Sunday, December 28, 2008
No room at the inn...
Lilly has been put back in an isolette, because she was burning too many calories trying to regulate her temperature, causing her to lose weight. She is now taking every other feed by bottle and weighs 3 pounds 9 ounces.
Elzi is also growing and is taking at least one bottle per day. She now weighs 3 pounds. I think she is happy to be beside her sister.
We have an appointment with the lactation consultant tomorrow to try to get the girls started with breast feeding. Hopefully, things will go well. The sooner we can get them feeding, the sooner they can come home. We can't wait!
Wednesday, December 24, 2008
One Week Old!
Ben and the grandparents were able to visit the girls in the NICU a few hours after they were born. They took some pictures to show me when they returned to my room. They explained that both girls were breathing room air, but Elzi had a little tent over her head to help her.
I was finally able to go down and see them around 9 PM that night when I was able to get out of bed and into a wheelchair. Lillian was in a crib with a warmer over it, and Elzi was in an isolette. They were both breathing on their own, and I got to hold each of them. It was sooo wonderful!!
I began pumping on Wednesday night, so that the girls could be fed breastmilk through a tube. Their tubes run through their noses and into their tummies. We visited them a few times on Thursday, and they were both doing fine. We were told that Lilly would probably move to the Transitional Care Nursery (TCN) the next day, and they hoped Elzi would soon follow.
When I went down on Friday, expecting to visit Lillian in the TCN and Elzi in the NICU, I was told that both girls were in the TCN. That was very exciting, as the TCN was described to us as the place where babies just practice breathing, eating, and growing until they go home.
While they have been in the TCN, both girls have received phototherapy to break down their bilirubin and prevent them from developing jaundice. Lilly spent a few days under her bili light, or "Lilly light," as Ben refers to it, while Elzi only needed it for a day. Both are now finished with their lights.
Lilly and her "Lilly light"...super blonde hair...and adorable butt crack
Yesterday, the doctor told me that they wanted to transfer the girls to the Special Care Nursery at Durham Regional Hospital. We would love for them to be moved as they would be closer to home and parking is a nightmare at Duke. However, Lilly has been having some trouble tolerating her feeds. She has not been fully digesting her food. They have run tests to determine that this problem is simply due to her prematurity and is not uncommon. However, we are waiting for her to tolerate her feeds before the girls will be moved.
Lilly is now taking some of her feeds by bottle, when she is not too sleepy. Today, she has been moved into a "crib" (without a warmer) since she is doing a good job of regulating her body temperature on her own. She was even wearing clothes today! I am hoping to get her into a Christmas outfit tomorrow.
Daddy feeding Lilly her bottle
Lilly in her new crib on Christmas Eve
Elzi is still in her isolette, but was moved into Lilly's room. Now they are side-by-side which makes visits much easier. Elzi has been gaining weight, but is still working on her temperature. Ben got to give her a bath today with the guidance of the nurse. He loved it!
Daddy's first baby bath with Elzi
Elzi warming up after her bath
...so much for being brief ; )
Daddy's First Bath with wiggle worm Elzi...and his video editing of the event
The Birth of Elzi and Lillian Buchanan
I guess I need to describe the birth of the girls before giving an update their current status.
On the morning of December 17th, my parents and Ben's parents joined Ben and I in my hospital room as we awaited 10:30. My nurse, who was great, started to get me ready around 9 or so. I was getting pretty anxious as we approached 10 o'clock, and it was not until 10:45 that the nurse and anesthesiologist came in my room and said, "We're ready." I was very nervous as they wheeled my bed out of the room and I left my family behind.
When I got to the OR, I was prepped for surgery. Once they were confident that my spinal had taken effect and all medical staff were in place, they sent for Ben. I was SOOO happy when he finally arrived. He sat beside me and held my hand as the operation began. Because Elzi had made her way to the bottom of my belly over the last month or so, she was the first to be delivered. She immediately began crying when they pulled her out. They held her over the curtain, so I could see her.
Next, they explained that Lillian was breech, so they were bringing her out very slowly. When they finally got her out, we did not hear her. They said she was a little stunned, and a few seconds later, she began to cry, too. They also held her over the curtain, and then took her out of the OR to where the baby teams were set up. Ben and I could hear them crying loudly through the OR door.
After a few minutes, they told Ben that he could go and see them. I told him to go ahead, and after a short time I heard, "We have a surprise for you, Mom." I was totally surprised when Ben came around the curtain holding both girls. He was able to sit down for a few minutes, so that I could look at them. It was so wonderful and comforting to see them both, and I was able to relax as they finished my surgery.
Wednesday, December 17, 2008
THE BABIES HAVE ARRIVED!!
Elzi Grace at 11:38 AM weighing in at 3 lb 1 oz, 17 inches long.
Lillian Elise at 11:40 AM weighing in at 3 lb 13 oz, 17 1/2 inches long.
Everyone is doing fine.
Amy will update you later.
Thanks to all for your thoughts and prayers.
Love ,
Grandma Linda
Monday, December 15, 2008
My Nerves are Getting the Best of Me
I had an ultrasound this morning, and both girls are doing great. Elzi was practicing breathing almost the entire time. It was to the point where my ultrasound was twice as long as it should have been as we waited for her to stop practicing, so the tech could do the cord dopplers. I think she just knows she will have to be breathing for real soon, so she's cramming for the big test.
I also took a tour of the NICU today. There are some really tiny babies in there. I got to see another 32 week baby, but he was pretty big for his age. He was trying to drink from a bottle. He was not very successful, but he was trying, and he was only about 14 hours old. I also saw some twins, but they were only 29 weeks. The one I saw was 2 1/2 pounds and she was TINY. I think the girls are going to be smaller than I had pictured them to be.
There is an antepartum lunch tomorrow for all of us still pregnant ladies. That will get me out of my room and allow me to socialize with some other patients. Then some of my fellow teachers are planning to come visit after school, and Ben will be coming later to spend the night. I am hoping that all of this action, and hopefully maybe some anti-anxiety medicine, will allow me to make it to the big day without a major breakdown.
My mom will be posting the birth announcement for me on Wednesday. I have no idea if my surgery will actually be on schedule or how long it will take them to deliver the girls, so be sure to check the blog periodically after 10:30AM. The next time I post, the girls should be here!
Saturday, December 13, 2008
Nothing New
As it stands, I should be home a week from today. They usually keep c-sections for about 3 days unless there is a complication, which they don't expect with me. It will be sooooo great to be back in my own bed!
Tuesday, December 9, 2008
Awaiting arrival
The doctors have said that everything is fine. My blood pressure is okay, and the babies are monitoring well. I am still having NST's twice a day to monitor the babies' heart beats. I am also having 2 BPP's per week, where they use the ultrasound to check on the babies' movement, muscle tone, breathing practice, and fluid. I had a BPP yesterday, and the girls did really well. They were practicing breathing a LOT, and as usual, they were moving around very well. I also had cord dopplers done to check the blood flow through the umbilical cords. The results from that were also good. They will do dopplers once a week, which I guess means I will only have one more!
I am counting down the days that I have to remain in the hospital. 8 more till delivery! I'm glad the numbers are getting smaller, but am beginning to get anxious about the fact that our daughters will be here in a little over a week! It's a lot to think about, so I try to keep my mind off of it. Now I'm just trying to stay busy until the big day.
Thursday, December 4, 2008
13 More Days!
The main concern now is the possibility of cord accidents, which has been a concern the entire pregnancy. If either of the babies' heartrate slows down too much while they are monitoring, it would be a sign of cord compression. If this happens, an emergency c-section will be performed to ensure the babies' safety.
As long as the heartrates are normal, as they have been, the babies will continue to cook for 13 more days. They have scheduled my c-section for the morning of December 17th. I guess we need to get to work on coming up with some middle names!
Tuesday, December 2, 2008
The Girls are Growing
Down For the Count
The doctor discussed with me the fact that my urine had 400 grams of protein when 300 is baseline. He explained that this meant that I did have preeclampsia which could affect many bodily systems. The protein in the urine indicates that the preeclampsia is affecting my kidneys, but I currently have no other symptoms of problems from preeclampsia. Due to the complicated nature of my pregnancy in general, and now with the preeclampsia on top, he recommended that I be put in the hospital for monitoring until delivery. He called the director of maternal fetal medicine to get a second opinion, and he agreed.
"Same plan, different location," is how he described it when he came back in. They are still planning to deliver at 32 weeks, but they want me in the hospital until then. He explained that the preeclampsia can worsen overnight, and they would not want me to be at home if that were to happen. As much as I really don't want to be in the hospital, I think it is probably the best precaution. I guess I'm lucky to have stayed out of the hospital this long. Many doctors put mothers of momo twins in the hospital automatically at 28 weeks, if not before. If there are any major changes in my condition, they will deliver right away, so now we just hope everything is okay until the 17th.
Friday, November 28, 2008
There's No Place Like Home
They discharged me around 7:00 PM tonight, and I am now on modified bed rest. This means that I don't have to stay "in bed." I can be on the couch or in a recliner, but I just need to relax. I can get up to shower, fix myself lunch, go to the store, and of course, go to my doctor's appointments. I am just not supposed to do any housework or make too many trips up and down the stairs...anything that could raise my blood pressure.
Now we are just keeping our fingers crossed that I do not have to go back into the hospital for another 2 or 3 weeks when I have my c-section. I can't believe it's so soon. It feels like December 17th is just right around the corner.
Thursday, November 27, 2008
Thanksgiving in the hospital...
1. If everything is normal (no protein in the urine) I may be able to go home tomorrow.
2. If I am preeclamptic, they will keep me in the hospital and monitor me until the babies are born at 32 weeks.
3. If I am preeclamptic and anything changes, i.e. blood pressure spike, they will deliver me right away.
The good news is, my family came to visit me today. A church from Raleigh provided Thanksgiving dinner for the 5th floor and their families. My nurse created a "pregnant lady parade," and we all got wheeled over the the children's area to get plates to bring back to our rooms. The food was great! My parents, my brother, his finance, Ben, and I all ate our Thanksgiving dinners in my room. It was not the ideal situation, but at least we all got to eat together.
The babies have had two good NST's today, and I have had very few contractions. Despite the fact that I am still in the hospital, I am feeling pretty good. We will see what tomorrow brings!
Wednesday, November 26, 2008
Admitted for at least 24 hours...
They put me in a wheelchair, and off we went. Let me tell you, that was a really strange feeling, being wheeled down the hall by some stranger when I was perfectly capable of walking. Granted, it would have been a pretty long walk from the clinic to the hospital, but never the less, it just felt strange. They took me to the labor and delivery triage and checked me in. One of the tests they were performing was for protein in my urine. This is apparently a big sign of preeclampsia, since it effects other parts of the body. There was no protein in my urine at the time, but they said they needed to collect my urine for 24 hours to rule out preeclampsia. The plan was to admit me for at least 24 hours.
I was admitted around noon today, so I will be here until at least noon tomorrow. They gave me a steriod shot this morning, and I will get another tomorrow morning. These will help the babies' lungs develop. I have also been having NST's every 8 hours, which have shown many contractions. The doctors have tried to relax my uterus and slow the contractions with fluid and medicine. They have checked my cervix twice and said that I was not going into labor. The contractions are just common with the irritation that comes from twins.
Finally, around 9 PM, my contractions had improved. I am still having them but can barely feel them. They have finally taken me off of the monitors, so I can eat and get some sleep. They will give me my next NST after I get up in the morning. I will try to post another update tomorrow. Whether they keep me here or send me home, I will definitely be off my feet, so I should have plenty of time to update the blog...that is until the babies decide to arrive!
Wednesday, November 19, 2008
Right on schedule
Baby B's heart rate was a little high at first, which concerned the nurses. They explained it as, you can only run for so long, then you get tired. However, her heart rate did slow down to where they expect it to be. They said she must have just been showing off. I guess she was the one kicking me so hard that it hurt! They were very happy with the amount of movement. They are moving like crazy now!
At my OB appointment yesterday, I saw a nurse midwife. She asked why they scheduled my appointment with her rather than an MD. I told her I was thinking the same thing but didn't want to be rude. She said to make sure they scheduled me with an MD from now on since I am getting so close to delivery time.
At my appointment next week, they should schedule my c-section as well as some steroid shots I will need. She explained that they will give me a steroid shot about 2 weeks before my surgury and another 24 hours later. These will help the babies' lungs develop, so they will be better prepared to breathe when delivered prematurely.
I have another non-stress test today. I have them 3 times a week now. Hopefully, I will be updating my blog more frequently now that I am not working. I will try to get some pictures up next time.
Tuesday, November 4, 2008
Good news and bad
My next appointment is next week, and hopefully Baby B will catch up a little by then. Please keep us in your thoughts and prayers. I'm sure I will soon have plenty of time to keep my blog updated ; )
Baby A's profile (top of head to far left)
No good pics of Baby B today
Tuesday, October 28, 2008
How do people carry twins to 36 weeks?
23 weeks
25 weeks...and counting
Tuesday, October 7, 2008
All Is Well
Baby B is at 21 weeks and 0 days. I'm very happy that Baby B seems to be developing normally despite her single umbilical artery. In fact, she has taken charge and pushed her way to the front of the line. (She is closest to the cervix now.) Baby B is 15 oz. She finally gave us a good view of her heart, after much coaxing, and it is normal.
This ultrasound was a relief. I go back in two weeks for an ultrasound to assess fluid and bladders and in four weeks for another growth assessment. Until then, Ben and I will be taking several classes and touring the hospital.
We already took a cesarean birth class that was a little unnerving but very enlightening. Our favorite tip from the class was the "job jar." The nurse instructed us to not allow visitors after the babies come home, only helpers. I wanted to go ahead and give you all a heads-up on this plan. Basically, if you plan to come visit the babies, you will be expected to select and perform a chore from the job jar. You can handle that, right? Our house will probably be cleaner than it has ever been!
Here is my 20 weeks picture.
Wednesday, September 17, 2008
No news is good news
...and sweet little "twin b" being shy, hiding her face with her hand.
Wednesday, September 3, 2008
It's a Girl...I mean It's Girls!
Normally, babies have 2 umbilical arteries and one umbilical vein. Occassionally, especially with twins, a baby has only a single umbilical artery (SUA). SUA is found in about 1 of every 100 live births, so it is very common. Most are not even aware of it, because without an ultrasound scan, it is not detected. Anywhere from one half to two-thirds of babies born with SUA are born healthy and with no chromosomal or congenital difficulties.
We are hoping that "Twin B" is one of those healthy babies. She is currently about one week behind developmentally, which they attribute to SUA (not any twin-to-twin transfusion, which would be more dangerous to both babies). Although they were unable to get a good picture of her heart (because she refused to turn over), they said that it looked symmetric. All of her other organs and limbs looked normal. Since she has already been screened for some of the common chromosomal defects, with normal results, they do not suspect any chromosomal abnormalities at this point.
The plan now is to go in every other week for ultrasounds. They will be keeping track of both twins' growth, fluid volume, and organ appearance. Hopefully, next time they will be able to get a good look at "Twin B's" heart and rule out any heart defects.
Due to "Twin B's" refusal to turn over, we could not get a 3D picture of her face. Below is a 2D picture of "Twin B" and a 3D picture of "Twin A." (I personally think the 3D image is a little creepy, but...)
Wednesday, August 27, 2008
And the Sex Is...
Wednesday, August 20, 2008
On the bright(er) side...
She agreed with most of what the specialist in Atlanta had told us, except for the whole bit about me going into the hospital at the beginning of the third trimester. She said that she was aware that this was normal protocol with doctors in Chapel Hill. However, this was not normally the plan for this practice. Unless I was determined that I needed to be in the hospital or something else happened where it was needed, she did not plan to put me in the hospital for my third trimester. This was the best news I had heard my whole pregnancy!
The plan that Dr. Murtha proposed was for me to come in about every two weeks, to check on the babies and make sure they were okay. She explained that for the next several weeks (up until 20+ weeks), there is really nothing that can be done to fix any problems that may occur. There is no way to predict if, or when, anything would go wrong, so periodic checks are the best we can do. Her plan for the third trimester is for me to come in about three times per week. I know this seems like a lot, but it beats the heck out of laying in the hospital!
Unfortunately, the decision to deliver the babies at 32 weeks seems to always be the plan for momo twins, as the risks of cord accidents outweigh the risks of prematurity at this point. This means that I will not be sharing my birth month with my children (who were originally due February 11), but instead they will be early Christmas gifts, arriving around December 17th.
After we discussed my pregnancy plan, we got to take a look at the babies. As usual, one was kicked back with its feet up (my baby) and the other was moving around like crazy (Ben's baby). Ben was very anxious to find out the sex of the babies, but neither would "give up the goods." One's bottom was too low to be seen and the other had its legs closed shut. The doctor joked that they must be girls tormenting their daddy. Oh well, maybe next Tuesday, when I go to my appointment without Ben, they won't be so shy.
Monday, August 18, 2008
The Honeymoon is Over
He explained that fraternal twins (which I wouldn't have been surprised to have since Ben and I both have a family history of them) are formed when two eggs are both fertilized. Identical twins, on the other hand, happen purely by chance (1 in 250 pregnancies to be exact!) when the fertilized egg splits. If this occurs before the amniotic sac forms, the babies share a placenta but have their own amniotic sac. (This is usually the case.) Unfortunately, my egg waited until about 7-9 days after conception to split, forcing my babies to have to share the same living space.
The doctor explained that our situation is an incredibly high-risk one. The main concern with momo twins is cord entanglement. As a result of cord entanglement, one or both babies' cords can become compressed to the point that they no longer receive any nutrients. These "cord accidents" usually occur gradually. Therefore, I will be very closely monitored throughout my pregnancy through ultrasounds and fetal monitoring.
The plan that he proposed to us was that I would visit the doctor about every two weeks during the second trimester, be admitted to the hospital at the beginning of my third trimester, and deliver the babies via c-section at 32 weeks. When we told him that we were moving to Durham, he let us know that he just moved from Raleigh and studied in Chapel Hill. Therefore, he was able to refer us to Duke Maternal-Fetal Medicine, having personally worked with the director. He suggested that we make an appointment as soon as possible after the move, so that the doctor here could take a look and come up with a care plan.
Needless to say, we left with a much more pesimistic outlook than we had when we arrived. It was kind of a reality check letting us know the honeymoon was over.
Specialist Referral
Sunday, August 17, 2008
Twins Confirmed
It turns out there is usually an image that looks like an engagement ring. However, our engagement ring had two diamonds instead of one. The tech said that she had never seen such a clear picture of twins that early (I was about 5 1/2 weeks). She called it "textbook".
The doctor confirmed the ultrasound tech's assumption that I was, in fact, carrying twins and that they appeared to be identical. She recommended that I make another appointment in a few weeks to get a better look.
Here we go...
Around the beginning of June, I visited the doctor to confirm that I was, in fact, pregnant. Although fairly unexpected, we were excited about becoming first time parents in a new house, in a new town, with new jobs. On my way out of the doctor's office, I had blood drawn and was on my way.
A few days later, I received a call from the doctor stating that although my urine test had been positive, my blood test was negagtive for the pregnancy hormone, and I may have lost the baby. She requested that I come in for another blood test, which resulted in a normal hormone level for that point in my pregnancy. Just to be sure everything was okay, I went in a few days later to ensure that the hormone was doubling every 48 hours as it should.
My next call from the doctor was both reassuring and surprising. Rather than doubling, my hormone had quadrupled, leading the doctor to joke about the posibility of being pregnant with twins...and thus begins our saga.