Our Little Family: January 2014

Be warned- I wrote this as my journal to remember everything leading up to their birth so it's really long!

At 29 weeks pregnant with Brayden and Sydney I felt strong and healthy. I was still swimming, lifting weights twice a week and doing yoga. My belly was getting big and I was starting to experience some heartburn and swollen feet by the end of the day; but overall I felt great.

On Thursday September 26^th I had my 29 week appointment with Dr. Terry early in the morning. Because of my twin pregnancy each Dr. appointment began with an ultrasound to check fetal growth, fluid levels, and if my cervix was dilating. Chris was scheduled to fly to Houston early in the afternoon, but he wanted to come with me and at least see the babies on the ultrasound before heading to the airport to catch his flight.

The ultrasound started off great, but we did notice that Baby “B” (Brayden) was measuring much smaller than Sydney. In the last ultrasound he had been a few ounces smaller, but this time he looked to be about a whole pound smaller. The ultrasound tech spent a long time measuring the cord blood flow, but we didn’t think too much of it.

After the ultrasound I went and completed the usual routine before Dr. Terry came in to talk to us; they weighed me, took my blood pressure, and I did the protein urine check.

When Dr. Terry walked into the room he said, “What are your plans for this weekend? It looks like you might be meeting your babies.”

Chris and I were completely floored. We were not prepared to hear that news.

Dr. Terry explained that in the ultrasound they discovered there was growth discordance and Baby B’s umbilical cord showed intermittent absent diastolic flow. Simply put, there were problems with how the placenta was functioning and it affected blood flow through the umbilical cord to the baby. When my heart pumped, blood would flow through the cord to the baby and when my heart was at rest (in-between beats) the blood should continue to flow through the umbilical cord to the baby. But, sometimes, for some reason, it cuts out for a second. This is associated with fetal growth slowing down or stopping.

If the umbilical flow got worse, and turned into reverse blood flow, it could cause distress to the baby and would require immediate attention and a preterm delivery to avoid the possibility of "fetal demise."

Dr. Terry originally had planned on checking my cervix at the appointment to see if I was dilating, but he said he wasn’t going to bother because I would be delivering via c-section. Dr. Terry was flying to WA that evening for his grandson’s baptism, but he said he would be on the phone following everything with me. He would be back on Tuesday, and if I was still pregnant, he wanted to schedule another appointment to see me. He had his nurse Cyndi walk us downstairs to the Maternal Fetal department to have a Doppler ultrasound (umbilical blood flow is measured through a Doppler ultrasound) performed by a Maternal Fetal Specialist. Dr. Marc Jackson came in and met with us. Everything was happening very quickly; and Chris was supposed to leave for the airport. Dr. Jackson said they might be admitting me to the hospital that day and the babies could be born very shortly.

Chris was unsure what to do; the Dr. said he wanted to keep the babies inside me as long as possible to give their little lungs more time to mature, yet also said we could be going in for an emergency c-section right away. They planned to give me a betamethasone steroid shot to help the babies lungs and hearts, and ideally they’d like the wait 48 hours until after the shots are administered to deliver to give time for them to take effect in the babies.

At this point, I was starting to get a little panicked, especially at the thought of Chris leaving me for the weekend. He called his boss Jason, whom he was supposed to meet at the airport, and decided to stay home for the weekend with me. This helped settle my nervous heart!

We went in for the Non-Stress Test and on the monitors both babies looked strong and had healthy heartbeats.

The Dr. decided rather than admit me to the hospital, I would come back the next day for another Doppler ultrasound and Non-Stress Test (NST). I received the first round of the betamethasone shot and we finally were able to leave the hospital around 3pm. We were both starving and exhausted. We went to Chick-fil-A for lunch then stopped by my sister Mikey’s house. My parents were flying out to Maine that afternoon to visit my brother Nate and his wife Laurie. We updated everyone and they were all very concerned. (Especially my mom!)

That night Chris gave me a priesthood blessing. In it he stated that the babies would come at what was the right time for them. It helped me realize that they were coming early and that all would be okay and happen in the right time frame. It calmed my fears and helped me to prepare for their early arrival.

On Friday (the next day) I went into work at Verisys and even though I had already submitted my two weeks notice and my last day was scheduled for the following week, I told them that that day would be my last day with everything going on. It was raining and Chris came and picked me up early because we wanted to get some errands done before leaving for the hospital. We stopped at the Lighting Store and ordered new lights for our kitchen and living room.

That night was the BYU v. Middle Tennessee State football game. My appointment at the hospital was in the early afternoon, so we packed our overnight bags for the game and the plan was to go to the appointment at the hospital then go straight to the Provo for the football game. We met with Dr. Flint that afternoon and he really wanted to admit me to the hospital that day. After the NST showed the babies heart-rates were strong and they were doing fine inside, he allowed us to leave; but we had to come back each day of the weekend for NST’s. I received the second betamethasone shot.

We went to Provo and the game was fun; we destroyed Middle Tennessee state. We enjoyed being at the game and spending what might be our last Friday night kid-free. The next morning we woke up and drove straight to the hospital to meet Kathleen our nurse for an NST at 11 am. Babies looked great; we went back again Sunday morning and Monday afternoon for NST’s.

On Tuesday afternoon we went in for our appointment with Dr. Terry. He was at a family member’s funeral and wasn’t able to come into the office, but he spoke on the phone with Cyndi about us. He was worried because I had not had a Doppler scan over the weekend, which he thought he had ordered. So the ultrasound tech took us back, and while on the phone with Dr. Terry, she walked him through everything she was seeing on the ultrasound. Cyndi instructed us to come back on Wednesday and start with a Doppler and NST downstairs in Maternal Fetal medicine and then go up and meet with Dr. Terry afterward.

So on Wednesday we went in for a Doppler scan and on it the absent flow looked worse than the week before. It was still intermittent, but it was occurring more frequently. Dr. Jackson said the wave pattern looked like Haystack Rock on the Oregon Coast; and you don’t want it to look that way with big peaks. Rather, the blood flow is supposed to be a continuous flow.

We went upstairs to talk with Dr. Terry and he explained that they would be monitoring this very closely day by day. With the intermittent absent flow if Baby B still looked good on the NST we can usually wait another day. But as soon as reverse flow showed up it would be an emergency c-section. Because the absent flow was progressively looking worse, Dr. Terry told us to come in the next morning (Thur) at 8 am for a Doppler and come prepared for a c-section.

Again, Chris was scheduled to fly to New York for a Conference. He felt a lot of pressure from work to make this trip; especially if this weekend turned out to be like the last; a false alarm. We explained all this to Dr. Terry and we came up with a plan. If the next morning reverse flow showed up, I would be going in for a c-section. If not, we could maybe buy a few more days. Dr. Terry said he thought it’d be ok for Chris to go. If I needed to deliver while he was gone, we could contact Chris and have him hop on the first flight home and they probably be able to wait a few hours to deliver the twins if they still looked good on the monitors. I still felt a little nervous, but knew Chris needed to go on this trip. Dr. Terry also explained that each additional day the babies were able to stay inside me was beneficial; until 32 weeks. At that point the risk would outweigh the benefit. So, at the most I would only be pregnant for another week and a half. (My 32 week mark would be Sunday Oct 13^th).

On Wednesday night we went on a date to Tin Roof Grill in case it was our last night before we became parents. We stopped at Carter’s and bought some preemie outfits for the babies.

On Thursday morning we woke up early to be to the hospital by 8 am. I was instructed not to eat anything after dinner the night before, so I was extra shaky from the nerves as well as the low blood sugar. Chris and I each brought our suitcases and drove in separate cars; we were prepared for either scenario; if things looked good Chris could head to the airport, and if not, we were both packed and ready for the hospital stay.

When we got to the hospital and they took my vitals before the Doppler my blood pressure was 142. The nurse asked if I was normally in that high of a range (I am normally in the 120’s). She was worried about pre-eclampsia. I was really nervous so I figured that was just what was making my blood pressure spike. A new maternal fetal specialist came in and did our Doppler; Dr. Richardson. On the Doppler the blood flow looked fine. There wasn’t a sign of absent flow. It was kind of surprising because so much absent flow had been present the day before. Dr. Richardson told us things looked great and he thought as long as the NST looked good that Chris would be fine to travel that weekend. The NST was perfect and my blood pressure went back down to the normal range.

Looking back now, I realize that Doppler ultrasound reading was a tender mercy. Chris was able to complete his business trip and get some valuable work done and I was able to enjoy a relaxing weekend and watch General Conference and get some projects done before the babies came.

While Chris was gone my sister Mikey went with me to my NSTs on Friday and Saturday. The twins were so active on the monitors! I never really worried about how they were doing inside, because I could feel constant movement. Both their heart rates were strong and they showed great accelerations. I tried to enjoy everything about being pregnant because I knew it wasn’t going to last much longer. I felt Brayden move a lot! His little head and bum kept going up under my ribs on the right side. With the NST’s done everyday it was really fun to watch how the babies changed position. One day they were both transverse across my belly with their heads and chests together, and Brayden’s legs went up and Sydney’s went down. The next day though, Sydney was completely head down and Brayden was feet down. They were in a yin-yang position with their chests together.

While watching General Conference I made headbands for Sydney and started making a BYU blanket for Brayden. I also made several burp cloths.

Chris flew home Sunday night; and had an adventure getting home. He was scheduled to fly out of Newark, but when he got into the taxi he accidentally told the driver LaGuardia. He didn’t realize his mistake until he made it through the security line and showed his ticket and they told him he was at the wrong airport!

So he had to take another taxi all the way to Newark airport. Luckily he made his flight and got home safely late Sunday night.

Monday, October 7 DELIVERY DAY

Our appointment was scheduled for 1pm. Chris went into work and I spent the morning tidying up the house, worked on some more crafts for the babies', showered, and ate lunch. Before picking up Chris and heading to the hospital, I put together all the things I would need for my hospital bag, but I didn't take the bag with me. I guess I was denial that it could possibly be the day.

As soon as we went in for the Doppler ultrasound, Chris and I could tell right away from the monitor that things didn't look good. The absent flow had progressed into reverse flow.

Dr. Jackson came in and double checked the Doppler monitor. He asked when the last time was I had eaten; I told him I had lunch just before coming in. Oops. The hospital likes to wait six hours after eating to perform a c-section. He decided to put me on the Non-Stress monitors to make sure Baby B's heart rate was still strong and having good accelerations. If he showed any signs of distress they would take me into the OR immediately.

On the monitor both babies looked strong, so we just sat and passed the time chatting with the nurses in the Maternal Fetal Medicine department that we had gotten to know really well over the past two weeks of coming in for daily monitoring.

Around 3pm they sent me downstairs to be officially admitted to the hospital and start getting prepped for surgery.

Last pictures of the twin belly before changing into the hospital gown

As we waited for time to pass I began getting more and more nervous. The wait was the worst part. My blood pressure started creeping up again to the 140's. Julie, my nurse asked me about pre-eclampsia again and had me do a protein urine test. It was negative. When I get nervous and anxious my blood pressure goes up. I think it was all just nerves. Chris gave me a priesthood blessing to help calm my fears and anxiety.

We called my sister Mikey and had her go to our house and pick up our hospital bags and bring them to us. My parents were flying back in that night from visiting my brother Nate in Maine and we decided not to tell them what was going on until after they landed, because I didn't want my mom to be worried the whole flight.

Finally a little before 6 pm it was "Go-Time"

It was a really weird feeling walking into the OR and seeing all the instruments ready for the surgery.

The OR we delivered in had these pass-through windows that opened up directly into the NICU. Each baby had a neonatologist, nurse, and respiratory therapist waiting.

Dr. Terry arrived and I immediately felt much more secure with him there. He is a giant, friendly man who I teased looked like the jolly green giant in his green scrubs.
The anestiologist started the spinal block. My legs tingled and my left leg felt really warm and heavy, but I could still move my leg and wiggle my toes on the right side. I asked the anestiologist about it, and he told me not to worry because some people can still wiggle their toes with a spinal block. But I could feel the cold air and could move pretty much my whole leg around. I got a little panicked when they started to drape my stomach and prep for the surgery. I again explained that I could feel my right leg. The anestiologist did a cold test and a prick test on my leg up to my belly. I could feel almost everything. He said that was really strange.
So, he took out the spinal block and started over again. That wasn't very fun.
The second spinal block worked much quicker and both legs became warm almost immedately- phew!
I was surpirsed how quickly they got everything set up after that.
Chris sat on my left side next to my head. He started off sitting down, but he kept creeping his head over and eventually just stood up so he could see what was happening. With the drape up close to my face I remember feeling very claustrophobic and that I just wanted to run away. This lasted for a few mintues, then turned into a foggy sleepiness. I was vaguely aware of some pulling. I turned my head to the right and felt like I just wanted to fall asleep and everyone to stop bugging me. I heard talk Dr. Terry say something about Baby A and heard a tiny baby cry, but it seemed really distant and only lasted for a few second. Then Dr. Terry said Baby B and I heard another cry from far off, but that too was gone. Chris explained later that he was surprised how quickly they got the babies out of my tummy and passed through the window.