Super Twins – Page 7 – Bump 2 Bab[y]ies

Homecoming

Published on September 7, 2013 by onesource4wellness3 Comments

The V-7 were reunited this past week. On Sunday, Theo and I landed in Madison after an uneventful flight. Theo was a champ and slept most of the way.

Theo is happy to be home sporting his new do!

It was quite emotional to walk into the Madison NICU and realize that we were all here, and here to stay. I just stood for a brief moment at the entry way and could see all of the entrances to their rooms and my husband standing right in the middle. My mind took me home to when some day soon I would be able to stand in the hallway and peer into their nursery and do this exact same thing. Needless to say, many happy tears followed.

WhatsAStuffedDisneyAnimalGottaDoToGetSomeGrubAroundHere — Our 6-seater table from the wonderful Tille family featuring new stuffed animals from Grandpa T

The following day, our family joined us for the reunion on Labor Day. We also were welcomed by NBC, ABC and Fox/CBS who helped to capture this exciting event for our family, but also for the city of Madison as we are the first quints to reside here. Our interviews with NBC and ABC are featured below:

NBC-15
ABC

The remainder of the week has truly flown by. The V-5 celebrated 1 month on Tuesday and in the NICU this celebration includes a battery of tests. All of our kiddos had repeat head ultrasounds and eye examinations to assess their eyes’ maturity, and to rule out retinopathy of prematurity (ROP). Also, Bella had an echocardiogram to investigate her persistent murmur. All of the quints have murmurs, but we now know that Bella does not have a PDA, Patent Ductus Arteriosis. Theo also had an examination of his intestines to see if they could begin refeeding and wake up his large intestine, just like his little sister, Ellie.

All of the tests brought reassuring news, except for one. Our little Lily Bug had minor PVL, which is Periventricular Leukomalacia. The good news is that her grade 2 brain bleed is resolving and healing, but this new finding of PVL was disheartening. PVL is an injury in the brain that affects the white-matter neurons. Infants with PVL most often display deficits related to motor control (movement), developmental delay and are at a greater risk of cerebral palsy and epilepsy later in life. Only time will tell if our little Lillian will face further challenges.

All of our little miracles are now a corrected gestational age of 34 weeks, which means we get to truly start focusing on feeding and growing. Enter this excited Mama who cannot wait to begin truly breastfeeding. No offense to my trusty pump, but nothing beats nuzzling with your babies. The next few weeks will help us to further assess Lily’s potential for feeding and motor issues, as well as, reveal our kiddos’ abilities to suck, swallow and breathe- a touch task for preemies.

It has been quite a busy week, but overall the Vanderwall family is over-joyed to be reunited. We are forever indebted and grateful for the all of the new and donated items that awaited ua at our home. I have had so much fun going through all of the items, organizing and partaking in some long-overdue nesting. So, thank you once again from the bottom of our hearts for all of the love, support, financial contributions and gifts that we have received. I can confidently say that the quints now have everything they need for when they arrive home. The only remaining item is a way to get them home. Next up on the to-do list…the V-7 mobile, or perhaps we’ll give new meaning to a VW bus!

Bon Voyage!

Published on August 29, 2013 by onesource4wellness5 Comments

This has been the week of travel for the Vanderwall quints. Isabella and Elliott celebrated their 3 week birthday by departing for a Madison NICU. Early Saturday morning, August 24, we packed up Bella and Ellie into a single isolette and began our transition. I joined the sisters, a nurse and a respiratory therapist for the trek on the medical transport prop plane.

It was an emotional 24 hours to say the least and got a good taste of what it may be like to go back to work and leave my little ones at home. I truly felt heartbroken to leave Lily, Kali and Theo for that day and a half. Tears flowed until we boarded the plane. I am happy to say that my heart perked right up when we landed near green grass and fresh water lakes. It also was such a blessing to see how excited Frank was to welcome our daughters home.

The girlies handled the flight and transition really well. Halfway through the flight Bella wet the bed through her diaper, living up to her latest nickname of “Bella Blowout,” and Ellie was not happy about it. For the remainder of the flight, Ellie proceeded to kick her sister to the side of the isolette. By the time we reached Wisconsin, Bella’s face was nearly plastered to the side of the chamber. Firsthand witness to sisterly love! Now settled into their new NICU home, they continue to advance in their feedings and are getting to be better breathers!

After a quick night in my own bed, I boarded a plane on Sunday morning to return to the remaining quints in Arizona. My Mama mission was and is to continue to urge the medical team towards quick, yet safe, transfers home.

Lily and Kali’s turn was early this morning. They have been ready to head home since yesterday morning but there wasn’t any room in the inn… or the new NICU.

Lily on her tummy ready to go see Daddy.

So, we packaged these little ladies up this morning and watched as the ambulance drove away.

Again, tears flowed. Although it truly is a bittersweet event and more of a “see you later” than a goodbye, I learned that a parent’s unconditional love does not make sense. There simply is no logic in my love for our children.

Lily and Kali also arrived safe and sound in Madison. They are now enjoying their new homes in a room right next door to their sisters. The nurses reported to me that the plane ride was uneventful, which is exactly what I was hoping for.

Now, all but one are only 20 minutes from their final destination- our home. Theo and I will remain in Arizona until he is also ready to get his wings. He is doing very well and has achieved 4lbs!

He and I have already logged quite a few hours of Kangaroo care, which I believe has definitely helped his breathing to get stronger. It is amazing to watch how his vitals normalize as we snuggle together. It also helps me to continue to provide “liquid gold” for all of these hungry babies… as evidenced by the overflowing freezer dedicated to the V-5’s breakfast, lunch and dinner!

So, that is the latest and greatest regarding the V-5. Prayers remain that all five and mommy and daddy will be reunited soon! Please join me in praying that we will all be back in Madison by Saturday to celebrate their 1 month birthday!

Lillian Grace

Published on August 20, 2013 by onesource4wellness1 Comment

Lillian Grace is one tough cookie. She has certainly had one of the more rough transitions to life outside of Mommy. This little love bug has faced breathing issues, a puncture in her lung, a brain bleed and an infection scare. But, she has conquered all of them! She is now leading the pack of ladies in growth and is one of the stronger breathers. You will notice below that she has fewer photos than the rest of the V-5. We did not want to bother her while she was healing, so we have some catching up to do now that she is well.

Little Lily has Daddy’s light hair, but Mommy’s nose. She is definitely a cutie like the rest! Our little Lily Bug is a great self-soother. Once you put on her little Lady Bug hat she is as happy as can be. She also cannot stand dirty diapers and she will let you know it. The minute she wets her drawers, she’s wailing. However, once you clean her up, she’s good to go.

If you click on an image, it will give you a full-screen slideshow of all the pictures.

Our little Lily Bug who closely resembles a Toadstool

Lily is quietly performing her own extubation_bye bye tube

We are so proud of Lillian and very thankful that God has granted her grace and has helped her to heal from her ailments. Please pray that His hand remains over Lillian and the rest of our Quints, so that they will continue to grow stronger and be able to return home together.

Who Loves Cute Pictures of Little Quintuplet Babies?!

Published on August 16, 2013 by onesource4wellness4 Comments

Over the next week, we will be starting a “Meet the Quints” series on our blog! Each post will feature one of our little cuties with lots of pictures and commentary. As we referenced in our previous somber-toned post The Quint’s First Two Weeks there have been many moments of pure joy in addition to the bumps in the road we’ve experienced thus far. These upcoming posts are our chance to share those joyful moments with you!

One last thing to prep you for the next five posts. The V5 are collectively in the best health they have been since birth. Still, they are hooked up to all kinds of Medical Miracle Machines (technical term) that are helping them to develop and grow into normal healthy babies. To help quell any concerns about their condition when we post wire-laden photos, below is a brief visual introduction into the anatomy of a typical NICU infant. Mr. Theodore Joseph has been selected to help enlighten you on the purpose of the lines and tubes you’ll see in the upcoming week’s pictures:

Anatomy of a NICU Baby, featuring Theodore Joseph

A: Free Baby Oxygen Bar/Spa Treatment – AKA: Nasal Cannula used to provide a variety of respiratory therapies

B: Hands-Free Food and Beverage Dispenser – AKA: Oral-Gastric (OG) tube used to provide breast milk and to check their bellies for residuals from prior feedings. It also can help to remove excess air from their tummies.

C: Personal Fitness Monitors (e.g. Nike+) – AKA: All of these wires are leads which are connected to a monitor which help to assess heart and respiratory rates.

D: Remote Thermostat Adjuster – AKA: The wire tucked under the heart sticker is a temperature probe which helps to identify the baby’s temperature and keep it in an ideal range.

E: Belly-Button Jewelry Clip – AKA: this is a clamp placed on the umbilical cords and is later removed.

F: Oxygen Bar/Spa Treatment Membership Card – AKA: This is a pulse oximeter which is used to assess and monitor the baby’s oxygen saturation.

The Quint’s First 2 Weeks

Published on August 15, 2013August 16, 2013 by onesource4wellness5 Comments

The quint’s first 2 weeks outside of Mama have been quite active. Frank and I have truly gotten a crash course in what it is like to be NICU (neonatal intensive care unit) parents. The highs are very high, the lows are very low, and often times they occur within minutes of eachother. We have been blessed with the time away from work to spend 8-12 hours everyday buzzing around the NICU watching nurses, taking part in our little ones’ care and meeting with the multidisciplinary team. Our most recent post announced the arrival of the V5 and told the story of our 24 hour honeymoon with five seemingly happy and healthy babies. After day 2 however, the honeymoon was over.

Here is a summary of some of the medical trials and tribulations our quints have experienced in their first weeks:

Spontaneous Intestinal Perforation (SIP): Two of our little ones had bowel perforations within the first 3 days. Both required emergent surgery, which they handled well. One of the SIP’s may have been caused by NEC, which they found in surgery. The other occurred higher in the small intestine, and the informed us that this may result in a feeding intolerance later on.

Necrotizing Enterocolitis (NEC): NEC is one of the most common GI diseases in newborns and preemies. It is when the bowel does not get adequate blood flow (Ischemia) and begins to die (Necrotize). Early and aggressive treatment is imperative because it can result in dire consequences – NEC is the second leading cause of death in premature infants. The good news for our quints, is that they did identify it early and were able to remove the affected portion completely.

Gastritis versus Bleeding ulcer: Inflammation of the stomach wall and ulcers can be common as the immature digestive track is learning how to work. One of our little girls experienced this and as a result we found blood in her gastric residual. This appears to be resolving with the help of Zantac.

Spontaneous Lung Perforation: One of our quints got a hole in their lung, which required emergent chest tube placement. Luckily, this incident resolved quickly.

Complication of PICC: PICC lines, or Peripherally Inserted Central Catheters, generally have limited complications. So, yet another rare event for one of our girls where her PICC moved from her heart to near her shoulder. This resulted in infiltration into her subcutaneous tissues and ultimately her lung. She became very swollen as her upper body filled with fluid. But, this tough cookie fought it hard and it appears to have resolved rather quickly.

Grade 2 Intraventricular Hemorrhage (IVH): Infants born before 30 weeks are at the highest risk for brain bleeds. Grades 1 and 2 have similar outcomes and typically resolve within a month. They do cause an increased risk of developmental delay but not much more than from being a high order multiple. We continue to pray for the health of our little one diagnosed with a Grade 2 IVH.

Apnea and Bradycardia: Apnea is a pause in regular breathing lasting more than 20 seconds and bradycardia is a drop in the heart rate. All of our quints have experienced this at some point. “A’s and B’s” are typically caused by an immature nervous system. The good news is that all of our children are learning to pull themselves out of these events without stimulation (aka rubbing their backs).

Respiration machines: All of our little ones had to be intubated after day 2, which was expected. Unfortunately, one of their endotracheal (ET) tubes moved too low and collapsed their little lung. This has since resolved. All of them are continuing to advance through the variety of machines, but I thought it was noteworthy to introduce inquiring minds of the different types.
- Intubation with an endotracheal tube (ET tube) with a ventilator
- Intubation with an ET tube and continuous oscillation
- RAM cannula with NIPPV (Nasal Intermittent Positive Pressure Ventilation)
- Nasal Cannula on CPAP, Continuous Positive Airway Pressure
- Nasal Cannula with higher concentration of oxygen than room air.

Needless to say, the first two weeks have been quite eventful. Although the events listed vary greatly in severity, it is difficult to watch our little ones experience any hardship. At the same time, it is certainly empowering to watch our children fight hard for life. Their resiliency is awe-inspiring! Today, we can say our little ones are collectively in the best health they have been since birth. You will get to see and hear more about their progress and personalities in our posts over the next week or so.

Oh, and one more update for everyone. We learned that our insurance company has agreed to cover the quints birth and NICU stay for each of our children. They have also agreed to cover medical transport of our children back to a NICU in Madison once they are stable enough to bring back to Wisconsin. What an answer to prayer! We now are hoping that everyone will be healthy, and ready to be transported at the same time.

Thank you for praying along with us through both the euphoric highs and near-death lows on this wonderful roller-coaster of a journey,

Zero to Quints

Published on August 9, 2013August 10, 2013 by onesource4wellness3 Comments

I believe further explanation of how we went from “status quo” to “the babies will be delivered within the next 45 minutes” is warranted. I was settling in for a day’s work on the morning of July 31^st, when I felt like I wet my pants. Now to be honest, I just assumed little Theo was going to be controlling my bladder for the day. But, upon further investigation, I realized he had popped his little sac and I had “broken my water.” I called my doctor’s office, but since they were closed it directed my call to the physician on-call, which just so happened to be Dr. Elliott’s “bat phone.” I felt awful for bothering him on vacation, but he didn’t mind one bit. He encouraged me to pack a bag and head to Ob triage (the moms’ ER).

We arrived at the hospital and were quickly shuffled in for an assessment. They tested the fluid and confirmed that indeed it was amniotic fluid. Then, they discontinued my nifedipine (calcium-channel blocker), gave me a steroid shot (Betamethasone) to enhance fetal lung development, and started me on 3g of Magnesium sulfate. I was then whisked away to ultrasound to confirm the culprit. It was indeed little Theo (baby A) whose deepest vertical pocket went from around 5cm to about 1.6 cm, which indicated that he only had about 1.6 cm of fluid surrounding his little body in his sac. His head was now so low in my pelvis he appeared as though his little body stopped at his neck.

The nurses assured me that once my contractions stopped, it was entirely possible I could remain pregnant for several weeks. This amazed me but they said it happens all of the time. Unfortunately, this scenario is only true if 1) your contractions do stop, 2) you tolerate the medicinal anti-contraction regimen and 3) you do not develop an infection. My contractions did stop, thanks to the “mag.” But, it was clear after 24h on the magnesium sulfate that I was not tolerating it, and my lungs began to fill with fluid.

Magnesium sulfate is used for contraction management. It is thought to affect calcium channels to slow uterine contractions. Typical side-effects include water retention, muscle weakness, sweating/flushing, nausea, vomiting, constipation, and blurry vision. For most, these symptoms are tolerable and some mom’s of multiples can again remain on magnesium sulfate for several weeks, in order to prolong their gestation. Unfortunately, I hit the jackpot and experienced all of the symptoms noted above.

My body was only able to combat these side effects for about 3 days. I was placed on b-pap to increase my oxygen saturation and Lasix to try and rid my body and lungs of the extra fluid. On the morning of August 3, I was moved back to labor and delivery due to my pending diagnosis of pneumonia. When I spiked a fever and my white blood cell count shot up, we knew today was the day. It was then that we got the news that we would get to meet the quints within the next few hours.

They informed us that Dr. Elliott was speeding to the hospital, on his way back from vacation, and we were going to try and wait for him to arrive around 4pm. But, when he heard that I had a fever, he gave the go ahead to deliver in his absence.

Thus, they unraveled the most well-orchestrated delivery I have every heard of. With over 20 people in the delivery room (6 teams: one for me and one for each baby), they delivered the quints in about 3 minutes. The entire “operation” took about 45 minutes. I vaguely remember these moments, but Frank was right by my side to catalog it all.

Following delivery, Frank headed to the quints’ recovery room. By the time I arrived, all were gone and up to the NICU. My mom awaited me in the recovery room, and was over-joyed to see me safe and sound. I, unfortunately, could not see our little angels until my fever subsided and my breathing had stabilized.

Dr. Elliott arrived and it was clear he was upset that he could not deliver our babies, but we truly respected his decision. He shared with Frank that sometimes as a physician you have to make a decision with your head and not your heart. If we had waited even a moment longer my infection may have complicated the babies course.

Those 48 hours preceding the birth of our babies, were some of the worst of my life. But, I know that without that treatment regimen, our 5 little miracles would not have passed the “steroid efficacy window” and may have been at an even greater risk for serious complications.

Our heartfelt thanks goes out to Dr. Elliott and the teams at Banner Desert for their superb, patient-centered care, compassion and wisdom. For I know that if we were anywhere else, the circumstances and outcome may have been very different.

We have much more to share with everyone and are working on getting some fantastic pics of the quints, so look forward to some more baby updates in the near future!

Lucky Number 7

Published on July 28, 2013July 27, 2013 by onesource4wellness5 Comments

Friday we surpassed yet another milestone! The babies have been cooking for 7 months, which means we are now above the average gestational age for quintuplets. All of the babies were measured on Friday and they are all measuring within a day or two of the recommended size for babies at this point in pregnancy.

The picture below is a cool diagram that my sonographer drafted for us, which depicts where each of the babies are located in my belly, along with their current weights and percentiles.

The weight of each baby is estimated based on the length of the baby’s humerus (bone in upper arm) and femur (bone in upper leg), the circumference of their abdomen and their head circumference.

Baby B's Abdomen and Kidneys — Baby B’s Abdomen and Kidneys

The biggest one in the bunch is Baby B at 2lbs and 12oz at the 62^nd percentile. Little Elle Rose (Baby E) is the munchkin, but not by much as baby D and Theo (baby A) are also the same weight (2 ½ lbs) but just a bit longer. At this rate, when the baby’s are measured again at 32 weeks they will be about 1lb heavier each. Let’s just hope this Mama can keep up!

All of their organs (kidneys, bladders, hearts, brains, stomachs) look great and are also appropriate sizes. The blood flow to Elle has improved and has stabilized. All heart rates remain within normal limits, and are often on the higher side, which is probably because they just can’t sit still. We are truly excited to meet our little wiggle worms!

I am also doing well. It seems I am stretching by the day, but my body is adapting. Pregnancy is definitely a physical challenge, but the emotional, mental and spiritual journey that accompanies gestation is truly a blessing!

The Quint’s Domain

Published on July 27, 2013July 28, 2013 by onesource4wellness1 Comment

The quint’s domain is nearing completion thanks to Frank and our invaluable friends! This past week Frank coordinated the rearranging of an abundance of furniture, cleaning of closets, and construction of all of the baby furniture and shelving!

I cannot thank Jake, Bethany, Sean, Jenny, Liz, Brad, Ryan, Hayley, Sam, Angela, Sunghee and Jo enough for their generosity. We have been so blessed by their friendship and support since day one. I can’t explain the peace that it brings me to know that our babies will have a place to lay their little heads when they arrive back in Madison. Thank you!

Here are some more snapshots of the action!

Our reconstructed office in the basement!

The new cribs constructed by Frank, Sam, Jake, Ryan and Jo!

Hayley cooking up a storm for our hungry helpers!

These shelves were built in mere moments as Sean moved about like The Flash

Fuzzy Wuzzy was a Baby

Published on July 13, 2013 by onesource4wellness5 Comments

Thank you for everyone’s prayers for Baby E, Elle Rose, because God is answering every one of them. At today’s appointment we found out that her Doppler readings from her umbilical cord were in the normal range, with only one reading just above normal! She is our little fighter. I also shared with Dr. Elliott that we name little Elliott (Elle) Rose after him and I think I saw tears well up in his eyes. I love the heartfelt compassion of my doctor!

Additionally, at today’s visit we got to see almost everyone’s little face, and most of them have what looks to be a full head of hair! The sonographer asked me if I was having heart burn and nausea and I answered with a resounding yes! She said it is most likely due to the amount of hair on their little heads, because the hair protein can irritate the GI tract. Theo and Elle have the most hair and the rest are little fuzz balls at this point. I’ll let you see for yourself!

Baby C’s Profile

Elle Rose’s Profile

Baby B & D didn’t want to come out to play at the photo shoot, so unfortunately we don’t have any images of those two little ladies. But, from what we saw today everyone remains on track with healthy hearts, brains, organs and blood flow.

My doctor also gave me a warning that this is the point where growth really picks up. Amazingly, all of the babies have shifted to a transverse position with their heads to my left and little feet to the right. Theo still has his little noggin tucked into my pelvis but his feet swing left. So, they are in ideal positions to bulk up…which of course Mama is going to need to find some XXXL shirts pretty soon! Muumuu’s here I come!

Again, thank you to everyone for your prayers! We appreciated every single one of them. We also want to send a special thanks to our friends at Culver’s who threw us a baby shower. Now our little ones can sport their little Culver’s onesies on their way home!

We are simply overwhelmed by everyone’s generosity and support. Please know we could not do this without you!

Happy 3rd Trimester!

Published on July 4, 2013 by onesource4wellness11 Comments

We have reached yet another milestone in this pregnancy! In just a few days we begin our 3^rd trimester!

Although the third trimester often brings aches, pains, and discomfort from gaining half of your original body weight it also brings the joy of knowing that- for me- in 9 weeks or less, I will be holding each of these beautiful miracles!

24 weeks, or 6 months, is a critical milestone because it is the point in the pregnancy where doctors will consider your pregnancy viable, or in other words if you give birth after 24 weeks your doctor’s will help to save your babies. Therefore, from this point on the babies are coming, it’s just a matter of when.

The average gestation for quintuplets is 26-27 weeks, which for me would be in 1-2 weeks. However, my current perinatologist’s average for quint pregnancies is 33 weeks and 1 day, and of course my personal goal is 34 weeks! When it comes to high order multiples average just isn’t good enough.

So, how does this compare to a singleton pregnancy if we make it to 34 weeks? Well, being born at 34 weeks for 5 babies is about the same as being born at 30 weeks for 1 baby. According to all of the statistics, the risk of brain bleeds, respiratory distress, cerebral palsy, etc. all plummet at 28 weeks (you can read more about this in my previous post, entitled Visit to the High Risk Clinic).

Our outlook is pretty good. At my last doctor’s visit on Tuesday, I was informed that I might be able to stay out of the hospital for another 3-4 weeks. This was music to my ears because:

Most make it another 4+ weeks after admission to the hospital before giving birth.
Our pregnancy is stable enough for me to continue to enjoy the perks of living in a home.
Hospital food doesn’t even come close to my mom’s delicious and nutritious cooking!

We also learned at our previous visit that all of the babies are growing at a similar rate now; they are all between the 60^th-70^th percentiles. My side of the family is known for making big babies, so we’ll see how this plays out. The only difference was that Baby B’s legs were much, much longer than everyone else’s. It looks like she takes after her Daddy and will be the speedy queen of the bunch. We also learned that everyone’s hearts, brains, kidneys and circulation look great!

The only concern from the visit was that Baby E’s umbilical cord did not insert centrally into her placenta, which is correlated with causing distress later in pregnancy. Right now, baby E is as playful as the rest, so my prayer is that her circulation stays strong. She has been the doctor’s concern since day one, so I know she is going to be our little fighter.

Now, for those that have bared with me to the end of yet another lengthy post, I plan to present to you the names of our five little miracles…with a bit of explanation of course in the next post!