Tuesday, April 29, 2008

Happy Zeroth Birthday!

The girls' adjusted age on April 26th was zero and we celebrated with a Zeroth Birthday Party!


Mom, Grandma, and Great Aunts
Jared graciously assisted the girls in blowing out the candle on their cake.

Sunday, April 27, 2008

Article - Phoenix Children's has new way to treat premature babies

My mom gave me this front page article from last Sunday's Arizona Republic newspaper. I thought I would share it with all of you. It talks about the NICU that the girls have been in. It's an awesome NICU!

Phoenix Children's has new way to treat premature babies
John Faherty
The Arizona Republic
Apr. 20, 2008 01:05 AM

Mayra Murillo walks into the dark, quiet room and lifts the blanket covering her daughter's crib. She smiles at the sight of Jocelynn.

The infant, born in March weighing less than 2 pounds, is sound asleep.

Mayra whispers to her daughter and holds her hand. She tells her that she loves her and that she is her mother.

The baby, still remarkably small, grabs hold of her mother's finger and does not let go.

This quiet moment between mother and child takes place at Phoenix Children's Hospital's new Newborn Intensive Care Unit.

The facility, which has been opening in phases and is now the largest in the country, represents a fundamental change in how premature babies are cared for.
The new place feels like a nursery.

Its predecessor was often described as a casino.

It was one large room lined with bassinets and bright surgical lights and fueled by coffee and desperation.

In the new model each of the 76 rooms is private, meaning the babies can grow strong and the parents can act like parents.

Next door to Jocelynn's room, a father is feeding his son.

Across the hall, another mother holds her child in a room so quiet the air can be heard pushing from the vents.

Doctors now know that a pre-term baby such as Jocelynn, who was due in mid-June, has the best chance to develop normally in a calm, serene environment.
She should be a fetus, so her frontal lobe - which will determine how she talks, behaves and feels - is still under construction.

Overloading the brain during this critical state with noises and lights could mean emotional and neurological problems in later years, even a lower IQ, research suggests.

The frontal lobe "is the most vulnerable part of pre-term development, and it is the most exquisitely human part of the brain that makes us uniquely human," said Heidelise Als, the director of neurobehavioral infant and child studies at Children's Hospital in Boston and a professor of psychiatry at Harvard University.

For Phoenix Children's Hospital, the goal was clear: Create a place that affords the best medical care for pre-term children while providing an atmosphere of womb-like tranquility.

"These babies should not be born. They should be in their mother's womb," said Dr. Mark Shwer, medical director at the care unit.

"This is part of a very strong movement to look at the quality of a child's survival."

Keeping babies alive
The changes in the newborn intensive care unit reflect how far the care of pre-term children has come.

Previous facilities were designed with the sole purpose of keeping children alive.

Children were lined up in rows of basinets and attached to monitors that buzzed with alarms.

What the facilities lacked in charm, they made up for with utilitarian efficiency.

"It was very, very efficient," Shwer said. "I could stand on a stool and look at 64 babies at once."

At Phoenix Children's newborn intensive care unit, where 80 percent of the babies were premature and half were considered "extremely pre-term," the staff was always busy.

Doctors and nurses hovered over children. Machines beeped and tubes stretched. The lights were bright because there were no windows. Parents tried to figure out where to stand.

"It was very much like a casino, except that it had clocks," said Deb Green, a nurse with 30 years of experience who now manages the care unit.

Over the past 25 years, improved training, equipment and pre-natal care pushed up the survival rate for babies born too soon.

The mortality rate for intensive-care newborns at Phoenix Children's is now down to 3 percent, Shwer said.

When Green became a nurse 30 years ago, a baby born three months prematurely had very little chance for survival.

"When I first started, a 28-weeker would just be left with the mother," Green said. "Now a 28-weeker is nothing. That's an easy baby."

As hospitals became better at keeping babies alive, some in the medical community began looking for ways to make sure that a baby did more than just survive.

Closing the 'casino'
Als, 67, has spent a lifetime advocating for pre-term children.

In 2004, the Harvard professor published a landmark study in Pediatrics that became the guiding principle for much of the design at Phoenix Children's new care unit.

In her study, she measured the brain functions of children who had been cared for as preemies in the old "casino" environment and compared them to children who had been cared for in the more serene setting she advocates.

The research, she wrote, "demonstrates that quality of experience before term may influence brain development significantly."

A premature child cared for in this type of environment will be less at risk of attention deficit disorder, could have a higher IQ, and may have better control over his or her emotions.

Hospitals, doctors and nurses already had been taking steps to improve the care for the pre-term patients in newborn intensive care units, but Als' study created a sense of urgency.

Her research also indicated the new environment will help the children grow stronger faster.

The data suggested that they will spend less time on supplemental oxygen, will gain weight faster and will spend fewer days in the hospi- tal.

Als' work urged the medical community to reconsider how they consider their smallest patients.

"These are fetuses, displaced into a different environment while trying to continue on their developmental trajectory," Als said.

Bonding with child
The new facility that Phoenix Children's Hospital runs at Banner Good Samaritan Medical Center is growing from 8,000 square feet to 38,000 square feet. The renovation cost $31 million, nearly half of which was raised through private donations.

It looks like a hospital, it even smells like a hospital. But the sounds of a hospital are missing.

It feels like watching television with the sound turned down.

There are tiles in the ceiling to absorb noises, and the floors also were built to remain quiet. The countless machines attached to the babies are vigilant but muted.

People speak in hushed tones. There are no phones in the rooms.

In addition to helping the children develop, this atmosphere also helps their families.

"It's so lovely when a parent gets to bond with their child," said DeAnn Huft, a speech pathologist who works at the NICU. "It's such a gift for the child."

Ava Jackson was born on March 6. The first child of Leland Jackson, 23, and Charm Daniel, 24, stayed in the womb for only 29 of the 40 weeks needed to be full term.

Daniel and Jackson have been at the hospital almost constantly to be with their daughter.

"It feels very good," Jackson said, holding Ava. "I love coming here to see my baby."

Unlike most babies at the care unit, Mark and Sonnie Linebarger's son Joshua was born at 38 weeks, the early side of full-term.

But Joshua was experiencing respiratory distress when he was born April 8, so he went to the care unit.

In the previous facility, the Linebargers would have a hard time holding their baby or even standing over him for long periods of time.

There wasn't enough room. Parents would back away when nurses or doctors would approach their child.

"A parent shouldn't have to be a visitor, shouldn't feel in the way," Green said. "A parent should be a parent."

In the new setting, the parents can.

"It's amazing," said Mark as he gave Joshua a bottle. "We've been here going on three and a half days, and I haven't left once."

Helping them grow
Mayra Murillo wears her orange identification bracelet all the time.

When she is home, it reminds her of her daughter.

Jocelynn is doing well, but things were dicey when doctors realized the child was not thriving in Murillo's womb.

They performed a Caesarean section on Murillo even though she was only 27 weeks along.

"It's hard to have a baby this way," Murillo said. "I was so worried. I'm a mom for the first time."

The quiet of the care unit has helped her forge a relationship with her baby. She can sit and watch her sleep. Or rub her head. Or just hold her.

At a time when she feels more helpless then any other, those small acts help her feel like she can actually help her baby grow.

"It's a good feeling just being able to hold her close," Murillo said, staring at her child. "It makes me feel good to know I'm helping."

Sometimes Murillo and her husband, Jairo Carrera, come to the hospital together. Sometimes they take shifts. But one of them is there nearly all the time.

"You worry about these babies," Murillo said. "You worry about all babies, I guess. But if this place helps her grow, helps her mind grow, that's incredible."

We're still waiting

We thought that today would be the day for Brielle to come home. Sadly, her doc called us this morning to say that she could not come home because she had a big Brady episode last evening. Apparently, she guzzled her food too quickly last evening, got "caught behind" in swallowing and as a result had her heart rate drop. And it was a big and long-lasting drop...AND she had to have the nurse vigorously stimulate her to get her heart rate back up. Poor, poor girl :( !! So with that, we totally understand why the docs want to watch her for the next couple of days. So we're still waiting...

The good news is I got to go down to the NICU this afternoon and see our little girl. She, again, is too cute :) And she nursed like a champ again - Yay! I took some pics of her (and her sisters). I hope to post them soon. You won't want to miss these pics ;)

Please keep praying for Brielle!

Saturday, April 26, 2008


I just had to post this tonight. Anna and Bethany are now on the other side of 9lbs. Anna weighs 9lbs 2oz and Bethany 9lbs 1 1/2oz. Crazy!! And to think they were just over 4lbs at birth a little over 7 weeks ago! How amazing! God is amazing in how He is growing these girls!!

BTW, Suzan weighs 7lbs 10 1/2oz and last I heard Brielle weighed 6lbs 9oz. Very cool!

Friday, April 25, 2008

Some things we've noticed about our girls - Part I

Suzan - she is the first born, or "baby A," and (I'm pretty sure) was the baby "on the bottom." I remember her "tickling" me with her movements. In-utero she was labeled "baby C." It's funny how the docs relabel them at birth. She's the third biggest girl. She loves to wave her hands and arms around and in so doing, doesn't like to be swaddled tightly ;) She's a slow and quiet eater, unlike her young sisters :P She has a very distinct cry. It's a very short, yet loud, "whaa!" She usually has a "concerned" look on her face, with her eyebrows furrowed. Her hair has the coloring of Anna and Bethany's, like a reddish brown, and she has such long and beautiful eyelashes.

Brielle Pictures

I'm sure lots of you are wondering "where are the pictures of Brielle??" ;) Well, I saw her again yesterday (Thursday) and was able to take some pics of the cutie little girl. So...here they are :)

Her sleeping
Her giving me a funny face
Brielle looking too sweet - ah!

And then her in her "color," purple

I don't know if you can tell or not but Brielle definitely has her own look to her. She doesn't look like Anna and Bethany (the identicals) and she doesn't look like Suzan. She just looks like Brielle :) She does have darker hair, bigger eyes, a different nose and, from what I witnessed at the NICU, an expressive mouth. It's so fun to look at each of our girls and see how individual they are, even the identicals (btw, Anna has chubbier cheeks than Bethany :) ).

While at the NICU, I was able to hold and cuddle with Brielle (talking to her about how much we want her to get big and strong and come home!) and then change her clothes and diaper and nurse her (which she nursed AWESOME! Yay!!). We hope and pray that the Bradycardia goes away and that she can come home soon. We want her home!

Tuesday, April 22, 2008

Not home yet :(

I know folks are wondering "so, is Brielle home yet??" I'm sad to say "no." :( She is still having the Bradycardia episodes but fortunately she "self recovers," or her heart rate goes back up on its own. Since she is still having the Brady's, her docs want her to be on a special 24-hour cardiac heart monitor to see how serious the Brady's are. So, we wait to see when she gets on this monitor or not.

I did see her yesterday (Monday). Yay! It had been two weeks since I last saw her in the NICU. She has grown! She is now 6lbs 9oz. Wow! That is great! She is so cute. She definitely has her own look. She was quite awake and wanting to eat. I enjoyed just holding and talking with her. I told her that we all want her home soon but want her to be big, strong and healthy when she comes home. She is so precious!

Please keep praying that God would take away her Bradycardia episodes and that He would bring her home soon!

Friday, April 18, 2008

Tomorrow! Tomorrow! I love ya, Tomorrow! You're always a day...a...way! (from the musical "Annie")

So...Paul tells me that he talked with the NICU today and Brielle will probably be coming home tomorrow. Wow! How fast things change (that's the life of the NICU ;) )! So if she does well for the rest of today, all of tonight and into the morning, then we can go and pick her up tomorrow. Tomorrow! We'll see how life gets having all four at home now - Ha! :P

Thursday, April 17, 2008

Welcome Home Anna!

It came to my attention that I did not have a "welcome home Anna" post on our blog. Oops. Guess in all of the hustle and bustle of having three newborns at home I forgot ;) So, without much further ado, here's Anna!

She and twin identical sister, Bethany, are both about 8lbs. I think Anna is now at 8lbs 1oz and Bethany at 8lbs even. And Suzan just crossed into the 7lb range and Brielle into the 6lbs. They are just growing like weeds - Praise God!

Having three at home was a little hectic getting used to. One newborn was really easy and so were two. Three threw us for a loop and I am sure four will just be like three, but one more ;)

We now wait for Brielle to get home. She passed her car seat test (when they do the test, you know you're getting close to having the baby come home!) and they have her on the "5 day Brady countdown," where she can come home if she doesn't have any intervention Brady's within the five-day window. So like I said, when they start talking about the car seat test and five-day countdown, you know you're getting close. Yay! Can't wait to have everyone at home then...a bit crazy but it's good :)

Sleeping Beauties

I just had to take a picture of Suzan, Anna and Bethany sleeping in their cribs. They look too cute and sweet!

Wednesday, April 16, 2008

6 weeks with quads

Yesterday, the girls turned six weeks old and I had my six-week post partum check-up. I can't believe it's been six weeks since that crazy morning on the day of delivery (check our website, under "Quads" and "Delivery/Birth," in case you are curious about that morning ;) ). So far, the girls are doing wonderful...all eating and gaining lots of weight (yeah, Bethany and Anna are almost 8lbs!), sleeping great and so cuddly! My doc said my incision and I look good. Yay! It's crazy to say, but I am sad to be "released" from PPA now. I got so used to seeing the folks there on a weekly basis and they were always so sweet and friendly to me. I enjoyed them!

Some things I've learned in being a mom of six-week old quads...
  • You need your systems! We have a system for feeding them, e.g. every three hours, staggered with two babies feeding at one time and the other two feeding about 30 minutes or less after the first two. We have a system on filling bottles and storing them, e.g. have bins with bottles, Dr. Brown vents, caps, nipples, etc. readily available for filling, have labeled shelf areas in the fridge (with "formula" and "breastmilk"). We have a system on daytime and nighttime feedings, e.g. nurse/bottle feed them breastmilk in the daytime and give them formula or fortified breastmilk at night. We have a system on identifying them, e.g. Suzan wears yellow, Anna wears pink, etc., etc., painted big toe toenails with "her color." We have a system of organizing their clothing, e.g. Suzan has a drawer with "yellow clothes," Anna's drawer has "pink clothes," etc., etc.
  • I didn't realize that my stomach muscles could separate so much! I guess it's a given, carrying four babies with a combined weight of more than 16lbs! I can fit four of my fingers between my stomach muscles. Ewe! Hopefully, with some help from a physical therapist or orthopedic surgeon, my stomach muscles will come back together on their own. We'll see?
  • We change a lot of diapers. Right now, with three of the girls at home, we change at least 24 diapers a day. Whew! With four, it will be at least 32 diapers at day. Praise God for the folks that have given us diapers!!!!
  • We need help! We have friends, family and folks from the church helping us out in the daytime. THANK YOU for your willingness to serve! We REALLY appreciate it! We have folks dropping off meals to us, as I can't imagine trying to figure out "what's for dinner" in between taking care of a baby or two (or three or four!), taking care of Jared, taking care of me, taking care of Paul, taking care of the house, etc., etc. Oh my! THANK YOU for the meals!! We also have help at night, which has been a huge blessing and opportunity!
  • You can feed two babies at once, either nursing or bottle feeding. Nursing two has been going well. Bethany is a great little eater. Suzan and Anna need a bit more experience with nursing (and I am guessing Brielle will need more experience with nursing too, just from talking with the NICU nurses about how she's been eating). We also learned how to bottle feed two babies at once, thanks to talking with another local quad mom.
  • Sleep is a must, for all parties involved!
  • Each baby has a different cry (and, most of the time, Mom can differentiate between them). Suzan has a short-lived cry and Anna and Bethany have a different sounding cry (although, since they are the identicals, their cries sound very similar - great! :P )
  • They are all so precious and sweet! You just want to hold and linger with each of them :) And with big brother Jared too!

It will be fun, and different and probably a lot more challenging, to see them get older...to see them smile, to "coo" at you, to get more mobile, to see their personalities come out more.

Our four year old

Guess what we found Jared doing one evening, after bedtime? Well, apparently he was bored and didn't want to sleep. So he decided to get up, go into Paul's office, pull out a drawer from Paul's desk, grab some scissors and chop on his hair. What?!?! And he did it twice! (Paul put the first scissors up and away but didn't know he had another pair, a "kids" or safety pair, in another drawer) I can't believe Jared did this!! Well, we have seen that he is bored a bit, just hanging out at home with us. Plus, I bet he did this for attention, with the recent change of having babies everywhere in the house.

So here he is...

This afternoon he's getting a very short haircut/buzzcut from Mom ;)

Tuesday, April 15, 2008

Brielle, at 6 weeks old

Paul got to the NICU today to see Brielle. While there, he took her picture. She's getting big now! Praise God that she is better at gaining weight. Paul said she's now at 5lbs 15oz, which is great! Yay! Plus, she hasn't had any Brady episodes since April 13th. Double Yay! So if she keeps this up, she might be home soon :)

Here she is...isn't she a cutie ;)

Saturday, April 12, 2008

Update on Brielle

Brielle is still in the NICU and will be there for a little while longer. She has two things keeping her there: 1) she is still having Bradycardia episodes, where her heart rate drops all of a sudden and 2) she is not gaining as much weight like the other girls. So today, Paul was at the NICU and talked to one of PPA's neonatologists, Dr. Slater Myer. She said she had a few ideas to help Brielle. One, she might have the nurses add some cereal to Brielle's breast milk feedings, so that the milk is thicker and thinking that it will allow Brielle to choke less on the milk (which should stop the choking and reflux Brady episodes). The cereal will also add some more calories to Brielle's feedings, hopefully making her "bulk up some." The other thing the doc said is that she might have the speech pathologist come by to see if they could help Brielle overcome her "Brady eating episodes." Hopefully, some of these suggestions from the doc will help Brielle!

Dr. Slater Myer reassured us that there is nothing physically wrong with Brielle. Just as Bethany came home earlier (@ 3 weeks old) than our expected 4 to 5 week discharge, Brielle might just be a baby that will be on the outer edge of the bell curve and come home later, like around 6, 7 or even 8 weeks old.

Please continue to pray for Brielle, that God would make her stronger and be able to overcome the weight and Bradycardia issues.

Wednesday, April 09, 2008

Our identicals??

At first, we didn't know which ones were the set of identicals. We looked at birth order, but that didn't help. We looked at blood types, but that didn't help. We looked at their last gestational growth ultrasound, but that didn't help. We tried looking at them, but that didn't help (as the two sets were split in the NICU). So up until now, we've been thinking Suzan and Brielle were the identicals until we saw this today...

Um yeah, I'd say, with 90% confidence, that Anna and Bethany are the identicals. They both have the same blood type. They both are the "big girls." And now, looking at them side by side, they look the same. Yeah, I'd say it's them two. Anyone else think so??

Three girls

Suzan, Anna and Bethany, in birth order. Bethany doesn't look too thrilled with Mom's photo shoot ;)
Now life gets a little crazy with three!

Monday, April 07, 2008

Eating well

All of the girls are eating and growing well. Paul and I just weighed Suzan and Bethany this morning. It's amazing and crazy...Bethany is now over 7lbs, at 7lbs 1/2oz!! And Suzan is over 6lbs, at 6lbs 1 1/2oz!! Yay! I am nursing them in the daytime and then they get their doctor-prescribed formula intake at the night feedings. They have to get formula, either straight-up formula or formula fortified breastmilk, for the extra calories. In any case, they must be eating well to be gaining all this weight. Yay girls! Oh, and Anna and Brielle are getting big too, at close to 7lbs and 6lbs, respectively.

All of this weight gain has been in the last month. That's amazing! Praise God for how well He is taking care of, and growing, them!

**and thank goodness my weight trend is the opposite of the girls ;) Somehow, I lost 70+lbs of my 85lb pregnancy weight in the hospital. It must've been all baby, placentas, blood volume and lots and lots of fluid. Now, only ~7lbs left...and a very wrinkly tummy ;)

Friday, April 04, 2008

Suzan with Big Brother Jared

Jared really loves his baby sisters. I think it was so cute when I heard him say "oh, she's SO cute Mama!" when Bethany came home. And today he wanted to hold Suzan. He knows all of their names too. Plus, when I asked him "who is this?", pointing to either Bethany or Suzan, he knew which one was which. He loves taking care of them, comforting them with pats when they are crying or caressing their heads. He also loves to show them his toys and how big he is. We hope he keeps enjoying his baby sisters, especially when all four are at home and when life gets really crazy here. He is such a sweetheart! We love him lots!!
Here are some pictures of him with Suzan...

1 month old

The girls are one month old today. Here are their stats...

Suzan -
5lbs 14oz (birth weight was 3lb 13 oz)
Anna -
6lbs 9oz (birth weight was 4lb 3oz)
Bethany -
6lbs 14oz (birth weight was 4lb 11oz)
Brielle -
5lbs 7oz (birth weight was 3lb 9oz)

Also, Brielle got off of her feeding tube today. Oh my! Now, all we need is Anna and Brielle to stop having the Brady episodes in order to come home. Who knows, maybe they will both come home next week? Then, we will really have a full house ;)

Praising God for how awesome these girls are doing! It is all Him!!

Thursday, April 03, 2008

Suzan Is Home

Yup, now we have 2/4, or 50%, of the quads home with us now. Suzan got discharged from the NICU today. She's joining Bethany in the purple nursery now. Hope she can put up with Bethany's grunting ;) Oh wait, they "roomed together" at the NICU so she should be used to Bethany by now.

Anna and Brielle are still at the NICU. Hopefully they both get bigger and stronger and then get to come home soon.


I thought I'd put a few hats on Bethany this morning ;) Here are some pictures of the cutie little girl...

Her wearing her "green" hat

Her wearing a hat or bonnet handmade by a friend's sister (thanks Jan!)

And her wearing a green knitted hat from my niece (thanks Nicole!)

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