BABIES!!!!

WARNING: This is a REALLY LONG POST…..so make sure you have gone to the bathroom, have a snack and possibly a beverage before you settle in to read it! :o)

Okay, so this post will be a little different than my previous ones….I’m having to resort to a day by day recap….and my days are a little foggy, so some of this is coming from the hubby and Memaw’s account of how things went down.

Let’s start at the beginning, shall we?
Monday, January 5, 2009:

Good thing the hubby reminded me to throw together the hospital bag this past weekend.

We arrived at our OB appointment Monday morning, and after the sonogram, Dr. G told us we needed to go to the hospital and check in.

At that time, Baby Boy B's amniotic fluid was measuring lower than it had been the previous weeks, plus he was continuing to trend smaller in size than Baby Girl A. These two things combined made Dr. G want to get a second pair of eyes, and put us on Hospital Bedrest.

So we called Memaw and Pa to head on this way. Called MommaJo to let her know what was going on. Then called one of our friends and asked them to watch E for us for the day. And then my brain pretty much ceased to function clearly.....go figure.

We arrived at the house, passed off E, grabbed our hospital bags and pillows and headed to the hospital. We were really nervous, and anxious to speak to the Specialist, Dr. Magee. But being the Monday after a holiday weekend, Labor and Delivery was pretty busy.

We told the staff, "hey man, we are not critical, so feel free to deal with those who are critical....but if we become critical, we would like to be moved to the top of the list!" ;o)

Late that afternoon, Dr. Magee came in and performed the scan and determined he did not think Baby Boy's levels were too low...he thought it was his positioning that was making it hard to determine an accurate read on his levels. Dr. G talked to him and they decided that we need to stay put and have scans done twice a week (Monday's and Thursday's) to keep an eye on Baby Boy. He was optimistic and thought we could go until 37 weeks. Dr. Graham did not want to push our luck, and put us in an emergent situation for the birth. We, needless to say, were siding with HER! :o) Sensing a birthing sooner rather than later, Dr. G ordered Steroid Shots for me to help with the babies lung development......and boy DO THEY HURT :o(

So the bottom line of all of that was "Go Check In Until These Kids Come Out." We were moved to a regular room around 9pm (this was after we checked in to Labor and Delivery for observation at 12:30pm). The hubby left for the night to go and retrieve E and head home with her, as she resumes school on Tuesday.....no point in jacking up her schedule over all of this....Memaw and I set about unpacking and settling in for the evening.

Then I started to notice that my legs were really starting to ache….they had started down in Labor and Delivery, but I contributed it to me having to be in the bed hooked up to the baby monitors…..basically, I did not think too much about it.

Also the steroids were keeping me awake. So what started out as something I did not think too much about turned into the only thing I noticed from midnight until 3:30am, when the pain was too much for me to handle. Every time I got up to go to the bathroom, that leg would throb and pain would shoot through my calf with what seemed like a knife stab. I almost fell twice. I tried to continue to ignore it until I noticed the knot on my left leg. I woke up Memaw. We called the nurse. She called the doctor-for-the-evening. He blew it off. She was visibly mad about his decision. So the nurse brought Hydrocodone for the pain, but wanted us to be sure to tell the Morning Resident about it. I managed to get a total of ONE HOUR of sleep…Memaw can (unfortunately) verify this as I keep her up with me from 3:30 on.

Tuesday, January 6, 2009:

The Resident came in, and I explained that I was in excruciating pain. She decided to have my legs Doppler-checked for clots. The nurse was relieved.

The hubby came to the hospital after dropping off E at school. Dr. Weinstein came in and also determined a Doppler of my legs was in order. This was scheduled to happen before lunch. So down to Radiology I went. The Tech was also pregnant, so we had something to chat about while she dopplered both of my legs.

The hubby and I were taken back to my room to wait for the results, which came rather quickly: The scan confirmed a 2.5 centimeter clot in my RIGHT leg and a ‘superficial’ clot in my LEFT leg. The nursing staff came in and put compression stockings (called TEDs) on both of my legs, and then put on the “Leg Squeezing Machine” – this was a set of calf-long blood pressure cuffs, that alternated inflating to assist with moving my blood around (to keep it from pooling in my legs). This first night of the Leg Squeezers was really annoying, due to me having to disconnect them every time I had to get up to go pee – remember I’m still pregnant at this point.

They also put me on Heparin Shots, 2 times a day, which REALLY burn…..and they have to be administered to the abdomen, in the subcutaneous fat layer – and mine was REALLY stretched thin, so finding it became a game of sorts. AND I also had to have my second steroid shot this night. Ah, Pain……is there enough to go around? My experience says “yes”. :o\

Dr. Graham came by to inform us that this latest blood clot development really puts us in a Critical category. The Heparin is necessary to keep the clots from growing and/or breaking loose and getting to my lungs and killing me and the babies. She has consulted with a Hematologist Oncologist (Dr. Maisel) that she has worked with before, and he will be stopping by tomorrow with his assessment of our situation. But she suspects that an intravenous filter will need to be put in place to catch any clots that come loose. The problem is we have Placenta Previa, which is a serious bleed risk, and now we have been put on Heparin (a blood thinner). She is visibly concerned, and is telling us that she is have team meetings with all of her colleagues that will be assisting on our case, and getting input from them for the next steps. She will meet with us again after Dr. Maisel meets with us.

Meanwhile, the hubby had gone and retrieved E from school and brought her down to the hospital to see me. She is a little cautious upon seeing me in the bed with the Leg Squeezer machine going. When the nurse comes in to check my vitals, she looks at her and in all earnest says:

You take good care of my mother, okay?

It was very sweet, and I was glad to know that she was somewhat getting that Mommy was sick, but that the nurses and doctors were there to help me, and that I was going to be okay.

Memaw took a picture of me in the hospital bed with the leg squeezers on, big-as-a-house-pregnant.

Wednesday, January 7, 2009:

We meet Dr. Maisel, who again confirms the clot is in the RIGHT leg…..which is just totally baffling to me, cuz the pain is totally in the LEFT. He assures me, it is the Right, with the pain in the left coming from a superficial clot. Okay…..he’s the expert.

My brain is really starting to become overloaded. I’m starting to really freak out on a mostly internal level, but I can totally see that changing and exploding into the external very, very soon.

So Dr. Maisel tells us that we will be on the Heparin until right before the C-section; at which point they will stop the Heparin (about 6-8 hours before surgery), and will resume it 6-8 hours after the surgery. So the filter HAS to go in. Great. He explains that usually, they go in thru the artery/vein in your leg and weave it up to the Inferior Vena Cava (IVC). However, me being the super-doper pregnant person I am, they have concerns. The other option is to go in thru my neck to get to the IVC. Neither sound appealing. I ask if I have to be conscious for the procedure, and he tells me unfortunately, yes…..but that some type of “happy drug” will be administered…..yea me.

All of this is starting to swirl around my brain at a rapid rate……and I kinda lose it a little bit….so when the nurse comes in to administer the Heparin shot for the night, I tell her that I don’t know if I’m really supposed to get it, given the filter surgery they are trying to have scheduled for tomorrow……she doesn’t argue, just says OK, and leaves.

When Dr. Graham shows up later that night, she says:
Dr. G: Cherise, you can’t be telling the nurse not to administer drugs to you! If you were a nurse, I would have you fired! You are fired!
Me: Oh. So I need the Heparin shot tonight?
Dr. G: YES!!! And then she laughs…

She then tells us that the plan is coming together. She has called in all her favors for all her colleagues that she would like to have on deck for the now decided Friday delivery day. (Memaw calls Pa to tell him to come on down). Dr. Graham does not want to name names, but does mention calling “Chris” for her anesthesia doctor. This turns out to be Dr. Christopher Haas.

She confirms that a filter does indeed need to go in. She also explains that she went down personally to find the “right doctor” to do the procedure from Internal Radiology. She was funny about it…she said:

I’m a Doctor Cherise. I can just write an order and make this happen. But I didn’t. I wanted to see the doctor face to face and talk with them and make sure they were completely on board with our case. You will be seeing Dr. Clair Savage. I have spoken with her several times, and she is very good.

I love Dr. Graham. She was SO COMMITTED to our case.

She also tells us that they will be going thru my neck to insert the filter. Also they will not be stopping at the IVC, but rather going to the Renal Artery. This should catch the blood clot(s) if it/they break loose. I will be awake during the entire process, which should take about 20 minutes. Then, I will be in the 'radiation area' recovering for another hour, I think. The entire time, there will be a dedicated person monitoring the babies for any changes, distress, etc. She also said there is a "minimal risk" to the babies due to the radiation from the x-ray. After the hour of recovery, I will go back to labor and delivery and get to see the hubby and my folks, and continue recovering until Delivery Day on Friday.

So I should point out that at this point, I’m really not sure where my IVC -or- Renal Artery is with relation to the entry point of my jugular. My hubby, being the overly intelligent man that he is, starts this conversation with Dr. G about “so, the filter will go thru the neck, thru the heart, thru something else, past the IVC and then be deployed in the Renal Artery”…..she says yes…….at this point I’m white as a sheet and my eyes are bugging out……WAY too much info for me……I was happy in my denial of “Hey, renal sounds close to the jugular, right?” He realizes his mistake and immediately starts to apologize and comfort me….too late….I start to cry……I’m so freaked out and scared.

She also says that the amount of “Happy Drugs” will have to be very minimal to reduce the risk to the twins…..again I say, yea me.

We call upon our good friends again to pick up E, and she has her very first “sleep over” with Mrs. Sidra, Mr. Paul, Sebastian and Ava. I’m worried about her, but comforted in the knowledge that she is in good hands.

The hubby stays with me in the hospital room and Memaw stays in hospital hotel…..neither one of them want to be ‘too far away’ from me, and frankly, I don’t want them to be too far away either……I’m really starting to experience this week as a spectator…..surreal …..

Thursday, January 8, 2009:

Dr. Haas stopped by and introduced himself. He and his team have been ‘tapped’ by Dr. Graham to participate in our delivery scheduled for tomorrow. He let us know that I will be unconscious for procedure. The hubby and Memaw will NOT be allowed to be in the OR for the procedure. I will have 5 IVs including a central line (thru the neck). The being unconscious part does have pros and cons, but after the last meeting with Dr. G, they are in agreement that unconscious is the way to go.

So then a little bit later on in the morning, the hubby and Memaw and I headed down to Internal Radiology to meet Dr. Savage and Dr. Giles, her colleague. The hubby and Memaw were peeled off at the waiting room and I was led away thru the “No Admittance Beyond This Point” doors (queue scary music sequence…)

When I arrived at the nurse station, all of the doctors and nurses went silent upon laying eyes on me……kinda weird, but then again, big-as-a-freaking-house-pregnant…..so didn’t REALLY put too much thought into it…..initially…

So I was parked in a location where I was facing the Nurses Station….there were funny little “Savage Country” posters on the walls …. I was beginning to speculate what Dr. Clair Savage looked like….at this point Dr. Giles wondered over and introduced himself, and explained a little bit about the procedure, and I managed to put a good face on it, and smiled weakly as he talked. Then Dr. Clair appeared. She smiled upon entering my little “holding spot”…..I could not help but chuckle and smile back….I said:

Me: You must be Dr. Clair
Dr. Clair: Yes I am
Me: So I take it you have talked to Dr. Graham
Dr. Clair: I have had SEVERAL conversations with her including one this morning; except in this conversation Dr. G started talking –BEFORE- I had answered the phone. When I did answer, Dr. G was saying ‘And another thing, I don’t understand why…’ I had to say ‘whoa, whoa, whoa….let’s start over.’

I had to laugh out loud. I said ‘Yes, Dr. G is VERY thorough.’ She said ‘You are right. I’m going to switch to her for my OB/GYN!’

Dr. Savage explains the Filter procedure as follows:
I will be wheeled into the Radiology OR. I will not be administered too much of the happy drug due to risks to the babies. The procedure will involve them administering a local in my neck at the point of entry. They will apply a dye first to decide on the placement of the filter. Then they will deploy the filter. This should take about 20 minutes.

So in I go…..the next part was kinda like a bad acid flashback (except that I have never done acid…hhhmmmm)…..So they move me from one table to another, and place my arms in these plastic shields to keep them from falling off the table – translated “trapped”. Then one tech starts to try to gather up my hair in one of the hair nets, and they removed my St. Gerard necklace and wrap it around one of my hands. Then they start to administer a little bit of the “Happy Drug”.

But nothing could be complete without a Claustrophobia attack, right? Dr. Giles starts to unroll this type of drop cloth across my face, where my head is turned to the left, exposing just the right side of my neck….but it keeps on unrolling until I can not see and I start having my anxiety attack….the only thing I can think is “I’m suffocating in a Wal-Mart bag!!!” I start to try to move my arm to push the drop cloth off my face, only to discover They Are Trapped. That’s when I lose it…..I say very deliberately:

Hey. Guys. I’m. Having. A Claustrophia. Attack.

Two Techs rush over and pull the cloth off part of my face to allow some fresh air to come in…I hear them discuss how much of the “Happy Drug” has been administered, and how much more I can take….which turns out to be not much….so then they ramp up the procedure…..they administer the local…which REALLY FREAKING HURTS…..then a serious of things happens….the lights go on and off a few times, one of the techs keeps messing with my hair, there is a lot of discussion between Dr. Savage and Dr. Giles on the placement. They administer –more- local…..then they start to deploy the catheter with the filter in it…..this part REALLY HURTS…..they have to push really hard, and I can hear the tube scraping on the drop cloth…..nothing says love like Sound Affects in a Scary Surgery! YIKES! I manage to hold it together….finally they pull off the drop cloth and hair net, and call the L&D nurse over to do the baby checks….but it has been too much for me and I finally start to cry….Dr. Giles says “Please don’t cry. I can’t go home today and tell my wife I made a pregnant woman cry today.”

Meanwhile, Dr. Savage brings and update to family:
• She had not been able to anesthetize me as she normally would have, due to the babies.
• I was more awake than normal patients having the same procedure.
• My neck was going to be sore, because they really had to push to get it inserted and thru to the Renal Artery.

So the hubby said “Great. So she will be in pain and pissed. Wonderful!”
Dr. Savage also told them that she had never performed this procedure on a pregnant woman before…..glad everything worked out!

Dr. Savage and Dr. Giles are back in the OR with me, intently watching the Labor and Delivery Nurse try to find good heartbeats on both babies….she finds Baby Girl pretty quickly, but can not find Baby Boy, due to him wiggling around too much. Finally she looks at the two Doctors and tells them she wants to go ahead and move me to L&D to hook me up to the big monitors. Both Doctors went a little stiff and opened their mouths….then Dr. Savage says, “Ok, but you will call us when you get the status on the Boy, right? All we need is a thumbs up, okay?” It became very obvious that Dr. Graham had told them to make sure the babies were alright when they were done. They were not thrilled at the thought of the nurse taking me without this confirmation in hand. The nurse assures them, and I’m carted off.

And of course, Dr. Savage was right….or at least partially right….I was indeed VERY sore on my neck…..so now my neck hurts and my legs hurt on top of all the ordinary aches and pains associated with 34 week pregnancy of twins! Yea Me!!!

That evening, Dr. Graham drops by to go over the final plan. The filter will stay in for about a month. I will be on blood thinners for about 6 months. Due to me having to be unconscious, she will need to go fast, and she will need to go vertical instead of horizontal on my abdominal incision. Since I will be unconscious, the babies will be born unconscious too. There will be 2 units of blood hanging when she begins and there will be 2 more in the room. There will be 2 NICU teams in there along with the Anesthesiologist Team, the Labor and Delivery Team and her Surgical Team.

The hubby and I tell her we completely trust her and her judgment in all things regarding this procedure. I reassure her that the vertical incision will be OK….and that I can always have it ‘fixed’ at a later date if it bothers me too much….that the important thing is to get the babies out.

She again reviews that the heparin will be stopped and then restarted after the procedure.
She leaves and we digest all of this info.

Meanwhile, Pa comes in and he and Memaw decide to stay close, so they stay in the hospital hotel that night, with the Hubby staying with me in the room.
E stays with Mrs. Sidra again.
Mr. Paul comes by to check on us and brings Krispy Kreme doughnuts. YUM!
Also Uncle Alan / Aunt Lisa come by and drop off some gifts for E “from the twins”. We are very grateful they can do this for us.
The hubby stays with me tonight.

With all of these procedures going on, Blue Cross/Blue Shield calls Dr. Graham “to find out if this is all for one patient.” Dr. Graham tells us that by the time she was done speaking with them, they told her, “whatever you need Dr. Graham, make it happen.” I SO FREAKING LOVE MY DOCTOR!!!!!!!

Friday, January 9, 2009:
Birthing Day! They stopped Heparin shots for the surgery.

Dr. Graham, Dr. Haas, 2 NICU teams, and the L&D team are ready (Latoya, one of the Labor & Delivery nurses came in on her day off just to be involved in my delivery).

They took me down around 7:30am, and put in the first IV, which knocked me out (thank God) before they inserted the other 4 IVs. The surgery started around 9:40am

M was born at 9:45am, she was 19” long; F was born 9:46am, he was 19.25” long – both were unconscious, like me [NOTE: if you want to know their actual names, send me an email].

Memaw, Pa and the hubby got to see babies almost immediately; the nursing staff offered to take pictures for us in the delivery room.

Everything went relatively smoothly; they were prepared for every possible scenario. After the babies were born, Dr. Graham clamped and cross clamped Uterus; then she discovered the bright red bleeding coming from the placenta’s AFTER this was done; she unclamped and had to deal with placentas then. Up until this point, she had not touched them, in an effort to control the bleeding risk.

Well, it turned out to be I had DOUBLE placenta previa, and they were stacked like pancakes. I had dilated, and both placentas had turned into accreta, grown through cervix and into vaginal cavity; they were the only thing keeping the kiddos IN. Dr. Graham did her magic, and stopped the bleeding with only having to put in 2 units (remember, they had 4 on deck). The nursing staff was so ‘shocked’ at the size of my uterus, they weighed it! The uterus plus both placentas weighed 4.5 pounds…..that was like a third kid!

At any rate…..I remember waking up around 3pm, semi-lucid for the first time…..but evidently, during my recovery, when the hubby and Memaw and Pa were in there checking on me, Swearing occurred…….I know, I know…..pick up your jaws…..

I am told there was a lot of
“Holy Crap, this HURTS!”
And a few of
“Shit, this Hurts a lot!!”
And finally, one
“I just want you guys to know, “F*#@ this Hurts!!!”

Now, I don’t remember any of this, but I’m going off reliable sources….not to mention, I did all of this in front of everyone, including MommaJo, who drove in that morning…….again I say, Yea Me. :o\ {sigh}

Evidently, later on I was wheeled to NICU to see M and F; I totally don’t remember this, but there are pictures of me doing this, so it had to have happened.

My Pain is unreal – abdominal and Neck; they have equipped me with a lovely pain-killer-button…..how I love that button!

They resume the Heparin shots. {sigh}

Dr. Graham checks in on us. She tells me in no uncertain terms that Lisa, our ultrasound technician in her office, literally saved my life. We completely agree. If she had not warned of the low fluid on F, we would have gone home and never given a second thought to my leg pain; I would have died going into the c-section without the blood thinners and filter in place. May God Bless Lisa!!!!

She also tells us that life can turn on a dime. After our successful operation, the next patient they asked her to assist on (not a regular patient of her office), had severe complications, and she is really worried about the baby……she asks us to put Baby Sophia on our Prayer List. The hubby sends out the request immediately.

So!

We are eternally grateful to everyone out there that was praying for us and our doctors. I believe it really worked. Those of you that know me really well know that I am not prone to being overly mushy or strongly religious, but in this case I must be both.
I would not be here nor would the babies if it had not been for my God, my Angels and my Doctors.

Go hug someone! And tell them you love them and that you are glad they are part of your life.

Okay, enough of that :o)

[NOTE: This is the recap of the first 5 days….there will be another post with the next few days worth of drama, but this at least catches everyone up on how we finally got babies. So stay tuned, because there was more drama…..which is not really saying anything, because what is life with Cherise without Large Quantities Of Drama!!! :o)]

Love to everyone,
Cherise