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.

Twin Hijinx

Generally, I post entries about topics that I would never say out loud and certainly not in polite company.  Today is kind of a rant about the difference between a singleton and a multiple pregnancy.  So, feel free to skip it.  It’s just nice to vent a little when you can’t to anyone in real life.

Now, I’ve never been pregnant before.  So I really have no comparison between a singleton and multiple pregnancy.  But I am 42 years old with depression, plantar fasciitis and severe degenerative disc disease in the low back that I’m told cannot be fixed with surgery.  I’ve tried to wean off of the Cymbalta that treats the depression and back pain simultaneously, but was only able to go from 120mg to 60mg before the depression got the best of me – so I’m stuck at 90mg.  This is a bit subtherapeutic for my back, but it’s a sacrifice I feel I need to make for the health of my little men.  So, we were actually happy that on our first chance, it was a multiple pregnancy.  I wasn’t sure how I was going to do this twice…and at an even more advanced age no less.

I’m an idiot.

From the beginning, this pregnancy has been very hard on me.  When it was triplets during the first trimester, the fatigue and nausea were debilitating.  Oh, and don’t forget the nearly daily migraines for which I could not take my beloved Imitrex.  We were so thankful that I had new job where I could sit with my feet up a good amount of the time.  One of  my coworkers recently expressed her amazement at how well I was doing because “we thought you’d be on bedrest by 13 weeks.”  I was living on vitamin B and Unisom, force feeding myself whatever I could choke down.

After I lost the triplet at the end of first trimester/beginning of second trimester, things improved immensely.  I figured I finally entered that golden bliss that was known as second trimester.  Yeah, with multiples, not so much.  Once I could eat again, I realized that the boys had rearranged my internal organs so that my stomach was about 1/5th the size.  So, the reflux, gas and burning of third trimester had already thoroughly established themselves.

Aside from that, the boys have grown very quickly – both consistently measuring larger than the average singleton AND I have consistently measured more than the 6 weeks ahead that twin mothers usually do.  At this point, I am 10 weeks ahead.  Their quick growth has caused a good amount of pain.  A muscle under my right breast separated and my right back ribs are strained to the point of ligament damage.  For a while, I had horrible hip pain from the round ligament stretching, but now it’s due to the relaxin.  So, I can’t sleep on my right, my left, my belly or my back.  I’m about to buy a hover bed…or a magician to levitate me.

As far as physical size, I’ve gained over 40 pounds and have gone from a Medium to an XL and those are starting to get tight.  I’m on my second set of maternity scrubs at work.  I don’t believe they make them in XXL, so I’m kind of SOL.

 

belly

Two nights ago, I woke up at midnight for…the same thing every pregnant woman wakes up for…and had some significant pain to the right lower abdomen.  I went to the bathroom to verify that there was no bleeding and no fluid leakage, then went back to bed, able to support my belly and minimize the pain.  By 2:30am, the pain was pretty intense.  I went back to the bathroom…nothing.  The pain was constant and I couldn’t straighten up.  It didn’t seem like contractions, but as this is exactly where the placentas lie, and one is low lying, I figured it was time to wake up DH and toddle off to the hospital.  I knew how it would turn out, but felt it was completely irresponsible not to go.

DH dressed in his work clothes, which made me giggle internally.  I knew darn well this would last until way passed the start of work.  Oh, the naivete of the male partner.

In the end, I was diagnosed with dehydration (I looked at my urinalysis, and that is not the case) and contractions (I watched the monitor and I had exactly 2 in the 6 hours I was there).  That was enough to buy me an IV.  Then, some OR staff walked in and asked if I was the one going for C-section.  I’m sure my eyes got comically wide as this was definitely NOT on my plan for today.  I’m scheduled for 4/8 and not a moment sooner, thank you very much.  Yeah, they were in the wrong room.  Not a great confidence builder, in my opinion.

When the doctor came in to discharge me, I asked what was up with this pain I was having.  She blamed it on the growth of the twins and shooed me out.

Oh, and my favorite part was the night nurse nagging me about scratching  my belly.  “Look, you’re making little blood trails.  You don’t want an ugly belly!  You need to use lotion.”  I restrained myself very admirably.  I wanted to scratch her face off.  Number 1, I use cocoa butter twice a day and I use so much, all my clothes and bedding are stained with the stuff.  Number 2, I’m fat and hideous.  What are a few scratches going to do to my bikini modeling career at this point? F-U, woman. F-U.

Well, the pain is still there but less intense.  Oh, and it’s on the left side as well now.  Yet another ligament injury, I suspect, from the rapid growth.  I have NO IDEA how moms of high order multiples do it.  I am so miserable I find myself in the bathroom crying in pain at least 2-3 times a week at work.

So, comments from coworkers that have made me want to turn into a banshee:

  1. I have a reacher for things that I drop because I detest asking people for help.  I have it labeled “Tara’s Reacher” and “Mr. Grabby”…mostly because a coworker handed it to a patient thinking it was her version of a cane.  One of my less-than-subtle coworkers asked why I needed it. “You’re pregnant, not disabled.”  Cue Look of Death.
  2. The same coworker said to me just the other day, “you don’t even look pregnant”.  I beg to differ.  I’ve been wearing an XXL men’s winter coat that masks my body shape and makes me look like I’m a smuggler.  Strangers have commented on my being pregnant WHILE IN THAT COAT.  I’ve had complete strangers touch my belly while in my scrubs and ask about the baby.
  3. The other woman at work who is on her third pregnancy, 2 weeks ahead of me and is carrying twin girls, keeps insisting that she’s bigger than me and I don’t even look pregnant.  I want to tell her that this is because she’s still squeezing into her size S scrubs and, as I mentioned before, I’ve upgraded to an XL that is QUICKLY getting too tight.  I like to hide as much of my figure as I can, especially since I’m now in a 38G bra with extenders.

Why does this bother me?  Probably because it is immensely difficult for me to deal with the reflux, the extreme shortness of breath (especially when baby B crawls up into my ribcage for a nap away from his brother), the overwhelming fatigue that causes me to sleep all day long when I’m at home, the pitting edema to my legs despite the compression stockings I use daily, and the continuous, nagging pain that never goes away and won’t until these little guys are in cribs.  To deal with this, my age and my bad back carrying 40+ pounds extra AND work 10 hour shifts full-time is quite a feat and I feel belittled when told that I don’t even look pregnant.  Plus, I feel like people are comparing my pregnancy to their singleton pregnancies they had when they were younger, fitter and stronger.  I want them to walk a mile in my now size 10 shoes (from 8.5) before they open their mouths.

Or I should just remember my hormones are raging and chill the F out.

 

26 week milestone

1518882745v0_250x250_Front_Color-White_padToSquare-true

Today we’re officially 26 weeks…me and the boys.  They could be born today and have a 80-90% chance of surviving.  This decreases my anxiety quite a bit, but, as I’ve read, we IVF Mom’s tend to worry more than other Moms every single step of the way.  We’ve been through enough heartbreak and tragedy that we do not take any of this journey for granted.  That being said, I’m having a lot of fun.

They have gone from little butterfly kickers to rabid weasels tied in a pillow case.  They are actually PAINFUL.  One likes to cuddle up into my ribs and decrease my lung capacity to half and the other thinks Bertha (my uterus) is his personal DoJo.  I have gone from a little paunchy to freaking humongous.  I no longer fit into my size 10 pants at one point, so I brought out the 12s.  I no longer fit into the 12s, so I bought size large maternity clothes from thrift shops.  I have now OUTGROWN MY #@^$% MATERNITY CLOTHES and have had to buy a new set in XL.  Apparently, my ass is pregnant too.  There’s a set of twins back there, presumably girls, just to keep things balanced.  And, speaking of “balanced”, there’s no such thing in pregnancy.  I am truly a T-rex, just flailing around, running into everything, knocking stuff off tables and shelves, then just staring at said items. “What falls to the floor, stays on the floor.”  My hubby told me to stand up straight for our last couple of belly pictures, so I had to look in the mirror to see what he was talking about.  I straightened my low back to a normal bend and promptly fell forward.

Sleeping is always an adventure.  I run a humidifier because the pregnancy congestion makes me mouth breath and snore otherwise.  I have a full bottle of Gaviscon in arm’s reach for the deluge of acid that likes to sit in my esophagus.  (There’s actually a bottle in every room at this point.)  Then, I have 5 pillows that need repositioning whenever I turn.  I tried one of those big pregnancy “U-shaped” pillows, but the shape and bulkiness is just not flexible enough for my needs.  Now, let’s talk about the turning in bed. I’ve started sleeping on what a nurse would call a “draw sheet” so that I can pull on it and help myself turn.  Otherwise, I’m just a turtle on its back.  Don’t want to have to wake up hubby to help.  He’ll get his turn at sleep deprivation when the boys come.

index

 

But, with every hardship and every pain, I just smile and thank the boys for being there and being healthy.  How can I complain?

CVS

My previous post reminded me that I neglected to tell the wonderful, amazing, Fun-Time story of my CVS.

testing

It was heavily suggested that due to my age, we go through CVS to make sure there were no genetic problems with any of the little guys.  “But, we had PGS,” I countered.  Aaaaand, he countered back that PGS is not 100% accurate and he’s seen babies diagnosed with Down’s after PGS.  So, we chose a clinician out of Chicago (60 miles away) who is credited with bringing CVS to the United States from Europe.  According to reviews online, people seem to like him.  It seemed like a no-brainer.

My first red flag was that I requested pre-procedure instructions, which they happily provided:

  1. Be here 15 minutes early.

So…yeah.  Highly informative.

We rode the train in on procedure day, walked the 10 blocks to the office and presented ourselves at the front desk.  They asked me for a urine sample, which I HAPPILY provided, then went back.  They ultrasounded the boys for a good long time, trying to locate their little placentas.  How this is possible is beyond me.  I did very much enjoy this as I got to see my 2 inch long babies squirming around, practicing karate and one guy was actually bobbing up and down like he was on a trampoline (and then fell to the bottom of the amniotic sack like a rock at the bottom of a pool).  What I very much did not enjoy was their conversation.  I heard a good deal about the vacation that Mr. and Mrs. MD were about to take.  And about the packing.  And about the plane tickets.  “Did you drink water today?  Your bladder’s empty.”  (Remember those great pre-procedure instructions?  Oh, and remember they had me give a urine sample up front?)  And, dear God, what was that awful pain?  “Relax.  It’s just a CVS.  That doesn’t hurt.”

Did you seriously just jab me in the coochy with a catheter, then suck out part of my uterus…with no warning…and no explanation…then chastise me for being nervous and in pain?!  Seriously?!

index

Then the REAL fun began.  Remember, we’re talking about 3 placentas that needed to be sampled.  So, we moved onto the right abdominal site.  It may help to explain that I’ve had some residual pain to that right side ever since the third IVF cycle.  That stimulation seemed to really bother my right ovary, then during the retrieval, my bladder was perforated.  It’s been bothering me ever since.

So, he injected “lidocaine”, which did not burn at all and made me think he accidentally used saline.  “I’ll take the 18 gauge.”  I’ll remind y’all, I’m a former ER nurse.  That’s the needle size used for traumas, anyone heavily bleeding, or drunk people who have pissed you off.  The information quickly sunk in that he was going to shove a 3 foot long pointy branch into my delicate lady parts.

surprise-300x190

Now, I’ve had some pain in my life.  I’ve had steroid injections to both feet and PRP injections to the elbow.  Those hurt like a Mother, leaving me unable to use said body part for several days.  But I  controlled myself, stayed still and let the doctor do his thing.  This was something Completely. Different.  First off, he was very interested in his conversation…about himself.  So, I can totally understand why he didn’t think to explain what he was doing or WARN ME HE WAS ABOUT TO SUDDENLY JAB THAT F#$%ING NEEDLE AS HARD AND FAST AS HE COULD THROUGH MY UTERINE WALL!  I’ll admit it.  I screamed, and my legs bent up.  “That hurt?!  You have to stay still.  Put your legs down.”

So, DH did what he could to comfort me while I wept through the rest of the procedure, knowing that this was only sample 2 of 3.  Honestly, had he not been there, I would have gotten off that ultrasound table and walked out, never to return.  Everything I read on the internet advised me that this was an uncomfortable procedure that caused mild, tolerable pain.  This was definitely NOT that.

Thankfully, there was probably a reason for that pain over there, because the left side was not terrible.  Firstly, I now knew that he was going to JAB suddenly.  Secondly, I did not have preexisting pain there.

So, the procedure came to a conclusion, we looked at the boys again to make sure there were no deleterious effects from the procedure, then the ultrasound tech put little kissy shaped band-aides over the gaping puncture wounds.  …AND this was the extent of my post-procedure instructions.

Then came the fun trip – 10 blocks, to the train station, with Bertha (the uterus.  Get it.  BIRTHa?) cramping up a storm the whole time.  Thanks for the recovery time, guys.  That was special.

So, in the event I am ever faced with this procedure again, I’m thinking I’ll pass.  Thanks but no thanks.  And I’ll certainly never go back to this septuagenarian with unstable hands again.

Tell Me This is Sarcasm

…please.

90807793aba17332c8b838a46dbd01b1

More like:

Monday: Drag self to work and try not to fall asleep at any point.

Tuesday: Drag self to work and try not to fall asleep at any point.

Wednesday: Drag self to work and try not to fall asleep at any point.

Thursday: Drag self to work and try not to fall asleep at any point.

Friday: Drag self to work and try not to fall asleep at any point.

Saturday and Sunday: Wash whatever laundry is ABSOLUTELY needed in the coming week, then sleep the rest of the day.