Birth Day for the Twins

Part 2:  Delivery Day
If you missed Part 1: The events leading up to delivery, you can click here.

A typical pregnancy is 40 weeks long.  Because of complications I was having, the doctors decided it would be safest for my health to deliver the babies early.  They were 34 weeks 2 days gestation when they were delivered on January 31st.  We'd had a delivery scare on New Year's Eve.  Apparently the babies were meant to be New Year's babies because they made their appearance on Chinese New Year!

In my room and ready to go Friday morning.  I have a large guage IV in each arm.  They will start another on in the pre-op area.  I have my lovely compression socks on.  

The closer I got to our delivery date, the more anxious I became. I worried that I would have a big bleed and need to deliver early. I worried about how the babies would fare. I worried about what would happen to me in the surgery. It was very difficult emotionally to get through those days.

Dode's ready too, 6:00 am

Do I look like an excited mother ready to meet her babies?  Nope!  At this point, I would have paid a lot of money to stay pregnant a few more weeks.

heading down and feeling very nervous

We had the large pre-op area all to ourselves.

My mom and Greg were there from the beginning.

Sharon and Lynn were there as well but we failed to get a photo.  It's so comforting to have family around when you're going through something scary.

In this photo, the doctor is telling me what a good job I did staying pregnant.  At this point, I was crying because I felt so badly that the babies had to come early.

some of the crowd in the operating room

Our delivery was a well orchestrated procedure. When Dode joined me in the OR after my spinal anesthesia was in place, he counted 25 people in the room. There were perinatologists, gynecological oncologists, urologists, anesthesiaologists, neonatologists and nurses. Most of those specialty doctors also had a fellow and a resident with them.  Because the room was so full, there were six more doctors and nurses from the NICU waiting for the babies in the operating room next door.

My doctor, Dr. Stephensen-Famy is in the middle.  There are residents flanking her on either side, Dr. Lai and Dr. Makhija.

The babies made their appearance at 8:21 and 8:22 am. We'd had an ultrasound the day before and it looked like our little girl would be the first one to make her appearance. The doctor sounded quite surprised when the first little baby she pulled out was our boy. He must have stuck his feet up at just the right time. For the rest of their lives, he can brag that he is older. Luke was born at 8:21 am. He weighed 4 pounds, 4 ounces and was 17 inches long. Leah was born at 8:22 am. She was 3 pounds, 13 ounces and was 16 inches long.

I never got to see the babies in the delivery room. As soon as each was born, they were whisked out of the operating room we were in and brought next door to be evaluated by the NICU team. It quickly became evident that the placenta would not detach and they began the hysterectomy. I was still awake at this point and having a lot of problem with nausea. They kept dosing me with medication but it wasn't helping. They stuck an alcohol towelette under my nose and that provided some relief from the nausea. At this point, having not even seen the babies and not feeling very well, I would have been thrilled if they put me to sleep. They kept me awake and proceeded with the surgery.

As the surgery progressed, I began to feel uncomfortable as they removed my uterus. Discomfort progressed to pain. When you go to the dentist and start saying, "Ouch," he backs off, gives you more Novocain and waits for it to start working before proceeding.  When you're having life saving surgery and start saying, "Ouch", do you think they stop and wait for your pain to go away?  Nope!  I could feel the incredible pain of them cutting away inside me. At the same time, there was intense pain in the IVs in both arms. I learned later that they were shoving blood in one arm and medicine in the other as they tried to get my blood pressure up. I felt like pain was assaulting me from all sides and started to get a bit hysterical. Dode finally asked if it was too late to give me a general anesthetic. They said, “No it's not”. He asked them to put me to sleep and I was so grateful when they told me I'd be drifting off.  I spent the next week thanking Dode regularly for being my rescuer from that pain.

When the doctor talked with me the next day, she told me that my surgery went as perfectly as it could.  I ended up loosing 3 liters of blood during the surgery (the average human has five liters).  Because they knew ahead of time, they were ready to take my uterus as soon as it became apparent that the placenta was not detaching.  When this kind of problem is not discovered until the delivery, the consequences are much more severe.  It's a problem my body has toyed with before.

With my first two babies, pieces of the placenta were retained which led to two uterine infections and with Isaac I had to have a D&C.  I had a miscarriage before Isaac at 17 weeks and needed two D&Cs to get all the placenta off.  With that pregnancy I also had a hemorrhage a few weeks after the second D&C, right in the middle of teaching a class of fourth graders while student teaching.  When Elizabeth was born, the doctor spent 45 minutes trying to detach the placenta.    I can vividly remember sweat running down his brow as he worked (and likely worried) to get everything delivered.  I ended up with another infection with her. With Miriam, even though I had a C-Section and everything was wide open, the doctor still had a tough time getting the placenta off.  She was the first baby I had that I didn't get an infection afterwards.  With this, my final pregnancy, the placenta was no longer playing around, it was well and truly attached.

The following day they had a difficult time keeping my pain under control.  I'd thought I'd feel a lot of pain at the incision site that runs from my belly button down to my pubic bone.  Instead, the pain I felt was deep inside.  Dode mentioned to a nurse that I was feeling pain in the same place I felt it when the epidural failed.  Apparently that is not what you want to say.  It didn't take long for one of the anesthesiologists to come in and explain to me that the epidural did NOT fail, it merely failed to keep up with my pain.  Because my blood pressure was so low, they couldn't give me more medicine without making it fall even more but the epidural was working just fine.  To Dode and I, the purpose of an epidural is to provide pain relief.  Any problem with that is a failure in our book.  I guess to an anesthesiologist a failure is something else!

First photo of Leah.  Dode left my operating room to go next door and see the babies.

First photo of Luke.

Everyone wants a bar code on their head!

In the recovery room, feeling very sick.

I woke up hours later in the recovery room. I had to stay there longer than planned because my blood pressure was so low. The family had been told I'd be in the recovery room about 1 ½ hours and would then be heading back to my room. Dode didn't want to miss me so he stayed in my room, expecting me at any time. After hours went by, he chased down a nurse who told him I was still in the recovery room.  As I slowly came back to awareness, I got to listen to the nurse and the anesthesiologist discuss why my blood pressure was so low.  The nurse thought the anesthesiologist had given me too much medication during the operation (from the operating room notes), the anesthesiologist said it was because of all the blood loss.  Irregardless of the reason, I spent quite a few hours a very sick girl.  I've heard leaders in our church teach that women go to the valley of the shadow of death to bring forth children.  I always thought that was just poetic words until this time.  I truly spent some time in that shadowy valley.

Leah soon after arriving in the NICU

Luke's first photo in the NICU

Once I was stable, about six hours after the surgery, I was brought back to my hospital room. It was a few more hours before my health was such that I could be brought over to the NICU and meet my babies for the first time.  If I had been myself, the long delay would have driven me crazy.  Because I was still so sick following the surgery, the hours went by quickly.

Waiting to hold Leah for the first time.

sweet reward, with Leah

In order to get from my room to the NICU  more easily, I stayed on the uncomfortable surgery gurney until late the next day.  Even with the epidural still in place, I had to push down on the pillow covering my abdomen as we went through the halls to decrease the pain.

getting introduced to Luke

savoring every moment with Luke

My first post-op complication.  This is the site where the IV gave me blood transfusions.  They were pushing the blood in so fast that the fluid infiltrated into the tissue of my hand.  You can see it hanging down underneath.  There is an actual indentation in the middle of my hand where a piece of cotton was taped down when the IV was removed.  It was so sore!  I wish that would have been the only complication of my surgery.  Part 3 will address those fun parts of my recovery.

If I had it to live over, I would have been more adamant about not wanting to be awake for the hysterectomy.  Because I never even got to see the babies, I wish they would have given me a medication during surgery that makes you forget the whole thing.  Having that memory of the pain when the epidural failed to keep up with my pain is not a comfortable memory.  Dode says he feels guilty he didn't ask them to put me out sooner.  He had no idea he had that kind of power.  I think they were just so busy with trying to keep me alive that they forgot they had the option to put me out.  You know how when you are in the hospital and they ask you to rate your pain on a scale of 1-10?  I used to think, "Being burned alive is a 10" and would relate my pain to that standard.  I now have a new reference point for a "10", having surgery where the epidural fails to keep up with your pain.  I hope I don't have to have another surgery where I am awake because I think I'd be pretty anxious about another "problem" with the epidural.