The five boys at the Conklin house sit patiently waiting for their 15-minute turn to use the lone IPad. They take turns on the device to play their games or watch online videos. While one of the 4-year-old boys takes his turn, the others occupy themselves with other activities.
"This is the way it is all day, until the battery finally dies," says Alissa Conklin.
"We can stop watching the clock when the battery goes and then they are done with the IPad for the day," Brad Conklin adds.
Having a handful of boys at home is challenging, but imagine having five boys the same age.
In January 2009, the Conklins visited the fertility department at Geisinger Medical Center in Danville. Early that spring, the couple learned Alissa was pregnant for the second time, having given birth to their first child, Eliana, five years earlier.
During their first visit, the Conklins were told of the possibility of multiple babies, but neither the fertility specialists or Alissa and Brad were ready for the total. The specialists counted four babies.
"At 12 weeks, I went for my first ultrasound appointment with Maternal Fetal Medicine and they found the fifth baby. We cried all over again. It was not what we were shooting for. I told them that day, if they find another one, I was not coming back," Alissa says with a laugh.
"I said, 'What's one more,'" Brad says jokingly. "In hindsight, four would have been easier. When you go to the store, nobody ever has five of anything. They always have four."
Alissa and Brad's terrific sense of humor and wit is perfect for the challenge they face raising quintuplet boys.
Before the Conklin boys, the most multiples delivered at Geisinger Medical Center were quadruplets. Quintuplets created uncharted territory for staff and doctors. Luckily the hospital offers the Center for Prenatal Pediatrics, a program that focuses on organizing care for families where mothers have complicated or high-risk pregnancies.
The Center has a coordinator who acts as a care navigator, walking through the entire prenatal course with the family and medical staff. The coordinator helps the teams plan, organize and create a medical plan well before the babies are born.
With high-order multiples, parents are guaranteed a preterm delivery. This is why it is critical that the high-risk obstetrician in maternal fetal medicine and the neonatologists work together to collect as much information about the pregnancy as possible to formulate a multifaceted plan, according to Neonatologist Edward Everett, D.O.
"Time is our friend with preterm babies. The longer the pregnancy, the more the babies usually benefit," he said.
"We worked with the family as well as the team to come up with a time at which mom would be brought to the hospital and monitored carefully. This would allow us to have a good sense of what was going on in utero and provide a good outcome for all five babies."
For the Conklins, it was smooth sailing.
"It was a really good pregnancy," Alissa said. "The doctor told me that my body was meant to have quintuplets. I laughed at him."
"The doctors said the pregnancy was better than some single pregnancies," Brad said.
Around 25 weeks into the pregnancy, Alissa and Brad were in the process of moving into a new home in Bloomsburg. During her prenatal visit, the maternal fetal medicine specialists decided it was time for Alissa to be admitted to the hospital for round-the-clock monitoring.
"I stayed in a nice big corner suite in the women's delivery wing," Alissa said. "My room was huge. I wasn't on bed rest, they just wanted me close. I wanted to be home, of course, but I knew that was best for the babies."
Alissa's stay lasted 6 weeks. At 31 weeks, the doctors decided it was time to deliver the babies.
"There were no complications until the last week or two. I was kind of shutting down the doctors said. Things were starting to happen with my bloodwork and kidneys. Stuff they didn't like," Alissa said. "I was pretty miserable those last two weeks. I received a pep talk from one of my doctors a few days before the babies were delivered. The team was there not only for my babies, but for getting me through those hard moments."
The team of doctors was extremely happy with the amount of time they were able to help Alissa carry her babies.
"We were blessed with a very solid plan that worked very nicely and Alissa remained pregnant for a good long time," Dr. Everett said. "Thirty-one weeks was an amazing opportunity for these babies. We were able to provide them with a strong springboard for a normal life."
On Dec. 10, 2009, one day after the 31st week, the teams of doctors and nurses assembled to bring the Conklin boys into the world. A team was created for each baby. Upon delivery each of the boys was passed through a window in the labor and delivery room to the waiting neonatology team in the NICU. The delivery went without incident.
"We were able to have what I would consider a non-emergent delivery. The boys were born in a very controlled, well-organized fashion, which takes some doing when you are talking about providing care simultaneously for five patients plus the mother," Dr. Everett said. "That takes a lot of organization. We had a lot of preparation time, which allowed us to be ready for when the time came for delivery."
Once in the NICU, Ian, Micah, Travis, Sawyer and Wesley resuscitated beautifully. Each benefited from the extraordinary care of the NICU staff and the many pieces of specialized equipment provided by Children's Miracle Network at Geisinger. Of the five, Ian had the most immature lungs and required a little extra care.
"Ian needed to be intubated and placed on a respirator for a short period of time," Dr. Everett said. "He had some immaturity of his lungs, which you often see with multiple gestations. He responded very well to surfactants and ventilation and was able to be taken off the respirator very rapidly."
Soon all five babies were able to leave the hospital, not at the same time, but within what Dr. Everett considered a normal time period for babies born at 31 weeks. Ian had the longest stay at six weeks, with the other four boys going home between 3 or 4 weeks.
Now Alissa and Brad faced the toughest test, caring for five newborns at once at home.
"We had two of the boys home the first night," Alissa said. "We did that on our own. The next day we had another baby come home and then we had some helpers start to come in."
The Conklins were blessed with an army of volunteers -- from family members to neighbors, even members of their church.
"We had 100 helpers at the very beginning," Alissa said. "There were people who came to help with the babies, people who stayed overnight with the babies, people who brought meals. When I was in the hospital, people brought meals and cleaned the house. We could not have done it without them. "
When it came time for Alissa and Brad to pick a pediatrician, they didn't stray too far from the people who had cared for them in the NICU.
"My husband often sends patients to me from the NICU and will let me know a little bit about them before they come see me," Geisinger Pediatrician Amy Everett, D.O said. "The one day he said to me, 'We have quintuplets.' I said, 'Wow, that is really amazing.' He said, 'Yeah. Guess who they picked for their pediatrician.' I thought, oh my goodness."
Dr. Amy Everett had the opportunity to meet Alissa and Brad during one of their prenatal group conferences, where they met with essentially everyone who was going to be caring for the boys once they were born.
"I was lucky enough to meet the parents before the boys were born, and I fell in love with them," she said. "They are great people. They have a great sense of humor, which if you are going to have five boys, you need. You could just sense that they were thrilled to be having these babies."
Dr. Amy Everett says the boys have been extremely healthy since their early start.
"They have been pretty healthy boys," she said. "They have had cold illnesses, stomach bugs, your run of the mill illnesses and things, but generally speaking, they really have done very well. I love when they come into the office. They are a bundle of laughs. I cackle the entire time they are here because they are so fun. They're great."
"When they were little, Alissa said she felt like all she did was change diapers and feed babies," said Dr. Amy Everett. "I told her, 'Oh honey, enjoy this time, because once they begin to be toddlers and they are all running around in different directions, that is going to be a lot more difficult.'"
The parents have been up to the challenge and have done an incredible job thus far with the boys.
"It is funny. The same parenting and discipline doesn't work for each child," Alissa said. "The outcome depends on the kid's personality. You do the same thing for all 5. One kid is like 'no problem, I'll listen,' the other is like 'yeah right, mom.' You have five at once and it really shows you that different types of discipline only go so far."
Alissa and Brad say the real challenge of having such a big family is not the parenting, but is just trying to be a normal family.
"The real challenge is trying to do things that normal families do," Alissa said. "Just this past summer, we were able to do some things. We went to Lancaster for two nights for a mini vacation. We went to the John Deere Tractor show at Penns Cave. They are really good about going places. We go to Lewisburg Park. We just try to be normal."
Aside from having a house full of children, the Conklins are very normal and have a healthy daughter and five healthy boys that have no ill effects from a high-risk pregnancy and delivery.
"This is what the Center for Prenatal Pediatrics does," said Dr. Ed Everett. "We try to take an abnormal situation and put a plan together that is going to give a parent normalcy, whatever that may be. Maybe it's a big piece of normalcy, maybe it is just a small piece, but it is something people can hold on to."
Donations to Children's Miracle Network at Geisinger help fund the Center for Prenatal Pediatrics at Geisinger Medical Centerin Danville as well as provide specialized life-saving equipment and services in the Geisinger Janet Weis Children's Hospital Neonatal Intensive Care Unit. In addition, gifts to Children's Miracle Network at Geisinger have provided pediatric equipment for the Geisinger-Bloomsburg pediatric office.