abc family

Homecoming

When Linus and Ambrose were just four days old (before these pictures were taken) we had the camera at the hospital and got some shots of them. It was Monday, almost two weeks ago.

Here's Ambrose, with an IV in his head:

And Linus, under the bili lights:

What a difference two weeks can make! I've been visualizing this for what feels like forever, and finally, today it happened: we brought both our boys home.

(Linus actually came home on Friday, but Ambrose needed two more days of phototherapy for his jaundice. He finally got discharged this morning.)

What a happy day!

Here's a last shot of me at the NICU with both babies, after we'd gotten Ambrose unhooked from the monitors and dressed in his own clothes.

And Bryan:

And both boys on my lap, just before Ambrose demanded to nurse one last time before we took him home. Ambrose is on the left, Linus on the right:

Secured and ready to go!

After we got home! Linus is on the left and Ambrose is on the right:

So happy to be holding my boys in my own chair!

And after more than two weeks in separate isolettes/cribs, I think they're happy to be together again too:

Thank you all so much for your support during this time! We appreciate it more than you know, and I'm so happy that you can all celebrate this day with us.

Linus's and Ambrose's Birth: Part I

Just like with Blaise's birth story, I think this one will work best as a multi-parter. Parts of it are going to be slow, because that's how much of it happened: painfully slowly (yet also too early - there's irony for you). But if you can't handle tedious and over-detailed, you're reading the wrong blog!

I gave birth to Linus Michael and Ambrose John, incredibly sweet and beautiful baby boys, in the first hour of May 12th. I live-tweeted the experience (well, okay - PARTS of the experience) but it deserves to be written out. It's got the ups and downs of page-turner: tedium, tears, twists and turns, triumph.

But before I jump into the birth story itself, there's some back story to share. It's not high-drama, but you need it for the story to make sense. I'll try to be quick.

On Monday, May 2nd, I had a routine biophysical profile at the doctor's office, and baby B's score (thanks, in my opinion, to an inexperienced ultrasound tech) earned only 6 points of the required 8. Since it was 5pm and the office was closing, that earned us a trip to Labor & Delivery triage for some monitoring.

The babies, in what would become a theme for them, looked perfect on the monitors. They were healthy and reactive (meaning their heart rates would go up when they moved around). I, on the other hand, was having contractions at a rate that made the midwife in charge of the triage unit decide it was good idea to check my cervix.

A surprise, but not a happy one: my superstar cervix, which had held steady at 4.5cm for so many weeks, was now 1cm dilated and 50% effaced. The midwife assured us this could mean nothing. It had definitely shortened somewhat from its 4.5cm, but the dilation could have been in place for weeks - early dilation is extremely common in women who've had previous vaginal deliveries. It was, she said, nothing to worry about.

Also a (small) issue during that triage visit was my blood pressure, which was high because I have white-coat hypertension. It'd been normal at home earlier that day, but the nurse who got us set up in triage told me that white-coat or no, if the numbers were high they'd have to admit me overnight and run a bunch of labs. Hearing that of course guaranteed that my blood pressure was not going down anytime that automated cuff came anywhere near me. (True story: with the nurse we had after the 7pm shift change, I relaxed somewhat - until she tried to surreptitiously set off the cuff, at which point I FELT my bp rise perceptively. Crazy stuff.)

But the first nurse was wrong. Dr. Friendly Nerdy, the doc on call that evening from my practice, is very familiar with my white-coat syndrome. The midwife talked to him and sprang me from triage around 9pm. 20 minutes after I got home, my bp on my own monitor registered a happy 120/80 - high for me, but well within normal range.

So that was Monday the 2nd - 1cm, 50%, blood pressure normal.

Bryan and I had a serious talk on the way home from triage and I admitted that since hitting 32 weeks, I hadn't been taking it as easy as I should have. (Meaning that I'd picked up strenuous habits such as loading my plate in the dishwasher instead of leaving it on the counter. Gasp!) I promised to apply myself to resting as best I could from then on. Which I really did, for the next few days.

Pushing Through

In my mind, I tend to play what you could call the Reverse Pain Olympics.

When tiny Blaise was hospitalized with RSV, I struggled and struggled, partly because I was just a couple weeks postpartum and partly because, well, I had a sick baby in the hospital.

But then I would look around the pediatric floor at the other children with their tubes and wires and IV poles, at the other parents who'd been keeping bedside vigil for weeks or months, and I felt like I had no right to be sad. They had it so much worse than I did. It was silly for me to be so upset about something so relatively minor.

It was silly, and yet I couldn't stop crying.

A week into Blaise's eleven-day stay, when I'd been sobbing on and off for twelve hours, I told the nurses on the floor that I thought I needed some help. One of them walked me down to meet with a social worker. We got tons of great care during our stay at the children's hospital, but for me that social worker was the single most helpful person I saw during the visit.

I worked my way, puffy-faced and hoarse-voiced, through a box of tissues. She listened, then with firm kindness dismantled my game of Reverse Pain Olympics.

Not only was it okay for me to grieve, she said, it was necessary. If I didn't process my pain over having my baby's first weeks disrupted by illness, it would turn into trauma. Everyone else's relative amounts of pain had no effect on my situation: I felt the way I felt about it, and I had to give myself permission to work through those feelings.

Mentally, I turned the corner that night. We went home three days later. I continued processing, and very quickly Blaise's hospitalization came to feel like a minor event in my life.

I'd been right about the relative smallness of the pain, but the social worker was right too: I deserved to grieve what I lost, and letting myself do it was the healthy way to handle it.

For the second time in a row, we're not having the postpartum period I imagined. I've said this whole pregnancy that our main goal was to grow healthy babies and hopefully bring them home from the hospital right after birth. The first part of that, blessedly, happened. The second part did not.

As parents of premature babies, we have pretty much a best-case scenario. Our babies were born at 34 weeks, 3 days, which is barely premature. They were big for their gestational age. They'd had steroids and breathed on their own immediately, with APGARs of 8 and 9. We've had minimal struggles with digestion (Linus), temperature (Linus), and jaundice (both, but mostly Ambrose), all of which are now resolved. I'm making an overabundance of milk - the freezer at the NICU is already stocked - and the babies are progressing on feedings, which is all they need to do to come home. As a bonus, they both have great latches and the few times a day that they nurse, they do well.

Our NICU has two areas, the ICU side and the Special Care side. Linus and Ambrose spent less than 48 hours on the intensive side before being moved to Special Care. The ICU is dark and humming, full of very young or very sick babies, many of the isolettes covered 24 hours a day. In Special Care, we have windows. At just nine days old, our babies lie in the sunshine in open cribs. They are big and healthy and close to full-term.

By preemie-parent standards, I have nothing to complain about.

But when I walk in the hospital each day and ride the elevator up to the third floor to visit the NICU, I often see a family coming out of the mother-baby unit right across the hall. The mom is in a wheelchair holding her baby, the dad carries the carseat, an older sibling might clutch a bunch of balloons. They're going home together.

My throat feels chokey and my eyes burn, every time.

I wanted that to be me, bringing my sweet baby boys home, and instead I've spent the first nine nights since their birth away from them, with many nights to come. When I wake and pump in the night, I look at pictures of them on my iPad to help trigger letdown. What I want to do is sniff their necks and rub my cheek against their soft heads.

We're lucky enough to live very close to a hospital with a Level III NICU. It's a 12-minute trip from door to door. I go to see and nurse the babies two or three times a day, and when I walk into the hospital and head for the elevator, I think about how my reason for being there is a joyful one. That's probably not true for most of the people I pass on my way.

There are the Reverse Pain Olympics again. Be happy, they say! You're lucky! You have no right to feel sad!

Thank goodness for that social worker from last time, for her kindness and firmness. She is the voice in my head this time around, reminding me that grieving is a healthy thing, that the only way past my sadness is through it.

So sometimes when I leave the hospital I sob in the car and bang my fist on the steering wheel, angry and upset about what I've lost and what I'm still losing every day my little boys spend away from me. I'm crying right now as I write about it, crying about the fact that Linus and Ambrose are not still in utero where they belong, crying about my body's inability to make it all the way, crying because this is different from what we wanted it to be, and harder, and I deserve to be angry and upset about that.

The only way through it: to put my head down and cry.

We're doing everything we can to make this time bearable for our family, and I feel good about the choices we're making. I'm home most of the time, sleeping in my own bed and showering in my own bathroom. Bryan and I spend the afternoon feeding together with Ambrose and Linus at the hospital, and stay afterward for snuggling and parental down-time. We trade off the 9:00 feeding, so one of us is here to put Camilla and Blaise to bed every night, and we're keeping their day-to-day life as normal as possible.

I feel, most of the time, happy and optimistic. The worst part of our NICU stay is over. We are coping well. Our babies are healthy and growing and in beautiful shape. It will feel like no time before we bring them home and are thrown into the chaos of life with four children so that - as I joked to one of the nurses yesterday - there will probably be moments when I wonder what was so bad about having the babies in the hospital after all.

But I will be able to smell their necks and rub their heads whenever I want to.

It makes me cry just thinking about it.

 

*I said 34w2d before, but technically, since they were born right after midnight, it counted as 34w3d. 

Photos and Prayer Requests

I have lots to write about our tiny boys and how they are doing, but if you're keeping up on Twitter you can at least get daily updates... and I promise to write more soon. In the meantime, this afternoon Bryan and I both got to hold Linus and Ambrose together. It was incredible, and we got pictures!

Edited to add: Linus is the paler baby on our left; Ambrose is the pinker baby on our right.

Our babies are doing as well as can be expected for their gestational age, but they're still young and immature and we have a good bit of NICU time ahead of us. (We don't know how much, and please don't ask unless you want me to cry. But we are on our way!)

I am having plenty of emotional ups and downs as I spend the nights away from my sweet babies and they make their two-steps-forward, one-step-back way toward coming home. I am updating Twitter daily with statuses and prayer requests, but here's a list of requests if you are a pray-er.

- For Linus's digestive system. He's having sporadic trouble digesting his feedings, and although everything looks normal with his belly, it's a sign of immaturity that we would like to see work itself out as quickly as possible.

- For Linus to start nursing. He did pretty well his first few days, but for the past couple he's refused to latch. His latch is decent when I can get him to do it, but he acts sleepy or uninterested at feeding time. I'd love to get him nursing and caught up with his brother!

- For Ambrose's jaundice to resolve itself as quickly as possible. It's making him sleepy and less voracious during feedings. He's getting phototherapy and it should work itself out in a few days, but we'd like that time to be as short as possible.

- For us to get nurses who are both competent and a good fit personality-wise. We've mostly had good experiences, but there have been a couple who were... difficult. Having babies in the hospital is stressful enough without having to worry about conflict with the nurses.

- And finally, for strength and peace for our whole family during this time. That I won't get too overwhelmed emotionally, that Bryan may not be too stressed by all his responsibilities, that Camilla and Blaise will have as much stability as possible and not feel the stress too much.

Thank you! It helps so much that all you lovely people are thinking of us and praying for us.

Babies!

What an exciting 24 hours!

As I posted on my Twitter (which is the only place I'm updating regularly), our sons were born at 12:38am and 12:41am today, Thursday May 12. Three minutes apart! It was a vaginal delivery and everything went pretty smoothly, thanks mainly to my rock star of a doctor. I'll have lots to write about the birth later.

In the meantime, here are some pictures!

The first baby born was Linus Michael, formerly known as baby B, who surprised us when he took the lead during the labor and ended up coming out first. (Really, this birth story is pretty eventful.)

Here's Bryan with Linus soon after he was born. Linus weighed 5lb, 7oz.

Ambrose John was slightly bigger than his brother at 5lb, 12 oz. (In case you were wondering... yes, everyone is pretty impressed that 34w2d twins weigh this much.)

Today the babies are in the NICU, doing well. They're breathing on their own and in cribs, keeping their own temperatures up. I'm pumping tiny amounts of colostrum, which they're getting through feeding tubes, and they're also nursing. We've tried two feedings and both babies latched well and nursed for a little while - sleepily, but they did it!

Camilla got to come over this afternoon and see her new brothers. Here she is holding little Linus:

Bryan changed his first twin diaper this evening, one of Ambrose's. He also happily held him:

Here's one of both of us with both our babies (and proof that I'm trying to fight my tendencies toward vanity, ha!):

And a close-up of the babies:

I'm going home tomorrow morning - can't wait to be with my older kids again! - and since we live about four minutes from the hospital, I'm hopeful that the logistics of having two little guys in the NICU should be manageable. We have no idea at this point how long they'll be there; it completely depends on their performance. But I'll keep updating as I can!

The labor was quite an ordeal, but I have to say that updating Twitter through it and getting all the support from various friends in the computer was a wonderful experience. Thank you all so much for being there!

Update

I left the hospital Saturday, at 33w5d, on strict bed rest with the goal of keeping labor away for a couple more weeks at least.

Then my blood pressure (which, since I have white-coat hypertension, I take daily at home) started going up.

On Monday, yesterday, I had a routine doctor's appointment. The babies performed beautifully on their biophysical profile. Seriously, beautifully! They are wonderfully healthy babies.

The doctor's main concern was my pressure, which was still within acceptable range but definitely on the rise. The results of the various lab work I'd had done while I was at the hospital indicated a mild case of preeclampsia. I actually don't have most of the symptoms (my ankles, weirdly, look perfectly normal), but the blood pressure was worrisome.

We met with Dr. Friendly Nerdy yesterday afternoon, and he said the normal protocol under these circumstances would be to readmit me to watch my blood pressure. Amazingly, I managed to talk him out of it, pointing out that going to the hospital would authentically raise my bp until it became an issue, therefore causing exactly what we were trying to prevent. He saw my point, and agreed to let me keep monitoring at home as long as I agreed to get some lab work done first. (Ha! they can draw my blood all they want as long as I get to sleep in my own bed.) It felt great to have a doctor actually listen to me.

But... today my blood pressure was up just a leeetle bit more. The doctors had given me a number at which I should given them a call if I got it, and my pressure was right on the threshhold.

Dr. Happy Chatty is on call today and she and I had a chat on the phone. Her take is that the day or two we could gain for the babies by waiting it out is not worth the risk we might take waiting to see if my blood pressure increases further. She did offer to give me one more day to watch and see if it goes down, but I'm sure it's not going to do that. So... 

I got her permission to take a shower and go out to lunch, which we did. We took Camilla and Blaise and had one last hurrah before we're officially outnumbered by our born children. It was great. Then we stopped at the bookstore briefly, just to kill time. Then we came to triage.

The fun thing is that - exactly as I expected - my contractions started ramping up as soon as I got off the couch. Yesterday in the doctor's office I was still at 3cm, 50% effaced. No change from last Thursday, but that's a decent jumpstart on the process, and my idea is to have my induction be more of an augmentation if possible.

I'm currently sitting in triage listening to the babies' hearts beat on the monitor (seriously, they are textbook babies! Tolerating the contractions beautifully) and breathing lightly through my contractions which are coming every four to six minutes apart. I know this labor and delivery are going to be different from my previous ones, but I'm excited to meet whatever is coming.

I'll keep updating my Twitter account as I can, and you can follow along on Bryan's Twitter too.

There's no way to say this as strongly as I want to, but thank you all so much for the prayers and thoughts and good wishes that you're sending our way. I love to jump online and see how much support we have from so many places... and I can feel the grace of all the prayers lifting us up. I'm peaceful and happy and it is thanks in large part to all of you.

Holding Pattern

Hey! It's me, writing for myself (yesterday's post was dictated to Bryan) which is in itself a good sign - I'm allowed to sit up now. And move around, and go to the bathroom by myself.

Yesterday was... scary, a little. Not a LOT scary, since the babies' current gestational age means their prognosis is good no matter when they're born from here on out. But still a bit scary, since at 33 weeks, 3 days you really don't want an every-five-minutes contraction pattern, which is what I had for a good portion of the late morning and the afternoon.

I think the most intimidating part for us was finding out that I was already dilated to 3cm, when on Monday - just three days earlier - I'd been 1cm. That was extra freaky for Bryan, I think. You should have seen his face in triage when the midwife announced the number! But 3cm, especially for someone who has had two previous vaginal deliveries, is not so unusual apparently, and since we're not seeing any effacement progression (holding steady at 50%) no one is freaking out. Even Bryan has calmed down.

I had one dose of magnesium sulfate yesterday, and three doses of a smooth-muscle relaxer that I don't know the exact name of, and have gotten a fair amount of IV fluids. I was also on strict bed rest (catheter and all - fun!) for the first 18 hours after I was admitted. Some part of that combo did the trick, since my contractions slowed overnight to almost nothing. Today I've had fewer than I've had in a single day in weeks, and I'm off the drugs now, just getting a little fluid through the IV, and getting up to go to the bathroom, etc. Also chugging water like it's my job, but that's such a habit for me now that I can hardly stand NOT to have a container of cold H₂O nearby.

It's funny how quickly things can change. Yesterday I was just praying we'd make it 48 hours to give the babies their best shot at lung maturity; now that my contractions have slowed so dramatically, my doctor says there's a good chance I'll go home tomorrow as long as all the current signs hold steady. I'd be on bed rest, I imagine, and my wonderful and generous mother has come to stay with us now "for the duration" as she says, which means I'd actually be able to rest as much as prescribed instead of getting up regularly to pour cups of milk and mediate sibling disagreements. (To be clear: since I was never on true bed rest, I was allowed to do those things before. I'm guessing since my dilation and yesterday's near-labor experience, they'll now be verboten for at least a week or two.)

The babies are doing beautifully - they've been extremely reactive on the monitors, and showed zero distress during yesterday's contraction-fest. In fact, today they've been released from constant monitoring, and we're just having two NST-length sessions. They both got an A+ after this morning's session. Awesome!

They've given me two shots of steroids to help the babies' lungs mature, and ideally delivery won't happen until at least a day or two after the second shot (which I had at 3pm today). I'm feeling optimistic about that. I'm also feeling optimistic about the babies in general. I might have mentioned on Twitter, but I know I didn't blog about it, that at Monday's ultrasound the babies were estimated to be 6lbs EACH. At 33w0d! Now, I think the tech was being a little generous with her measurements, but I'd be surprised if the babies didn't weigh 5lbs each right now. That's just crazy!

(Also, the big question - raised by Dr. Cheerful-Chatty who seems more concerned with this than the other two - was whether I have gestational diabetes. I tested fine at 26 weeks, but it's been a while since then. But I got a glucometer on the Thursday before Easter and checked sugars for a week and they were all fine. Apparently I just grow big babies.)

(Which, actually, I do! Blaise was born at what I am in retrospect certain was 37 weeks exactly, and he was 7lbs 11oz and clearly ready to come out. Biggish, early-maturing babies seem to be the name of my game gestationally. Which is actually pretty awesome since I'm pregnant with twins and threatening preterm labor.)

At this point, it's definitely looking like we'll make it to tomorrow afternoon, and I'll hopefully get to go home then. The next milestone is Monday, on which I'll be 34 weeks. And every day until then, and after that, counts. 

Thank you so much for all your prayers and kind thoughts! It means so much to me to check in online and see how many people care about our family and these babies.

I'll update if things change, but in the meantime: no news is good news.

In which we go to the hospital again...

Hey everybody! I have been posting updates on my twitter feed (link in right sidebar), but thought I'd update here as well. I've currently been admitted to Labor and Delivery because my contractions were ramping up this morning. We're hoping delivery is not imminent, but there is no way to tell at this point. I seem to be holding steady at 3 cm, 50% effaced, with contractions that are regular, but not strengthening. Our current goal is to make it to Saturday afternoon, which will be 24 hours after tomorrow's 2nd steroid shot. After that, we'll go from there.

I am 33 weeks, 3 days today. 34 weeks would be a great milestone, but at this point the risks are pretty low and the prognosis for our babies is excellent. We would, of course, appreciate all the prayers and good thoughts you can spare. I'll update twitter regularly, and we'll try to update here as well.