It was an exhausting, emotional day. We had just welcomed our two tiny babies from heaven to our family and here we were, unable to hold them, and just watching their fragile little bodies working so hard just to breath. Ella was kept intubated most of the day and around 3 p.m. the RT thought we could try to take her off the vent. Emmie remained stable most of today. We hadn't slept much since the night before they were born, so we were completely exhausted. We headed home from the NICU that night, so full of emotion. When we got home, I still had to call and make sure they were doing o.k. before I could go to sleep. The nurse said they hadn't changed since we left the hospital and we knew we'd be back again bright and early the next morning. Just after 11 p.m. that night, the phone rang. It was one of those calls where you just know something is wrong. Dr. Gerday called to let me know that they had to put a chest tube in Emmie because she had developed a pneumothorax (a pocket of air inside her chest but outside of her lungs) and that was they only way to release the pocket of air. Both of my girls also had to be re-intubated that night and put back on ventilators. I cried myself back to sleep that night.
August 7, 2009
The chest tube that Emmie required the night before had taken care of the pneumothorax and they were able to remove it today. She will forever have a tiny scar on the side of her chest telling this part of her story. Our wonderful home teacher, Sam P., came to the hospital today to help Ezra give the girls a blessing. We cannot express how grateful we are for Sam & Holly P. They know better than anyone what this experience is like having had a 1 lb 12 oz premie themselves. Sam also brought us lunch today which was heaven since I seem to forget that I need to eat these days. The girls remained stable throughout the day, but still required a lot of respiratory assistance. Believe it or not, the girls still haven't had their first bath yet. Most moms get see that the day their babies are born...not us. So tonight, we attempted to give Emmie her first "half bath." I call it a half bath, because we pretty much were only able to wash her head/face with cotton balls before she worked herself up and ended up on C-PAP that night because of the respiratory distress it caused her. But here she is, half cleaned up today. The big wrap/gauze on her side is where the chest tube was inserted. Two days old, and I still have been able to see Ella's face or hold her. My heart literally breaks everytime I leave the NICU without holding that sweet little angel.
August 8, 2009
Today was a good day. I was finally able to see my sweet little Ella...like this:
She was still on a ventilator which prohibited us from being able to hold her. Emmie and Ella both also required phototherapy for jaundice, so they were sporting some face masks that kept them concealed too. This also meant that they couldn't be out from under the lights for more than 20 minutes/day. So during the course of the 8-10 hours we would spend in the NICU, there was only a 20 minutes window of opportunity that we could hold them. Today, we finally got that chance with both girls. Later in the day, the RT again felt we could try to take Ella off the vent. With that out, we were allowed to hold her for the first time today for 20 mnutes. I was in heaven.
August 9, 2009
Ezra was able to hold Emmie not long after we got to the hospital today. She is just on a high-flow nasal cannula today. They are hopeful to be able to attempt to bottle feed her in the next day or two. She is on a good regular schedule for changings and feedings. Ella is doing so much better today too. She has had a central line inther umbilical cord and that was taken out today. That takes us one step closer to the girls being able to co-crib while they are in the NICU. I was able to hold Ella throughher 5 p.m. feeding today (both are being tube feed). She is also on a high-flow nasal cannula but with minimal support. The doctors are still planning to keep them for at least 7-10 days. Both will need a 7-day antbiotic regimen. After they were born, the girls' placentas were sent for a study and they both came back with evidence of a bacterial growth which was making them sick while I carried them at the very end of the pregnancy. Dr. Townsend also came into see how they were doing today which was so nice of her. All of the nurses were surpised to see a perinatologist in the NICU, because they said they hardly ever come in to see how the babies were doing. She explained to us the results of the placental study and also said that she believes the bacteria that infected the placenta was the same that caused my sinus infection the week before we delivered the girls. How crazy to think that a sinus infection would cause my babies to get so sick and need to be delivered 3 weeks early!
August 10. 2009
My mom came to the NICU today with me. Emmie and Ella were sleeping when we got there. Our nurse, Chris, said that Emmie was a little diva this morning. She was wide awake at 7 a.m. and wanted to be held and see what was going on. Both girls were able to be taken off of phototherapy today which was so great because this meant we could actually see their sweet faces with out the billibands. We also tried to bottle feed Ella today for the first time. She did so good and took 3/4 of her feeding through a bottle. Emmie's respiratory rate was still too high to be able to try to bottle feed today. Because they were off the billilights, we were able to hold both girls for almost an hour each. It feels so good to hold them in my arms. Something I completely took for granted with my first two kids. I was also sent home from the hospital by the girls' nurse today because my legs, ankles and feet looked like the stay puff marshmallow man. I was so swollen!!! I could care less about how swollen I was, I just wanted to be with my girls.
August 11-19, 2009
Ezra and I came in today and our sweet little darlings were in a big girl crib together.
So cute! Our sweet nurse, Debbie, took pictures of the girls for us since they were both dressed and sharing a crib. Emmie and Ella's RR were too up and down to try bottle feeding again today. So frustrating because we know we cannot take them home until they are taking every feeding by bottle, but they are struggling to be weaned off of their cannulas. Patience is a hard lesson sometimes! This is how the days passed for the next week. It was slow, daily progress to wean them down on the oxygen they were getting and slowly try to bottle feed as they could handle it. We were finally able to get them on room air on the 14th. Emmie was eating like a champ! She would take every feeding, and take a full feeding, by bottle. Ella, however, was not quite so eager to bottle feed. This would keep us in Nursery B for several more days while she tried to catch up to her little sister.
August 20, 2009
After 15 days of seeing this, we were ready to bring our babies home! Today was the day and we were to excited to fill their little car seats. Well, as much as these tiny babies could fill them...
We are so grateful for all of the nurses and doctors at the NICU who cared for our little girls. And while it seemed like an eternal 15 days, we are so thankful they were coming home, where they belonged. To finally have babies sleeping in the crib that had been waiting for them to fill it with their cries and baby smells.
August was a crazy month at our house! We were, of course, expecting the arrival of our twin girls this month, we just didn't know it would be so early! The following are part of what I journaled during our "experience." It's a long post...bear with me!
Tuesday, August 4, 2009
With my pregnancy being that of multiples, I was having two weekly non-stress tests done since I was 32 weeks along. Most of my NSTs were normal with the girls being a little non-cooperative through some of them, but nothing that raised any concern. That was until August 4th. That day I had a routine NST and an ultrasound with Dr. Dizon-Townsend at MFM at AF Hospital. Both the girls looked great on the ultrasound. They were measuring small, in the 15% percentile, for gestational age, but the perinatologist assured me that was totally normal for a twin pregnancy. I was then moved to the NST room and hooked up to the monitors and that's where I stayed for 2+ hours. Baby A (aka Emmie) was causing the doc some concern. Her little heart raced in the 180s for the first 20 minutes of the NST. When her baseline HR finally dropped to a healthier level, we couldn't get her to make any accelerations. After 2 hours hooked to the monitors and a BPP on Baby A (which she passed), Dr. Townsend decided to let me go, but scheduled me for an amniocentesis the following Tuesday to determine if the girls' lungs were developed enough to induce me earlier than we had originally planned. So I started preparing myself to be a mother of 4 the following week. That still sounds weird by the way...mother of 4! Now I had a definite delivery date and all kinds of thoughts and emotions were racing through my mind. Little did I know what the next 24 hours would bring.
Wednesday, August 5, 2009
I woke up this morning with thoughts of all the last minute things I wanted to accomplish for the girls. I work better under pressure, so nothing like procrastinating things a little! At 9:15 a.m. the phone rang. A call from UVRMC...hmmm. It was my perinatologist calling to say that she had worried about me and my babies ever since I left her office the day before. She asked that I drive down to UVRMC for a repeat NST just to make sure everything was o.k. I was a little panicked, but thought she was just being thorough and that there was nothing to worry about. So I woke Ezra up and told him what was going on. We got ready and dropped the boys of with a friend thinking we'd be back with in 1-2 hours. We were hooked back up to the monitors and little Baby A repeated her pattern from the previous day. They continued to watch the girls' hearts for over an hour and then Dr. Townsend came in to tell us that she was not comfortable with what little girl A's heart was doing and that she had already called the hospital and told them I would be coming in that afternoon to deliver. WHOA...seriously? We were not totally prepared for that news. And now I was scared that something was wrong with my babies. The doctor said the HR pattern Baby A was giving us was indicative of an infection and that she was most likely sick and she needed to be delivered. I knew they would be tiny babies but now, they may be sick too. I was so excited to finally meet these sweet little angels, but also scared at what may lay ahead of them. Being so unexpected, we had to take care of a couple of things before we headed to the hospital. We packed bags for the boys and dropped them off with their grandma for a sleepover and also had to run to SLC to drop off Ezra's company van. Once we ran our errands, we checked into the hospital around 2:30 p.m. Oh, yeah, and we were informed that my doctor, who I knew was on vacation that week, had fractured his pelvis and was out of commission. So the doctor on call that would deliver me was new to the clinic and I had never met him. Wonderful! And when he called the hospital to let them know I was on my way, he told them I would be having a c-section...um, no thank you! Apparently this doctor wasn't as experienced with twin deliveries and we knew that Baby B was transverse, so he decided that a c-section was necessary. So, when we arrived at the hospital to deliver, they were prepared for a c-section until I told them otherwise. My doctor had assured me through the entire pregnancy that as long as the lower baby was head down, and she was, that we would not need to do a planned c-section. Long explanation, but part of the story :) So, here I am in all my prego glory, about 7 hours before my babies were born:
We were also told by our nurse that with twins, they are required to have two doctors in the delivery room, and that we would deliver in the O.R. in case they needed to do an emergency c-section to get the second baby out. That meant that Dr. Parker would be there as well as the less experienced Dr. Taylor. I breathed a huge sigh of relief because Dr. Parker had delivered over 6000 babies and he has seen and done it all! The nurses reassured me that if Dr. Parker delivered me, he could do it without a c-section. So, we were hooked up to the pitocin to induce labor and then we waited. After a couple of hours, the contracts were painful enough I asked for my epidural which became a nightmare in and of itself. I don't know if it was the weight of two babies or what caused the problem, but my epidural didn't take. Dr. Taylor came in and broke my water at 6 p.m. and was feeling every single contraction! The anesthesiologist came back in to check my epidural and he was so puzzled as to why it was only working on my feet! He gave me and extra heavy dose of medicine to see it it would take effect, and it did nothing. He decided he needed to pull it out and move it up one spinal block. When they sat me up to prepare to reposition it, my blood pressure fell through the floor and I nearly passed out and felt like I was going to puke! They decided they needed to lay me back down and get the weight of the babies off my spine and within minutes, my epidural kicked in. The doc said it was one of the strangest epidurals he's ever done. I was finally feeling better with the epidural working now, but was positioned funky and was hurting a bit so the nurse tried to help me move, and my blood pressure crashed again. Same feelings...I wanted to throw up so bad, and I felt like I could just pass out and wake up next year! We're still not sure why my blood pressure was so out of control, but I finally stabilized and at 9 p.m., the nurse checked me and said, "Oh, wow, you're ready to deliver. I'll go call the doctor!" Par for the course this day, she called Dr. Taylor to let him know I was ready to deliver and they would be moving me to the OR only to find out he had been called to another hospital to deliver someone else. Seriously people!! So, lucky me, Dr. Parker was there within minutes and we were wheeled in to the OR.
We were all setup in the OR and the room was full of nurses and respiratory therapists...I've never had so many people attend a delivery before! With one little push, and I mean little, Emmie was born at 9:15 weighing 4 lbs 9 oz and was 17 inches long. She was so tiny! Ezra was able to hold her for a minute as we delivered Baby B. Ella was transverse and high in my abdomen, so Dr. Parker had to deliver her breech. He tried three times to pull her out, but she kept kicking one leg out to the side and doing the splits. Ella was born at 9:22 p.m. weighing 4 lbs 13 oz and was 18.5 inches long. she was struggling so she was whisked away to be cared for by the nurses and RTs. I wasn't able to hold either of my little babies that night. That was SO hard as a new mom! The girls were taken to the nursery and around 12:30 a.m. I was transferred to mother/baby. At 1:30 a.m. I was able to go see them in the nursery. It was so good and yet so hard to see them in the nursery. They were my babies but they were struggling so hard to breath. The pediatrician told us they may need to be transferred to another hospital with a level 3 newborn ICU. My heart broke! How could I be stuck in the hospital while my brand new babies were being sent to another hospital? I cried for the rest of the night in my room. So many emotions were flowing at that point. At 4 a.m., the pediatrician came to my room and told me they decided the girls were too sick and needed to be sent to the NICU. The transport team was on their way and they would bring the girls in to see me before they left with them. They wheeled my tiny little babies into my room in an incubator on a bed with so many machines it was bigger than my hospital bed. I knew they would be getting the care they needed, but it was so hard to see them leave me. I couldn't sleep after they left. At around 5:30 a.m. a neonatolgist, Dr. Gerday, called from the NICU to let me know that they had made the transition safely and that both girls required a ventilator to breath for them. I don't think at that moment, I really understood how sick they were. I'd always taken my babies home from the hospital with me within 24 hours of their birth. Something I'd taken for granted too.
Thursday, August 6, 2009
This was a whole new experience for our little family. I felt so good that night and was able to get up on my own by 6 a.m. that morning and I now that Heavenly Father was blessing me that night. At 7 a.m., Dr. Parker came in to check on me and he knew I wanted to be with my babies. So he signed my discharge paperwork and at 9:30 a.m. I walked out of the hospital to head to the NICU at UVRMC. I was not prepared to see my fragile little newborns in the condition they were in. Ella was on a ventilator and because of her breech birth, she had extensive bruising on both legs from her knees down. She was completely purple and black. Both girls also required photo-therapy lights because of jaundice so we couldn't even see their faces. Emmie had done well enough in the first few hours in the NICU, they were able to take her ventilator out and we were able to hold her for just a few short minutes that day. I wasn't able to hold my precious Ella until she was 4 days old. But despite the fact I couldn't hold them, I needed them to know I was there, so we sat by their bedside all day that day.