Thursday, July 29, 2010

Pregnancy, Delivery, Complications

So why start this blog now when the girls are already 9 months old? Well, have triplets. You'll see. It's a damn load of work! So I'll try to summarize the last 18 months in as concise a manner as possible. Then I'll try to keep up to date about the happenings "Live". ish. For those of you who find the mundane details about triple amounts of baby poop, spit-up, etc, you'll get a kick out of some of our stories. Otherwise, I guess I'm just writing this for myself and the girls. Perhaps someday they'll enjoy reading about what we went through trying to keep them healthy, happy, and somewhat sane.

My pregnancy was difficult. Twin pregnancies tend to be, I understand. There's a lot be done. Since I'm a big gal to begin with, the extra weight played hell on my joints. But the kicker was the "morning" sickness. I was as sick as a dog. For the ENTIRE pregnancy. No one told me that it could last the whole time!! Other than that, things were okay until August. My legs began to swell and my blood pressure started to rise. My urine output decreased significantly and started to contain protein. It appeared that I was in the first stages of preeclampsia. I developed gestational diabetes. That especially sucked because the only things I could keep down were bland carbs like crackers and potatoes. No-nos for diabetes. The doc put me on partial bedrest.

Meanwhile, Cassie's cervix was softening. Quickly. The doctor determined that she was actually the higher risk of the two of us and put her on restricted bedrest. I was still to lay down as often as possible, but she was only to get up to use the restroom. And that was to be as infrequent as reasonable. What a pair we were. Our wonderful friends brought us groceries and toiletries as we camped out in the bedroom with re-runs of Golden Girls and our baby shower thank-you notes.

My legs continued to swell at an alarming rate and it eventually became impossible for me to get myself into bed. We went to the doc who referred me to a specialist at Tacoma General Hospital who promptly admitted me. They ran scores of tests on me and the babies. They concluded that I had developed HELLP syndrome (Hemolytic anemia, Elevated Liver enzymes, Low Platelet count--a rare, life-threatening condition) and the babies must be delivered immediately. I was 35 weeks along. The physician on-call did not believe we should take the time to induce me. She was concerned that my blood pressure would continue to rise and I could suffer a stroke. So, we prepared for a C-section. I was very disappointed. In addition to having a significantly longer recovery period, I knew that a vaginal birth would be beneficial to the respiratory function of the girls. They were going to be premature anyway, and I was worried about their breathing. But it couldn't be avoided, so they sliced 'em out.

October 22, 2009--Devynn was born at 12:02 a.m. She was 17" long and weighed 5#, 6 oz. She had nice color and a healthy, super-loud cry. Delaney was born at 12:04 a.m. She was 17.5" long and weighed 5#. She was gray and her cry was weak. They let us look at her for just a moment then rushed her to the Neonatal Intensive Care Unit. They allowed us to take Devynn to the recovery room. However, she was clearly laboring to breathe. Within the hour, she joined her sister in the NICU.

My stay in the hospital was average for a post-Caesarean delivery. I was still really swollen, in fact, I weighed 2 pounds more the day after the girls were born then I had the day before. Bummer. After 4 days, the doc ordered my incision staples to be removed and I was released. Because we live over an hour away from Tacoma, we were allowed to stay at the Tree House, a facility which is set up for families with children staying at the hospital. It is an amazing place. Anyone who wants to contribute to a fine charity, I recommend sending your pennies to the Tree House.

Devynn was doing quite well in the NICU, and was soon moved upstairs to the Intermediate Care Nursery. Delaney was struggling a bit more. Upon her arrival in the NICU, she was put on a CPAP to force air into her lungs. She soon developed a tear in her left lung and a chest tube was inserted. The physicians tried for two days to encourage her to breathe on her own, but ultimately, Delaney had to be placed on a ventilator. This was a discouraging development for her moms. We were overwhelmed to think of this little delicate angel with a tube in her chest, a tube in her throat, a tube in her navel (for feeding), and IVs in her feet.

But that Delaney, she's a fighter. She was only intubated for three days before she was breathing on her own. A week later, I went to the ICN to feed Dev, and there was Delaney in the isolette beside her! She's tiny, but she's mighty!

Devynn was growing well during this whole event. She was very flexible and happy. Liked whoever was holding her, LOVED the male nurses and doctors, and brought me to tears everytime I saw her. Not having the ability to hold Delaney at all, I spent every second I could with Devynn, even though the nurses would only let me hold her for about 30 minutes every two hours. I just sat next to her incubator until I dozed off every night. She, like her sisters, was perfect.

Cassie was still on bedrest, but not being a very obedient patient. She wanted to spend time with her daughters, but we certainly didn't want Drew to be premature. We knew now how terrifying that could be. She was preeclamptic so did her best to obey Doc's orders while still visiting the girls whenever possible. Her blood pressure was beginning to rise and she was one miserable girl. She also had significant edema and couldn't get comfortable in any position. We figured Drew would be coming along shortly.

The afternoon after I was released from the hospital I noticed that the waistline of my pants was soaked. It was a very strange sensation. I knew that the body did some weird things post-birth. But...seep? What the hell? I asked Cassie to look at my incision. It had re-opened. I lost control at this point. I had tried so hard to ignore the serious nature of the pre-eclampsia, the HELLP syndrome, etc., but seeing my "guts" (as Cass put it...more accurately, it was just fat) sticking out pushed me over. I was a sobbing mess. Cassie dragged me up to the hospital where they attached a "Wound Vac" to the incision. This involves packing the incision site with a special gauze, taping over the entire thing with shrink wrap, and attaching a tiny vacuum that sucks out the fluid. It deposits the "gut-juice" into a little plastic tank on the side. Everyday, I had to return to see the wound nurse, she would dump the juice, repack the wound, and send me on my way. This process was not as pleasant as it sounds.... Not only is it incredibly disgusting, it hurts like holy rolling hell.

During one of these sessions, my nurse looked at my legs--still swollen--and said, "your legs have gone cellulitic. You'll have to be re-admitted." I was sent to admissions and my swollen ass, gut vacuum and all, was put back in a hospital bed for two more days to get intravenous antibiotics and diuretics. I was released, went upstairs, and sprang my two beautiful girls from the ICN. They were coming home with me!

Cassie was in and out of the hospital with tests on her and Drew. They wanted to get Drew out as soon as possible as Cass' blood pressure was not great, but Drew's lungs weren't quite ready. My sister-in-law was helping me with the twins as Cassie was brewing Drew. They finally induced Cassie on November 6 (Grandma Coyner's birthday!). She pushed for hours, but Drew wasn't having it. So at 12:12 p.m. on November 7, 2009, Drew arrived via c-section. She was 19.5" long and 7#, 6 ounces. She had more hair than any child I've ever seen and came out screaming bloody murder. She wouldn't let anyone but Cassie or I hold her and she was feisty from the first breath.

We took the family home after Drew was released from the hospital. Drew was badly jaundiced. She spent a couple of nights under the bilirubin lights and seemed to have improved. When we got home, we took her to the pediatrician for her first check-up. Before they even made it home from the appointment, the doctor called and said she needed to be admitted to the hospital immediately for critical bilirubin levels. This was our fifth separate hospital admission. Cassie was disconsolate. Our beautiful babies were going through way too much to bear. I remember thinking, if we make it through these first few weeks, the rest will be a breeze.

But the challenges were just beginning.

Wednesday, July 28, 2010

A Little History...

It all began in 1999. I'll spare the details of how we met, and all other minutiae related to our relationship, living arrangements, family, etc. That'll all come out in other posts, I'm sure. But I met Cassie while living in Montana (of all places). We got along very well and we fit together as an unlikely, but delightfully complementary couple.
We agreed that children were definitely in our plans, hopefully very soon. So we began the process that same sex female couples must endure--finding a donor, drawing up agreements, negotiating the embarrassing realities of dealing with ovulation cycles, sperm, and at-home insemination. A month became two, then three, then 12. It was frustrating, but not yet daunting. We sought medical assistance and began the mental running total of what would soon be a surprisingly expensive and emotionally exhausting venture.
Over the next 9 years, Cassie and I each attempted to conceive. Our little journey involved copious methods of diagnosis and treatment--including intrauterine insemination, excrutiatingly painful and invasive tests, countless rounds of oral medications, numerous cycles of injectable hormones and drugs, four sperm donors, three clinics, and, in Cassie's case, even surgery.
Anyone who has struggles with infertility understands this path and knows it too well. It's hard to verbalize the emotions which come up when our bodies fail us in this way. Life, in whatever form, is the only given in these bodies. And the desire to reproduce life is one of our basest instincts.
As our friends bought homes, paid off their student loans, and grew their 401ks, Cassie and I were putting all the extra scratch we had into the baby making fund. We charged up and paid off one $10,000 credit card 3 times.
25 years old soon became "mid-thirties". We were both very aware of the ticking of the clock. We had discussed adoption, but we were really "craving" a baby (selfish, admittedly) and adopting a baby was every bit as expensive as in vitro fertilization (IVF), a method which had always seemed financially out of reach. As our 35th birthdays approached, we decided to fire up the ol' credit cards a final time and invest in IVF. We swore this was it. No more. If we were unsuccessful, we would travel more, see the world, and then move closer to our nieces and nephews in an attempt to experience children vicariously.
We found a clinic nearby which did a great deal of fertility research and, thus, could charge a bit less for IVF. We met with the doctors and the suggestion was made (by them, not us) that we take eggs from Cassie and implant them in both of us. We had relatively healthy uteruses, that was not the issue. By implanting in both of us we would increase our chances of taking home a baby. The chances of us both becoming pregnant was only 12-13%. It was a good plan. We paid our deposit, and started the process.
Fast forward about 6 months, Cassie and I are all drugged up--her body in hyper-ovulate mode, mine in ovulatory hibernation. We were devastated when only six eggs were harvested, and only two "took". These are signficantly low numbers for IVF. It's not unusual for 20 or more eggs to mature and about half of those typically become viable embryos. We knew at this point that if a viable pregnancy was not achieved we would have no "back-up" embryos to freeze for future use. We went in to the implantation a bit despondent, but trying to be hopeful.
Well, it worked.
And then some.
The egg implanted in me actually split. I was pregnant with identical twins, and Cassie was pregnant with a single pregnancy. We were due Thanksgiving Day, 2009.