Thursday, October 31, 2013

I should charge admission

I expected that being out with twin babies would attract attention and comments. I sort of get it. Twins are interesting. Personally, I have never gotten especially excited when I saw twins out in the world, but I did notice them. Maybe being married to an identical twin takes some of the novelty out of it. Who knows.

What I didn't expect was just how much attention we would get. I have to be honest, I didn't get the attention and unsolicited belly rubs from strangers that I was told to expect when I was pregnant so I sort of thought maybe the twin attention thing was more talk than reality.

I couldn't have been more wrong!!

Yesterday we ventured out to The Grove/Farmer's Market for lunch and to take my computer to the apple store (to make sure I didn't ruin it by spilling breast milk on it). This is a very popular and touristy place in LA so it's always pretty crowded. We live in walking distance so it's a nice easy way to get out of the house with the babies without the hassle of getting them in and out of the car. As we sat eating at some outdoor tables, I think about 90% of the people who walked by made some sort of comment about twins. "Look twin babies...awwww". Some actually stopped to talk to us (and not just about us) and ask questions. It's really weird to hear everyone who walks by make comments about you. One older woman just stood behind me and stared into the stroller at them. One woman with 6 year old twins told us it really does get easier. SH said he saw a Japanese tourist take a picture of us. (Really? That is just weird). 

We have gotten comments and questions before when we have gone out, but yesterday I felt a little bit like a side show. It felt like everyone we passed was whispering about us. I really don't understand what all the fuss is about. I was sort of in shock. SH had to laugh and said "welcome to my world". He has been dealing with this his entire life and I am just now understanding that. His brother lives in another city so I don't witness them being out in public together all that often. I had only seen very little of how fascinated people can be with twins - especially identical twins. I am hoping because Paige and Riley are fraternal, and so far look quite different, that it won't be as bad for them as they are growing up. I want them to feel like individuals and not like some sort of attraction. I guess managing this is just an extra challenge to raising twins. I think it's definitely helpful that their father is a twin and can understand what they will deal with everyday.

This is all very new and weird for me, but it's not really a bad thing. It will be hard for me because I don't really like talking to strangers. I guess I'll have to learn to be better at that. Learning to be a little more open is probably good for me. 

Tuesday, October 29, 2013

Breast feeding

Here's a problem I never considered having - I spilled breast milk on my laptop after pumping. It got into the keys so I am letting it dry out for a few days before attempting to turn it back on. I am really hoping I didn't ruin my computer. In the meantime, I  am writing this from my phone, so pay no attention to typos.

I fully expected breast feeding to be hard. In fact, I expected that I wouldn't be able to do it. (How's that for pessimism?) We researched formulas and were ok with either supplementing or just having to formula feed. I wanted to deal with that before the babies were born because I knew it would be to much to deal with while I was chock full of post partum hormones. Oh, how naive I was.

Turns out I was right - sort of. I am producing almost enough milk so we are supplementing one or two feedings a day with formula. This is fine because our NICU doctor actually wanted us to give them a higher calorie formula twice a day to help them put on weight (which it has. They have gained over 2 pounds since leaving the hospital a month ago. Yay.). The problem is the girls aren't latching correctly. I was using a nipple shield at first because the lactation consultant in the NICU recommended it. so they seemed to be latching fine. I thought at first the problem was they didn't have the energy to fully breast feed while they were still in the hospital. When my nipples started hurting, I thought they just had to "toughen up" a little. But the pain kept getting worse and I started to dread feeding time. I couldn't get them to latch without the nipple shield and if they did it was incredibly painful. Plus, neither one likes my right boob. It produces less milk and the "flow" doesn't seem as good. Did i mention that Paige does more of a chewing thing than sucking? yeah, that feels awesome. Breast feeding is really turning out to be even worse than my already low expectations (and that's saying something). 

So, last week I spent 2 hours with a lactation consultant to see if I could fix these problems. She checked for anatomical issues with the girls and they do have small palates, I think she said, so that can contribute to the pain. That will likely resolve itself as they get bigger. She showed me how they should be latching and when she got them on there correctly it did finally feel better (though still a tiny bit uncomfortable because my nipples feel so raw). I even got them both latched at the same time which was awesome. I finally had hope that I could do this. I was feeling pretty good about it, actually. 

Then I tried it on my own. I got a good latch a couple times but only after 10 excruciatingly painful "wrong" latches. I was frustrated and in tears and so was Riley. Paige just stops trying after I pull her off to relatch enough times. Even though I know it's possible to get it right, I'm not sure I can deal with the pain involved to get there. I have taken a few days off and am only pumping with the hope that my nipples heal a little. Then I will try again. Honestly? I think I am ok with just pumping and formula. I have cried a lot about it and feel more conflicted than I thought I would, but I have felt less anxious the last couple days knowing I wouldn't have to attempt breast feeding. But, I will give it one last shot before throwing in the towel. I'll probably try again tonight and see how it goes. I'm supposed to have a follow-up with the lactation consultant this week but I think I will cancel. As helpful as she was, she was also not understanding of any situation that didn't involve exclusive breast feeding. She wanted me to call my pediatrician right then and there to see if I could stop the formula feeding. Her goal for me is to even stop pumping and bottle feeding breast milk. That isn't my goal and isn't realistic for me. I'll have to go back to work eventually. I just felt there was a tiny bit of judgey-ness there. SH thinks I am reading to much into it and he didn't think she was judgey. But if I went back and told her I intended to only pump, I think she would spend an hour trying to talk me out of it instead of understanding my situation and working with it. She charges too much money for me to feel like that. 

I don't really know what to so at this point. If it were up to me (and I guess it is), I would probably give up on breast feeding and switch to pumping and supplementing with formula. SH really wants me to give it another try. He thinks I am giving up to easily and I probably am. He doesn't understand how painful the trial and error is, though. So for him, I will try again but I am not feeling very hopeful. 

Anyone have any tips or advice or words of wisdom to make me feel less guilty about giving up?

Wednesday, October 16, 2013

Life in the NICU

It's only been a few weeks, but already the whole NICU experience feels like it was a lifetime ago. It feels like it was a different world.

Now, where did I leave off? (Sorry, this will probably be a little rambling - I am trying to get it all out in the 20 minutes I am pumping)

While I was still being stitched up (thanks for putting my ab muscles back together, Dr. B!), the NICU teams (5 people for each baby!) took the babies from the OR. They asked SH if he wanted to go with them and he didn't know what to do. He didn't know whether to stay with me or go with them. I told him he had to go with the girls. Someone had to be with them. So off he went to get his first taste of the NICU.

Meanwhile, I was taken to a recovery room where I was put back on magnesium (to prevent a seizure) and could not get out of bed for 24 hours. That meant I couldn't go visit the babies, not even in a wheelchair. It broke my heart. Just another twist of the knife by the universe in the whole baby making journey, I guess. SH came back with reports on the girls. He also made sure to bring me pictures. Overall, they were healthy. They were 4lb7oz and 4lb8oz - probably the biggest babies in the NICU. They just needed to mature a little more. Both girls needed oxygen and I was so grateful I had the steroid shots a few days before so neither one needed to be on a ventilator. The nurses were waiting for me to pump before they fed the girls anything. They wanted the first thing they gave them to be colostrum from me. Even if it was just a drop (which it pretty much was).  Once I was taken to my room and got settled in, SH went back and forth to the NICU to deliver my pumped colostrum/milk and kept me posted on what was happening with them. When SH was in the NICU we would do Face Time so I could see them and the nurses could give me updates on how they were doing.

At this point, I was starting to see why they wouldn't let me out of bed. The magnesium is awful! I was so out of it. SH said I was slurring my words. I could barely keep my eyes open but I couldn't really sleep either. It felt like I would fall asleep and start dreaming, but I was also aware of being awake. It was really odd. I was really hot. I probably couldn't have stood up even if I wanted to.  I think I had some conversations with doctors and nurses that I don't really remember.  I'm not sure why anyone thought it was a good idea to ask me any questions during that time.

Finally, it was time to stop the magnesium and visit Paige and Riley. I think it was around midnight by the time I finally made it up to the NICU. I was exhausted and really overwhelmed by the whole thing. You have to scrub in before entering the NICU. Then there are just so many machines making so many noises and all sort of alarms are constantly going off. It's a little terrifying at first. Then I see my babies all hooked up to wires and IV's and all alone in their isolettes. I finally got to hold them, but honestly, at that point, I think I was too overwhelmed by everything to relax and just be with them. When we came back the next morning, they had put Paige on a CPAP to help her breathe easier. Her lungs still needed a little help so this was basically forcing air into her lungs. There was a huge tube going across her little face and when I saw her I just burst into tears (the beginning of lots of crying). Riley was still being given oxygen but that tube wasn't nearly as big and intimidating.  Thankfully, Paige only needed the CPAP for a couple days before her lungs figured out what they were supposed to be doing and she was back to just needing some oxygen.

It took me a few days to feel a little more relaxed and know what was going on. I learned to tune out most of the noise and know what different alarms meant and what all the numbers on their monitors were. I was able to hold them and do skin-to-skin without feeling like I was going to break them or pull some sort of wire off of them. We helped with taking their temps and changing their diapers before feeding them. SH learned to be a master swaddler (I still struggle with getting a good swaddle) I started trying to breastfeed them but it still took too much energy for them to do it for a full feeding so we still had to give them bottles of pumped milk. They were getting almost all breast milk by now with only an occasional supplement of formula. They made improvements everyday, though sometimes there were setbacks. All preemies have what they called Brady's (bradycardia - slow heart rate) and they aren't a big deal as long as they are able to self correct without intervention, but Riley was having more than usual so she had to have an EKG. So for about a day we were worried that Riley might have some sort of heart problem. Thankfully, it turned out to be nothing. The doctors thought maybe it was just happening because of the magnesium I was getting before delivery.

At first, no one would give us any sort of time frame for when they might go home. All they would say is they usually go home by their due date. They were born 7 weeks early! I couldn't even think about the possibility of them being there for 7 weeks. We were really hoping they would be able to leave the hospital once I was discharged. Because my blood pressure was still high from the preeclampsia, I stayed in the hospital for 6 days.  Unfortunately, that didn't happen. I had to go home without them. Leaving that hospital without my babies was, without a doubt, the hardest thing I have ever had to do. As we drove away, I just cried. I looked over at SH and he was crying, too. I couldn't believe that after everything we went through to have these girls that I still had to wait for our family to all be together.  I knew they were in good hands, but they should have been going home with us.

It was in that first day or two after I was discharged that the NICU doctor started talking discharge for the girls. And possibly by the end of that week. Both girls were able to maintain their oxygen levels and were taken off of oxygen. They were both able to take all their feedings by mouth so their feeding tubes were removed. Every time we got to the NICU and saw some sort of tube removed was cause for celebration. The best day was the morning we got there and Paige was in an open bassinet. Being in an open bassinet and maintaining their body temp was the last step to going home. We had started calling the isolette the glass case of emotion so it was great to see them get out of it.

So, after only 10 days in the NICU Paige and Riley were discharged and they were going home together. The first few nights at home were nervewracking. I'm sure every new parent worries about if their baby is still breathing, but after seeing their oxygen levels fall and heart rates slow on the hospital monitors, we were especially freaked out. How would we know if something was wrong? I think we spent most of those first nights constantly checking on them and just watching to make sure they were breathing. We have relaxed a little now, but still watch them for awhile once we put them down to sleep. I suppose that worry will always be there.

We are grateful that our girls were never really in any danger. Nothing was wrong with them - they just needed to cook a little longer. It was a stressful situation, but I always knew both girls would be going home with us. There was a baby next to us that was really tiny and had been there for at least a month. She had toys and pictures and even a mini ipod in her isolette. She was definitely there for the long haul. We saw her parents there more than any others, though we never talked to them. This baby did not seem to be doing well. We would hear the doctors discussing her case if we were there during rounds, but couldn't understand any of the medical jargon. One day, SH asked one of our nurses about her. She was apparently born at around 24 weeks and her prognosis was not good. The nurse said she didn't think she would make it. I really hope the nurse is wrong and that little girl pulls through. I think about that family sometimes and wonder how they are. Then I look at my two healthy babies and realize that, despite everything we had to go through, we really are very lucky.

Wednesday, October 9, 2013

The long version

Wow. It's been 3 weeks now since the girls were born and I am finally getting around to posting the full story. I have been thinking about it a lot and just haven't been able to concentrate long enough to write it out. I will try to make this as coherent as possible, but I make no promises.

Last time I posted I was in the hospital for possible preterm labor. I ended up being there for 2 nights. Since nothing changed or advanced in those 48 hours, my OB finally agreed to let me be on bed rest at home. That was a Friday. My OB wanted me to make it to 34 weeks and I was pretty confident I would make it. I had a week to go!

I made it through the weekend without anything changing. I was pretty uncomfortable and to make it worse, while I was on IV fluids in the hospital the swelling spread from my feet to my legs. I had tree trunks for legs. I actually gained 15 pounds in water weight during my 2 days in the hospital.  I also went from peeing every half hour to only a few times during the whole day and that seemed pretty odd to me.

Then early Monday morning I woke up with a really bad headache. I didn't think too much of it. Mostly I was annoyed I couldn't take advil because I knew tylenol wouldn't do anything for it. Then I started throwing up. At this point I started to get a little worried. SH consulted Dr. Google and those things came up as symptoms of preeclampsia. My blood pressure was completely normal just 2 days before in the hospital so we were hoping all these other symptoms could be normal. SH decided to email our OB. We figured we should let him know, but didn't actually think it would be a big deal. We didn't hear back from him all day so I figured it must not be anything urgent. He finally got back to us on Tuesday and wanted me to come in so they could check my blood pressure. It was really high. Somewhere in the range of 170/80. I also had protein in my urine. He told me I had to go back to the hospital. So, off we went. On our way there I told SH I didn't think I would be leaving the hospital before having these babies. He agreed. Although I think both of us thought it would be at least a few days before that happened.

I get to the hospital and they start pumping me full of magnesium (to prevent a seizure) and giving me all sorts of medication to lower my blood pressure. At this point it was clear I had preeclampsia and they were just trying to determine how severe it was and whether they could bring my blood pressure down to give the babies a few more days.  I was dealing with the nurses and residents and no one was really telling me anything other than the babies would be born soon - maybe that night or maybe in a couple days. The NICU doctor came to talk to us within an hour of us being there and told us they were ready anytime the babies came.  She seemed confident the girls would be fine. She said they would probably be the biggest babies there. I was still managing to stay calm somehow. I thought this could all be controlled and maybe we could get to 34 weeks. Then they told me they had a room ready for me and were moving me. They wheeled me into a delivery room (bonus - it was one of the rooms with huge windows overlooking the hollywood hills - one of the rooms I was hoping to get. Sadly I would not be in there for long).  This is about when I started to realize this was really happening and I was having these babies whether I was ready or not. I had already made it clear I was hoping for a vaginal birth. Looking back, I think they were getting ready for possibly inducing me. They did an ultrasound to make sure they were both still head down (they were) and checked my cervix to see if I had dilated more since my last visit (I did not). That's about when my OB showed up. He said my platelet count was low and I was not responding at all to the 4 doses of blood pressure medication they had given me. He said I had to have a c-section and we were doing it in the next 15 minutes. What?!?!?! He said we didn't have time to wait for me to have a vaginal delivery. The babies were fine and not in any danger, but I was and they had to get the babies out ASAP. Did I mention that SH had run home at this point to feed the animals and give keys to our neighbors so they could take care of our dog? He was gone for maybe a half hour. When he left it was safe to assume nothing was going to happen immediately. (Seriously, it never failed that doctors only showed up with important information during the times he left the hospital).

Now I really started to freak out. I was shaking. Like full body shaking I was so scared. I think I may have started to cry at one point, too. My OB was awesome, though. He tried to keep me calm through the whole thing.  He apologized because he knew this wasn't what I wanted. So, SH got back and put on his fancy outfit for the OR and off we went. I think I may have asked at some point if I could be put out completely. I seriously did not think I could handle feeling them pulling and tugging babies out of me while I was awake. Remember, I pass out when I get blood drawn. Thankfully, the first thing the anesthesiologist did was give me something to calm me down and I finally stopped shaking. He did the epidural and it was a piece of cake. My OB and one of the nurses did an awesome job of talking to me and keeping me distracted. (I'm pretty sure I was telling them I was supposed to be home watching the finale of Dexter and now I would have to watch it with the babies and that didn't seem like an appropriate show for them to watch). As with most things, the c-section wasn't anywhere near as bad as I anticipated. I could feel tugging and pulling but it didn't bother me. It was really an odd feeling, actually. He pulled the babies out and I heard them cry and I was so glad I was awake for that. (SH took pictures of the surgery, but I haven't looked at them yet. I am a little afraid to.) They brought Riley over to me so I could see her, but Paige needed oxygen so I didn't get to see her before they took them both to the NICU. 

This was all such a whirlwind. I think I showed up at the hospital around 3:30pm and the girls were born at 8:30pm. I certainly never anticipated this happening. It wasn't until days later that I began to understand how serious it was for me. Mostly because of how alarmed the nurses were each time they took my blood pressure in the following days. I am still battling the high blood pressure which may not get better for weeks still.  I think everyone was trying to keep me calm so didn't really tell me anything more than they needed to. I am just so grateful we all came out of this safe and healthy.

Ok, I'll talk about the NICU and finally holding my babies later. SH is on his way back from the airport with his mom who will be staying with us for 2 weeks. This should be interesting.

In the meantime, here is a picture:
Riley is on the top and Paige is on the bottom