On Thursday we had our visit to the breast feeding support group as usual. As usual, each of the boys is gaining at a greater than average rate - Grayson is now up to 11 pounds, 5 ounces and Noah is 10 pounds, 12 ounces. Since last Thursday, Noah can't seem to get enough to eat and Grayson seems inclined to let his brother catch up a bit, so we'll see what the scale says this week.
On Tuesday we took them in for their 2 month checkup only to find that their appointment was on Monday. We re-scheduled for Friday when the boys got a round of immunization shots and a routine check. Grayson (or is it Noah?) has an umbilical cord hernia - his belly button is an outie about the size of a large grape. Our own research told us that this condition usually resolves itself, which Doctor Szold confirmed. If it does not by the time he's three or so it may require surgery to repair, but such case is not the norm. (Theresa just confirmed for me that it's Noah, not Grayson, with the enlarged belly button).
If we're to make it to the museum today, I've got to go as it's starting to get late and we don't want Cody to miss it two days in a row. So I guess that's it for now.
Oh, almost forgot. Theresa goes back to work on Wednesday, the 11th (two days from now). She's leaving me all alone with the boys the rest of the week, so you may not hear from me 'til next week when the boys start going to daycare with Mattea. A new chapter in their young lives already!
As you know (if you check the "What's New" page), Grayson has already gotten to 10 pounds! On April 3rd, at discharge, he weighed 5 pounds, 3 ounces - he's almost doubled that in less than 8 weeks! For all of our concerns about "preemies" and development and size and weight, they both seem to be doing great! Noah's doing well too, though not as piggish as his brother. His 1 ounce deficit at birth has become nearly a 10 ounce deficit to his bigger brother now.
You may recall that I ventured the theory that we were in for quiet boys for the first four weeks or so, which is how long they would have stayed inside Theresa had they gone to full term? Right around week five, they started being awake and alert for longer periods and started to discover that their lungs were good for more than just breathing. They could also be used to propel some pretty good noises! At first they would treat us to a symphony of noises - squeaks, creaks, grunts and groans. Then they would treat us to their impressions of barnyard animals (although I'm not sure where they'd have heard the originals) - you know, bleating like goats, neighing like horses. Ah, but that was child's play to what they've discovered now... Now they've learned how to cry!
Not that little "Isn't that cute" newborn cry, where you can barely hear it. They've developed some pretty powerful lungs. So powerful that if we aren't quick enough to soothe their concerns, they cry themselves hoarse and create even more entertaining sounds. Kind of like raspy frogs I think.
This past weekend, our children ganged up on us. The boys with their 8-week-old cries, and Mattea with her 3 year old-ness. (And you thought we had the perfect family, didn't you...) By Monday night, all we wanted to do was go to bed early (which naturally, we didn't get to do for a variety of reasons). What's that about what doesn't kill you makes you stronger? We got stronger by the hour this weekend! Speaking of getting stronger... (you may not see the connection now, but you will in a few minutes...)
Do you believe in love at first sight? I don't. Never have. (Lust at first sight, maybe, but that's an entirely different topic for another forum!)
So, you may be thinking, "Why do you ask?" As the father of newborns I feel that I may speak with some authority on this issue, at least from one person's perspective. Some of you non-parents out there may be under the impression that all parents immediately fall in love with all of their children at birth. I'm here to tell you - it ain't so. At least not for me, and I'd wager many, many more that may or may not care to admit it. So why do I bring this up? Truth in advertising, I suppose. Any long time readers know that I generally write with a very positive perspective as my vantage point. You'll find no change of reference here, as you will soon see. But the fact of the matter remains that when I changed Mattea's first diaper over three years ago, I felt somewhat detached - as though this were not my child, but I performed the service for another. Don't get me wrong. From the day she was born, I would have done anything necessary to protect my child, including sacrificing my own life for hers. That may be due more to upbringing than to love, but just because I didn't love her yet, did not mean that I did not care for her, or about her. I just didn't love her yet.
I bring this up now, because I am experiencing similar feelings with the boys, and I'll never be experiencing these feelings again, as Noah and Grayson will be the last additions to this Hernandez household. And I wanted Mattea and Noah and Grayson to know that if they experience the same sensations that I'm going through now, and went through with Mattea, that it's okay. 'Cause ya know what? I couldn't imagine my life without Mattea in it now, just as I could not imagine my life without Theresa in it. I love them both very much. And soon enough I'll feel the same way about Grayson and Noah. Love takes time to develop. At least for me, and I imagine most. But, as I recall reading not too long ago, love is not just a feeling, love is a verb. To love. To serve. To do. And right now, Noah and Grayson can't do anything for themselves. They rely on Theresa and me to meet their needs. They rely on Theresa and me to love them. My love for them is developing as I do things for them. My love for them is getting stronger each day, as I change their diapers and see them look up and smile at me. As I watch them in their sleep and see fleeting smiles as they dream of... what do 8 week olds dream of... giant lactating breasts floating across the sky? I couldn't tell you when I fell in love with Theresa. I couldn't tell you when I fell in love with Mattea. But I can tell you that as each day goes by, I'm falling in love with my sons. And as I look back on these past 8 weeks, I'm already cherishing all of the memories that my boys are giving me. Even the crying.
First, you should know that the boys are gaining weight like crazy! You may remember that they gained 10 ounces each the week of the last posting? Well, the following week they each gained another 10 ounces, and last week they gained 13 and 14 ounces! They've been eating a lot this week too, so we expect tomorrow's visit to the breast feeding support group to show another significant gain. Noah is losing some ground to his brother now - as of last Thursday, Noah weighed 8 pounds, 2 ounces and Grayson weighed 8 pounds, 8 ounces. They have little double chins going on, and they're starting to show some meat on their arms and legs.
While their feedings grew further apart for a short while there, they seem to be coming closer together again. Only now, they are telling us they want to be fed more frequently. And while the cluster feedings at night aren't as bad as they were for awhile, they still are demanding to eat more in the evenings. So now, we're back up to eight or more feedings a day for them. One thing that makes it a little easier... occasionally we can get them both latched on at the same time, so the total time devoted to feedings is not really increasing dramatically.
Mattea is doing pretty well with all of this new activity going on around the house. One thing that Theresa and I have both noticed about Mattea is her increased emotional sensitivity. She'll break into tears for seemingly minor issues, and does throw the occasional tantrum if things don't go her way. While her behavior is not unexpected, it doesn't make it any easier to take. So we try to make sure we set aside some one on one time just for her. She absolutely adores her extended family, so we try to get to family events so that she can spend time with them. She loves to make pretend phone calls to Uncle George and Aunt Lia, or to Auntie Sister. It's funny - when we ask her if she'd like to talk with them, she says no, but she has long pretend conversations with everyone.
I'm afraid that one of my theories regarding the boys may have been somewhat on target. I theorized that because the boys came early, they spent most of their time sleeping to make up for lost time in mom's belly. Now that they've been out for six weeks (Six Weeks!), they have more awake and alert periods. And yes, more crying time. Mostly, they just cry when they're hungry. But now, they seem to cry if they've been awake for awhile, and they get bored. Or if they get their arms out of their burrito wrap. They both are getting very strong, and it's difficult to wrap them tightly enough. Even my expert wrapping technique is not enough to keep them swaddled from one feeding to the next. We're still pretty fortunate that one's histrionics don't generally bother the other, but occasionally one does get the other one going. It doesn't happen often yet, I just have a feeling that we'll probably be seeing more of that in the future.
Theresa has been very kind to me, and let me sleep through her nighttime feedings the last few nights. While not being able to sleep through everything, getting a bit more sleep has certainly been helpful. If we can build up enough of a supply of expressed milk, I'll return the favor.
Mattea brought home a cold from daycare, and I think everyone's got it now, including the boys. They just seem to be a little more demanding, and it seems that they're a little congested. They sometimes have little sneezing fits too, which sounds pretty funny 'cause they're so tiny. But at least being breast fed they should hopefully be receiving the necessary antibodies from Theresa to help fight it off.
That's about it for now. I'll keep you updated as best I can, and we'll get more pictures up soon.
For those of you that have never seen the movie "Groundhog Day", it stars Bill Murray as a local television weatherman who goes to Punxsutawney, PA to cover the famous rodent, only to repeat the day over and over again until he changes his ways. In many ways, it felt like we were living the same day over and over again when we brought the boys home. Continuous feedings. Lack of sleep. Diaper changes. All happening way too soon after completing the last one. We finally are seeing some relief.
It has been a busy couple of weeks. I had no idea it had been that long since I updated my journal. Much has happened in this short time, so let's get to it!
On Wednesday, the 16th, Noah lost his umbilical cord. Mattea's hung on by a thread seemingly forever, but it finally fell off at about three weeks. So Noah's was early by comparison. Grayson still clung tightly to this last physical connection with mom. The 17th saw us get out to the Breast Feeding Support Group. Noah - 6 pounds, 2 ounces, Grayson - 6 pounds, 5 ounces. Each gained about 8 ounces over the previous week - at the upper end of the expectation, so we were very pleased.
In the evenings, we noticed that the boys were starting to demand more milk. We would feed them and put them back to bed, only to have them cry for more. We accommodated them either by Theresa feeding them again, or supplementing with expressed mother's milk (what Theresa had pumped earlier). At first this was just a little, but in the last few days has occasionally become the ravenous demands of two tiny voracious never satisfied mouths. On at least a few occasions now, we have had to feed one or both of the boys three or four times within about a 2 hour window! At the most recent support group meeting, we learned that these are called cluster feedings, and they typically occur at the most stressful time of day (which our evenings would qualify as - getting Mattea home from daycare, fed, changed, ready for bed; the boys fed, changed, ready for bed; us fed, changed, ready for bed). The upside is that the boys are doing phenomenally well regarding weight gain - they each gained 10 ounces over the previous week! (Well ahead of the 6-8 ounce norm). This put Noah at 6 pounds, 11 ounces and Grayson at 6 pounds, 15 ounces. The lactation consultants basically said that we could feed them whenever we wanted to since they are such good gainers. As I mentioned last time, we were starting to stretch out the night time feedings to get a little more sleep. Now, we're not waking the boys up to feed them at night. They're waking us up when they're hungry. Last night, it turned out to be around midnight, then around 5. But we're hopeful that as they get used to this pattern, they'll let us sleep a little longer at night, and we'll make sure that we get enough in them during the day.
Grayson finally decided to let go of his umbilical cord stump just yesterday, 24 days after he was born. So he took the crown from Mattea, who I think went for 21 days before she lost hers. (Theresa also wanted me to let you know that Grayson smiles a lot now)
One other item of note - The boys had their little visit with the man with the scissors on Monday, the 21st - and no it wasn't for a haircut. They received a local anesthetic for the procedure, and they cried more for that than for the circumcision itself, during which they made not a sound. I watched, with some sense of curiosity, though Theresa elected to maintain a safe distance from it all. If you are at all interested, a description of the procedure can be read here (Method C. 4.)
We got a chance to get out on Easter Sunday also. Jim and Judy hosted the festivities, and all the kids enjoyed an easter egg hunt while the boys got passed around from arm to arm. We're still fortunate that the only time they cry is when they're hungry, so they were a pleasant experience for those in attendance. I'm sure we'll have less pleasant experiences in the future! We'll get pictures posted soon.
So, why, might you ask, is Groundhog Day over? Because now our days are sufficiently different from one another that we almost have real lives again! Theresa and I have each been able to wander out for brief periods, unescorted into the world beyond. Oh, the simple pleasures of parents of newborns! Until next time...
The short hospital stay confirmed for us the reality of having two new additions to our lives. I slept at the hospital every night, but the fact of breast feeding (or in our case, trying to breast feed) twins, really hit home as we adjusted to a new daytime routine. Noah and Grayson doing their best to learn their new way of nourishing themselves; Theresa trying to remember how to get started all over again. Dr. Szold reminded us that newborns often don't eat for the first three days or so, and these guys fell firmly into that window of indifference. Still, a significant amount of time dedicated itself to this first learning experience for the boys.
Theresa, keep in mind, was in the process of recovering from major abdominal surgery. Walking the corridors, directed by her doctor, consumed some of our free time. Most of the rest, between feeding attempts, seemed to be filled with trying to rest for the days waiting ahead for us at home. Our homecoming was delayed a bit on Thursday afternoon when both boys temperatures dropped below the acceptable envelope. Off to the oven for a bit, and they sent us home - just like that!
If you ever wondered about such things, yes, you can put three child safety seats in the back of a Maxima. We are fortunate that two are rear facing and one faces front, elsewise they would not fit. Mattea holds court in the center, keeping a close eye on a brother to each side. Of course, that leaves little room for anything else, especially when the boys dual stroller resides in the trunk. A minivan is in our future - likely sooner rather than later.
You may recall that the first night home three years ago, these new parents made a trip to the Emergency Room with Mattea for the parents' sake, more so than the child's. I must say (with some pride), we did not repeat the trip with Grayson and Noah. Not that we were without concern, but we did feel at least a bit more comfortable. With that, here's a look at our first days:
Midnight - first feeding of the day. Change diapers (clothes too if I did a bad job with the diapers - about a 50/50 chance the first few nights). Depending on the boys hunger and our wakefulness, anywhere from an hour to an hour and a half from start to finish for each feeding session. Then sleep for an hour or two.
Three - second feeding, same as the first, just a bit more bleary eyed! A little more sleep.
Six - third feeding. Mattea gets up usually around 6:15-6:30, so she'll come in and watch her brothers have breakfast, then watch Disney as she dresses. Then we get Mattea ready for school, and try to get her there by 9:00.
Nine(ish) - fourth feeding. After that, it's time for breakfast, and then catch a shower if I couldn't get one in while getting Mattea ready. Then it's...
Noon - fifth feeding. You're starting to get the idea. The guideline provided for us suggests that the boys eat 8-12 times per day. We're shooting for eight. Then we get our own lunch in. If we're lucky, maybe a short nap while the boys sleep.
Three - sixth feeding. By day two almost all of their clothes and blankets are used, so I throw a load in the wash before I go get Mattea from daycare, bring her home and fix her something for dinner.
Six - seventh feeding. Once done with the boys, I put together something for us to eat, usually after we get Mattea to bed around eight. Fold the stuff I threw in the laundry earlier.
Nine - eighth feeding. If all goes well, maybe a chance to get a little nap in before the midnight feeding. Or do all of the other things that there is no time to do during the day. Like update the web site with new pictures or a journal entry. Or work on my taxes. Or just regular stuff like getting groceries, taking and making phone calls, living life. Then start all over again.
While we are experimenting with modifying the feeding schedule slightly, we still need to get in eight feedings a day. There are not too many other ways of doing it. We just started going four hours apart at night, and 2 1/2 hours apart during the day. The boys have not adapted to this yet, but we just started. If it works, we'll get a couple slightly larger chunks of time to get some sleep in. Also, we've improved the feeding times to just 45 minutes to an hour now, so that also freed up some time. My diaper application technique has also improved so we have fewer superfluous clothing changes thrown into the mix.
Speaking of the boys, if you ask Mattea what their three jobs are, she'll gladly tell you: Sleep, Eat, and Go Potty! They do great at all three, with eating being their weakest link at the moment, though they're still doing very well. Since they were due to remain in mom's innards a few weeks longer, they're probably not quite ready for all of this worldly stuff just yet, so they do a great job of sleeping. Generally, we need to wake them up to eat, though occasionally one or the other will let us know that he's ready to eat before we're ready to feed him. They generally only cry if they're hungry. They may fuss a little while being changed, but settle themselves very quickly. Surprisingly (at least to me), when one cries, the other pretty much ignores him, even if he's awakened or is already awake. Only once or twice since we've been home have we heard stereo histrionics.
We had a follow-up appointment with their pediatrician last Saturday and he pronounced everyone well. Hospital discharge weight was 5 pounds, 2 ounces for Noah, 5 pounds, 3 ounces for Grayson. By Saturday: Noah - 5 pounds, 6 ounces, Grayson - 5 pounds, 8 ounces. Theresa went to a Breast Feeding Support Group meeting on Thursday to get some pointers. By then: Noah - 5 pounds, 10 ounces, Grayson - 5 pounds, 12.8 ounces. According to the statistics, they should gain 6-8 ounces a week and both are right on track.
Lessons learned:
Don't take 5 pound babies out for a walk!
We wanted to get some exercise in for Theresa, so we took the boys for a stroll around the neighborhood. It was cool and breezy, so we bundled them up really well. We thought. Upon returning, it looked to me like Noah's face was purple around his mouth, and his breathing seemed labored, developments that we failed to notice during the walk. I assumed it was a breathing problem since the lungs are one of the last things to develop. Taking their temperature, we measured a couple degrees lower than what was typical for them, which is a degree or two lower than what it would be for you or me. A quick phone call to Dr. Szold provided some assurance and indications of what to watch for. We threw some blankets and clothes in the dryer to warm them up and provide additional heat. Oh yeah - turn up the thermostat in the house (duh). Hour by hour their temperature inched up, and Noah's breathing became less labored. Noah's lungs work fine - we were just subjecting him to a little (more extreme) bout of hypothermia! The last few weeks in the womb they're really adding weight more than anything else. Without that opportunity, neither Noah nor Grayson has any fat on them yet. Regulating their body temp is one of the things that we need to help them with. So - don't take five pound babies out for a walk!
Don't postpone taxes until after the birth of twins!
In all of my free time (see above schedule), I need to prepare my taxes for last year. We moved last year. Some of the records that I need are still in boxes in the garage. A sleep deprived man, doing taxes after moving from one house to another and not being able to find things is not a pretty sight. But, hey! I've got a couple more days... plenty of time!
And finally, don't say that you're going to do something if you're not certain that you can follow thruough.
I said that I'd get this entry up probably on the 8th or 9th. I'm going to play it safe this time. You will definitely see a journal entry and more pictures before the boys turn 18!
“It’s time to go! My water just broke!”
These are the words that I awoke to on Monday morning. Theresa's water broke at about 5:45 AM. The large wet spot in the bed and the puddles on the floor left no doubt the boys would be here soon.
We had previously packed a hospital bag. We just needed to toss a couple of items in and we were ready to go. Mattea’s labor was over 24 hours, so we had no real sense of urgency as we got ready. Edwina planned on heading home around six and was already up. By the time I was out of bed, Theresa was already downstairs, talking with Edwina, who quickly decided to stay an extra day. That made many decisions easier for us - basically, throw the bags in the car and get Theresa to the hospital. Edwina would get Mattea up, fed, dressed and off to school and catch up with us later.
As we made our way to the hospital, we made a couple of quick calls. Theresa went straight to the nursing station upon arrival, where they moved her into a triage room right away to evaluate whether or not she was really in labor (as if there were any doubt!) I brought in the bags and left to park the car. I had signed Theresa into labor and delivery at 6:32 AM. Our second child, and first son, was born at 7:53 AM. Our second son was delivered one minute later according to their bracelets (although I think more than a minute elapsed between them).
While driving in, Theresa's contractions were regular and five minutes apart. As we got to Interstate 8 (about 10 minutes into our 20 minute drive) they started coming about 3 minutes apart. The closer we got to the hospital, the more intense the contractions became and the faster I drove. By the time I got back from parking the car, the intensity of the contractions started showing itself in the light sheen of perspiration on Theresa’s face, in a room that was about 65 degrees. 7:00 AM is shift change time, so we got in just as this process began. Theresa’s contractions were getting stronger and a second nurse came in to take over part way through the process. Theresa said something along the lines of “I can’t take this”, referring to the pain, followed shortly thereafter by something along the lines of “There’s something going on down there!” with just a bit more focus in her voice. One of the calls on the way in was to Dr. Gellens service (you remember… her regular OB/GYN that is in Cabo this week?) to let them know that we were on our way in, and that Theresa was carrying twins. The delivering physician had not been determined yet, as the doctor’s shift change also occurred at 7:00 AM, and there was some confusion at this point as to which it might be. They did determine by now that we were planning on having a repeat c-section. The oncoming nurse asked the departing nurse if she had checked Theresa’s cervix yet. When the first replied in the negative, the oncoming nurse checked Theresa’s cervix – and that’s when all hell broke loose.
They found Theresa to be at “Zero, plus one”. Roughly translated, I think that means that she had fully dilated (10 centimeters) with Baby A’s head starting to crown. All of this without any pain treatment yet. Almost immediately upon this discovery the nursing staff in the room increased from two to about four or five. “We need a doctor, NOW!” as they rolled Theresa out of the triage room into the operating room. Another nurse, almost grabbing me by the arm, “Dad, you come with me”. I leaned over and kissed Theresa on the forehead. “I love you… see you in a bit”. And she was whisked away.
I found myself next in a very small changing/waiting room where the nurse instructed me to put on a pair of disposable coveralls over my jeans and sweatshirt, one of those funny hats, shoe covers and a mask. In about ten minutes, the door on the other side of the room opened; “Dad, do you want to come with me?”
Warning: This is where the graphic part starts. Theresa had already been prepped and her epidural had been started. (Refresher: that is the pain treatment to numb the lower portion of the body). The operating room team consisted of two doctors, the anesthesiologist, at least two operating room nurses, a pair of nurses for each child, plus a few others I think that just wanted to stand around and be a part of all of this. Busy place. The first incision had already been made across Theresa's abdomen when I arrived, and although I couldn’t actually see them cutting through muscle and placenta, I was able to watch the scissors move in the doctor’s hands. Fascinating. It was apparent that the epidural had not completely kicked in yet. I could feel the tension in the room – no joking like in the operating room of “E.R.” or “M*A*S*H”. Theresa could not feel the cutting, but as they spread her incision it was obvious that she was not free of pain. It reminded me of a trip to the dentist where you’ve received the lydocaine, but it hasn’t fully kicked in yet when he starts working on you. The dentist could always say “Let’s give that a moment to take effect”, but there was no time for that here. Baby A entered the world first, so quickly that I missed the photo op. Mister A was handed off to his pair of nurses, and when Baby B came, I was ready. I think I got a photo or two of the birth over the vertically placed sheet separating Theresa’s head from her torso. I was watching the two sets of nurses scrubbing, cleaning and wiping the boys so I missed the delivery of the placenta. When I looked back Theresa’s uterus was on her belly, with the doctor’s hand in it up to his wrist checking it out to make sure that everything looked good. (OK, it’s over). Theresa looked over at Baby A and said, “Oh, he’s beautiful!” I got a chance to hold Baby A, and then both of them at the same time. Then “Dad, why don’t you come with the babies to the NICU?”
It was a short walk across the hall. The cleanup process continued as each baby received his own nurse. Necessary medical procedures were performed: injections, blood samples, vital sign measurements; then their first bath. Seeing two nurses perform the same process in their own way provided a unique perspective. Stereo, but everything not quite matching up. B got his hair combed after his shampoo (A got a hat). Oh, Baby A – 18 ½ inches, 5 pounds, 11 ounces. Baby B – 18 ½ inches, 5 pounds, 12 ounces. About as close as one could expect, I guess. I stepped out to make a couple quick calls. I didn’t reach anyone “live”, so ended up leaving a couple of messages.
Stepping back into the NICU I didn’t know which one to look at. I moved from incubator to incubator, taking it all in. My fears of not being able to tell them apart returning, looking at these identical boys. Grandma Judy showing up somewhere in here, then stepping out to call Jim. I moved back and forth between the boys – which would be Noah? Which Grayson? How would we know? Edwina showed up soon after – they wouldn’t let her into the NICU because she isn’t a parent or grandparent of the boys. Judy took her outside to peek in through the windows at her new nephews. I held them up, displaying my children for the first time. Then Judy told me that Theresa was out of recovery and asking for me.
I headed downstairs to see my wife. Theresa looked a little groggy and still in pain, as one might expect just a few hours after major abdominal surgery. I let her know that Baby A would be down soon, and Baby B would be not far behind. B’s breathing was still a little fast so they wanted to keep an eye on him a little longer. Judy and Edwina came in. I went out to track something down and met Lia coming down the hall. I walked her upstairs so we could take a quick look at the boys through the window. It looked like they were getting ready to bring A down. A blur of activity the rest of the day. First Baby A came down, then Baby B. Visitors and phone calls, in and out. The boy’s first feeding attempts. Mattea holding her little brothers (with dad’s assistance). I ended up collapsing into a chair in Theresa’s room about 7:30 PM. Why was I so tired? All I did was hold Theresa’s hand, saying “You’re doing great!” and spectating at the all the events going on around me the rest of the day. By the way, all three were doing great.
I made three different attempts at starting this record of events on Monday night. With each effort, I grew more frustrated, not being able to express my thoughts the way that I wanted to. Finally I gave in to sleep around midnight. The term "Running on empty" applies not only to the body, but equally to the mind. The nurses took the boys then, ostensibly so we could sleep, but I think mostly so they could hold them and share them among themselves. We got about four uninterrupted hours of sleep in. So ended the first day of a new life; not only for our boys, but for us as well.
It seems like things just keep getting busier and busier. A whole slew of Tragesers (and assorted attachments) have spring birthdays, so last Sunday we hosted the Trageser Spring Birthday Bash. If I remember correctly, celebrating birthdays were Jim (the elder), Liz, Thom, Larissa and Christopher. The party had to be held somewhere, and since Theresa isn't getting around much these days, everyone decided to have it here. Among the highlights (too numerous to mention them all) was a great broiled salmon that Lia seasoned with homegrown herbs and lemon provided by family gardens!
We had two non-stress tests (NST's) set up for the boys this week, which Dr. Schrimmer suggested we schedule until their arrival. These are essentially heart rate monitoring sessions with Theresa at rest during the measurement - they just strap on a couple monitors and listen for half an hour. After Theresa's marathon sessions in the hospital being attached to the monitors for sometimes two hours or more to get an hours data, these sessions of only thirty minutes seemed to fly by. Both sessions (Monday and Thursday) went as expected with no abnormalities.
Thursday we also saw Dr. Gellens. Again just a weekly follow-up, and Theresa, Grayson and Noah all checked out fine. (Yes, we've selected names for them (no we don't know which is which yet) and since many of you had heard them already, we figured we'd tell the rest of you.) Not much to say, other than the fact that they're now gaining almost an ounce a day, so they should be somewhere around 5 1/2 pounds by now.
My sister Edwina visited this weekend to bring some duplicate infant items from up north provided by family and friends, and to help get things ready around the house. In anticipation, I'd peeled the wallpaper borders down from Noah and Grayson's room (it had yet to be painted). She arrived in her daughter's SUV, so first we took advantage of the opportunity and used it to go get a dresser and bookcase for Mattea. Mattea's existing dresser and bookcase go to the boys, and she gets new ones to match her new(ish) big girl bed. With Edwina here we got the boy's room prepped, painted and a new window treatment installed. The attic was raided for stored reusable infant clothing, feminine clothing was re-stored pending arrival of a little girl cousin for Mattea (nothing that we know of yet, but you never know!), and the Christmas decorations were finally moved from the garage into the attic. Oh yes, and we actually got to visit a little whilst accomplishing all of this! We're just now winding down from all of these activities and Edwina will be leaving in the morning (after doing her best to spoil our daughter!).
That's pretty much it for now. I'm still betting that they'll arrive this week since Dr. Gellens is on vacation. We'll all find out soon enough.
9:00 AM we had an appointment for a growth scan ultrasound. 11:00 AM we had a follow-up appointment with Dr. Gellens. Add a couple of errands in there along the way and pretty soon it's 3:00 PM. Anyway... on to the latest.
Had the alarm set for 6:30 (just in case), but Mattea came in at 6:15 to start our day. We cuddled for just a few minutes, then went down to wake mom up. I don't recall if I mentioned this before, but I sleep upstairs so Mattea doesn't have to navigate the stairs at night half asleep looking to join us in bed when she wakes up in the middle of the night. While not an every night occurrence, it happens often enough that we don't want her falling down the stairs looking for us. So Theresa sleeps in the guest room so she doesn't have to navigate the stairs and I sleep upstairs in our bedroom. (Not the ideal arrangement, but it's only for the short term.) Our goal was to be on our way to daycare by 8:00 and we only missed it by 15 minutes! (You'd think an hour and a half would be more than enough time to get ready, wouldn't you?)
We dropped Mattea off and got to the Grossmont Women's Health Center very close to 9:00 AM. I dropped Theresa off at the front door and went to park. Theresa told me as I walked back to meet her that the nurses saw her coming in through admissions (which is where she needed to check in) and probably thought that she was there to deliver! Not quite yet. Naturally, since we were on time, the staff was not. We didn't get in to see the ultrasound tech until about 9:30. The machine that they have at Grossmont amazes with its' clarity versus the machines that I had seen at Dr. Gellens office or at UCSD. No chickens or baboons this time, but I actually got to see the face of one of my sons! (The other was being bashful and wouldn't look at us). Don't get me wrong... it's not like looking at a photograph, but there were recognizable eyes, nose and mouth. Pretty cool stuff!
All the picture taking and measurements in, and the tech pronounced their sizes: A is 4 pounds 15 ounces, and B is 5 pounds! So baby A put on a huge growth spurt to catch up with his brother. In fact Dr. Schrimmer, the perinatologist, thought that the machine only printed one babies' growth line since they were almost exactly the same. Remember, all of the ultrasounds at UCSD were on a different machine, so the only data this machine had were from today, and the original ultrasound that was taken that put Theresa in the hospital in the first place. Way back then they were the same size, and now they are virtually the same size. Of course, meantime, they were all over the map. But both of them at the 5 pound mark is just outstanding news (since the car seats that we have are rated for infants from 5 pounds on up! What do you do if they're under 5 pounds... leave them at the hospital 'til they get bigger?) Dr. Schrimmer also said that the maturity level of multiples is generally a week or two ahead of "singletons", so we're really kind of like at the equivalent of a 36 week gestation if there were only one child in there. All of this was very gratifying to hear. Finally, he said that in the unlikely event that we're still pregnant in three weeks, he'd like to see Theresa again. So Dr. Schrimmer seemed to think that we're getting close.
We had about a half hour before our appointment with Dr. Gellens so we stopped by the front of the hospital and got a couple of coffees to drink while we waited. (Don't tell anyone! Theresa is a borderline gestational diabetic, so she really wasn't supposed to be having a decaf vanilla latte. But her chef has been preparing her nutritionally balanced meals, so her blood sugar readings have all been in line... and it was a small coffee!)
Since we had just seen Dr. Gellens last week, it was a pretty routine visit. All the way up to the point when he asked if they had checked her cervix at the earlier appointment. When we replied in the negative, he decided to take a look and discovered that Theresa had already dilated about 3 1/2 centimeters! Talk about shocking news... we're not ready for this yet! No signs of labor yet, so he just sent us on our way with an admonition not to go into labor on Saturday (his son's baseball game) or Monday night (his anniversary). He also mentioned that he's going to be on vacation the following week, so that is my new bet on when they'll be here. He didn't deliver Mattea because he was out of commission due to a surgery that he had. So I'm thinking that when he goes on vacation, that's probably when these guys will come. But you never know.
So the reality is starting to hit again. We're going to be having a couple of babies pretty soon! We stopped and had lunch on the way home so Theresa could maximize her "out" time. Talked about some of the immediate plans. Theresa did what she does and started making lists in her head. As soon as we got home she started committing the lists to paper, and I started washing all of the boys clothes that Theresa has been buying online. That's when it really hit me... washing my sons' first sets of clothing... we're going to be having a couple of babies pretty soon!
Theresa's appointment completed, we scheduled another growth scan ultrasound appointment for Friday the 21st, with a follow-up appointment with Dr. Gellens. We'll keep you posted on the outcome.
After eight weeks and two days, Theresa finally got to come home yesterday. All of the monitoring over these past many weeks taught us a number of things that we wouldn't have known otherwise: The boys heartbeat rates range normally from about 120 beats per minute up to 170 or so. Most typically they would cruise along in the 140-150 range. One or both would occasionally drop below this range (considered a deceleration, which is looked upon negatively if it lasts too long) usually during or after a contraction. Theresa would generally have 3 to 5 contractions an hour (this whether she was on Magnesium Sulfate, or not). The trace that you see on the strip of paper that indicates a contraction does not indicate the severity of a contraction, only the presence of one. Some measured contractions were so minor, that Theresa didn't feel them at all. We also learned that Theresa is essentially a borderline gestational diabetic. The majority of the time her blood sugar level (which was measured four times daily: fasting before breakfast, then one hour after each meal) fell within the range of a non-pregnant, non-diabetic person. Occasionally, her blood sugar level would rise above the threshold of a non-diabetic. This all sounds very good until you realize that Theresa had been placed on a diabetic diet. No desserts. No Caramel Macchiatos from Starbucks. No muffins to go with the coffee. We were sent home with a machine to monitor blood sugar levels, so that type of monitoring will still continue. The rest - apparently they were comfortable enough with the readings that Theresa had been registering that we are able to get by without them.
Why am I passing along all of this information? Probably to justify to myself why Theresa was housed in a hospital room for eight weeks, rather than free to roam the earth like the rest of us. (Okay, so she probably would have been home on bed rest, but at least she would have been home!) Much of the above information was learned early on, but in today's world of malpractice suits and otherwise non-medical-friendly patients, I'm sure that many doctors subscribe to the "Better safe than sorry" tenet. And you know what? If they were your children in your wife, you probably would too. I know that I do.
When we finally left the hospital early yesterday evening, we went to pick Mattea up from daycare. She did not know that her mom was in the car waiting for her when we came out. As it was later that I normally pick her up, they were just getting ready to serve dinner, and Mattea was fussing about wanting to eat dinner there rather than at home, or at the "hostibal" with mom. I said that it was late and we needed to go, so she was being recalcitrant all the way out to the car. When we got in, she didn't immediately see her mom. When Theresa turned around to look at her, you should have seen the smile on Mattea's face! She just lit up! There are few things better than seeing a child's pure emotional reaction (a positive emotional reaction of course... we won't talk of anything else just now).
So now what? Theresa reached 32 weeks yesterday. If she goes into labor within the next two weeks, we go back to UCSD Medical Center to deliver the babies because of their extensive experience with "preemies" and multiples. If she makes it to 34, we go to Grossmont Hospital (which is where Mattea was delivered). At 34 weeks, given the fact that we've already had two rounds of steroid shots, they are virtually full term babies, as far as risks and outlooks go. Especially given this little tidbit: Baby B is up around 90% on the growth chart, and Baby A is 40-70%. Speaking of charts - Theresa will see Dr. Gellens (her regular OB) next Thursday, and we'll have another growth scan ultrasound the following week to see how they're doing.
So now you're up to date with all of the latest. We'll keep you posted as we know more.
I'm talking, of course, about Theresa's long overdue (by our standards) ultrasound. I had come to expect them every two weeks, since her medical team established this pattern during the first four weeks of Theresa's imprisonment... I mean confinement. So when it didn't happen last week, we resigned ourselves to having to wait another week. But the additional days of delay were unwelcome at best. So much for all of my blather, you want to know what we found out, don't you? (I figure if we had to wait a little longer to find out, why should you think that you're going to just walk right in and know what's going on?)
OK! OK! The boys are doing great! This was the first time that I've been present in awhile to watch while they were performing the ultrasound. The ultrasound technician was very experienced; she had over twenty years running these machines. And from my perspective, you'd need just about all of that experience to know what you were looking at. She globbed a whole bunch of goo onto Theresa's upper abdomen and, like a painter, would reach up every once in a while and dip her magic wand into it (the better to glide around on Theresa's lower abdomen and sides to see Pip and Pop). She'd stop moving the wand periodically, store an image to the hard drive (yes it's all computerized), then continue on her merry way, storing image after image in this manner. Each image was labeled something, either with the touch of a button, or if need be, she'd type in a little description. Soon (actually it took almost an hour for both boys), she had a storehouse of information for the doctors to make their judgements from.
She stored images of bladders, kidneys, hearts, spines and various bones, most of which looked like non-patterns of gray and darker gray to me. Theresa thought she saw a chicken at one point (don't laugh... a little later I swore I saw a baboon in there!). Now you can see why those years of experience can be beneficial. Apparently everything looked as it should, and none of the images raised any cause for concern.
Both Baby A and Baby B have gained weight since their last pictures. Baby B is still outpacing his brother, picking up almost 1 1/2 pounds in just over three weeks, going from 2 pounds 14 ounces to 4 pounds 5 ounces! Baby A is still smaller, but he also picked up over a pound going from 2 pounds 8 ounces to 3 pounds 10 ounces! Think about that for just a moment. Theresa already has 7 pounds and 15 ounces of babies squirming around in there. Plus all of the other baby groupies and hangers on (you know, amniotic fluid, placenta, all kinds of fun stuff). And in theory she still has two months to go! Now for the kicker. Hold your hands up about 15" apart - Pip and Pop are each about that long already! Two of 'em! Doing the "We want out of here stomp" on Theresa's bladder! I realize that they're all curled up, but come on... that's gotta be just a little uncomfortable!
I'd love to tell you more, but it's time to visit my beloved wife. One last thing. There are rumors flying around of her going somewhere next week. Could be home. Could be Grossmont Hospital. Could be nowhere. (That's what I hate about rumors). We'll keep you posted.
I'm continually amazed at how quickly time passes. As one gets older, it seems as if time passes ever more quickly. By the time I get really old (130 or so) I doubt that I'll be able to keep up with the things going on around me. Sometimes I have a hard time doing that now. When I sat down to type this, I didn't realize that it had been nineteen days since my last entry. I'll try not to keep you in suspense for such a long time in future.
Today marks week 31. Had anyone told us on January 7 that we would still be in the hospital awaiting the birth of the twins, I probably would not have believed them. (Being the writer of this journal, I can use the editorial "we" in sentences such as the one that you just read. Theresa is not here to slap me and say something along the lines of "I don't see your *** glued to this bed 20 plus hours a day for seven weeks running!") But here we are.
The last couple of weeks have been difficult for any number of reasons. Theresa was struck with a couple minor bouts of depression, and although I'm not sure that she recognized it as such initially, I believe that anyone who called or visited within the last couple of weeks may have picked it up depending on when you caught her. Mattea turned three on February 18, and we had a party for her on Sunday the 16th in mom's hospital room. Having your first child's third birthday party in a hospital room is less than the ideal from a parent's perspective. Fortunately, both Theresa and I have learned that we can learn from Mattea as well or better than what she can learn from us. And one of the things I know that I learned from that experience, is that for Mattea, it was not important where the celebration was held, but what was important was that she got cake and ice cream and presents and got to be with family! Joy really does come from the simple things in life, and sometimes as adults I think we forget that and we focus on the things around the simple things.
Another interesting fact came to light in one of our telephone conversations. Some of these calls were just a few minutes and some of them lasted close to an hour or so. I guess sometimes it depended on whether I was driving long distance or just going from meeting to meeting. In any case, in one of these conversations we came to realize that during the first five weeks of Theresa's hospitalization, she had at least one visitor every day! When we made that discovery, I told Theresa that she must be much loved. I found it absolutely amazing that any one person could have that many people care about them so deeply (let's face it - some people will never go to a hospital to visit a friend or family member). Granted, many were repeat visitors (thanks again to Grandma and Grandpa for taking Mattea to see her mom). But remember, I was out of town the majority of that time. But I think once we made that determination, it kind of reinforced the fact that she's been doing time for awhile now.
So when you think about it, she was about due for some R&R (Rest & Relaxation (or Recuperation) for those of you who were never in the military). So the end of my project this past Friday was good news since it coincided with the doctors change in view offering Theresa the opportunity to go on wheelchair rides up to an hour a day - Woo Hoo!!! (Hey, when you've been cooped up in little rooms for weeks, and any change of pace is offered up, you'd be looking to challenge other patients to wheelchair races too!) So now Theresa's new monotony includes me a couple of times a day, with trips around the hospital and grounds to vary her day to day experience.
"So what's going on with the boys!?" (I hear you shouting!). They're doing just fine. How fine, I can't quite tell you just yet. Theresa was scheduled to have another ultrasound done yesterday to measure their growth and probably to take another look at her cervix. I say "was scheduled" because it was re-scheduled for Friday. So we'll have to wait another day to get some new approximations on their size. The MD types have been satisfied enough with everyone's progress that they have reduced the number of monitoring sessions all the way around. Theresa now has only two monitoring sessions a day, each for an hour's worth of data (which sometimes can take a couple of hours, or occasionally as many as three). Theresa has been freed of the contraction monitor on a continuous basis as well, and that gets strapped on now only when the boy's heartbeats are monitored. (Theresa has gotten better than some of the nursing staff at locating the boy's heartbeats when they fall off of the monitor).
One thing that I don't think that I've mentioned is that UCSD Medical Center is a teaching hospital. I guess that makes sense if you realize that UCSD stands for the University of California at San Diego. As such, Theresa's rotating staff of Ob/Gyns are exactly that - rotating. Some of them may not become Ob/Gyns in the real world of real doctors (I'm getting this from my wife, so if I've got it wrong yell at her not at me (you better not yell at her while she's in the hospital on bed rest with my sons in her belly!)). I mention this because one of her OBs didn't like the looks of things on the twins monitoring strips, so she was sent down to labor and delivery "just in case". Nothing happened, so she was sent back up to Maternity (another private room, thank goodness). I think all of that happened a couple weeks ago now.
But here's the real reason you keep coming back to read these little notes of mine. We're going to have some babies before long! How do I know? As Mattea would say "Because I do!". In just the last couple of days Theresa has mentioned the fact that she is experiencing some hip and pelvic pain that hadn't been there before. She's also experiencing some back pain that wasn't there even just last week. At first she was attributing it to the duration of the bed rest, and the fact that her bed was improperly set when they moved her from room to room (It's an air bed and needs to be set for the height and weight of the patient. When they moved her it changed to a default which was not correct for Theresa). While all of that may be true, being the seasoned papa-to-be that I am now, I see it as Theresa's body telling her that things are changing to accommodate the birthing of these babies. That being said, let me go on record right now saying that I don't think that we'll see these guys come out before Theresa gets to 32 weeks (which would be next Thursday). But I'll be surprised if we make it to week 34. We're also looking into the possibility of Theresa moving to Grossmont hospital, which is where her primary OB practices, once she gets to the 32 week point. Why? Because then Theresa would have her own OB calling the shots, not a group of rotating residents. That's the plus for Theresa. The thing that we want to be sure of: will the boys get the same care there as they would at UCSD? The neonatal center at UCSD is among the best there is, which is why she is there right now. We want to be sure that Grossmont is capable of handling premature infants with complications (you never know) before we make this decision. One thing that I have learned in my research - you don't want to transport premature infants from one facility to another.
So that brings you pretty much up to speed as to the latest developments in our pregnancy. I'll try to put up a short note tomorrow regarding the information gained from her ultrasound - but no promises.
We reached the critical 28 week benchmark yesterday. This officially marks the end of the second trimester, which is why it carries so much weight with the medical types. Knowing that the evaluation period was coming up, a new round of tests and examinations were conducted this past Tuesday. First, they wanted to check on the heft of the boys again to see how they're doing. Seems they're doing just fine. (Put on your best ringside announcer voice if you please...) "First up, we have Pip "Don't gimme no lip" Hernandez adding on a sizable 6 ounces over the past two weeks, coming in at a very nice 2 pounds, 8 ounces. And on the other side of the belly we have Pop "But I'm on top" Hernandez moving toward the heavyweight end of the spectrum with a rousing 10 ounce gain to come in at 2 pounds, 14 ounces." So it looks like the little guys ain't so little no more.
A bit of news that we didn't really want to hear, but can't really be surprised about, is that Theresa's cervix has shortened to .6 or .7 centimeters. I guess when you have a couple little guys in there adding that much size, even if mom is lying down they are going to put some additional pressure on things. So that requires a slight cautionary stance be taken. In addition, a fetal fibronectin evaluation was performed for additional information. Apparently, this is a test that measures a specific protein that can indicate potential for impending labor. This test came back positive, or indicating that this protein was present. While this does not indicate that labor is necessarily imminent, it does increase the odds of delivering prior to 37 weeks (like we thought that we were going to make it that far anyway!). So it looks like Theresa is probably on hospital bed rest for the duration (sigh).
But... yesterday they took out her I.V. (YEAAA!) and stopped the Magnesium Sulfate as planned. They were relocating the shunt every three days, so at least she doesn't have to deal with that anymore, and she can move about a bit more freely. And this afternoon she had an opportunity to speak with the Perinatologist (OB/GYN on her team in charge of the babies before they're born) and got some additional information. They decided to give her one more round of steroid injections to assist in the development of the boys. They also decided that if (I should say when) she actually goes into labor, they will deliver the babies rather than try to delay any further. So we finally have some concrete information rather than "we'll re-evaluate". Obviously, we still don't know when this could happen. It could be this weekend, or it may not be for several weeks still. They are still monitoring Pip and Pop just twice a day, but Theresa is being monitored for contractions 24 hours a day now. This morning her contractions were slightly stronger and coming more often than before with that trend continuing into this afternoon. The boys have become more active with the elimination of the Magnesium Sulfate from their systems, and Mattea and I were both fascinated this afternoon as we had our hands on Theresa's belly and felt these gyrations going on under her skin.
One of Theresa's regular nurses was taking care of nurse stuff this afternoon while Mattea and I were visiting. After one particularly sizable contraction (relatively speaking of course) she wandered in to see how Theresa was doing, and commented about whether Theresa would have these babies before she (the nurse) comes back on Monday. If I were a betting man (wait a minute... I am a betting man!), I'd take that bet. It may just be wishful thinking, but I don't think we'll see these guys that soon. I guess we'll find out in a couple days!
Going to work last Sunday was one of the hardest things that I've had to do in awhile. The previous week and a half was full of unexpected developments, and although we knew that something like this could happen, we're never really prepared for it to happen to us. The important thing was that Theresa was in very capable hands, and although I didn't like the prospect of leaving, the nature of my work requires it.
Naturally, I called Theresa pretty much every opportunity that I had. We talked three times on Monday (morning, noon and night) and my mid-day call on Tuesday was rewarded with some outstanding news! Tuesday I had to drive from the San Francisco bay area on the first leg of a trip that would take me to Seattle. As I stopped for gas, or something to eat, I decided to give Theresa a call before I drove out of cell phone coverage. The hospital staff had just completed an unexpected ultra sound examination and gave Theresa some unexpected, but very welcome news: her cervix had actually lengthened (from 1.25 centimeters to 2.7 centimeters) and the boys weighed in at 2 pounds, 4 ounces, and 2 pounds, 2 ounces! They are growing faster than what I had projected! Baby A (yes, I know, you want to know, but you'll have to wait...) gained 10 ounces in 14 days, and Baby B gained 9 ounces in 14 days. The significant 1000 gram benchmark has already been reached! You can't imagine the unbelievable sense of relief that we felt with the introduction of this news. It was like we got hit with a double whammy of good stuff! First, to hear that the mandated bed rest was not only reducing the stress on Theresa's body, but actually reversing things, was something that I did not realize could happen. What I was hoping for was that it would stop shortening. After talking with her nurses, Theresa learned a bit more about it and discovered that it's not necessarily uncommon for the reduction in physical stress to cause the cervix to lengthen. But then to hear that the boys broke the 1000 gram barrier was just outstanding. We ended up talking on the phone for over an hour because we were in such good moods.
It's hard to top news like that, at least in our stage of the game that we're in at the moment. We did get another potential little ray of sunshine though. Theresa learned that there were several other women in the post-partum ward in similar situations to hers and that some of them got to go home! So the possibility does exist that she may actually get to come home at some point prior to giving birth! (It's amazing the things that you get excited about when your life is turned upside down). Obviously there are many factors that need to be considered, and we're still two weeks away from any definitive change in her treatment. But knowing that she may get to come home is very good news indeed.
Well, it's almost midnight now (you didn't know it took me this long to write this stuff, did you?) and I'm just a little tired. But I wanted to get this up for anyone that might be looking for some additional info over the weekend. I'll try to post some pictures this weekend also, but no promises. I've got a lot to do in the next day and a half before I head back out. I'll write more as I can.
When I went in to visit Theresa yesterday afternoon, Theresa's nurse-du-jour, Toni, was in with her trying to monitor the twins heartbeats. As you know by now, this can take awhile, so we had an opportunity to talk about Theresa's situation. Toni agreed with us that a semi-private room with a new mom and a new baby might not be the most relaxing place to be. Toni told us that the hospital's labor and delivery ward had been on bypass the last few days (meaning mothers-to-be that wanted to deliver there were routed to other hospitals because they were full) and that they were full and had no private rooms available. We would have to wait until one became available.
As Theresa and I talked, I learned that she had seen a perinatologist earlier in the day. Apparently, they are taking a team approach with her, rather than having just one doctor involved. I guess that makes sense; if they rotate through the hospital during the week, all of them should be aware of what's going on. The team had evaluated her situation and determined that her treatment would continue as it is until she reaches 28 weeks (assuming that she makes it that far), and then they would reevaluate. Still no concrete decisions, but I guess when you are standing on shifting sand concrete won't provide a good foundation. But at least now we have a clear plan for the next three weeks.
I left Theresa to go get Mattea and bring her back to visit, and while I was gone Theresa called to tell me that they were moving her to a private room! A woman who had been in a similar situation to Theresa's reached her 36th week, so they moved her downstairs to labor and delivery. Toni told Theresa that since she had been such a good patient (not complaining about the things that many would complain of in her situation), Toni told her "We've got to take care of our good patients!", and moved her to the newly vacated room!!! (We wondered to ourselves how long the woman had been there, but some questions you really don't want the answer to).
When Mattea and I got there, Theresa was in a much better frame-of-mind (as you can imagine), and Mattea munched on her chicken nuggets as we visited with mom.
So... Theresa is in a private room and we have a clear vision of the next three weeks, assuming that there are no surprises. Her contraction monitor is saying all is well thus far - still no more than two or three an hour and sometimes going hours without one. We don't really want to be where we are, but it's a heckuvalot better than where we were a week ago! Theresa is under the care of a team of specialists at one of the premier maternity wards in the state (which probably makes it one of the better units in the country), and she and the boys have stabilized since being admitted last week. Since that was such good news for us, I wanted to get it out right away.
We've recruited Liz and Thom (Theresa's sister and her husband) into staying at the house when I go back to work next week. That way Mattea can have as close to a normal routine as possible. They'll get her ready in the morning, get her to daycare, and pick her up at the end of the day and get her home to sleep in her own bed at night. I don't know yet that they truly understand how valuable and important that is to us, but I will reaffirm that to them as I can. As much upheaval as we have in our lives right now, any constancy is a good thing, and having family around for Mattea is very important.
As Theresa has been moved, and may be moved again, the best way to reach her if you are so inclined is through the switchboard at UCSD Medical Center 619-543-6222. I just tried the number and was given the wrong room, so be prepared to possibly call a couple of times. If you could, please try to limit your calls to 8:00 to 10:00 AM or 1:00 to 2:00 PM PST. That way if she's had a rough night she might be able to get a nap in before lunch or mid afternoon.
Just a quick note on some research - every day that the boys stay inside right now, their survival chances improve 2-3% daily! And UCSD Medical Center delivered on January 1st and 2nd over a 15 hour period a single birth, then twins, then triplets, then quadruplets! You can read the article here. It was very heartening to read this article since that is potentially exactly the situation that we may find ourselves.
I'm off to see her in a bit, but wanted to provide an update for those checking in. That's it for now.
As most of you know, we are pregnant again. We sold our beautiful, charming little old house in El Cerrito earlier this year and moved into a larger house in Carmel Mountain Ranch (just north of San Diego proper, but not quite North County) in anticipation of the event. We were planning on having another child soon, and wanted to make sure that we had room for her (or him). I think we're all pretty much in agreement on this... moving is one of the worst possible things that one can subject oneself to! It's been months, and we still have stacks of cardboard boxes unpacked in the garage. At least we've finally gotten rid of our storage unit (which we had to get to throw stuff from our old garage into so it looked somewhat presentable. Now we're in the process of throwing away all of the things that we should have thrown away before the move!).
In any event, we got pregnant relatively quickly after moving into the new house. Theresa is due on May 1, 2003. When she went in for her first ultrasound appointment (a few months ago), I was traveling somewhere in Southern California. When I called to check on her appointment, the first thing she told me was that her doctor could hear the heartbeats... TWINS!!!
Talk about a shock! I think for the first two or three weeks, we were both mentally acknowledging the fact, but not processing the information. We had to wait awhile to find out the sex, but we also learned right away that they are identical! (My worst fear, still, is that I will not be able to tell them apart!) We now know that they are identical twin boys. I think we're still processing....
So that's the condensed version of our last few months.
On Tuesday morning (January 7) she called to give me the report of her routine ultrasound appointment with her perinatologist (an Ob/Gyn with additional certification in high-risk pregnancies, which category Theresa falls into being of AMA (advanced maternal age (don't those politically correct medical terms sound ridiculous!)) and carrying twins). It was not a routine report. In tears, she told me that she was being admitted to the hospital that afternoon because her cervix had shortened to the point of impending labor, and her contractions were often enough to be of concern. Her perinatologist ordered her to immediate hospital bed rest, and with the very real possibility of impending labor, ordered a round of corticosteroid injections to assist in the development of the twins lungs, and anti-contraction medication to try to slow or stop her contractions.
Being in shock myself, I called my friend Mark, who is my liaison with the company that I work with and told him that I needed to get home right away. I knew that I'd need to work at least through Wednesday since it was already Tuesday afternoon. He made some calls, and miraculously, I had a replacement on the way to take over for me as of Wednesday night (maybe there is something to this prayer stuff!). I went straight to the hospital to see Theresa when I got in Wednesday night around 8:00 PM.
Pregnancies are measured in gestational weeks. As of yesterday, Theresa is 24 weeks along, with a full term pregnancy being 40 weeks. Babies delivered prior to 38 weeks are considered to be premature. If she were to deliver today it would not be a good thing. Since Tuesday, I have not even considered the possibility of that happening, but there is the very real possibility that these boys could come at any time. So today, I finally acknowledged that fact to myself, and started checking things out.
There are many, many web pages of parents of "preemies" available on the web. Looking for any information that I could find on preemies, I stumbled across some of these first. I didn't want to read stories of other parents, I wanted facts! What are the odds that we'd be facing with these boys if (I should say when) they decide to come early. But the more I looked initially, the more web pages I found of parents telling their stories. So I decided to read one. Tommy was born in 1994 at 1 pound 10 ounces 15 weeks early. He's now in second grade, 47+ pounds and developing normally. I read a couple more stories and was amazed at the resiliency and durability of prematurely born infants. I finally found some facts. One of the things I learned is that babies born 800 grams or more have a greater than 90% survivor rate. 800 grams comes to about 1 pound 12 ounces. Babies A and B (we've not finalized name choices yet, though we are very close and will probably need to come up with some very soon) weighed in at 1 pound 9 ounces and 1 pound 10 ounces on Tuesday. And with their current growth rate of about 1 ounce every couple of days, they should be right around 800 grams or so now. Considering that 500 gram babies (1 pound 1 ounce) have only a 40-50% survival rate, that made me feel much better. If they grow to be 1000 grams before birth (2 pounds 2 ounces), the odds significantly improve. Don't get me wrong. I understand that gestational age is a major factor as well because each day that goes by provides additional growth and development in a protected environment - mom's belly. We would really like to see these babies stay put until at least 28 weeks. At this point, I think we have to acknowledge the likelihood that a 38 week pregnancy just ain't going to happen!
When I first saw Theresa Wednesday night it was basically just a huge sigh of relief to see her. We had no idea how long she'd be in the hospital on bed rest, but Dr. Hall (the perinatologist) that she'd seen on Tuesday morning had said that he thought it might be as much as seven to ten days. While just catching up on the days events, the on staff Ob/Gyn came by to say hello. Since I had just arrived and didn't really know much of the background I was just asking some general questions, and when I asked about the length of Theresa's stay, she said that it would probably be until Theresa got to 28 weeks (or four weeks vs. 7-10 days!). Sometimes it's easier to tell someone something when you have no connection to them. Sure enough, yesterday it was confirmed that she'll probably be in the hospital on bed rest at least until she's 28 weeks... assuming we make it that far.
She has received two corticosteroid shots for the twins and was initially given an anti-contraction medication in pill form (I forget the name). It can only be given for 48 hours because of the strength of the medication, and then they use Magnesium Sulfate (Epsom Salt) injected through the IV lines which seem to be standard issue for any hospitalization. Theresa said that they started the Magnesium Sulfate as of late last night, and she didn't care for how it made her feel. She says she just feels kind of flushed all the time now, and slightly lethargic. The problem with that is that she'll probably be on the Magnesium Sulfate for the duration.
I'm taking off until Friday of next week. Hopefully that will give me some time to get some things done around the house in preparation. But from what I've learned so far, we're in for a long uphill battle with the twins spending the first two or three months of their lives in the Neonatal Intensive Care Unit (NICU or Nick-you). Generally, they won't come home until their original due date and sometimes not even then.
I will tell you the names that Mattea has given the boys - Pip and Pop. Pip and Pop are the otters on Bear and the Big Blue House and to Mattea these apparently sound like perfectly good names for her little brothers. She is looking forward to her role as big sister (she has become more nurturing with her own baby dolls).
Speaking of Mattea, I know that I haven't provided any updates on our little girl in quite awhile. I've already spent more time writing than I should have (it seems time becomes ever more of a premium as more of it passes by). So you'll have to wait awhile longer to hear the latest. She's getting big (as our friend Geneva says - "that's what happens when you feed and water 'em") and we have some Christmas pictures that I'll be posting soon. But now I've got to publish this and make a couple changes to the site so that you can actually read it, and I still have to get down and see Theresa, so I just have to stop writing for now. For those of you that had already heard this news, thanks for your thoughts and prayers. For those of you just hearing now, thanks for your thoughts and prayers. I'll have to figure out how to put a guest book up so you can drop us a note. That's it for now, but check back in a few days for more news.