I wrote this up for myself too so I was very thorough and it's VERY LONG!
On August 5 I had an appt with my OB/GYN. I had already started working half days and was going to ask him to put me off work in 1.5 weeks. In a quick ultrasound, he told me everything looks good. I told him I was having some tightening that felt a bit like menstrual cramps but when I have them, I try to drink some water and lay down. He said I was doing the right thing but told me to have the radiologist check my cervix at my appt the next day. So on August 6 I worked half the day and then left for my 1 pm ultrasound scan. I was having a few pains that morning at work but nothing terrible. I was planning to go home after my appt and rest. This was one of probably two appointments that Dick did not attend with me.
At the appt, the technician was having trouble finding my cervix. She called in another tech who also couldn't find it. They called in the radiologist who also couldn't find it. They recommended I visit my doctors office to get checked. During the exam, I was having more frequent cramps and felt like I had to poop. I figured I was nervous and had an upset tummy. I also realized that I was having contractions but figured they were Braxton Hix - even though they were starting to hurt more and more. I took a big poop at the radiology office and in retrospect, was probably lucky I didn't give birth right then and there! I called my husband to update him and told him he didn't need to come down yet. I probably shouldn't even have driven but I drove the 8 miles or so to my doctor's office. The nurse practitioner checked my cervix carefully and determined that I was 5 cm dilated and had baby A's bag of waters right at the edge of my cervix. They popped me in a wheelchair and pushed me over to the hospital which is two doors down. I was taken to triage and admitted right away. I called my husband and told him what was going on. He was at work only a few miles away and rushed over.
They put me on magnesium sulfate, terbutaline, and something else (green pill) to aggressively stop the contractions. They also gave me a steroid shot to help the development of the babies lungs. I was a mess, my first time in the hospital ever. I had an IV and a catheter for peeing. I had to stay laying down. The drugs made me feel like crap. I was super hot, really foggy, tired, etc. I had my own nurse and was having my blood pressure, reflexes, breathing, etc checked all the time. I was told I would need to stay in the hospital until the babies came. That night I was feeling so super foggy the nurse asked if I would like a blood test to check to see the level of the magnesium in my blood. I said yes, just to be safe that I was not OD'ing. At first the nurse took the blood sample out of my IV arm. She came back with the results in emergency mode saying the results were "10" which is a toxic amount. Even though she knew she should not have taken the blood out of that arm and that the levels were probably not that high, she was obligated to turn off the mag. I immediately felt my head clear and my body cool down. It was nice but at the same time, I was worried my contractions would start up again. The nurse took another blood test out of my other arm and went to the lab. When she came back she said my levels were actually 7.5 but that was an almost toxic level (toxic level is 8+) so they reduced my dosage from either 3 or 5 to 1 I think. Later in my stay they had to increase the level up to 2 to stop contractions. Man was I glad to have asked for that blood test...
They have a floor in the hospital where there are a number of women who are on long-term bedrest in similar conditions to me. However, I was not allowed to join them on that floor because I was so far dilated and they didn't want me to be away from the labor and delivery floor. So I settled in for the long haul. I don't know if the drugs made me emotional or not but I was upset about the condition I was in. I am a mover and do-er so it was very hard to be hospitalized. At first I had nothing to do to pass the time. But I also couldn't concentrate on anything like a book or whatnot. Dick spent the first night or two with me on a very uncomfortable bedside pull-out chair. I was admitted on a Wednesday and he took Thursday and Friday off and spent the weekend with me too. He started going home at night though so he could be comfortable and take care of our pets. The time DRAGGED... But I was also very busy. I got tests all the time, meals delivered, some sponge baths, one nurse even washed my hair while I lay in bed! The nurses were awesome! I also got visits from the NICU staff, counselors, physical therapists, my doctor, the doctors on call, etc.
I had two stressful events while I was there (other than the obvious stresses of preterm labor, worrying about the babies, and being bedridden)! The first stress was how to deal with bowel movements... After 2 or 3 days without one, I started getting stool softeners and laxatives. The doctors did not want me to push out a bowel movement at all, let alone get constipated. I did get permission to use a bedside commode. The three times I used it were the only 3 times I got out of bed all week. It was a stressful endeavor every time because I did not want baby A's water to break while I was pooping!
The other stressful event we had was an incident of heart palpitations I had Sunday night. I've gotten heart palpitations since I was in college. I've asked lots of doctors about it, including my OB/GYN. I'm told it's kinda like a muscle spasm caused by an imbalance of different chemicals in the heart. Usually, when I get one I can make it go away pretty quickly by laying down flat on my back and breathing very deeply, holding my breath for a few seconds when my lungs are full. That night in the hospital I couldn't get rid of them. This happens to me once in a while. We told the nurse about it and she was monitoring me and alerted the doctor because they wanted to make sure it was not a side effect from some of the drugs. I finally gave up trying to get rid of the palpitations and tried to sleep. They went away after 2 hours. But it was scary to have my heart beating over 150 bpm for 2 hours!
So, I spent from Wednesday, Aug 5 to Thursday, Aug 14 laying down... it doesn't sound terrible until you are there. I felt so helpless. I'm usually a "do-er" and it was very depressing not to be able to do anything - even bathe or go to the bathroom. Not to mention the drugs affected my brain so I could not effectively read or do much else other than watch tv. Nurse and dr visits kept me busy. Meals, phone calls, and visitors helped the time go by. I had some visits from friends and co-workers and that was really nice.
I can't remember if I moved rooms on Aug 13 or 14... But I moved to a new room. I was supposed to get my IV moved that day from one arm to the other. The nurse tried twice to move it but had no luck. She consulted another nurse about the IV. This nurse was wondering why they were planning to move the IV instead of installing a pic line (for longer term stays). She was also made aware that my contractions were actually breaking through the meds. This nurse decided to check my cervix. I was a little nervous about it because my dr had not wanted to check me because doing so might break baby A's water. But the nurse felt it was necessary. She said I was 10 cm! They consulted the on-call dr - Dr. Johnston - who told me it was time to deliver. The previous plan was wait to deliver until one of my waters broke. I asked her to call my dr. He said if I needed to deliver and it was during the day he would come over to deliver the babies. It was 5:00 pm and they could not reach him. The on-call dr said at 10 cm it was time to deliver - this way we could do it in a controlled way as opposed to waiting for my water to break and having to hurry (in case the babies were in distress). I agreed - partially because they were so early - I left the medical decisions to the doctors... If we were full term I was prepared to fight off all the interventions. In this situation, I did not feel as confident doing so.
So... I called my husband and told him to get to the hospital asap. I also called my mom and told her she was going to be a grandma again soon!
The next few hours were a whirlwind! My husband got to the hospital in record time! I'm so proud of him and how he handled this whole situation. He was really there for me the whole time - even though he gets woozy at the mention of a needle! They stopped my magnesium sulfate drip. Daddy got into his "hazmat" suit and they wheeled me into the OR. They deliver twins in the OR in case they need to do a quick c-section. It was recommended and I agreed to get an epidural. I was tired from my rough week. And the doctors recommend an epidural with twins in case baby b decides to turn sideways after baby a comes out and they need to manipulate his position some - or go to a c-section. I ended up with a "spinal epidural" because that's what the anisthesiologist recommended. I really did NOT want a c-section and made that clear. Although, what's scary is that if I told them I did want a c-section, they would have done one and maybe even preferred it! the doctor who was with us asked if we could wait 20-30 minutes while she delivered another baby in the room next door. We thought that would be fine because I was not feeling the contractions anyway and my water had not broke. In the meantime, another dr came in and said she would deliver the babies. This new dr was just starting her shift and the other was supposed to be leaving soon. We were a little nervous and disappointed at the sudden change because we really liked and had a lot of confidence in dr. Johnston.
My contractions did not really kick in very quickly. I could not really feel them nor did I feel the urge to push. This really surprised the nurses since I was 10 cm... They ended up giving me a pitocin drip. Since I could not feel the contractions, the nurses and dr told me when to push. Baby a had her arm up by her head and it was sticking out a bit but the dr helped move it and wouldn't let me push until her arm was out of the way. With the epidural, it was hard to know if I was even pushing... but I pushed for about 2-3 10-second pushes and out came baby a!! I could hear her crying - it was so sweet... They took her right away into the next room where a team of NICU doctors and nurses got her all set up with breathing tubes and everything she needed. Next, baby b was trying to put his arm out with his head... But I believe the dr helped him move his arm and it was time to push again. I found pushing difficult mostly because I had a hard time holding my breath for their VERY long 10 seconds. In fact, after pushing baby a out I was seeing stars so they gave me some oxygen. Again, I only pushed maybe 3-4 times to get baby b out. It was a little sad because the dr was not very encouraging. At one point she said, "Keep pushing, this is important!" Like I don't know how important it is... I'm not sure if baby b's heartbeat was ok or not... they were monitoring him so maybe she was just telling me that I needed to hurry up and get him out. I don't know... 10 minutes of pushing doesn't seem like much! But I also wouldn't have wanted to do anything to hurt baby b. Another time she said, "If we don't get him out with this push, we're doing a c-section." Not the nicest thing to say... Dick was good tho, he whispered in my ear, "You're doing great." That was nice. The dr ended up using the vacuum to get baby b out. He was also taken straight into the room next door to get his breathing tubes and such.
Daddy went with the babies to watch how they were doing and to video them. I stayed on the operating table while we waited for the placentas. They were stubborn. Dr. Castillo was massaging my abdomen to try to get them out. She was pushing kinda hard... Then I noticed her with needle and thread and asked if I had torn. She said she gave me an episiotomy. Really?! I hadn't noticed. Later I asked Dick about it and he said he knew they were doing it. It was before Veronica came out. News to me... I guess that's good that I didn't notice! Might have been nice to have been asked/told, tho!
Dr. Johnston came back in at that point. I think she was coming back to deliver the babies but saw that Dr. Castillo had already done so! But Dr. Castillo left and let Dr. Johnston finish me up. She found my placenta to be very easy to get out. And she finished my stitches.
Dick had followed the babies down to the NICU so I was wheeled back to my room. I waited there until someone was ready to take me down to the NICU to meet our babies. Dick called me to ask where I was. He was in the NICU waiting for me. I told him I was on my way. :-) I don't really remember seeing the babies that day. I think I was in shock. I'm glad we have it on video but it's hard for me to see pictures of them that first day with the tubes down their throats. I still haven't watched the birth video yet - I think it will be hard...
We were moved up to the 6th floor, I believe, into a recovery room. It was evening by then and after the nurse got us settled and checked me out, I think we went to sleep. I couldn't believe how sore I was those first few days! At 7 am one of the lactation consultants came by to give me my new pump and show me how to use it. I was pumping when Dr. Barmeyer came by! He sat and talked to us while I pumped my breasts - nothing came out that first day or so. But I had to pump anyway to get my supply to come in. We visited the babies a few times but we couldn't hold them. After 12 hours they had the tubes out of their throats and they were on CPAP. It's a kind of mask over their noses to help them breathe. It was very hard for me to move still, but we visited the babies a few times a day and pumped and met with different hospital folks and ate meals and got checked by nurses. They really keep you busy! I think I finally took a shower Saturday morning - that felt good! A little less than 48 hours later, on Saturday afternoon, we went home without the babies... It was weird.
It took us a week or so to get a visiting pattern set. It was still hard to function in general with the pain, soreness and the pumping every 3 hours! Some days we visited once and some days twice. We could hold them after a few days so that was good. We did some kangaroo care. They weren't getting any extra oxygen for very long but kept the CPAP a few days to help them expand their lungs when they inhaled. After that they just had some small tubes at the bases of their noses to blow air in. Then those were gone in less then a day. They changed from IV's to pic lines and then those were gone too after about a week. They had jaundice and so each spent 3-4 days under the bili lights. They were getting fluids through their pic lines but also got tubes installed through their noses to get food to their tummies. They got some donor milk until I had enough supply for them. I have been continually a little short of what they need but I'm still giving them plenty of "liquid gold!" They "graduated" to the "low side" of the NICU after only about a week or week and a half! They were both also continuously gaining weight after about 1 1/2 - 2 weeks. :-) In order to go home they need to 1) be over 4 lbs, 2) be getting all their food through their mouths, and 3) have no more "events" of bradys or apneas. Those are when their heartrate dips or they stop breathing for a moment. I believe they both still have a few bradys here and there but they are self-resolved - meaning the nurse doesn't have to do anything, it just goes away on its own. They were also getting bottles and practicing breastfeeding after only a few weeks. On Sept 3 the dr told me they'd probably go home in 2-3 weeks! That was sooner than I expected.
When they were born they were:
Veronica - 3 lbs, 2 oz
Jackson - 3 lbs, 8 oz
At 8 weeks they are:Veronica
- over 5 lbs! Jackson
- over 7 lbs!
They came home on Sept 20 - exactly one month before their due date. They were about 6 weeks old and they're still doing great!!