Sunday, May 31, 2015

Special Delivery

So, yeah, 7 months between entries is appalling, even for me. But, in my defense, a whole heck of a lot has happened since I last wrote. The biggest and best thing to happen? I became Mommy to two perfect little girls, who are now five  and a half months old. They are a blessing (and a challenge) every day, but our path to being a family was not easy.

There’s no way to cover everything in one entry, so I’ll have to rewind later on. So here are the highlights, so to speak. After my last entry in October, things started to get very difficult. School was quite busy; I was working on my YA novel, Life Unlimited, in an attempt to polish it for agents (something else that fell by the wayside, alas), and I began to experience complications in the pregnancy. You’ll recall that, other than that scary bleeding episode in early September, the pregnancy had been quite uneventful (steadily shortening cervix, but still not bad). I had little in the way of pregnancy symptoms, and even managed to go on an Alaska cruise for my 40th birthday in August.

That all changed in late October/early November. They had been monitoring me for the shortening cervix, and it kept getting shorter. The words “bed rest” kept getting tossed around, but I kept hoping for the best, and that I’d be able to make it through the semester and into the New Year (the joke was everyone telling the babies, “2015 is your year, not 2014!”). Then I was diagnosed with gestational diabetes in November. I was able to manage it with diet, and didn’t need insulin, but it was difficult (I like carbs, dammit!). Walking was also getting increasingly difficult. Not because I was really big, or anything (in fact, towards the end I lost a little weight), but because I would get abdominal pain after a few minutes of walking.

Then I began to itch – A LOT! I chalked it up to the dry indoor heat, and I just lathered on the moisturizer (to little effect). Even my friends, all mothers (and several moms of twins), said, “Use Eucerin!” None of us knew that this itching could be (and was) a sign of something much more serious.

When I went for a routine appointment on December 1st, a number of things happened. First, the ultrasound indicated that I had virtually no cervix left. I was also dehydrated, and my blood pressure was slightly elevated. I already knew what the doctor would say – bed rest. It was what I had dreaded most, and it was effective immediately. That meant I would miss the last couple of weeks of school, as well as final exams. Frankly, bed rest caused me more stress than going to work would have! But the other issue was that the next day, I was expecting the moving company to come pack out my stuff, to finally make the big move to Yonkers from the City. But no amount of bargaining would convince the doctors of anything but immediate bed rest.

Don’t worry, I haven’t forgotten about the itching. On that same day, I mentioned casually to the doctor’s assistant that I was itching like crazy. Immediately, she said, “You need to tell the doctor that.” I responded, “What? Is that a thing?” Apparently it was. The doctor ordered bloodwork, and a week later the verdict was in: Cholestasis. Basically this is an overflow of bile from the liver into the bloodstream. For the mom, it doesn’t mean much – just that awful, intense itching. But for the baby(ies), it can prove fatal after 35 weeks gestation.

I received that news on December 8th (the day after my shower, which I will have to write about another time), when I was 31 weeks and 2 days along. My doctor felt we could manage it with medication and, since I was due for an office visit and non-stress test the next day, she felt we could continue to monitor and rest for a few weeks. Unfortunately, that all changed on Tuesday, December 9th.

Maybe it was the stress of the move, and dealing with school stuff, and worrying about this new diagnosis, but when I went in that morning, I just sensed that I would not be going home, and I was right. Now, in addition to the diabetes, and the cholestasis, my blood pressure was through the roof. And the non-stress test showed that I was actually having contractions. The doctor sent me straight to the hospital. We thought it would be for a few days of bed rest and observation, but that was not to be.

I missed out on a lot of things by choosing to have my children in the way that I did. No dad. No grandparents. And no packing of a “go-bag” or planning my hospital trip or developing a birth plan. No. I just drove myself to the hospital that day, walked in, and asked for labor and delivery. Then I went upstairs, checked in, and texted a few people. Surprise!

Of course, the real surprise came the next day. On Tuesday, they just kept monitoring my vitals (which remained all over the place), and they told me I had to stay overnight so that the perinatologist could check me the next day. On the morning of Wednesday, December 10th, after once again checking my vitals, they brought me a breakfast tray. Minutes later, the nurse comes running into the room and shouts, “Don’t eat anything!” I said that I hadn’t because I was waiting for instructions. She said, “Good. If you need to deliver today, then you need to have an empty stomach.” Yeah, basically, my response to that was, “Wait, what now?”

Things moved, strangely, both fast and slow after that. By then I definitely had preeclampsia (my blood pressure had remained steady at elevated levels. They gave me magnesium to help with that and to try and slow the uterine contractions (I was now hooked up to all kinds of monitors). They did an ultrasound around late morning, at which point they saw that both babies were lined up, ready to come out (this was a switch because for most of the pregnancy, Twin B – Hayden – had been vertex, with the babies basically forming a T for “twin.”). What they also saw, though, was meconium. Twin A – Jocelyn – had passed fecal matter into the amniotic fluid. This was a potential sign offetal distress and posed a possible risk to the baby’s health.

By about 1:30 in the afternoon, they had decided that I needed to deliver the babies that day. Again texts and calls had to be made. And decisions too. I hadn’t taken the birthing class yet (it was scheduled for December 21st). In fact, when I remarked on that to one of the nurses, and said I would need to cancel. The nurse laughed and said, “I run that class. Consider it canceled.” The big issue was how to deliver the girls. The doctor said it would be better for them to be delivered vaginally. Now I had never imagined a vaginal delivery. You always figure that twins end up as a C-section. Plus. With my vaso-vagal syncope, I didn’t think I would be able to handle labor without passing out. But I wanted to do what was best for the babies, so I said I’d give it a go (they do it in the OR just in case they need to do a C-section after all).

That afternoon, they gave me more magnesium for the preeclampsia, while at the same time starting Pitocin in order to induce active labor. That was around 3:30PM. As I waited for the labor to progress, I emailed my boss and tried to get matters settled for the final exams. When he found out I was in labor at the time, he wrote, "How are you even emailing at a time like this?!" Hey, I'm nothing if not professional!

By 5:30, I needed the epidural (I’m no hero!). At about 6:30 or so, I was 4 CM dilated. Around 9:00, I decided to try and take a nap. I was exhausted and starving, and I figured that I had a long night ahead of me (first births are usually a long labor, right?). I couldn’t get comfortable and one of the fetal monitors slipped. The nurse had come in and was working on the monitor, when the doctor came in to check me again. To everyone’s surprise, I was 9CM, and he decided that I needed to go into the OR. I texted my friend Maria, “Time to scrub up!” and she hurried in from the waiting room where she, my brother Keith, and my cousins, Ann & Bill were having pizza. “I thought you were napping!” she said. “Guess not,” I replied.

By 9:45, we were on our way into the OR. BY 10:15, I had started pushing. At 10:32, Jocelyn was born. She had the umbilical cord around her neck, and the doctor basically told me and everyone near me to freeze while they removed it. I barely saw her as they whisked her away. Hayden had no intention of waiting and was out 5 minutes later. She made her personality known immediately when she grabbed the doctor’s stethoscope out of her ears as she was examining her (that’s my girl!). I got to see her and give her a kiss before they took her away.

They took me back to the room, and I could finally eat! My cousin Jeff (who shares a birthday with the girls!) scrounged up a couple of blueberry muffins from the pantry. I don’t even like blueberries, but these muffins were the best thing I had ever tasted! It wasn’t until 3AM that I got to see the girls in the NICU. Hayden was doing well, but Jocelyn was struggling a bit. My gut somehow told me that would change, and I was more right than I ever wanted to be. But that is a long (but ultimately happy) tale that must wait for another entry.