank you!!

Love,

Kristin & Tim

Babies A & B "money shots"

2009-01-30T18:12:00.003-05:00

Here are the ultrasound photos I didn't have scanned in yesterday when I posted the 20-week update. Your guess is as good as mine on exactly where the boy parts are in each photo labeled "boy". There's also a nice profile of each baby. Handsome, aren't they? :)

Nursery Update

2009-01-29T21:42:00.005-05:00

Just to give you an idea of where we're headed with the nurseries, here are a couple "in progress" shots. These shots of the first nursery were taken at the beginning of January - featuring one of my helpers, Cait Rebera. I used the argyle design on the crib bumper pads as my inspiration for the diamond pattern and colors in the border on the wall. The second nursery is in progress and will look the same - though we've run into some issues with the yellow paint coming off with the tape. We'll have more pictures of the completed walls hopefully this weekend - once the 2nd nursery painting is finished and the gifts piled in the 1st nursery are organized. We'll have some white shelves to hang on the walls. And I'm still looking for ideas on curtains. It's coming together - slowly, but surely.

20-week update (a week late...)

2009-01-29T19:44:00.006-05:00

Hi everyone! As many of you already know, last Thursday was our 20-week ultrasound appointment. And we're happy to report that all five of us came thru with flying colors.
The appointment started out like any other, but this time I received a flu shot - just as a preventative measure. I also got a lab slip to get my glucose tested. With multiples, there's a higher risk of developing gestational diabetes. We'll get the results at the next appointment.
Next was the ultrasound. We knew we were in for the long haul - up to 30 minutes per baby in what they call the "level 2" ultrasound. Our tech, Lori, looked for and measured virtually everything from head size to the number of toes the babies' feet - including every organ and bone in between. As she studied each baby, she also confirmed their sex. We already know that Babies C & D are boys, so we were anxious to find out what Babies A & B had in store for us.
(drumroll please...) ... We've got FOUR BOYS. Yep, that's right - 4 boys. But I guess we shouldn't be too surprised. We've beaten the odds with this pregnancy so far - all 3 embryos attaching, one embryo splitting into twins, etc. The odds would say we should have a mix of girls and boys...but why would the odds apply now? :) We're still working on the names. We know Samuel is a major contender for a first name; McKay and Donald are front-runners for middle names. We'll definitely let you know once we make some final decisions. (I don't have the ultrasound pictures scanned yet, but will post the "money shots" for Babies A & B this weekend.)
The really good news that came out of the appointment is that all 4 babies are healthy and growing right on track. Baby A is weighing in at 14 ounces, Baby B & Tommy are 13 oz, and Joey is 12 oz. In addition, when Dr. Donald saw my cervix measurement on the screen, his eyes widened and in true ESPN Sports Center style he said, "She - could - go - all - the - way!" Certainly he didn't imply that I'd go a full 40 weeks, but he did say that a cervix measurement like mine at 20 weeks is a "very promising sign" of a long gestation. Very good news all around. And from this story, my coworkers have come up with a new superhero: Super Cervix. :)
So the appointment ended with another "2-week pass": Dr. Donald sent us off saying, "Keep resting. Keep eating. We'll see you in 2 weeks." So no bed rest yet - but I am trying to take it easy when I can. Tim is certainly picking up my slack around the house - and we've discovered that we've got a great circle of friends here in Indiana. They've offered to help us with everything from grocery shopping to house cleaning to snow shoveling. Our local peeps are definitely our family away from home. Thank you!!!
I've been feeling more and more movement from the babies. Some kicks are strong enough to be seen and felt from outside - and Tim got to feel a couple good kicks last week. Just tonight while I'm typing this, I stopped to watch my belly move while a couple of the boys worked on their wrestling moves. :) I can only imagine what it'll look like as they get bigger. Tim is convinced it'll be tag team wrestling going on in there before long.
Tim is out of town this weekend - up north with his dad for 5 days of snowmobiling - so I'll have lots of time for more blog updates. I hope to get you all caught up on the nurseries and both baby showers earlier this month - with lots of pictures. Thank you again for your continued support and prayers!
Love, Kristin & Tim

Happy New Year!

2009-01-02T11:50:00.004-05:00

We started out the new year with our scheduled 2-week visit to the doctor this morning. All 5 of us are progressing well and received a clean bill of health. The appointment this time was short and sweet: no growth measurements on the ultrasound. They measured each baby's heart rate and all are very good - in the 140s and 150s (within the "normal" range). The ultrasound tech commented that things are starting to get a little cramped for space in there - so much so that we still couldn't get clear shots of Babies A & B to determine their sex. Hopefully we'll be able to find out at our next appointment on January 22. The doctor used a tape measure to check my fundal height (or is it fundal length?) - basically the size of my uterus. I think he was a bit aggressive last time when he estimated my size at 26 weeks - because this time with the tape measure, I'm coming in at 27 weeks (though I'm only 17 weeks along). The only words of caution he gave me today were to be sure to get more rest. As I near full-term size, the risk of pre-term labor increases and one of the best ways to avoid that is to get plenty of rest. Since we'll have the painting finished in the nursery in the next week or so, that will certainly help increase my rest time. Speaking of the nursery: With my friend Dana's help, I'm about 75% done with the border in the first room and will start with the border in the 2nd room on Sunday or Monday. I'll post pictures soon. I think that wraps it up for now. We wish you all a wonderful 2009! Love, Tim & Kristin

Baby "Bump" at 15-16 weeks

2008-12-30T09:13:00.005-05:00

I'm not sure you can really call it a "bump" any more. As you can see from the pictures above, I'm certainly gaining in belly size on my sisters-in-law! For some reason, the pictures loaded in reverse order - so I'll start from the bottom:

The headless pic with 2 pregnant girls in pink and red was taken at the Sasse Christmas party at our house on Dec 20. Kate is about 12 weeks ahead of me, but Tommy, Joey, A & B are certainly doing their best to close the gap.

The next shot is Nikki and me on Christmas Eve at their place (I'm wearing green in this shot). Nik has about 14 weeks on me...so I'm not sure I'll be able to catch up to her before little Sophia arrives in late February.

The last shots were taken on Christmas Day at Pat & Don's. (believe it or not, we did not plan to wear red that day) From left to right: Kristin, Kate & Carrie. Carrie is about 16 weeks ahead of me, but her baby is growing ahead of pace, so she's measuring closer to 40 weeks. She's certainly got us all beat in the belly department!

We'll go back to see Dr. Donald on Friday for a quick check-up, so we'll have an update on the weekend. In the meantime, we wish everyone a safe and happy new year!

Love,

Kristin & Tim

15 Weeks

2008-12-22T09:51:00.003-05:00

We saw Dr. Donald again last Thursday. Sorry for the delay in posting our update - we had 36 people here for a family Christmas shindig over the weekend (15 of which stayed the night), so finding time to update the blog was tough to come by. Thank you again, to Tim's parents Pat & Don for all your help with the party preparations and clean up. We certainly couldn't have pulled it off without you!

But back to the business at hand. Everything went very well at the appointment. Dr. Donald is very pleased with our progress so far. The big news with this ultrasound is that all 4 babies are still growing strong and have great heart rates. They're all weighing in at about 5 oz each - right on track. Also, my cervix is still measuring very well - not shortening or causing any concerns. All great news.

I'm still feeling good - though I definitely feel the impacts of my rapidly growing belly. (Though only at 15 weeks, I'm measuring more like 26 weeks. We definitely have to get an updated "baby bump" photo out here on the blog.) My skin is already feeling tight and my stomach gets full with much less food. I also find myself out of breath after climbing a flight of stairs - but I guess this all comes with the territory; I'm just experiencing it a lot earlier than if I were expecting fewer babies.

Though it is a little earlier than the norm, we were able to find out the sex of the identical twins. Baby A was way too shy and didn't give us a peek at anything. Baby B was a wiggler and didn't provide a clear shot. But Baby C & Baby D are definitely BOYS! Meet Thomas Michael (formerly Baby C) and Joseph Timothy (Baby D). The photos at the top show a profile and a "money shot" of each boy. Tommy is definitely not shy...

Our next appointment on January 2 will be a short one - which will be a nice change. Instead of taking measurements of all 4 babies, they'll use the ultrasound simply to check heart rates - and hopefully the sex of Babies A & B. When we go back 2 weeks later, they'll do the full "level 2" ultrasound - like they normally do at 18-20 weeks. This is the ultrasound where they measure all of the anatomy of each baby: organs, limbs, spine, etc. It'll take approx 30 minutes per baby (hopefully they'll give me a potty break between Baby B and the twins). If we haven't found out already, this should be when we can get a final count on the number of boys and girls.

We're looking forward to seeing friends and family over the holidays - and comparing belly size with Nikki (approx 30 weeks along) and Katie (approx 28 weeks). :) Thank you again for your continued support and prayers. Merry Christmas!

Love,

Kristin & Tim

13 Weeks 1 Day - Doctor Visit

2008-12-08T18:01:00.007-05:00

Last Thursday, we had our regular 2-week visit with Dr. Donald - the high-risk specialist. This was Tim's first time seeing A, B, C & D in action on the ultrasound screen - so it was pretty exciting.

All 4 babies are measuring right on track: ranging from 13 weeks/1 day to 13 weeks/4 days. (right around 7cm in length). All 4 heartbeats are strong and Dr. Donald was very pleased with our progress. He said I'm measuring around 22 weeks. (The size of my belly will certainly catch up to Nikki and Katie before too long!)

The big news from this visit is that we were able to see (plain as day) a membrane between the identical twins (babies C & D). Whew! The main thing we'll need to watch out for is the Twin-to-Twin Transfusion Syndrome (TTTS) that I mentioned after our last doctor visit. This occurs in about 15% of all identical twins. The vascularity in the shared placenta can get mixed up - crossing veins and arteries. When that happens, a shift in pressure occurs: one twin sort of becomes a high pressure zone and the other a low pressure zone. This forces the majority of the blood flow and amniotic fluid from one twin to the other. This can result in a much slower development rate for the twin with lesser fluids. There's no way to keep TTTS from happening, so it's something we'll just need to watch for. Due to the increased risk for the identical twins vs. the other 2, Dr. Donald said the twins and their condition will pretty much drive this pregnancy - and may be a huge factor in determining the time of delivery.

During our appointments, while the ultrasound tech takes all the measurements (which takes quite a while with 4 babies), I can't see the monitor. So this time I watched Tim's face for his reactions to what was going on on the screen. When his eyes lit up and he smiled, I knew it was because a baby was moving, or he recognized specific body parts in the black & white blobs on the screen. But the best part for him seemed to be when the sound wave of the heartbeats was up on the screen. He'd smile big for that part. :)

As you can see in the photos above, the babies are definitely growing and looking less like aliens and more like babies. They're labeled a little differently, but Baby A (Sac A, Baby 1/A) is looking right at the camera. Baby B (Sac B, Baby 2/B) is bumping heads with Baby C and was quite a wiggler according to the tech (B is the one on the left). Baby C (Sac C, Baby 3 C) is waving at us this time. And Baby D must have been taking a nap and provided us a wonderful profile shot with a clear view of an arm and a leg too.

As for Tim and me, we're certainly keeping busy. Thanksgiving weekend, my sister-in-law Nikki joined me at Babies R Us to help me register. (Thank you Nikki!) Talk about overwhelming. I'm still not done with the registry - after almost 3 hours in the store. I'll finish the rest from home and do it online. Last week I taped around the moldings on the walls we need to paint in the nurseries and Tim put on the primer yesterday. The plan is to paint the walls yellow this week so I've got time to work on the stenciled border in the nursery we're still using as a guest room before the Sasse Christmas on the 20th. I think we'll come in just under the wire... We're also starting our Christmas decorating and finishing our Christmas shopping. Lots to do this time of year - and we're doing our best to get in all that we can without over-doing it. So far so good.

Thank you again for all your wonderful comments - and for all your thoughts and prayers. I'd also like to send a big thank you to Aunt Bonnie for her wonderful prayer before Thanksgiving dinner (even though you made the 2 pregnant girls cry!). It was beautiful and we certainly appreciate your love and concern for our babies' health. Thank you!

Love

Kristin & Tim

Just a short update

2008-12-01T10:29:00.004-05:00

As many of you know, our next doctor appointment was scheduled for today. I received a call from the office this morning to reschedule. So we'll go back to see Dr. Donald on Thursday afternoon. We'll have more to post after that. In the meantime, we'd like to thank all our friends and family for their - ahem - 'helpful' suggestions on names for the babies. Here are a few examples of the generous help we've received so far: Ronnie, Bobby, Ricky & Mike (from the 80's group New Edition) John, Paul, George & Ringo Joanie, Chachi, Potsy & Ralph (Happy Days characters) Amy, Bryan, Cindy & Dwayne (names of my former coworkers at Morley to match A, B, C & D) And a couple random names for girls: Dixie Tuesday William (courtesy of our 4-year-old nephew Aaron) Keep the suggestions coming. Given the laws of statistics, if we get enough suggestions, we're likely to find SOMETHING that we might use... :) More to come later this week. Thanks again for all your thoughts and prayers - definitely keep those coming too! Love, Kristin & Tim

Baby Bump - 11 weeks

2008-11-21T09:16:00.005-05:00

It may not look like much, but it's already enough to keep me from wearing any of my regular pants. The maternity pants are, of course, too big still - but so much more comfortable. I'm 11 weeks along - but measuring more like 20 weeks for a singleton pregnancy.

I forgot to mention in our last post that I had attended a parents of multiples group meeting earlier this week. The group is made up of about 14 families. Most of them have twins and one has triplets. The ages of the multiples range from toddler to twenties, but all the moms have one thing in common: they can relate to what a multiple pregnancy is like. I think they'll be a great resource - and wonderful extension of our support network in the area. The next meeting isn't until January and several of the moms offered to pick me up, expecting that I may already have several limitations on my activities by then. It was a really nice feeling to be welcomed by a group that understands what I'll be going through.

Well, Tim had his "escape" last weekend hunting. I've got my escape this weekend: scrapbook weekend at a wonderful B&B up north in Clare, MI with the girls. Take care, everyone. We'll post new info and photos soon.

Love

Kristin & Tim

10 weeks, 5 days and counting

2008-11-18T17:40:00.009-05:00

Yesterday was our first visit with Dr. Donald - the high-risk specialist. He's an all-about-business kind of guy, but I think I'm going to like him. He's direct and doesn't sugar-coat anything. I like that approach. But - I did get him to laugh, so that helps me feel more comfortable with him.

Tim was up north hunting and had to miss the appointment, so our friend Dana (an OB nurse) came with me. I wanted a second set of ears and eyes to help me remember all the information the doctor threw at me. And Dana's insight and experience as a nurse in this field certainly came in handy.

The appointment started with an ultrasound. The tech took a number of measurements and was a bit overwhelmed at the prospect of measuring and tracking FOUR babies. I learned that they provide "measurements" in terms of time with respect to how far along I am. Meaning, all 4 babies are measuring between 10 weeks/3 days and 11 weeks. Since I was at 10 weeks/5 days at the appointment yesterday, they're all on target. It was amazing to see more than just blobs on the ultrasound screen. The were moving around and turning over. It was crazy to imagine all that activity going on inside my belly - and I can't feel a bit of it!

As you can see from the photos they've certainly progressed from the "blob" stage. I think they look more like miniature E.T.'s - just with shorter arms. :) You can't see Baby A very well in this shot - mostly because it's back is turned to the camera. Baby B is posed in a perfect profile. Baby C is looking right at the camera and Baby D (taking after it's dad) looks like a bit of a goofball - standing on it's head.

The ultrasound served many purposes. In addition to measuring the length of my cervix (which at 6cm is very good), and measuring the growth of the babies, we were also trying to determine the "chorincity" of the identical twins. In plain English, we were looking for a membrane or some separation of space in the sack the twins share.

Let me back up a bit: Depending on when the split into twins took place, the babies may share a placenta and one or both of 2 sacks (or membranes). Though it is early to tell, our twins may be sharing the same placenta and the same space - no membrane or separation between the 2 of them. Though this has big risks associated with it, there are also some positives. If there is no separation, the babies can become tangled with each other's cords. Or they may encounter Twin to Twin Transfer Syndrome (TTTS). I need to learn more about this, but it involves one twin absorbing the majority of the nutrients and utilizing most of the fluid in the sack.

If there is a separation, they would each be more likely to have their own placenta. If that's the case, this brings more risks to the pregnancy because a 4-placenta pregnancy is much more complicated than a 3-placenta pregnancy.

It's still pretty early to be able to tell exactly what we're dealing with. So I'll go back in 2 weeks and they'll take another look. Unfortunately, ultrasound technology just isn't good enough to provide a clear image of the membranes around each baby - especially this early. We'll just have to wait and see. And regardless of if there's a membrane or not, there's really nothing we can do about it. We're just along for the ride. So until we know what we've got, we'll just focus on the things we can control (nutrition, rest, etc.) and stay optimistic.

After the ultrasound, the doctor gave me plenty of time to ask a long list of questions. And he even drew a couple diagrams on a whiteboard to clearly explain his answers. He can't provide any firm asnwers regarding things like bed rest and travel restrictions because there are so many variables at play. But he did give us some things to keep in mind: at 24 weeks, I'll be the size of a full-term single baby pregnancy - that's the end of February. My biggest enemies are pre-term labor and an "incompentent" cervix (if it gives out under the pressure of 4 babies). Rest - and, if needed, medication - will be the best ways to stop both of those enemies. I'll be fortunate to make it to 30 weeks (though my personal goal is 32). In the last weeks, I'll certainly be on bed rest in the hospital - that could be just a couple weeks or it could be a couple months - there's no way to tell now.

So even though we know the babies are on track and everything looks great right now, lots can happen. Please keep sending good vibes our way. We truly appreciate all your love and support so far in this process. We'll certainly be depending on it in the coming months!

Oh - and for those of you that have asked, yes - we will post a profile shot of my "baby bump" soon. Once Tim gets home from up north, we'll take a photo and post it out here on the blog for you to see. :)

xoxo

Tim & Kristin

And then there were 4

2008-11-03T19:01:00.006-05:00

Welcome to our new blog. We hope you find this website useful and informative. We want all of our friends and family to keep up on what's going on with our - er - interesting pregnancy.

Thank you to everyone for your well wishes, wonderful reactions to our news and for all of your support so far. We're certainly going to need a lot of support in the coming months (years!) and feel fortunate to know we can count on all of you.

Just a few basics to get everyone caught up:

As of today, we're at 8 weeks and 4 days. We're expecting 4 babies - including one set of identical twins. Our official 40-week due date is June 11, 2009 but the babies will arrive much before that. I'm hoping for 32 weeks, which is April 16.

We've had a few ultrasounds so far. The photos of the first 2 are attached above. In the first set (on the left), there were 3 gestational sacks. In the set on the right, we found out there were actually 4 babies inside those sacks. Their unofficial names are A, B, C & D. :)

We saw my regular OB on Friday, October 31. Though I'm only at 8 weeks, I'm measuring more like 12 weeks - which only makes sense since there's a lot more baby in there. They did another ultrasound, but didn't print photos or take formal measurements. All 4 still have strong, healthy heartbeats and are the the right size for 8 weeks.

Our next appointment will be with the maternal-fetal medicine doctor. This is the high-risk specialist. Hopefully that appointment will be scheduled soon - we should know more later this week and will post more information when we have it.

Thanks again everyone! We'll be in touch again soon!

Love, Kristin & Tim