Revisiting October 17, 2009, A Birthday Celebration

Our first two children have birthdays in November. Madison was born 11/13/2003, and Kaitlyn was born 11/2/2005. As our triplet pregnancy progressed, even though the due date was in January, we realized that the date of delivery would likely be prior to November. Because we knew that our lives would be changed dramatically after we delivered, we made it a goal to have a grand birthday bash for the girls and schedule it early in hopes that we would be able to share the moment with them.

As fate would have it, Tiffany was diagnosed as having low amniotic fluid a week prior to the scheduled date of the party and we opted to have her stay in Albuquerque to be closer to the NICU and also hoped that a 2100 ft drop in elevation might have a positive effect on the pregnancy. On Friday October 16, Tiffany was scheduled for a prenatal visit which revealed that Ethan's umbilical cord flow was stagnant during the rest of Tiffany's heartbeat. It is supposed to continue flow during the resting beat, so the condition was very precarious. Tiffany was immediately admitted to the hospital and I was soon packing my bags and headed from Los Alamos, NM to Albuquerque. To be honest, I do not remember any detail from that Friday evening. I do know that I was unwilling to accept that Ethan's condition would worsen and that I fully anticipated Tiffany being in the hospital several weeks before delivery. Saturday October 17 arrived. The day was complicated as I was supposed to be home with Madison and Kaitlyn getting ready for a birthday party. Instead, I was in the hospital soon to find out it would be a birth date indeed. Back to the party, it's a good thing that my mother and brother-in-law were able to be there for the kids. I don't know what we would have done otherwise. As it was though, it was a grand party with inflatables and clowns. Everything was taken care of by a party organizer which made it a lot easier. (I suggest that if you are able to do so, to have one such birthday party for your kids. The memories are well worth it.) We just wanted the kids to have fun, so we invited as many as possible. 

Meanwhile, back at the hospital it was hurry up and wait.  There were lots of nurses and labs drawn and in the midst of it all is the struggle to be calm when there's so much anticipation.  It wasn't until late morning that the prenatal specialist did rounds and checked Ethan's status via ultrasound.  The results were not good and there was indication that his cord flow had indeed started to reverse.  The clock had already started counting down to some point in time that he would essentially suffocate without a blood flow of fresh oxygen.

We were immediately given our options and we chose to go ahead with an emergency c-section that day instead of chancing Ethan passing in utero and the likely damage that would cause Devon.

What followed was a steady stream of doctors and NICU doctors and nurses and paper, lets not forget the paper.  As much as you want to be attentive in such a situation, eventually it becomes a bit overwelming and everything starts to sound like Charlie Brown's teacher.  I caught the parts about needing steroids to help the lungs and first thing first is that each child would have to be successfully intubated which would be challenging with such small infants. 

The period of time that followed seemed like an eternity.  There was some sort of holdup on getting the script for the steroid filled.  I had actually anticipated getting a steroid dose the prior evening, but the prenatal specialist elected a wait and see approach, apparently because it was still a bit early as far as gestational age goes.  Eventually, the dose came and was administered and at some point the anesthesiologist had administered the epidural, and Tiffany was carted off to the OR.  My job was to suit up and wait until called upon, and soon enough I was called upon.  It is difficult to give justice to any description of the moments prior to birth as I waited on one side of the cloth trying to comfort both my wife and myself.  I was very much caught up in consoling her when I was tapped on the shoulder with a "Dad, you don't want to miss this."  As I peered over the cloth the surgical team made quick work as Ethan was born followed quickly by Devon.  Their frail bodies were quickly wisked away and thru a door into the NICU.  Reagan was a bit more difficult to deliver as she was carried much higher in the uterus than the other two.  When she was born, she came out crying.  With the silence experienced during the birth of her brothers, the cry was a welcome sign and Tiffany and I simultaneously gave a sigh of relief and we embraced each other with smiles on our faces.  Ethan was born at 10.6 ounces, Devon at 18 ounces, and Reagan at 23 ounces.

Thus started our experience with the NICU.  Before Tiffany had been stitched up word had came that all three infants were successfully intubated.  Next to Reagan's cry, this was the second best news of the day.

Prenatal Hell, Pt. 2

The interview went well, and surprisingly no questions about what I envision five years from now. Second interview was with the prospective workgroup and found out that one of the members was a grad student at UT same time as me, so maybe there's an inside track. Unfortunately, things won't happen quick and it will be the better part of a month before any decisions are made.

So back to catching up, where was I? Oh, triplet pregnancy and prenatal hell. I don't know if it is any easier for those who do not adhere to the acknowledgement and adherence to a greater being, but I ponder how one without an absolute moralistic foundation feels about the tough decisions. For me and my wife, we are Christian and although our actions and/or reactions do not always reflect a conciousness that we are not in control, we simply are not in control. We're not religious, well not overly religious because I suppose you cannot exercise faith in God without some degree of religion. But through all of those episodes of prenatal hell, the professionals that we dealt with seemed perfectly fine to suggest that termination is always a viable option. Even if you put aside all arguments about the morality of choosing to terminate a pregnancy, I hold fast to the notion that we are given every capability to love and care for each child that we bring into this world.

Needless to say, that although my wife and I were shattered visit after visit, our resolve was to make every effort to bring three children into this world. Our next to last prenatal visit morphed from a coctail of probabilistic birth defects to the realistic condition that the amniotic fluid was dangerously low. Our corrective action was to get Tiffany out of the elevation of Los Alamos, NM at 7400 feet above sea level to Albuquerque where the elevation was considerably lower at 5300 feet. To boot, the only NICUs in the state of New Mexico are in Albuquerque. For one week, Tiffany was on complete bed rest and drank fluids like crazy in hopes of increasing the amniotic fluid. On the last prenatal visit, Tiffany was told that Ethan's umbilical cord flow was stagnant between heartbeats. She was immediately admitted to the hospital and I packed bags and left for Albuquerque. The next day, Ethan's cord flow was reversing during the resting beat. This condition was certain to cause mortality and there was an unknown finite window for action.

Our options were to either have emergency c-section or to let Ethan pass in utero. At 24 weeks gestation, the odds were stacked against all three should we choose emergency c-section. Choosing to let Ethan pass in utero would give Devon and Reagan better chances at survival, but since Ethan and Devon shared a placenta, a sudden change in blood pressure could leave Devon seriously brain damaged. Neither option was ideal, but we choose to go ahead with the emergency C-section and give all three children a fighting chance to beat the odds. That afternoon, October 17, 2009, Ethan was born at 10.6 ounces, Devon at 18 ounces, and Reagan at 23 ounces. All three were sucessfully intubated and our NICU experience began.

When she was born, Reagan let out a cry. Given the gravity of the situation, it was one of the most beautiful things I have ever heard.

Father Interrupted (Prenatal Hell, Pt. 1)

I have an interview tomorrow. I am fully anticipating the interview standard, "What do you see yourself doing in five years?"

Five years ago, I had two children, resided in Fairfield, Ohio, had a good job with a solid wage. My five-year answer at that point in time would not have come close to being close to describing where I am now and the path that got me here.

I started this blog a few years ago not really knowing what I wanted to blog about, and you can see that it has been several years since I last posted, so I believe that I got it partly right when I titled the blog Blogger Interrupted, but I should have titled it Father Interrupted. There's a lot of detail to make up, but the triplet pregnancy did not go well. Early on in the pregnancy it was apparent that one of the triplets was not developing according to schedule. Well, none of the triplets was developing according to schedule, but Baby A was even more so than the other two. Babies A and B were identical boys, and C was a singleton girl. We picked out the names Ethan, Devon, and Reagan respectively.

I just realized there is so much to say that bringing everything up to speed in one post could be construed as intolerable cruelty to humans, so I will try to tell our story in several posts.

The remainder of this post will be on prenatal care, or as I have come to know it: prenatal hell. It is my opinion that those who specialize in high risk prenatal care can only reduce their liability by eliminating the risk factors. So as an expecting parent, the cycle is as follows. You love your unborn child, you care for your unborn child (which in the paternal sense means to meet every need of the expectant mother, both physical and emotional), you look forward to prenatal visits with excitement, during the prenatal visits you endure the explainations of how your children are at risk for the assortment of birth defects, you listen to your options as the specialists slant the conversation toward reducing those risks, you leave shattered, you second guess what the right thing to do is, then you embrace each other and pray. You go home with resolve that your decision is the right thing. You love your child, you care for your child, you look forward to the next visit with excitement and anticipation.

Ultimately, we are not in control of the events that shape our lives. However, we are in control of our responses. We can choose to live in fear, or be filled with joy.

Well my 6 month old (yeah, there is a LOT to catch up on) is crying so I had better wrap things up.