Wednesday, September 20, 2006

Wow! People still sometimes read my blog! I'm utterly stunned. And thrilled! I've missed blogging, though I've filled the void with multiple pregnancy-and-mommy-oriented message boards. I kept saying I'd start a baby blog, but I never got to it.

The back story on Lilly and Kate is that I found out I was pregnant July 15th last year. It had been taking a while, so we had been seeing a fertility specialist, and were just starting to talk about taking Clomid. I was terrified of doing that and having multiples. Then I got pregnant on my own and was so relieved. Then at 7 weeks 4 days into my pregnancy, this is what we saw on the ultrasound.

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I was completely petrified, and Ryan turned to me and said "This is going to be great!" and said it with such enthusiasm that I had to believe him!

I had all-day-and-particularly-evening sickness until about 15 weeks. I got big fast. At 19 weeks we took a trip out to Hawaii to see Ryan's sister and her husband, who happened to get pregnant the same time we did. Her due date (3/23) was 4 days before mine. We had a great trip! It seems a million years ago, now. Here's me in all my pregnant glory on the beach at Hanauma Bay.

At 24 weeks, a few weeks before Christmas, my doctor had me stop working and go on modified bedrest as a precautionary measure. Preterm labor is very common with twins, so he was doing everything he could to prevent it. The day after Christmas I realized I was having contractions. They were regular for a while, but then they stopped, so my doctor told me to come in the next day. I felt great that day. So good I let Ryan stay at home because he was working on a deadline. Up until that point he had been at every appointment with me.

When I got to the doctor, I felt fine for woman carrying 27-week twins. I had one contraction when I stood up in his office, but I wasn't worried. He did a fetal fibronectin test and internal exam, my cervix is closed. Then he does the transvaginal sonogram and my previously "long and closed" 3.5 cm cervix is down to 1.3 cm. Do not pass go, do not pick up husband, go staight to Labor & Delivery, he will call ahead and be there later.

They admitted me and put me on terbutaline, and put all the monitors on - 1 for contractions, 1 baby a, 1 for baby b. I was covered in monitors. I got 3 doses of injected terb, followed by oral every 4 hours. I started breaking through with contractions before 4 hours was up, so they went to 3 hours. That seemed to work. Kept the monitors on all night, etc. Nothing exciting recorded. Next day they sent me down for a sono with the maternal-fetal-medicine specialist, and although the babies looked awesome (2 lb 9 and 2 lbs 13 were the estimates) I was now 70% effaced, fingertip-1cm dilated. Within an hour I was in an ambulance, lights and sirens, on my way to North Shore University Hospital, because they have a better NICU in case my babies were going to be born.

There, they went through all the drugs. Indocin and terbutaline at first didn't do it. Magnesium sulfate stopped everything for several days, but is toxic enough that they took me off that and tried a terbutaline pump. That made my heart rate way too fast, so they had to take me off. Then I went on nifedipine, which lowered my blood pressure like crazy, but it stayed just high enough to be safe. It wasn't as effective though. After 2 weeks, everything failed and at 2:30 in the morning (Tuesday morning), I woke up out of a sound sleep. I felt kind of funny "down there" and thought maybe my water had broken so I called the nurse immediately. It turned out I was bleeding, and I totally freaked out thinking I had a placental abruption or something, but she said that would be really painful and this as not. I had to try really hard not to panic. She called for the resident to come in, and in the meantime tried to keep me calm.

The resident came in, checked my cervix and said I was now at 3cm (before I was 1-2) and that the blood was probably bloody show. I called Ryan and told him to get up and get here, because it looked like we'd hit our expiration date. They took me down to labor and delivery again, put all the monitors on, and I was contracting every 1-2 minutes. Some of them I felt really strongly (and painfully) and some I didn't even notice. In came the bag of magnesium sulfate, which I didn't try to fight because I knew it was my only hope of not having babies that day.

The mag slowed down the contractions considerably. They got as far as 20 minutes apart, though each one was quite painful. Around 11 they brought me down to maternal-fetal medicine and the doctor who usually does my Level IIs did a biophysical profile. He was very concerned when he saw how low Baby A (who became Lilly) was and asked when I had last had my cervix checked. I told him 3am and he said OK, he was going to call up and make sure someone checked my cervix when I got back to L&D. While we were waiting for the perinatalogist, I told Ryan I thought this was it. He was still in denial. At some point he was like "Yeah, I'm so tired...I'll probably go home in a little while when they bring you back to your room." I somehow knew that wouldn't happen. The contractions started coming closer together and were really really painful - enough that I couldn't really talk through them anymore.

I watched the doctor's face while she checked my cervix, and I saw her eyes get big. I was 6 cm, 100% effaced, and Baby A's membranes were bulging. That was it, she told us there was no way to stop it at this point, so we would stop the magnesium and have babies today. She reminded us how we had gotten two more weeks out of them and told me she highly recommended an epidural because both twins were head down and they were going to let me try vaginally (very important to me and that made me feel a lot better), but if I needed a c-section, having the epi on board already would save valuable time. I was all for it, and I could not believe the change in my personality outlook after I got the epi. I suddenly realized I had been in some level of pain for a looooong time.

At that point, we called my parents, and invited them to come sit with us and wait for my water to break. They were allowed to hang in the delivery room until that point. Once we had time to get over the initial shock and fear, we started to get excited to meet our girls and to have the PTL ordeal over with, even knowing that this early birth had so many dangers. My parents were really great and supportive, and it was surprisingly nice to have them there. I was super-sleepy and drifted off a few times while they all chattered, which was fine.

Mostly we sat and watched the monitor to see how close the contractions were. They got to 3 minutes and incredibly regular, and the doc sent my parents out so she could check me. 10 cm, ready to rumble. Mom and Dad came in to kiss me good luck, and suddenly the medical parade began! Our quiet little room was invaded by neonatalogists, neonatal nurses, anesthesiologists, pediatricians oh my! I think there were a dozen of those people, plus the attending perinatalogist, my L&D nurse, and the two resident physicians who did most of the work.
They broke the first bag of water, which felt kind of cool - like a little internal "poink." The contractions started coming closer together, and it was time to push. They told me to push like I was constipated. LOL! With each contraction, they had me push 3 times. They were awesome, because they didn't count or anything - they just said OK...PUSH! and told me what a great job I was doing. I think we repeated that over 5-6 contractions, and then I got to see my Lillian's head emerging below - what an incredible feeling. They took her and cleaned her up, and let me hold her for the most amazing 15 or so seconds of my life. She was beautiful, with the sweetest little lips I had ever seen. I fell in love with her instantly, and it was heartbreaking to have to give her up. But, we had more business to attend to.

While I was falling in love, the doctors were locating Kate. Unfortunately, she must've seen her sister going down that narrow passagway and decided she wanted none of that. She didn't actually flip, but even more dastardly, she folded herself in half so that her head, hands, and feet were all right in the same spot. There was nothing to be done but a c-section.

They wheeled me next door to the OR, and pumped up my epidural. The section was a piece of cake. I didn't get to hold Kate, because one arm was in restraints, but Ryan did for about as long as I held Lillian. I got to look at her sweet little face, and fell for her just as I had her sister. She is beautiful. I was so exhausted after that I nearly fell asleep while they closed me back up! Spent about an hour in recovery, and they brought me up to my room. They left the epidural in and gave me a PCA pump, which was very helpful. I couldn't sit in a wheelchair that night, so I couldn't go the NICU, which was awful.

Ryan and my parents went to see the girls, and I was stuck just lying in bed with the phone and TV for distractions. That was the hardest part. Knowing that for 7 months I was everything to these babies, but now I couldn't even get out of bed to see then.

Having them in the NICU was amazing motivation to get moving and I had to force myself to recover more quickly than I thought was humanly possible. Lillian stayed 63 days in the NICU, coming home March 13, and Kate came home 2 days later. Kate came home with a nasal cannula and oxygen, which she finally ditched for good in late May.

You'd never know to look at them now how difficult their start was. They are both around 16 pounds and chubby chubby chubby! When we go out, people ask how old they are and when I give their actual age (as opposed to their adjusted age, which is how old they'd be if they were born on their due date) no one even bats an eye. I am incredibly grateful to everyone in the High Risk Antepartum Unit and the NICU at North Shore University Hospital. Without them, my life would be a well-rested tragedy, instead of the exhausting joy it is today.

1 comment:

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