NICU

The girls were both taken to the NICU for breathing difficulties after they were evaluated in the OR.  Although I knew this was very likely to happen given their prematurity, it was still hard to see them go.   Later on, I was able to witness a new baby coming into the NICU so I know what this time was like for them.  They were surrounded by a team of nurses who evaluated their condition.  Their IV's were started, and they were hooked up to monitors and the CPAP machine. 

In the meantime, I was in the recovery room unsure of when I would get to see or hold them.  After awhile, I was told by the nurse that we could stop by the NICU as my bed was wheeled upstairs to the post-partem rooms.  It would be up to the nurses upstairs when I would be able to see them again after that.  As we made our way to the NICU for the first time, I was excited to see the girls again, but I was also nervous about what I would find since I had not heard any update on their condition yet.  The girls were in the first two slots, and my bed was wheeled between them.  I received my first reports from the nurses responsible for them.  Baby A (Eowyn, but we had not named them yet) was on CPAP, but she was not receiving any extra oxygen.  Baby B was also on CPAP, but she was requiring a little bit of extra oxygen to keep her oxygen saturation high enough.  I was told that I could touch them at this time (both Jason and I were allowed but no one else).  It was a little hard to see them.  There was little I could see of their faces behind the CPAP equipment.  I had just given birth, but instead of holding and nursing my newborns, I could only reach over and touch them.  I knew that the L&D nurse needed to get me upstairs so I tried not to stay to long, but it was so hard to leave not knowing when I would be back.

First view of girls in NICU

Tessa

Me and Tessa

When I got up to my room, I met my new nurse.  I immediately asked her when I could return to the NICU.  She told me that I could go back whenever I could get up out of bed.  If I could get up, I could go back later that evening.  If not, I could go in the morning.  I was determined to go back as soon as I was able.  A few hours after I was taken upstairs I was ready to try.  The nurse brought in a wheelchair.  After collecting my catheter bag and my IV pole, I was ready to go.  We went back down.  Jason and I decided to name them while we were there.  Although we had determined their names while I was pregnant, we were waiting to see them to decide which baby would get each name.  It was still hard to see their faces, but I was a little tired of referring to them as Baby A and Baby B.  Both Jason and I were in agreement that Baby A would be Eowyn and Baby B would be Tessa.  I could have stayed there forever, but I knew that I needed to return.  I decided to stay in my room the rest of the night so I could concentrate on getting some rest and pumping.

We returned the next morning to find Eowyn off of the CPAP.  She now was only receiving air through a nasal cannula.  Tessa was still on the CPAP, but she had been weaned off the extra oxygen already.  I was able to hold Eowyn for the first time that day.  This was also the day that most of the family got to meet the girls, including Gabriel.

Gabriel seeing Eowyn for the first time

Gabriel seeing Tessa for the first time

Gabriel back to see the girls again later in the day

Holding Eowyn (1 day old) for the first time

Tube Feeding for Eowyn

Over the next few days, Eowyn was taken off of everything but the monitors, and she was moved from the warmer to a crib.  Tessa finally made her way down to a nasal cannula, and then eventually came off of it as well.  Tessa was having some issues with jaundice though so she was put on a bilirubin light and a bilirubin blanket.  I was glad when all of that was done, and the patches could be removed from her face.  She kept pulling at them and ripping them off.  Tessa finally got her own crib as well.

Eowyn being fed with bottle

Tessa with nasal cannula (notice her hand by the tubing)

Holding Tessa for the first time..Jason is holding Eowyn for the first time

Eowyn free of all but monitors

Tessa free of all but monitors

Tessa in an open crib

Now all that was needed to come home was 5 days without alarm, a steady show of growth, and passing their car seat test.  Eowyn did this fairly quickly and was ready to come when she was 8 days old.  It was so hard to bring her home without Tessa.  I knew from then on that I would be torn between being home with Eowyn or at the hospital with Tessa.  We were hoping that Tessa would come within a few days, but she continued to have bradycardia alarms.  Most of them occurred when she would eat.  The hardest one for me came the day after Eowyn came home.  Tessa was at almost three days without alarm so we were hoping to bring her home in a couple of days.  The NICU called me at home to let me know that she had just had another quick one.  We would have to wait at least another 5 days to bring her home, and we couldn't even be sure that it was the last one.  I was so upset.  I was tired of it all.  I wanted them both at home.  I wanted them both healthy, and I was tired of waiting.  I calmed down though, and Tessa had her last brady the next day.  She finally came home at 15 days old.

One Month..or -5 Days

My girls were one month old on Saturday.  I can hardly believe it.  I think it seems even shorter because it took two weeks to get everyone home and settled.  It also seems odd that they are a month old when they were not due until this coming Friday (hence the -5 days for their adjusted age). 

Eowyn is the quieter of the two, but she is also more particular.  Although she can cry when she wants to, she often will let me know she is ready to eat by grunting instead.  She is a messy eater.  She will let her formula dribble out the sides of her mouth as she eats.  She can take forever to burp.  Eowyn sleeps best swaddled.  If you try to put her down without it, she will wake herself up by jerking her arms around.  She does well with tummy time though.  She can get her head up well.  She has even rolled over once.  It was completely by accident.  Her big head listed to the side and over she went.  At first, Eowyn will hardly ever open her eyes, but she has started to look around more in the last week.

Tessa is a girl who knows what she wants.  When she is hungry, she lets you know...loudly.  When she is tired, she sleeps really soundly.  She is our champion burper and squeaker.  She does not do as at tummy time.  She can lift her head enough to turn it from one side to the other, but that is about all.  When Tessa's awake, she looks around at everything with the widest eyes.

Both girls are growing.  Their one month appointment isn't for another week so I don't have official stats, but both have gained around 2 lbs since birth.  I can hardly believe how heavy they are getting; although, that is relative since they are about the size of Gabriel at birth.

I took pictures of the girls today.  They are not on par with the professional pictures my sister took a week ago.  If you haven't seen those, check them out here http://photos.willowgrovephotography.com/p237457698 .  I think they are funny because Eowyn looks the same in all of them, but Tessa's face is so expressive.  Here is what I imagine her saying.

Hi Mommy!

Do you taste good?

What is that!

I don't know about this.

What is that?

I'm happy.

I'm sleepy.

June 16th

I had a plan that Thursday morning (I know..shocking).  Jason was off that day.  Both he and Gabriel were going to my appointment with me to meet my doctor.  I was then going to come home and write a blog post to update everyone about my pregnancy.  Things did not go as planned.

The first part of my appointment was fairly routine.  I had my abdominal and vaginal ultrasounds to check on the babies and to check the length of my cervix.  My cervix had shortened some again, but overall, I was okay with the number.  At the very end of the ultrasound, I asked if Baby A was in a frank breech position.  For those who don't know, there are several different types of breech positions.  I was concerned that if she was in a frank position (baby is kind of folded in half with legs up by face) for too long that she might have hip problems after birth.  I was relieved when she said no.  Then she looked at the picture again and told me that she saw a foot down by my cervix.  I thought nothing of it as she took a picture and labeled the foot on the screen.  Little did I know that this was the beginning of the end of my pregnancy. 

We had about a half hour wait before my appointment with the doctor.  When it was time, my OB walked in, met Jason and Gabriel, and immediately told me I was going straight to the hospital after she was finished with me.  She wanted me on bed rest at the hospital for the remainder of my pregnancy.  I was a little shocked at this news.  She explained that she was doing this because Baby A was footling breech (one or both of baby's feet are below the baby and near the cervix) and the risk of cord prolapse was very high (cord comes out of the cervix first and oxygen is cut off when the baby puts pressure on it).  She decided to go ahead and do a manual check on me while I was there.  I was really excited when I heard this.  For so long, we had been getting weekly updates on the length of my cervix, but I had no idea how dilated I was.  I really had started to think that I was going to make it to 37 weeks or beyond, but I knew I might have to rethink that if I showed a decent amount of progression.  As she proceeded with the check, I waited patiently to hear how many centimeters.  Instead, I heard my doctor tell me that she was delivering these babies today.  Why?  She could feel Baby A's foot during the check.  Her concern for my water breaking and a possible cord prolapse was too high.  I did ask my OB before we left how dilated I was.  I was 1 cm.

I was shocked to say the least.  Five minuted before, this had been a normal appointment, but now I would be delivering the babies immediately.  To be honest, I wasn't sure how I felt about this.  You see, a cord prolapse had been on my radar.  Although I had not talked with anyone about it, I knew that Baby A's breech position put me at a higher risk for it.  I had thought about what I would need to do if my water broke at home to check for this.  This being said, I had not looked up anything on footling breech positions.  Was the risk so much higher that it warranted taking the girls?  I knew that they were likely to need NICU time at 34 weeks 6 days.  Should I sacrifice this time for lung and brain development to prevent the possibility of a prolapse?  I struggled with these questions all that afternoon as things were prepared for my C-section.  I still somewhat struggle with them now.  I have looked up information on it though.  Cord prolapses can happen as much as 25% of the time with footling breech presentations.  Knowing that, I have come to terms with the decision to take them.

I was quiet as they prepared me for my C-section for another reason as well.  I was remembering the last time I gave birth.  I knew that was a far different situation this time, but there was a part of me that still felt that much could go wrong.  I felt so close to having the girls there, but I was still afraid to really believe in it.

My C-section was relatively uneventful.  I was a little worried that they would have to put me under general anesthesia after they missed when trying to put in my spinal the first time, but he was able to get it the second time.  Baby A, Eowyn, was born, and Baby B, Tessa, followed two minutes later.  Eowyn cried right away.  Tessa made some noises right away, but she didn't start crying well until she was stimulated some.  It was a welcome sound after the silence of my last delivery.  I had some hope when I heard them that their lungs might be well enough developed to avoid the NICU, but it was not to be.  After assessing them for a few minutes, they were brought to me for a quick peek before they were taken away to the NICU.  I was eventually wheeled to the recovery room.  I was so happy that they were here, but I had no idea when I would see them again.  I didn't know when I would hold them for the first time.  I felt a little empty and alone.

Eowyn Grace

Tessa Alexandra

Meeting Eowyn before she was off to the NICU

Meeting Tessa

Fifteen Years Ago

Fifteen years ago today, Jason and I went on our first date.  He was 21 and I was 16 (but only for two more days).  My parents knew where I was that day, but I was not entirely honest about who I was with. 

Jason and I met at Kroger.  My mom wanted me to get a job during my junior year of high school, and Kroger seemed the perfect place since she already worked there.  I don't even remember the first time I met Jason, but we got to know each other throughout that spring of '96.  At first, I didn't pay him much attention.  He was 4 years older than me, and to be honest, we didn't have that much in common.  Another coworker and I even tried to set him up with another cashier.  I didn't realize he was interested in me then.  I didn't even realize it when he transferred to third-shift but continued to come into work early to go through my line and buy a drink.  I am not sure when we decided to go on a date, but I do know that we asked for my parent's permission.  My dad heard his age and said no, so I went out with him anyway (I know..not my finest moment).

When I woke up this morning and looked around, I wondered what Jason would have done then if he had gotten a glimpse of our life today.  My guess is that he would have ran.

The Girls are Here

I had every intention of writing another blog post before the girls were born, but it was not to be.  My body is telling me that now is not the time to write the girls birth story, but I thought I would post a few pictures.

30-Week Weigh In

I had both of my 30 week appointments in the last day or so.  Both went okay, but not fully as expected. 

My OB appointment started with my introduction to nurse practitioner #2 (for those of you keeping...yes, I know that is just me...that is 4 doctors, 2 nurse practitioners, and 4 ultrasound techs that I have had this pregnancy not including my fertility doctor).  I was a little annoyed that at 30 weeks I was again being seen by someone who knew nothing about me or my history.  I had even sat down before this appointment to write a list of questions for my doctor, and I realized that none of them were going to be answered.  I don't know if I have just been spoiled up to now, but at my previous two OB's, the only time I ever saw a nurse practitioner during my pregnancy was at my first appointment with Gabriel to get information and a pre-natal prescription.  The rest of my appointment went quickly and smoothly.  I am measuring 41 weeks now.  Jason was finally able to make it to one of my appointments, but of course didn't get to meet my doctor.  He doesn't have a good track record.  He met the OB that delivered Gabriel only once right before he was born.  He met the OB that delivered Nathaniel that day after he was born, and he never met the OB who delivered Kade (Roanin delivered himself).  And yes, each of my children so far has been delivered by a different doctor.  I am assuming we will break that trend finally since I believe that one doctor will deliver both of these girls.

I also had my last regularly scheduled appointment at my high-risk doctor.  The babies both looked fine.  Baby A is measuring 3lb 5oz and Baby B is measuring 3lb 8oz.  Baby A is still transverse, and Baby B is now breech.  I told my sister a long time ago that I hoped my decision for a VBAC would be very clear with future pregnancies.  The twins are living up to that.  They are making a C-section the clear choice.  The one issue with my scan today was my cervix.  It has now shortened to under 2, and it is showing some funneling at the internal os.  My high-risk doctor is asking my OB to think about running another fetal fibronectin test.  I am hoping that I will her from my OB about it on Monday.

Mostly right now I am struggling with how to prepare myself.  I basically see this pregnancy ending now in one of four ways:

1.  The babies are born mature.  My hospital stay is fairly normal with the babies in the room with me.  We are able to come home together.

2.  The babies are born premature.  They will spend time in the NICU before they come home, and they will possibly have problems with breathing and/or feeding, along with other potential health problems.

3.  I will lose the babies.

4.  A combination of the three above.

I now this options are not exclusive to me, and really every pregnancy faces these options.  But, many women dismiss the last three, and proceed as if option 1 will happen every time.  I felt that way largely with Gabriel.  Being pregnant with multiples though has made option 2 much more real to me, and the death of the triplets make me face option 3.  It is hard to believe that the next seven to eight weeks can hold such a vast array of possibilities.  I just pray that I will trust and rely on the Lord no matter which one comes.

Pregnancy with Multiples

I always hesitate to say anything about pregnancy.  I always think that I am not qualified to say anything definitive on the topic even though this pregnancy is my third.  Yes, I will soon be delivering my fifth and sixth child, but I still wonder if I have had enough "normal" pregnancy to say anything.  They say every pregnancy is different, but I have taken that to extremes.  I have been pregnant with a singleton, twins, and triplets.  I have either been pregnant with only boys or with only girls (apparently we don't do mixed multiples).  I have been overdue, induced, and C-sectioned, but I have also labored and delivered pre-term.  Having been pregnant with two sets of multiples, I do feel like I can at least comment there.

Congestion-  Although every pregnant mother increases her blood supply, women pregnant with multiples do it to the extreme.  With twins, the blood supply is doubled, and it goes up even more with other higher-order multiples.  This increased blood supply helps create congestion.  With the triplets, the congestion was annoying mostly.  I would need to blow my nose constantly during the first trimester.  I would get coughing in the morning in the shower so hard that I would get sick.  Most of these symptoms subsided by my second trimester which was good, because I had bigger issues to deal with by that point.  With the twins, the congestion has never really seemed to let up that much.  Twice, it has flared into a full-blown infection.  The first time took my about a month to fully get over, and at its worse, I was barely able to walk because my muscles were so overstretched from coughing.  This time, I have been dealing with it about two weeks now.  It seems to be getting better, but I have pulled a muscle in my side.  As long as a cough in a very specific hunched-over position, I am good.  I have been coughing so much lately that I should have great abs, but I looked down and that does not look anything like a six-pack.  I am just hoping that I will be done with the cough before I deliver.  I had a cold when I had my C-section with Gabriel.  Not fun.

Movement-  Singleton moms have it easy here.  Once you are feeling the baby move, you count your movements twice a day.  You can be relatively sure that the baby is doing okay.  With multiples, it is not so simple.  The babies unfortunately will not respond to a roll call.  I have tried to talk to them about the sensibility of this proposition, but they aren't buying in.  In some instances, it is very easy to determine who's who, but if they shift positions, it becomes impossible.  Then, you are left wondering if they are both okay. 

Size- Imagine on the day that you are due, that the doctor came in and told you that they were going to keep the baby inside fro another 8-10 weeks.  The baby would roughly double again in size.  When that time was over, it would be safe for you to come back and deliver.  This is how many moms of multiples feel.  I am currently measuring full term.  If you added up all the baby/placenta/fluid weight that I am carrying, it would match a singleton mom at full-term.  I still have 8 weeks at least for my babies to be born healthy from the start.

I don't want people to read this as if I am complaining.  I will go through anything I need to get to healthy babies.  I just thought I would give you some insight to pregnancy with multiples.