Sunday, December 30, 2007

Another step in the right direction

Woo-hoo - Makayla's off the CPAP, for the time being. Don't be surprised if she's back on it tomorrow...but for today...yay! She is on nasal canula oxygen, and she maintains her oxygen level quite well, but she tends to work hard to breathe, so she may need to go back on the CPAP. Her CRP (measures for infection) decreased today, which means the antibiotics are working - another yay!! Her bilirubin has continued to increase (causing jaundice), so she started phototherapy today - she's working on a suntan under the lights. :) She's still not being fed - maybe tomorrow if she continues to improve. Her chest x-ray was fine. Her echocardiogram shows two holes in her heart - but both are very common in preemies. For now, they will just keep an eye on them; if they don't close on their own, surgery may be in her future. Apparently they still don't know what's causing the irregular rhythms, but they are giving her some IV calcium and sodium bicarbonate to try to get her electrolytes better balanced to see if that helps.

Mackenzie has graduated from an open bed to a "condo," aka isolette. Even though it sort of looks worse in the pics, it's actually a good sign - it means she's not as critical and they don't need such immediate access to her. She only lost 6 grams yesterday, which means we can hopefully expect her to start gaining now (all babies lose a certain amount after birth, but so far her loss has been very minimal). She is having some "residuals," which means there is still undigested milk in her tummy 3 hours after her feeding, that they have to suck out with a tube. This afternoon they had us give her Pedialyte for her bottle feeding instead of breastmilk, b/c she had too much residual left from her previous feeding. I think this is just caused by an immature digestive system. Her labs look great - no signs of jaundice or infection at all. Darrell got to hold her for a long time this afternoon after I did her bottle feeding. She was very sleepy and looked so content in his arms.

This morning I had to take my dad to the emergency room, as he was having chest pain and was in atrial fibrillation (for the 3rd time in the last couple months). Fortunately, all it took was some IV medication to correct the heart rhythm, and he was released a couple hours later. He is scheduled to fly home next Saturday, 1/5/08, so we pray his heart doesn't act up anymore and that he can have an uneventful trip home.

I am continuing to struggle with pain and extreme fatigue. Just walking from the parking lot into the hospital today was almost more than I could manage. I'm hoping that a few more nights of good sleep will help; if not, I'm going to call the doc later in the week to have them recheck my hemoglobin level. I was very low going into delivery, and even lower afterwards. My doc talked about doing a blood transfusion, but was hesitant for fear I'd have a reaction, so ended up just putting me on iron 3x/day. But it may just not be adequate - we'll see what happens.

Saturday, December 29, 2007

Pictures

Makayla right after birth...

Makayla on 12/28/07...
Mackenzie on 12/28/07...

Daddy holding Mackenzie on 12/28/07...

Daddy and mommy, with mommy holding Makayla (you can really just see her hat, which is ivory and pink, and her tubes...we were doing our first skin-to-skin time (also known as kangaroo care).


These are the days in the NICU

Okay, here's a baby update...things change so quickly in the NICU though, so don't be surprised if things are totally different by the time you read this!!

Mackenzie, the tiny one, is such a little fighter and is doing great - apparently having to fight for everything in the womb is serving her well now. She's still on room air, breathing on her own. She's getting breastmilk by tube feed every 3 hours, but gets one feed per 12 hour shift with a special bottle made for cleft babies and is doing quite well with it. She will try breastfeeding on Monday. She hates the feeding tube and pulls it out often. She is not jaundiced, her heart and kidney tests all came back normal, and she is very alert. She looks right at me, and will almost instantly calm down when she hears my voice or I put my hand on her. She loves to be held - which works out well, since her daddy and I love to hold her!!

Makayla, on the other hand, is headed in the wrong direction. She's on CPAP to help her breathe, though is only getting room air through it so far (thank God). The respiratory therapist said she may need to be intubated briefly for a second dose of Infrasurf (a surfactant which helps the lungs function better). She's having some sort of heart problems (episodes of low heartrate and lots of irregular heartbeats) and so far they haven't figured out why...her EKG was abnormal, and we have an echocardiogram pending. She's also got an infection somewhere - her blood culture was gram positive - and they are starting her on strong antibiotics. She's not taking any feedings at all yet. I did get to hold her for about a half hour yesterday, but today she's too sick to be held. She's also getting jaundiced and will probably have to start phototherapy tomorrow.

I'll try to update as often as possible, but it is a daily roller coaster in the NICU!!! Thanks for your prayers - we just want our girls healthy and home with us ASAP!!!

The long and crazy birth story...read at your own risk!!

Wow, what a week!! Christmas day/night, I went to bed at 10:00 p.m. I woke up three hours later, at 1:00 a.m. on 12/26, with painful contractions. I started timing them, and just when they would be regular (every 5 minutes) for an hour, I'd go about 15 minutes without one - so I never woke up DH or went to the hospital. But they sure hurt!!

That morning, Wednesday, I had an OB appt at 10:10 a.m. I told him I'd been up all night contracting and in pain. He checked me, and I was 2 cm dilated and 80% effaced. He was so indecisive...ugh. First he said I should go back on mag sulfate to stop labor...I said absolutely not, that the babies needed to be delivered. I told him about the size discordancy and other concerns - he hadn't received the report from the peri yet. So then he said maybe they did need to be delivered and said we would do a c-section since B was breech. He sent me over to the hospital.

I got to the hospital and checked in; the nurse called him to get orders, and he tells her to set me up for a vaginal delivery (go figure - I've been asking for this the entire pg, but he kept saying not unless both babies were head-down). So they admit me, and I am contracting all day...sometimes with as little as 20-30 seconds of rest between long, painful contractions - I had terrible back labor radiating into my thighs. I was getting Demerol every 3 hours, but I didn't want to get the epidural yet at that point.

By 10:00 p.m. Wednesday night - 21 hours into labor - I was STILL 2 cm and 80% effaced. The OB decides maybe I'm not really in labor, and restarts my Procardia (used to stop labor). UGH!!! I continued to contract all night, though much more slowly, but then started to have some mild bleeding. By 5:00 a.m. Thursday, I was starting to pass some small clots, and I asked the nurse to please check me again...she did, and I was 3-4 cm and 90%. Ironic - they give me med to stop labor, and I finally progress...

Around 9:00 a.m., they decided to break my water, since I was still only about 4 cm. I asked for the epidural at that point, and good thing - the contractions became unbearable after that. Once the epi kicked in, they started some pitocin to try to get things moving. Unfortunately, not long after that, Makayla (A) started having heart rate decelerations with every contraction...so they put me on oxygen and started an amnio-infusion through an intra-uterine catheter to try to replace some of the fluid I was losing to see if that would help Makayla...it didn't.

At 2:00 p.m., I was still only 6 cm. I think at that point, I counted something like 10 or 12 different tubes/sensors/etc. hooked up to me!!! It was getting a little scary and overwhelming. But all of a sudden, at 2:45 p.m., I had a lot of increased pressure in my rectum, and I asked the nurse to check me again - I was finally 10 cm!!! The action picked up immediately, as they had to move me to the operating room for delivery - just in case I needed a crash c-section.

The OR was scary and freezing cold. The anesthesiologist was a moron and was so busy talking on his cell phone that he thought we were doing a c-section and got me completely numb - just in time for my OB to freak out and ask how I was supposed to push out two babies when I couldn't feel anything!! And talk about an audience - in addition to me and my DH, there were 14 other people in the room - my OB, the anesthesiologist, the neonatologist, 3 L&D nurses, and a 4-person NICU team per baby.

Anyway, I told them if someone would kindly tell me when I was having a contraction (since I could feel NOTHING), I'd be happy to try pushing...so that's what we did. My OB thought it would be forever, so was leaving the room and told them to call him when I was close. Two pushes later, they yelled for him to come back b/c Makayla's head was coming out!! Talk about mind over body - I couldn't tell at all whether or not I was actually pushing, but my mind was working really hard to focus on pushing!!

Makayla was born at 4:14 p.m. Thursday 12/27. She came out bright red, screaming, with Apgars 8 and 9. But she turned quickly and they had to briefly intubate her and give her a dose of surfactant to help her lungs. I didn't get to see her before they whisked her off to the NICU.
Then things got ugly. My OB used the ultrasound and manipulation to get Mackenzie turned around (she was breech). He succeeded in this quickly, but then her heart rate crashed - it was down in the 30's at one point, and was in the 60-70's for extended periods of time. My OB started cussing, saying, "Oh $hit, oh $hit, oh $hit," and started asking for various tools and yelling at nurses to get ready for a c-section. He told them we didn't have time to get another OB up there, to get a doc from the regular OR up there right away. Meanwhile, I was apparently gushing blood, and he had his arm UP TO HIS ELBOW inside me, with his other arm across my belly, trying to get her out. At this point, I was thankful the anesthesiologist had made me numb - I can only imagine how much pain I would have been in if I could feel that!! Just when my OB said we were going to start a c-section, he said, "Oh, wait, there's a head!" I was pushing with all my might (well mostly my head, since I couldn't feel) - one after another after another - even between contractions. My heartrate was 130 and my blood pressure was 170/?? b/c I was working so hard - I was terrified she wasn't going to make it. I finally got her out at 4:29 p.m. - only 15 minutes after her sister, but it seemed like an ETERNITY!!

She came out pale, limp and not responsive, but quickly perked up. Her Apgars were 5 and 8, but she needed no respiratory assistance, and they were able to bring her over to me before they took her to the NICU. That was when I saw her cleft lip - the peri had somehow missed this on all of my ultrasounds!!

The rest of the time in the OR, they delivered my placentas, etc, and got me cleaned up. I had a reaction to the epidural and started shaking uncontrollably - warm blankets have never felt so good!! They took me to my post-partum room, and by about 6:30 p.m., I was able to walk over to the NICU and see the babies. Of course, I should have not been so stubborn, b/c within about 15 minutes of being up, I got a terrible spinal headache from the epidural, and got stuck in bed for the remainder of the evening...IV fluids and lots of caffeine did the trick and by about midnight, I was feeling much better.

My recovery has been very slow. My body was really traumatized by the delivery - hello, OB climbing inside me! I am still having to take a lot of pain meds, and at times can't even hardly walk the pain is so intense. I am still having episodes of uncontrollable shivering, even though I'm not running a fever - doc says it's b/c my body is still kind of in shock. They talked about giving me a couple bags of blood today, but b/c I tend to be so overly sensitive to stuff, they were afraid I'd have a strong reaction, so they held off on that.

I'm home now, and hopefully will get some rest and start recovering a bit more quickly. It was very hard to leave the hospital though, without the babies, but I know they're being well cared for. Next post - baby update...

Monday, December 24, 2007

No babies yet!

I have to admit, it has been a stressful few days. I'm so worried about Mackenzie and it's hard to not think about it. I had my NST this morning, and both babies passed just fine. I tearfully told the nurses and pernatologist how worried I've been and that I really just want to deliver so the babies can be monitored and nourished in the NICU, but the doc insists that the babies look good on the NST and that it's still a little early to deliver them if we don't have to. So we continue to wait...and pray a LOT.

Happy Christmas Eve!!!

Friday, December 21, 2007

Today's tests

I had another ultrasound today to check the babies' fluid levels and dopplers on their umbilical cords. They won't measure growth again for another 2.5 weeks. Baby A still looks good. Baby B continues to have almost no fluid around her, and she is showing increased resistance in her cord, which continues to be cause for concern. However, both babies did well on the non-stress test, so the doctor is comfortable still holding off on delivery - in spite of the fact that I had packed my hospital bag just in case. :) As usual, I was contracting every 4 minutes or so, but not painfully, and they weren't concerned - they wouldn't try to stop labor at this point, anyway. I will return on Monday for another non-stress test, then I have a regular OB appt on Wednesday, and then a repeat ultrasound and NST on Friday.

Of course that's all assuming I don't actually go into labor before then!!! I did have several hours the other night when my contractions had become quite painful and I was starting to wonder if I was in true labor. However, after 3-4 hours, they calmed down on their own.

Meanwhile, I get bigger by the day (by the hour, it feels like somedays), and have a host of aches and pains that accompany the end stages of pregnancy. I have to keep reminding myself that I'm almost done!! It has been a stressful week, to say the least. And now that I got a better view on ultrasound of exactly how the babies are lying, it has become apparent to me that most of the time, I'm feeling Baby A move. Baby B is so squished without any fluid that it makes it harder for her to really move - just another thing for me to worry about!!! Thank goodness I have a handheld doppler with which I can check their heartbeats myself anytime I get concerned!

All we can do at this point is pray and pray and pray some more - as much for the babies' health as for mine and Darrell's peace of mind!! I've had a really hard time sleeping this week - which I always do, but it's been magnified this week b/c of my worrying about the babies. Say a prayer than I'm able to get some rest this weekend!!

Monday, December 17, 2007

Grow, Mackenzie, grow!!!

I had my growth ultrasound with the perinatologist today; of course, it would happen that the one time I go to an appointment alone, things start to go wrong!! Baby A (no, no name yet - but the field has been narrowed to 4 possibilities!) looks great. She's weighing in at 4 lbs, 8 oz.

Baby B, Mackenzie, however, is not looking so great. She's only weighing in at 3 lbs, 6 oz, which is only the 15th %ile. Her amniotic fluid is on the low side, and they did a doppler study on her umbilical cord which gave an unfavorable reading as well. The combination of problems has the doctor concerned that her placenta is not adequately nourishing her, which is causing her failure to thrive.

So they did a non-stress test (NST) after the other tests - basically you just lay there while they strap monitors around your belly to monitor the babies' heartrates and activity levels, as well as contractions. Both babies did pass this test, so that was one good thing.

I will go back on Friday to check Mackenzie's fluid volume and umbilical cord again, and they will repeat the NST. Basically, if at any point things look worse, they will do a c-section to get the babies out. From here until I deliver, I will have NST's twice weekly and the other tests once a week. They'll do another growth scan in 3 weeks (if I'm still pregnant by then!).

I have to admit that while the contractions don't freak me out, this news does have me scared. Friday feels like FOREVER to wait to find out more! Please send up extra prayers that Mackenzie will be nourished and start to grow better, and that both babies will be protected and healthy.

Sunday, December 16, 2007

Recent pics

Today is mom's last day with us for now...boo hoo! She flies out this afternoon, after having been here for about 6 weeks...don't know how we'll go back to life without her!!! Something tells me my dad (who's been in town staying with my brother, but will come over here this evening) won't be cooking up a storm like my mom has done while she's been here!

So here are some pics of the newly organized and decorated scrapbooking/twins room (they'll sleep in our room, but their clothes and changing table are in my scrap room), the newly furnished living room, a pic or two of Anthony, and a pic or two from my baby shower.









Friday, December 07, 2007

Spare some prayers for a woman you don't know?

I know devastating things happen to people every day, all around us...but this one struck a little too close to home. One of the moms on my Pregnant with Multiples message board posted horrible news. Over the weekend, she and her husband were on their way out to dinner to celebrate their 5th wedding anniversary. She was about 24 weeks pregnant with twin boys. Someone t-boned their car, and she had to be cut out of the car. She survived, with multiple fractures and internal injuries. Her husband also survived - she didn't say the extent of his injuries. But they lost BOTH of the twins - one due to the trauma of the accident and one due to the mom's blood loss.

I just can't even imagine the heartbreak they are going through right now. If you can spare some extra thoughts and prayers for this woman - Allison - and her family - they definitely need it right now!

Just reminds me how much I have to be thankful for!

Thursday, December 06, 2007

Stick a fork in me....I'm done...

Aaahhhh, my nightly ritual of which I'm becoming SO fond....take my meds around 8:00 (including an Ambien, which you would THINK would help this process along, but not so much these days), go to bed with Darrell and Anthony, spend an hour or so getting Anthony to go to sleep while Darrell falls asleep before his head hits the pillow, and then...

About 10:00, get back up, pee a few times, lay back down, listen to Darrell's CPAP machine make annoying noises, roll over (a 10-minute process in and of itself) several times....wait a while, get up again b/c my stomach is now growling...

Eat something (lately it's been Trader Joe's Candy Cane Joe-Joe's) - the only time of day my body seems to handle the carbs well enough...drink some milk...

Lay back down, get up to pee, toss and turn some more, figure out if I should be timing these annoying Braxton-Hicks contractions...

Finally get back up, resigned to the fact that I'm never going to sleep again in my life and go to the living room to play solitaire on my laptop.

Then I usually finally fall asleep around 1:00 a.m. - usually I've moved back to my bed by this point and have relocated Anthony from my spot to his toddler bed; still get up several more times to pee and/or take meds for contractions, finally get up for the day around 7:30 or 8:00.

Fortunately, my mom is here to take care of Anthony, so the one luxury I have is that around 10:00 a.m., when I'm completely exhausted from not sleeping at night, I'm able to lay down and get a couple hours of sleep. I suppose my OB would say this is my body's way of prepping me for when the babies get here - but really, doesn't it make more sense that you should go into this newborn-stage fully rested???

I feel huge, though everyone tells me I'm not, and I've still only gained 11-12 lbs since the beginning. Nonetheless, I have 2 kids squishing everything in my innards, making everything difficult.

I'm feeling pretty much DONE and can't wait for the pregnancy part to be over. That said, I am praising God that I've made it this far - 31 weeks, 3 days - and I honestly do hope they stay in the cooker at least another couple weeks. The less time they have to spend in the NICU, the better! BUT, come Christmas Day, when I hit 34 weeks, I'm gonna be praying they come out! I can't even begin to imagine the misery of having to stay pregnant until my actual due date of Feb 5!!!!

I did have 2 doctor's appointments this week. The one with the peri was my final cervical measurement. My cervix had shortened by over a centimeter, down to 1.75 cm from 3 cm, but they were not concerned, as this is pretty much expected at this stage of the pregnancy. I also had an appt with my OB, who was just thrilled at how great I'm doing and that I've made it this far. She was SO thrilled, in fact, that she gave me permission to go to the salon for a haircut - so tomorrow morning, mom and I have joint appointments to get our hair done at the Aveda salon. Aaahhhh...I truly can't wait!!! My first non-medical outing in months!!

AND, not only do I have that to look forward to, but our baby shower is this Sunday afternoon - yay!!! I get to be a normal pregnant woman for a few hours. Last time, with Anthony, I had already delivered by the time I had my shower...so it will be fun to still be pregnant this time around! I don't even care if anyone brings gifts - I'm just so thrilled to be getting out of the house and spending an afternoon with friends and family!!!!

I will continue to have weekly dr. appts, including another growth ultrasound on the 17th (if I haven't delivered by then!). My OB said I will also be starting Non-Stress Tests soon (where they monitor the babies' heartrates, activity, and contractions for a period of time). At my last u/s, Mackenzie was still breech, so it's continuing to look like I'll probably have a c-section.

OHHHH - big news - Baby A is much closer to having a name!! Darrell has narrowed the list down to 3 names - I'm not sharing them yet, but we will let you know when a final decision has been reached!

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