Sunday, June 29, 2008

Friday, June 27, 2008

E-Mail Update #8 -- BABIES!!!

Many of you have heard by now that the babies are here! They were very timely, making their arrival on Wednesday, June 25, right at exactly 30 weeks -- our second goal due date. They also arrived on the anniversary of my seventh week in the hospital. Here are their stats (and in birth order):

Piper Grace: 3 lb. 2 oz., 15 3/4 inches long, 12:36 p.m.
George Henry: 3 lb. 15 oz., 15 1/2 inches long, 12:37 p.m.
Rosemary Faith: 1 lb. 14 oz., 13 inches long, 12:37 p.m.

Things happened very quickly. I felt my first strong contraction at 11:15, was fully dilated (to the doctor's GREAT surprise) at around noon, and had the babies less than 40 minutes later via emergency c-section. In the operating room I had two anesthesiologists, four ob/gyns, and two nurses watching me. The babies each had a team that consisted of a neonatologist, a neonatal nurse, a respiratory therapist, and two other people that I can't remember (it was a team of five for each baby). There was also a senior supervising neonatologist for all of the babies.

My mom had come down on Tuesday, and she was in the hospital room with me when everything went crazy. Luckily, the nurse who I had that day just saw me when it all started and knew something was going on, and she told Mom to call Gary and get him over here quickly (I missed that part, and was kind of surprised when Gary came running in). Gary left work in the middle of a meeting and made it just in time for the doctor to check me and announce, "Okay, sweetie, we are having these babies -- RIGHT NOW."

The UAB team was fantastic. I couldn't believe that we moved that fast. I was especially impressed that the ob/gyns made the call that I had enough time to get an epidural so that I could be awake during the surgery. Many times doctors in this situation will not look closely enough at the situation to determine whether or not that is possible and will put the mother under general anesthesia, which means the mom is not awake during the birth. These doctors not only took great care of me and our babies, but they also thought of me and made sure I had the best experience possible. The neonatal team also made sure that I got to see the babies after they were born before they went to the NICU. I was completely blown away by how beautiful all of these babies are!

The babies all started out breathing room air -- which is amazing for 30-weekers. Those steroid injections really did their job. Henry had to get a little oxygen help a few hours after he was born, but it was not for long at all and he came off the extra oxygen very quickly. Rosemary and Piper have not needed any extra oxygen. I was allowed to see the babies around 2:00 a.m. this morning (due to the surgery and waiting until I could sit up). We arrived at the most critical care NICU to find that Rosemary and Piper were no longer there -- they were moved to a stepdown nursery (which is a less critical care NICU). We were amazed. We were especially amazed that tiny Rosemary made it there before Henry! Henry was moved to the stepdown nursery a few hours later. We are told to expect them to stepdown again in a few days.

When we talked to the attending ob/gyn this morning, we learned why Rosemary is so little. Her umbilical cord did not pass through the placenta correctly, which means that she was not getting all the nutrients, blood, etc. that the other babies were. No wonder the poor thing wanted out! The neonatologists were actually encouraged by this because it means that there is not a problem with Rosemary herself -- there was just a problem with the "food" she was getting in there. The nurses all refer to Rosemary as the "fiesty one" of the three, which of course is no surprise to me.

The neonatologists have been amazed at how healthy these babies are, and we ourselves cannot believe how great they are doing. To my ultimate surprise, I was told today that it is possible that Henry could come home in just TWO WEEKS! We had originally been told 5-6 weeks as an estimate for all of the babies, so two weeks is almost beyond comprehension! Of course things can change, but so far we have some extremely healthy babies who are well ahead of the curve.

I am also pleased to attach some pictures of the precious ones to this e-mail. There are three pictures of each baby attached -- at birth when we first saw them, at 6 hours, and at 21 hours.

For now, we are not seeing visitors in the hospital. We are trying to spend as much time as possible with the babies, which means that we are not in our room very much and when we are it is for resting and getting medical care.

I will continue sending updates when I can. Thank you all so very much for thinking of us and keeping these babies in your prayers.

Piper at Birth:
Henry at Birth:

Rosemary at Birth:

Piper at 6 hours:

Henry at 6 hours:

Rosemary at 6 hours:
Piper at 21 hours:
Henry at 21 hours:

Rosemary at 21 hours:

Tuesday, June 24, 2008

E-Mail Update #7

Only three days since the last update. . . . I bet you're thinking that something must have happened! Well, the babies are still all inside, but I just have more to report now.

At midnight on Sunday night or Monday morning, whichever you want to call it, my water broke. More specifically, Rosemary's water broke. (When is it not that child causing trouble?) It was about as shocking to me as you can imagine. I've also now learned how to get every nurse in the unit in your room immediately -- just hit the little buzzer and tell them that your water broke. It was almost funny how fast everyone moved.

Now, in the movies, once the water breaks -- it's all over and the babies are born. Believe it or not, that's not necessarily the case in real life. At UAB, if a pregnant woman is 34 weeks or farther along and her water breaks, the babies are born. If a pregnant woman is less than 34 weeks along and her water breaks, it is called PROM (premature rupture of membranes) and the babies are born ONLY if the woman goes into labor -- and labor is no longer stopped at that point. Considering that I've spent the last 7 weeks in the hospital battling preterm labor, I was positive that my water breaking would send me into full-blown labor. Not so. For some reason, once my water broke, my cervix decided to stay stuck at 3cm. Of course, now it is even more likely that I'll have these babies sooner rather than later, but not much is happening now.

Most people have never heard of the baby staying in after the water breaks, and have in fact been told that the baby must be born in 24 or 48 hours to avoid problems with the baby, so I'll tell you what our doctors have told us. For a term baby, that is the case. For a premature baby, that is not necessarily the case. There is still some fluid around the Rosemary and more continues to build and then come out of the sac all the time -- but fluid is not absolutely necessary to babies at this point in the game. If the water breaks very early (around 16-24 weeks), then there is a high risk to the baby of lung development problems and also of deformities to the baby for not having as much cushion, among other risks. The risk of deformity is extremely low for us at this point because Rosemary is fully formed now. There is still a risk of lung development issues, but only if Rosemary stays in for longer than 2-3 weeks from the time the water broke (which no one really thinks will happen anyway). There is indeed a greater risk of infection, so I'm on antibiotics and being watched very closely for any infection. The babies' heartbeats are now more closely monitored, and the doctors are on the lookout for any placenta or cord issues with Rosemary. Around 32 weeks, they will start checking my amniotic fluid for lung development, and will deliver me as soon as lung development appears to be complete. So far, Rosemary, Piper, and Henry all look great.

One would think that the most shocking moment of that day was when my water broke. Not so. Later on, after I was transferred to Labor & Delivery, the doctor was doing an ultrasound to see which baby's water broke (I, of course, already knew it must be Rosemary). Then the doctor said, "It looks like your little boy on the bottom had the membrane rupture." And I said, "Oh, it's a little girl on the bottom -- her name is Rosemary." The doctor's response: "Well, Rosemary has a penis and is peeing right now." WHAT?!!! Seriously -- what part of that statement is not disturbing?!! I spent the great part of the rest of that night and yesterday strung out on drugs, wondering what gender babies I actually had in there, and hoping that we hadn't already scarred "Rosemary" for life. I was also planning to have my Mom immediately exchange the ladybug comforter for the frog comforter so that the poor child wouldn't come home to an inappropriate cribset. We have now this morning learned that was a MISTAKE and that Rosemary indeed is a girl (and Piper is a girl and Henry is a boy). Now that the babies are so cramped for space, it's hard to see what belongs to who, and apparently it was a shot of Henry peeing (yes, apparently they pee in there) close to where Rosemary's legs are. Just when you think you've heard it all. . . .

I will have an ultrasound next Monday for growth, and I will make sure the tech checks between the legs just once more to make absolutely sure that we know what we have in there. . . .

Tomorrow is 30 weeks!

I hope you're all doing well and having a great summer.

Sunday, June 22, 2008

Just Like You Were There

A few days before the babies were born, I all of the sudden wanted the cribs to be put together. I sent Gary home on a Sunday to begin the process. I hated not being there, but I wanted to know that it was being done. This is the e-mail Gary sent me from home that evening when he finished putting together Henry's crib, along with the attached pictures:

This thing looks like it has right angles everywhere, but it doesn't. You have to re-bolt every corner because the pieces just don't fit together. 2) Other than not being square, putting a crib together is pretty easy as long as you don't read the directions. The directions are a joke. I never saw or used part "I" and I used every part in the box. (it is super sturdy - don't worry) 3) There are no less than 50 warnings on the crib, in the crib box, on the crib directions and on the crib mattress. The effect of a warning wears off after about the fifth one. The most important one seems to be the one regarding the dimensions of the crib mattress, The crib mattress, however, has no dimensions listed. I measured the crib mattress, but it is squishy and you can change the dimensions by pushing on it. It looks like it fits to me. It is nice and tight. 4) Don't ever let anyone talk you into starting a crib business. This is a pretty nice freaking crib. It is the nicest one I have seen in person, and the price does not at all reflect the quality. I think cribs are a low margin business. Either we are paying way too much for every other piece of furniture in the house, or we stole this thing, Then again, I didn't have to put the other furniture together. The packaging probably costs as much to produce as the crib itself. I would expect the Mona Lisa to be shipped in something like the setup for this crib. Overall, there is just way too much production that went into making that crib for anyone to have made a decent profit on it. 5) cribs are really big. The room is almost full and we only have one crib put together. We may need a bigger house - or one less bar and pool table. 6) I can't wait for you too see it in person. You are really going to love it. It looks much nicer in the house than it did in the store. It will be the perfect bed for one of our little babies, or all of them if you still want to be able to walk in and out of the room.

I love you. I am going to take a shower and pick up up some dinner.

Saturday, June 21, 2008

E-Mail Update #6

Hello, everyone. As of today, I have made it to 29 weeks and 3 days! I can hardly believe it. Now we're less than one week away from our second goal delivery date, and we're more one week past the first goal delivery date. I am amazed and thankful and just really glad to still be here in the hospital and pregnant.

I had an ultrasound this past Monday to make sure all the babies have good amniotic fluid, and they are looking good. This coming Monday's ultrasound will be for amniotic fluid as well, then the following Monday the babies will be measured to determine approximate weights. Measurements of the babies are only done every 3 to 4 weeks to make sure that we are getting good measurements. Apparently measuring them more frequently can lead to inconsistent results.

From here on out, pretty much any time I have the babies, we can expect for them to come home from the hospital sometime around the first week of August. The neonatologist said that after 28 weeks that you can expect the babies to come home around the time that I would be 35-36 weeks pregnant. If they were born before 28 weeks, however, we could have expected a much longer NICU stay.

These babies are really getting anxious to get here. It's as if they're saying, "Okay Mom, you said 28 weeks and we did it -- now let us out!" My contractions have picked up a lot and seem to pick up more every day in frequency as well as strength. Up until this point sedation seems to work to slow them down. The new attending doctor on rotation for this past week and next week does not like using "narcotics" to stop contraction, so we have tried some different drugs to try to stop the contractions. They didn't work, but I also didn't become more dilated or effaced, so for now I'm to just deal with the contractions. Not fun, but so long as these babies stay inside for as long as possible, I can do it. I haven't been sent back to Labor & Delivery in the last week or so, so that's great. As of this morning, I'm still 3cm dilated and 75% effaced, but I was told on Tuesday that Rosemary has "dropped" since last Saturday.

I think we're going to make it past 30 weeks -- but how much past I don't know. Most of the doctors seem to think that 30 weeks will be about all I can do. The new attending doctor said that I could make it several more weeks and possibly go to 35 or 36 weeks. But she also had tried to send me home earlier this week, so I'm not sure what I think of her predictions. She had admitted that if I went home I may have to make daily trips -- or perhaps two trips a day -- to be checked due to the frequency and strength of my contractions. I still don't understand why this was considered a valid plan. I've been having contractions consistently 2-4 minutes apart for the last few days, but if I'm at home I'm supposed to come in to the hospital if I have more than 10 an hour, so I don't understand why they would send me home just to drive straight back.

Anyway, I told Gary about the plans to send me home, and he tracked the new attending doctor down to plead our case. Gary had told me beforehand that he was willing to go to jail to keep me in here, and I don't think he was kidding. Gary did a good job when he talked to the doctor and she has now agreed that she will not try to send me home until I am at least 32 weeks. Considering that every time I go home I come back in less than 24 hours more dilated and more effaced, we both think that if I'm sent home again that I'll be back to have the babies. Even the attending doctor said that labor probably wouldn't be stopped if I were dilated to 5cm -- and possibly even to 4cm, and I'm very close to that now. At least for now, I'm staying at the hospital, which I think is good news for all of us.

Well, this was not a very exciting update -- but in my position a lack of excitement is good! I hope everyone is doing well, and thank you for all of your good thoughts and prayers.

Wednesday, June 11, 2008

E-Mail Update #5

Well, I'm still in the hospital and no one is talking about sending me home, which is fantastic. Today I am 28 weeks pregnant! We are so happy to have met out first goal delivery date. Our next goal date will be 30 weeks, which will be here on June 25. My doctor told me last night that she thinks we are going to make it to at least 30 weeks, which is extremely encouraging.

The frequency of my contractions definitely increased over the last few days. The contractions really started picking up on Friday, and didn't seem to be letting up. On Saturday and Sunday my contractions were right around 2 minutes apart for quite a while, but thankfully some demerol helped slow down those contractions. Yesterday, when everything started up again, they decided to send me back to Labor & Delivery to get IV drugs to stop the contractions (I've been in the antepartum unit, and they don't have the nurse/patient ratio necessary to run IVs and monitor them closely enough). After several hours of magnesium sulfate, indocin, demerol, and antibiotics, I was sent back to my regular room in the antepartum unit in the wee hours of this morning. I'm feeling pretty good today with few contractions, but they will continue to monitor me closely. At my last check last night, I was just a bit more dilated at 3cm and remained 75% effaced.

An ultrasound tech came around and measured the babies on Monday. I was 27 weeks and 5 days pregnant when they were measured. Here are their stats:

Rosemary: 1 lb. 14 oz., 18th percentile for singletons, measuring 26 weeks and 0 days
Piper: 2 lbs. 3 oz., 36th percentile for singletons, measuring 27 weeks and 1 day
Henry: 3 lbs. 1 oz., 80th percentile for singletons, measuring 29 weeks and 4 days

And so Henry remains my little chunk. The doctors were more than a little surprised to see such a big baby in there (and yes, my belly is lopsided where Henry is sitting). And of course Rosemary is on the small side, which makes things a little weird. I have a baby measuring almost two weeks behind and a baby measuring almost two weeks ahead. Amniotic fluid levels for all of the babies are acceptable.

I am now going to be getting weekly ultrasounds to look at the babies and to check amniotic fluid levels. The babies will not be measured again for 3 weeks, unless something in the weekly ultrasound indicates that measurements should be done. The doctors said that for now the biggest concern is definitely the babies being born early, and that they are not going to worry about growth ultrasounds unless a pattern or problem presents itself.
Even though Gary and I are a little concerned about Rosemary being smaller than the other two, the doctors said that for now they have no concern over the growth rates of the babies. There will only be a concern if Rosemary drops below the 10th percentile, which would indicate that she may have "intrauterine growth restriction" (IUGR), which is common for multiples -- especially for the baby on the bottom of the pile. Another concern would be if Henry grows so big so quickly that he is preventing the others from having the room to grow properly. The doctors said that occasionally a decision has to be made whether to take all the babies early to save one even though the others are fine, or to leave them all in and see how the struggling baby does. However, the doctors stressed that we don't know that Rosemary is struggling because she may just naturally be small.

The doctors also reminded us that these are fraternal babies, so it may be that we just happen to have a big baby and a small baby and a medium-sized baby -- and that there is nothing wrong at all except that they have different genes. Gary's mom did point out that the babies in their family are usually very small. The babies in my family are usually pretty big. I think that my mom is as surprised at Rosemary's size as Gary's mom is surprised at Henry's size. . . .

I can't tell you all how thankful we are to have met our goal delivery date. When we were admitted to the hospital almost 5 weeks ago, I had thought there was no way we'd make it this far, but here we are still. And now we're hoping to make it to 30 weeks!

28 Weeks

Here I am during a non-stress test:

Here are the girls' heartrates during the non-stress test (Rosemary on the left, Piper on the right):

Here's Henry's heartrate during the non-stress test:

Saturday, June 7, 2008

Wednesday, June 4, 2008

E-Mail Update #4

Hi, everyone.

Again -- I've added more people to this update as my brain seems to function to remember everyone and as others ask to be on this update. If anyone knows of someone who also wants to get the updates, please let me know. I will get a full list eventually! If you are new to the update, the first one is at the bottom.

When I woke up this morning I was exactly 26 weeks and 5 days pregnant. Then I was informed later on this morning that I am actually 27 weeks pregnant today. There are numerous ways to calculate how far along I am, and apparently the procedure has been changed. The doctors have decided to follow the dating from an early ultrasound to calculate my due date, because they think it's more accurate. It's very odd, and Gary said more than once that he didn't know they could do that, but it does mean that my new goal delivery date is only one week away. Of course, it would be best to make it much farther and well into the 30s.

As discussed with the doctors here over the last week, I was sent home on Sunday. I was checked on Saturday and told that I was still 1cm dilated and 50% effaced (I had been told the previous Monday that I was getting closer to 2cm dilated, but not there yet so I would remain 1cm officially), so it seemed that I had no change since I was 23 weeks and 3 days. We went home on Sunday, and I was able to spend a little time with my cat, Francesca, who had apparently really missed me. Francesca rarely left my side the entire time I was there, and seemed to be quite attention-deprived (just wait until we bring home three babies).

Anyway, the main reason we agreed to go home on Sunday was because I would have an appointment with my doctor on Monday morning. We got there for the appointment, had an ultrasound (the babies are all fine), then Dr. Kimberlin checked me and determined that I was 2.5cm dilated and closer to 75% effaced. We were sent directly back to the hospital and here I am now. Re-admission is not fun -- it involves answering the same questions all over again, IVs, a trip to Labor & Delivery, lots of monitors, and lots of drugs. I've had a lot of people ask what I've been on, so here's Monday's list: (1) magnesium sulfate (an IV drug to slow contractions); (2) indocin (an oral medication to slow contractions); (3) demerol (an IV drug to sedate me and hopefully slow contractions); (4) antibiotics (via IV in case I deliver); (5) rescue steroid injections (to help develop the babies' lungs in case we deliver in the next three weeks -- I had my first round three weeks ago). I was taken off the magnesium sulfate, demerol, and antibiotics yesterday. I received one more steroid injection yesterday (the last for this round), and yesterday went on percocet as needed for contractions. I'm being taken off indocin today.

So, today marks 4 weeks that I've been in the hospital, if you don't count the two times I've been sent home only to be sent back less than 24 hours later. The attending doctor (a new one) this morning mentioned sending me home again in a few days and I just stared at him. I think we can safely say that going home has not been treating me well, for whatever reason and even if I'd like to be there. Gary told me that he would handle that part of it with the doctors, so I'm just going to let him fight that battle, if there is one.

As far as the babies, they are still doing great with very healthy heartbeats. Rosemary is curled up at the bottom, and Piper is curled up to the right above Rosemary (we even got an ultrasound picture of Piper on Monday with her big toe touching her forehead, which is pretty cute, though strange looking). Henry, on the other hand, is all sprawled out on top of his sisters, sucking his thumb, and taking life easy. He may as well now while he can. . . . We'll measure them again next week to make sure they're growing well.

We talked to a neonatologist on Monday. As you may or may not know, UAB has one of 15 regional NICUs in the country, and is ranked at the top of those NICUs. We were told on Monday that if our babies were born on Monday, they would have a 97% survival rate, a 70% chance of not having any long-term effects from the prematurity, and would probably spend around 10-12 weeks in the hospital. If we can hold off until 28 weeks, we have the same survival rate, but a 97% chance of not having any long-term effects from the prematurity, and they would spend around 8 weeks in the hospital -- thus 28 weeks is the big goal. Of course, later is almost always better, and I would be thrilled to see these babies get here sometime in the 30s and come home much sooner after their births. . . .

We are definitely hanging in here and plan on taking home some very healthy babies -- though we would love for their birthdays to be in July and not June! We are acutely aware, however, of how lucky we are to have made it to June.

Thanks to everyone for the kind thoughts and prayers. I'll update later when there is more news.

Monday, June 2, 2008

Home Less than 24 Hours and Back to the MEU. . . .

I was sent home from the hospital on a Sunday, had an appointment with my doctor on Monday (06.02.08), and was sent promptly back to the hospital. Here's a picture of me in the MEU (again). . . .

And here's a picture of me in Labor & Delivery during a non-stress test. . . .