Moving Up

This weekend, the kids have taken some great positive strides, but we'll save the best for last: First, all three are no longer on IVs, which means they are getting all the nutrients they need from feeding (including a growing diet of breastmilk, courtesy of Mom) and shows their capacity to absorb food. Second, the girls both came off their CPAP machines; CPAPs (continuous positive air pressure) are not ventilators since they do not breath for the patient (it is a major positive sign that the kids have never been on ventilators), but instead have a tiny tube that sits just inside the exterior tip of the nostrils and mildly blows compressed air to make sure breathing passages are open so the kids can breath on their own. Third, all their bloodwork has been excellent.

Which leads to the first part of the exciting news: Today, Easter Sunday of all days, Rory graduated from the NICU (neonatal intensive care unit) to the next step up, the SICU (special intensive care unit). Babies only get moved up if they've demonstrated a steady capacity over a day or two to breath without a CPAP (i.e., no apnea, or "apnic events" as the docs and nurses call them), require no IV, and have excellent bloodwork. Tonight at 7 p.m. Danni graduates to the SICU to join her sister. Tomorrow or the next day, Leo is likely to join them there. Typically, we've learned, boys move more slowly through the NICU than girls, so it's either that or the girls are just showing off. We spent the better part of the weekend with the kids, and after a little break today will be going back tonight to root Leo on and to see Rory and Danni in their new digs.

A SICU and a NICU, though, can be daunting places. At this hospital, which actually has one of the best such units in the country, there are 38 infants in this care at any one time. Each baby is on monitors 24 hours a day checking their heart rates, breathing rates, temperatures, percentage of oxygen intake, and more, and we have gotten pretty good at reading the meaning of the figures on the computers near them. Every 12 or 24 hours, depending on each child's status, the children get bloodtests, which means a prick with a needle in their little heels. Intravenous tubes run from the tiny arms of those needing extra nutrient support, and most, like our babies at this point, have tiny tubes running into their mouths down to their stomachs for feeding since they are not yet strong enough to suckle for themselves. A specialist nurse keeps a close eye on every two to three infants and manages their care. The nurses, by the way, are outstanding down the line, and across the shifts we've met many of them. It is incredibly comforting to experience their affection for their charges and to learn from them as they describe what they're doing -- and let us join in too, such as changing the kids.

Meanwhile, every day, one of the NICU doctors leads a small team of a couple residents and a nurse on "rounds," evaluating a host of data about each child's status and altering their feed rates, IVs, and so forth depending on their progress. We have been lucky enough to be there for rounds every day for our threesome, and the doctor really is excited about how well they are doing. We're counting on Leo to join his sisters at the next level soon!

Now, the second piece of the really exciting news: Because the girls are off the CPAPs, they no longer have the gear on their heads or faces that these devices requires, which means that we have been able to see both of their faces for the first time for an extended period, and today held them for a long while as they looked at us in all their glory and studied our faces as we studied theirs. In case you're wondering, yes, they are indeed identical. And, if we don't mind saying, they are absolutely beautiful.

The Names

We have no experience by which to judge whether naming one child at a time is more difficult, more interesting or more fun than naming three born together, but we sure did enjoy the process of trying to come up with names for our threesome. We actually have had the names for months now, testing them aloud and in combinations as triplets. Most of all, we wanted the pair of first and last names to sound good together, including with their siblings' names. We also wanted the names to be relatively easy to pronounce on sight and, because of family background and our experience in Ireland (where we got engaged), to have at least a hint of Irishness. Finally, we decided with triplets that a few special qualities would be appropriate:

1. Each name would be strong and singular, able to stand alone on its own and not easily abbreviated, so each child had his or her own distinct identity.
2. The names wouldn't be alliterative, including the identical twin girls.
3. The names would have something in common with one another to connect them as triplets, though in a subtle fashion.
4. Each child's pair of names would include a name we liked and a name with a special family link.

And we wouldn't tell anyone the names before the children heard them first (which drove some family members nuts, although we appreciated all the memorable suggestions, like Eartha, Winda, and Firer).

Our choices were:
Leo Francis: Leo is a name we like for a variety of reasons, while Francis is Daddy's middle name.
Rory Marí: Rory is a name we like for a variety of reasons, while Marí invokes the first name of the Dad's mother, Marion, and of his Godmother and great aunt -- Marí means the same as all three of their names and is the first four letters of grandma's name. (It's pronounced Mur-I.)
Danni Christine: Danni invokes Mom's stepfather's name, Danny, while Christine is a name we like for a variety of reasons.

The names connect in several ways to each other, but the key subtle connection is that each of the first names has the sound of the second syllable of the children's surnames in a unique way (e, y, i).

We hope they all go together well. And that the kids like them!

p.s. The kids are doing great, and Momma continues to recover nicely.

The Kangaroo

It is now 44 hours since our little ones were born, and one experience has quickly become our favorite: The Kangaroo. A baby is removed from his or her isolette and placed on Mom or Dad's bare chest as the parent lies back in a recliner, and there, for an hour or more at a time, we get to hold our child next to us, to feel them breathe with our breathes, to feel their hands and feet push and press against us, to watch with amazement as we say their names and they open their eyes to find where that voice is coming from. We will be doing as much of this as makes sense and is possible over the coming weeks, and the NICU nurses tell us it is good for all, especially the babies who benefit from the natural warmth.

Each baby is in its own isolette now, and inside there, able to sleep and stretch and reach snuggly within a cozy shell of blankets on all sides. We visit them as often as we like to watch them, touch them, see what the nurses do to care for them, and of course to Kangaroo.

Momma is slowly recovering from the duress and after-pain of the C-section, babies are doing great, and both parents are running on fumes and loving it. Rory and Danni have isolettes opposite of one another in the NICU, and at the other end of the room (about 25 feet away) is Leo. Positions are assigned based on which NICU nurses have openings in their areas as babies are born. Each nurse has 2 to 3 infants each to watch over, and thus far we have been impressed by the attentiveness and even affection that the NICU nurses all seem to have for their charges. Who can blame them?

Yes! Yes! Yes!

It is with profound joy that we announce that this morning we welcomed our three little ones into the world:

Leo Francis, 5:30 a.m., 4 lbs, 1.5 ounces, 17 inches
Rory Marí, 5:31 a.m., 3 lbs, 10 ounces, 16 3/4 inches
Danni Christine, 5:33 a.m., 3 lbs, 3 ounces, 16.5 inches

Everyone is doing great, Mom included. We have just returned from visiting them for the first time in the NICU, where they are being well cared for, and not only do they look great, but all their vitals are excellent. This is a glorious day.

Day by Day

Today was a good day -- thanks to a good night's sleep. The good night was made possible by an NST result "textbook" in its clarity, in the words of our favorite nurse. The NST monitors the babies' heartrates and requires a measurement of two points of acceleration 10 bpm over the average rate during a 20-minute span (do not depend upon these descriptions if you will soon be taking the MCATs). The challenge for the nurses is lining up three monitors on the surface of the belly with three babies' hearts simultaneously even as the babies shuck and jive below. Watching the nurses try to pull off the feat is a bit like watching Rocky trying to catch three chickens.

We have learned the only way getting the NST done is if Momma sits up the whole time, and that is taxing.

Mom's vitals, meanwhile, are in a good holding pattern above any necessity at this time to deliver, so the doctors will be making their decision on a day-by-day basis, and we are getting acclimated to this being's Momma-to-be's new temporary home.

One of the MFM (maternal fetal medicine) doctors that is part of the team monitoring the situation came by to visit yesterday. He said that a mother of triplets making it to 31 weeks is a "mammoth" achievement. Thinking of the size Momma has reached, we have been amused by his choice of words. As the nurses change shifts, we continue to meet new personnel, although we think after more than 72 hours here we are on the verge of knowing every nurse in the labor and delivery unit. One after the other, they ask, "How many babies in there?" and we say, "Three," and they say, "Wow, and you've made it to 31 weeks?!" It IS a mammoth achievement.

1 out of 100?

An eventful few days that rolled us back to status quo -- happily waiting. Thursday morning, Momma came in for her check-up and learned the babies now weigh 4 lbs 2 ounces (boy), while the girls weigh 3.8 and 3.5. The docs also saw signs of preclampsia returning, and so again she was checked in. We've been in the hospital since, with regular testing keeping the situation closely monitored. It's now Saturday afternoon and the holding pattern remains. The doctors have thoroughly explained the situation to us, and have made clear they will err on the side of caution to protect Momma and the babies. The docs continue to earn our confidence with the care and attention they are giving and with their detailed responses to our questions. As it now stands, Momma will be in the hospital for the duration as it is important to prevent an emergency delivery and to make sure that the docs are ready to respond promptly when signs make clear it is time to schedule one. When will that happen? Could be tomorrow, or the next day, but it also wouldn't surprise the doctors (or us) based on what they're seeing (actually as of today trending away from the need for a delivery as opposed to Thursday's indicators) if the big day doesn't come for another week or even more.

The basic schedule is checking the babies' heartbeats every 7 hours and Momma's vitals every 4 hours, and conducting the necessary bloodtests to stay on top of the preeclampsia every 24 hours. Momma-to-be has been incredibly resilient, actually tough, in the face of all the poking and prodding.

Our sincere thanks to everyone who has been checking in and sending us their thoughts and prayers via email and text messages. We are chilling out here at the hospital, and as the hours pass, enjoying our children's speaking to us through their heartbeats in stereo. They apparently are already adept at a little jazz, a little rock 'n' roll, and a little fusion.

1 out of 100

Momma-to-be went to the hospital last Friday for her weekly check-up, and she didn't get out until Sunday. Why? Because the doctors saw signs of preeclampsia, which can be quite dangerous, and decided to take a closer look. Preeclampsia is common, particularly at this point of a pregnancy, for moms carrying triplets, and we had been cautioned by the doctor that this could happen. Forty-eight hours, multiple tests (checking data like protein and sugar levels), and a few encouraging conversations with our doctor later, the results were...signs of the mildest preeclampsia (for all intents and purposes given the normal experiences of moms of multiples, a great outcome) that allowed a return home with a prescription to rest but to continue getting up on her feet at least every two hours to avoid blood clots.

And we learned this: based on the wide range of data the doctor gathered from the weekend of testing, she concluded that there is only a 1 in 100 chance that we would deliver in two weeks or less. So in its own strange way, the visit led to great promise that we will at least get to week 33, which is longer than average for triplets and would ensure even further healthy development of the little ones.

We also learned that every day the children stay with Momma from here on out saves another three days in the NICU.

Below we've included a new picture to inaugurate another milestone week. As you can see, in the last week, everything has changed, sizewise, that is. Momma has entered a whole new level of large.

We're getting there -- but still in no hurry!