Thomas in the NICU

Thomas Ervin

Like the other babies, Thomas was considered critical when he arrived at the NICU. However, his respiratory distress was more severe than the others. He was on a ventilator until June 26. Then he was placed on a CPAP until the 30th. After that he was on a nasal cannula and weaned to room air on July 1st. This was especially nice because it meant he could move into the big crib with his siblings instead of having to be all by himself. It also meant we finally got to really hold him! Throughout this time he also received aerosol treatments and medication. On July 17 his oxygen levels dropped. A chest x-ray revealed a partially collapsed lung. Thomas went back on the nasal cannula until July 23 and resumed aerosol treatments until Aug 1.

Thomas received antibiotics for possible infection, although I could find no documentation that he actually had any infections. He received dopamine for 7 days for hypotension. He was anemic and received a blood transfusion June 24. He had 2 cranial ultrasounds while in the NICU and would later have a third after discharge which was pronounced normal. He was circumsized on July 26.

July 20 he was diagnosed with gastric reflux. They started him on Reglan and switched his formula to Enfamil AR. Thomas started drinking from a bottle on July 6, but progress was slow. He only got one bottle a day. By July 22nd he was taking 3 bottles a day. It wasn't until July 30th that he finally was taking all of his feedings from a bottle.

Thomas was discharged from the hospital on August 4th. He was just over 6 weeks old. Yea! Welcome home, Thomas!

The NICU

The kids were taken across the street to the NICU at East Tennessee Children's Hospital. As I was mainly unconscious the first week, I have to rely on their discharge papers for most of the info I'm about to share with you.

Jonathan Carl

Due to respiratory distress and possible infection, Jonathan was considered critical and unstable when he first arrived at the NICU. He was on a ventilator for 3 hours, then a CPAP for 6 hours. After that he was on room air and stable consistently. Test results showed that there was no infection, so he received no antibiotics. His cranial ultrasound was normal. He received phototherapy for one day. He started taking bottle feedings June 26 and fed exclusively from a bottle after the 27th. Jonathan was circumcised on June 30. He was discharged from the hospital on July 6th.

Zachary Franklin

Zachary had the same prognosis as Jonathan upon arriving at the NICU. He was on the ventilator for 2-3 hours and then on room air and stable. He also had no infections and received no antibiotics. His cranial ultrasound was normal. He received phototherapy for 1 day. He started feeding from a bottle exclusively on June 25. Zachary was circumcised on June 30 and discharged with Jonathan on July 6th.

Reagan Leanne

Reagan was also considered critical, but unlike J and Z, she was stable. She was on hood oxygen for 2 hours and then on room air doing fine. She had no infections. Her cranial ultrasound was normal. She received phototherapy for 2 days. She began bottle feeding on June 25 and was discharged on July 6th with Jonathan and Zachary.

I was able to go and see them every day for at least a little while. I was never able to stay very long because I was so weak myself.

Thomas is a separate post. Since he had more issues, I'll talk about him later. These three came home together. They were 16 days old. My parents had come to Knoxville the night they were born and stayed until I seemed on the mend, returning to Memphis on June 25. They had come back to Knoxville on the 30th when I was discharged from the hospital, and were still there when these three came home. Aunt Jodie and Cousin Kinley, who had also come and gone when the babies were born, flew in from Memphis on the 6th to welcome the kiddos home too, so Jim and I had lots of help, thank goodness! More on all our help and visitors later!

Welcome Home, Jonathan, Zachary, and Reagan!

The Birth

The babies were delivered by c-section on Tuesday, June 20, 2006, at approximately 4:30 in the afternoon. The operating room was crowded with doctors and nurses from both Ft. Sanders and Children's Hospital all ready to receive my little ones. I was 34 weeks and 2 days along in my pregnancy, well past the 31 week national average for quads.

Jonathan Carl was delivered first. He weighed 4lbs 9.5oz and was 17in long. He was placed on a ventilator for transport to the NICU.

Zachary Franklin was delivered second. He weighed 5lbs 1oz and was 18in long. He was also placed on a ventilator for transport to the NICU.

Reagan Leanne was delivered third. She weighed 4lbs 12.5oz and was 17.75in long. She was placed under an oxygen hood for transport to the NICU.

Thomas Ervin was delivered fourth. He weighed 4lbs 9.5oz and was 17in long. He was placed on a ventilator for transport to the NICU.

After delivery, the babies were brought to my room before they were taken on to the NICU. They were each in an isolette, and I couldn't really see them, but I did reach out and was able to touch Jonathan's hand before they were taken away.

The next few days are really a blur to me. I remember seeing the babies in the room, and I remember little snippets here and there, but mostly I was unconscious or semi-conscious at best. My relatively smooth pregnancy turned into a very hard post-delivery. My uterus, which is supposed to contract in upon itself to stop bleeding after giving birth, just sort of laid over in exhaustion and did nothing, so I just continued to bleed. By midnight Tuesday night, my kidneys had begun to fail. Somewhere between 2 and 4 :00 Wednesday morning, my blood pressure dropped to 58 over 31. I received 3 units of blood on Wed., 2 more on Thurs., and another 2 on Friday. Friday morning they decided to install a central line in my neck because my veins were so shot they couldn't find one good enough to draw blood from to test.

I finally started to come back to myself on Sat. I remember waking up that morning and calling out for Jim who was by my side in an instant. I wanted to know what day it was, what had happened, and how the babies were. Jim was relieved to know that I remembered having given birth. He was afraid that I wouldn't. My vision was very poor. I wasn't totally blind, but everything was very dark and hazy. I couldn't recognize anyone until they spoke. I was told that this was a side effect of the magnesium sulfate that I was given to keep my pre-eclampsia from progressing to full-blown eclampsia. It was very disquieting, but I was assured that it would improve with time.

By Monday I was improved enough that they moved me to a postpartum room, and that night I got to go see the babies for the first time since they were born. Jim and one of the nurses wheeled me over to Children's. It was hard not being able to really see them, but I got to hold them, except for Thomas, but we'll talk about that later. I made the nurses cry when I asked them to tell me about my babies. Well, okay, I cried too!

I got to go see the babies every day that week, whenever someone was available to wheel me over there! Finally on Friday (June 30), they took the central line out of my neck and let me go home.

The Pregnancy

I figure there's no better place to start then here...the pregnancy. After trying for a year and half to get pregnant (and I mean really trying, with temperature charts and everything!), we decided it was time to get a little help. My doctor had been testing my progesterone levels, and they were extremely low. He suggested I take Clomid to boost my progesterone and ensure ovulation. He warned me that there was a slight increase in the risk of twins when taking Clomid. We took the risk! Several of my friends had also taken Clomid to get pregnant with their single babies. It sounded like a good idea. And it worked! In November 2005, I got pregnant! Because of the chance of twins, my doctor ordered an ultrasound at about 8 weeks. As I was looking at the screen, I thought it looked a little strange. The sonographer said, "Yeah...yeah, there's four!" I said, "Four what?!?" She answered, "Four babies!" I started laughing. Jim started moaning and nearly threw up. My doctor promply sent me to the Perinatal Center, where they specialized in high-risk pregnancies, which I had suddenly become, and so began my journey into quadville!
Considering my situation, my pregnancy was surprisingly smooth. They started me on weekly progesterone shots pretty early on. I had a cerclage right before Spring Break in March. After that I only taught half-days. At the end of April, I spent a week at Ft. Sanders Hospital where we discovered I had begun having contractions. They started me on a terbuteline pump which gave me a fairly constant stream of medicine straight into my leg to help control the contractions and sent me home with a monitor. I had to monitor my contractions twice a day. I did not go back to teaching after this. It was bedrest time for me! Jim set up a little fridge and microwave in the living room for me so I hardly had to get up for anything. My wonderful friend Michelle, who had recently moved to Knoxville, came over every day at lunchtime and made me lunch so I didn't have to work too hard and kept me company so I didn't go stir-crazy. (Side note: On the very same day that Michlle's husband Judah interviewed for the job that would eventually bring their family to Knoxville, we had the ultrasound that informed us we were having quads! God plans things so perfectly!) I owe so much to Michelle for helping Jim take care of me all that time!
The babies were due July 30, but I had always assumed that they would arrive more like the end of May or early June. Instead, they hung out in my ever-expanding tummy until June 20. I was at home on bedrest until the day before they were born. In the realm of quad pregnancies, that's practically unheard of! My doctors admitted me to the hospital on the 19th because my blood work was starting to look funny. The morning of the 20th it looked bad enough that they decided it was time for the babies to enter the world. I was coming down with pre-eclampsia, so the time was now. I was about to be a mommy!

Welcome!

Well, here we all are just before Christmas. The kids are 6 months old here. There's me and Jim and from left to right the kids are Jonathan, Zachary, Reagan, and Thomas. We send out a big thank you to our neighbor Cris for going along to the park with us to take the picture. She did a great job! The is just a little post to get us started. I'm going to follow it up with some background posts to catch any readers up-to-date who may not have had the joy of following our story until now. I hope you enjoy reading it. I'll do my best to keep things recent, but with four babies at home, don't expect too much!