Saturday, December 14, 2013

Birth & The NICU

My son is napping in a footed fleece pajama onesie with snowmen on it, out the window looks like a snowglobe, I have the Fireplace popping on my TV screen (hey, it's a New York apartment--no chance of a real one), and all is calm for a moment. I have a mild cold so I am unable to spend time with the girls until it passes. Seizing the opportunity to update my risky twin blog.

Thanksgiving was on the 28th this year, so by the time the morning of the 30th came along, I was still kind of in a white chocolate pumpkin cheesecake coma. My father, my mother, her significant other, and my husband all spent the days with me leading up to that Saturday. I was on the Labor and Delivery Floor starting that Thursday, the very day I turned 32 weeks, for continuous monitoring. It was pretty uneventful; played cards, watched TV, took pictures.

When I woke up on the day of scheduled delivery, at 32 weeks and 2 days along, I took a quick shower and then had a new IV line put in my arm. I put on my first hospital gown of my 8 week inpatient stay. The nurse helped me put the non-slip hospital socks on, and she ushered me down the halls with another nurse to the Operating Room. My husband was getting a quick coffee (fair!) and given a set of scrubs. He wasn't allowed in the OR until they were completely ready to truly begin the Caesarian.

It was pretty much how I had envisioned it. The room was extremely technical, stocked to the brim with various medical supplies; it actually could have been easily mistaken for a stockroom. Except there was a creepy, shockingly narrow steel table smack in the middle of it all. The lights were very bright and the whole room was very intimidating. I told the nurses this and we all shared a nervous laugh. I was trying my best to make light of how truly intimidating and horrifying the room was, and they tried to help me by saying "it's just supplies, really."

The anesthesiologist helped me sit up on the table, scooted me to the edge towards him and began injecting the spinal block of epidural. Then, an anesthesiologist who was clearly above him, moseyed in and began nit-picking with him about placement and such, really just a pissing contest, as in the end he agreed the first guy did everything correctly. This made me a touch nervous, but reassured me hearing the second guy confirm it was all okay. Getting an epidural is difficult because you cannot move while they are injecting a massive needle into your spine. If you move, it can destroy your nervous system and do serious permanent damage. Yay, fun, and not nerve-wracking at all! I must admit, though, getting an epidural is a lot easier when it is a planned delivery. With my son the year before, I was having contraction on top of each other by the time they were putting it in, and this made it unbelievably difficult to not move a muscle. With a regular epidural, you have a constant drip of the drug, and a button to push if you want extra along the way. With a block, like during my c section, it is a limited amount because the whole thing is very controlled.

After the spinal block, I was laid down. Even if I hadn't been 8 months pregnant with twins, the table was damn small. It truly freaked me out just how narrow. There was a point it was turned to the side with me on it, while I was vomiting (wee! yay!) so I wouldn't choke on it and die, and being turned was terrifying--especially because they forgot to warn me it was being turned. Grr.

The epidural set in fast -- too fast. Cue the weeping. I got a bit hysterical. Going from feeling like yourself, to being completely numb from the waist down in about, oh, 5 minutes flat, is terrifying. I felt like a prisoner in my own body. Absolutely paralyzed, like an anchor that had sunk to the bottom of the ocean. The nurses felt bad for me, and the doctors felt frustrated that I wasn't enjoying it--ha. They didn't say that; it's how they acted. Through both deliveries, it's the nurses who nurtured my emotional well-being. The doctors are just there for technicality and procedure. Sorry I'm not sorry, if you're a doctor reading this. Be nice to us, doctors. One day you will need a doctor, too.

The sheet was put up so I could not watch what was going on, thankfully. I began feeling very hot, very ill, very uncomfortable, nervous and sad. Finally my husband was allowed in, just when I was about to ask, where the hell is my husband? Let him in already! He was all "scrubbed in" with his cap, gown, shoe covers. He sat near my head & took pictures. He said why are you crying? We're about to meet our little girls. Everything's fine.

There was flurry of people near my stomach. I never really saw them, it's a blur. Then the exciting but dreaded word was announced and repeated back, "INCISION."

Then came the endless tugging. It's difficult to explain if you've never experienced a c section. I am not entirely sure was happening, but it felt like the lady was reaching inside of my womb and turning and positioning both babies. I was just staring vaguely near my husband, wide eyed, horrified, just laying there experiencing one of the strangest feelings I could ever try to physically and mentally process. Soon, Twin A was born. She came out crying, and I began crying. She was presented to us, sitting in the pediatrician's arms, crying and looked bigger than I had imagined. I was so happy! Then, out came Twin B. The pediatrician presented her to us; she was kind of holding on to him and quiet; he said she is fine, just too startled to cry. She was quite small and I was taken aback. Even though they were only a few feet away from us, my vision is crappy, and her foot looked like it had formed backwards or something. Luckily, this was an optical mistake and completely founded in delusion. Gavin snapped a picture of each girl. 

They were whisked away to the intermediate nursery where they were cleaned up and put in isolettes; their half-way stop before their new home in the NICU. Gavin was overjoyed, we agreed they looked great and that B was very small. He assured me they are fine. He snapped a picture of their cords--the reason all of this was so risky. They were tangled ten times with one loose knot right in the center of all the tangles. Yes, that is not a good thing, but it wound up looking a lot better than what I was imagining it to look like. B's cord was smaller. She had a 2 vessel cord instead of a 3 vessel cord like her sister (and like the rest of most of the world's population.) This means she was missing an artery in the cord; on top of sharing a placenta i.e. all nourishment, it is no wonder she came out one whole pound less than her sister. While the team began fixing me up, they took my husband with them to see the babies get cleaned up and such. Lucky him, that's what they did with our son, too. He's always the first to say I love you.

They suctioned out my uterus. EW. Then stitched it up, rearranged it back inside of me, then stitched the skin up with dissolvable stitches, and placed steri-strips along it. The gown was brought down over my body, and the curtain was taken away. Everyone who had been on the other side of the drape, watching this all happen, making it all happen -- they were all gone by the time the drape was taken away; it was peculiar to me. So very technical and common to them. Then I was transferred to a stretcher. Again, with the shifting narrow table turned to the side and I clutched on for dear life like a cat trying to be put in the bath. They assured me I wouldn't fall; I didn't believe them, not even for a second. I was on the stretcher, then taken to the recovery room. Gavin met up with me there. Maybe an hour or two later I was able to wiggle my leg. We laughed because we were both reminded of the scene in Kill Bill where Uma Thurman keeps saying "move your big toe, move your fucking big toe" after in a coma and experiencing atrophy. He left for a sandwich or something.

My dad came by to congratulate me, then he swooped up my son in the lobby. My mother and Bob came to congratulate me. They left and I was alone for a moment, exhausted. To my delight, they wheeled in Twin A -- Miss Lucy -- in her isolette and I was so over the moon happy. I opened one of the portholes and stroked her little soft red leg in utter amazement. After a few minutes, I said okay, go ahead and take her to the NICU. Then a few moments later, they wheeled me into the intermediate nursery, and I was able to see Twin B -- Miss Violet. She was so small I was afraid to bother her. I was just so happy to see them in the flesh. They took me back to the recovery area, and she was taken to the NICU with her sister.

Both girls were put on CPAP, these big tube looking things that create and airway to breathe better, but they were breathing room air all along. When Gavin visited them in the NICU with his mother, his brother, my father, my mother, and her boyfriend, they all saw them on CPAP. When I went to visit them the following morning, they had been taken off of it the night before, so they only needed it a couple of hours. Amazing!

I was taken back to the same room I had spent the following 8 weeks, which was a relief because it had become a second home to me. Getting transferred from the stretcher to my bed was horrific. They expected me to help move myself to encourage me to move a little bit. It was difficult to do. I had a catheter in me so I didn't have to get up to pee. They encouraged me to alternate sitting up and laying down to help blood flow and healing. The day of and the day following major surgery especially abdominal surgery, you are prone to nasty blood clots. I got several shots of heparin, a blood thinner, the day of & days following the surgery to help prevent it.

I could not keep any liquids down for several hours after surgery. I finally was able to keep down some soup later that night. I was so weak, and living off of scrolling through the pictures my husband took of our family meeting the girls in the NICU. It made me blissful to see pictures of them. They looked so good, I was so proud and relieved. Absolute miracle babies.

My husband was in a funny mood and it was driving me nuts because laughing hurt so much. You know the saying laughter is the best medicine? Well it is NOT, if you've had a caesarian. Good lord. Avoid any comedy at all costs for at least 3 days if you are going to have a c section.

My tips if you are going to have a c section:
- no comedy for 3 days, the laughter will make you cry -- in the worst way
- take your pain medicine regularly and insist your nurse wakes you up throughout the night to administer it to you
- if you want to give your baby breast milk, start pumping right away around the clock (yes, set alarms. you will have alarms set for pumping, and for when to take your pain medicine -- it is exhausting.)
- drink at least an entire pitcher of water the next morning, so when you get up to pee (with help & 2 people watching -- fun) they will let you come off of your IV line.
- shower but do not scrub the area & blow dry your incision site with a low, warm blow dryer
- do not use the wheelchair, walk (unless you are dizzy)
- do not let your husband try to tell you there is enough room in the hospital bed for him to share it with you now (because there isn't - get out!)
- do not drink with a straw, too much air
- do not eat until your nurse says its okay
- cheese, cracker, and cured meat and mild thai soup were fine on my stomach when I was ready to eat about 12+ hours later
- if you saw Bad Santa and remember "you ain't gonna shit right for a week" well, you're not. So deal with it. And fuck Colace it didn't work either time I've had babies. Just know it will probably be yet another terrible experience.

Fast forward two weeks later. The girls are still in their heated isolettes but are being weaned down and starting to be clothed, prepping them for open crib. Once they are both able to be in an open crib, they will be reunited (I cannot wait!!! They haven't seen or held each other since my belly!) They both have feeding tubes but are both working on taking bottles and the breast. Formula makes them both sick and they both are thriving on my breast milk, of which there is aplenty. The doctor and lactation consultant continue to be amazed at my supply, ha. My body definitely got the signal I had twins, even if they were 8 weeks early.

I am able to change their diapers, take their temperatures, and hold them. I love doing kangaroo care with them; they are tucked inside my shirt and we enjoy skin-on-skin cuddling for at least an hour, if not 3 hours, until my ass is numb and I need to get up to pee, or switch to the other baby.

They are outrageously precious. Each little sniffle, smile, pout, frown, fart, sneeze, is just perfect. They have no health complications thus far, and I thank my lucky stars. Their only hurdle now is getting off the feeding tube, getting to open crib, and packing on a bit of weight. At birth, Lucy was 4 pounds and Violet was 3; they are both up from their birth weights today, so that is good. They are making great progress. They really do look great. They look just like their brother when he was an infant last year.

When they were born, their pediatrician (nice guy) said they would be home in 2-3 weeks. Well, it has been 2 weeks. I am afraid to ask when they will be home now because I don't want to be let down. The dresser is finally up and stuffed to the brim with their clothes and whatnot, and the crib arrived yesterday. So, we are still reading up the house for their arrival, but I can't wait for them to get home. I miss them so much when I am away from them. I know they are in great hands, but I want them in my hands! Soon enough.

Hospital room view:

 
Holding Lucy
 
Left to right: Lochlan last July, Lucy, and Violet
 
Kangaroo care; the best!
 
11 days after the twins:


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