Wednesday, September 26, 2007

The birth story!

Here's the story of our birth and the first couple days at the hospital. Click on the pictures to enlarge.

At our last appointment , the doctor said that he wanted to do an amnio at 37 weeks to check for lung maturity, and if the lungs were mature, then we could decide to deliver at any time. Baby A was still breech, so it’s a C-section for sure. 37 weeks is considered full term for twins, and both their fluid levels were starting to look a little low, so the doc was thinking there wasn’t much reason to wait any longer, if the test showed that their lungs were mature. And, as you can see - I was pretty darn big. Hard to imagine getting any bigger.

Friday, September 21
We checked in at 8:45 for our amnio appointment. I had been told it wouldn’t hurt at all, a pin prick as the needle goes in. Well – that part was true. But what they didn’t mention was the extreme cramping feeling once the needle was in. He had a hard time finding a good pocket of fluid, so he had to move the needle around a bit – and that hurt. I got pretty emotional after that – not just because it hurt, but also because this was stacking up to be a pretty overwhelming day. We’re not quite clear which twin’s sac the fluid was taken from – it was in an area where they were both close together. But we think it was from Baby B. If we had known what we were having, then they would always take the fluid from the boy, because boys tend to be less mature than girls. But – we didn’t know who was who – so they just go with the one that they can get a good pocket of fluid from.

We hung out and waited for the results. We took a walk around the neighborhood and enjoyed probably the last of the late summer weather. The number came back good – lungs are mature. The decision was made – we are go for delivery. So we checked in to the hospital – C-section scheduled for 12:30.

It all happened so fast – it’s a bit of a blur. We got in a room, me undressed and into the hospital gown, and hooked up to the monitors. I was having some contractions – actually more than I had ever had before. Maybe from the anxiety of the day? Also my blood pressure was higher than it has ever been. The nurse got the IV in and got some saline going. The anesthesiologist came to talk to us, to explain the procedure for the spinal. Jim got his gown and hat on. And we march off down the hall to the OR for delivery.

In the delivery room – they had a station set up for each baby. I was told that one will be set up where I can see it, but there wasn’t room for both in that spot, so one of the babies would be where I can’t see. It was a little overwhelming walking into the room – I’ve never been in the hospital before, never had surgery – and especially overwhelmed by what was about to happen. First they prepped me for the spinal, and the flood of emotions starts again. The spinal went fine, then I was down on the table and there were lots of preparations happening around me. Jim was right by my side the whole time.

The room was so full of people, and it seemed like everything was happening at a very fast pace. Two doctors doing the surgery, the anesthesiologist, a couple of nurses that had been attending to and prepping me, a nurse and a respiratory therapist for each baby (apparently standard practice for twins). From the time they started the surgery, to the time that the first baby came out, was maybe 10 minutes. The surgery itself was very strange – I could feel pressure and tugging, but no pain. Once they were all the way in, and starting to take the first baby out – there was lots of strong pulling and pushing. It was a very strange sensation – lots of pressure.

And all of a sudden – the doctor announced that the first one was coming out – and did Jim want to stand up and see what it was and call it out. We were surprised – it was so fast. Jim took a few seconds to realize what was even happening. And he stood up, looked over the sheet, and said “it’s a baby boy!”. This was baby A – he came out one leg first. It was 12:49 pm.

I guess I probably started crying again then – or maybe I had never really stopped crying.

Only a minute later – at 12:50 – out came the next baby – and dad called it a girl! I heard her cry as soon as she came out. Jim says – “that would be your daughter over there”. That was a big moment – to hear him say “your daughter”. Wow.

Baby A – our boy – was taken to the first warmer – the one I could see. I didn’t actually hear him cry right away. I could see that they were cleaning him up, stimulating his breathing, suctioning him out, giving him some oxygen.

Jim was trying to take photos of him. Then he saw the girl come out. He headed over to see what’s going on with the boy. It’s all happening very fast – Jim was trying to snap pictures of both of them, check on how I’m doing, it’s all pretty hectic. He didn’t get to cut the boy’s cord because the nurses were too busy working on his breathing.

Pretty quickly it became clear that our boy needed to go upstairs to the NICU – he wasn’t breathing like they like to see – grunting a lot, retracting – all signs that he’s struggling to get enough air. They were holding an oxygen mask over him. Everybody has asked, was I afraid that he wasn’t ok? I wasn’t really. I think it helped that I could see him, so I could see what they were doing. And even though I could see that they were doing some extra work on him, I could also see that the pace was not panicked. They seemed very methodical, and it was pretty clear that it was all more of a precaution, versus a really bad situation.

In the mean time – the baby girl was cleaned up. Jim got to cut her cord. She was wrapped up and Jim carried her over for me to see her. I kissed her face and marveled at her. It was an amazing moment. Words can’t really describe the feeling. Just amazing.

They finished up the surgery on me in what seemed like no time. In reality I have no idea how much time had gone by, so much was happening all around me, that I was no longer aware of the surgery. When they were done with me, they started to move me back to our room, along with our baby girl.

Jim and I had previously agreed that if either of the babies needed to go to the NICU, that he would go with the baby. So we split up – Jim and the boy still in the OR while they are getting him ready to be moved. Me and the baby girl headed back to the room. I held her in my arms on the ride back, and I vaguely remember a few people in the hallway congratulating me on my baby, and I remember thinking that it wasn’t quite right because really I had two babies, but only one was with me.

Pretty quickly once we were back in the room, the nurses helped me to start getting her to breastfeed. She latched on pretty well right away – she’s a natural. This is an amazing feeling, to be breastfeeding my own baby less than an hour after she’s born.

Once back in the room, as we’re getting settled, the NICU team and Jim came by with our boy – so I could have a chance to get a look at him before they take him upstairs – because at this point I had only seen him from a distance. I didn’t actually get to hold him, but the nurse held him up to me so I could see him close, and they were holding a little oxygen mask by his face. He’s so precious – they both are. Beautiful, perfect faces. Their skin is so soft and they’re covered with soft peach fuzz.

It’s amazing how different they look. She looks like a girl and he looks like a boy. She has a very round face, long eyelashes, long fingers and fingernails and toes. Full lips and a round mouth. He has a longer and thinner face, shorter fingers and toes, but he is longer and bigger overall. He doesn’t really seem to have eyebrows at all, and he has very tiny eyelashes, barely noticeable.

At this point, we made our final agreement on the names. We were pretty sure about this as we went in – we had to full boy names and two full girl names, and we had prioritized our top boy and girl names so we agreed on which we would choose if it was one of each. But we wanted to just double check with each other before we starting telling them. And so they are – Daniel James, and Callie Ellen.

And off they went – Jim and Daniel up to the NICU. Callie and I got settled into our room for a few hours of recovery. We would be moved to a post-partum room in a few hours.

Once Daniel was settled upstairs, Jim came down to check on us and give us an update. Daniel was doing ok, they had him on a bit of supplemental oxygen for a little while – less than an hour – but now he’s on room air. They were just monitoring him, but for the moment his stats all looked ok. He had what they call a 'wet lung' - not uncommon for c-section baby, compounded by the fact that he was breech and a boy - both factors also contribute to a greater chance for respiratory issues.

Jim finally got a chance to spend a few minutes with Callie, and while he’s there Callie got her first bath – we waited for Jim because he had the camera and I wanted pics of her bath.

Once we were all done with that, she was bundled back up and we were ready to move to our new room that will be our home for the next few days – in the mother baby unit. The nurse arranged things so that we could go up to the NICU on our way, so I could see Daniel. They were able to wheel my whole bed right on in there next to his little bed, and I finally got to hold him for the first time. It was amazing to see them both together, to hold both my beautiful babies at the same time. He had a bunch of wires hooked up, but it was all just for monitoring. They assured me that he was doing great and would be back with us soon.

And sure enough - Daniel did well in the NICU and was able to come down to the room with us just a few hours later.

The first night I was still on an IV for pain medication, with a steady dose and then a button I could push every 10 minutes for more. I definitely needed it – as the spinal wore off, I had a lot of pain. Initially the pain is primarily cramping as the uterus shrinks back down to size. The first night I was just allowed to have ice chips and water.

The first night with Daniel was rough – because of his breathing issues they want his blood sugar tested every few hours – to see if he’s able to maintain that. Testing that involves pricking his heel to get a drop of blood. It was so sad to see him have to endure this, he screamed every time. Nobody got much sleep that night. But we were so happy to have both babies with us.

Saturday, 9/22 – 1 day old.
The next morning – Saturday – the nurse decided she wasn’t happy with Daniel’s breathing. She had a couple of NICU nurses come down and take a look, and they agree that he should go back upstairs to be monitored more closely. So off they went again. Again Jim went with, and the day was filled with Jim going back and forth between our room and the NICU.

Daniel got formula in the NICU. But they called down to say that I could try to come up and feed him at noon if I wanted to – someone from lactation would be waiting to help. Of course one day out from surgery I was not able to walk very well, so they got a wheelchair so Jim can wheel me up. And a very nice nurse from the pediatric unit came to watch Callie while we went.
They had a glider chair pulled up next to his crib for me, and we attempted to nurse. But he was not getting it just yet. It was hard to get him to open his mouth wide enough, and when he did and we can get him on, then he didn't seem to know what to do. He just looked up at me with these wide, sad eyes, as if to say “I don’t know what to do mom”. It was a little hard for me, but everyone was very encouraging and assured me that he’ll get it eventually. So we didn’t force the issue too long, we didn’t want to wear him out, and instead I gave him a bottle of formula. At least I got to spend some time with him, holding him and looking into his beautiful eyes.

Eventually we had to let him go back into his crib so he can rest. It’s hard to say goodbye. Even though I knew he was just there to be monitored, and he was in excellent hands, and was in so much better shape than all the other babies in the unit – it was still heartbreaking to leave your baby there.

Jim got to spend a bit more time getting to know Daniel this day, since I was not so mobile. He learned how to help him eat better. Daniel was eating on his own – he didn’t need an NG tube, like most of the other babies in that unit. But he did need help. He didn’t quite know how to keep his mouth closed around the nipple and suck. So they taught Jim to do what they call “chin support” – holding the baby’s chin up while he sucks, so that he had a tighter grip on the nipple. It helped him figure out what he’s supposed to do.

The rest of the day was uneventful, feeding Callie, getting updates on Daniel, trying to manage my pain from the surgery. I was finally allowed to eat some real food, which tasted very good. At around 10:00pm we finally got Daniel back for good – he checked out ok all day. He’d still be watched a little more closely, getting his blood sugar and oxygen levels checked a few times a day.

Sunday, 9/23 – 2 days old
Sunday was our first whole day all together. We spent our time just getting to know the two babies, me finally getting to spend some real time with Daniel. It was an emotional day for me. For no particular reason, I guess the combination of lack of sleep and an overwhelming surge of hormones. But there were lots of floods of tears throughout the day. Holding the babies and looking at their faces made me cry – I was just so overwhelmed with how in love I am with them, and how lucky I felt to have them. It was a long road getting here, and when I thought about how blessed I felt, the emotions overflow. Especially when holding Daniel – with the rough start that the little guy has had, I never want to let him go.

It was amazing to see that they already have unique little personalities and they behave differently.

Callie is totally content all the time. Feed her, change her, swaddle her up and she’s happy. In the womb she was all curled up in a ball, with her little feet tucked up under her – and now we see that she likes to get in this same position. She seems very content when held this way, and naturally gets herself into this position. When unwrapped – she gets her little arms and legs swimming like crazy. Jim starts calling her the Monkey Girl – because of the way she kicks her legs all over the place, and the way she grips on to everything she can get her hands on.

Daniel has amazing startle reflex. All babies have this – but his is working overtime. His entire body jerks. And he does it every minute or so. If he’s unwrapped, his arms & legs fly up every time he does it. It’s hilarious – we laugh at him every time (terrible, I know!). Jim started calling him Mr Jitters. He still does it when swaddled tightly, but at least then it keeps him more contained so he doesn’t wake himself up every time.

I still stand by my contention that I would not choose a c-section if it wasn’t necessary. Yes, the delivery was a piece of cake. But the recovery was not. The pain was pretty significant at times, and I had to really keep on top of my pain meds in order to not be really uncomfortable. Getting up out of bed was really hard – straightening up the body after being in a sitting position really hurt. Every time I had to get up to use the bathroom was a challenge.

About Daniel and breastfeeding… The first few days it just wasn’t working for him. He was not combining the latching on with the sucking. And I could not really get him to open his mouth wide enough to latch on. He was given formula in the NICU for the first 1.5 days, and when he rooms in with us. I tried at each feeding to get him on. It was not until about day 3 that he started to show signs of maybe getting it –we could occasionally get him latched on, although he wasn’t sucking very strong yet. The milk had not come in, and the colostrum was not easy to get out – it was harder work than his weak little body was able to do. I started pumping on day 2, and had been able to pump a small amount of colostrum for him, but not enough to feed him. It was emotionally hard to know that I could not give him what he needed and he had to have formula, but I was continually reassured that it will be fine, that he’ll be a good breast feeder when my milk comes in and he gets a little stronger.

Callie took to the breastfeeding right way. We got her latched on pretty quickly and she figured out how to suck. It was a really amazing feeling, to be feeding my own child from my breast, within an hour of her birth. The struggle with her in the following days was all about waking her up to feed.

Daniel HATES having his diaper changed and just being naked in general. This was the only time that he screams. But as soon as he’s dressed and wrapped back up again, he’s content.

Callie is the squirmiest baby ever when getting changed, but she rarely cries. She’s hard to change because she kicks her legs around so much. They both make little squeaky sounds – like little squirrels. Sometimes while they are sleeping. Sometimes when they are just slightly unhappy, but not so much that they cry – they sound like sad little squirrels.

My feet swelled up after the delivery – something I definitely was not expecting. I thought all that water & swelling went away after you delivered, I wasn’t prepared for it to get worse. My feet were so fat that I could just barely squeeze them into some flip flops. And they HURT – my skin is stretched and I couldn't really move my toes very well because they’re so fat.

Monday 9/24 – 3
I got my staples out of my incision. I was terrified for this. The idea of having staples in you in the first place sounds freaky, and I imagined that it would hurt a lot to get them out. But it wasn’t nearly what I had feared – actually it didn’t hurt at all.

Daniel was circumcised. We were a little concerned about this, since he had already been through so much, we felt bad putting him through yet another thing. But he came through it like a champ. About ½ hour before his scheduled time, the nurse came and put a little numbing cream on him. Jim went with him for the procedure. They gave him some shots to numb, and Jim said that Daniel didn’t fuss at all.

And this afternoon we went home from the hospital. We got the babies bundled up in their car seats for the first time. and off we go. Mom and John and Aunt Callie were waiting at the house for us. It was a great welcome – lots of tears.


Truck Driver Wife said...

Thank you for sharing your wonderful pictures and story. You are amazing and your babies are beautiful

seattlegal said...

Thank you for sharing! I am so jealous of all those OR pics you have - Jon took 1 the entire time we were in there.

My son had a similar rough start - he had to go to the special care nursery for a while and that was hard. And the feet swelling up afterwards - I wasn't prepared for that either!

Congratulations again - they are just so cute!

Jaimie said...

I wasn't prepared for the swelling either. It was horrible! Daniel and Callie are just beautiful.