Monday, May 25, 2009

Maggie's NICU Spa Day (and a fun day for all)!

Mommy and Maggie right before her shampoo!


Yesterday when we were at the NICU I noticed that Maggie's hair was looking a tad yucky- so I asked her nurse last night if we could give her a bath. When we were told yes, I was thrilled! Today Chris and I headed into Boston earlier than normal so we could give her a bath- unfortunately traffic got in our way, so instead of a bath we gave her a shampoo! It was so much fun. Maggie and Charlie had a very fun nurse today who dubbed Maggie's shampoo as her "spa day in the NICU".... tee hee! Enjoy the pictures!

Maggie sporting the "Salon cape"... gotta keep those clothes dry!

Getting a warm towel massage!

Getting the shampoo rubbed in.. that feels good!

Rinsing her hair!

Yay, now I am nice and clean smelling!

Getting her hair dried (and sporting the ever fashinable "yeti" look).

It is very nice to be clean! Thanks Mommy and nurse Melissa (and my photographer, Daddy)



Today I also got to dress Charlie in a new outfit! While the nurses do an awesome job of picking out cute clothes for them (and I think love that part of their job), it is fun to pick out their outfits myself (such a normal mommy thing to do).


Sporting a very fashionable brown striped onsie!

Due to a "diaper problem", Charlie is now wearing a really cute light green onsie with a cute blue dinosaur.

We still get some of the best expressions from Charlie!



Chris also got to hold Sophie today. It is so nice to see more of her face- she has her new C-PAP nose prongs on. Despite having Daddy's undivided attention, Sophie decided that she wanted more people paying attention to her! She decided to sneeze out her C-PAP nasal prong while being held. Luckily, the nurses were very calm and replaced it quickly!

Daddy and Sophie. Sitting together, looking quite comfy.

Sophie's new purple hat.

A better facial shot than we have gotten in a long time! Sophie seems so much more comfy without her other C-PAP nasal prongs.

Hanging out with Daddy.

Weekend Update One

Maggie and Charlie hanging out together for a few minutes on Sunday!



It's been a crazy and fun weekend! Chris' Aunt Mary flew in to visit for the weekend on Friday. On Saturday Oma, Grumpa, Muti, and Chris' Aunt Mary came in with us to see the babies! It was a lot of fun watching them visiting with the babies. I also got the opportunity to hold Sophie, which is a wonderful experience everytime. Saturday evening we went out to dinner (Whitney was even able to join us which is always fun!!!). It is always a good time... we all gave the poor waitress a tough time!
Muti looking in at Sophie.


Oma looking at Charlie (in Mommy's arms).

On Sunday my mom came in with us... (my dad had been up most of the night so he decided to stay home and recover- he'll be coming in with us during the week). She enjoyed seeing the babies all dressed up! She thought they looked adorable (which they did!). We then went to my parents' house for a yummy dinner!
Mommy getting to hold Maggie and Charlie at the same time, for the first time!

Sunday, May 24, 2009

Honored

Since I know what everyone who comes to look at this site is looking for: A baby update... we'll start with that.

The babies are awesome. Maggie and Charlie are officially considered Feeders and Growers. This means that they are not being looked at as a concern for major problems at this point- don't worry- they are still watched very closely. Now, for them the main focus is on getting some weight onto their skinny little bodies and watching them outgrow some of the typical preemie problems: mainly they need to learn how to take food by mouth (we'll start bottle/breast feeding for some nutrition in a week and a half or so), to stop having apneas and bradycardias (when they forget to breath or their heart rate drops), and when they can consistently maintain their body temperature without any additional help. Right now Maggie is 2lb 14 oz! Charlie is 2lb 10.6oz! The other really big news with them is they graduated to wearing clothes and being swaddled. They look really cute. They currently have some heat still in their isolettes mainly because the nurses are concerned with them using up too much energy keeping their temperatures stable, and right now we want their energy to be used to gain weight and grow!

Maggie in her very first outfit. So cute! A brown with pink polka dots with a sheep. It says: Baby Girl.

Charlie, all swaddled up... our little baby burrito. He loves to sleep when he is being held.



Sophie is also doing quite well. She has had her c-pap machine changed: instead of the large 2-prong c-pap that goes around her head she is now using the one prong c-pap that goes into one nostril. This is because the pressure of the other c-pap was irritating her nose. This was the same thing that happened with Maggie a few weeks ago. Luckily by changing the type of c-pap and using some ointment on Sophie's nose, it should be "all better" really soon. Sophie is also getting a series of Vitamin A shots- there was a study which showed that a series of 12 vitamin A shots helps reduce the long term effects of using mechanical breathing assistance. Sophie has been a lot more alert during care times and has been keeping her eyes open for longer periods. This is wonderful to see. She is such a strong little girl. The doctors tried one more time to do a lumbar puncture on Sophie the other day, however they were unable to use the fluid they got as it was tainted with blood. Due to this, the team has decided to continue Sophie's antibiotics for several more days- just to be on the safe side. Every time I look at Sophie I feel amazed that she is doing so well and so proud to be her mommy! Chris and I get the privilege of holding her every other day (because of her size). Since we take turns, this means I only get to hold my peanut every 4 days... but it is worth it to see Chris holding and loving on her!

Mommy cuddling with the little peanut: Sophie. How cute and tiny she is!


Now, to the reason I titled this post: Honored. I truly feel honored to be these little babies' mommy. I feel blessed beyond belief. But, I am also honored to be Chris' wife. It is amazing to watch him through this entire experience. First, when I was on bed rest he took care of me, the house, the laundry, and at times the grocery shopping. And let me tell you, staying home on the couch everyday often left me very cranky- and Chris was usually able to cheer me up and help my mood! Then when we got admitted to the hospital and I was scared and worried, he helped keep me calm and as relaxed as he could. In the operating room he was the biggest help... he talked to me and told me what was going on... and he took pictures of the babies so I could look at them while in recovery. In the hospital- he took great care of me, making sure I got pain medication when I needed them, that the nurses took care of me when needed, and that I took care of me. Then my incision opened, and he has been taking care of it every day... go surgeon daddy! But the most wonderful thing to me is to watch him taking care of our children... taking their temperatures, changing their diapers, calming them down, and holding them. I am honored to have him as my husband and the father of my children. I love you Chris!

Chris holding our little baby burrito: Charlie. He was wearing a cute little blue onsie underneath.

Saturday, May 16, 2009

Holding Maggie for the First Time (or when I finally started feeling like a mom)

Unlike most moms I had to wait 5 days before I got to hold any of my babies. But 5 days after they were born on May 12th I got to hold my "biggest" daughter, Maggie! It was such an amazing feeling.
As you can see, when the nurse put her in my arms, I started to cry. She is so tiny, but so perfect.


I knew I was only going to get to hold her for a few minutes. The nurses were not sure how well she would do holding her temperatures up and she still had her umbilical lines in so we had to swaddle her as to make sure we were not taking any chances on pulling her lines out!


I had to call my parents and tell them I was holding Maggie. I started to cry again!!

On Friday all three babies had their umbilical lines removed (Maggie and Sophie now have a Picc line) (A peripherally inserted central catheter (PICC or PIC line) is a form of intravenous access that can be used for a prolonged period of time (e.g. for long chemotherapy regimens, extended antibiotic therapy, or total parenteral nutrition).) Maggie and Sophie require their Picc line for total parenteral nutrition (TPN- a solution including all the salts, glucose, amino acids, lipids and added vitamins needed for nutrition ) which they will require until their stomachs are able to tolerate enough breast milk during a feed to provide them adequate calories. Charlie is already getting enough breast milk during feeds (with additional calories added) so he does not need TPN any longer!

As all 3 babies no longer have lines in their umbilical cords they can all be held. Chris and I are now doing what is called Kangaroo Care, where the baby is placed against our chest, skin to skin, with a blanket draped over them to keep them warm. This provides the babies with our body heat so their temperatures stay stable as well as providing a bonding and calming experience for both the babies and Chris and I! Right now we can do Kangaroo care every other day with Sophie. We are not sure if we will be able to do daily or every other day Kangaroo care with Charlie and Maggie.

But as of now I have held Charlie once, Maggie three times, and Sophie once.
Chris has held Charlie twice, and Maggie once. He will get to hold Sophie for the first time tomorrow!

Friday, May 15, 2009

Editor's Revisions

For those that read my previous entry, I realized after I posted that I left out a few key pieces of information that I had planned to include. So, here are the editor's notes:

Being born on May 7, the Triplets were at a gestational age of 30 weeks and 2 days. The average gestational age for delivering triplets is 32 weeks. "Full term" is 40 weeks, which means our 3 are approximately 10 weeks premature. We are all very impressed that Erin managed to carry these 3 as long as she did.

It is hard to judge exactly how long the NICU stays will last. For most babies, doctors predict they will stay until around their original due date. This is only an estimate as the circumstances of each individual child determine when they are able to go home. In our case, our "official" due date was July 14 (which also happens to be our wedding anniversary). Current thinking is that Maggie and Charlie may be ready to come home around this time. Because of Sophie's much smaller size, she has further to go. Best estimates right now are that she may be ready around 2 weeks after the July 14 date. So while we are officially parents, we have quite a wait before the kids are ready to come home. As difficult as this is to experience, and for others to understand, we have to remember that this is what they need right now. We'll keep driving in to see them and look forward to when they're ready to be home.

I think that's all the revisions I meant to include. I'm sure I'll come up with more as time goes on. Once again, thanks for all the support out there. We really do appreciate it.

-Papa Chris

Thursday, May 14, 2009

1 Week Old!

Wow, what a week it has been. This is a "Dad Entry". Since today marks the Triplets' 1 Week Birthday, I'm going to try to do some recap on the events of the week so we all feel caught up and you hear it from Dad's perspective (which is admittedly a bit rare in this blog).

On Wednesday 5/6 we went in for our weekly doctor's appointment. This appointment was different however, in that we were basically getting a 2nd level 2 ultrasound to check on things especially baby C (Sophie). Turns out things were looking less than good and the decision was made to admit Erin and do delivery in about 48 hours, pending a follow-up ultrasound the next day...

On Thursday 5/7 we anxiously awaited the follow-up and tried to deal with becoming parents earlier than planned and on short notice. At the follow-up things had gotten worse since the day before and so delivery was moved up. It was now around 3:30p.m. and the C-section was scheduled for 8:00! At this point, families started showing up. Both sets of soon-to-be grandparents came in not sure how to handle the imminent delivery of their grandchildren. There was excitement, to be sure, but also apprehension at how things might turn out.

By 8:00 we were prepping for surgery. Erin was carted off and I was made to wait and change into some extremely fashionable blue surgical attire. After some pacing and thumb-twiddling I was brought into the operating room. Skipping some gory details (pun intended) at 8:58 Maggie was born followed in the same minute by her brother Charlie. At 9:00 Sophie emerged. All 3 children were brought to neonatal teams in the OR while surgery was completed on Erin. Because Sophie was the most worrisome case they quickly brought her over to meet Erin and was then whisked away to the NICU followed shortly by her siblings.

Around 10:30 Erin was still recovering and I got to go to the NICU to meet the Triplets for the first time. A little later we brought Erin in on her gurney. After that, Erin was brought back down to the room and I brought each set of grandparents through. By the time all was said and done it was somewhere around 1:00 in the morning.

The morning of Friday 5/8 we were still reeling. We got up to the NICU about 12 hours after the kids were born to visit them. Later in the day, the Grandparents and some more family members came by, including Maggie, Charlie, and Sophie's Great-Grandmother! We were quickly learning how the NICU works and spending lots of time with medical personnel giving us tons of information to absorb. By now we had learned a few things:

Maggie and Charlie were doing well, but there was more concern over Sophie. Maggie was born weighing 2lbs9ozs, Charlie at 2lbs7ozs, and Sophie at 1lb4ozs. Maggie and Charlie were put on a breathing device called CPAP. This helps the lungs stay open while exhaling, but keeps the child breathing somewhat independantly. O2 is added to the air supply as needed. Sophie was intubated and on a ventilator. This is basically the machine breathing for you. Intubation also paralyzes the vocal chords, so while we heard Maggie and Charlie in the OR and since, we had yet to hear Sophie's voice at all. We had never heard her cry. This is in part because Sophie was born without a heartbeat... There I said it. Her initial Apgar was a 0. Maggie and Charlie had identical Apgar scores of 7 at birth and 8 after 5 minutes. At 5 minutes Sophie had moved up to a 2. With low Apgar scores at 5 minutes they do another test at 10 minutes. By this time she moved up to a 6.

So Maggie and Charlie were looking good, while Sophie was struggling. By end of the day Friday she was continuing to progress. We were anxious, but remaining optimistic.

Saturday 5/9 brought more visitors. Everytime we went up to the NICU we seemed to get more good news. Maggie and Charlie continued to do well and Sophie was working hard to catch up. She proves herself a fighter and just keeps taking tiny steps in the right direction. We're so proud of all 3 kids.

Sunday 5/10 - Erin's first Mother's Day. A crazy day of celebration and being overwhelmed. Families came back, but were nice enough to spread the times out a bit. Each visit to the NICU kept getting better. We were getting to know some of the staff now and enjoyed spending time with the 3 little ones. Erin received some very thoughtful Mother's Day gifts and cards. She even got some of the sweetest cards from the Triplets (as made by the NICU staff)! It was all very nice. At this time we also unveiled some gifts Erin found for our families. Grandparents all got "Proud Grandparent of Triplets" attire. There was even a shirt for Great-Grandma! It was very nice, but very busy. We were happy for a little more downtime on...

Monday 5/11 - Like I said, more downtime. We got to spend more time on our own with the Triplets. My parents did come by later in the day, but the activity was nowhere near overwhelming. Talk started of trying Maggie and Charlie off their CPAPs. Just waiting to see how they did, but all 3 kids were continuing to make strides in the right direction! We were also told that we might get to hold Maggie and Charlie the next day! (if only it were that simple!)

Tuesday 5/12 - The day we got discharged. Erin's recovery was going very smoothly and her time as an offical patient ended. We had been told about an extra room that would allow us to stay one extra night, so we signed up and after being discharged moved our stuff over. During this time, another new visitor came by and we took her up to be introduced. Everything was going smoothly and plans were still to try holding Maggie and Charlie for the 1st time starting at 4:00. Then it happened. We were down in our new little room just thinking about heading back upstairs when Erin's incision started to bleed. While this would have been a bummer anyway, we had already been discharged and she was no longer a patient... After a LPN came by out of the goodness of her heart we were advised to call the OBs office. By now it's 4:00 and everyone is closing and we're supposed to be up in the NICU. We end up having to go through GYN triage where they take their sweet time dealing with Erin's incision. Erin's parents showed up just as this was all starting and were sitting down in our room just waiting. My parents had decided to come in for the evening and showed up a little before we finally left triage. Didn't get readmitted, but had some more things to deal with.

We go meet our parents. Erin's parents had been there so long Erin took them in to NICU and I waited with mine (only 2 guests in NICU allowed at a time). Erin's parents decide to leave and I bring mine in. Finally, they say that Erin can hold Maggie. All that waiting and frustration, but it finally happened. We had to hold off on Charlie because his temps were on the low side, so he had to stay in the isolette where it was warmer.

Wednesday 5/13 - The day we get kicked out of the hospital. Not a day we were really looking forward to. Leaving 3 kids in Boston while you go home an hour away is a bit weird, and not very pleasant. A lot of good things happened though: Maggie and Charlie were taken off CPAP. They are now breathing all on their own. Charlie took right to it (he hated having the CPAP on anyway). Maggie had a little more trouble, but has been able to stay off and is doing great. Hooray for no more breathing equipment! Just as important, Sophie went to CPAP being taken off her ventilator. She is now doing more independant breathing. She needs the extra help from CPAP, but it's one more move in the right direction! Charlie's temps were back up, so I actually got to hold him! Pretty surreal, actually. I almost forgot how small they are, but when I got into "baby holding position" I had to bring my arm in closer to adjust. I'm not particularly small, so holding him makes him look tiny. Hard to imagine what it will be like when it's Sophie's turn. Eventually we had to leave and come home. It wasn't easy leaving them, but it was good to get back to our own space. It's also nice that the NICU takes calls 24hrs a day, so you can always get an update.

Thursday 5/14 - The Triplets turn 1 week old! Our first day of driving in to visit went very well. I think we'll manage to find a routine fairly quickly. All 3 kids are doing exactly what they need to do. Erin got to hold Maggie again today. She and Charlie are still doing great without the CPAP. while Sophie's doing great with it. There's no doubt it will be a long road ahead, but we're on the right path and will get there eventually.

Extra credit to those who actually managed to read this entire entry. You're now pretty well caught up on the Triplets' first week of life. Thank you for all the support you've offered and so generously given. I hope we can continue to fill this blog with good news, and also that most entries won't be nearly as long winded as this one.

-Chris
aka "Dad" --How cool is that?!?!

Friday, May 8, 2009

First Pictures of the Triplets!

Well, I have heard a call out for pictures loud and clear. Here you go! Just as a warning- these pictures are all from the NICU. The babies do have wires attached to them along with breathing equipment. If you are concerned: the babies are not in any pain and everything attached to them is a good thing and vital at this point. They are adorable and precious little (very little) ones!

Enjoy the pictures!


Maggie right after being settled into the NICU. At this point she is less than 1 1/2 hours old!



Charlie right after being settled into the NICU. He is less than 1 1/2 hours old!

And here is Maggie relaxing on her Sheep-skin bed at 12 hours old!

Charlie chilling out on his sheep-skin bed at 12 hours old!

Sophie looking quite comfy on her sheep-skin bed at 12 hours old!


Mommy changing Sophie's diaper for the first time! The diapers are so, so tiny!

Mommy also got to take Sophie's temperature! What a cute little girl!

The Himmel Triplets have arrived!

The Himmel Triplets have arrived. After meeting with the radiologist on Thursday afternoon we discovered that Sophia's umbilical cord blood flow was showing some reversal. Due to this, we decided to push up the delivery. We got back to our room and started to make some phone calls to gather our families all together. Around 6:30 pm, Erin was taken to Labor and Delivery (and chris went with her) for them to start her IV and get all the needed paperwork taken care of! At 8pm, Erin was taken to the OR to start her Spinal anesthesia. It took several tries to get it right... that was the tough part! Once the Spinal was settled the OR staff settled Erin and got her all ready. Chris was brought in (in his cute little blue OR suit) and got to sit next to Erin as they started the surgery. The surgery itself wasn't bad. I couldn't even feel the first cut or anything. It was odd at times when the doctor would start to push and pull... but no pain was felt!

Magdalena Ruby was born at 8:58pm and weighed in at 2lbs 9 oz.
Charles Thomas was born at 8:58pm and weighed in at 2 lbs 7 oz.
Sophia Sada was born at 9:00pm and weighed in at 1 lb 4 oz.

Maggie's appgar scores were a 7 at birth and an 8 at 5 minutes. We could hear her cry in the OR! Charles apgar scores were the same... and we also heard him cry! Sophia's apgar scores were not quite as good: she had a 0 at birth, a 2 at 5 minutes and a 6 at 10 minutes.

Once we got upstairs to the NICU to see the babies, Maggie and Charlie were on C-Pap with room air. They had lines in them for TPN (IV nutrition). Most of their lines are in their umbilical cords. Sophia was started on a regular ventaltor. As the evening went on she got tired and was changed to an Oscalating Ventalator. The great this is that as of this morning she was back on the regular ventaltor! Sophia also received platelets as her blood counts were a bit off.

Last night Grammy and Grandpa Hutch got to meet the babies and love them. Oma and Grumpa Himmel also got to meet the babies and touch each one. They were very patient waiting in the hospital room while everything took place downstairs!

This morning Chris and I went upstairs to check on the babies. Maggie and Charlie look great! They are both fairly happy. We even saw they enjoy sucking on pacifiers! The hope is to start them on Breast milk tomorrow! We were warned that both would likely be under bilirubin lights by this evening for Jaundice- which is very normal for their size! Sophia also looked quite good this morning. She is still tiny, but was very active kicking her legs and opening her eyes! She had a brain ultrasound done this morning and we were informed by her nurse that the ultrasound came back as normal! They have started her on antibiotics as a precaution while they continue to make sure that she is just a little thing and that there isn't anything else going on wrong with her! She was started under the bilirubin lights as well. There is talk of starting her on food fairly quickly! It's amazing. She is still very fragile, but things definitally look better for her today. Please keep up your prayers and good thoughts- they are certainly working!

I am doing okay today. Some mild pain around the c-section incision. Luckily the pain meds I have been given have made a huge difference! I have already walked a small amount to the bathroom and have stood up in the NICU when visiting the babies. I am trying to take it easy and not over do things. I am a bit tired... may try for a nap later on! I currently still have a catheter in as well as an IV... however it appears both will be removed around 9pm tonight. I am supposed to try to take a walk outside on the floor later today as well! I started pumping today and so far have done fairly well... I actually got a little bit out!

Today, my sister Tonya and my brother-in-law Andy stopped in to meet the babies! Later on, great-grandmother Muti, Chris' sister Whitney and Mere, as well Oma and Grumpa are coming by to meet (re-meet) the babies. Grammy and Grandpa are also stopping in shortly.

Things are looking good. Keep the babies in mind and keep all prayers and good thoughts coming! It has been a good day so far! We'll update with any changes.

Thursday, May 7, 2009

Week 30... the excitement begins.

Hi. Well I am writing this entry bright and early Thursday morning from my hospital bed at Beth Israel. To put it mildly, yesterday did not go the way Chris and I had hoped it would. We had our appointment at radiology and then with our doctor. When we met with the doctor he let us know that Sophia has not really grown (at least by what they can measure at this point) in the last 2 weeks. At this point she also has little to no discernible fluid around her. Maggie and Charlie are doing well. They keep growing and have good fluid levels. Because of this, I got my first of 2 steroid shots (and I checked... I will not be able to go hit a really good home run for the Red Sox nor will the babies after these) yesterday. The steroid shots should help the babies' lungs mature a bit as well as some vasular system and gut growth. This is important. Today we will meet with the NICU (neonatal Intensive Care Unit) staff as well as have some further testing done to make sure that the cord blood on Sophie does not reverse. As long as she remains stable from yesterday it sounds like the Himmel triplets will arrive Friday late afternoon/evening. I will update more after our consults today when I know more. At this point we know that Charlie and Maggie are doing well and should do alright in the NICU and we know that Sophie needs to be born and to go to the NICU in order to get the nutrients and oxygen to grow and thrive so this is the right thing to do. Just a bit scary to me.

Our current contact info:
Room: 638, Stoneman
Beth Israel, Boston

Room phone: 617-667-6272. You can also reach us on our cell phones at this point.

Chris is with me. I am so blessed to have him here. He really knows how to keep me calm and collected.

Love,
Erin