(click here) THE TRIPLET'S BIRTH AND LOGAN'S DEATH SUMMERY

Logan was the donor of twin to twin transfusion syndrome in a triplet pregnancy. His brother Jacob was the recipient. Andrew was fraternal he had no issues. Logan was always a little smaller than his brothers on early ultrasounds as early as 12 weeks. I actually asked the doctor if he thought they had TTTS and he assured me that they did not and it was normal for one baby to be bigger than the other because one baby had a larger portion of the placenta. So weeks went by with no super close supervision. My last doctors appointment was a quick one where he looks in the office to see if all the babies have heart beats and fluid and that is it. My last long detail ultrasound was about a month prior to this. I am just past 24 weeks at this point. I just stopped working and I told the doctor the day before this office visit I thought I passed what looked like part of a mucus plug. He check my cervix said I was closed and normal and told me to look out for signs of pre term labor. Just over the 25 week mark I noticed I was having painless tightening of my stomach while putting away my daughter's cloths. I decided better be safe than sorry and went to Labor and Delivery triage. To my surprise as I thought I was wasting my time with Braxton Hick contractions I was dilated to 3 already.

I get the news that I will not be leaving the hospital until the babies are born even if it is 3 months! 12 hours later I was transferred from my local hospital by ambulance to Winnie Palmer Hospital for Woman and Babies in Orlando, FL I was hospitalized for 2 weeks before they were born. Daily ultrasounds were done to check each babies biophysical profile. Around 27 weeks after about a week in the hospital was the 1st mention that my babies had TTTS. Their was a sudden shift over a few days of fluid. Logan's fluid was always on the low normal side and Jacob's on the high normal. I can't remember the exact numbers but I know Logan's was around 2 at this point and Jacob's around 14 normal being (4-8)I consented to an amnio reduction to Jacob's fluid. This was to help prevent pre term labor from starting again and to hopefully allow a shift in fluid back to Logan per the OB/GYN. Less than 2 liters of fluid were drain before I felt a sharp stabbing pain. One of the worse pains in my life. They thought my placentas were abrupting and almost rushed me to surgery. Lots of medications later the contractions stopped and things went back to normal .4 or 5 days later a 2nd amnio reduction was done. Jacob's fluid was around 18 now and Logan at this point had less than 1cm pockets. I was not placed on a 24hr heart monitor for Logan he was now considered "stuck" and at one point they thought Jacob had hydrops then they told me that he did not. The early morning of July 18 (this was 28 weeks to the day) Logan apparently had some dips in his heart rate. The nurses had come into my room several times and made me wear oxygen to help it come back up. He also had 2 days of poor biophysical profiles where he has not "breathing" on the ultrasound plus the fluid at this point they could not even find a pocket to measure. His bladder could not be seen and none of the babies show any growth in 2 weeks.

So it was decided July 18th would be their birthday. Logan born 1st at 1lb 14oz 13inches long Jacob 2nd at 2lb 8oz and 15 1/2 inches long Andrew 3rd at 2lb 9oz and 15 1/2 inches long. Logan show poor signs of life and had bad apgar scores. He was eventually stabilized with intubation and transferred to the NICU. Jacob was also intubated. Andrew was actually placed on a high flow nasal canuala and NEVER required being intubated. Logan was intubated for 6 weeks continuously. He was strong and had one heck of a temper. He was my angry kitten. He extubated himself almost daily after the 1st 10 days. During the 1st days of his life he was very sick and required high frequency ventilation I think it was 4 or 5 days. He then was weaned to a conventional vent and they started weaning his oxygen. Jacob was extubated after 2 days was placed on cpap for a week or so and eventually high flow nasal canula. Andrew went from HFNC to cpap after a week or so and was not c pap for 3 or 4 weeks. Both Andrew and Jacob had their ups and downs with oxygen going back and forth with cpap for a day or 2 during their stay before oxygen was weaned totally. Logan on the other hand was weaned to the high 20's-low 30% range (room air being 21%)at 6 weeks he was place on c-pap and a day or 2 later was placed on a vapotherm which is a really high flow nasal canuala. I think it was at 8 liters. He did well on this for a few days then suddenly started needing more and more oxygen. Within 24 hours he was placed on c pap then intubated and placed back on high frequency ventilation. The reason for the sudden deterioration was RSV. The NICU was having a huge outbreak of RSV to the point they had to move all the babies to 1 pod and still had babies on isolation in other pods. By now Andrew and Jacob left the Critical care pods 1 & 2 and went to the transioning pod (3) They were all in pod 2 together and when the outbreak came Logan along with alot of the other babies in his pod 2 room were moved to pod 1. This is where Logan spent the rest of his life. Andrew and Jacob were also + for RSV but never show signs and even weened off their oxygen while +. The RSV caused Logan's already poor lung to be worse than before. His chest x-rays were horrible you could not even see the outline of his heart or any good area of his lungs. After a week of intubation again he was placed back on cpap then the vapotherm again. at 8 weeks I belive he suffered a broken femur to his left leg. It went undetected by doctors and nurses for approx 12 hours before diagnosed and treated. No one know how it happened or when they just had a est time of 12 hours. He even endured a tub bath that the night nurse tried to give him to calm him down from his crying. She even noted his leg was swollen! but never told the doctor until rounds that morning. He was on pain medication around the clock. Due to the pain and him clamping down not wanting to breath and the respiratory depression from the narcotics Logans was intubated again. 3 or 4 weeks passed attempts to get him of ventilator failed. He was addicted to narcotics and has placed on methadone. He had several short courses of steroids to boost his lung volume, but nothing lasted more than a few days. His oxygen needs stayed high. Needing 100% oxygen some days but stayed in the 60's% range mostly during this time. In later November he became very ill. His Co2 went to 180 (normal being 40) he was on a lot of support on the ventilator at this point and on 100% They were running out of options. (BTW Andrew and Jacob were discharged home on September 23 2009.

Andrew has healthy Jacob has dianosed with multi cystic encephalacia on his bilateral peridal lobes covering most of his periodal lobes i.e. bad brain damage the cause was unknown if it happened before birth from the TTTS or amnio reduction vs. premature birth) Logan eventually was given antibiotics, a mediaction to paralize him to stop him from fighting the ventilator, and higher doses of new steroids. He was also placed on nitricoxide for pulmonary hypertention. After a scary 3 days he responded. It was like God had handed down a miricle. Over the course of the next few weeks Logan was taken to surgery and given a trach since he could not be weened off the ventilator. He stayed on steroids this entire time. He was weened to a low dose and actually weened his oxygen as low as 23 and 24% I was praising God for the wonderful mircle he had given me. Things were looking up and he was coming close to coming home. Every time they weened the steroids totally his oxygen needs went up but instead of the 60's and up they stayed below 50% Christmas came and went. He went to surgery early January. I believe January 4th for a bilateral inguinal hernia repair, an inisian (sp?) and g-tube placement. He recovered well. He was transitioned off the ventilator onto pressure support c-pap mode. Steroids were weened again from surgery. Orders were made for home vent and trach supplies. We were learning how to care for him when he came home trach care gtube care etc. Their was some insurance issues that delayed the home vent from being ordered. He had reached his Million dollar max on our private health care plan and we were waiting for medicaid to approve services. Mid January his oxygen needs started to rise again. (BTW no mention after the 1st RSV infection he was tested + 2 other times and also contracted a staph infection and another hosptial accuried infection shortly after trach placement I just remembered)No one seemed to worried about it. I seen Logan well last on January 25th. The nurse had gotten him a TV and he had been watching The Lion King for a few days. He really liked it. My husband and I were driving to Orlando to watch a video on trach care when recieved a phone call from his doctor telling us he became unresponsive (like he did in November due to high Co2) and that his Co2 was over 200. She said he started going down hill during night shift and had a high Co2 over 100 all night and no one ever called me. Logan was placed on high frequency ventilation again and a work up for sepsis was in place. Over the next 24 hours he seemed like he was responding Co2 went down into the 70's he started to wake up and open his eyes, but he was far from allert. He was on a lot of medications to sedate him and his eyes seemed glazed a little. By late Friday night he stopped responding to treatment was on 100% oxygen and on high frequency ventilation. He was being paralized again by medication, was very swollen, and hardly had any urine output. They stopped his feeds on Thursday morning when he was placed on high frequency and was being hydrated with IV fluid. 4am on Saturday morning January 30th. He still was moving his legs and arms a little. You could seem him continueing to try and breath over the vent. This baby boy fought and fought.He never gave up. His Co2 was 222 at this point. His lungs had given out. He prayed over him. I told Logan not to fight anymore. I asked God to take him away from the suffering he had endured over the past 6 months and 12 days. I sat with him a while and went back to the "room in" room in the NICU with my husband continue to pray God's will and hope for a miricle. I was back at his bedside at 8am. One look at him and I knew what choice Logan had made. Logan decided to be with God. He stopped breathing. His eyes were pin point (he was clinically brain dead from the Co2) the Co2 was so high it could no longer be read on their machine. Logan was gone. Their was no turning back. My husband called our pastor and members of out church to come. I had my sister bring my children, good friends came, and a photographer from "Now I lay me down to sleep" came. We took Logan off high freqency ventilation and placed him back on conventional ventilator so my husband and I could hold him. We were worried he would die before my sister could get their. His pulse and oxygen sats went low and stayed low for 20-30 min. Then suddenly just like crazy Logan's body always did his pulse went to 130 and he start sating 100% on the monitor. Logan was still unresponsive, swollen, not peeing, and now had blood coming up into his g-tube. I had them do one more ABG before I made my decision it was still to high to read. The doctor told me there was nothing more that could be done and that he was gone. We took him to a private room still on the ventilator once our friends and family arrived. We took lots of pictures, prayed and said our goodbyes. I took Logan's oxygen from his trach at 1pm. I help him in my arm as I watched the color drain from his skin, his lips, and tongue. He was not breathing nor showing any signs of life. The last movement he had was when his spirt left his broken body and went to Heaven. He was in my arms as I rocked him and I felt his body stiffen then suddenly relax. He looked so peaceful. He was pronounced dead at 1:17 pm on Saturday January 30, 2009. This was the best day of Logan's life and the worst day of mine. I know in my heart that Logan met God that day we can only hope to be so lucky. During Logan's dying processes. It suddenly came to me why Logan had so many ups and downs he would do better one week and crash the next. God was constantly calling Logan home and Logan fought for me and my family. I loved him so very much. I realized once he died, that this pure, undying, unselfish, wonderful love I had for him. A love so strong I could never feel anger or any other feeling except for a beautiful powerful love. This was Logan's purpose he showed me and many other people that followed his story while he was alive the Love that God feels for his children.

Logan's story did not end at his death. God poured an abundance of miracles upon my family the days following. I sat in the funeral home telling the director that money was no object that I wanted Logan to have the funeral he deserved when he was trying to talk us into a simple grave side service. I insisted he have a full blown funeral and it did not matter how much it cost because I was under the impression his life insurance policy would pay. The director informed me that he had been in the business for 20 years and that insurance companies NEVER paid out to premature babies with pre-existing medical conditions for policy less than 2 years old. I was looking at $5000 bill for just the casket and service expenses. The day before my husband and I were going to take every credit card we had down to the funeral home and max them out to give Logan what we felt he deserved. The funeral director calls my husband and says "this has never happen to me before." An anonymous person who apparently read Logan's obituary that day. Felt it on his heart to call our funeral director and ask about us. Turns on this man had recently lost his wife and her funeral was recently organized by the same person and felt that his wife would have wanted him to pay for Logan's entire funeral cost. I love this stranger who did this for me. I am in awe that someone could still do something so nice for a baby and a family he did not know. Thank You Sir you have no idea what an impact you have had on my heart. This was our 1st miracle from God. With the help of an awesome church family and my friends. Logan had the most kick butt service I have every seen. Over 100 people showed up for his view and his funeral. Our music leader at our church played at his funeral and his burial. 6 people excepted God as their Lord and savior at the end of his service. A memorial fund was opened in his name by friends. Almost $2000 was donated for his headstone. Even the police escorts were donated by the Sheriff. He sent his motor officers to escort his funeral. He had an awesome long procession. So many people came together for us donating time, and money for the sake of our family and out of respect for Logan. Logan has made me a stronger person, a better Christian, and has strengthen my relationship with my friends, family, and God. Logan is survived by his mother Jennifer, father Jack, sister Ava and his brothers Jacob and Andrew. They will always be triplets and my miracles. I always called Logan my angel baby and that is what he is now. He is in heaven with the angels.
This is the only picture I have of our entire family together and it was the one and only time I ever held all 3 of my boys in my arms at the same time.

8/16/11 update:
My survivors Andrew and Jacob are 2 now. Andrew is a thriving ACTIVE 2 year old. He is a very picky eater, but outside of that he is running and playing. He is behind a little bit and does not do everything a "normal" 2 year old would be doing, but he is catching up fast.

Jacob continues to struggle every day. He recently had his adenoids and tonsils removed to help with his airway and hopefully help him eat by mouth soon. It has been 8 months since he stopped eating by mouth. It was very hard for me to allow this to happen, but he was sick all the time from repeat aspiration pneumonias. He has had hard recovery from the T&A surgery, but is doing well now. He usually vomits daily, but at times can go weeks at a time without vomiting. He has gained some arm and head control, but not much. He will rarely flip himself from his stomach to his back and I have only once witnessed him roll from his back to his stomach. He is happy. He loves noise and watching tv. He likes to look at bright lights. He babbles a little, but says no words. We were told he was blind, but recently have been told his vision is improving. His wheelchair is on order. He can not sit, hold objects in his hands, stand, or walk. We have faith that God has great purpose for my children and continue to trust in God to provide for our needs and continue to help our son gain function.

Ava is getting so big. She is 4 now. She is starting VPK this year and will go into Kindergarden next year. She loves to tell us what to do. :-) She thinks she is in charge and tends to be "the boss" She is very sweet and loving when she is not the boss and definately loves here mama.