Sweet Katherine, so alert and comfy in her incubator
Kai cuddling with daddy
Together again on mama's chest
Our precious little miracles have arrived!
November 12th, 2008
3:35 pm
Kai Michael: 2 pounds, 7 ounces
Katherine Elizabeth: 1 pound, 15 ounces
So it turns out that I still don't know what heartburn feels like, but I do know what it feels like to have my liver breaking down and my kidneys stop perfusing...
Those dreaded night-time hours of pain that I wrote about in two previous entries turned out to be pre-eclampsia, otherwise known as toxemia or pregnancy induced hypertension. Maybe it was the nurse in me being a bad patient, or maybe it was a bit of denial...probably both.
On Tuesday, November 11th I was admitted to my hospital because my labs were abnormal. My blood pressures were elevated, my liver enzymes were quite high, and my platelets were dropping. My urine output began declining, and soon a plan was made for me to deliver the next day by c-section. The only cure for pre-eclampsia is delivery. I couldn't believe this was happening and I just wanted to fast forward time to 34 or even 32 weeks. I didn't sleep a wink, not even 30 seconds that night. Rich fell fast asleep to the sound of our babies' heartbeats while I layed there wide awake, thinking of each and every scenario possible. It was definitely a moment where ignorance is bliss, and I just knew too much.
In the morning, my doctor came in and we talked about transferring to UCSD where they have a Level 3 NICU. La Jolla only has a Level 2 NICU, and even though UCSD is not known for their stellar L&D/post-partum nursing care, the NICU is wonderful at UCSD. We wanted to do what was best for the babies, even if it was scary going to a hospital where I didn't know anyone. This wasn't about me though. It was about these babies, and soon I was loaded into an ambulance and on my way to the U. I had medication called Magnesium Sulfate that makes you feel like you're on fire (even my eyeballs felt hot!) and very loopy.
My parents arrived shortly after I was transferred to UCSD. Heather came down as well, and my friend Jamie was also by my side, who just happened to be my L&D nurse at La Jolla and was allowed to leave work to be there with us. I am so thankful she was there. A nurse practitioner spoke with us about all of the possible complications and what to expect of our tiny 29 weekers in the NICU. It was impossible to focus on her (partly from the magnesium) and everything she was saying, and I felt like bursting into tears but had to swallow hard and keep my composure.
Soon Rich, Heather and I were in the OR, and within minutes of cutting our beautiful babies were born. Kai was born first, and gave a little squeal as he arrived into this world. Katherine was immediately to follow, (both born at 3:35pm) but we didn't hear a peep out of her. That was incredibly nervewracking. Both babies were quickly wisked away by the team of doctors, nurses, and respiratory therapists. Things all seemed to run together at this point, and my thoughts were consumed with 'why didn't Katherine cry?' and 'why did Kai stop crying.' My arms began to jerk uncontrollably off of the armboards, part of the hyper-reflexia from the pre-eclampsia. I was trying so hard to stop shaking and jerking around, and kept thinking, 'just don't have a seizure in front of Rich.'
Back in the recovery room I was given some medication to help the jerking and shaking, which worked really well. My blood pressures were almost completely normal again. I was still very hazy and hot from the magnesium, but I was with it enough to wonder why nobody was telling us how our babies were doing. Two incredibly long hours later, Rich was allowed to go into the NICU. I wanted so badly to be there with him, but I was stuck in my bed, barely being able to move my legs. I was so determined to get in there that I encouraged my nurse that I was just fine and began trying like crazy to start moving. Thankfully she gave in and they pushed me on the gurney into the NICU, Jamie at the head of my bed.
I am finding it impossible to explain my emotions and first thoughts when I met my baby girl Katherine for the first time. In fact, I am flooded with tears just thinking about it. She was so tiny, but so perfect. So many wires and tubes. I was instantly in love and wanted to scoop her up and hold her tight. But all I could do was reach out and touch her gently. Kai had a privacy shield around his radiant warmer and the doctors were performing a sterile procedure on him to place his lines, so I was not able to see him immediately. But soon they wheeled my bed over to see my precious little boy. He was still covered with the sterile field, but I was able to reach out and touch his little hands. So perfect. My perfect, tiny little babies that I have been waiting so long to meet. I'm not sure how I kept my composure, to be honest. Nurses were explaining things to me, but I don't remember a word anyone said. I could barely focus on their faces, let alone listen to their conversation. I just wanted to scoop my babies up and run out of there, to fast-forward time to when they are absolutely healthy and strong. It was incredibly overwhelming to think about the road ahead.
My post-partum experience was interesting, to say the least. Let's just say that I'm thankful I'm an L&D nurse and know what 'should' be going on with my care. I tracked my own urine output, which was slow to get back to normal, and made the CNA's double check or triple check my blood pressures when they were high. I dictated my own medication schedule, as some nurses would completely forget to give me some of my meds. Heather stayed with me the first night and Rich went home with my parents. Rich stayed with me the next three nights. On Saturday, my sisters and brother-in-law showed up at the hospital and completely surprised me. I was so happy to see their faces and couldn't wait for them to meet our babies.
Rich and I are each allowed to bring one visitor at a time into the NICU. It was so amazing to watch the interaction between my parents and my sisters with Kai and Katherine. In a way it made me feel very lonely though. Being 2000 miles away from your family during times like these is pretty tough. During our hospital stay, we were flooded with gorgeous flowers and many voicemails of support, well wishes, and encouragement. Thank you to everyone for all of your support.
The first two weeks of life have been a whirlwind for the babies, and for us as parents. I think we've felt every single emotion under the sun. Initially after birth, both babies were breathing only with the assistance of CPAP, continuous positive airway pressure. Basically there are 2 little tubes that go inside of their nostrils that blow continous air into their lungs to keep them inflated. They didn't require oxygen with the cpap, only the pressure to help them breathe. Through the first night, they must have gotten tired and they were both intubated, which is a mechanical device that breathes for them. That was very short-lived, and the next day they were both back on CPAP. The PICC-line team attempted twice to insert a PICC line into Kai, but were unsuccessful. A PICC line is somewhat like an IV, but it goes all the way into their hearts and can stay in place for months. Through this is where they get their fluids, nutrition, and medications. A few days after they were born, Kai's nurse from the Ukraine named Borus was taking care of him, who also just happens to be on the 'PICC team.' He has a very thick accent and is terribly difficult to understand at times, but he is an encyclopedia worth of knowledge and I trusted him instantly with my precious boy. Borus was finally able to get Kai's PICC line in! It's a huge feat, as the procedure itself really takes a toll on the baby. Katherine was able to get her PICC line placed the very same night, on the first attempt.
Both babies had open PDA's, which is a valve in the heart that should close after delivery. They both recieved one round of medication which successfully closed both of their PDA's. If the PDA doesn't close after three rounds of meds, then it requires surgery, so needless to say we were ecstatic to hear they both closed after only one dose. Kai was neutropenic (very prone for infection) and needed a dose of medication to stimulate his bone marrow to produce more white blood cells, and it also worked after only one dose. Katherine began breathing on her own on day 3 of life! Strong little peanut! Kai has been on CPAP the majority of the past two weeks, with a couple trials off of it here and there. His poor little nose was getting really swollen and bloody, so I am so thankful to say that he has now been off of it and breathing on his own for the past two days. Both babies had fluid in their lungs, which is common with preemies, and both were given a diuretic to pull the fluid out. A few days ago Katherine was getting a little tired of breathing and would 'forget' every now and then, so she had to go back on CPAP for a day and half. Her nose starting getting very sore and bloody also, and she kept fighting it and taking it off herself. So they decided to let her try to breathe on her own again, and so far so good! It makes me so happy to see them both breathing all on their own.
After each dropping a few ounces (which is quite a bit when you weigh less than 2 pounds!), both babies are now just over their birth weights. Katherine joined the 2 pound club two days ago! We think Kai is going to look more like his Daddy. He certainly already has Daddy's personality. It's hard to say who Katherine looks like right now because she is just so tiny and needs to grow into her features still. We think she will have my eyes. She is a very mellow little girl and nothing much bothers her. She doesn't even cry when she's bare naked on the scale. However, if she doesn't like something, she certainly can speak her mind. Maybe her personality will be more like her mama's.
Rich went back to work last week, and I basically spent each waking moment at their bedside. It is incredibly difficult to be at home. I have this overwhelming sense of guilt if I'm not there, and I think about them 24/7. I already know them better than any nurse there, so I just like to be there 'just in case.' They are in wonderful hands though, and we couldn't be happier with the NICU care. I am pumping literally every 2-3 hours for them, even at night. I don't sleep much, but I have absolutely no complaints over it. I'm not a typical mom who can 'sleep when they sleep.' No napping for me. The only thing I do at home is eat, pump, and sleep. Maybe once the babies are a little bigger and stronger I'll be able to spend enough time at home to at least clean a little bit. We'll see.
We've certainly had a rocky road into parenthood, but Rich and I couldn't be happier right now. I think this has brought us even closer together. We balance each other out, and when one is feeling down, the other tries to bring them up. We love these babies more than anything else. I never knew this kind of love existed.
My two beautiful, perfect, tiny monkeys...
