The Reflux - has hit the Quads

MOLLY

KURT

MEGHAN
COLE

GERD - or Gastrointestinal Reflux Disease -

Better known as Mom and Dad's worst nightmare has started.

Cole, Meghan, and Kurt have all started spitting up and shrieking in pain post feedings. We thought it was the beginning of the post preemie stage when the babies seem to want to be awake, held, and stimulated more. Instead we have little ones who are shrieking in pain after they eat because their esophagus is irritated with gastric juices from their stomach contents causing irritability and pain. Meghan seems to be the worst requiring a lot of attention and special care. For the last few nights Chris and I have taken care of one or more of them throughout the night - meaning they need to be held up right to prevent this burning pain.

So the treatment is ZANTAC we hope.

As for the babies they are growing big, gaining weight and becoming unique individuals. As far as Dad & I can tell Cole likes to eat sleeping then awakens curiously after feedings and wants to see if you have noticed he is awake often playing possum. Kurt likes to evaluate his surroundings. He is often found looking around for hours peacefully and quietly. (He's gonna get away with everything) Meghan lets you know if you have disturbed her, irritated her or wants your full attention. Last but not least Molly loves to be the baby although she is the oldest. She is very laid back, looks around usually at night and is the smiler of the group. All of the babies are content so this GERD needs to move out of the Schwartz Clans esophagus so we can all have a smooth and enjoyable,but tired newborn stage.

Here are some pics from their Due Date - September 28th, 2008.

Cole's Recovery

Cole has been doing well. He was grumpy post surgery and little sore from his incision. I was suprised from his quick recovery. When Jason was 23 days old he also had pyloric stenosis. He was the youngest ever to have laproscopic surgery to repair this valve. He had lost a lb. and it took him 4 days in the ICU to get released. Looking back Jason was a lot sicker before he was diagnosed. Cole on the other hand was being watched much closer due to prematurity and being a multiple. I realized he was very sick after the last stool I had induced earlier that afternoon. Once he vomited during the night it was only a matter of scheduling coverage for the other siblings and deciding which hospital to go too. I preferred Childrens hospital with my single babies, but decided to drive to St. John's due to Cole's birth and history prior to this upcoming hospitalization. I'm glad I did. Well, the care was good, the surgeon was informative and cautious.(something I'm glad about with babies) And his recovery efficient. Cole is up to his normal feedings, stooling well and tolerating a 4 hour schedule once again. Thank goodness. By the way Cole didn't miss a beat he eats second and sleeps soundly, and lets you know when he wants to be up and out. He loves his pacifier ..................................

My little Cole

Cole

Kurt

Meghan

Molly

Cole


Kurt & Meghan - 6 weeks old


Our 6 week picture - Molly, Kurt, Meghan, Cole

Cole has been growing like a weed. He is the youngest of the 4 babies and my baby of all babies. He has been constipated and looking back on a week of events and some discussion I can see why we ended up where we did..................
Cole had been straining to go to the bathroom quite often but never seemed to quite manage to get out a stool or have a consistent pattern. I would be lying if I thought it was just rock hard stool that concerned me but he was vomiting too. So like the hospital I gave him glycerin suppositories so he could be relieved.
Well, I forgot to tell you the night before ( I think Monday) Cole could have died - very scary,but thank god I was in the room. I was feeding Molly when Cole vomited after I fed him, It sounded like a lot , but I was sitting in the chair with Molly and waited for him to cry,grunt, etc.. Well he didn't .... So I got up still feeding Molly and saw him turning blue. I had a moment of oh shit and decided to chuck Molly's bottle, place her quickly not softly into Meghan's side of the bed between Meghan and the wedge and pick up Cole. I gave him many back blows, and started sucking all kinds of milk from his nose and mouth and did it all over again till he cried and regained color. Needless to say I checked on him quite a lot over the next hour feeding Molly and Kurt and wondered if I should spend the night in his room. Oh well .... I didn't ...
But as the story goes he was blocked up and was going that way again and so was Meghan .... So I called the doctor & the call was to give 1 tablespoon of Karo syrup in their bottles 2X's a day and let them demand feed no longer than 51/2 hours between feedings. OK good an answer to this problem......
So My kids were chugging right along on a 4 hour schedule with Meghan eating 100ml, Cole at 90ml, Kurt 90ml and Molly at 80ml. I increased there feeds by 10ml (Monday) and started the Karo Syrup in 2 bottles throughout the day yesterday (Tuesday).They were all waking up early to eat.
Well today(Wednesday), .......They are starting to get sluggish and not eat well and not wake up. ( just a few feeding) So I fed them at the regular 1/2 hour time limit and if they ate 60+ I would call it o.k.. So I went to a 41/2 hour schedule at 8 p.m.tonight ( Wednesday night) ...................... we will see - it's trial and error ..................... So Last night (Wednesday), the babies fussed from 10:30 till Chris fed them at 11:30-1:30 (starting to become a habit.- the fussing) then I set my alarm for 4:15.................... Megan started fussing at 3:45... .so much for that Idea of letting them sleep through, so I got up, got the bottles and headed for their room ................ all of them were out cold................ so I ...... fed them ........ remind me never to do that again ..... so everyone ate 1/2 their bottles at this feeding time ( I could not feed some we'd be a mess in the a.m. )
Well I can recall today (Thursday) that they were very sleepy after the Karo bottles .. which were at Chris's feeding last night and this afternoon. plus bath time ....... So again I called the Doctor
I felt like a new mom .... repeatedly questioned my M.D. about the dosage of Karo and further suggestions to this high octane syrup that seemed to just make feeding time more painful and the kids more sleepy (not a bad side effect if you just have one baby and could try letting it sleep through the night without major consequences. )
So its Thursday afternoon when I just happened to walk into the room where Cole is being burped by my help and I see him arch way back, and start to foam at the mouth. Of course without hesitation I grabbed him, starting suctioning his mouth, requested my help to go to the nearest store and by my favorite glycerin suppository for him. He was relieved, but the scary thing was his stool was all liquid and very green ............ actually it shot across the room as I massaged his belly. (really resolve does work).
Then I did a familiar test Dr. Herbers did on my son Jason over 4 years ago - this reaction prompted me to believe Cole has pyloric stenosis. I took the M.D. instructions down and awaited for Cole to have them......... At 3a.m Cole vomited his feedings again and I packed a bag, awoke Chris and went to St. John's ER. While I was driving I recalled thinking should I go to Children's hospital instead, I hope this isn't true and Dad you better watch over him. Well at 7a.m. the diagnosis was made and at 11a.m. his surgery was being performed. At 4:30 Cole made it to recovery and was placed in the PICU overnight for observation. He had a few apnea spells post surgery and needed a little caffeine for heart rate drops. All in all he is home and recovering well.

Meghan is next we will watch her to see what happens over the next few weeks.

Our Hospital Stay in NICU South -

I have been very unsuccessful at loading these pictures for everyone. Hopefully this link will recapture our stay in August at NICU South. All of our Nurses, Doctors and other families we met along the way will stay very close to our hearts. We really appreciate the kindness they have shown to our unique family and are glad to have our whole family home.

P.S. I included my growth pictures for all of you to see how big I got!!!!


http://picasaweb.google.com/jillmschwartz/Movies#5247006389174471666

K. Scully photography - A Must in my book

One of my good friends from Creighton has a unique style and creativity that cannot be matched. Kristin spent a day with us in our visits to the NICU North and provided me with this assortment of her days work. I first of all cannot thank her enough for her thoughtfulness and everlasting memory she has provided not only me but my babies as well of their start in life. Kristin you do amazing work .............. it's not work it's art

thanks again and I am lucky to share this with you

jill

( p.s. this site will steal you heart......... )

http://www.kscullyphotography.com/

once you have arrived at her site hit enter on/under the middle picture then go to client proofing , once there then type in one of 2 passwords both are very unique and worth reviewing.

quads b&w
quads color

if unable to log in try seeing the pictures on this site.....

http://flickr.com/photos/kristinscully/

1 month flies by when you have 4 new babies

Well I guess I have some updating to do.

The last pictures were from the first weekend that we were in the hospital.

Over the last month I was released from the hospital on August 12th. That day was particularly hard since I wanted to go home to see Chris, Jason & Kyle, but at the same time I finally was able to start getting to touch and hold let alone meet Molly, Kurt, Meghan & Cole.

As I moved back home, I seemed to miss what had been normal to me - breakfast in bed, familiar nurses and techs I had come to know well, wheelchair rides with transporters and family, particular Md's & their residents, and of course TV, The Shower Chair, and my next door neighbor Saadia.

It didn't take long and I was back to St. John's again this time visiting the NICU. At first we spent most of our time trying to make it before their schedules started or the limited time they could be held was gone. The staff accommodated us nicely especially with the extended family I had visiting in shifts each day. I would look forward to seeing them and meeting new nurses and talking about this miracle that seemed so unreal. They spent the first weekend working towards reducing their oxygen demands and breathing on their own. Molly and Cole both needed to be intubated briefly, given surfactant to help their lungs mature and recover prior to breathing on their own. By my departure all babies except Cole were breathing on their own - that was 8 weeks prior to their due date. What a miracle that was in itself.

Everyday I expected some setbacks or information that a baby or babies would struggle, need some type of support or have something major to be evaluated, but each day brought out more good news - all O2 demand negated, all bilirubin levels decreasing from photo therapy, no anemia problems requiring intervention, all ultrasounds to detect brain bleeds negative, hearing/vision screens normal, and all heart murmurs benign. All of the babies were moved to the South in 1 week a fast but much needed change from the critical north NICU. Thank god for miracles and a few good angels protecting these babies.

As each neonatologist would visit and discuss each child they would get an enormous grin on their face and say, "they are all doing so well, so well Jill, no worries get some rest." As the end of August approached, ( just shy of 2 weeks from my actual release) Dr. Chao thought 1 to 3 babies might be released from the NICU. Chris and I were shocked let alone suprised by the thought of three babies coming home in 2 1/2 weeks from birth. We prepared for them to be in over a month possibly more - not home in 2 weeks. As I discussed this home coming I started to tear up thinking I can't leave Molly here by herself - I just thought I'd never be able to get back. Now thinking about it I wouldn't be able to not with the demands of feedings around the clock and the exhaustion that follows you like a little cloud over your head, but you just seem to keep going. As I realized I was probably only talking about a week or a few days more I just couldn't bear it. I apologized to Dr. Chao because I realized there are much worse things I could be crying about right now ......... but he said every child is special and not every child is your own so that helped me realize I wasn't being selfish just wanting to not leave anyone behind.

So as the end of the day passed and the new day came I braced for this new change. I was glad they were coming but was still hoping they would stay longer to help me recover & get them home safely together. Again, someone was watching over us as the babies all slowed down together, I believe to wait for their sister Molly and to help me recover, but scientifically because the circumcisions fatigued the boys eating patterns and the now known "cold corner" of NICU south helped put Meghan into temperature fluctuations requiring a isolette.

Over the next week Molly caught up with intake of feedings, the boys started to eat well again, and Meghan regained her steady temperatures. ( For the NICU nurses that moved them I thank you - especially since it was your busiest time of a long 12 hour day.) As they kept improving it dawned on me they were all getting close to going home, but not until the nurse informed me to sit down that it was actually going to happen. It paid off and all of my babies arrived in pairs over the Labor Day weekend.

Janel's photos from Sunday Aug. 10th visit

08/08/08 - How lucky are We !!!

Hey All,

I would like to share with all of you our good news -The Schwartz Quads were born on 8/8/08.

Crazy as it seems the delivery date was originally scheduled for August 7th, 2008 @ noon, but Dr. Bartelsmeyer felt that I should push to go longer since all of the babies had plenty of fluid around them and I wasn't preeclamptic, and my pre-term labor pains seemed to be settling down because of strict bed rest.
So my husband and I met with him to discuss delivery vs. another date so.............. we moved the date back 5 days to August 12th ....... I thought it was attainable ............. looking back I was so done physically and mentally, but when your told your outcomes for the babies would be better what's a woman to do?

So instead of me deciding the babies and my uterus did.

On August 7th, at 8 p.m. I started to have contractions in an irregular pattern. They increased in intensity and duration, but the nurse and I realized my procardia was not taken and was due an hour ago - usually that quieted them down and eventually stopped or slowed them. Well this night they became regular over the next hour and more continuous to the point of needing to call Chris my husband into the hospital.

He had just left 2 hours ago with the kids and needed to arrange things for them. So he arrived at 10:40 and Dr. Webb proceeded to tell us we were going to have a birthday party tonight.

Thank God he (Dr. Webb) is easy going like me. It was happening so quickly I felt like I was the only calm one preparing me for delivery. As I proceeded to give out instructions to my husband and uncle we wheeled down to 2nd floor- by bed uggh!! Soon I realized we were not coming back for more bed rest and it was going to be midnight soon. The nurses were teasing me that they might have different birth dates 8/7/08 & 8/8/08 - I really didn't contemplate their statements too much just in awe of that it was going to happen tonight.

Soon my IV, epidural and family were all there. They told me their well wishes and gave me hugs and kisses before I left for the OR. As I wheeled into the OR, 4 open beds for the babies were on my right with at least 20 nurses, therapists and a neonatologist were standing waiting for Dr. Webb to appear. At this time I was crying and asked the anesthesiologist to give me something to relax, in about a minute I was ready for bed. (Thank god for drugs!!!!!!) On the other side a surgical team of 6-8 nurses and residents were on the Left. Then Chris appeared in his yellow scrubs and we waited for Dr. Webb. When he arrived they all clapped and away we went. I looked up at the clock and my husband said, "Jill you did it you made your goal - it's 8/8/08."

I wanted to deliver on a Friday and get past 32 weeks edging me closer to 33. At the time 8/8/08 didn't mean much but just a date to get to - to prove to Dr. Bartelsmeyer I could make it past 30 weeks and give Chris time off without taking much vacation time, but the biggest factor was to have their lungs healthy and developed. So 8/8/08 is lucky for me because that just what happened.

So Molly Joan and Kurt Thomas arrived at 12:47 and Meghan Kay and Cole James came at 12:48.I met them at 5 a.m. and have been watching them grow and get closer to home ever since. They are currently in the South Nicu and are off IV's, Breathing on their own, ultrasounds of their heads were negative, they are all early nippling at 33 weeks, have regained and surpassed birth weights and are working to control their temperature. Each one looks a little like both of my older boys but I don't believe they are identical. We won' t know till much later. I don't think they will be and I am glad for them to be different. It seems like this is still a dream but reality is approaching quickly.

As for the news, I thought it was nice and crazy at the same time. I was on heavy drugs and realistically was exhausted, but the news was looking for a nice feel good story of the day and I'm glad we were able to bring that to the St. Louis area. Chris and I were elated to share them with you all and look forward to getting our babies home soon.

For now I'm Glad to be home -Jill
P.S. the pictures are coming.................

Guess who arrived - 08.08.08

Hello all,

It is Aunt Jamie writing for Jill. I know everyone has been waiting to see pictures of the babies and wanting updates. So I let Jill know I would take care of it while she is in recovery. She wanted me to inform everyone she will write a story about the past couple of week so I will spare you my version.

Jill is doing great and is coming home tomorrow. As far as the babies, they are all doing great. Just spoke with Jill and 3 of the babies are breathing by themselves. One of them is still n oxygen but should be off soon.

Below are pictures of each baby and I have listed their names, length and weight in the order their picture appears.

Molly 16 1/4 inches long weighing in at 3.8 pounds, first born
Kurt 17 1/4 inches long weighing in at 4 pounds, second born
Meghan 17 1/2 inches long weighing in at 3.13 pounds, third born
Cole 16 1/2 inches long weighing in at 4 pounds, the baby of the family










Who would have thought that they would be in the paper and news this much. Here are some of their articles

http://www.stltoday.com/blogzone/parents-talk-back/parents-talk-back/2008/08/a-set-of-quads-pick-08-08-08-to-arrive-at-st-johns/

http://www.examiner.com/a-1527702~Quadruplets_born_at_suburban_St__Louis_hospital.html

http://www.myfoxstl.com/myfox/pages/News/Detail?contentId=7167089&version=5&locale=EN-US&layoutCode=TSTY&pageId=3.1.1

IT'S AUGUUUUSSSST !!!!!!!!!!!!!!!!!!!

Quite a while ago, the babies started getting tested 2 times a week to check their well being and occasional growth. This testing is done twice a week it is called a Biophysical Profile. This test each week, tests each baby for four specific things. Heartbeat & Rate, Breathing, Amniotic Fluid Volume & Movement. Each portion is scored up to 2 points to determine their effectiveness. Biophysical profiles started after I received steroid shots back in my 27Th week. Each week, I was hoping the babies would score a 8 and so far each week they have done just that.

Another valuable test is the 3 week growth scan. This test gives us the growths of the babies, but also tracks their growth in percents which is more valuable to the physicians and gives a good outlook as to how well they are doing overall. After my last test, Laura the ultrasound stenographer, explained how well my babies have been doing. She said, "most people just want their weights and are happy, but the physicians' look at these percentiles." As she points to the computer screen I see 45% - 50% and a graph with four scrambled letters falling between a high and a low line. She continues to explain "that this means your babies are on track and have been since they started testing." Apparently, those percentiles show all of the measurements together over the months and although they are quads they are growing like a singleton. Your babies would be half way to how big they would be at full term. By them staying on track they have grown accurately to their gestational age. ( That means all of them not just one). So Mama is very proud of them!!!

So here are their 3 week weights...............................

Baby A (Girl) ...... 7/7/08 - 2lb. 7oz. ....................... 7/27/08 - 3lb. 4oz.

Baby B (Boy) - 7/7/08 - 2lb. 9oz. ............................. 7/27/08 - 3lb. 5oz

Baby C (Boy) ..... 7/7/08 - 2lb. 13oz. .........................7/27/08 - 3lbs. 9oz.

Baby D (Girl) - 7/7/08 - 2lb. 10oz. ............................7/27/08 - 3lb. 5oz.

Overall 3 lbs. in 3 weeks and an average 2 ounce gain per baby per day ........ no wonder why My Body is getting heavy. Please wish us luck as we continue this endeavor to stay on track and be healthy.

Jill