BockTriplets!

The kids are still in the hospital, and we don’t know when they are coming home. We do know what they need to be doing before they can come home though… In order to bring a preemie home from the hospital, the kid has to:

1. Be breathing room air – All three of our kids have been on supplemental oxygen at one point or another, and in some cases have come off and then gone back on. Right now Daniel is the only one getting any oxygen support, and this is just through a little positive pressure through his nose. Daniel was on a ventilator for a while, which can cause some other things they look for (see below).
   
   
2. Be able to maintain their own body temperature – This is why you see them in those little plastic terrariums for a while… these things help maintain a body temperature without having the preemie expend too many calories. All of our kids have spent some time in these, bt are all now in cribs. They have cleared this hurdle.
   
   
3. Finish their meals by mouth – based on their body weight, they needto be able to eat a certain amount all by themselves. So far, none of them are doing this, although Christopher is coming close. All of them are nursing from a bottle, but they tire easily, or have trouble coordinating the eating and breathing. In the videos you can see little feeding tubes going in through their noses… They need to be off of these entirely.
   
   
4. Gain weight – Every newborn drops some initial body weight before they begin gaining weight… With preemies, it is important they get through this quickly, as they don’t have much body fat to begin with. Christopher is now up past his birth weight, but I’m not sure where the other two are.

This is the routine stuff. They are also watching for any other complications (such infections from their IV tubes) and other typical preemie problems (like sleep apnea), but so far there are no real concerns. They just checked Daniel to make sure he didn’t have any complications from the ventilator, and he is doing fine.

So we don’t know when they are coming home, but everyone is progessing well towards their exit conditions. They occasionally have setbacks with things like oxygen support, and the amount they have to eat is a moving target, but we are probably halfway there. They have been getting tremendous support from the Birthing Inn at the hospital – I have been really impressed with the quality of care they are getting there.

Being under very good care of Doctors (and Dave), I have had a relatively uneventful triplet pregnancy. I even joked that I’d carry them until they were 18 years old. I hadn’t had awful morning sickness, I was generally comfortable, I loved watching the lava lamp that was my belly as the boys rolled around. Then week 31 rolled around and I was not as comfortable any more. Christopher & Daniel would have races up and down my ribs. It became very difficult to take a full breath. And Christopher was pushed against my stomach so I could only eat small amounts at a time and eating took forever. Then Anthony would have the hiccups causing my lower belly to drum out a steady rhythm. And Daniel would stretch pushing me first in the back and then in the front (felt like I was unwittingly doing the hoola).

Then 6/14 rolled around and the Doctor said I had to deliver.

Dave dressed in his bunny suit, and I was wheeled into surgery and prepped to see my babies for the first time. I could feel the doctors pushing and pulling inside of me and then I heard the most beautiful sound. Anthony’s first cry! I’m sure anyone who has had a baby knows what I’m talking about. And those who haven’t think I’m nuts.

Then Christopher was pulled out from what felt like under my ribs. There again was that beautiful sound but also a wonderful feeling – I turned towards Dave and said, “I can breathe!”.

Finally, out came Daniel and there were three crying babies! Everyone was out and crying – it was an amazing sound. Thst is when Dave took the pictures below.

There are several really good stories that belog on the blog, but they are Lorna’s to tell. Help me encourage her to write them – add your comments to this entry! (BTW, comments don’t look like they appear at first, but they do – they go into a queue that I approve – so there is no spam on the site. It should tell you that, but it doesn’t. So there is a bug, but rest assured, your comments are added.)

If she doesn’t write something soon, I’ll have to start telling them. I might even include some of the pictures I took of Lorna in the hospital (yes, this is a threat).

In the past couple of days, between running back and forth to the hospital, Lorna and I have managed to:

• Agree on and order 3 cribs
• Agree on and purchase baby seats and a couple extra bases
• Agree on and get paint for the nursery (Yes, we have been puting this off far too long)

Nicole (my sister-in-law) is handling the car-jockying necessary to get the baby seats installed. We can’t fit 3 baby sets in any one car, so we are doing 2 in mine, 2 in Lorna’s, and 1 in my mom’s (in case of emergencies).

Kim (my friend and business partner) is coordinating to get a painter in to handle the room so we don’t have to.

My friends Mike, Colleen, and Mary have given us more baby stuff than we have had time to sort through yet.

There are a lot of medical staff I owe some thanks to, but I’ll handle that in a separate entry… although, I’d like to thank the nurse that drew the ‘Huey Dewey and Louie’ ducks that you see in the video below. When we get home, I’m going to scan them, have them made into Wallhogs and used in our nursery decorations.

Thanks for all your help guys!

This video is fresh – from this afternoon. You can see Daniel in his isolette and Anthony and Christopher in their cribs… all still have assorted wires, IVs and nose feeds in.

I can’t believe it has been 6 days – on one hand it feels like ~3-4 (because that is how many nights I have slept), but on the other hand it feels like a month (because I have done about a month’s worth of effort on stuff).

You can hear the nurse in the background of the video on the phone with tech support over some issue they were having with their Microsoft Exchange email server. Not coincidentally, this was also the first time I heard Christopher crying.

Anthony, Christopher, and Daniel have spent the past few days in the neonatal intensive care unit. They are on a completely normal course for preemies at this age, so all this is nothing to be worried about.

Christopher is still doing the best. He hasn’t needed any kind of special attention, and today he moved from an isolette (the little plastic habitrail in ) into a real crib. Those isolettes are amazing little things that stay quiet in the bustle of a busy hospital room and keep a constant temperature. He is eating from a bottle, but hasn’t quite figured out how to get it ‘straight from the tap’ yet, if you know what I mean.

Anthony is still in an isolette, and is still on a little bit of oxygen (40%, with room air at 21%). He is eating well too, and has even gained back a little bit of weight. (Newborns lose a little bit of excess water weight before they start to gain their own weight).

Daniel has had a tough time – he wasn’t getting enough oxygen, even in a little tent, and he was wearing himself out by breathing so hard. To understand what is happening, a little bit of medical pseudo-knowledge is necessary.

In the womb, babies don’t need to breathe, but they ‘practice’ it anyway – taking breaths for a few minutes, then stopping, and so on. When a baby is born, the lungs expand when hit by air, thanks in part to a chemical called surfactin that the baby makes. Because Daniel was so young, he didn’t have his surfactin yet.

Because of this, they put Daniel on a ventilator and gave him some surfactin as a mist into his lungs. By that afternoon, he went from exhausted and unable to breathe (despite getting oxygen), to resting and well oxygenated on room air.

This afternoon they started weening him off the ventilator. It is currently set to give him 40 breaths a minute if he tries to rest, but when I saw him, he was breathing on his own at about 67 breaths a minute.

Lorna is still in the hospital as well; I’ll let her tell her stories on the blog when she gets home…

Even with the good news, they are still 7 weeks premature and have some fighting to do before they come home. The latest news is that Anthony and Christopher will be coming home before Daniel, but nobody will be coming home for at least 2-4 weeks.

It has been facinating seeing everything they are doing for them. I had learned a lot watching a bunch of baby shows on A&E and Discovery Health Channel (I had set my Tivo up to record anything with the word ‘triplet’ in it), but seeing it in person, when it is your own kids, is a much different experience. I never knew how cool those isolettes are – they have HEPA filtered air, they monitor the temperature of the baby and regulate the internal heat (so the baby doesn’t have to spend calories regulating its body temperature), and cut out most of the sound. They should make those adult-sized, with air conditioning, a flat-panel HDTV, and a place to plug in your iPod. You could revolutionize air travel by giving each passenger one of these and just stacking them inside of the body of an airplane. I bet you could fit even MORE people in stacked on top of each other – the airlines should love that.

Ok, that got of topic, but I don’t know where to edit it back. I’ll just leave it and let you laugh at my ramblings.

Announcing: Anthony Edward Bock

AKA: Baby “A”. 5Lbs, 4ozs.

He is doing very well, but as is typical for preemies, he is on a little bit of supplimental oxygen. Actually, it isn’t even oxygen, it is just room air with a little pipe in his nose to help him breathe.

Announcing: Christopher Russel Bock

Previously known as “B”, his face is prominently featured in the 3-D ultrasound also on this blog.

He is 3lbs, 14ozs, and doing the best of all of them. He doesn’t need any help at all, and seems to have doubled in size in the first 12 hours.

Announcing: Daniel English Bock

This is Baby “C”, who always liked to kick mom in the ribs. He is 4 lbs, and an unknown number of ozs (I’ll update when I find out.)

Again, as in typical for preemies, he is on a little bit of oxygen, but he is doing very well.

All were born last night around 6:40 pm. Mom is recovering, but as of 10:00 this morning hadn’t even seen them outside of the delivery room – they are in the Neonatal ICU, and she is in a separate recovery room. If you are one of our friends in the area tracking the blog, sorry, but we can’t have any visitors yet…

We are at 33 weeks today. It is also our 8th wedding anniversary. Everything is going well – at this point no news is good news…

I have always been a people watcher – and it has gotten more interesting when I see people chatting about Lorna.

A few days ago, after a doctor’s appointment, Lorna and I had lunch out. The hostess asked Lorna, “Is this your first one?”, to which Lorna replied, “no… it is out first three.”

The hostess looked a little confused, so Lorna let her off the hook by saying “I’m having triplets”. She got all excited, doted over Lorna for a second, and then I watched as she bounced around to a couple of the waiters and waitresses, telling them something that would immediately make them look on our direction.

Today, we went and checked out the pediatrician we are thinking of using. They were expecting us, and as Lorna approached the counter, they started making a fuss about how they have never taken care of triplets before. Another mother of a patient came into the reception area and started hearing fragments of the story, looking with intent as she put together the story. She finally asked Lorna, “Are you having more than one?” Lorna said, “I’m having triplets”. the lady looked shocked, and then the little girl with her said, “That would make my belly hurt…” to which her mom whispered to one of the nurses, “That’s not all that would hurt…”

One of the books we first looked at when Lorna got pregnant included an excellent description of the nutritional needs a woman pregnant with multiples will need – this includes things like extra protein, extra calcium, and other things you might thnk it takes to build a baby. With multiples, of course, you need more of it.

Since I love to cook, I came up with several different recipes using this information, but as we got further along in the pregnancy, I found myself with less and less time to do the cooking.

I’m sharing this recipe here so that other people with multiples might find it useful. Add a comment if you try it!

Nutritional Considerations and Ingredients

Flax Seed Oil

With 3 developing brains, mothers of multiples should be trying to get a decent amount of the good oils like Omega-3 (the source of the ‘fish is brain food’ meme). Flax Seed oil is great for this. I use it in almost any recipe in place of margerine, butter, or vegetable oil. You can definitely find it in any health food store. This is crucial for multiples – as a lot of brain growth happens in the last trimester, which will likely be cut short ifyou have to deliver early. Giving them this edge up early can help.

Extra Protein

Protein is important too. you can add dry milk to just about any baked good recipe to pump up its protein content. Experiment with your recipe to see how much you can add – this will make baked good brown a little faster.

Soy Milk

I also use soy milk in baked goods in place of milk or water. Lorna doesn’t like the taste of it for drinking, but in something baked, you’d never know the difference. Why soy milk? Soy is a nutritionally complete protein; it provides everything a growing baby needs. In particular, I use Silk brand Soy Milk, which comes in several variations. the two most useful for pregnancy supplementation are the one with Omega-3s and DHA (again, useful for brain development), and the unsweetened one (if mother needs to control gestational diabetes).

Eggs

I also make a point of using eggs that claim to have Omega-3 levels higher than ordinary eggs. Our grocery store contains several brands that claim this. By the way, if you add powdered milk to a recipe (as described above) I have found you can add an extra egg to any recipes that call for 2 already… further bumping up some nutritional value.

Other Things

If you can eat them, nuts are good – they contain trace elements, other good oils, etc. I will also occasionally add benefiber to some baked goods – it mixes in without changing the balance of the recipe at all, and can help with some ‘other issues’ often experienced late in pregnancy.

Since we are going to use those guidelines to enhance package mixes, realize that the nutritional value of what you create will largely depend on the package mix you are enhancing. So follow this advice too:

• Don’t buy a package mix if the nutritional label shows any trans-fats. They are evil – if nothing else, they will make it harder for you to lose your pregnancy weight… worse, they can set your kids up for weight issues.
• Avoid artificial sweeteners. I’m allergic to nutrasweet, so I think they are evil anyway. They provide nothing of value and run the risk of messing up you and your children, so why mess with them?
• When comparing two mixes, choose the one with the lower saturated fat and the lower suger. If you subtract the sugars from the total carbohydrates, you’ll get a rough idea how much complex carbohydrates the mix has… these are good.

Putting it All Together – Pumpkin Loaf

As much as I love to bake, I’d love to share a recipe that starts with roasting and mashing pumpkins… but sorry, not today. I bought a pumpkin loaf mix at the grocery store that met my requirements above, and tweaked it as follows:

• Used soy milk (with Omega-3 and DHA) instead of water
• Added dry milk (it would have reconsituted to a quart)
• Used Flax Seed Oil instead of margerine or butter
• Used 3 eggs instead of 2 (and used Omega-3 eggs)
• Added 2 cups of walnuts
• added 1/4 cup of benefiber

The end result? delicious! I could feed this to guests and I don’t think they’d have any idea it had been tweaked at all. The addition of nuts, dry milk, an extra egg, and fiber also made the recipe much bigger – I made two 5×9 loaves, where the original recipe said it would make one.

By the way, this same technique works well with the box blueberry muffin mix (although I also add more fresh blueberries to them).

If you plan on breatfeeding, these suppliments can help support the enhanced butritional needs of the mother after delivery.