There is a reason it has taken me nearly two years to recount the birth and survival story of our little miracles. It brings up raw emotions that are difficult to relive. I have to be honest, I've started this post over twenty times and not been able to write more than the first line. Their birth is a small piece of their unforgettable journey to survive. As I sit here 35 weeks pregnant, and feeling the beginnings of labor pain once again, I'm brought back to the uncertainty and the unpleasant memory of the birth of our twin baby boys.
On the morning of October 22nd, 2012, I left work for what I thought would be a quick doctors appointment. I asked my dear friend and next door neighbor teacher to unlock my classroom after lunch in case the doctor was behind schedule. When I arrived at my OB's office, I was elated to see that there was no wait at all. Dr. Andrea Herbert had been my OBGYN for ten years. She has been there for me throughout all the important stages of life; including my pre-marriage talk, struggles with getting pregnant, struggles with staying pregnant, and the delivery of our first son via emergency cesarean. During my first pelvic exam of this pregnancy, she looked worried and asked if I'd been having contractions. I let her know I'd felt a few braxton hicks every now and then. She replied, "they're not called braxton hicks if they make you dilate." I found out I was dilated to 4 centimeters and 80% effaced at only 26 weeks pregnant. I was informed that baby A's sac was bulging out of the cervix. She instructed me to go down to labor and delivery immediately. They hooked me up to multiple heart beat and contraction monitors and found that I was contracting every 5 minutes. They gave me nifedipine every three hours to stall the preterm labor. Nifedipine is generally used to lower high blood pressure that has also been proven to relax the uterus. I remained at the hospital in antepardum while they monitored the babies and I for the next 11 days. I had daily non-stress tests to check the babies safety, health, and growth. The ultra-sound technician measured the lining between the babies sacs each day. (Random: I'll never forget how impressed they were with the amount of fluid in the babies sacs and the thickness of the lining. On several occasions they printed out the sonograms to show everyone in the office.) The first night I slept at the hospital, Dr. Jerald King, from the NICU, visited my hospital room. He came to inform me of possible problems my preterm babies might face at birth. I've since looked him up and come across some of his great accolade's and accomplishments. However, at the time, he spoke at me like I was somehow in control of what was happening to my body. I did not chose to be in this position. I took care of myself. I ate healthy, drank loads of water, relaxed as much as I could. I did work full time, however, I lectured from the front of my classroom on a stool. I had no idea that I was in preterm labor.
Dr. Herbert came to visit my hospital room each day to lift my spirits. She told me that if I could make it to 34 weeks, she would send me home on bed rest. I was hopeful, and naive. I thought for sure I could make it. I thought I could do anything for eight weeks, surely I could stay in that awful bed and keep my babies in. Other mommies on my floor got a wheelchair ride each day. I was so jealous! Paul and Joey came to visit me for dinner each night. We'd play games, sing songs, and paint pumpkins. There was one thing I learned very quickly; that no matter how much I did not move from that bed, the babies were still in control. It was Halloween evening and I had a work meeting in my hospital room earlier that day. I recall feeling a bit tired, but I read one of the tabloid magazines a friend had brought me to keep my mind off of the discomfort. After Paul and Joey left my small stale room to go and sleep in our home, I felt a couple powerfully strong contractions back to back. My first thought was, "I am not going to have my babies on HALLOWEEN!" I paged the nurse at the desk and they hooked me up to the contraction monitor. I refused to call Paul to let him know things had deteriorated. I was determined this was a false alarm.
At first I could talk through the contractions when they were twenty minutes apart. By the time it had reached 10:00pm, they were every five minutes and I was beginning to sweat. I was given niphedepine every 15 minutes, instead of the usual three hour intervals. I was beginning to feel anxious for what seemed inevitable. The resident doctor came in and informed me that I was dilated to 5 centimeters. After midnight, just 2 hours later, I was at 7 centimeters and in full labor. I finally decided I should call my husband. Before he got to the hospital, I was alone for what seemed like an eternity in full fledged, weeping, wailing, gnashing of teeth labor. My contractions were overlapping one another. I was starting to panic. A very commanding nurse came in and got me to focus on a spot on the wall and helped me to take slow and steady breaths. I have an extremely high tolerance for pain, but when asked what my pain level was, I blurted out that I was at a ten. I was given fentanyl in my IV and told it would last 30 minutes in my system before I'd need it again. The nurse warned me that it would make me dizzy. I recall laughing hysterically when it kicked in. Within 15 minutes, I felt a rush of pain all over again. It came on strong.
The doctor on call was alerted to come in for my delivery. At first I was crushed it wasn't Dr. Hebert, but thankfully it was her best friend and former roommate, Dr. Ponder. She let me know that there was nothing they could do at this point to halt the inevitable. It was then I found out Matteo was breach and that I would have to have a cesarean section. They wheeled me into the operating room and strapped my arms down to the bed. The anesthesiologist, with urgency in his voice, went through the dangers of anesthesia at a rapid speed. Before I could even process what he had said, I felt a sharp pain in my abdomen. I looked up at Paul and could see the terror in his eyes.
In the wee hours of the morning, on November 1st, at 28 weeks and 6 days gestation, Luca Vincenzo let out his first whimper. Matteo Omer, on the other hand, was nice and cozy growing inside of the womb. The doctors had to do some serious manipulation of tugging and pulling to get him out. All I could see was Paul's face. He looked down at me with concern on his face and said, "he doesn't look good." They passed the babies through a large window and into the Newborn ICU. We sobbed.
I remember being brought out of the operating room and staring up at the three concerned faces of Paul, a surgical nurse, and the neonatologist, Dr. Fung. All at once, I could feel the pain of the invasive procedure my body had just endured. I was writhing in pain. They all just stood there and stared at me. It was bizarre.
There I was, laid out on a stretcher being wheeled back into the room I'd spent the last eleven nights in, but this time without the comfort of having my babies in my belly. I wasn't permitted to see my babies for the better part of the day. Each time I called for the nurses, they gave me some story as to why I needed to wait longer. My patience for obeying the rules of the system had vanished. I got out of bed and started creeping toward the elevator. Paul went and grabbed a wheelchair just before I fell to my knees. On our way down, I had a million emotions running through me. I had no idea what to expect.
We were buzzed into the Newborn ICU, signed in, and then directed to a giant sink with several spouts and a stack of sharp sponge scrubbers. We were told to take off any rings and wash/scrub our nails and hands up to our elbows, for three consecutive minutes. As I stood there leaned against this tub of a sink, staring at the clock, I could feeling every ache, pain, and stitch. While I waited for Paul to finish, I took in what would become my new normal. Everything appeared somber, quiet, and sterile. No one smiled. No one said a word. Just before we entered our babies room, the volume increased around me. I overheard what seemed like a handful of people whispering loudly. And then I caught the beeping sound of the oxygen and heart monitors. A sound that would become so familiar that after three months of continuous beeping, it was comforting to me.
When I laid eyes on my infants in their isolette's, I knew we weren't going home together any time soon. The thought crept in my mind that maybe we would never be able to bring them home. They were connected to all kinds of devices. No one acknowledged us when we walked in. Paul wheeled me over to Luca first. They began to recount a few things they had done for him. They explained that being a preemie he had immature lung function, even with his corticosteroids before birth, he had RDS, or respitory distress syndrom, and therefore was given surfactant replacement therapy through a tube placed in his windpipe. Then they connected him to a C-Pap, continuous positive airway pressure, again through his windpipe. This continuous flow of air through the tubes, was allowing him to breathe on his own, but putting enough pressure in his lungs to prevent the sacs from collapsing. Matteo, on the other hand, had the same treatments done, but was on a mechanical life support ventilator. It was also placed in his windpipe, but it was breathing for him. Both of the babies were not alert or awake for their treatments. It wasn't until much later, when we were alone, that I saw eye lids flutter. I sang to them the same song I had sung each night while they were still safe in my tummy.
I love Luca, he loves me.
We love Matteo, yes sir e.
He loves us and so you see,
We are a happy family.
Matteo was the first one to crack a smile. I saw hope.
After a few days in recovery, Dr. King had informed me that baby A, Luca, had a severe infection in utero, and if they hadn't have been born early, they wouldn't have survived much longer. I was so numb from all that had transpired, that I don't think I fully understood what he had shared with me until much later.
We were trained on how to care for our babies in their isolettes. At first, they were being fed lipids, which is an organic compound of vitamins and calories given through their IV's, until they finished a round of antibiotics. Finally, they were administered nasogastric tubes through their little noses, into their esophagus, and then into their stomachs. Over the next three months, our babies endured daily heel pricks, IV burns, iron deficiencies, viral meningitis, and worst of all Luca's NEC scare. Necrotizing enterocolitis, or NEC, is the most common cause of preemie deaths. Often the first sign of NEC is blood in the stool. It is common in preemies born before 32 weeks. It is the result of an underdeveloped intestines that can crack and bleed and even die off. This allows for bacteria and waste to enter the bloodstream. Most preemies that have this life-threatening infection, have to have surgery. Traditionally they go in and remove part of the small or large intestines that has died off. Luca was part of the smaller percentage of preemies that somehow escaped this invasive surgery. He was monitored closely and once again taken off of my milk, until the blood in his stool suddenly stopped.
Many babies came and went during our NICU stay. After our little ones could maintain their own body heat post bath, continue to gain weight, keep their oxygen saturation when sitting in a car seat, passed their hearing exams, and were cleared from retinopathy of prematurity (ROP), they were released to finally come home. At three months old, and now full term, both babies were 5lbs each. Luca came home five days after his littler brother Matteo. Luca could never fully maintain his oxygen saturation without the help of a slow flow, therefore, he came home on oxygen and stayed on it until he was six months old.
Not to be forgotten, after the babies had been home for three weeks, they were admitted to primary children's medical center for a two week stay with respiratory syncytal virus, known as RSV. Needless to say, their weekly weight checks went from the doctors office to in our home. I think waiting rooms are the breeding ground for most infectious diseases.
The three months the babies spent in the hospital felt like one very long day. I'm not sure I even ate or slept. In a short amount of time, I learned a great deal about survival medicine. But I also learned how important it is to trust your instincts. I fought to keep my babies alive every single day. Sadly, I also learned the not so pleasant political side of the NICU. It did feel like a nightmare at times. For example, the NICU doctors, or neonatoloigist, that cared for our babies, rotated every two weeks. I believe that it would have been in the best interest of our babies to have had the same doctor for their entire stay. Every two weeks, I had to prepare myself for what kind of care my babies were going to receive. Some NICU doctors were more conservative than others in regards to how they approached the care of my children. The one constant were our two primary care nurses. They were the only people I could trust to actually listen to our families requests and truly know and understand the individual needs of our babies. I saw both of them, on one occasion or another, fight for our little ones. That brought me great satisfaction.
"Now ye may suppose that this is foolishness in me; but behold I say unto you, that by small and simple things are great things brought to pass; and small means in many instances doth confound the wise. And the Lord God doth work by means to bring about his great and eternal purposes; and by very small means the Lord doth confound the wise and bringeth about the salvation of many souls." Alma 37:6-7
Warning: some of the pictures below are graphic.
Baby A: Luca Vincenzo