Thursday, February 13, 2014

Twins Update - Week One

Bentley and Aria are officially a week old!  It has been quite eventful, and each day they make amazing progress.  The nurses and neonatologists here at St. Alphonsus hospital like to manage our expectations and won't hint at when they could be coming home, but my hope is that if they continue on at this rate they will be home within a week or two.

This week Aria went off oxygen, and both twins got off the IV's.  They still have on heart and respiratory monitors, although I am happy to report they have not had any apnea or heart issues.  Aria had a billirubin level of 12.5, and I'm not sure what Bentley's was, but they both spent nearly a day under lights and are now much pinker.  They are both still in the incubators.  The doctor indicated that they have the body fat to be in cribs, so the nurses are trying to wean them off the incubators by dressing them very warmly and lowering the temperatures bit by bit.

Feeding is going very well.  From the first practice feedings when both were able to latch on till today, much progress has been noted.  Each day they are stronger and last longer at breastfeeding.  Bentley has an awesome latch and Aria is getting better day by day.  Both are also taking some feedings by bottle.  A nurse explained that if we waited until they got all their nutrition from breastfeeding they would be in the NICU for a very long time.  So as of today, they get about 50% of their milk (I pump and bring in the expressed milk each day) from a bottle and 50% from the feeding tubes.  Of course, they get some with breastfeeding too, and they just adjust down the tube feedings depending on how well they did at the breast.
In order to come home, a preemie baby needs to be regulating their own temperature (getting close!), be gaining weight (check!  Bentley is now 5 lbs and Aria is nearly back to birthweight at 4 lbs 13.7 oz), and be feeding well (halfway there).

Cadence is loving spending time with Grammy, although she wants to meet the babies very much.  Age 6 and under are banned from the NICU during cold/flu season, so we bring her videos and pictures.  Each time my Mom drops me off at the hospital, Cadence exclaims "Babies, babies! Hi, babies!"  She also helps me with pumping and putting milk into the fridge for the babies. I know she will be a great big sister!
I am very proud of the babies for their excellent progress this week and hope they continue so we can have them home soon!  Things like this really bring a family together and remind one what is truly important in life.

Thursday, February 6, 2014

Best Week Ever

Monday morning, at 34 weeks pregnant, my water broke.  I was not in active labor, so I sent Ben to work with Cadence for a couple hours while I got things ready around the house.  As I headed in to be evaluated at Labor & Delivery, I called Ben to invite him to meet me there.  He explained that it was not a good time and he was very busy, to which I naturally had to ask, "What could be more important than supporting your wife through delivering your twins?"

Turns out, he had a really good answer.  While at the office, he had a transaction that required change.  He opened the petty cash drawer and was surprised to see it only contain $10 instead of it's requisite $200.  Upon reviewing our security footage, he discovered our employee sneaking in on Saturday night and robbing the drawer.  What do you do?  Well, in hindsight you send the employee home, close the office and put a sign on the door explaining your wife is prematurely in labor.  We decided to not let on that we knew about the $190 theft and hope that she was intending to replace it before we noticed.  Ben was able to join me at the hospital and support me as they induced labor with Pitocin.

The rest of the day was a wonderful blur.  Even the painful bits are all awash in the joy of having our two precious darlings.

Tuesday we awoke exhausted.  When we finally stumbled down to our recovery room from the NICU the night before, it was past 3 AM.  We got some fitful sleep, interrupted by pumping and nurse check-ups.  We took it easy, visited our little angels and were very pleased to hear some great progress reports.  Ben checked the security cameras at work and found that his employee had been asleep in an empty office for over an hour.  He decided to stop by the office on his way home to check in on Cadence.  He texted his employee to give her a heads up he was on the way over, and she said she would head out to lunch.

When he arrived at the office, he checked the cash drawer.  It now contained $30.  The day before the deposit had been $20 short.  He began to do some research and found that unauthorized and unaccounted withdrawals had been made over the past 10 days in increasingly larger amounts, including two that totaled $677 from the day before, while he was tending to his family.

Well, the hope of an honest misunderstanding or that she had been borrowing with an intent to replace quickly was shattered.  Ben checked with the employee to find out when she would be back- 20 minutes.  He called the sheriff's office and they sent over officers to arrive in 30 minutes so as not to tip her off.  Well, they showed up and she was not there.  Ben shared his story and evidence and they waited for an hour, no employee.  Figuring she saw their marked vehicles and got spooked, the started packing up.  Just as they were leaving, her car pulled in.

Our employee entered the office like everything was normal.  As they began to question her (letting her know the whole time that she was not under arrest and did not have to answer questions), she started off playing dumb but quickly realized the jig was up and confessed.  The police asked if she had written checks to herself, and she said yes.  Naturally, she was fired, so they accompanied her as she went through the office collecting her things.  After she left, the police explained the next steps to Ben.  They would present the evidence to the detective to build a case. The detective then passes that on to the prosecutor, who decides what to do with it.  They assured us she would be arrested.

Ben forwarded what information he had, then began to look into these checks the employee had mentioned.  He found several instances where she had forged his signature and written checks to herself, all within the past 10 days.  The amounts with the withdrawals and the petty cash money totaled around $2100.

Ben finally was able to go check in on our toddler and pick up supplies from home.  He returned to me for our celebration dinner at the hospital, and another visit to our newborns.  The theft was a large topic of conversation as this was quite dramatic and fascinating situation to be in.  We speculated over what the 19 year old could possibly have spent it all on (she claimed every dime was gone) when she also receives $1000 government support, a full-time paycheck from us, and up until recently lived at home for free.

Wednesday, Ben woke up early to attend an Entreleadership training with Dave Ramsey.  We had purchased it months prior counting on a March 14th due date!  On his way home he stopped by the office and checked his bank account- two more checks had hit, written and cashed the day before, bringing the total stolen to over $4000.  Yup, while he was in the hospital with his premies and recovering wife the employee we hired to depend on for just this time was taking full advantage.  I was discharged from the hospital, did one final breastfeeding with both twins (holding and feeding them is just the best.  They look so strong and healthy), and picked up Cadence.  Ben had to look into these new checks but was able to get home around 8 PM.

I am nervous about what a new day will bring, but excited as well.  It seems like embezzlement and grand theft would be a blight on our special birth week, but honestly for all the bad news we have been so blessed to receive excellent news with every NICU visit.  Each time it is like we are visiting different babies that are stronger and more alert.  I want them home with me so badly, and to be able to hold them and talk to them as long as I like, but even seeing all the tests and wires and tubes can't dampen the joy, peace, and just fullness of love I have within.  My brood of babies has tripled and so has my capacity for love.  This has been the best week ever.

Tuesday, February 4, 2014

The Twins Birth Story

 I had such mixed and powerful emotions over Cadence's birth that it took me several weeks to gather my thoughts and write it out.  With the twins, things started out emotionally fraught but ended with a joyous high where I wrote out the whole experience on my phone once returned to my room while Ben was in the NICU with the kids.

On the morning of February 3, 2014 I was 34 weeks, 3 days pregnant.  Huge, increasingly uncomfortable, but generally in good health and spirits.  I got out of bed to get dressed around 9:00 AM and felt a small gush of fluid.  Ben was on the phone and I let him know I thought my water broke.  As it continued to leak out I started repeating to him "Not pee, not pee! My water broke!"  He hurriedly concluded his conversation.  We were both shocked as this was quite early yet in the pregnancy and we thought we had several weeks left.

I went ahead and took a shower as Ben packed his hospital bag and an overnight one for Cadence.  He took her with him to mail packages and to finish last minute work at the office.  In the meantime, I packed my bag and got ready for the big day, though I was still in a fog of disbelief.  Internet research seemed to indicate that you could hold off up to four days after your water broke before inducing labor, so I was in no hurry to get to Labor & Delivery.
A poorly aimed selfie, taken at 34 weeks, on my way out the door to Labor & Delivery.

I arrived at the Saint Alphonsus hospital at 11:30 AM and was given the tests for amniotic fluid, all positive.  Nurses Candy and Christina were assigned to me and Candy did an inconclusive cervical check.  Still no contractions.  An ultrasound was performed and discovered Baby A (Bentley) was head down, Baby B (Aria) head up.  Dr. Rebecca McCaffrey came in and we discussed the options.  We could schedule a c-section, or could induce labor and hope that Baby B would flip.  If she did not, there was a chance of the 'double whammy' where I would vaginally delivery Bentley but the need a c-section anyway.  Dr. McCaffrey said in her experience, about 10% of the time a caesarean would be required.  90% odds of successful vaginal was a risk I was willing to take to enjoy an easier recovery and avoid major surgery, so I decided to go ahead with trying for a vaginal birth.  I called Ben and let him know that they would be inducing labor so to grab me some lunch and head on over.
When my darling Cady walked in, she heard the heartbeats on the monitor and timidly stated "Baby!"  She approached the bed and I pulled her up to sit beside me.  She patted my tummy and the babies, surprising me with how much of the situation she seemed to grasp.  We had a quick lunch I barely tasted.  The pitocin started but was at the lowest dose, so while the screen showed contractions, I wasn't feeling much.
I could do this all day!
We called around and found a place with my visit teaching companion, Amy, for Cadence to spend the night and set up with my visiting teacher Karen to watch her Tuesday.  Thank goodness for that program!  Ben left with my little girl and I settled in with a book.  The nurses gradually raised my dosage ever half our or so, and by the time my handsome husband returned the contractions were like painful Braxton Hicks.  Luckily, no back labor this time.  We hung out for several hours, watching Superbowl commercials, reading, talking with mom, Aunt Diana, and Emily. etc.  A NICU doctor came to answer our questions and fill us in on the possible complications a 34 weeker could face.  That was quite scary and made me begin to wish I'd defied medical orders and stayed at home even a few more days.

 Around 6:00 PM, they let us know that the food service would be closing soon, so we put in it dinner orders.  Contractions were getting very painful and quite close together, but our next nurse on duty, Liz, let us know I couldn't eat after an epidural so I worked through the pain in order to enjoy my beef pot pie and chocolate shake.  Afterward, it was just short wait before Rob, our CRNA appeared to deliver blessed relief.  The epidural seemed to take much longer than with Cadence.  It didn't help that the contractions were coming every couple minutes.  Or when Rob remarked he'd hit a vein and that I would have a bruise.  I squeezed Ben's thumbnail with each contraction and his yelps of pain made me feel a little better.  Finally, the epidural catheter was in place and they laid me down... only the contractions were still coming fast and heavy and things weren't feeling much better.  Gradually, the pain lessened.  I would have rejoiced, except I was retaining full feeling in a 2x6 inch strip along the left side of my tummy, a bit above where my leg joins my body.  Rob advised that sometimes it takes awhile for the medicine to be fully effective.  We waited a half hour, during which time painful contractions struck at about 3 every five minutes.  Everything was pins and needles except this one swatch and that one hurt unbearably.  Rob was standing by and listed the options, including the possibility of needing to start over.  I was near despair, but the first option of switching medications solved all as each contraction was lessened until finally no pain.  I still had pins and needles, developed a slight but constant nauseousness, and was rather uncomfortable in my bed. Oh, and later the shivers started.  Still, I felt no pain and I was able to even get a couple hours of fitful sleep.

No likey contractions.
Around 11:30 PM, Dr. McCaffery came in and checked my progress- fully dilated and station 3.  "Let's get this show on the road!"  They began the process to get me to the OR, where twins are delivered in case the necessity arose of an emergency c-section.  I was given a hairnet and Ben was presented with a white suit, hair net, mask, and booties.  He began to disrobe but the nurse quickly begged him to wear the suit over his clothes.  (She asked me later if he had been just joking about only wearing the white 'monkey suit'.  I responded that I wasn't sure, but I though she shouldn't have stopped him! Then his buns could have been flapping in the wind in the OR. Let the daddy share in some of the humiliation that is giving birth!)

After what seemed like ages, a team of nurses entered to transport me.  The OR was quite different than my room.  Bright lights, tons of machinery, and a pack of doctors and nurses.  They moved me to the operating table and got me situated in the stirrups- much nicer than people holding my legs!

Within minutes, I was bundled in warm blankets from the waist up and given a few sips of water and Dr. McCaffrey said it was go time.  I gave a first push and she exclaimed, "Oh, a head full of hair!"  She directed me to push again. "Again for the shoulders!" And with that third and final push, Bentley was born!  He started squalling right away, a wonderful sound from a premature little guy.  Dr. McCaffrey rubbed him up and cut the cord, then passed my beautiful boy to his NICU team.

Ben came and reported "He looks just like me!  He is doing great."  I could hear the pride in his voice and read the joy on his face.  It reminded me of the first time after the anatomy ultrasound where we found out we were having a boy.  I said something about "our son" and Ben gave me the biggest smile.  I know he loves his girls, but there was something really special about his joy over his first son.  

I kept blinking back tears of joy as I looked over at the team working on our little son, but there was more work yet to be done!  Dr. McCaffrey was reaching inside me trying to get a grasp on little girl to flip her while Dr. Bouchard manned the ultrasound machine to guide her.  Little one was not cooperating, hiding in her slippery bag high up at the top of my uterus, so Dr McCaffrey broke the water bag.  Little girl still didn't flip, so the doctor grabbed her little behind and helped pull her out, bum first.  She didn't ask me to, but I felt the pressure and guessed I ought to be pushing.  Luckily, Ben was back by my side because it all happened so quickly he could have easily missed it!  After only two pushes, Aria was born, but it was definitely the most uncomfortable part for me. 

Aria, released from the womb, gets to stretch out!
Baby Aria made me nervous because it took her awhile longer to cry and she was so tiny.  After a few seconds that felt like forever, she gave some little delicate shrieks and was whisked away for clean up and evaluation.  I followed the babies with my eyes while the doctor worked on delivering the placentas, a blood red tissue mass with two dangling purple cords.  Then she pushed and pushed on my uterus, cleaned up the blood, and delivered the happy news- no tearing!

At last, face to face with my Bentley!

During the placenta delivery and clean-up, they brought my bundled little son over and laid him on my chest. He was so small and the spitting image of his daddy.  He was pink and had the sweetest expression, which surprised me.  When Cadence was born, she had the grouchiest look on her face.  She was all red and just grumpy looking.  I seriously considered asking them to put her back!  Bentley was calm and serene in comparison.  I talked to him while he struggled to keep his little eyes open, and we talked with his daddy.  Having met him, Ben and I decided to forgo Camden or Calvin and name baby boy Bentley since he was a little miniature of his daddy.  All too soon, the NICU team came to get him back in his warmer.
Happily, the space vacated by my little guy was soon filled by his sister.  Aria was so small and delicate, and was mewing like a little kitten.  She looked so much like her brother, with the same sweet pink cheeks, though her demeanor was notably less serene.  We discussed how unfair it was that she be yanked into the world so early when she was more than content to continue gestating within, and such an undignified entrance!  Her eyes were open wide as she looked at me and let me know just what was on her mind.  Oh how she mewed out her frustration!  It made me want to name her Caitlyn, Kitty for short, but I needed time to discuss with Ben who had always loved the name Cecily, which would also fit my precious little kitten.
Aria and I finally meet.
Soon they took her to get her on oxygen, and Ben went with the babies up to the NICU.  I was cleaned up, wrapped in warm blankets, and moved back to my bed for transport back to my room.  Everyone congratulated me on my beautiful children and the efficiency of the delivery. I thanked them all in turn for their roles played.  On the way out of the OR I noticed the clock said 12:15 PM, so I asked the nurse what time the babies were born.  Bentley came into the world at 11:49 PM and Aria was close behind at 11:55 PM.  They came close to having separate birthdays, but I am glad they will share.

Big Boy Bentley!

Sister isn't too far behind

Aria in her isolette.  All the tubes and wires break my heart, but she looks so peaceful here.

When Ben was able to rejoin me, he shared pictures of our darlings being measured and weighed.  Bentley came in at 4 lbs 14 oz and 18'' long, while Aria was a dainty 4 lbs 9 oz and 17.5'' long.  In comparison, Cadence, born at  40 weeks, was 7 lbs 5 oz and 19'' long. 

Over the next 24 hours, we were introduced to the NICU world.  The babies both made immense progress overnight.  The latest word when we left them at 3 AM was that Aria might require a lung x-ray and extra help beyond the oxygen supply.  They also planned on waiting a week before introducing feeding tubes beyond the IV drip.  By our next visit around noon the following day, Aria was off the supplemental oxygen, both were on feeding tubes and they invited me to try to bring Bentley to the breast.  (He did great!  He is a little champ.  I adored getting to stroke his downy little head).  Ben and I stood over yet-unnamed baby girl's isolette and debated- Cecily or Aria?  Either seemed to fit her delicate sleeping features.  We went over the pro's and con's of each lovely but different name.  In the end, it seemed like the more we tried saying the names out loud, the more she looked like an Aria.  And so, we decided to commit and fill out the paperwork. 
Aria is looking so bright and alert, this is 20 hours after birth.  I think she looks a lot like Cadence here.

 By the last NICU visit of the day, we were allowed to hold Aria.  I rocked her in my arms and we talked to her for a very sweet hour.  From my water breaking yesterday morning to that special time holding my precious little girl tonight, it has been a very full and very special 36 hours. Benjamin and I are besotted with our tiny infants.  How needlessly I worried if I had enough love in my heart for three babies.  I still love Cadence just as much, but my heart has expanded capacity and I can already say that the pain and discomforts of pregnancy and labor have been abundantly worth the reward.