Addendums to the Birth Story

The PDA was declared CLOSED the day before we left the hospital with {M}!!!  He now has a normal, perfectly functioning 8 week old heart!

The lung issue, I feel the need to elaborate.  Gestational diabetes *can* cause lung maturity issues.  My diabetes was diet controlled, so no one suspected we'd have any complications.  WRONG-O.  I was on bed rest in the hospital for a month in order to keep them inside me as long as possible.  The combination of GD complications and pre-e's restricted blood flow caused them to have majorly immature lungs for their gestational age.  No one could have predicted that my complications would have ended in this conglomeration.  Its hit or miss.  I was one of the unlucky ones who got all the bad from these diseases.  I don't want my story to scare anyone who has to deliver early.  My situation is NOT the norm.

{M} is off all oxygen now and doing well.  We keep the oxygen at the house just in case we notice a need for it. Thankfully, he's done well with the transition and we pray that he continues to do so.  He has such a beautiful face and I'm happy to finally see all of it!

Circumcision.  Yes {M} is circumcised.  The procedure was fast and {M} slept through the entire thing.  They used a numbing cream and some sugar water on his paci to ensure he kept calm and couldn't feel much.  They gave him a couple shots of lidocane (I think it was lidocane) to numb the area.  They made a small incision on the tip of his foreskin and put the plastic bell onto the area.  They wrapped the skin around the bell, clamped it and they were done.  The bell and the foreskin fell off about 5 days later in his diaper.  No blood at all and very little discomfort.  He was a little fussy the afternoon of the procedure, but he ate and slept just fine.  The next day he was back to normal.  

Coming home a week apart.  That was VERY difficult.  It was so hard to walk out of that ward with one healthy baby not knowing when the other would be healthy enough to join her.  I felt like we were abandoning him.  I hated it.  We spent 10-12 hours a day up at the NICU with him.  It was exhausting, but I wanted him to feel us and know we loved him more than anything.  The day he came home was perfection.  It hasn't stopped yet :)

Breastfeeding.  This will forever be a big regret of mine.  The c-section + the NICU stay + them not being healthy enough to breastfeed immediately + the stress + pumping = a mountain of cards stacked against successful twin breastfeeding.  I *really* wanted to be successful here.  I've seen so many lactation consultants-even preemie & twin lactation specialists.  Nothing worked.  I still carry the guilt of not trying harder, but I just couldn't.  I pumped around the clock and tried to bf every day several times.  {A} latched ONCE.  {M} never would.  By the time we were home there was no time for pumping and my supply never reached twin capacity and dwindled as the days passed.  Sure I could have tried herbs and supplements and cut more time out for pumping.  I didn't have it in me to stress about it anymore.  My babies needed a happy, together Momma.  M and I made the decision together to go to formula exclusively.  I'm heartbroken that the babies only got 3 weeks of breast milk, but the lactation team tells me if they were going to get ANY, thats the perfect time to have momma's milk.  So, I resign myself to stinky chalky formula that the babies just love.  Their burps smell awful and their poop even worse, but they are getting the nutrition they need and I feel good about that.  They get full, get all the nutrients they need and are chunking up like you wouldn't believe.  They smile when they are done and that makes me happy that they are content with our decision.  I wish there was a way to make synthetic antibodies :)  Then my heart would truly be at ease with our decision.

How do you do it?  This is my favorite question.  When someone finds out I have twins they look at me with pity in their eyes and as "how do you do it?"  Then they jump on a soap box and tell me about how hard "JUST ONE" was for them.  Well first of all, there's no "just one" about it.  All babies take work and singleton mothers have their hands full too.  Every baby is different.  My answer is, "they make it easy."  Its true, they do.  They are both VERY easy going, good babies.  They eat every three hours (on the nose) and sleep 6-8 hours every night.  They typically sleep between feedings, at the very least between several of them.  When they are awake we do tummy time and sing and dance around the house.  When they cry we rock them or put them in the sling so we can get stuff done around the house.  Babies are emotional creatures.  They react to your emotions.  If you are calm and happy and loving, they will be too.  If you are frantic, they pick up on that and will feel the fear.  

We spend a lot of time listening to music, making eye contact, doing tummy time, singing and praising every little thing they do.  We talk to them endlessly and tell them how much we love them every other minute.  I'm so blessed.  I could not have wished for two more beautiful children.  They are smart and healthy and the love all the kisses they get peppered with all day.  Sometimes I feel like Charlotte from Sex and the City when Carrie confronts her about not running anymore (she's pregnant)


Carrie Bradshaw:  What makes you think something bad is gonna happen?

Charlotte York: Nobody gets everything they want! Look at you. Look at Miranda. You're good people and you two both got shafted. I'm so happy and...something bad is going to happen.

Carrie Bradshaw: Sweetie, you shit your pants this year. I think you're done.

I want to sum this birth story novel up with this.  Pregnancy is tough, birth is even tougher.  Your baby, my babies and every other baby out there is so worth every single moment of pain, sadness, discomfort, etc.  Its normal to fear what you don't know, but if I made it through this with a HUGE smile, you will too :)  Also, be aware of Post Partum Depression (click the "symptoms" link to know what to look out for).  Its very real and very scary if you're dealing with it alone.  If you have any of the symptoms please talk to your OB.  Don't suffer alone.  Your baby needs a healthy HAPPY Mommy.


When my kids were in the NICU I had a very difficult time.  As I mentioned, I cried non-stop and carried so much guilt.  I was a mess.  I suspect coming off twin pregnancy hormones, not sleeping and the whole circus going on in the NICU, that I had a touch of the baby blues.  My OB recognized this and prescribed medication.  I took it while in the hospital.  I filled the script when I got home, but never took it.  I have it in my make up drawer just waiting for the day those feelings crop back up.  I hope they don't, but I'm not living just for me anymore.  I have to take care of myself for my kids.  They need me.  I'm happy, happier than I've ever been, but I know ppd can come back.  

I hope you enjoyed reading about our journey as much as I enjoyed recollecting it.  It was hard, no doubt about that, but I'd do it all again in a heartbeat.  Theres no way to adequately describe the love a mother has for her children.  Its a feeling I pray every woman (who wants to) gets to experience.  

P.S. for my pregnant, ttc and adoptive momma readers, don't wait 8 weeks to blog your birth/adoption story! I'm dying to read all of them :)

Birth story continued...

When I left off, I was recovering in my room waiting to get the ok to be wheeled down to see my babies.  After a few hours it was finally time!!!  My sweet post-partum nurses got me dressed and ready in my wheel chair.  At this point I was still catheterized, so I got to bring my lovely pee bag with me.  M pushed me in my chair.  The hallways felt like they went on forever.  Finally we got to the NICU door.  We pushed a button that alerted the NICU nurses we were there.  They have a camera at the door so the nurses can make sure you're someone they recognize.  Tight security.

The doors open and the first two beds on the ward are my babies.  M wheels me in between their beds and I look back and forth between the two beds at the teeny little bodies, bodies that I made, bodies that had been wiggling at me from the inside until that day.  It was a strange moment.  In that moment I was really meeting my babies for the first time.  I was filled with so much love, yet seeing them full of IV's, tubes and breathing apparatuses (at that point it was just nasal canulas) made me really upset.  I'm not sure how much was hormones, how much was a month of bed rest, how much of it was true sadness, etc, but I cried.  Hard.  I sat in between them and held their little hands.  I kissed their sweet heads.  I couldn't bear to see them like this.

As I sat there crying during what should have been a very happy moment, the NICU nurse Crystal came to introduce herself.  Through alligator tears I asked her a thousand questions, many of them redundant and repetitive.  She tried to bear with me, but I could tell she was annoyed with my hysterics.  I caught onto the vibe and started to ignore her.  I wasn't here to talk to her, I was here to love on my babies.

I spent several hours there that first night.  I got to feed {M}!  I cuddled and snuggled them.  I hope they felt how much we loved them, even from the very beginning.  Around 11p we went back to my room.  It had been a long day and I still hadn't rested.  I would never truly rest again...even as of this very minute.  That night was full of waking.  First it was all the scheduled medications.  Then my urine output was very troubling. Then my IV blew-had to get a new one at 2a.  Then I got blood thinner shots about 3a because I'd been on bedrest so long they were concerned about a blood clot.  You get the idea, no sleep.  How can a girl sleep when her children are across the ward without her???

At some point the nurse came in with a NICU update.  The babies had to go on CPAP.  Fudge.  This was the first of a lot of bad news we'd receive in those first few days.

The next morning we got up with the sun to go visit our babies.  Both had cpap masks on and more IV's.  They hadn't eaten yet and wouldn't get to for several days.  Another day full of tears and questions shot at whoever would listen in the NICU.  Were they going to be ok?  Our "just a quick once over for observation" NICU visit had turned into an indefinite stay.  Queue mommy guilt.  What if I would have pushed the Dr's to let me go another week or two?  Could I have prevented GD?  Why did I get pre-e?  I should have excersized more and ate less.  I'd later find out that there's nothing I could have done to change their situation.  

The day passed much like our first NICU visit.  We met the babies Neonatologist Dr. Struebel.  Also a mother of twins :)  She.was.AWESOME.  She came to my room and talked to me, mother-to-mother.  We talked a long time about what caused this and what we were going to do to get them healthy.  At that point she predicted they'd be discharged by the time I went home.  Ha!  Regardless of that overestimation, we loved her.  There's no way she could have known what was really wrong with our boy.  

Day 2.  Day 2 was tough.  Still hadn't slept at all and the weight of my babies condition was a heavy one to bear with a body coming off of twin pregnancy hormones.  I spent my days crying.  I cried all day long.  Literally.  I was so full of guilt, I couldn't take it.  Why did I agree to deliver at 36 weeks?  Everyone around me reminded me that 36 weeks was awesome and my body wasn't a safe place for my babies anymore.  They had to come out.  Sometime that afternoon the Nurse Practitioner came to my room to tell me that {M} was going on a ventilator.  He was down trending and needed MORE help.  Hysterics.  

They intubated {M} (tube inserted into his lungs) and administered surfactant therapy-basically a synthetic surfactant that coats the lungs to keep premature lungs from sticking together.  Surfactant replacement therapy would go in through the vent tube and into his lungs.  The Dr's assured me they ALWAYS saw incredible results.  Nothing.  It didn't work.  It always works, why didn't it work on my HEALTHY 36 weeker?  

Meanwhile {A} is weaned off the CPAP onto high flow canula.  She was progressing so well, why was {M} struggling so hard?  Life on the vent continued.  It was heartbreaking to see him so upset.  He couldn't cry or swallow around the tube.  He tried to cry.  His face crumbled and he just wanted me to hold him so desperately.  I couldn't.  I could barely touch him.  I spent hours slumped over his bed just touching his soft head.  I cried and told him how much I loved him.  Wow, this is really hard to recollect.  Not hard as in I can't remember, hard as in painful.  He had a UA (umbilical IV) in his belly button-the line ran from the belly button up into the ventricles of the heart.  If that line was pulled out he could bleed to death.  We had to keep him calm.  They had to sedate him a couple times.  Big babies like him weren't meant to be on a vent.  

The next day we came in to see {M} getting an ECHO.  His perfect little heart was thumping away on the screen next to his bed.  The ultrasound tech smiled up at us and tried to make small talk as he looked for the cause of our son's deterioration.  The heart?  OMG, I thought it was just a lung maturity issue, it can't be as serious as his heart, can it?  I asked the tech what he saw.  Of course he deflected me.  That made me panic. Some of the techs tell you its all clear.  The ones that don't have something to hide.  Our nurse that day, Andrea, watched the tech work.  When the coast was clear I asked Andrea what she saw.  She said she thought she saw a PDA.  I had no clue what that was, but she assured me it can occur even in babies this close to term.

A bit later that afternoon, the PDA ("significant") diagnosis was confirmed.  Sometimes they treat them, sometimes they let them heal on their own.  They said we needed to treat {M}'s because it was causing a massive amount of blood flow to the left side of his heart, causing enlargement.  The Neo came over to talk to us.  She explained that he would get his first dose of Indomethacin.  Usually these things closed after two doses.  They finally felt confident that the PDA was the cause of all {M}'s lung issues.  Too much blood was going to that area making the lungs heavy.

First dose down.  They *think* the murmur (caused by the open valve/duct) sounds better.  Another ECHO. PDA still open.  Seriously?  They did decide to extubate though.  He was pulled off the vent and put onto a CPAP.  At this point {A} was on room air (no breathing help) and eating breast milk from a bottle.  As soon as our boy came off the vent they took his UA line out and let us hold him.  We got to truly hold our son for the first time in 6 days.  It was unbelievable.  We reunited the babies and let them snuggle while we basked in all that was new parenthood.  We changed diapers, fed them breast milk bottles, rocked them to sleep and loved on them endlessly.  It sucks that it wasn't in the comfort of our home, but it was the best place for them at that point.

A couple days later {A} came home-April 3!  Bittersweet that we had to leave her brother behind.  More tears.  By this point I was ok with how everything was going.  I knew {M} was truly on the mend and I got to relax a bit.  Everyday {A} and I went up to the hospital to be with {M}.  Everyday we left in tears.  {M} made big strides in the 7 days he remained in the NICU after his sister went home.  He missed her :)  He took to feeds a little slow, but eventually he got it down pat.  Breathing was another issue all together.  He remained on oxygen until last Friday...as in May 13-7 weeks old.  He was discharged on April 10 and the four of us went home as a family!

It was a long hard road, but they are so very worth every bit of it.  They are happy, healthy babies.  They are wonderful eaters and even better sleepers.  Even today, on their 8 week birthday, they are still sleeping 6-8 hour stretches at night.  Thank you Jesus!  Breast feeding didn't work for us.  I'll forever be upset about that.  I never produced enough for two and when both babies got home there just wasn't enough time to pump for such a small amount.  I'm sad, but I'm not going to worry about it.  Hopefully next time around I'll be able to breast feed :)

There you have it.  I'm sure I missed some details, but thats the long and short of it!

A twin birth story---is massively long

I need to write this down so I don't forget :)  They will be 8 weeks old on Tuesday.  Oh my GAWD.

My pregnancy was progressing much as you'd expect with twins.  My cervix was long and holding up like a fortress.  My blood pressure was doing great.  The babies were growing perfectly and I was feeling pretty good.  On Feb. 23 I went to L&D for a routine NST (non-stress test).  When you are pregnant with twins, the doctors appointments are frequent.  Starting at 32 weeks twin moms start the bi-WEEKLY non-stress tests.  During this test they put two toco-monitors around your belly, one for each heartbeat.  For about 30 minutes to an hour they record the babies heart beat accels and decels.  They like to see lots of each.  That tells them that the babies are moving and resting just as they should be.  

So back to Feb. 23, 32 weeks pregnant, my grandma's birthday.  I went to L&D for my NST.  Before they hooked me up to the toco-meters they took my bp and vitals.  The nurse (Anitra, who I came to be very close to) asked me if my bp was usually this elevated.  *PANIC*  I asked her why.  She said it was "up there" but wouldn't tell me just how up there.  Greeeaaaat.  Anitra left to go call my doc, but not before hooking me up to the monitors.  For the next hour M and I sat listening to the swoosh swoosh swoosh of our babies heart beats and a couple rounds of baby hiccups.  Both of us were pretty nervous and we knew that my perfect pregnancy was about to get complicated.

Anitra came back and said, "you just bought yourself a hospital stay".  I sort of figured this was coming.  I knew that having twins gestating meant my chances for pre-ecclampsia were HIGH.  They put in an IV and informed me that they would be doing a 24 hours urine catch.  For 24 hours you pee in a bucket and then they test the urine for proteins.  This is also the point where they told me that my mild symptoms could turn serious at any time and they may have to deliver the babies.  I got my first round of steroids to mature the babies lungs *just in case*, were they to come 8 weeks early.  Petrified at this point.  

A few hours later I was moved to my ante-partum room (the one I'd be in for the next 4 weeks, I never left).  I got settled in my new home and hooked back up to the monitors.  Babies looked fabulous BUT the monitors picked up several contractions.  At this point in my pregnancy contractions were VERY common, I wasn't worried.  The nurses were.  They did a manual cervical check *ouch* and an FFN (fetal fibronectin).  The FFN is a vaginal swab that checks to see if there are any secretions present that may indicate labor is imminent.  A positive FFN means labor is a good possibility in the next two weeks.  A negative FFN means, you guessed it, labor is not imminent in the next two weeks.  Mine was negative and my doc decided that my contractions were probably just harmless.  And they were.  They were present at every NST, but I never went into labor.

So I spent the first of many nights in room 316 on L&D.  My 24 hour urine catch results came back early afternoon the next day.  I was officially diagnosed with mild pre-ecclampsia.  I knew I could deliver them at any time, so I stuck to the doc's instructions and stayed in bed...for a month.  That month wasn't all bad.  I heard many a baby born in the rooms near me.  We'd hear cheering, sometimes screaming, then the beautiful sounds of a newborn set of lungs.  That always made me smile :)  Life was beginning all round me and it was awesome.  

Everyday the OB's would come see me and let me know that things were status quo, but that I'd be staying until delivery.  I was ok with this because I wanted to keep {M} & {A} cooking as long as I could.  The nurses were my saving grace.  Seriously.  Anitra, Sonia, Renee, Sarah, Debbie, Jenny 1 & 2, Melisa, Kristin, Barbara, Kelly, etc etc etc.  Love love LOVE them and always will.  They got me through a tough time and I'll be forever grateful.  

Lets fast forward to the week of the birth, shall we?  I made it, with mild pre-e (go me!) to 35 weeks on strict bed rest.  Three NST's a day, blood draws every Monday and Thursday morning @ 6a (what a way to wake up), physical therapy (for my pelvic separation) three times a week, etc.  March 17, Dr H Lee walked into my room, fresh of a Caribbean vacation-fully not expecting me to have made it through the week she was gone, and told me we had a BIRTH DATE!  She said if I made it to 36w she was ready to deliver me.  D-day was 3/22/11 @ 11a.  She didn't want to push my body any further (the blood pressure was climbing).  OMG.  My babies were coming in a WEEK.  

Day before BIRTH DAY.  M and I sat in my room, the last day it would ever just be us.  We were both nervous and we wondered out loud what they would look like and who they'd be.  Neither of us slept.  At all.  We were so excited!  

BIRTH DAY 3.22.11

8am the delivery nurse came in to put my IV back in, pump me full of fluids, give me some nasty drink that was supposed to ward off nausea and some pill-no idea what they were for.  I signed the c-section paperwork-I understand that this is major surgery and can result in infection, blah blah blah and death.  No turning back now :)  

The anesthesiology team came in to tell me all about the dreaded SPINAL.  I signed more paperwork saying I understood that they could miss and I would be paralyzed for life.  Only kidding :)  It was just a consent form for the medication.  I loved my anesthesiologist.  I think that makes a HUGE difference.  Dr Baller was one of the sweetest women I'd ever met and she talked me through the whole c-section.  Loved her.  I saw her just last week and she remembered me and asked me how I was doing.  So sweet.  

Now it was time to take my last few steps as a pregnant women.  I waddled across the hall into the OR and onto the table.  There were about 25 nurses of various practices all waiting for me and my babies.  As I sat on the table, shaking from the nerves and the frozen room, people were prepping me.  I had anesthesiology prepping my back for the spinal.  I had my delivery nurses putting bp cuffs on my my arms and an O2 canula on my face.  The NICU nurses were prepping the warming beds for the babies.  I couldn't stop staring at the warming beds.  I just 20 short minutes my babies would be in there screaming and getting acclimated to the world.  

I sat on the table paying close attention to what the anesthesiology team was telling me.  They needed me to roll my back more.  Are you effing kidding me?  I can't roll it anymore I've got a twin belly resting on my KNEES.  At that point my delivering OB stood in front of my rubbing my arms and legs, trying to keep me warm and trying to pull shoulders forward so the anesthesiology team could find my spinal cord.  The pre-e had me pretty swollen and they were having a tough time.  They warned me, but I still flinched.  "Here comes the 'bee sting'".  Ouch, but not as bad as I was expecting.  Then came another and another and another.  They were numbing me up really well!  Once the numbness started to kick in they brought out the big guns.  Spinal time!  They poked.  OWWW!  They hit a bone-you can't numb a bone unfortunately.  Damn fluid retention.  Poked again.  OOOOOOOWWWWWWWWWWWWWW!  Hit bone on the other side.  At this point I was scared.  Scared that they'd never find my damn spinal cord and that I'd never get these babies OUT of me.  

Just when I thought I couldn't take another zing to the spine, they found the right spot and I felt the warmth of the spinal flowing through my lower body.  They spun me around and laid me down on the table.  They pulled my arms onto the cross bar and put a temp sticker on my forehead.  It was all happening so fast.  At this point it felt like my legs were "asleep".  It was the strangest feeling.  I just wanted to get up and walk around and make that pins & needles feeling go away.  They inserted the catheter and started to test my skin to see if I could feel anything.  NOPE. I was solidly numb from the collar bone down.  I never even felt the tugs and pulls they warned me about.  

M was finally allowed to come into the OR with his daddy scrubs on.  He looked excited and scared and oh so ready to meet these two beautiful creatures.  Around this time Dr H Lee and Dr Sun started hacking into my abdomen.  I was blissfully unaware.  I asked the nurses around me what was happening and they told me they were almost to Baby A.  WHAT?  That was fast!  The next thing I knew Dr H Lee was yelling at M to come see his son born.  Cue tears.  M got to watch our son slither out of my body and into the waiting arms of the NICU nurse practitioner.  M was snapping away with our camera and he followed that little boy over to his warming bed and took pictures of his first moments on earth.  They are beautiful pictures.  

Crying, screaming.  Our baby boy was here!  Overwhelming love.  Just an instantaneous feeling of joy.  I was watching my husband watch our son.  It was amazing.  One minute later, Dr H Lee called to M again to see his daughter born.  She came into this world screaming like nothing I've heard before.  She's still got those lungs and she lets us know it ;)  The NICU nurses brought {A} over to see me and I was in such awe.  I have a blonde daughter.  What?!  I have a blonde daughter?!?!  M was snapping pics of {M} and I called over to him "she has blonde hair!"  He looked at me and his eyes got HUGE.  He was so excited.  He walked over to her warmer and started snapping pictures of her.  I watched all of this unfold as if it wasn't happening to me.  I smiled and I literally felt my heart swell.  

I heard all of this second hand, but their apgars were {M}: 8 & 9 {A}: 7 & 9.  M cut {M}'s cord, but {A} was too squirmy and he didn't feel comfortable around her with sharp scissors.  He left it to the professionals ;).  She's still squirmy wormy!  They had their footprints taken for the birth certificates and all the post-birth brouhaha.  The NICU nurses and M carried the babies over to me and held them to my face while I was getting put back together so I could kiss them.  Oh my gosh, I'm a mom.  These beautiful, squirmy, pissed off infants were MINE.  I smelled them.  I took in everything about them.  I still remember what they smelled like, what they felt like, how they sounded, what they looked like.  Best moment of my life, meeting my children.  We took our first family pictures and they were whisked away to the NICU for evaluation.  Any baby born at or under 38 weeks gets a quick once over...though our babies once over would be anything but quick.  

M followed our new babies to the NICU and took more pictures, fed them their first bottles and loved on them while I was getting stitched back up and when I went to recovery.  Recovery was AGONY.  I wanted to go hang with my babies, but I had to wait.  M came to see me and brought me pictures and news.  I couldn't believe it was all happening without me!  At least M was there with them.  I relaxed and let the spinal wear off.  I was taken back to my room for some rest and relaxation.  Of course I couldn't rest or relax, I wanted to be with my babies.  I pumped for the first time and tried to keep my cool while I waited for permission to be wheeled down to see them.  M visited several more times, bringing MORE pictures and stories about how beautiful our babies were.  I was DYING to get to the NICU!

The rest of the story coming tomorrow :)  Stay tuned!