remembrances

One year ago today, I was lying in bed pregnant as can be, and was woken by an unnerving sensation that I was leaking fluids. It was one in the morning, and I was 28 weeks pregnant with the twins. I went to the bathroom to confirm my suspicions, then called my midwife who I'd only met twice before. Her calm advice to wait until morning didn't sit well with me - I'd read way too much about twin pregnancy and my experience with perusing dual care with both a homebirth midwife and the department of maternal and fetal medicine at the hospital had brought with it enough sense of caution to heed a late-night warning. With much hesitation and feelings of guilt about waking a friend from precious sleep, I climbed the stairs and called out to Korin. We drove to the hospital, exchanging reassuring thoughts - it was nothing, they'd check me out and I'd be home in a few hours.

Sadly, that wasn't to be. My most terrible, vivid memory from that long night came about an hour after arriving at the hospital - I had just been examined and was still lying on the awful gyn-ey (get it? gurney for ladies? why must we endure dumb humor on top of an already uncomffortable situation??). The doctor was wondering if my water had broken, and was about to do a swab to confirm. And suddenly, horrifyingly, Baby A's bag of waters unmistakenly broke.

Amniotic fluid rushed from me, and with every breath, every sob, continued to flow. I remember lying there, crying uncontrolably, saying to Korin that I felt as if my babies' lives were pouring out of me. The resident who was with us when this happened told me that I would likely deliver the twins within 24 hours. It was truly one of the most grief-filled moments of my life. Twenty-eight weeks, zero days. I knew the risks of delivering that early.

***

Of course, we all know how this story ends. I hope you don't mind as I recall these things here for myself. I haven't given a lot of deliberate attention to the stressful birth of Shoghi and Maxwell, either within myself or here on the blog. I find, though, that now that these hot days of summer are passing by, I am keenly aware of what was going on a year ago. My gratitude for how things turned out is beyond measure. At the moment, though, it felt very precarious, fragile, and uncertain... Since I have never told their birth story, I figure this is a good place as any to start.

(photo by Amy Crawford)

well babies

I'm finding it very difficult to post as often as I'd like these days! I must have 3 or 4 posts that I've started, only to be distracted by one or another pressing matter.

We had our 9 month well baby visit this afternoon, and the kiddos are doing fantastically well.

Shoghi
height: 27.5"
weight: 19lb 8oz
he's climbed from being off the charts for low weight at birth, to now being in the 25th percentile for all 9-month babies.

Max
height: 26"
weight: 18lb
he's climbed from being off the charts for low weight at birth, to now being in the 12th percentile for all 9-month babies.

Excellent!
Max's eczema is a little more controlled now, except it's appearing on his chest and arms, which really makes me sad. It's the worst on his little hands. We are using the Weleda cream (thanks for the recommendation, none-such!) and hydrocortisone (not on his hands). Shoghi still has a persistent cough, so he was evaluated for asthma today, which they concluded he is not showing signs of at this point - hooray, that was wonderful news.

We also took a walk over to the NICU for the first time since their discharge. It was strange to walk those halls, and a little meditative, too. The last time I made the walk from the Children's Hospital to the Main Hospital where the NICU is, I was still pregnant, and was not in fact walking. Every other day, if I had a visitor while on my month of hospital bedrest, I would get my 30-minute break from lying flat, and they would push me through the halls, finding a terrace in this wing or that to get some fresh air.

Taking the boys there today was like a little graduation. I'd actually been meaning to go there for a few months, but the last time we were at the campus for a doctor's visit, the boys were too fussy. Anyway, it was good to go, to stand out in the hall (we weren't allowed into the unit) and chat with some of the nurses who cared for them for the four long weeks they were in the hospital. One of the nurses remembered that Shoghi had been readmitted for reflux that was causing him to stop breathing, and it touched me that she really remembered them after so long. They made all the appropriate oohs and aahs about thier robust, perfect, big bodies and said how cute they were. It was very sweet.

At the same time, the whirring and beeping of all the monitors, the sterility of the NICU pods... it was all right on the other side of those locked, swinging doors. The grieving parents, the ailing, growing, crying, sleeping, kangaroo care-loving babies.... it was all right there. That was hard. Remembering so viscerally that time of longing, fear, disappointment. I have been thinking a lot about that time lately, realizing that 9 months later, I still haven't written about their birth. Our nursing woes began in those rooms; their first hours were spent without me in those bright, open beds; our sense of triumph and amazement to wrap their incredibly small (but 5 pounds!) bodies in our moby wraps and carry them out, first through those locked doors, then down the elevator, through the lobby, and miraculously, outside, into the open air and sunlight....... that whole time was charged with more emotion than I can even bear to open myself to.

And now here we are. We spend our days exploring, crawling, chatting, reading, singing... doing all the simple things babies this age are meant to. Maxwell and Shoghi, thriving. It gives me pause. What an incredible, enormous, humbling gift to be their mama.

apnea countdown, continued

All day long, I agonized over my last post... I don't like to complain too much about my experience, and yet again, I'd like to paint a realistic picture of what this has been like for me, for us. I'd like to think that someday, I will be able to take what I've learned here and help someone else get through their own NICU circumstances. If that's a little too ambitious, then maybe more simply, I'd just like to be able to record my experience, for myself, for my boys, for my family and friends. That experience, like many others life brings, is shaped with so many facets of emotion and thought.

These days, I don't have much time to process, or to think out how to say things. I'm weary by the time I get home from the hospital at night, and if I use the computer at all, it's to quickly check email, then to edit photos, and lastly, to put up a blog post. Then of course I also have to pump for the boys, as soon as possible after I get home, then again before bed, and if I'm lucky enough to drag myself out of bed at 3 or 4 in the morning and again at 6. It's hard to get up and sit alone in a room with a breast pump in the wee hours of the morning... I'm assuring myself that while it will still be hard when the boys are home, their cries and hunger will leave me no choice, and so it will be in some way easier. At the very least, I will be interacting with my children, and not a bunch of plastic parts. You know what I mean.

As the boys have become more alert, I've been looking for some simple
black and white "toys" for them to look at. This morning, Laurie brought
over this beautiful mobile she made just for the boys.

max, enthralled.

Anyway, this leads me to my dilemma about my post from last night... and my perhaps dramatic way of requesting that people not remind me to see the silver lining. I don't necessarily have a clear thought about how I should have written it differently, but the alternative would have been for me to write nothing at all, and I'd rather be able to just put out an emotional plea that comes from a slightly irrational state.

Last night I didn't tell the whole story. The whole story would have included the part where I got to the hospital and was told that they both had had apnea spells, but there was no documentation of the spells except in the computer... and the artifacting from the heart and respiratory leads can look like a spell where none had actually occurred. In other words, the night nurse had made no notes of intervention, which is very, very unlikely in the case of an actual apnea event that would have lasted over 30 seconds. I never was able to get an answer as to what had happened or if the spells had been authentic, leading to some rather profound frustration at the idea that they might be spending extra time in the hospital when they could safely be home with me.

Today, Max & Shoghi had their carseat tolerance tests -
which sits them in their seats for 90 minutes to see if they
have any apnea spells at this angle.
Both boys passed, but Shoghi will go home in a car bed,
since he is too small for the carseat.

Today's request, then, is rather different... it's a request to simply be with me, with us, through this next phase of the countdown, without congratulations or too much excitement. Today, the doctor told me that, barring any issues, Shoghi and Maxwell will be coming home on Saturday. Now every hour is fraught with excitement and fear, all at once. Will I be buckling seatbelts on my little guys on Saturday, or sitting at their bedside again with a heavy heart? I tried to put my faith in them having grown out of their apnea, and went tonight for a last-minute run to get supplies... baby bottles, waterproof pads, sleepers, and more diapers. Me... shopping for these things for my babies, my boys, my sons. It makes my chest tighten with emotion just to say the words "my sons."

This part of the journey is one I haven't yet shared with many outside my immediate circle... this feeling of disbelief, this sense that, without having them with me physically, they are not actually my children. It is something that I can almost not touch with words, a feeling that is vague and sad and something like instinctual, and perhaps explains some of the pain of this separation we've had for the past month. Suffice to say, I have been holding my breath for 4 weeks now, waiting for the moment when I can take my babies into a room and close the door behind us, to lie with them and really look at them, to hold them and share the knowing that we are indeed a family.

Hopefully that sacred day is less than 36 hours away. Sit with me awhile, then, if you don't mind... wait and hope with me that when I write next, it will be with my beautiful sons, home at last.

3-Week Vitals

Happy 3-Week birthday to my sweet, sweet boys!

Thanks to Grandma Dort for these cute sleepers!

Max, snuggling with mama for some kangaroo care
current weight: 5lbs, 10oz (birth weight: 3lbs, 15oz)

Shoghi seems to be trending towards taking all of his food by mouth!
Here he is without his gavage (feeding tube)
Current weight: 4lbs, 9oz (birth weight: 3lbs, 7oz)

week one in photos

"O Thou by whose Name the sea of joy moveth and the fragrance of happiness is wafted. I ask Thee to show me from the wonders of Thy favor, that which shall brighten my eyes and shall gladden my heart. Verily, Thou art the Giver, the Generous."

Baha'u'llah

Happy One Week Birthday to my two sweet boys. You have melted my heart within me.

Some photos from Week One

my little joey

((First, let me just thank all of you for your loving comments and wishes. I've loved reading them over the past days, and feel surrounded by the most amazing and powerful support. I have very little computer time, especially now that I'm not in the hospital, so I hope you'll bear with me when it takes a while to respond to your emails and calls... I have received all of them with love.))

Shoghi's gorgeous hand

Today I spent about 7 hours at the NICU with Shoghi and Maxwell, and for most of that time, we practiced Kangaroo Care. All this means is that I open my shirt, unswaddle or undress the baby (I do this one baby at a time) and we snuggle skin-to-skin. Some of that time may be spent practicing nursing, but mostly, the boys just sleep. Here are some photos of Shoghi, who looks beyond content, don't you think? I was trying to get his whole body, with his teeny legs curled up underneath him, but didn't quite capture it.




And because I can't leave him out, here's Max, snuggled up in his isolette this afternoon.


My goal for tomorrow is to give the low-down on all of the amazing progress my beautiful sons are making. Assuming they keep going as they have been, they'll be home before we know it. (well, maybe not before I know it, because every day of separation from them is torture, but you know what I mean!)

See you tomorrow!

heavenly day

Yesterday gave us cause for celebration: Maxwell and Shoghi graduated from their previous beds into isolettes, their IVs were removed, and all of this made it possible for us to get them close enough together for a reunion. It was a 3-step process...

Mon was holding Shoghi and I was feeding Maxwell, so we brought the chairs closer...

Shoghi sensed something was going on and started crying... meanwhile Max stopped sucking and opened his eyes wide to find his brother. He was looking to his right and trying to turn his head until they were finally beside each other...

Peace at last - brothers side-by-side; both of my sons in my arms.
I don't even have words for this kind of elation.

As soon as they progress from their isolettes, they'll be co-bedded in an open crib. I can hardly wait.

a week for my papa

My mom is arriving today and will be here until Friday, so I figure some sort of daily posting is in order. Dad couldn't come along this time, so this will serve to keep him included.

Actually, I'm just hanging around for now, waiting to be called down for my NST (non stress test) and waiting for the call that her plane has arrived, even though I probably won't see her until about 4pm (it's 12:30 now). So far, it's been a pretty uneventful day.

I'm 31w3d today. I have not shared before that reaching that third day after turning over a new week is a big deal for me - it always makes me feel like the next week marker is most definitely attainable (unless there's an emergency). So today, 32 weeks is feeling close... something I can hardly believe.

Last night I got the idea that I should take a couple of pictures with a tape measure, so that's how we'll start.

Measuring around: 47"! Who ever thought I'd be proud of such a number,
nevermind post a photo of it! Ha!! That's my view of my belly, of course.

The red string is something some of my friends and I did at the beginning of this
pregnancy, to bind the babies to me until their healthy birth.

Fundus measurement: 47cm??? Ok, this is totally inaccurate because I'm standing up,
but this is a measurement from the bottom of my uterus to the top. In a singleton
pregnancy, after 20w, this generally measures 1cm for each week of pregnancy.
47cm at 31w? Probably not. ;o) I should be measuring somewhere around 36cm.

30 minutes

Every other day, I get to have someone take me out of my room in a wheelchair for a half an hour. Precious, precious time to fill my lungs and achy sinuses with fresh air. Here are some photos from Sunday, when Laurie, Korin, and daughter R were all here. Don't tell anyone I was standing!

The Thirty-First Week

Thirty weeks, two days today, and miraculously, there are not a lot of changes to report. It's been a pretty good, if busy, few days. My nurses have really been a lot of fun, and I'm feeling more secure than in my last post.

poppies from Laurie

a little pretty goes a long way

the 30-week growth scan

On Thursday, we had our latest ultrasound. It had been 3 weeks since the last one, and I was anxious to see the boys and how they were faring. Sadly, there won't be any pics to share... it's just too crowded in there. I didn't even get a clear glimpse at their profiles.

Zeus (whose membranes are ruptured) has gone from 2 pounds to 2 pounds, 12 ounces. He's just a little peanut, in the 24th percentile. I'm hoping for a little bump for him between now and the birth, since I've started taking some supplements that have been shown to enhance the function of the placenta.

Oden went from 2 pounds, 6 ounces all the way up to 3 pounds 5. A pound in 3 weeks! He's in the 50-something percentile for his size and age.

The doctors also looked at fluid levels. We clearly anticipated low fluid for Baby A, since the sack hasn't (yet) repaired itself, but there was almost nothing to measure. It shook me a little, thinking of my sweet boy tucked away in the womb, surrounded by his collapsed sack.

fancy soap, books and other distractions help!

how can Zeus continue to gestate without fluid??

There have been some questions about this, so let me address the situation to the best of my ability without turning to Dr. Google. When the bag of waters ruptures preterm (before 34 weeks), and there is no sign of infection or labor, the pregnancy is allowed to continue. If the baby/ies are past 24 weeks, their lung development is finished, although the lungs are not yet mature, and apparently the presence of amniotic fluid is most important when the lungs are still developing.

The baby/ies receive all of their nutrition, blood, and oxygen through the umbilical cord, so this is why they are monitored on a daily basis by both non-stress tests and doppler; if the umbilical cord is compressed, they will detect a deceleration of the heartbeat. If this were to happen (a prolonged decel) while I was being monitored, they would just keep us on the monitors longer to determine if the baby was in distress. Fetal distress would be one of the reasons for an immediate delivery.

So, the amniotic fluid at this gestational age is not critical to the baby's development. Because it is replenished every time the baby pees (did you know that amniotic fluid is mostly baby pee at this age??), Zeus does have increases in his fluid levels, allowing him to flex and stretch his limbs and build his muscle.

I was also told this week that babies who have been "stressed" like Zeus and even Oden have before they are born early are for the most part stronger and more resilient than preterm babies born my surprise.

things necessary for a long stay in the hospital:

good lip balm, hydration for the body and the sinuses

things to anticipate

Yesterday I had my maternity portraits done here in my hospital room. I'm really excited to see the resulting photos. That should happen sometime this week.

Tonight, my sis is coming to spend the night, which is always welcome. She went to the Portland Farmer's Market today to get the lambskin I've been wanting for the babies, so I can't wait to see that, and as an extra bonus, she'll be able to take me on a 30-minute wheelchair ride. As long as it's not too hot, we'll go out to one of the terraces that overlooks the whole city and faces Mounts Hood and St. Helen's.

Our friend Miriam just sent out a box, containing in part a belly cast kit, which we'll probably do either this week or next. I'd like to wait for for the first week in August, but if there's any indication that I could deliver next week, we'll try to get it done. She suggested that a photo be taken of the boys in the belly of the cast after they're born, and then again at a year. Sounds really cool to me, thanks Mir!

My mom is coming out a week from tomorrow for several days, so that's a major excitement. She's never been to Oregon, so although she'll be here at the hospital for much of her visit, I hope she gets to see something of this amazing and beautiful place. The same week, my friend Julie is going to be coming through, so it's going to be a ton of fun.

As for me, I have a work deadline this week, plus I'm striving to finish writing a bunch of thank you cards and get some knitting started and completed! Oh, yeah, and the small thing of keeping myself pregnant, which no doubt will involve spending most of my time lying on one side or another in bed. But we're not really thinking about that part.

In terms of hospital life, I don't think we have any special testing this week. Just keeping on keeping on is the plan.

baby-related task for tomorrow:
choose baby announcement design from Oblation and figure out wording.

holding strong

I've been thinking every day that I should post some kind of an update, and you'll all probably be happy just to know that we're all doing fine, but aside from telling you that, I have wondered how to fill the space here.

Every day in the hospital takes on a life of its own. Some days, like today, my sister or friend are with me, and it's a great distraction, even if we're doing nothing more than watching a movie. Other days, the visits are shorter, or my mood is more fragile, or it's so chaotic that I just about go out of my mind. Being in the hospital without a major injury comes with its own special kind of mental stress that I really had never considered before. This is neither a restful nor a healthy environment.

So, the good news is that we're all well. 50% of women with PROM (premature rupture of membranes) go into labor in less than a week from the time of rupture, and I have now clearly fallen on the more favorable side of those odds. Today is my 11th day in the hospital, and there is no sign of infection or fetal distress. On Thursday, I will be 30 weeks, and with each day and week that passes, the baby boys have a better and better prognosis.

The stress of being here is starting to take a toll. When I'm alone, I'm keenly aware of both my body and its many sensations and the clock on the wall. I have been feeling like I'm standing on the edge of a cliff, like any of the variations in how I feel might herald the end of the pregnancy and/or danger for my babies. It doesn't help that spending 11 days "resting," plus the growth of the babies and my belly results in aches and pains heretofore not experienced. Is this back ache a sign of labor? Does the fact that they're moving less today mean they're in distress? Why do I have a headache? It's my responsibility to monitor how I feel, but all this time alone in this small room is like being trapped in a symptoms magnifier. It's mental torture. I won't even begin to tell you about the food situation. It's far too depressing.

Tomorrow I have another growth scan to measure the babies, estimate their weights, and check the fluid levels. I should have something to report then... hopefully a nice profile shot of each.

So, yeah. One month from today, August 21st, is my goal for the pregnancy. That's 29 days from today. Count it down with me, friends... one day at a time.

the past week

from Sunday, 28w3d

refreshing shower? yes! stiff upper lip? not so much.

flowers from mom and dad

this is the printout from a non-stress test. the two lines on the top are the traces of the babies' hearts, and the line at the bottom shows any contractions of the uterus (none!)

3 belts: a fetal heart monitor for each baby, and the contraction monitor for me.

compression "boots" to avoid blood clots in the legs

hydration & communication, and rescue remedy

supportive friends.
Korin, me, my awesome nurse/friend R, and my amazing sister behind the camera.

change in plans

28 weeks and 5 days today, and let me tell you, the days themselves have never seemed so important to me. I'm going to make this post a quick one, since I've been trying to put one up for days and keep getting interrupted.

I woke up from my slumber last Thurdsay night/ Friday (28w) morning to discover that I was leaking fluids. Made my way to the hospital with Korin, and upon arriving, experienced the horrifying sensation of my bag of waters breaking, at just 28 weeks.

By the grace of God, I'm still in the hospital, carrying my two boys in the safety of the womb. Every day is a gift to them, and I am hoping to be here in the hospital until the ripe gestational age of 34 weeks (or longer). They're looking good on the daily non-stress tests, visibly practicing fetal breathing, putting on weight, and moving like crazy. Throughout this whole time, the goal will be to stave off infection so that they can stay where they are.

I'm feeling optimistic overall, and while staying in the hospital is a drag, I can honestly say that I am willing to endure any discomfort in order to get the boys to a safer age to be born. I'll try to post as often as I can, to share the positive updates and document what this process is like here in the hospital with ruptured membranes.

So, with that, I'm going to rest. See you tomorrow!