I havent had a chance to even read your comments, although I know several were left on the post from 2 days ago. As I was planning to post yesterday (and it was good news), the evening quickly changed, so forgive me for the 2 days in posting and also in backtracking.
Yesterday morning's heart tones was great! Bobby was mostly perfect! He had his moments, but he charted 25/30 minutes in a good zone. We were so thrilled. On top of that, my blood sugars were finally normal! Two big gifts in one day!
And it was a busy day. My MIL came for a visit and to drop off homemade food; then, my girlfriend, M, came with her 11w daughter for some time; and then, my girlfriend, A, came with wedding books in hand to look at wedding and bridal gowns. I was a busy girl! They were all back to back, but it was so nice to see them all and feel "normal" for a bit. I held Lucy and played with her and then had a wonderful time looking over the magazines (making fun of some gowns and falling in love with others). A left around 2:30-2:45, so that I could get my afternoon nap. (Good friends know nap time!)
At around 2:30, I started feeling "not me". I cant really explain it. I'd been having Braxton Hicks over the last few days (which I now think were possibly helping Maya making her little turn around!) but I wasnt feeling those. I just felt off. At 3pm, I started having painless contractions, very similar to the ones I had when I was dehydrated. Checking water pitchers, I noticed I'd only finished one and had barely made a dent in a second. I quickly drank a pitcher and laid on my left side for half an hour, which is what my nurses have told me to do in the event I have the painless contractions. By 3:30, they hadn't subsided and were now uncomfortable. I paged K, my nurse. The CRNP came in and asked what was going on. I explained that I was having contractions that had gone from painless to uncomfy and asked if I could get on the monitor, just because I wasnt sure what the deal was. She found both babies quickly and then put the TOCO on. Nada. Meanwhile, I'm feeling pain that begins in my lower belly, near the sides, and runs into my back. By the time it hits my spine, it feels like someone is crushing me or sawing my back in half. And this pain is just getting worse and worse. K comes in and puts her hands on my belly when I say I am feeling them. Nothing. No hardness. No peaks. And they are super irregular. Some would come for 30s then a 2m delay then a 45s contraction with a 10s delay then... You get the picture. No rhyme or reason. The CRNP decides to do a cervical check and whips out a speculum. This is cut short because I get a contraction in the middle of it. She is only able to confirm that the cerclage is still there and holding. So, she does a digital exam and comes away with 1cm dilated, cervix gone, stitch still holding. The resident, Dr K, is called. Momentarily, she arrives and does a digital; 1.5cm dilated. As Dr B is away at a conference yesterday, she calls Dr M, who is covering his patients until 5pm (she is not the night time coverage). It's now around 4:30. An hour has passed and I am in more pain in those moments than I ever thought possible. On of my sweet nurses, J, rubbed my back through the contractions while K held my hand as we waited for Peter to arrive. Dr M called the head of MFM and consulted; they decided to try an emergency dose of procardia and, half an hour later, a second dose. Dr M called me and explained that if I wasnt in full blown labor, the meds could stop the contractions; but if I was, they would have no impact and delivery was our only option. I cried.
The procardia did nothing and a second dose was given 25 minutes later. Nothing. The contractions were now on top of each other with no time in between. K said that she was feeling mild hardening but nothing that signaled a "normal" contraction (I found out this morning from Dr K that both she and the nurses were very concerned that my contractions were super irregular and that they couldnt feel the palpitations with a hand test). They moved me to Labor and Delivery. The head of MFM recommended a C-section right away, since they wouldnt be able to tell whether or not Bobby was in distress and since labor was, in her opinion, imminent.
It all moved so quickly. Peter finally arrived, the anesthesiologist and on-call delivery doctor came. New nurses from L&D took over from our APU nurses, but K stayed. A voice of reason in a sea of confusion. My resident, Dr K, came and said that Dr M had left her engagement (she was judging her daughter's cheerleading match... I still cant believe she came back to the hospital for me when she wasnt even on call for the night) and was in the parking lot and would meet us in delivery. We signed the necessary forms and Peter was given his scrubs. I was wheeled into a bright room down the hall, where everyone was pulsing with activity.
Dr M arrived and explained the plan. I would have a spinal with an epidural placed for back up (imagine getting a spinal and on top of that having the epi catheter placed in case they needed to give you more meds; if not, no additional drugs, if so, it's all squared away). She would remove my cerclage and if I dilated to 10cm in 60 seconds, they would attempt a vaginal delivery; she wouldnt go natural because she said that she felt we would have to have a c/s and she didnt want the time constraints that having to get me up, in pain, to place the meds would have caused. Assuming I didnt dilate, I would have an emergency Cesarean. The babies would be handed off the NICU and be taken away immediately. My APU nurse, K, held me during the drugs and kept the babies on the monitor until it was time to cut.
I will never understand why women choose to have drugs for a vaginal birth. The second the spinal was placed, I had no feeling whatsoever in my lower body. I didnt feel the speculum or the removal of the cerclage. I was amazed when they told me it was out. In 1 minute, I went from 1.5cm to 4cm. They told me afterwards that, had a I been normal, they would have expected a delivery within the hour. But alas... No normal for me. As soon as the check came back that I wasnt 10cm, the screen went up and Peter was brought in. He held my hand but once the surgery started, he went from sitting to standing. Even though only his eyes were uncovered, you could see the "this is cool" factor as they cut into my belly. (Thank God, I couldnt feel a thing. The whole idea skeeves me out.)
Within minutes, I saw his eyes change. Our son was lifted out of my womb, completely intact in his water bag. The bag was burst, his cord was clamped and cut, and within seconds, his NICU team had him. "We have a baby boy!" Dr M said happily. Less than a minute later, Peter's face lit up again as our little princess was lifted out (after quite the production) feet first. "And now, a little girl!"
So, without further delay, here are our sweet babies!
Bobby was born at 7:20pm. He weighed 2lb 15oz and was 15in long.
Maya was breech (yep, she somehow turned breech since Tuesday's ultrasound) and was born feet first (and with a sour look on her face that said "Put me back in!"). She weighed 2lb 5oz and was 14.25in long.
We were both paying more attention to what was going on with the 2 NICU teams than my surgery so I dont really know what they were doing (putting me back together I assume!). Both babies were breathing and had color. Maya was on her own; Bobby was struggling so they intubated him for taking him upstairs. We saw the babies as they were being wheeled away. Peter left and went with them, and I remained on the table for another half hour as they finished a double stitch on my uterus and stapling my belly closed. Afterwards, I was taken back to my L&D room to recovery from the drugs. The feeling in my toes began to come back in, followed by being able to move my legs.
After another hour had passed, the nurse offered to call NICU and ask them to send Peter down so that I could have an update on the babies. He came and told me that they were both stable and doing well. Both were breathing room air on their own and Bobby's heartrate was normal. He gave me my cell phone so that I could call the grandparents while I waited to be taken up to the NICU on the gurney, and then he went back. I called and gave them the news. They were brief talks because I still felt off from the spinal and the morphine to help with the pain for the c/s. (Which leads me to this: I am currently in pain and discomfort, even with meds. I cannot imagine choosing a c-section electively!)
My babies were on this earth for 2 hours before I was finally allowed to see them. It was so wonderful to watch them for those blessed moments. I couldnt really touch them because the bed couldnt get close to them in their covered isolettes. But just to see them. I watched Bobby have his diaper changed (after #1 and #2!) and saw Maya enjoying her nudity. Bobby cried as the nurse put his clean diaper on him; his preference is obviously naked, LOL.
I was brought back to my APU room which is now designated as a postpartum room, and was given pain meds. About 5 minutes in (if that long), I also threw up. What fun. I dont do well with narcotics; so, then I had to have anti-puking meds to help out my pain meds. Nice... A nurse gave me an icepack, which has been a wonderful thing. I have it on my belly now, actually!
Peter's mom drove up to give us her camera for the pics and she stayed in our room with us, to help take care of me while Peter went back and forth from here to the NICU. I wasnt allowed to leave my room because of the surgery, but he would come, take a nap on me, then get up and go upstairs for a while, and repeat. I think he made 3-4 trips, and Peter's mom went up once at 4am to check in on them.
Today, although I've been in a lot of pain, I've had 3 wheelchair rides to the NICU to be with the babies. We can go and sit with them anytime (except shift changes) but we can only touch them every 3 hours. They are doing "cluster care" to help the babies deal with so much stimuli, which means that they are only disturbed routinely every 3 hours. I have organized my pumping schedule around this so that we can take up the syringes (which will hopefully turn into bottles soon...)
As of now, they are both stable.
Bobby is having an arrhythymia every now and again. He is breathing on his own and has a CPAP for positive pressure at 5. He is able to keep warm, however he is in a warm air isolette (where he can enjoy being in just a diaper!). He keeps his feedings down well. He likes to suck his pacifier (which they tell me means he may be a great breast boy!) He has a strong grip and held my finger for 15 minutes. It was wonderful. Just wonderful. Peter goes up for every 3 hour rotation to touch them and to bring what I've pumped. On his last visit, he said that Bobby used his arms and legs to lift himself up from his little pillow! What a strong little man!
Maya's heartrate is stable and mimics what it was in the womb. She is breathing on her own and has a CPAP for positive pressure at a 6. (She was an 8 because she had a couple of apnea spells over the last 24h, but she is doing better now!). She is able to keep warm, but like Bobby, is in a warm air isolette. She hasnt fed as well as her brother; early on, she had air in her belly, which made her quite unhappy but the nurses helped her get rid of that! Since then, her feedings have been better. She is not a pacifier girl. It was attempted twice while we were there and she showed zero interest. When I was with her this last time, she opened her eyes and watched me as I said her name and held her little hand. She wrapped those beautiful fingers around my thumb and I sat there until she fell asleep.
The doctors say that they are doing outstanding. Everyone is surprised when we tell them that they were born at 27w5d (just 27.5 hours short of our 28w goal...) They are plump, pink, and having few issues at this point. They are simply beautiful. I know I am biased but they are. Most likely, I will be discharged on Monday. We are trying to figure out a schedule since I cant drive for several weeks. But, it looks like I will come over in the late morning and stay until Peter comes from work in the evenings. I can pump here and be with them (even if I cant always touch them).
We changed diapers today and helped with feedings- those were such gifts! I cant lie to you and say that I am not overwhelmed. My babies are over a day old. In my mind, I still cant believe they arent inside of me. I touch my now soft uterus and wonder what happened. We dont know why labor started. My water didnt break. My cerclage was fine. Was it an infection? They sent the placentas for testing. Was it simply that they were ready? I just dont know...
We know that life in the NICU is an uphill battle. That there are good days and really bad ones. We are afraid of what the bad ones might entail, but thrilled for the prospect of good days and thriving twins.
For those of us who know us in real life; please dont be offended if we dont call or answer your calls. When we are in the NICU, there is a no phones policy. Schedule wise, we are there every 3 hours. We stay for at least an hour at a time. Into that plays breastpumping which is about 1/2 hour. Plus eating and sleeping. We will get your messages and return them. Email is best, although bear with us if we are delayed in emailing. Right now, our priorities are Bobby and Maya, which each other coming in next.
I will do my best to blog when I log in for email. It may not be every day right now while we are in the hospital. The naming of the posts will change too. There will be (NICU day X) in the posts from now own. We will count today as the first full day, so tomorrow would be (NICU day 2) and so on...
Dr B called today but my nurse was helping me finish pumping and stand up for the bathroom, so we missed his call. I'm sure I will talk to him this weekend. There is so much more to say, but for right now, I need to go. I will leave you on a high note. Dr B called Dr M and asked why she was in doing the c-section (he was surprised since it was her night off). Her response: "It's Carol. I couldnt just let her do this alone, especially with people she didnt know." I was really touched by that.