Sunday, August 28, 2011

Feeling Powerless

When I got home from the hospital, I felt completely powerless. I had lost my babies and didn't know why. I now had at least two weeks off from work on disability leave and nothing to do. Before leaving the hospital, my mother and I had decided that we would make things (me hats and her quilts) to donate to the hospital in appreciation of the items that had been given to our babies.

Once at home, I did two things: I started looking into March of Dimes and I started knitting tiny hats. I found that March of Dimes had a walk coming up in less than a month, so I threw myself into that. It gave me something to put my energy into and I felt like I was making a difference because I was raising money to help prevent tragedies like ours. I recruited a few walkers and started posting for donations on facebook. Incredibly, in about three weeks, with only six walkers, we were able to raise over $1,800!!

During those few weeks,  I did some knitting, but mostly focused on the walk. However, once the walk was over, I needed to take up something else to help take away the powerless feeling. I started doing more knitting and started talking to others about it. A lot of people who I told what I was doing were interested in participating too. I found that we would soon have more items to donate than we could use for just a one-time donation, so I started thinking about making ongoing donations and forming an organization to make it happen. I worked on the idea with a friend and that's how An Angel's Love was born.

The Verdict

The afternoon after the funeral, I received a call from my doctor's office. The doctor told me that they had received preliminary pathology results back and that both placentas showed signs of bacterial infection. I had a doctor's appointment scheduled for the following week and I should find out more then.

At the doctor's appointment the following week, the doctor went through each line of the pathology report with us. Essentially four things happened, any of them could have happened first and caused all of the others: (1) my cervix dilated,  (2) the membranes ruptured (my water broke), (3) Kaylie's placenta abrupted (separated from the uterine wall), (4) a bacterial infection formed from bacteria normally present in the birth canal (but usually prevented from entering the uterus by the cervix). The doctor suggested that perhaps Kaylie's placenta abrupted first, then the blood clot that would have formed between the placenta and the uterine wall would have attracted the bacteria, but said that we would probably never know for sure what happened. He said that placental abruption is a rare occurance and having had it happen once does not make it more likely to happen again. He also noted that whatever happened was likely caused by the extra stress of carrying twins and that a singleton pregnancy would be likely to have no complications.

A couple months later, we decided to consult with a high risk obstetrician to see if they could provide any more insight, so that we would be well prepared when we were ready to try again. This doctor had the same pathology report, but suggested a different cause. She also said that we may never know exactly what happened, but "the good news is" that it almost certainly happened because we were having twins ("a woman's body is only made to carry one baby, it's not made to carry multiples") and that we would likely have no trouble with a singleton pregnancy. She suggested what may have happened was that the babies were growing too fast for my uterus to keep up and the pressure forced my cervix to open a tiny bit, thus allowing the bacteria to enter. Once the bacteria was inside the uterus, my body detected an infection and, in an effort to protect me, initiated labor. She recommended cervical measurements weekly from week 18 to 24 next time around.

The Funeral

As soon as the doctor confirmed that my water had broken, we started making funeral plans. I was too overwhelmed to think about it much, but luckily I was surrounded by people who could.

My husband called a funeral home. At first, the only option they offered was cremation, but after we talked to the staff at the hospital who told us there was no reason we couldn't do a burial, we called the funeral home back and arranged for a burial. My sister-in-law donated her cemetery plot to us (both she and my husband were given plots when they were teenagers by their mother), so that we didn't have to find a plot.

After that, I was asked what I thought of a number of ideas, and I agreed with whatever. My mother-in-law took the whole week off from work when we came home from the hospital and she made the majority of the arrangements.

Both of our families chipped in and paid for the entire funeral and made significant contributions for the headstone.

The funeral itself was lovely, but heart wrenching. Just seeing the tiny little casket broke my heart. We buried our babies with their bears (the day we found out the sexes, my husband went shopping and got them each a bear - one pink, one blue). We let them keep their hats and blankets and we wrote a note to each of them to go into the casket.




Wednesday, August 10, 2011

The Delivery

Sunday morning was Easter. We were supposed to be visiting with my family (Saturday we were supposed to have taken the dogs to a Mets game, but we missed that). On Saturday, I had asked family members to bring my things to the hospital so that I could start to knit some hats for the babies. I started working on Caiden's early Sunday morning. After getting through a few rows, I felt a gush of water. We called the nurse who came in and checked on things. I don't have a good sense of time because everything was so overwhelming, but I am sure we waited hours for the doctor to come in. Eventually, the doctor came in and said that they were now sure that my water had broken (until then they were unsure) and that there was nothing more we could do and I would need to deliver the babies. They recommended inducing labor to speed things along so that I wasn't in labor for days. We agreed.

They gave me a pill to initiate the labor. While the medicine went to work, the family started trying to get someone to come and pray with us. Since it was Easter Sunday, it took a lot of calling to reach anyone. But all the calling eventually paid off... The hospital produced their chaplain who said a couple prayers with us. A short while later, the hospital also produced a Catholic priest who was tied to the hospital. Shortly after that, our church's deacon (whose son my husband grew up with) stop in and said a few prayers. After that, our old priest (who had moved to a new church) arrived to say prayers and give us a blessing. We joked that we were the most blessed people on earth that day because of all the praying and blessings.

After taking the pill, I started freaking out because I hadn't decided yet how to handle the pain of labor (I was only 20 weeks pregnant and labor had seemed so far away). The nurse told me I could have anything I wanted. They had been giving me Oxycodone for my back (it was very sore from the uncomfortable position I had been laying in), so I ended up requesting that in the end.

Just after taking the Oxycodone, I started shivering violently. The nurse quickly brought blankets from the warmer and wrapped me up. Unbeknowst to me, this was the start of labor. (What does shivering have to do with labor? I still don't understand it, but apparently it is a common sign...) After shivering for a few minutes, my water burst. The doctor came in and with one push Caiden was born. The doctor wanted me to concentrate on delivering Kaylie, so he would not let me see Caiden at first, but when it appeared Kaylie was not quite ready to make her exit, the doctor introduced us to our son. Just before pushing, the doctor had warned us not to expect our children to look like full-term babies, so we steeled ourselves for the unexpected. He looked nothing like what we had prepared ourselves for; I would never have believed it if I hadn't seen it with my own eyes: other than being off-pigmented (dark) because of the early stages of development, he was a perfect looking tiny little baby with 10 tiny fingers and 10 tiny toes, his mouth opened and he had a tongue! His little ears were in perfect proportion to his head. It was the littlest things that amazed me.

Kaylie decided to come into the world with a burst! When her water broke, it soaked the resident who was sitting at the edge of the bed (though my doctor had enough experience to back up). She was born 27 minutes after her brother. She amazed us with her strength by taking several breaths. Her heart beat for a while, though again I have no sense of time...

The priest who had given us the final blessing came back to baptize the babies. Then the nurse brought in tiny hats and small quilts. She put the hats on them and my husband wrapped them very meticulously in their quilts. Our wonderful nurses took the babies to get their hand and footprints and take pictures. (And when we asked for clearer footprints because my husband wanted to get the footprints in a tattoo, they went off and did more footprinting.) They also weighed the babies: Caiden weighed a little over 12 ounces and Kaylie weighed about 10.5 ounces. We were not ready to say goodbye, so we kept the babies with us for the night.

Tuesday, August 9, 2011

The Hospital

I called the doctor early the morning of Good Friday to discuss concerns. I was 20 weeks 2 days pregnant. The doctor told me the office was closed that day, so I should go to labor triage at the hospital and they would check me out. I told my husband that I would be going to the hospital, but he should not worry because I was sure it was nothing. We were beyond the risky time of pregnancy anyway. Nothing could be really wrong at 20 weeks. Plus, just three days earlier we had the anatomical ultrasound and everything looked great.

I got to the hospital, filled out paperwork, and waited for someone to check on me. All the while, I was getting more nervous that something might really be wrong. While I waited, I listed to the woman on one side of me take a non-stress test because she was worried that her 7th child who was due in a week or two had seemed to be moving less (the baby was fine the doctor reported), and the girl on the other side who was trying to decide whether her baby should go to the same pediatrician she was going to and her mother debating whether the baby's state insurance plan would cover everything (she was sure her insurance plan wouldn't cover a second generation). My husband called to say that he was going to come to the hospital as soon as he could leave work, but I told him not to rush and to call before he left because they would be doing an exam any minute and I would probably be leaving by the time he got there.

Finally a resident did the exam and found that I was several centimeters dilated with Caiden's amniotic sack poking through. She informed me that the hospital did not consider a baby to be viable until 23 weeks and there was very little chance I would make it that far. She said they would do an ultrasound shortly to see how the babies were holding up. My husband called around that time and I said "Are you coming??" (all I could manage to get out without breaking down). The ultrasound machine was brought in, but then was needed in the OR (apparently the hospital only has one mobile ultrasound unit??), so I waited... When my husband arrived, the doctor explained the situation. We saw the ultrasound and both babies were doing well with strong heartbeats. The doctor decided to admit me. I was placed into a special bed that raised my hips above my head to help keep the babies in.

Shortly after being admitted, one of my doctors (who was on call that day) came in to discuss our options: do nothing and see what happens, initiate labor and deliver the babies, undergo a procedure that would deliver the babies without us seeing them, talk to a high risk obstetrician. We chose to talk to a high risk obstetrician, who presented two additional options: take anti-contraction medicine (I was having contractions, though I didn't feel them) and try to postpone labor, attempt a "delayed delivery" in which we would deliver one baby, then try to stop labor and save the second twin. We opted for the anti-contraction medicine. We didn't want to do nothing and certainly didn't want to choose to lose one or both babies. In the meantime, my doctor had ordered that I couldn't eat anything for the rest of the day, so I forcibly fasted for Good Friday.

By Friday night we had several family members at the hospital with us. My husband, my mother-in-law and I played Uno (but I couldn't lift my head, so they had to tell me what the top card on the pile was and then I would hand them my card to top the pile). Saturday passed much the same. We had another ultrasound, which showed that the babies were still doing fine. However, it showed that there had been no improvement in our situation. I was still several centimeters dilated and Caiden's sack was still poking through. We contacted friends asking for their prayers. My husband told me "If you're not sleeping, you should be praying. Those are your only options."


We had some really special support in our couple of days there. My sister-in-law, who hadn't done any city driving since a bad accident several months before, drove herself to the hospital, braving a drive that even makes me nervous. My grandmother was with us the whole time, keeping my mother sane. My husband never left my side, except a few trips to the hospital chapel. My mother and mother-in-law were with us during (and beyond) all visiting hours. In addition, we had a couple of very special nurses.

The Name Game

Of course, from the name of the blog, you know the winning names, but pretend you don't for this story...

Once we knew the sexes, we started to decide on names. I had suggested early in the pregnancy the name Caiden for a boy. My husband loved the name Shea, so he suggested Caiden Shea. I liked it and the more I thought about it, the more it grew on me, so I thought we were set with a boy's name, until my husband said he wanted to name him Dominic. I was looking for a name with an Irish feel to match our last name (even though our Hayes actually comes from England), so I didn't like Dominic. We continued to debate about it while deciding on a girl's name.

My husband had always liked the name Mia for a girl, but I was never sold on it. I didn't mind Mia ask a nickname, but thought it was too short to be a full name, so I proposed all kinds of names that could have Mia as a nickname. He didn't like any of them. Eventually he offered that we could name our boy Caiden Shea if I would give in on the girl's name. He would even let me pick the girl's middle name. I really liked the name Kailey. Even though I didn't think Mia Kailey sounded great together, I decided I would get used to it eventually. Now it was settled; we had named our kids, but couldn't tell anyone yet since it would give away the sexes.

We started calling the babies by their names. Mia was quite active and one night I told my husband how she had been kicking me all day. Out of the blue he asked if I liked the name Mia Kailey. I told him that I didn't really and after a few minutes he said "what do you think of the name Kailey Jordan"? I told him that I really liked it. After some discussion, we changed the spelling: Kaylie to ensure that she wouldn't be called Kylie and Jordyn for a more feminine spelling.

Caiden Shea and Kaylie Jordyn
I still think these are the greatest names and can't imagine topping them when we name future children. One of my biggest heartbreaks in the hospital weeks later was the thought that I would never get to call them by their names. I had tested each name from every angle and even looked forward to chastising them with "Caiden Shea and Kaylie Jordyn!!"

Boys or Girls?

At 18 weeks, we went to the doctor for a very unexciting ultrasound to measure my cervix to make sure I could hold twins in. The measurement went well and I asked if we could look at the babies. The tech said that she could try to figure out the sexes if we wanted. We did, very much so! So she started with Baby B and announced "It's a girl!". Baby A was much less cooperative. Eventually, she was able to get a good enough angle to announce "It's a boy!"

My husband couldn't have been more happy. I was hesitant. My husband had declared that if the twins were one boy and one girl, our family would be complete. I had always wanted more than two kids, so this was disappointing to me. However, by the next day, I had realized that this was the perfect scenario: my husband was thrilled about having a boy, I was thrilled about having a girl, his side of the family had only girls, so they were thrilled about a baby boy joining the family, and my side of the family had only boys so they were thrilled about a baby girl.

A couple days later, we went to the Mother of Twins sale (a huge second hand sale of all things baby). The clothing was separated by gender and age. He immediately went to the boys' section and I went to the girls' section. We each enjoyed picking out items for our selected gender and left with a couple bags of clothes and one neutral toy.

However, our mothers were scheduled to come to the anatomical ultrasound scheduled for two weeks later where we had expected to learn the sexes, so we decided not to ruin the surprise and elected not to tell the family the sexes. This made for an interested couple of weeks while we tried not to give away our secret...

Twins!

We elected to go through the first trimester screening (which checks for Down Syndrome and other chromosomal abnormalities) mainly because it required an ultrasound, which would be the only opportunity we would have to see our baby before 20ish weeks. Two days before the ultrasound, we had the 12 week appointment, our first opportunity to hear the heartbeat. The doctor seemed to be in a hurry, so we listened the baby's (singular) heartbeat for about 10 seconds. We left completely unsuspecting of what was to come...

Before beginning the ultrasound the tech explained the purposed of the test. She told us she would be looking for triplets, then when she saw the looks on our faces, she clarified "three chromosomes, not three babies!". As she began the ultrasound, she ran the wand across my whole belly to get oriented and then paused and said "Um... twins? Did you know there were two in there?" And then she showed us that there were really two! We were totally shocked! Very nervous, but very excited.

Telling the family became much more interesting... no one in our generation had twins! However, the most annoying question I discovered from non-family members: "Do twins run in your families?" How many twins are really born because twins "run in the family"? (Hint: very few) I dreaded having to answer this question for the rest of my life whenever I told someone I had twins.

I quickly started researching everything twin - I found special cribs, play pens, Boppies, names, clothes... I signed up for the Greater Rochester Mother of Twins Club to get support from local mothers who could give advice.

We started thinking about names, but it was too overwhelming to come up with 4 full names (two boys, two girls - they were fraternal, so could have been any combination of boys, girls, or one of each), so we put that on hold until we could find out the sexes.

The Pregnancy Test

We had tried unsuccessfully for several months entering December 2010. I was charting my temperatures, and toward the end of December when my temperature was supposed to be elevated to indicate that we were expecting, it started dropping .1 degrees per day for several days. I decided that must mean that we had been unsuccessful again, so I was oblivious to every sign that told me otherwise. On New Year's Eve, we went to dinner at Chili's and I was craving a big fat juicy slice of tomato. That didn't strike me as odd. On the 1st, I went to visit family. During the trip I started to notice soreness in my chest. That was what finally prompted me to take a test when I returned home. During the trip I had not had a private moment to talk to my husband about my suspicions, so I decided to take the test without telling him (since it was the middle of the day and it might not turn out positive anyway). As soon as I put the stick down, it immediately produced one very bright pink line (this first line was the one that was supposed to indicate positive). After a few minutes, it showed a second very faint pink line. I hid the test behind my back and brought it to my husband saying "I have a surprise for you". He said "Are you serious?" but upon further inspection was skeptical since the second line was so faint, so he went out to get a different type of test (the kind that shows a plus or minus). As soon as I took the second test, it showed a bright plus sign. We were so excited, but nervous - this was our first pregnancy, what should we expect? What would happen next? Would we have a boy or a girl? Would we be good parents?