The Pregnancy

A Little Dose of Reality

4 Comments 22 November 2008

First, a quick explanation on the picture to the left. The diaper you see there is the diapers that the preemie babies in the NICU wear…smaller than a dollar bill!!! The picture of Casey and I was taken three weeks ago when she was 20 weeks pregnant! Moving on…

As if our week wasn’t crazy enough with our little hospital excursion, we also had a meeting on Thursday called a Patient Care Conference where we met the team of people who will be involved with Casey’s and the babies’ care once we get closer to delivery. There were nurses, doctors, clinicians, neonatologists, perinatologists, obstetricians, a rep from legal, a couple VP’s of something or other, and even one of the chaplains. In all, there were 20 people in the room, not including Casey and I. Twenty people who represented different teams that will be responsible for making labor and delivery of our babies a success…WOW!!

We had already been told that there will be at least 18 doctors present at the delivery (3 assigned to each baby and 3 just for Casey), but we found out that there will be at least 30-40 people involved at any one time while the C-section is performed. The hospital has organized teams of doctors and nurses who have volunteered to be on-call 24/7, including holidays and weekends, starting at 24 weeks and continuing until the babies arrive to ensure that they have all of the needs covered when the time comes.

A Herculean effort to be certain, which we knew was coming, but seeing all of the folks in the room and hearing them describe their role in the birth of the quints served as a little dose of reality as to the magnitude of the situation we are faced with. The doctors discussed several of the different risks involved with premature birth as well as the probabilities of survival and disability and they have asked us to make a few decisions in regards to resuscitation efforts (resuscitation was defined for us as any use of breathing tubes or other equipment necessary to keep the babies alive).

Probably the most striking statistic that was thrown at us was the survival and disability rate as it relates to gestational age of the baby when it is born (the number of weeks that Casey has been pregnant which is 22 weeks as of today). At 24 weeks, the survival rate is 25% and of those that survive, 95% have long term disabilities which may include Cerebral Palsy and severe mental retardation. At 28 weeks, the survival rate is 95% while the disability rate is only 5%. What a difference 28 days can make!!

Casey and I have already made the decision that no resuscitative efforts will be attempted prior to 24 weeks. The likelihood that any of the babies could survive if born that early in their development is highly unlikely and if they did survive, it would only be through incredible intervention that would be very hard on the babies. Beyond that, we have been asked to decide what level of resuscitative efforts we will allow assuming they make it past 24 weeks. Will we allow a breathing tube, chest compressions, or anything beyond that? I don’t know what all of the different levels are, but it is something we will be talking with our doctor about at our next appointment on Monday.

After the meeting, a couple of the nurses took us through the NICU and allowed us to see a few of the babies they were treating. That was an incredible sight to see!! These babies were SOOO little!! It was cool to see the wall of baby prints that they had on display and see how tiny their little hands and feet were. It’s hard to imagine we’re going to have five of these little guys in a couple short months!

All in all, the meeting went very well and we were thrilled with the level of concern that the hospital is taking in preparation of our arrival. We had been counseled on the risks and probabilities of survival and disability when we first found out about the quints so we were not disheartened by this news. We were actually advised to undergo a selective reduction at the very beginning to get down to two babies because the risks are so high. Clearly, this was not an option for us!!

As far as our mindset is concerned, not much has changed. We knew from the beginning that this was going to be a dramatic experience in our lives and it has certainly lived up to expectations! Casey and I have leaned heavily on our faith in Christ to get us to this point and we will continue to do so to get us through the next couple of months. We can use all the prayers we can get so please continue to pray for the health of the babies and for Casey’s body to remain calm as it continues to grow and change rapidly! Please specifically pray for guidance and clarity with the decisions we must make in regards to resuscitation. We’re wading into really murky waters with what is the right thing to do and can use some guidance on this one! Thank you all so much for your love, prayers, and support!!
God bless,
Ethan

The Pregnancy

Update on Casey

6 Comments 18 November 2008

Casey had a great night and the contractions have stopped. Basically, she was experiencing Braxton-Hicks contractions, but way too early in the game to be taken lightly. They are sending her home later this morning with instructions for strict bed rest until the babies arrive. The contractions are expected to continue from time to time so we are officially on pins and needles from here on out. When the contractions become noticeably more painful and increase in regularity, we’ll be headed back to the hospital. I imagine this won’t be our last overnight stay before she is admitted long term.

Thanks to everyone for your prayers and concern! It really is fascinating to see how people have rallied around Casey in prayer during these times of uncertainty.

God bless,
Ethan

The Pregnancy

Hospital Visit #2

6 Comments 17 November 2008

It’s amazing how quickly things can change. We’ve had a great couple of weeks and a very nice weekend, but got thrown a pretty serious curveball today. Casey and I went this morning for a checkup with her ob/gyn and she ended up in the hospital! Casey had high blood pressure this morning at the doctor’s office so they wanted her to be admitted to the hospital for monitoring. The doctor told us to expect that she might be kept overnight, but we might go home later this evening.

When she got here, all seemed to be going well with the blood pressure, but they found a new complication – she was having contractions. They are relatively mild and pretty sporadic, but they are definitely contractions. Now that she knows how to identify the contractions, she has realized that she has been having them for several weeks, but did not recognize them as contractions. The scary part here is that if she proceeds to early labor, there is nothing that can be done to stop it. If that happens, the babies have very little chance of survival. They have given her a couple of medications that are supposed to calm the uterus, but they won’t do much to prevent pre-term labor if her body decides it’s time for that.

At this point, we have no idea how long Casey will be here or if she’ll be allowed to leave at all (there is a possibility they will decide that she is safer here and that she will have to remain here until the babies are born). I don’t know exactly what the deciding factor is, but for now all we know is that we will be here overnight.

We have several friends taking care of our immediate needs and are very grateful for all of the prayers and encouragement we’ve received. Please continue to pray that Casey’s body will quiet down and those babies keep incubating!!

I’m not sure if I remembered everyone that I should have on this email so please forward this on to other friends and family!

God bless,
Ethan

The Pregnancy

Exciting, Amazing, SUPERCOOL!!

1 Comment 15 November 2008

I’ve got a couple of quick hits to share:

First, the EXCITING: I felt the babies move!! I’m not sure how many of them I’ve felt moving around in there, but there are three different places on Casey’s belly where I can feel the little bump of tiny heads or feet or arms! I’m pretty sure I feel Baby B, C, and D, but who knows??

Next, the AMAZING: We were reading online that a 21 week baby is approximately 10 inches long from head to toe. That means that Casey has more than four feet of baby inside her belly!! Wow!!!! Thank God for the fetal position!

Finally, the SUPERCOOL: My woman has had the most incredible attitude through all of this! She has dealt with aches, pains, nausea, muscle spasms, vomitting, major food aversions, back aches, a trip to the ER and two days in the hospital, sleepless nights, major immobility, shortness of breath, and on and on and on, but through it all she has kept a smile on her face! She would stand on her head for the next nine months if she had to to keep these babies healthy and for that she gets the SUPERCOOL Mom-TO-Be Award!! Keep smiling, Casey Ann!! Oh yeah, the picture? Halloween party at a friend’s house…that’s as close to Hillbilly Casey as she’ll ever get!!!

The Pregnancy

In the News…

3 Comments 12 November 2008

What a crazy day! Casey called me this morning when I was out on one of my projects and asked how flexible I can be with my schedule today. Apparently, KVUE News, our local ABC station, caught wind of our story and wanted to do an interview…today…for a news story…today!! So, at one o’clock we’re sitting on our couch, both wearing microphones, talking with a reporter about our lives. It was so much fun!

This all happened because our unofficial publicist, Emily “Superstar” Yeck, sent an email to Olga Campos (one of the anchor’s for KVUE) about us on Sunday. She forwarded it onto Mari Alvarez, a reporter for KVUE, who interviewed us today and the rest is history!!

It was really cool to see the whole process unfold – from the interview, to the excitement of telling our friends what was coming, to hearing ads on the radio for the newscast highlighting our story, to the teasers throughout the broadcast, and finally to watching the feature on the six o’clock news! Probably the coolest thing, though was that we were able to be together with our small group from Marriage Builders (the Sunday school we attend through Riverbend Church) to watch it! Since these are the folks who made all of this possible and have been our biggest supporters from day one, it was only appropriate that we were all together to share in the fun!!

For now, the video is linked at http://www.kvue.com/video/index.html?nvid=302888. You’ll have to scroll down in the “local video” box until you find “More Quintuplets in Austin”. In the next few days, we’ll post the video to our website, http://www.joneslife.net/. Check it out!!

The Pregnancy

50 Fingers, 50 Toes!

4 Comments 04 November 2008

Before I begin with the update, I want to explain the picture to the left. The sonographer happened across this image as she was measuring the babies today. We can count at least 7 and maybe 8 feet in this picture…can you find them all?! Too cool!!
Updates, updates…we have updates! Casey started partial bed rest today (Monday was her last day of work) which means she is supposed to spend about six hours per day lying down (not counting sleep hours). Unless something dramatic happens, she will not have to go on full bed rest until her body just hurts too bad for her to move.
We had an appointment today with Dr. Berry, our perinatologist, where they did an anatomy scan of all of the babies. All five checked out healthy and all of their measurements were right on track for 19.5 weeks!! This is what we expected to hear, but it feels really good to have it confirmed! The four girls weighed in around 11 ounces, while Big Bad Jack came in at a whopping 13 ounces – that’s my boy!! On a side note, I forgot to mention that Jack got his first baseball mitt last week when my parents came to town…thanks, Mom!
The next 6-8 weeks are critical for the health of the babies and there are several major milestones that we will be focused on along the way. The first milestone is 24 weeks which is the point at which it is reasonable to resuscitate the babies if they are born this early. In other words, if Casey’s body were to go into labor before this point and it could not be stopped, it would be highly unlikely that they would survive.
The next milestone after that comes at 26 weeks. If the babies are born at that time, the likelihood of survival is high, but the likelihood of significant defects is also high. After that, we focus on week 28 which happens on New Year’s Eve. Delivery at 28 weeks is the average for quintuplets and we hope to beat this! If the babies are born at this time, their likelihood of survival is very high and the likelihood of defects is dramatically lower. At 28 weeks, we claim victory! Beyond that, every week is critical to minimizing the time the babies spend in the NICU and to further strengthen their development, but the likelihood of major complications is much lower.
Our goal is to deliver the babies in early February at 32 weeks. For a point of reference, if this were a normal pregnancy, the due date would be March 27! Casey will likely spend the last 3-4 weeks in the hospital on full bed rest (with two nurses at her bedside to help move the belly when she needs to turn over!!). We have a meeting later this month with the NICU doctors and staff at Seton to tour the NICU and go over the delivery plan…apparently this is going to be quite a production with up to 18 doctors (three for each baby and three for Casey) plus nurses in the delivery room!!
Please keep the prayers coming over the next 8 weeks for both the babies and for Casey! Casey’s spirit is strong and positive, but she gets more and more uncomfortable every day as her body literally grows before our eyes! We have been incredibly blessed throughout this experience and we pray that these blessings continue throughout the rest of the pregnancy!
God Bless,
Ethan

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