Friday, August 1, 2014

The Twins: The birth story

Like usual, I woke up to pee at some point during the early morning. Quickly though, the awareness of a gushing sensation hit and I leapt out of bed. That's pretty impressive since I had long since stopped leaping anywhere. I thought it was my water breaking but when I went to the bathroom I could see that it was blood. As it streamed down my legs, I heard a splat as a golf ball sized clot hit the floor.

It was about 5:45 am on the weekend, so I called out to my hubby who was dead asleep.  Of course, his confused face made me smile but he quickly switched into go mode. He started to rush around and lamented that we hadn't gathered a bag together. I laughed and pulled out my already packed bag and listed off the last minute things we needed. My sister had arrived the night before for her spring break and was sleeping next door to E. This was handy as we quickly whispered to her that we had to go and then hubby ran down to the basement and told Granny.

I called the doctor's office immediately after I made it into the vehicle. With a forty minute drive, I knew that would be plenty of time to hear back from the doctor. The answering service said we'd hear back from the doctor within thirty minutes to find out if we should come in or not. I laughed and said we were on our way regardless. This time around, there was no way  I would ever let someone dissuade me from getting checked out. While the on-call doctor was not mine, I had many friends who saw Dr. S and loved her. I breathed a sigh of relief that I wouldn't have to deal with the two who drove me a little crazy.

Since it was six in the morning on a weekend, there was nobody on the road. Hubby drove his typical 10 miles over the speed limit and didn't even yell at anyone until the last turn before the hospital where we were sitting at a red light with no one coming in either direction. The ride was pretty uneventful, but I tried to stay still so that the blood didn't leak out of the towel I had strategically placed. Hubby dropped me off at the door and then went to park. By the time I had gone about ten steps, he was already back and pulling out a wheelchair. I blew it off saying that it wasn't that far, but he insisted. It was a good thing too since it's much further when you're squeezing your legs together to keep the blood at a minimum. Yes, I was not entirely realistic....I can't imagine why. :)

The triage nurses were expecting us and took us to the tiny intake room. There wasn't much in my record for the nurse to find since my preadmission appointment was scheduled for the following Thursday. Whoops. She checked to see if the bloody flow was amniotic fluid but couldn't tell since there was so much blood. Pretty quickly, they went ahead and moved me to an antepartum room. The doctor came in almost immediately after and asked me if I was nervous. For once in my life, I honestly wasn't. From the beginning of the pregnancy, I knew this day was coming.

The nurse and the OB calmly and methodically checked us out. The OB took a look at the babies with an ultrasound machine. She examined the blood clot that I had wrapped in toilet paper and threw in a plastic baggie. The OB told me that I would be in the hospital from now until the babies came. She said this gently to me like I would be surprised or upset. I smiled and said, "I figured."

Next the perinatologist showed up and did another ultrasound which still showed the babies as doing fine. He explained that the bleeding could be a tear in my cerclage which is why they didn't want to put one in the first place. Alternatively, he indicated that the placenta could be detaching which he couldn't identify from the ultrasound. Meanwhile down below there was still blood slowly trickling out of me.

The OB and the peri talked back and forth about the cerclage and then decided to take it out. They propped me up on an upside down bedpan for a better angle which SUCKED. Between the pain and the nausea/dizziness from cutting off the blood flow from laying flat, I wanted to kick their asses. I swallowed the urge until they adjusted the speculum which caused what felt like a flap to extend in the wrong direction. I have no idea what it really was but it about made me come off the table. They finally ponied up and got the stitch out.

Afterwards, they rolled me on my side and started to check the babies again. The doctors were talking about keeping the sheet to weigh the blood to get a good estimate of my blood loss. It was then that I felt a huge clot slip out and then a huge gush of blood. I looked up at my hubby and he was staring at where the blood was flowing. He looked up and the doctors who were across the room, pointed towards the blood, and said this can't be normal. I felt terrible so I laid my head back down. By this point, the nurse who was working on the ultrasound finally got a read on the babies. This part is pretty blurry to me, but I remember the doctors talking, the babies' heartbeats dipping, and then the peri saying, "We need to go now." I glanced over my shoulder at my hubby and was already rolling out the door and into the OR.

The anesthesiologist started explaining to me that we didn't have time to do a spinal and would be putting me out as soon as everything was ready. People were piling into the room and several introduced themselves. The anesthesiologist kept talking to me explaining that each baby would have a team working on them. I laid there desperately wanting to be put out because I felt so bad and wanted it to be over. However, I knew they had to wait until the last minute so that the babies wouldn't be affected as much by the anesthesia. So I sucked it up and waited those horrible minutes staring at the ceiling. Finally they gave me the dose of medicine and it took longer than normal for me which gave me time to think about them cutting me open before it took effect. Awesome. I was pretty out of it at that point, but I remember thinking about the babies and having immense faith in the skill of the doctors. I was right about that.

Apparently it didn't go so well in the OR, and I woke up in the ICU.

While I was blissfully unaware of everything going on, my poor hubby was sitting out there waiting. After the peri had indicated that we needed to go, we were out of the room incredibly fast. The room emptied out and he was still standing there. He went to the door and a nurse came back to tell him that he couldn't go with me. Afterwards he told me that he realized he hadn't even had a chance to say anything to me before they whisked me away. He waited there until they had the babies out and then they had him wait by the elevators to go up to the NICU with them.

The next day, the doctors told me what happened. Over the course of a few days I heard a couple of different perspectives from the OB, the peri, the anesthesiologist, and later on a NICU nurse. I kept asking because I felt a need to reconstruct their emergence into the world since I missed it...

Neither baby was that easy to get out, however baby boy N was first and not as difficult as his sister A. By the time they managed to extricate her, the anesthesia had reached her, and she didn't wake up until hours later. One of the NICU nurses who was there told me they were just standing there waiting and praying for her. The kids were rolled outside the OR where hubby first got to see them and accompany them to the NICU. N only required a CPAP for breathing while A needed to be on a ventilator. N and A weighed in at a whopping 3 lb 7 oz and 3 lb 4 oz respectively. The kids were both stable so hubby snapped some pictures and headed back down to wait for me.

When the NICU nurses were rolling out of the room and avoiding the blood pools on the floor, the OB and the peri hollered for them to call another doctor in to help with me. I was hemorrhaging, and they could not figure out where it was all coming from. They were checking both where the placenta had abrupted and around my cervix. In an average c-section, a woman will lose about 1000 cc of blood. For me before the c-section, I had lost approximately 1400 cc and then lost another 1600 cc during the surgery. My blood pressure kept bottoming out and they ended up transfusing four units of blood. They finally stopped the bleeding right before they were about to move on to a hystrectomy.

When I talked to the OB the next day, I asked her if my experience was normal. She literally looked ill when she thought back to it. The look on her face was repeated between the different professionals that I had explain to me what happened. The OB and the NICU nurse were the most frank about it. Quite simply, it was bad. They thought they were going to lose me.

But, they didn't.

While I feel a bit like a drama queen saying this, the reality that I could have died and left my three children without their mother just rocked me. I've never in my whole life been so grateful to the medical professionals who took care of us. While I would never plan to have a delivery like this, I don't care about anything other than the fact that they saved us.

When I woke up in the ICU later that day, I felt pretty darn good. Most of the doctors and nurses seemed surprised that I rebounded so well despite everything. After the 24 hours that I was stuck in the ICU, I happily moved to maternity and was able to go right up to the NICU to finally meet the kids. Then later that night I was able to hold both of them during their feedings. It was amazing to finally hold my sweet babies.

Thanks for your patience with me getting the story out.