Tales from the NICU!

 I'll save you the suspense and give you the short version first. Everyone is doing great! The babies continue to amaze us as well as their staff with how well they are doing.

We have established a loose routine for now. I am still feeling really exhausted so I seem to end up running to the couch for some rest most afternoons. In the morning I get up for some coffee and time with the doggies. I spend a little time catching up on the previous day's news clips on Roku, then get showered and head over to the hospital. I am making myself walk over there at least once per day and sometimes I'm able to do it twice. I like to hold each baby while I'm there and spend time talking to them. They seem now to recognize both my voice and Andy's and react to them when they are awake. They smile a lot these days and their eyes love to roam our faces. They sleep up to twenty hours per day so those moments of smiles and eye contact are precious to us.

As of late last week all the babies are back above their birth weights. Also new is that twice per day the babies are now allowed to supplement their regular feedings with either bottle or breast. This will prepare them for a couple weeks from now when they will be expected to take most of their nourishment this way in anticipation of removing their feeding tubes. The babies are doing great with the feedings, though some are catching on more quickly than others. So far Roland is the undisputed champ! This past week the peanuts graduated to wearing clothes. They are amazingly cute in them. We have filled their drawers with clothes and let the night nurses choose what they wear. It is always fun to come in the next morning and see what the nurses choose. We did, of course, opt to dress them ourselves for the first time.

Mom putting Micah in his first onesie.

Dad putting Becker in his first onesie.

The whole crew in their duds.

Last, all the babies have lost their umbilical cords. In Roland's case, he truly lost his cord. It was sitting in the isolette next to him one minute and was gone the next. The nurse thought she may have accidentally scooped it up in his dirty diaper. Poor Roland. Hopefully he won't mind being the only one without his cord in his baby book since Bad Momma was unwilling to go rooting through poopy diapers to retrieve said cord.

Here's what we've been up to.

The Crows

A flock of crows is referred to as a murder. My darling husband feels this is also an appropriate name for our bunch, and has taken to calling them "A Murder of Mielers". I have expressed my strong disapproval and suggested alternate references, such as a "gaggle", a "flock" or even a "litter", however in Andy's eyes, all lack the panache of the murder reference. So, as I continue to struggle with picking my battles and letting go of control, I breathe a sigh, roll my eyes ever so slightly, and grudgingly accept that we may forever be known as A Murder of Mielers. You win hubby, you win.

Micah

First, Micah looks so much like his Daddy. It's the first thing people say when they see him. Not only are their facial features very similar, but Micah is extremely long. His fingers seem almost disproportionately long. Think of a puppy who has yet to grow into his paws and you'll have a pretty accurate picture. Dad is 6'4" tall and I wouldn't be a bit surprised to find Micah looking eye to eye with him one day.

The babies are allowed some tummy time each day, safe at this age only because they are being monitored constantly. Unfortunately, Micah thinks tummy time means "face plant" time and as soon as he is on his tummy he turns his head completely into his swaddle. This sets off his alarms and summons the nurse, who turns his head to the side, only to find him face down a minute later.

Last, a story from way back to over two weeks ago. I was still admitted to the hospital and the Mieler babes were barely a day old. Behind each baby's isolette is a dry erase board with their name, care times, nurses name, parents names, and the goal each baby had been given for that day. I had a similar board across from my hospital bed not far away. On day two Micah's goal read "poop!". Seeing this, Andy calls across the room to me, "look Jen, you and Micah have the same goal today!" And so begins life with four men.

Becker

I think I have fewer pictures of Becker than the other kiddos, but with good reason. It is really tough to catch him in different poses, other than sleeping on his side! My mellow guy is a champion sleeper. Snoozing, however, is not his only talent.

Last week the little ones were under the care of Sam, one of our fantastic nurses. The conversation went something like this, as I stood by Becker's isolette, ready to change his diaper.

Sam (looking a bit sheepish): Jen, has Becker peed on you yet?

Me (surprised, amused): No, why do you ask?

Sam: Well, it's just that, um, I've worked with a lot of babies, and never seen such a strong urine stream on a preemie.

At this point I glance down at the isolette, the top of which sits a full foot and a half above my baby boy. I see quite a bit of condensation collecting on the top, and realize that there must be a malfunction within his temperature and humidity controlled environment. As I'm about to ask Sam about this I notice a very thin stream of liquid, which I trace down to Becker, smiling happily up at me.

Me: Oh my gosh Sam! He's doing it now! You weren't kidding! He's reaching all the way to the top!

Sam (gets up from the computer, walks over): Jen, why didn't you cover him???

Me: Cover that? I'm way too impressed!

We had a great laugh as I finally covered the stream, which must have sprayed unfettered for at least thirty seconds. Of course by then poor Sam had to clean and sterilize a full half of the isolette, as well as change his sheets and swaddle. The little stinker has done it three times more under other nurses care and is, in typical Becker fashion, lackadasical about the whole affair.

Snuggling with Grandma Lin.

Roland

It's almost impossible to me that he was once considered the weakest and least likely to survive. This guy is so strong and funny! He is a champion at both his pacifier and his feedings. He and Marin are both now on the shortest possible feeding span because they are doing so well. Roland is still working on losing his old man wrinkles on his forehead. He also seems to be shedding a bit of the hair at the top of his head, but growing more on the sides. Combine these with his tendency to go red faced when he is fussy, and he often looks like a very cute, very tiny, grumpy old man!

Roland is very alert and has a thousand facial expressions when he looks at you. It's easy to completely lose track of time staring at this little one.

Grandma snuggles!

 Snoozing on mommy with Marin Grace.

Marin

Marin continues to be our naughty little drama queen. The PDA in her heart has not yet closed, but has been downrated from "moderate to large" to "moderate". Since her other clinical signs are good, the doctors will wait it out for now and hope that she is able to close it on her own. If she still has it at discharge, we will be referred to a cardiologist, who will make a recommendation on whether she will need surgery. Please continue to pray for this naughtiest of our monkeys!

She has also developed some super dry patches on her skin, and continues to make her eyes cross on a fairly regular basis. I tell her it's not very pretty, and she'll have a tough time finding a date if she continues to make goofy faces, to which daddy nods and says "good!". Andy is quite sure that she will not be allowed to date until she is eighteen.

But don't feel to sorry for our girl here. Being the only girl in a sea of boys, she gets tons of attention. Everyone wants to hold and touch her, and of course, pinch her cheeks. I'm not too worried about her being spoiled though. Those boys will be sure to keep her in line!

And last but certainly not least, a few days ago we were able to get the family together for our first of a lifetime of family photos. It was such a precious few minutes, seeing all our babies together, and then being able to hold them all together. We continue to marvel at God's power to do amazing things. If these four miracles aren't proof of God's incredible love for us, I don't know what is.

Left to right, Micah, Becker, Roland and Marin

Thank you all for your continued prayers and support. We tell people constantly that we owe our amazing progress to the many people who lift us up daily in prayer!

Love and blessings,

Jen and Andy,

Micah, Becker, Roland and Marin

(The Murder of Mielers)

We're One Whole Week Old!

Okay, technically we're one week and one day old, but Andy and I were late at the NICU yesterday staring at those sweet faces and I just didn't have it in me to write when we got home. So please, in the interest of me feeling like an awesome mom, close your eyes for a moment and pretend that we are all reading this yesterday!

As of their one week birthday, all the babies are either back to birth weight or just an ounce or two away. The nurses tell us that preemies often take up to a month to get back to birth weight, so we are extra proud of these overachievers. Of course, I'm willing to acknowledge that we may be ever so slightly biased.

I stood at each isolette at each baby's exact birth minute. It was so fun to remember back to a week ago and the happiness I felt as each came out crying. We are amazed and humbled at the progress these guys have made in a week. Every day I walk in half expecting the nurses to tell me that Roland and Becker went out on a double date. They're making such big strides every day!

Mr. Micah is still our sweet feisty guy. When I reach into his isolette he almost automatically reaches for my hand and holds on tight. His nurses expect that when I see him today, he will be off of CPAP. A few days ago the doc's detected a heart murmur which they suspected was PDA, a very common condition in which a vessel in the heart fails to close completely. Many babies resolve this on their own, or treatment is just a three day course of ibuprofen. When the doctor came in yesterday to confirm the diagnosis with an ultrasound, the murmur was no longer detected. She thinks that Micah closed the valve on his own in the couple days since she first heard the murmur. He is such a sweet boy, and so far the biggest cuddler.

Becker cracks everyone up these days. His one remaining issue is some spitting up after his feedings. so the staff has increased the duration of his feed to two hours hoping this settles his stomach. And though we know it's too early, the little ham is smiling. It's the funniest thing. He opens his eyes, looks around, and this big lazy grin slowly spreads across his little face. It's too cute! I'll try to get a picture soon but he was fast asleep in his swaddle for his birth minute picture and I was afraid that if I woke him I'd get a screaming baby picture instead of a smile. His face looks a little messy because he had some spit up from his last feeding. 

Roland is our strong boy, though he didn't start out that way. Remember, this was the peanut that the doctor's thought would not survive in me through the first trimester? Roland is a warrior! Every day lately the reports on Roland go something like this. "Nothing to report. He's doing really great." My one complaint is that since he discovered the swaddle I don't think I've seen his eyes once. The swaddle seems to have cured him of wanting to be awake, and every time we see him he is in a slow easy sleep. 

And then there's Marin Grace. MG had a heart murmur as well, and it her case, PDA was confirmed with the ultrasound, so she started on the ibuprofen treatment yesterday. The side effects can be trouble with digesting food and trouble in the liver, so she will be monitored closely for signs of these side effects. I know a lot of ladies in my Quad Mom's group whose little ones had this issue, and the outcomes have been very good. All in all, pretty minor stuff in the scope of preemie issues. She adores sleeping on her stomach so the nurses let her do it for some time each day. Unfortunately, this time stomach time coincided with her birth minute picture, and every time I tried to move her hand down, the little stinker shot it right back to her face. Who would have thought our little girl would be the camera shy one? Oh, well. Trust me, the cuteness is there! She is also opening her eyes quite a bit and doing great with her feedings. The nurses expect that her CPAP will be removed by Monday. Last night, Andy tried to tell the nurses that she would not be Daddy's Spoiled Little Princess, and the room erupted with people laughing and telling him that she would be daddy's pampered girl. Andy finally grinned and acknowledged "there may be some pink clothes from daddy in her future".

And last, because you've been asking, here's mom. Unfortunately I was due for my 30 week photo the day the babies were born, so the best "before" shot I have is 29 weeks. I was probably about five pounds bigger than this when the babies were born last week. Though I so badly wanted to hold them in until 32 weeks, I must admit that I am enjoying things like bending over, sitting upright, and being able to walk up and down the stairs without breathing like a bull, fighting the urge to pass out, and resting for thirty minutes after.

My surgery went great. I had some pretty severe swelling in my hands and feet, which has just started to go down in the last couple days. I am getting a not-quite-migraine every day that doesn't seem phased by the Motrin I take for the surgery pain. Last, the carpal tunnel I had during a few weeks of pregnancy came back with a vengeance after the babies were born. I am working on knitting blankets for them, and got less than two rows done the other day before my hands went numb.

And since everyone loves hearing about other people's dreams as much as they love watching four hours of someone else's vacation photos, I give you, My Dream. After csection, gas is very common. Not just ordinary gas that a belch will cure, but big roaming bubbles that expand the stomach and cause lots of unpleasantness down south. In my case the gas became really bad Friday. That night I fell into a half sleep, basically sleeping, but somewhat aware of happenings in the conscious world. As I dozed, gas bubbles began to move around my stomach and became pretty intense, so intense, that they began to feel like the movements of the babies inside me. I had a very vivid dream that the gas was a fifth baby that had somehow been missed on our many ultrasounds, and that I was going to have to go into surgery again to give birth to a fifth baby! That dream wouldn't have been so awful, except that every time I woke with it and realized I had only been dreaming, I fell asleep again only to repeat the dream and wake shortly after scared all over again! It was a pretty unpleasant Groundhog Day kind of night, until I was finally able to come fully awake in the morning and assure myself that we have only four, not five babies. I repeat, NOT five babies.

Basically, all my little issues are totally normal post csection symptoms and I have no real complaints at all. Today will be my last day driving to the NICU before I start taking advantage of the short walk over to get some exercise, and start rebuilding the stamina I lost with all my couch time during pregnancy!

So here you go, before and after baby. As of yesterday, I'm still 35lbs. over my pre-pregnancy weight, so I've got some work to do. No more Rice Crispy Treats for me Grandma Mary!

Last, with the pregnancy fatigue and all the activity since the babies were born, we still have not opened all our gifts or managed to send out a single Thank You for the beautiful gifts already received. So for now, please know that we are grateful for every last one, and you will be getting a proper note of thanks just as soon as I can write without my hand going numb.

Love and blessings,

Jen and Andy

Micah, Becker, Roland and Marin

And Marin Grace, The Independent

Marin Grace
Born: 9/10/15 @ 11:29A
Weight 3lb. 4oz.
Length: 16"

The delay in Marin's update is for the best possible reason. Unexpectedly, I was holding her! But more on that later.

Marin is turning out to have her momma's independent streak. While the boys love to hold hands and grip our offered fingers almost immediately, Marin will often spread her fingers wide when we try to hold them. "Um, thanks but no thanks mom." I sometimes sneak a hand hold while she is asleep and compliant.

Also unlike her brothers, she has been trying to cause all sorts of drama. The nurses think she wants to be sure she doesn't lose attention to all the boys.

She started out with the same gear as the boys, IV, CPAP, feeding tube, lights. Then Saturday night we got the very scary call that she had developed a pneumothorax, a small hole in her lung. The doctor would insert a chest tube to pull out the air that was leaking into her chest cavity, but from there, Marin would have to do the work. The doctor told us that he expected the hole to be healed within three days, at which point the chest tube would come out. When three days passed and the chest tube remained I worried a bit. There were a few bedside tears.

Tuesday night, the chest tube was still in place but slipping. The doctors began to talk of having to pull the tube and insert a new one if she didn't resolve the hole in a day. That same night we were there when the nurse cleaned her up and changed her CPAP hat. To do this they turned off her light and removed her little goggles, and I got to see my baby girl's eyes for the first time. She looked back and forth, up and down, as I looked on, tears rolling down my cheeks. As I gazed down at her beautiful face, marveling at the perfect focus of those tiny eyes, she looked up at me, and went cross eyed. Spell broken. Little stinker. Not to worry, though. The nurse explained that this is just a function of prematurity. It will take her a little time to develop control of her eye muscles.

Then last night we walked in expecting no real change from my visit hours earlier, and was thrilled to find staff at Marin's bedside, removing the hated chest tube! Her X-rays the day prior had shown no sign of leak so they had capped off the tube and waited a day to confirm with a second X-ray. No leak! And the news kept getting better. Even though she was only minutes removed from the chest tube, the doctor thought that she would benefit from being held immediately. After six days I was about to hold my tiny girl for the first time!

 Marin, 1 day old

Marin, eyes open at 5 days old

Marin, 6 days old

Day 6, Mom and Marin's first ever snuggle time!

In Rides Roland William, The Gunslinger

Roland William
Born 9/10/2015 @ 11:27a
Weight: 2lbs. 13oz.
Length: 15.5"

Our boy Roland totally lives up to his namesake so far. He is calm and in control, unless he wants his binkie, in which case he shrieks like a banshee until the small piece of rubber is inserted into his tiny waiting mouth. He has the least amount of hair of the four, making him the easiest to identify by head alone. When we tuck his legs up like the nurses showed us, mimicking their environment inside me, he has a tendency to kick back the first few tries. It makes me laugh because he has been doing this against my hand for over two months, every press of a certain spot of my stomach meeting with a gentle kick back from my boy. And lets not forget that it was the trademark restlessness of The Gunslinger character that led to my water breaking six days ago!

Roland began his NICU life with IV, CPAP, and feeding tube. He was later put on lights and needed to be intubated due to some trouble breathing. He was extubated less than a day later and did great on his CPAP. He was off his lights for three whole days before he needed a little extra time sunning himself. After three days without his little glasses, he was used to looking all around the room (the nurses tell us that at this age, they distinguish light, dark and faces) and he was not happy to have his eyes covered again. As of this morning, Roland is on the least support of anyone. Not only are his lights and CPAP off, but his IV has been removed as well. Aside from surface monitors for heart rate and such, he has only the feeding tube left. The soundness of his sleep when I left him this afternoon tells me he's feeling pretty darn happy about the whole thing. He and Becker seem to be in a race to see who comes home first, so it will be interesting to see what Beck does in the next few days.

Roland, 1 day old, intubated but with no lights yet

Momma's first baby hold ever. Roland was the lucky guy at 3 days old.

Roland, 6 days old, sleeping soundly in his new swaddle, almost wireless!

Presenting Becker Andrew, One Cool Dude

Becker Andrew
Born: 9/10/2015 @ 11:26a
Weight: 2lbs. 9.5oz.
Length: 15"

It seems totally appropriate that Becker was given Andy's name as his middle. So far, Becker is the most like his father. This guy is super laid back. He doesn't cry a lot and when he does it's generally pretty brief. We were told at the beginning that the babies will feel most comfortable with both legs and arms tucked tightly against their bodies, but Beck is proving them wrong in his case. No matter what they put over his chest, no matter how they tuck or swaddle his arms, he always finds a way to get them up by his face. He most often looks like someone kicked backed on an ocean somewhere, "too cool for school" glasses over his eyes.

Becker started with the IV, CPAP, feeding tube and lights, but at two days old had already mastered breathing to the point that he kicked the CPAP and it has not returned so far. He too is now off the lights and looking just as cool without his sunglasses. It is such a treat to see there eyes wandering over to me! As of day six, Becker now only has his IV and feeding tube. We expect the IV to come out within a few days or less. The babies all have to keep their feeding tubes for a few more weeks, as the suck, swallow, breathe skill won't develop for a bit yet. 

Becker, birth day, already holding a hand to his head

Becker, 1 day old

Becker, 2 days old, daddy's very first hold with a baby

Cool dude, sunbathing at 4 days

Becker at 6 days old, no more glasses...

but those hands still up to his face!

Introducing Micah Paul, The Feisty One

Micah Paul
Born: 9/10/2015 @ 11:24a
Weight: 3lbs.
Length: 17"

Before I get to Micah, a general note about all four babies. They are the hairiest little beasts you've ever seen! No one can believe how much hair they have. Had these been forty week babies they very well may have emerged sporting a range of dos from mullets to bobs. In addition to all the hair on their heads they have the soft fuzz covering their bodies which normally falls out just before full term birth. It's all quite amusing and of course only adds to their general cuteness in my eyes.

The docs pulled the kiddos out in order as they were lettered during ultrasounds, A, B, C, D, so I'll proceed the same way.

I think every nurse who has worked with Micah has used the exact word, "feisty" to describe him. I love that he is not frail and lets the nurses know he is there. He's a good baby, but very vocal when he's displeased, which to his credit is not incredibly often.

Micah started off with all the usual preemie accessories, IV, CPAP, feeding tube and bilirubin light. A couple days ago he had a twelve hour trial off the CPAP but went back on. The doctor's anticipate it coming off again, hopefully for good, tomorrow. Yesterday evening he went off his bilirubin light and now we can see his gorgeous eyes when he wakes up long enough to open them.

Micah got spoiled with daddy holding him at four and five days, and mom at day six. He was fussing before the holds but calmed immediately when Andy or I held him and nestled contentedly in our chests for an hour each night. 

Micah Paul, 1 day old

My favorite, Micah's epic tantrum at 3 days old

Micah's first hold with daddy

Micah, 6 days old