Thursday, September 26, 2013

thirty weeks! - 9/23/12 - 29w4d

I am thrilled to be here! I remember a time, not so long ago, when this day seemed to be an impossibility. When we saw the doc this week he seemed to share in our enthusiasm at how far we have come but, at the same time he was hoping for a few more weeks. Dr. Shields made it very clear that his perspective has changed and the longer Joshua stays in the womb the better it is for him. In talking to Dr. Yin she believes that Joshua will be the one to pull the trigger by losing his heartbeat and as such we would have no choice but to deliver.  Rob and I have talked and I think that we fall somewhere in the middle. Selfishly I don't think I could carry around a deceased baby but, as long as things stay "status quo," then we want to let all three boys bake as long as possible. Regardless, Dr. Shields will admit me to the hospital by 34 weeks so that he can monitor me daily (that's if I haven't delivered yet).

Truth be told however, I believe it will happen at 32 weeks. This might be due to the fact I have had this number in my head for a while now or because I am measuring 39/40 weeks and am just not sure if the human body can stretch much more. It might also have something to do with the fact we are starting to feel mentally exhausted. This has been such a medical pregnancy with all the doctors appointments and now to add on bed rest and bi-weekly non-stress tests. So, we would like to see what you think. Leave us a comment, if you would like, guessing the day and time from now until the 7th of November as at that point triplets are considered over due.

Now to address the elephant in the proverbial room or possibly it is just the thing I have been thinking about all week. I know that last week Rob wrote a very long sappy post about me and I wasn't sure if I should praise him publicly because that's what he did for me or not. I decided that instead of tooting his horn in a long dialogue about the wonderful man he is, I would just leave you with this: that God doesn't make mistakes. While I might be Rob's earthly hero, God formed us to fit together and I am a human with lots of problems. All that to say God gave me this perfect fit in a man who can balance out my crazy and then still look on me with love and somehow see something good. I don't know about you but I think that's amazing. 

Tuesday, September 17, 2013

restraint - 9/16/13 - 28w4d


Samuel Abraham

This will be a double post. Last week not much happened. Our ultrasound tech was the sort of abrasive one who seems to rush through, puts Katy flat on her back, and barely allows us to get a word in edge-wise, but whatever. At this point I feel like we have a pretty good grasp of what we're looking at and could almost manipulate that machine myself if they let me. In any event, she did measure all the boys and here's where they stand at 28 weeks 4 days:

David - 29 weeks 4 days, 2 pounds 13 ounces
Samuel - 28 weeks 4 days, 2 pounds 9 ounces
Joshua - 26 weeks 0 days, 1 pound 11 ounces

Once the doc came in, there wasn't much more to say. He asked about our previous meeting with Dr. Turbow, the neonatologist, and we explained what we had learned. What Katy failed to mention last week was that her blood pressure (BP) was slightly elevated so the staff took the time to do a mini-ekg on her to make sure there were no signs of preeclampsia developing. Everything looked normal so that was a plus. At this particular appointment they didn't even concern themselves with it. She saw Dr. Yin later that day and they did check her BP twice as it was somewhere around 130/82 or something like that, but it came back normal the second time. 

Yesterday was the other appointment I'll bring you up to speed on. Same as all the previous one's but for one exception. Dr. Shields spent quite a bit of time analyzing Joshua's brain and came to the conclusion that he has what appears to be at least one, maybe more, small cysts on the inner layer of the sac that surrounds his brain. He didn't seem concerned at all though, strange as that may be. When I asked him how serious it was in comparison to the kidney/lung issues, he made some comparison that completely came out of left field. He said it would be like me seeing someone going 66 in a 65 MPH maximum speed limit zone, no big deal. I told him I had no idea what he was talking about and that I go after all the speeders as all cops do of course.

Again, prior to Dr. Shield's appointment Katy had another one with Dr. Yin. Sorry about the lack of chronological order in this post, I do realize it's quite sporadic. Anyway, on our way in to Dr. Yin's office, we actually rode up in the elevator with her as she was on her way back from lunch. We happened to have just finished eating Chipotle and had a bag of chips that Katy was munching on as we walked in. I joked with Dr. Yin that this was how we made Katy seem like she was gaining weight at the rate she wanted her to. Katy quickly jumped in and defended her eating habits, particularly in the past week, claiming she believed she had gained at least five pounds, probably more. Dr. Yin skeptically looked at her and then gave me a look. I said I didn't think so and it was probably only one or two pounds that the babies had gained in that time. Dr. Yin laughed and said we'd have to see. Well, one pound later on the scale, Katy was none too happy once she sat down on the table in the doctor's office. As such, or so she claims, her blood pressure was even more elevated to 140/80. As Dr. Yin was reading her chart, she immediately informed Katy she was now on at-home bed rest consisting of potty breaks, one shower, out on the couch in between and then in bed and if necessary, taking Nick to and from school. No cooking, cleaning, errand running, or anything else outside of this scope.

I have to say that while this wasn't the most welcome news, we were both pleased with how far she had made it without being put on bed rest. That didn't stop Katy from petitioning like a flailing politician in a lost race. She pulled out all the stops and did everything possible with her rhetoric that she could to convince the doctor to not put her on it yet. Dr. Yin quickly put a stop to the debate when she asked Katy if she'd rather be at home or in the hospital. Obviously her answer was home and therefore, the doc said, she could rest at home or lie on a hospital bed for up to five and a half weeks. Katy gave up at this point, at least with Dr. Yin. At the appointment talked about above with Dr. Shields, she held onto a pointless hope that she could convince him to retract Dr. Yin's orders. That obviously didn't happen.

So, here we are. Just shy of 29 weeks and Katy is confined to the house except for doctor's appointments. It probably didn't help that the day before, Nick brought home a picture he drew from Sunday school in which he was asked to draw the paralytic that Jesus healed and he drew a stick figure with a big belly with the word "momma" written above it. 

That's the update, so if you want to stop reading and not read my soap box sappy monologue below, feel free, but I'm going to write it anyway.

I've said before, whether in a blog or small group I don't remember, but my wife is my earthly hero. When she was a junior in high school, excelling in swimming and water polo and with a high probability of going somewhere on scholarship, she came down with spinal meningitis and encephalitis. Fortunately, it was not the bacterial kind, merely viral, for if it was bacterial she wouldn't be with us now. The sickness completely incapacitated her, taking away most of her fine motor skills, including writing, coughing, swallowing. It slowed her speech, impaired her movements, and put her through a rigorous recovery process that included months of speech, occupational, and physical therapy. And yet, she came out through it all, not giving up, willing to keep pushing and fighting. There are still residual affects that she suffers from, namely her speech and some lack of control in her balance and hand-eye coordination. And yet, in spite of all that, she graduated high school, went to community college on her own, got two AA's, graduated from Sac State with a BA, all in the face of taking at least three times longer than the average person to write, type, read, and anything similar. My wife is my hero because I don't think I could have done it and maintained the faith that she has. I would have easily been drawn into a world of self-pity, frustration, and anger, and yet Katy came out of it thanking her Father for letting her get sick, for without it she wouldn't have met me, gotten married, have the friends she has, the church she loves, given birth to Nick, been a foster mom to Matty and Zane, and carried David, Samuel, and Joshua. She looked at her adversity as a blessing, not a curse, and did what we all should do, trust that the God of the universe will work all things for good to those who love Him as He promised He would. 

I say all that to say this. My wife is amazing. Here she is carrying three babies with joy. Excited at the possibility that God has for her to be a mom to four boys. Never complaining that she didn't get the girl she always wanted. Never complaining about the puking, lack of appetite, sneezing accidents, none of it. Even as we've been trying to figure out how we are going to handle the strong possibility of our son's demise, she maintains a steady course and steady faith. She is the most amazing woman I have ever known and I've known quite a few, but she takes the cake. She said to me tonight as I was packing Nick's school lunch that I needed to slow down or I would get burned out, and yet she had no idea that it's her example of strength in Christ that keeps me motivated daily just to keep up with her. If she begins to waver I will crumble like a house of cards, but I know that won't happen. She is my anchor, my best friend, and the most unbelievable thing to happen to me outside of my salvation. The amazing part is, she is too humble to admit any of this and thinks I exaggerate. That is normally true, but not in this description of her. 

The other day, my buddy Kevin and I were talking about marriage and the idea of whether or not we found our identity in our brides. We both sheepishly looked down and admitted we did. Then one of us asked the question as to whether we would be closer to God without our brides and we both confessed we probably would be farther away. Whether or not this is a good or bad thing is a topic for another blog and another day, but the point is that I do find my identity in Katy. She helped mold me into the man I am today. But don't blame her for the bad, immature, and improper parts, she is only human and I am still a work in progress.

My bride is who I aspire to be. The one I see Jesus in. The one I thank God is raising my children. And the one that I don't know how I could do all of this stuff we are going through without, but I'm glad I get to. 







Tuesday, September 10, 2013

how old are we? - 9/3/13 - 26w5d

Samuel

This has been a hurdle week for me, my first baby Nick not only started kindergarten but turned 5 as well;

I was really hoping that I could stay out of the hospital until this week is over and it looks as though I met my goal. Although, in reality there is no good time to go sit on your behind in the hospital, eat the food, and be watched ALL the time. So, you might be able to understand my apprehension when Dr Shields wanted me to have my blood pressure checked at the appointment this week and the relief I felt when he told me that it was perfectly normal. We had the same technician we were blessed with two weeks ago when we did not have any pictures so, this week when she handed us seven pictures we were elated but later found out that they were all of Samuel. 

Dr Shields had a new assessment of Joshua this week. He told us that there was still no fluid and he still can't really see the kidneys but one more sign that there is something wrong is in the way that his rib cage is developing. The screen showed that the ribs start out very narrow toward the top but then flare out as they go down toward the belly. This might mean that the lungs have not been able to develop do to the lack of amniotic fluid. The way that I understand it is a baby breathes in the fluid stimulating lung growth and Joshua has gone for so long without fluid that we have to assume his lungs have not been able to develop at all.

The next thing on the schedule was for us to get a tour of the NICU and then meet with one of the three neonatologists at our hospital. So, we headed over to the hospital only to realize that we had to pick up Nick from his first day of kindergarten in about 30 minutes. We did a quick walk through of the OB ward and the NICU fighting back emotion and memories of our sweet boys Matthew and Zane. We were ushered into the office of Dr. Turbow, who will be taking care of our three babies. True to his name and with the added incentive of our time crunch, he did a lot of talking and we did a lot of listening. He told us about his background and that he was the rookie neonatologist on the floor with only 20 years of experience. He also told us that it would be best if we could get to 34 weeks before delivering which I thought was very optimistic of him but I think he was speaking more in terms of David and Samuel's post-partum  development. He asked us to not tie his hands in regards to Joshua and both Rob and I thought that he meant we should just let Joshua go but to our surprise he clarified saying that a lot of parents just want to hold the baby when there might be something that he could do. We asked what the order of things would be and how much time he thought we might have.  Obviously he was not able to give us a time frame but he did say that the first thing he would do is try to get a breathing tube in so that he could get Joshua over to the NICU for an x-ray of the kidneys. It is very possible that due to the lack of amniotic fluid and lung development, he will not be able to find any lung tissue for the tube to go into and we will hold Joshua right away through his last seconds. We also found out that a baby has to be at least a year old for a kidney transplant so if he cannot find anything in that area then he would stop all efforts and give us the chance to say good bye. The last thing we asked was about Joshua being an organ donor and the doc told us that it was a very political thing but he would look into it for us. He thanked us and then we had to literally run/waddle very fast to the elevators.

It was quiet on the way home partly because we were rushing and partly because God gave us peace at least for this week. We are praying for a miracle and asking everyone else to pray as well, but we also understand that even if we don't get to bring Joshua home with us, God has already used this little life for His glory and that is a miracle in its self.

Monday, September 2, 2013

hear my humble cry - 8/26/13 - 25w4d



David in 3D


David looking at the camera...creepily


David Side Profile


Joshua Side Profile

We've been keeping you guys in suspense for a while, only to have another appointment tomorrow. Sorry about that. Katy kept telling me all week it was my turn to write. I've had trouble formulating how to write all of what I've been thinking.

Not much changed again this week. Joshua is still lacking fluid. The boys all got measured again. David now weighs in at 2 lbs 4 oz, Samuel at 2 lbs even, and Joshua at 1 lb 5 oz. Dr. Shields told us he wants us to meet with a neonatologist and tour the NICU this coming week so we'll do that after the appointment tomorrow.

The only thing new that was reported was that he took a pretty close look at Joshua's heart in relation to his chest and his chest is definitely not keeping up with his heart, which is good and bad I guess. Good in that his heart and head are growing as they're supposed to be, bad because obviously something is going wrong internally, we just don't know what. Best guess at this point is still that his kidneys are either non-existent or not functioning at all. Other than that, he's behind in his growth but still growing, so that is a praise that he's not stagnant.

Right now Katy and I are doing our best to wrap our heads around the possibilities that could occur. So far we can think of three scenarios:

1 - Joshua is totally fine, spends some time in the NICU, and comes out in a few months
2 - Joshua needs major medical attention and could make it
3 - Joshua comes out and can't survive on his own, and do we try and keep him alive, or just hold him while we can

We're sure there are other scenarios as well, but they all seem to be variations of those three. The first is easy. The second, tough but doable. The third, nearly impossible to comprehend.

The last scenario has caused us to consider things like, do we have a service for him? When? Before David and Samuel are out of the NICU as well? Should we keep him on life support to donate his organs? Should it just be the three of us? Should we bring Nick in? Should we bring family and friends in to meet him and say goodbye? Should we spread his ashes? Plant a tree? A plot?

Some of these may seem grim, but all of them are real. These are the sorts of things you think about. While sitting here writing this, I considered another question: Can we get them all together one time to hold all three at once? As I typed, this beautiful rendition of "Pass Me Not, O Gentle Savior" by Red Mountain Church was playing in the background:

Pass me not, O gentle Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by.


Savior, Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by.


Let me at Thy throne of mercy
Find a sweet relief,
Kneeling there in deep contrition;
Help my unbelief.


Savior, Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by.


Trusting only in Thy merit,
Would I seek Thy face;
Heal my wounded, broken spirit,
Save me by Thy grace.


Savior, Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by.


Thou the Spring of all my comfort,
More than life to me,
Whom have I on earth beside Thee?
Whom in Heav’n but Thee?


Savior, Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by. 

This is our selfish and direct request that we unashamedly pray for us and our boys. We are confident of our Joshua and the better existence he will have wrapped in his Savior's arms, but our concern is on the brokenness that is sure to come for Katy, Nick and I, as well as all that love us and our sons.

I was recently asked whether if I could do it all over again, both with Matty, our foster son, and with Joshua, if I would. If I knew ahead of time the grief that would come with Matty and the decisions involved with Joshua, would I do it all again. I related my answer to something I read recently. In our Sunday School class we're going through a new book entitled, The Meaning of Marriage, by Tim Keller, and in it he quotes C. S. Lewis as saying in his book, The Four Loves, this about love:

"Love anything, and your heart will certainly be wrung and possibly broken. If you want to make sure of keeping it intact, you must give your heart to no one, not even to an animal. Wrap it carefully round with hobbies and little luxuries; avoid all entanglement; lock it up safe in the casket or coffin of your selfishness. But in that casket - safe, dark, motionless, airless - it will change. It will not be broken; it will become unbreakable, impenetrable, irredeemable. The alternative to tragedy, or at least to the risk of tragedy, is damnation."

This type of action, shutting the love I have for these boys up forever, is and never will be an option. My answer to whether I would go through all this again is whole-heartedly and unabashedly a resounding yes. No way I would even give up the love I have experienced with all of my sons for even a second. In fact I would go through any scenario a million times worse if it meant being given the opportunity to love my boys in the way I have. 

I cannot predict what will happen, nor can Katy, nor any doctor we see. Only God knows what will happen. What I do know is where and in whom my faith resides, and He is greater than this situation and all of us, and in Him I go to and ask that in either tragedy or overwhelming joy, He hear my humble cry to not pass us by.








decisions - 8/19/13 - 24w4d

Sorry, we did not get any pictures this week as we had our scan done by a new technician and she was focused more on doing her job than printing out pics, which is a good thing. The scan was very short as she didn't take any measurements this time because the doctor asked for them every two weeks and we had them done last week. After she was finished, Dr. Shields came in to do his own assessment. It was silent for a long time, as usual, while he looked at all the babies. He finally broke the silence by talking about David and then Samuel and just how well they are doing. Then he laid into Joshua. He first looked at the heart and found it to be taking up an abnormally large portion of his chest. We were told that this was more likely an indication of Joshua's small size and that his heart is probably the right size. He also took a look down at where the kidneys are supposed to be and saw two masses that are clearly over sized for Joshua's body. The doc said that if these are indeed kidneys and are malfunctioning in some way, then this explains the lack of fluid for Joshua. He then gave us two possibilities for Joshua at birth. The first is that the placenta has been delivering nutrients this whole time but Joshua's body is just not equipped to process them. The second would be that the nutrients are not being delivered at all and therefore Joshua does not have the chance to grow. These are significant because in the first instance Joshua would still not be able to grow after birth but in the latter he would just need to eat a lot after birth so that his abdomen could have the chance to catch up with the rest of his body.

The appointment then turned even more depressing when we were asked to think about what we would want to do with Joshua after he was born. The doc was trying to be very political about how he said this but what he was getting at was do we want to hold him until he dies or would we like to send him off to the NICU. This was not something that Rob and I have talked about before, we just assumed that they would need to take him right away. We do want to give him his best chance and do the right thing for this little guy but what is the right thing??? There are so many other things to consider as well like the fact that we would want to donate his organs and that would probably mean that he would need to be put on life support to keep his heart pumping so, we don't even know how long he could be with us anyway.

Both of us went to the dark place of playing the "what if" game after this appointment. I try to reassure myself by saying that we won't have to make these decisions until these little guys are out but I might be more concerned with the looming possibility of having to make all of these decisions on the fly. Then I think about things like how we want Nick, our eldest son, to have the chance to meet little Joshua and how we have two more little miracles to think about and do right by. I then find myself trying to find some worldly comfort by saying that I already know I can do twins and maybe this is why we had Matty and Zane for a time. While they were not the same age we got the call for Zane right after Matty went through surgery and was having trouble eating and sleeping. I also know just how long it took our whole family to grieve that loss but in this case there are two other babies who need ALL of us and deserve to feel loved. So what I keep coming back to is that I am asking questions only God can answer and if he can just be merciful and give us the strength to trust in that, our family will make it through.