Plan B

I never made a plan B.

The boys were to come on April 8th at our chosen hospital with a level 3 NICU (just in case).  I had decided that they would be at least 6 pounds a piece and we would all be discharged home together at the same time.

Sunday, March 20th, my blood pressure started to climb until it was over 160 systolic.  I had a headache and the swelling had gotten out of control.  I no longer had legs.  They were just tree trunks all the way down.  I had 3+ pitting edema from the belly button to my toes.  My weight gain was 10 pounds in the last 10 days and because of this swelling, I was constantly dehydrated even though I drank like a fish.  I went in for monitoring yet again at the hospital.  They found protein in my urine.  All this was adding up to an early case of preeclampsia.  They gave me more IV fluids, ordered a 24 hour urine to be collected the next day, then sent me home.

Thursday, March 22nd, I worked half a day, and decided that I just couldn’t do it any more.   Even a desk job was impossible to do now, I was so uncomfortable.  I had to pee every 30 minutes and getting to the bathroom was proving very difficult with my fatigue and dizziness.  I saw my OB later that day, who discussed the results of the urine with me (there was protein, but not enough to be considered preeclampsia YET) and took me off work officially.

That night, the boys were quite feisty.  The one in my pelvis, Kyle, was really going crazy.  I remember telling DH that I had to pee NOW, then sitting on the toilet and just dribbling urine for a long while.  I laughed and told Kyle to get off my urethra so I could pee properly.  When I stood up is when I saw that I was not dribbling urine; the toilet was filled with blood.  I called to DH, telling him we had to go to the hospital NOW and to grab the bags.

We contemplated for several minutes, as we drove, whether or not to call 911 (I didn’t want to because I knew they would refuse to bring me to my hospital and take me to the local one with a level 2 NICU)  I called my doctor to let him know we were on the way and needed him to meet us there.  DH called 911 and met the paramedics at the fire station.

Sure enough, they brought me to the closest hospital.  There was definite decreased fetal movement from both boys and I was now passing large clots.  My BP was 230/110 and I could not stop the involuntary shaking and I was getting hysterical.  I remember begging them not to die.

Apparently, Kyle’s placenta was all jacked up.  Part of it had separated from my uterus, while the rest of it was abnormally implanted (placenta abruptio and accreta).  When they cut me open, I am told that fluid from my swelling just drained out everywhere.  The surgeons just looked at each other.  The pressure as they pulled out my little guys was immense.  The anesthesiologist told me, a little too late, that I would feel an elephant on my abdomen.  That MF-ing elephant was huge!

The cries I heard were the most  beautiful things I’ve ever heard  in my life.  A feeling of relief washed over me and I started to weep.  They were alive.  They were breathing.

I was briefly presented with two babies, told to kiss them, then they were whisked away.  From listening to the surgeons, I could tell that I was losing a LOT of blood as they worked on removing the placenta.  My anesthesiologist struggled to keep the dividing curtain up as far as he could, knowing that I should NOT see what was going on (later, DH said he got a glimpse and it was horrifying).  I started to continuously vomit and feel very lightheaded and near unconsciousness.  I remember thinking that I was going to die right there on the table, leaving DH to raise two premature infants by himself.

The next few hours are a blur.  I remember them giving me blood transfusions and the pediatrician telling me how the boys were doing, although I only remember every third or fourth word.  They were in the “Special Care Nursery” on CPAP to assist with their breathing.

After surgery, my blood pressure continued to elevate.  They eventually put me on a magnesium drip, which made me hot as hell and feel like total garbage.  The magnesium, among other things, started to mobilize the extra fluid from my tissues into my blood stream, overwhelming my heart and putting me into pulmonary edema.  All this fluid was accumulating in my lungs and I couldn’t breathe.  They called a rapid response on me that night.  I got my friend, Mr. Catheter, back and they gave me IV diuretics to get rid of the extra fluid.  I lost 50 pounds in that first week including baby, placenta and fluid.  As of today, I still have about 10 pounds of edema left.

DH slept in the vacant bed next to me, head at the foot end.  When I asked him about that later, he admitted that he wanted to  watch me to make sure I didn’t die.

I slowly got better, was discharged, then continued to pump every 2-3 hours and visit the boys in the nursery. I had an  incredible amount of fatigue, to the point where I couldn’t even stop into the store to get a gallon of milk.  My incision, which we knew would open up and heal from the inside out due to the incredible edema and drainage of said fluid, opened up and became infected.  I had redness up to my chest.  They admitted me for IV antibiotics.  As I sat in the ER listening to the doctor tell me I needed to be admitted, I knew this could prevent me from seeing my babies.  According to policy, I would not be able to visit in the NICU if I was admitted anywhere else.  The ER staff fought to get me readmitted to the New Life section, even though that was unheard of.  But that wasn’t the end of it.  It was obvious that the nurses didn’t want me there.  Even though I routinely scrubbed in every day, they made a point of telling me to scrub in and forbidding me from doing skin to skin contact.  I was even told that I had to make sure to keep my incision covered.

Think about that for a second.   They wanted me to know that I had to keep my c-section incision covered.  Did they expect me to prance around the NICU WITHOUT PANTS ON?!

In short, they made me feel like a leper.  Then, I was sent to the wound clinic for assessment and treatment.  My OB wanted a wound vac.  In my experience, wound vacs are for extensive wounds like bed sores and diabetic foot/leg ulcers.  I thought this was way overkill and was sure the would clinic would not prescribe this.  Then they did.  My incision opening was not just down to the muscle.  It tunneled 14 cm under the surface and would never heal unless I had a wound vac for a couple weeks or had daily packing of the wound for a month or so.  After a call to the NICU to “ask permission” (insert extreme eye roll here), we chose the wound vac.  The tunneling actually healed up in a week, which was the first stroke of good luck yet.

The babies progressed slowly, having feeding tubes in and out repeatedly as they just couldn’t eat enough on their own.  Finally, the day came for baby B to be discharged after 24 days in the NICU.  Baby A came home 2 days later.  Even though we were now fully in charge of these two people and could not rely on the nursing staff to do feedings at night, having them home together was a huge relief and made care much easier for us both.

I’m still swollen and fatigued, but getting better every day.  The boys just can’t get the concept of nursing yet, so I am stuck pumping every 3 hours and feeding them with a bottle every 2-3 hours.  I only sleep 1-2 hours at a time.  There is an ungodly amount of cleaning that comes with pumping and bottle feeding.  And let’s not forget the piles and piles of laundry.  All that being said, I’ve never been so happy in my life.  I went through hell for these boys and they are the most perfect little things.

I think I’ll start a new family tradition of them giving me gifts on their birthday.  Lord knows I deserve it.