Test follow up

This post will be difficult to write because a) the medical stuff is over my head and b) it's not the news we wanted to hear. 

On Wednesday, they performed a follow up echo on William for his heart and cranial ultrasound on Ryan. The results came back yesterday and the doctor came by to discuss them with us. 

William's echo still showed a small PDA, but the doctor was not overly concerned at this point. William will have another echo follow up in a month to see how his heart looks then. Hopefully the PDA will be gone! :)

Ryan's ultrasound still showed some bleeding in his brain. We were really hoping and praying that it would have cleared up on its own over the last week. The good news is that it hasn't gotten any worse, but the radiologist is leaning towards calling it PVL (periventricular leukomalacia), which is damage to the brain. It's still a grade 1 bleed, so if there is some brain damage, it could be very minor. It just scares us that Ryan is at an increased risk for developmental delays. The doctor told us that they will do weekly scans on him and follow it closely and involve therapists as needed to help him out developmentally. Please pray for our sweet boy that this will not affect him and that he will grow up to lead a healthy life! 

I got to hold Ryan yesterday and I read two books to him, told him all about his name (which family members it came from) and we prayed together. 

The strange thing is that Ryan is still on his high flow oxygen tube and is really doing well with his breathing. Out of all three, he is breathing the best and you would assume he is the healthiest. I hope his breathing success translates to healthy brain function!

William and Stokes are still doing well. They are working on gaining weight and doing better with their breathing. The respiratory therapists and nurses give them breaks off their CPAPs multiple times per day and they aren't able to stay off the CPAP very long before they start displaying episodes of brady-ing and desat-ing. They need to get better in this area before we can upgrade them to high flow. Other than that, they are sleeping and hanging out! I can't wait to see their faces better once they are off CPAP and onto high flow! 

Thank you to all our friends and family who have been so supportive, encouraging, generous and prayerful with us. We are blessed to have so many wonderful people in our lives and we take comfort in knowing that the boys will have an awesome "village" that will be surrounding them. 

More updates to come. Please continue praying for the triplets! :)

Day 15 in the NICU

Ryan got upgraded to high flow oxygen today, so now he only has a breathing tube instead of the CPAP. He looks great and was doing really well with the high flow all day! We hope that he can stay on high flow and just keep growing! He hasn't gained as much weight as his brothers and is just now slightly over his birth weight. He did have to get some blood today because his hematocrit levels were low so they gave him an IV and started his transfusion this afternoon. This also means he won't get his next feeding until midnight tonight. The nurse told me that the blood will make him feel better and will help to keep him on the high flow! Here are a few pictures of our handsome boy without his CPAP!

William is hanging in there but us also getting a blood transfusion this evening. They think the extra blood will help with his breathing. William is getting the largest feeding amounts of all three boys and is going to catch up with his brothers  soon size wise. Here is his picture from today. 

*side note about blood transfusions...they are a little scary and sound serious but today a nurse was telling me that she was impressed that this is their first one after being here for 2 weeks. Hearing that made me feel better! :) And in case the boys have to get more blood, their dad, Thomas, & their Aunt Ashley have made direct donor blood donations for the boys. They were both matches for Ryan and William. Unfortunately their donations weren't ready for today's transfusions but will be ready in case they need more later. We like to keep it in the family ha!

Stokes is still doing great and has really evened out with his breathing.  This is probable due in part to his transfusion the other day. His respiratory therapist said he may be able to get on high flow again soon! Fingers crossed! 

(This is a modeling pose he wanted you to see!)

Kangaroo with Stokes

Thomas got to hold Stokes for the first time today. They had some good father-son bonding time. Stokes did great and it seemed like he really loved the skin to skin time. 

Look at that sweet little hand all curled up!

Yesterday he got a small blood tranfusion because he was brady-ing  and desat-ing more than usual. That means he wasn't breathing and his heart rate was dropping. He is usually able to correct both himself within a few seconds, but it is worrisome that he was doing it more often. The medical team thought he would feel better and behave better with some extra blood. They gave him about 2 teaspoons (less than a full transfusion) and today he seemed more like himself and was doing better with breathing and heart rate. Lethargic baby = bad, feisty baby = good. He was really letting out some big cries today when he got put back into his isolette after being held by his dad so we knew he was feeling better. It was really sweet!

Today Stokes weighs 2 lb, 7.8 oz. He's our "big" boy and will be up to 3 lb in no time!

Ryan has gained some more weight and now weighs 2 lb, 4.7 oz. He has been behaving today and acting calm and peaceful...just what we like! :) He took a 45 min break off his CPAP and handled it like a champ. 

William is up to 2 lb, 3.1 oz. He took a 20 min break off his CPAP and did a great job, better than expected from his nurse. He was kicking his legs a lot today and showing us his big feet. 

That's all for now. It was a pretty good day for these Peery boys!

Test results

We got to the NICU this afternoon to get the cranial ultrasound test results and were really nervous and anxious to hear. And we got good news! Stokes and William's tests came back normal (no bleeding), however Ryan's test showed a little bleeding on the left side and in the front on both sides. The doctor classified it as a grade 1, (grades go from 1-4 with 4 being the worst) and said they struggled to determine whether to classify it as normal or a grade 1 since the bleeding was very minor. She told us not to even worry about it at this point and although we would have preferred for it to come back totally normal, we feel good about the results. Ryan will get another ultrasound next week to see if it has gotten any better on its own and Stokes and William won't get another ultrasound until it's almost time to go home (barring illnesses or other issues that may cause bleeding). Overall we are feeling blessed. Thank you for all the prayers! 

More good news...the boys are putting on some weight. They dropped below their birth weight during their first week and are starting to put it back on! 

Stokes now weighs 2lb, 5.1 oz

Ryan now weighs 2lb, 1.9 oz

William now weighs 2lb, 1.7 oz

Here are some pics of the boys and their decorations (I made the Clemson signs and my friend Wendy made the monkey signs!)

(Not a great pic of Ryan today, sorry!!)

A few pictures

I just called the nurse at NICU for an update and the boys have not had their cranial ultrasounds yet. The timing will just depend on the ultrasound tech's schedule. Keep the prayers coming! For a general update, the doctors have only rounded on William so far and they said he does not have to be under the light today, which is great, and they are taking away one of his IV bags. This means he can start getting more milk during his feedings! Go William!

Since I have been a little challenged with posting pictures to this point, I decided to post a few now that I think I have figured it out :)

Thomas holding William 

Me holding Ryan 

Good news and important test tomorrow

I am at the NICU right now and have a few quick updates.

Stokes-has been spitting up some and was working really hard on his breathing with the high flow tube. They put him back on his CPAP today and he is feeling a little better without having to work so hard on breathing. This is minor and not a big cause for concern. I feel like he will be back on high flow in no time. You can really tell he is feeling better from his infection because his personality is starting to show more again vs when he had the infection he wasn't acting totally like himself.

Ryan-his echo to check his heart's response to the PDA medicine came back and the hole has closed. Hallelujah!!! There is one more small hole but not enough to warrant more meds. They will do another echo in a few days to see if it has closed on its own.

William-his echo came back and he also has a PDA (hole in duct), but it is very small and also not enough to warrant meds. They will recheck again in a few days. He has had a few Brady's while I have been here today but is mostly correcting them on his own, which is a good thing!

Here's the latest news...all 3 boys will have a cranial ultrasound tomorrow to check their head and to see if there are any blood leaks there. PRAYERS NEEDED that all will come back A-Ok!!! I am really worried about this because the damage from cranial bleeding can be very serious. We will be anxiously awaiting results.

Rachel, a March of Dimes rep, came by today and dropped off some orange and purple knit hats for the boys. She saw the Clemson signs I made for each of them and realized that they are little tiger fans and thought they would like the hats...and they do! Here is Ryan with his new hat.

1 week old!

Our babies are 1 week old today and we are so proud of them! Side note: I started this post yesterday, sunday 9/1, but wasn't able to finish it so they are technically 1 week and 1 day old now! :) I want you to know in advance that this is going to be a long post...we have a lot to catch you up on!  I was hesitant at first to put pictures of them on here because the boys are so small and it is scary to see all the tubes and wires attached to them, but I know a lot of you want to see what they look like and we have strict limitations on NICU visitors, so I changed my mind about posting pics on the blog. Now for the first week summary...let's start with kangaroo care. Kangaroo care is skin to skin contact. Basically the nurse gets them out of their isolette and puts the baby right on your chest so they can hear your heart beat and gets some body warmth from you. As you can imagine, this treatment is very beneficial to baby and parents! Thomas & I have been in heaven when we have gotten the chance to hold them. All three boys did great with kangaroo care! The nurses keep an eye on their stats to make sure they maintain body temp, keep heart rate steady, continue breathing, etc. We have gotten to hold the boys for a whole hour each time and were so glad that they seemed to enjoy it and didn't have negative bodily reactions. Thomas has only gotten to kangaroo with William so far and I have gotten all three.  Here are pics of kangaroo care.

Stokes:

Ryan:

William:

Here are a few notes about their health for the first week of their lives...
All three boys were put on a ventilator as soon as they got to the NICU. On their first night, they all got transitioned to CPAPs, which is a step up. The CPAP helps them to breathe but doesn't breathe for them.  We were so proud to hear that! The CPAP is a tube over their nose and has straps that cover their face and head to keep the tube in place.  Each of the boys has been on and off the phototherapy lights, which treat jaundice and other issues. When they are under the light they wear these black masks over their eyes. Thomas and I love it when their light is off and the CPAP is off so we can see their faces!

Stokes-the nurses all call him our "feisty" one and tell us he is going to be a troublemaker. He acts like a sweet angel when we are around! :) Apparently he has a temper and will let his nurses know when he is mad.
He did great in his CPAP and got to come off it during the entire hour I held him on Tuesday at 3 days old and was breathing entirely on his own. Pretty impressive!
As of today, 9/1/13, he was put on high flow oxygen, which is similar to the CPAP but only has the plastic tube with the inserts that go into his nose, instead of the big tube and straps everywhere. Hopefully he will continue doing well with it so he can stay on it!
On Friday we were notified that his blood work tested positive for bacteria and he immediately got put on antibiotics and got more blood tests started. The doctors were worried there was a chance that he might have meningitis. We heard yesterday that his 24 hour culture came back negative and heard today that his 48 hour culture was negative, too! Praise God! It appears the antibiotics are doing their job.
During his antibiotics he wasn't able to feed with breastmilk and was only on IV fluid (not great for trying to gain weight and get big!), but he is back on milk today. Good stuff.
He definitely has the darkest hair and coloring and his skin looks red! He is starting to lighten up though. Thomas had dark hair as a baby so he definitely didn't get that from me. Haha!

Ryan-this little guy had a lot of trouble with breathing during his first few days. The nurses prepared us and told us that he might have to go back on the ventilator at any time because his little body was just working too hard to try to breathe. But guess what....he is doing better and has yet to go back on the ventilator. He's holding strong on his CPAP. His chest was initially pretty concave and you could really see what a struggle it was for him to breathe, but we can already tell a big difference and are so proud of how far he's come!
The doctors did find an issue when they did his echocardiogram (heart scan). Forgive the lack of technical knowledge, but one of his values or ducts had not developed and sealed together. This is very common with preemies and the doctors were only mildly concerned. They gave him a 3 day dose if meds to help the heart heal and will do another echo soon to retest and see if the meds worked. Only time will tell.
During the three days he was on the heart meds they weren't able to give him breastmilk either so he has spent three days on the IV only. We can't wait to him to get back on breastmilk and start putting on some more weight!
Ryan's general demeanor is fairly laid back. He has these beautiful loooooong fingers and is always doing something funny or cute with his hands, fingers outstretched. It's adorable. His coloring seems to be the lightest of all three but his hair is fairly dark as well.

William-although he was born the smallest, William sure is tough! He was initially struggling a little with his CPAP, but is doing much better now. In fact he got on the high flow oxygen tube for about five hours the other day and did really well.  He couldn't get on full time yet, so they put his CPAP back on, but it's good to know that he is making progress towards the high flow tube.
William has a tendency to forget to keep his heart rate up due to lack of breathing consistently, which is called a "brady". His heart rate will fall out of normal range and his monitors start beeping. Thomas and I were scared to death when this happened for the first time during a visit, but the nurses are very calm about it. They give him a few seconds to self correct it and if he doesn't the reach into his isolette and jostle him a little to give his heart a reminder to pump.
They say sometimes the smaller babies do better in the NICU and the doctor made a comment the other day along the lines of William being a little more stable than his brothers at this point. He has been on breastmilk while his brothers have been on IVs and the nurses bumped his feelings up from 6 hours to 3 hours. As long as he handles that well, they will increase the amount of milk he is getting and then eventually add some extra calories. We told him that he might not be our smallest for very long!
William has a little bit of feistiness in him as well and one of his nurses told us that she fell in love with him while taking care of him the other day. :) He is already a ladies man! His feet are really big, like, almost as big as his calf/lower leg! They are just perfect. He was kicking his legs yesterday and I was just staring, especially when he would show me the bottom of his feet.