Tuesday, September 30, 2008

We are the Champions!!

Ya'll may think the title is funny, but that's what I felt like singing Sunday (9/28) when they moved my last 2 in the NICUto the progressive ICU. Heath moved to neonatal progressive ICU on last Thursday (9/25) at shift change. Leah and Ricky were moved Sunday afternoon, between 5:30-6:00pm over to PICU. First they took Leah and then Ricky. As we followed Ricky in his isolette, the nurses down the other isles came to see; they were also all smiles and happy. Some said bye, yeah for the McLean's. I lifted my hands in victory, feeling like I had should be giving all of them high 5's because our team had won the battle! Yeah! Wahoo!! I wanted to do a happy dance! We had graduated all of them to progressive. So once again, even as I am typing this, I am filled with emotion, sweet joy! We arrived the underdogs, but we conquered! Our babies and how well they have done is a true testimony to what the power of prayer can do!! God bles all of you who have prayed daily for us for so many months. I'm blown away on a daily basis to what God has done in our lives. He is truly the Great Physician!

I've been trying to write this since Monday night, but always seem too tired to keep my eyes open or find something else that also needs to be done! I know this will only get worse! So here it goes...

Last Wednesday (9/24), all the baby's had their first eye exam to see how severe they may have retinopathy of prematurity (ROP). The retina is made up of many small blood vessels at the back of the eye. When a baby is born prematurely, the normal blood vessel growth changes. The blood vessels become very large and easily break. This abnormal growth is called ROP. If the blood vessels bleed it causes scar tissue. As the scar tissue grows, it makes the retina pull away from the back of the eye (retinal detachment). Retinal detachment can lead to poor eyesight or even result in blindness. It's a given that all of them will have some ROP. But thank goodness all were only in Stage 1 (mild). So they will repeat in 2 weeks and see if there's any changes.

Also since last Thursday (9/25), physical and occupational therapy (PT & OT) has evaluated each baby to see where their strengths and weakness's are. the 2 main things they are looking at right now is their sucking reflex and for them to keep developing their physiological flexion (this is the scrunched up position they would be in the womb). They want them to have strong flexion by the time they go home. They also brought them these new hallo pillow's to help head shaping.

Randy has been working nights at Comanche Peak since Sunday. His days off last week were Friday and Saturday. So we went up Friday (9/26) evening to see the babies and see if we could get in on some bath time. I was able to give Heath and Ricky their baths as Dad taped the festivities. the little toots were both pretty squirmy, trying to wash them in their little buckets they give you at the hospital. They were both kicking and pushing with their little legs, but like getting their hair washed. It was so much fun! Randy held Ricky that evening too. On Saturday (9/27) we went up that afternoon and stayed late again. Its nice and quiet on the night shift. Randy held Leah and Heath that night. Then Sunday (9/28) afternoon, much to our surprise, they said they were moving Ricky and Leah to progressive before shift change. Jenna got to hold all 4. Nana held Ty and Heath and Pa held Heath. The kiddos had such an awesome week!

This week has been no different. Monday (9/29) all had head sonograms to look for bleeds. Steven and Leah's were clear which was expected. Since Ricky and Heath were the sickest when they were born, they both had a questionable spots. Ricky had one at the basal ganglia which Dr. Levy was surprised that it showed up. he said he's really not worried about this because the radiologist noted it as questionable. Heath had a questionable spot show up on the left frontal of the brain. this on the other hand is a place that's more worrisome. So we will repeat another head sono in 2-3 weeks to see if there's any changes. He said all the babies will get MRI's before they go home for one last check. All have been growing great this week and tolerating the increases in their feedings. Little Leah had pulled her feeding tube out of her mouth Saturday evening. When she did the tape attached to her cheeks to secure the tube also came off with a layer of skin with it. They put these little clear dressings called tegaderm over the area so they could re tape the tube to it. This Tuesday (9/30), we took the tegaderms off because it was getting moist under it. So they got all that off her cheeks, cleaned them and left them open to air so it could dry out. Bless her heart, her skin is so sensitive and thin! But within a day the areas were already dried up and looking better. Ty had his nasal cannula out of his nose alot today and was holding his Sats great on his own. We took it off of him for a trial run while I held him and didn't have any problems.

Wednesday (10/1) was another big day, I was able to try to nipple feed (try to see if they would take a bottle nipple) for the first time!! Right now they can try once a day for 30 minutes. Whatever they haven't eaten after 30 minutes then they put through their OG tube. they also turned Steven Tyler's O2 down to 1/2 Liter at room air and Heath's down to 1 liter at 25-30% oxygen.
Steven Tyler took his entire feed of 34ml with no problem! Leah took her 30ml with no problems, spit up once during and once after, but very little. Heath took 26ml of his 36ml feed. Ricky took 13ml of his 37ml feed. All did great for their first try!! We will also try to get them to latch on to breastfeed probably after a few more feeds.
MoMo (Randy's mom, Joyce) came for a visit that afternoon and got to hold Leah and Steven Tyler.
Today, Thursday (10/2) Heath took his entire feed of 36mls. Ty took his plus a little extra, 37mls in 30 minutes. Leah sucked her 30mls down in 15 minutes!-Little Piggy! Ricky didn't get to try this afternoon because he was breathing too fast (don't want to stress him out).

Their weights and lengths:
Ricky: 4lbs. 10 oz. length:16.93 inches (43cm)
Heath: 4lbs. 9oz. length: 16.53 inches (42cm)
Steven: 4lbs. 0oz. length: 15.35inches (39cm)
Leah: 3lbs. 11 1/2oz. length: 15.94inches (40.5cm)

Today is also Ashley's 13th birthday! Happy Happy Birthday!! We Love ya girl! Holy Guacamole she's now a teenager!!
I'll post pictures tomarrow from this past week.

Wednesday, September 24, 2008

In the News...

Randy and Steven Tyler

Jenna and Ty (I have know idea why it turned this way and don't know how to fix it!)
Baby pictures from Monday 9-22-08 5weeks old
Ricky Shane

Heath Allen

Steven Tyler

Leah Grace

The babies are now the talk of the town! Yesterday, as many of you may have seen, the babies were on Channel 8 for a quick blip and on Channel 11 & 21. the Fort Worth Star Telegram also came out and have their story in today's paper in section B and on their web page. I didn't get to see the channel 8 since it was on at 5, I was stuck in traffic, of course, in Fort Worth. My sister said that they screwed up the info. I don't know who filled them in because all they sent was the cameraman, oh well. Channel 11 and 5's both turned out good. The babies once again did great through the interviews. Ricky and Steven slept through their closeups. I guess they were camera shy. Heath was wide eyed this time and so was Leah. Heath was more the ham this time. And now all of you know the story behind Steven Tyler's name. Yes, Kristi and I have been Areosmith fans forever and we love the name! It fits him perfectly!
You can pull the stories up on the webpages:
http://www.nbc5i.com click on health category then its under local health-top stories
or you might can go straight to the video http://nbc5i.com/player/?id=667348
I couldn't find it on channel 8 web page, if anyone does, let me know.
http://cbs11tv.com/ktxa under health also and when I clicked on the channel 21 link, it came up on the iTexas viedo on the left of the page.
http://www.star-telegram.com it's on the main page today
Now for the run down since last Friday the 19th.
We went to the see the babies after the girls got out of school early on Friday. Randy and Ashley started with the boys in the NICU while Jenna and I went to progressive. I could tell as soon as I layed eyes on Leah she wasn't herself and didn't feel good. Her little abdomen was distended and guarding (when you would stretch her legs out she would immediately pull them back up to her abdomen because it was painful). On of the other nurses came and checked her too. I told them we needed an xray because something just wasn't right, could be just gas and constipation or could be more (NEC). So one nurse went and got the doctor on call from the NICU, and after assessing they got xrays and did a round of blood work to make sure there wasn't an infection brewing also. On top of that she a 2 little areas on her cheeks where the tape had broken down her skin. So they had put some antibiotic ointment on it and were trying to keep from the nasal cannula rubbing it too. I was once again scared to death, because with the abdominal distention it was making it harder for her to breathe making them have to increase her oxygen % and bump her back up to 2liters/nc. So they had to stick her multiple times to get lab work. Then they moved her back to NICU because there was a questionable spot on the right side of her abdomen and they had to start an IV to give her fluids and also blood since she was anemic. So they stopped her feeds until they repeated the xray at 8pm. It was better, the area was probably gas and stool making a funny picture on xray. But with babies you can't be too cautious and repeated the xrays again in the morning. So they restarted her feeds after she got her blood. She was resting better before we left that night and did fine through the night. Everyone else was doing good, thank goodness. Having one scare the daylights out of me is enough. You can't imagine the sinking feeling that I get when something concerning arises. We coast along doing great and then like a train hitting you get jolted back to reality that there not out of the woods yet.

Saturday morning, my mom came and stayed with the girls so we could leave early to go check on the babies. They had a work day Saturday at the house to get the siding on the outside. Thanks to all who came and worked. Then at 5pm was the "Quadfest Benefit" down at the park. Leah's am xray looked better, still alot of gas and distention. They decided to give her a suppository to help get things moving a little better. Heath's belly still pretty round but has good bowel sounds and soft. Ricky and Ty were hanging out being good.

On Sunday, the doctor decided to try Ricky on the nasal cannula since he had a red spot on the inside of the left nostril from the bubble cpap prongs. He liked getting all that off his face! He was having to work a little more so they turned him up to 3liters/nc oxygen % between 38-40%. They said since he's bigger he may require a little more O's at first. I was so happy to be able to see his round little face and head full of hair again. It's unbelievable how much he looks like he's changed! Randy and I were saying to each other, "look at his fat little cheeks...he's got a double chin, he looks so big, but he's only 3lbs!" To us 3lbs is big. Heath was doing great on bubble cpap with his O2% down to 23. Steven Tyler also just hanging out. He was wide awake Sunday afternoon. Jenna and Randy both held Steven for the first time. Ty is the first one Randy has held. I told him, " see how good it makes you feel!" He wanted to wait till they were a little bigger before he held any of them. Jenna wanted to put clothes on Steven Tyler. She had picked out sleepers for each of them last week. So we got out his preemie brown and blue striped sleeper and it still just swallows him! I didn't think it would be that huge, but it was. So I guess we'll wait till he's a little bigger.

Monday I came into to a wonderful surprise; Heath was off the bubble cpap!! He-man, as I call him has graduated to the nasal cannula likes his brothers and sister. I thought he would be on cpap longer, but praise God that he's not! He was doing great at 2liters and at 35%O2. He was so happy and calm having all that stuff off! And yes tears of joy again getting to see that beautiful round face and eyes. He's got a receding hair line like his Daddy! Ricky was also doing better with his O2 % down to 35. Ricky and Heath had their feeds increased to 30cc, they made it to an ounce! Leah is at 25ml and Steven at 26ml. Leah's abdominal xray still shows some gas, much much better. She had a good blow out the night before after her suppository.

Yesterday was crazy because I had my postop check with Dr. Tabor at 1pm and then the news crew coming after that at 3:30. Dr. Tabor has grown a mustache, never thought I would see one on him! I'm kicking myself now that I didn't get a picture. I'll have to sneak back over and get one soon to put on the blog. I took them pictures of the babies. They fell in love with them too and how wonderful they look! Thanks Doc for taking such good care of me, I miss seeing ya! He is truly an amazing doctor and now a friend who I plan to harass ever so often so he doesn't forget me!

Here's our current weight and lengths:
Ricky Shane:3lbs. 14oz length:42cm (16 1/2 inches)
Heath Allen: 3lbs. 11oz length:43cm (17 inches)
Steven Tyler: 3lbs 8.79oz length: 38cm (15inches)
Leah Grace: 3lbs 1oz. length:40.5cm (16 inches)

Quadfest on Saturday turned out great!! Thank you to all the gals from Hico and my coworkers who made everything possible and worked so hard to get everything together!! There's an extra jewel in your crown for all your love and support! Thanks to all the businesses and people who donated items for the silent auction. With the auction and meal nearly $6,000 was raised to help us with expenses. Hico is such a wonderful, supportive town. I'm proud to live here and be associated with this community.

Big Sis and 4 Generations

These pictures were taken on Sunday, September 14th.
Jenna holding Leah, practicing one of her big sister duties.

Granny( great grandmother, June Arendt) and Leah

Nana (grandmother, Janie Holderman) and Leah

Four Generations of beautiful ladies!

Thursday, September 18, 2008

This week in Quadville...

Ricky Shane zonked!

Heath Allen having a look around.

Steven Tyler laid out as usual.

Leah checking out Aunt Kristi

Leah working her tongue. Don't ya just love the little cap!

The babies did well through the weekend. On Sunday morning Heath had to have a chest and an abdominal xray because his abdomen was distended he was desatting more, making them have to turn up his oxygen. His lungs were sounding coarse and were whited out more on the xray (not good). So they started him back on breathing treatments every 6 hours and chest therapy. The bubble cpap causes more air to fill up the stomach, so they will watch it and did another set of xrays on Monday. Saturday evening and Sunday you could tell he just didn't feel good. He was fussier and just wiggling around more than usual for him. And the extra activity coming from other babies around him was upsetting him more when I tried to hold him on Saturday. So come Monday morning, his lungs looked better, but his abdomen looked worse, and he had to have blood (not uncommon in preemies with immature RBC"S). His small intestine was what they call "stacking". It looks stacked on top of each other, more defined on the xray and distended with a lot of air. This is worrisome for NEC- necrotizing entercolitis. NEC is when tissue in the bowel dies due to inflammation or infection. So they have to watch for air in the bowel wall and free air in the abdomen (means the bowel could have perforated due to the air in the bowel wall). So they gave him a suppository to help him poop and cut out the extra calories/protein in the breastmilk and repeated the xray that evening at 8pm. It was better with the bowel less defined. So the xrays on Tuesday and Wednesday were better and then today's was questionable again. So they repeated it again a few hours later and gave him another suppository. The radiologist said it was OK, NO NEC. Thank goodness. But we're keeping a watchful eye on him. The nurse said his bowel sounds are good and his abdomen is soft.

Also on Monday, Princess Leah surprised us all and got moved to the Progressive ICU (PICU). I called that evening to check on them, and oh by the way, we moved your little girl to progressive! She was doing great and actually had her O2 turned down to 1Liter and not having any problems with her feeds so she got promoted!! I knew she would beat the boys. GIRLS RULE!!! Ricky and Ty were doing good on Monday. the nurses were chasing them a little with their O2 %, they both tend to drop their sats during feeding time.

Tuesday, Ty got a little blood also because his hematocrit was at 25.6 and he was symptomatic (has periods of low heart rate and can't keep their O2 saturation's up consistently in their normal range, get too low). It perked him right back up!

The child life specialist's Melinda and Jada gave me "My early arrival baby journal" which is geared toward the premature infants. It touches on the milestones that we look forward to in the NICU. Thank you ladies for the baby books.

Yesterday was interview with Channel 5 News!! Talk about being nervous. My husband's words of wisdom for me were, "Glad it's you and not me. Try not to sound like a hick." Thanks Sweetie!! I'll try not to say ya'll to much! But all in all I think it went Ok. Dr. Levy and I both interviewed and then they got some shots of me with babies. They also filmed me holding Leah, she loves the camera! She was wide-eyed and just smiling! She's Miss Photogenic!

And after all that Ty got moved over to the PICU with his sister! Way to go Bro! Aunt Kristi got to hold Leah and hear her little hiccups. She sounds like a baby puppy. Randy got it on tape on Friday. It's too cute.

Sunday, Leah was also busy being passed around. Granny and I were over talking to Heath when Leah's nurse comes over and says, "You need to bring the camera, Jenna's holding Leah." WHAT?!?! I had just told Jenna the day before when she asked when she could hold Leah, that she'd have to wait till she got a little bigger. Well, I guess not. The nurse asked her if she wanted told hold her little sis and of course she said yes! The nurse said she had a little sister in the NICU when she was a kid. She thought it was important for her told hold her sister too. So there I find Jenna all smiles holding Leah. She did a great job and loved every minute of it. Then we passed on to Granny and then Nana. Granny about put Leah to sleep rocking her. But she was all smiles. She is the most animated at this point.

Their weight's as of today were: Ricky Shane-3lbs 6oz, Heath Allen-3lbs 0.6oz,
Steven Tyler 3lbs 2oz, and Leah Grace-2lbs 10 1/2oz.

A New Do

Yes, I know its already been a week since the last post. So Sorry! My keeping up better just hasn't happened yet. On Thursday, I stayed home so Sissy, aka Dana Ross, could update my do. I had been needing it cut since before I was put on bedrest. So about 2 weeks ago she gave me a call and said she wanted me to come in so she could cut and color my hair for no charge. Such a sweet and very appreciated gift from her and her mom, Lavada. I feel like a new person! She didn't want me to put this picture on here, but I'm doing it anyway! That's Sissy's youngest granbabby, Peyton. He's adorable! Thanks again Sissy for doing such a wonderful job! Love ya girl!

Thursday, September 11, 2008

Me and My Babes

Ricky Shane

Heath Allen

Steven Tyler (Ty)

Leah Grace

Yesterday, Wednesday the 10th was the first day I held all four babies in one day! It was the very first day for me to ever hold Ricky Shane. It was a blessed day!! The babies have been having another great week. All continue to tolerate their feeds without problems and oxygen saturations have been in the ranges they need to be. So when Dr. Levy says he has nothing to say, its a good thing!

Monday, September 8, 2008

Update 9-3 to 9-7-08: Great Week!!

Randy's hand on Ricky's chest

Heath Allen with his 1st teddy

Heath and I

Steven Tyler found his ear to play with

Sweet little Leah Grace

OK, so I didn't get this posted any better than the last, but I'll keep trying!! This one will be alot shorter without all the medical jargon. All the babies have done absolutely great the rest of the week! On Wednesday, Dr. Levy decided he would try Ricky on the bubble cpap again, but might wait a little longer on Heath. Well we get there Thursday morning at about 10:20 and they had extubated Ricky (taken the tube out), had him off the vent and back on the bubble cpap doing great! And much to our surprise, he decided that Heath was doing good enough to take him off the vent also. So 30 minutes later, he's extubated and on cpap doing great also!! Thank You Lord for ANSWERED PRAYERS!! So Ricky and Heath have been doing awesome on the cpap for the rest of this past week. They do xrays on their lungs and tummy's every other day or every couple of days. They do an xray on their abdomen's to check how much air they have in their stomachs and intestines from the cpap (it's normal for it to cause more air). So after feeds and during the day they hang up their feeding tubes to an open syringe ("to chimney") to help get out excess air. Heath is also getting a little chest therapy from respiratory to help clear out his lungs a little more. They have tolerated the switch so well and maintain great O2 saturation's. Steven Tyler (aka Ty) and Leah are also just trucking right along too. They are both down to 1.5 L/min. on their high humidity nasal cannula's. They keep their O2 sats within range like they need too with occasional drops that they resolve on their own. Everyone is is gaining weight. They add calories to the breastmilk on all the babies. Ty and Leah are also getting extra protein added too. They have all gained for the week too. Heath made it over the 3lb. mark!

As of Sunday, these are their weights:

Ricky Shane: 2lbs 15 oz.

Heath Allen: 3lbs 0.68oz

Steven Tyler: 2lbs. 6.1 oz

Leah Grace: 2lbs. 2 1/2 oz

Last night I got to hold Heath and Leah!! Leah I did kangaroo care which is holding her skin to skin on my chest. The parents get to do this to help keep the babies temps up and for bonding. She is just so tiny!! But felt so good to have her against me and she did wonderful keeping her O2 sats up and not getting stressed out from it. It did her mommy alot of good too. Heath I was able to cradle in my arms due to his cpap lines, so sweet too. Today I hold to get to hold Ricky and do kangaroo care with Ty also. Ricky is the only one I've not been ablt to hold yet, so I hope I get too today.

Tuesday, September 2, 2008

Quad update 8-27 thru today 9-2-08

Once again, sorry for waiting so long to post. By the time I've gotten home each late afternoon/evening there hasn't been time or any energy left in me to sit down and post. I hope this week I'll get better at posting every few days...we'll see! This is going to be a run down since last Wednesday, the day after my last post. This one will be long so get comfortable!

Ricky Shane: He's the one with the temper! Randy and I have decided he's the one who's going to lose his temper and be holding his breath till he passes out. He hasn't liked the nurses messing with him at all. When they do, his O2 sats drop like a rock. They've been keeping him pretty well sedated up until today (9-2).
8-27-08: Wed: Ricky's weight was 2lb. 10 oz. (1200gms up 80gms). They turned off his small bili light yesteday afternoon since his bilirubib was down to 2.9. His feeds this am were 7ml every 3 hrs and were increased to 8mls in the afternoon. His night blood gases were not so hot and his carbon dioxide level was up this am. So they had to turn his vent pressures back up to 32. St noon his gases were better, CO2 (carbon dioxide) was down to 36 (way better) but they only came down to 31 on the pressure. They kept his oxygen percentage at 30% on the vent also which had him keeping his O2 saturations at and around 90%. They also started him on Lasix 2 times a day to help pull some fluid off.
8-28-08/Thurs: weight: 2lb 10 1/2 oz (1210 gms). Since he did better yesterday pm, Dr. Levy tried to wean Ricky off the Jet ventilator this am, but no dice! Didn't tolerate it at all. his CO2 went back up into the 70's when they did a blood gas at 1038, so he stays on the Jet. By 1240 his blood gases were better, CO2 back down to 54. They increased his feed today to 12ml every 3hrs and is tolerating. His chest xray is still very hazy. He had to have blood tonight because his Hematocrit had dropped from 34 to 28.7. His ultrasound of his head today was negative for any bleeds-PRAISE GOD!!!
8-29-08/Fri: weight: 2lb. 10.33oz (1200 gms). Ricky's O2 sats got better after the blood. This am his feeds were increased to 15ml every 3hrs and they decreased the rate on his TPN and lipids). His CO2 was in the 50's early am but his noon gas they were 61. He got fiesty and decided to grab his tube so that irritated him and then he had to be bagged (use an ambu bag to give him extra breaths/help ventilate him)because his Sats dropped into the 40's. After he settled down his O2 saturations returned to within normal range. Still on lasix to pull off excess fluid.
8-30-08/Sat: weight: 2lb 14oz (1300gms). His feeds were upped to 18ml every 3 hrs. Today Ricky had his umbilical venous catheter d/c'd (removed) and they stopped his TPN and lipids. They are starting a peripheral IV to give him small amount of fluids. The nurse started the IV in his right hand first but he jerked just right and it clotted off so then they tried to restart it in his left hand and it ened up being arterial, so they left it in to draw blood gases and draw blood instead of sticking him so much. They finally got another one in his little head. His blod gases at 4am were better but then the one they drew at noon was bad. They redrew it out of his arterial line and they were so much better at 2pm.
8-31-08/Sun: weight: stayed the same. His feeds were upped to 22ml every 3hrs. They turned off the Jet ventilator for a minute this am, but when the doctor listened to his lungs, they were very wheezy. So they left him on the Jet and started some breathing treatments 3 times a day with a medication called Zopinex (like an albuterol inhaler). they were able to stop the fluids in his IV but he still is getting the Lasix to try to pull off some fluid. His blood gases were much better today and will try to lower the pressure on his ventilator.
9-1-08/Mon: weight:2lbs. 8.92oz (1160gms). His feeds are still at 22ml abd they are adding sodium since his level was a little down. Ricky's weight is down alot today but that was ok since he had some fluid he needed to get rid of. His chest xray was better today, the Zopinex treatments helped and will continue. They are slowly going down on the pressure (PIP) on his vent. At 4am it was at 23, noon down to 21, and then to 18 at 8pm. He scared me this afternoon at about 4pm when we were about to leave. He decided to drop his O2 saturations down into the 40's and no one was even bothering him. They turned up his oxygen, tried to suction to see if he had a plug, and repositioned him. They got out the ambu bag to bag him and he started to pick back up. It's like he knew what was coming if he didn't straighten back up. he slowly came back up and they left his oxygen turned up a bit till he got back up to where he neede to be. Then his blood gas was just fine after all of that..thank goodness!
9-2-08/Tues: weight: same as yesterday 2lb 8.92oz. his blood gases were good thru the night and his 8am gas was also good so they turned the pressure (PIP) down on the vent again to 17. Ricky's feeds are at 22ml still with calories added. The nurse today was spreading out his sedation meds a little more to see how he tolerated it. He had some of his usuall up and down sats this am, but they put him on his tummy and gave him one of the preemie pacifiers and he loved it! his O2 sat's were at 97-99% after that. They took out his arterial line because it quit working. Dr. Levy is thinking about trying him on bubble c-pap in the am, pray that he tolerates it!

Heath Allen: To me he looks like a little old man. His face is much thinner than Ricky's is and his hair isn't as thick. He likes being on his tummy and keeps his hands up under his chin or around his face alot. Jenna says that Ricky and Heath can fly since their on the Jets.
8-27-08/Wed: weight: 2lb 11oz (1220gms). Heath had a rough night. he had to have his oxygenation turned up on his vent from 40 all the way up to 90 at one time. They had to give him some IV boluses of Normal Saline and extra sedation because he kept fighting the vent. They got a bunch of stuff out of his lungs when they suctioned them and his chest xray was worse this am. His morning gases were better so they tried him off the vent this am and his blood gas got worse, his CO2 went up to 81 (bad). He went right back on the Jet vent. they started him on Lasix also to get some fluid off his lungs. He only dropped his sats low once today after back on the Jet vent and his blood gases improved, CO2 going down to 57. They increased his feeds to 12ml every 3hrs and is tolerating with no residual in his stomach. he like to be on his tummy and had alot better sats when he is.
8-28-08/Thurs: weight: 2lbs. 11.3oz (1230gms). Heath's feeds were increased to 15ml every 3hrs today. His echocardiogram of his heart ws negative and his head ultrasound to check for bleeds was also negative-PRAISE GOD!! his chest xray his still crummy; left side worse than the right which may be from him getting more of the dose of the surfactant on the right than left. He is also still on lasix. All the babies got a prophylactic dose of Indocin which is said to help prevent head bleeds and with PDA's (the heart murmur that babies can be born with). Dr. Levy says he may wait till Ricky and Heath are closer to 1500gms before he tries tp pull them off the vent again. He's trying to max out each one on their feeds and start adding calories and fats/proteins which also helps the lungs develop. Today his sats were good in the low 90's (they like the babies sats to range from 83-low 90's).
8-29-08/Fri: weight: 2lbs. 9 3/4oz. Heath doing well this am last night and this am his CO2 was in the 50s. his oxygenation setting on the Jet vent ws between 30-40%. Heath desats but brings them back up on his own. His feeds are still at 15ml every 3hrs and tolerating well. his sodium was low and his potssium elevated so they made adjustments to his TPN to help correct the imbalance. He had to have blood today because his hematocrit dropped from 35 to 31.6. When we got to the hospital Friday evening, Heath had been taken off the Jet ventilator and was back on the regular vent. his blood gases and O2 sats were doing fine after the switch. He his also still on Lasix to pull off excess fluid.
8-30-08/Sat: weight: 2lb. 8oz. His feeds were incresed to 18ml every 3 hrs and added calories. He is also tolerating the vent. Heath also will get mad or for no reason drops his sats down into the 70's and then slowly comes back on his own 9this isn't unusual for preemies). The left side of his lung is still worse. It looks like someone who would have emphysema. Dr. Levy said Ricky and Heath will have some chronic lung disease we just don't know how much yet and how long it will take to get better. It's possible they may be on oxygen when they come home. He wants them off the vents as soon as possible because the longer their on them, the worse the chronic lung disease can be. Tonight Heath finally opened his eyes good.
8-31-08/Sun: weight: 2lbs. 10oz (1200gms). Feeds increased to 22ml every 3hrs. Today they are taking Heath off the TPN and lipids and saline lock the PICC line (keep the line, but won't be using it) and will take out the PICC line Monday. His blood gases have been good. he still goes up and down on his O2 saturations, but held them up better in the evening.
9-1-08/Mon: weight: 2lb 10oz. (1210gms). Starting at 4am, Heath's CO2 levels climbed to 85 and then the next 3 gases at 5, 7, and 9am were all in the 70's. So they increase the pressure to 23. Dr. Levy also started him on the Zopinex breathing treatments and said if his CO2 doesn't get better, he goes back on the Jet ventilator. His feeds are still at 22ml every3 hrs and they added sodium alsoto them. They took out his PICC line today. At 1100 his blood gas had improved and his CO2 was down to 54. At around 4:20pm when Ricky was acting up and we were about to head back to Hico, I look over from Ricky's bed to see about 5 people standing around Heath's bed with the top open. When he was laying happily on his tummy, he got hold of his ET (breathing) tube and pulled it back. He of course started to desat and his vent alarms went off. They had to extubate/ remove that tube since it was no longer in the proper place and reintubate him. They put a new tube that was the same size (2.5) back down. He was not tolerating it because too much air was leaking around it. So they extubated (removed) that one and put down a half size bigger (3). the chest xray showed his left lung was over inflated so they readjusted his settings that had been just changed by the on call doctor back down to what they were before all the commotion happened. So they got him resituated and of course his next gas was awful with a CO2 of 75. But by 8pm it had improved and his CO@ was down to 55. He was doing much better this evening and they decided to leave settings as in for now since his sats were good. I tell ya, that is something you never want to see. First Ricky and his little spell and then Heath. Standing there watching them having to work on your baby for nearly 2 hrs and there's nothing you can do-you are completely helpless. Seeing Heath with his little eyes wide open and alert while they were trying to get him reintubated- you can't help but wonder what's going thru his precious little mind while all of this is taking place. I'm glad he won't be able to remember that, but I'm afraid it might be stuck in my mind forever. I know everything was going to be Ok at the end but it doesn't make it any less traumatic or less scary.
9-2-08/Tues: weight: 2lb. 9oz (1190gms). Heath's blood gases this am better with his CO2 down to 45. They decided to not make any changes on his vent for now. He did well the rest of the night. Dr. Levy increased his feeds to 24ml every 3 hrs and added a little more sodium to them also. He gets another chest xray, and blood gas in the am. They will also increase his caffeine in the am also. He was doing well the rest of the afternoon back to having some of his usual desats but always pulled them back up on his own.

Steven Tyler: Randy calls him pretty boy becasue he has the blondest hair you've every seen. He likes his pacifier and seems to have one of his hands above his head, on his head, or tucked behind his head.
8-27-08/Wed: weight: 2lb.1 3/4oz. Ty had a good night, vital signs stable. He's on the high humidity nasl cannula at 3L. His feeds were increased to 5ml every 3hrs and tolerating. He's still on Vancomycin but the gentamycin was d/c'd (discontinued). he got a glycerin suppository this am because he needs to poop! At 1pm they upped his feeds to 7mls. I got to check his temp and change his itty bitty diaper. his blood gases were d/c'd and he still had no growth on the cultures. We got a kick out of watching him sleep, looked like he was chasing rabbits, wiggling and raising his eyebrows and would straighten his legs out and strech when I was changing him.
8-28-08/Thurs: weight: 2lb 3/4oz (930). Feeds up to 10ml every 3hrs. He had a little spit up with his first increase but did well with the rest. Doing good today! Head ultrasound negative for bleeds-PRAISE GOD!!
8-29-08/Fri: weight: 2lbs. 2 1/2 oz (980gms). They upped his feeds at 5am to 12ml every 3hrs. He will breathe fast and drops his sats but will recover on his own. At 5pm his feeds were upped again to 15ml and tolerated well.
8-30-08 Sat.: weight: 2lb 3/4 oz (930gms). Ty had his O2 upped to 4L. He was having some apnea this am, dropping his sat and hear rate at change of shift. His O2 sats stayed good in the 80-90's. His feeds increased today to 18ml every 3hrs and added calories. Today they also took out his umbilical venous catheter (UVC line). They d/c'd his TPN and lipds also. Thought I was going to get to hold him today, but he was too up and down on his O2 saturation today to do so.
8-31-08/Sun: weight: 2lb 3.6oz (1010gms). Doing good. Increased his caffeine today to see if will help him keep his sats up more. His feeds still at 18mls. His O2 is still at 4L. He had 3 apnea episodes last night, needed to be stimulated and go up on oxygenation % to 50 and then work his way back down. We had to stimulate him a few times this am but would come back up. I GOT TO HOLD HIM!!! It was the best feeling in the world to be able to finally hold one of my precious babies. Not being to hold them or even just touch them after they are born was absolutley excruciating. To be deprived of that time to bond was worse than I ever imagined. To be able to kiss him on the head and just get close enough to smell him! (moms know what I mean about smelling your babies) I had lots of happy tears! He did so good too, keeping his sats in the high 90's up to a 100%. I think he liked it too! I got to hold him for about 30 minutes before they hooked up his feeding.
9-1-08/Mon: weight: 2lb. 4oz (1030gms). His feeds stayed the same at 18ml. He also is still at 4L with O2 % at 30%. Doing good, has his usuall ups and downs on his sats but recovers on his own. No apnea spells this evening.
9-2-08/Tues: weight: 2lb. 2oz (1kg). This am he was doing good with no apnea, just desatting some. Feeds still 18ml but added 24 calorie/oz. He was started on iron today. But this evening, Samantha his nurse, said he was being a bad boy and she was going to have to ground him! He had dropped his sats several times and had 2-3 episodes of apnea. He would have to be stimulated and turned his O2 % up until he recovered.

Leah Grace: Our little princess! She's such a doll and very active. Jenna says she looks like she's dancing when she gets going. Leah's our good girl and minds better than her brothers.
8-27-08/Wed: weight: 1lb 15oz. (809gms). On 6ml feeds every 3 hrs. her highest residual was 4cc but after she pooped then it went down to 1cc. She had a good night, had to be turned up to 23%on O2. She's on 3L and sats in the low 90's. She opened her eyes good today and I got to change her diaper.
8-28-08/Thurs: weight: 1lb 14oz (860gms). Feeds up to 9ml every 3 hrs with just a trace of residual left in her stomach. She's occasionally desatting sothey upped her to 4L of O2. Her hematocrit was also low at 27.7, slowly gone down from 33 on the 24th. Samantha her nurse got her IV in with just one stick in her right foot and Leah didn't even cry! So she got blood today, but doing good, sats better after blood. Her head ultrasound also negative for bleeds-PRAISE GOD!!
8-29-08/Fri: weight:2lbs (930gms). Doing better today with less drops in heart rate and desats since she got blood. Feeds up to 12mls every 3 hrs. She had little sqieeky hiccups tonight, so sweet!
8-30-08/Sat:weight: 2lbs (910gms). Today they d/c'd her TPN and lipids. Increased feeds to 14ml. Started some fluids in her IV . Her sats go down some but she recovers on her own. Today she was showing us her cute little grin. Got her a preemie pacifier to try out, not sure exactly what to do with it.
8-31-08/Sun: weight: 2lb 1oz (940gms). Today she gor her PICC line out and they increased her feeds to 16ml every 3 hrs. She's desatting some but still comes back on her own. Doing well this evening, tolerating her feeds.
9-1-08/Mon: weight: 2lb 1oz (930gms). Went to 17ml on her feeds. Her iv in her foot was d/c'd today. Her O2 is still at 4L and oxygenation % 27-25. Doing great and figured out how to suck on her pacifier this evening.
9-2-08/Tues: Leah's feedsstill at 17ml with added calories. Her O2 down to 3L. Having a few desats but nothing new. She started her iron today. Only had one spit ip this am. The nurse said her cord fell off and they kept it for us. She may be little but she's mighty!!!

1st day of school 8-25-08

Monday the 25th was Jenna's first day of first grade! She says her favorite subject is math. Of course she likes recess. Most of her friends are also in her class like Emily, Victoria, and Ryan. She wishes that her other classmates from kindergarten Grace and Hayden were in there too, but aren't.

Quads 8-27-08

Our little princess: Leah Grace 8-27-08 9 days old

Our little hot head: Ricky Shane 8-27-08 9 days old

Our little old man: Heath Allen 8-27-08 9 days old

Our pretty boy: Steven Tyler 8-27-08 9 days old