Mommy DOES know best!!

I have to say that my "check-in" at the NICU was successful! Taking care of 3 boys without Dad and still pumping was A LOT of work and I think I got a total of 2.5 hrs of combined sleeping sessions. I was happy with the progress made so I have taken a "slip leave" from my Dr. Mom duty and Dad is there for some night time feedings to make sure all is still going well and on track for some homecomings!

I am going to try and do a brief recap...I have a 2.5 yr old to read stories to and, of course, pumping to get to! (Update: I did not keep this brief and had to take a break to hang with B and resume during a pumping session, ha!)

Ben left me at the NICU yesterday at about 4pm as I was on  mission to get to the bottom of why Evan has been kept longer for reason being feeding "episodes" that we never witnessed between 10am and 10pm.

I started with the 5pm feeding and all boys did great. I finished up around 6:30pm (Payton was still finishing through his NG tube) and did a pumping session before heading downstairs for dinner.

I returned for the 8pm feeding with the night RN who had been reporting episodes of O2 and heart rate stats drops for Evan during his previous two 11pm feedings. I started noticing inconsistencies immediately. She brought me 75ml of milk in a short fat milk storage bottle instead of 60ml of milk in a long skinny feeding bottle. Evan did drink all 75ml but the bottle was horrible! With his side-lying feeding order this bottle was too fat to keep a nice flow into the nipple and resulted in him taking in a lot of air with his feed. I asked the RN to never use these storage bottles for feeds again, please.I was not able to burp him completely and get him settled enough to lay down for over 30 minutes. I handed him off to the RN to keep him vertical while I moved on to R and P. I did not finish feeds until 10:40pm, just enough time to pump and start all over again!
For the 11pm feeding Evan did not even want to wake up. Who can blame him, he over ate (his Dr only has him ordered for 60ml according to his weight) at the previous feed and took over 90 minutes to fall asleep from being so uncomfortable. The more I thought through this all I started thinking, REFLUX! I got him to eat 27ml but he would not wake up and I told the RN I wasn't going to push it and he was done for now. Even with this small amount once I lay him down to move on to Riley, he was uncomfortable again!! I don't think I finished all boys and pumping until 1am!

At 2am I was awoken by a hungry Evan who took his entire 70ml (still, too much) bottle down without any signs of pre-mature feeding like we have been getting told. In fact, he was eating like a champ! After this feed I was burping Evan when he let out a really good one! BUT, about 20 seconds later I watched milk slowly flow out of his mouth and him starting to gag...REFLUX! Luckily the RN saw the whole session and agreed that he was eating great and yes, this looks like reflux to her too! Finally- an answer to why he was choking and dropping stats, not during, but AFTER feeds.

The rest of the story is more of the same...no sleep, change, feed, burp, pump, repeat. Throw in a car seat test Riley, a visit with another newly delivered triplet family (Congrats SCHHHH~that makes up Mom, Dad, Big Bro, and impressively big trips of 2 boys and a girl! From, BBBEPR :) ), a glass of OJ over ice with graham crackers and PB, and a whole lot of heart racing for Mommy as I lay listening to various alarms and wimpers, and you have the rest of my night in a nut shell ;)

I was very happy at 8am to share the reflux revelation with one of our favorite day RNs who will be with us for 4 whole days in a row, that's an eternity in NICU schedules! We came up with a game plan to switch to Dr. Brown bottles, cap feeds off at 60ml for now and start Prilosec on Evan...all we had to do was convince the Dr :) Luckily, that wasn't hard either! Ben came and had breakfast with me after a snowy drive in (crazy weather) and we had a nice consult with the doc. The NEW plan is for Riley to come home tomorrow and to see how Evan does once the meds kick in and he uses the new bottles. If he does "perfect," the earliest he will be home is Sunday. We are hopeful, but also not holding our breath. We are ok with him staying now that we know what we are dealing with and just pray that the meds help and we get happy, "Easy Evan" back and ready to come home. It's too funny that our small-but-mighty-Rowdy-Riley showed his brothers he wasn't messin' around and stole the 1st homecoming show!

My hope is that once E and R are home that Payton will continue to improve, hopefully at a faster pace now that all of the hospital attention will be on him only. We are in for a busy 10 days as we await the arrival of Nana and Papa L, but we are looking forward to some nice family memories in the making :) We will nap when the 'grents arrive!

All of this discharge talk with the Dr has been a real eye-opener for us as well. They have some rules for us, and they mean business! Since it is still the beginning of flu season in Portland and there is a nasty respiratory bug going around they are putting us on "preemie house arrest."

-They only want us leaving the house to go to the NICU to see brothers or to appointments (I already have SIX scheduled for Riley!! "Small but Mighty" buys you lots of outpatient peds/lactation/eye/ear/therapy referrals!!), and even then we are not to wait in the lobby or any confined spaces with other peeps- especially kids.

-We are to limit visitors to those who are there to help for a significant amount of time and who have had their flu shots. This is the hardest one as so many people are waiting to meet these special little boys! Soon my friends, soon! They understand that we may have visitors stopping by with meals, well wishes, etc, they just ask that these visits are minimal and don't involve any cuddling.

-Brody is to avoid daycare as much as possible and to not bring additional kids into the environment with the babes. We all know how germ friendly kids can be! I think B's hands will be as chapped as ours from washing in no time at all ;)

-They encourage walks outside in the fresh air! Maybe we can introduce the boys to some friends during an afternoon stroll ;)

We understand the need for the strict rules, hearing that a simple common cold could cause a re-admittance for any one of these boys would be THE.WORST.THING.EVER. They say that preemies being hospitalized and on a vent for longer than when they were first born is a very real possibility, and I am not willing to mess around with that! So don't be surprised to see multiple bottles of hand sanitizer strategically placed around our house for the next year, haha! And please use them... a lot!!

Please pray that  1) the meds/bottles will work for Evan and he won't have to be put on an inclined mattress which will only delay his homecoming 2) Payton continues to improve with his feeding skills and potential weaning off of oxygen 3) for a safe homecoming of Mr. Riley Warren, and 4) for our family to transition quickly to these big changes and struggles of having a preemie or two at home and one still in the NICU.

xoxo, B