December 4, 2009

So, around 2am on Decemeber 4th, I got up to use the restroom.  I had been in the hospital since the first and hadn't had a bowel movement - a common problem with patients on bedrest.  I was trying to go, but everything in my abdomen hurt.  I gave up my efforts and went back to bed, but as I went to get back in bed, I was in excruciating pain.  One of the Jen's had stayed the night with me.  I think she went to get the nurse or the nurse just happened to come in the room.  (I guess I should mention here that my memory may not be 100% accurate, but it's how I remember it and based on what people have told me.) 

Bacause the pain was so intense, I couldn't hold still.  I was on and off the bed, sitting, standing, squating.  I was desperately trying to get into a comfortable position, but I couldn't.  I pulled the monitor belts off of me - it felt like they were a vice on my abdomen.  At one point Jen yelled at me to save my IV because if I pulled it out, the nurses wouldn't be able to get another one it.  So, during all my writhing around, I had my arm in the arm trying to protect my IV.  I remember thinking that I was totally out of control and that if I couldn't control myself, the nurses and doctors wouldn't be able to control me.   I was telling myself to hold it together - I could have been saying it outloud, I don't know. 

(Later when my Reproductive Endocrinologist - an OB/GYN who specializes in fertility - reviewed my file and I told him my experience, he said what probably happened was as I was getting in bed, it increased the pressure in my abdomen.  That pressure was too much for my already inflammed liver and it caused my liver to rupture.  I was bleeding from my liver, which filters all your blood.  A large liver rupture can cause you to bleed to death.)

The OB resident came in my room.  Before I could yell at her to GET OUT, she was gone again.  (I had fired her the first night I got to Roseville.)  And, then the doctor came into my room.  He asked the nurse if my midnight labs were back.  They were and they weren't very good - my platelets (helps your blood clot) had dropped again.  I remember telling the doctor that the babies were killing me.  He said it was time to do the c-section.  I asked if we could wait until Bubba arrived from home.  He said no.   I also remember asking for a priest.  I really thought that the three of us were going into the OR and that only two of us would make it out alive.  They gave me something.  It was either pain medicine or a sedative.  It helped. 

So, then the rush was on.  Anesthesia came by to talk to me about the surgery.  I told them to please make sure they gave me everything in their bag of tricks to keep me from barfing my guys out.  I normally have nausea and vomiting for up to three days after I have general anesthesia and I didn't want to do that after a c-section.  The decision had been made for general anesthesia because my platelets were dropping and giving me a spinal was way too risky. 

If I close my eyes I can see every ceiling tile and light from my room to the operating room.  I know exactly what their ceiling looks like.  I remember going into the OR and hearing everyone working to set up the room for a twin delivery.  I could feel the energy as well.  I know very well what it's like to be in their position and now I was the one on the table waiting.  And, waiting.  I started to panic a little and then I heard Mary Jo's voice.  I had worked with Mary Jo and she has this calming presence about her.  She was helping set up the room and I thought if she was there, I would be okay.  (Funny thing, I don't even know if Mary Jo knew it was me.)  But, then they called her out of the OR and I started to panic again.  I grabbed the anesthesiologists hand and told him I was starting to panic because it was taking too long.  He reassured me that it was okay and reminded me that they weren't going to knock me out until everyone was in place.  (This is done so that the babies don't get much of the general anesthesia.)   And, the anesthesiologist said to me that he was going to give me the propofol.  I saw his start to push the mikly white drug into my IV.  I remember thinking, "I'm not Michael Jackson," and wanting to make the joke, but I was out. 

Colton Duayne was born at 3:27 am.  He weighed 900 gms (1lb, 15.8oz) and was 14 inches long.

Sean Patrick was born at 3:28 am.  He weight 540 gms (1lb, 3oz) and was 12.5 inches long. 

Both boys required a lot of help at birth.  They both required chest compressions and breathing tubes.  While the boys were in the NICU, a form was accidently given to me that said when Sean was born, he had absolutely no heart beat.  None.  Now, the labor and delivery nurse in me knows that it would be expected that the boys would need breathing tubes and possibly chest compressions, but to see it in black and white that your baby was born without a heartbeat is completely earth shattering. 

As the boys were taken out of the OR, they were taken through the recovery room on their way to the NICU.  Bubba had just arrived and met up with the boys in the recovery room.  He followed them down to the NICU.  He stayed only a few minutes.  He said it was too much to watch and didn't want to be in anyone's way. 

My poor nurse, Cindy, really earned her wages that night.  I am probably the patient she still talks about when she wants to share a nursing horror story.  She was actually the one who "called" my c-section that night.  When the other nurses questioned her since the OB hadn't seen me to call it, she told them, "Oh no!  She's done!  I'm calling it!"  She had to draw blood out of the boys' umbilical cords (the part still attached to placentas).  She said there was no room in the OR, so she had to do it on the floor.  She also later told me that she swore she saw the doctors praying over my uterus.  I was bleeding.  I was bleeding very badly.  She said the doctors considered doing a hysterectomy.  They gave me misoprostil and two doses of hemabate to stop the bleeding.  (The main side effect of hemabate is diarrhea - horribly smelly, profuse diarrhea.)

I had actually predicted how my delivery would happen.  When I was being transfered to Roseville, I had text a friend, Liberty, who was a L&D nurse there.  I was telling her I was being transfered and why.  Because we know how things go in L&D, she asked me, "So, when is your crash?" (meaning my emergency c-setion).  I had text her back, "at 2:40 in the morning on a busy night."  When I had arrived in Roseville, there were only a few patients, but the evening of the 3rd, every labor room was full and the doctors were doing back to back to back c-sections.  It was the DEFINITION of a busy night!  My c-section was called around 2:40. 

It's normal to spend a few hours in the recovery room before being sent to your postpartum room.  I was there from about 4 am to somewhere between noon and 2:30 pm.  I don't remember the first few hours in the recovery room.  I have been told I was "fiesty, yet directable," and kept negotiating everything that was happening and kept dropping F-Bombs.  Apparently, me thinking I felt like I had been hit by a truck translated into me yelling, "I feel like I've been hit by a fucking truck!" Oh, my poor nurses.  I wouldn't want to put up with me in the recovery room! 

At one point, I kind of woke up in the recovery room and I looked for my bands.  I knew the nurses would have given me bands that matched the babies.  I looked to make sure I had two bands.  If I only had one, then it meant Sean didn't make it.  Oh God!  How many bands??  TWO!!  WOOHOO!!  I also remember the doctor coming by to check on me.  I asked him if he had to do a classical incision (up and down on the uterus which requires c-section deliveries for all future pregnancies).  He said yes.  I asked him if he used sutures or staples (to close my skin).  He said sutures as if he would never have considered staples.  I gave him a thumbs up and dozed off. 

In the recovery room, my blood pressure was 170/110 to 175/115.  At least I was consistant!  I was given a PCA - patient controlled analgesia.  Oh God!  I loved my PCA.  It was the BEST. THING. EVER.  If my pain got to be too much, I would just hit my lovely little button and everything would be alright. 

I was finally moved to postpartum.  The nurse was a little concerned to find so many absorbant pads underneath me.  I said told her I had two doses of hemabate.  She got this horrified look on her face.  I reassured her that I wasn't suffering the dreaded hemabate diarrhea.  She was so relieved.   Nobody wants to clean up a hemabate mess.  NOBODY. 

In my postpartum room. I slept and slept.  It felt good after only sleeping about three hours a night.  I had some visitors - my mom and Ralph and my cousin.  I don't remember much more than that.  The social worker did come by and give me some information and pictures of the boys.  Bubba had also taken pictures of the boys using my phone.  I looked at those as I began using the breastpump.  Bubba had finally gone home to get some sleep. 

When Liberty got off work that evening, she came to see me.  I hadn't eaten or gotten to see the boys yet.  She found me some food and a wheelchair.  Even though she had an hour drive home and was getting up early in the morning, she spent about an hour with me in the NICU.  The boys were about 21 hours old when I finally got to see my sweet tiny baby boys.

That night, as I drifted off to sleep, it began to snow.  It hadn't snowed in Roseville in 20 years.   

One Year Ago Today . . .

I woke up feeling like something REALLY bad was going to happen.  I tried to shake the feeling.  I cleaned house, I baked, but the feeling was still there.  In the late afternoon I took a nap.  When I woke up, I made dinner.  Within about 90 minutes of eating dinner, I became sick.  I thought it was my gallbaldder.  By three am on Dec. 1st, I was in Triage 4 at Antioch Kaiser.  I was crying in pain.  I mean crying.  By about noon the decision to admit me, start me on magnesium (to prevent seizures) and give me betamethasone (to help mature the boys' lungs) was made.  The call was made to Walnut Creek Kaiser.  They couldn't take me.  The doctor was saying he was going to call Oakland; I offered to go to Roseville.  Traffic and parking in Oakland is horrible.   Oakland was actually called, but couldn't take me either.  Roseville had room for me and the boys.  At about 2 pm on Dec. 1st, I in the back of an ambulance on my way to Roseville Kaiser. 

Let me tell you, I have never been so scared in all of my life.  I was terrified!!  I knew what was happening and how bad this could/would end up.  My nurse who admitted me was so super nice.  She actually sat with me a prayed for the mine and the boys' safety.  She was a sweatheart.  Really.  And, then, on came the night shift nurse.  Oh Lord!!  She scared me.  I never thought I would be afraid to fire a nurse, but this woman scared me.  I mean, really scared me.  And, lucky me, I ws stuck with her for 12 hours.  Whoever thought of 12 hour shifts was INSANE!!  When she left, I knew I would never have to have her take care of me again.  WHEW!

(I should interject that the rest of my nurses were awesome!  Tish, Lib, Stephanie T, Cindy:  you ladies all ROCKED! Cindy - sorry for trying to die on you.  I really didn't mean to.  I swear.)

I spent the 2nd of December feeling pretty good until midafternoon when I was sent to ultrasound.  I was trying to get transferred to Walnut Creek (they now had room for us).  The perinatologist wanted a growth ultrasound on the boys before allowing me to be transferred.  Well, the ultrasound showed that Sean was severely intrauterine growth restricted (IUGR) - he was in the 3%tile of growth - and his umbilical artery had almost no blood flow.  So, that meant no transfer and the intermittent baby monitoring I had just been granted was switched back to continuous monitoring of the babies.  It also meant that Sean wouldn't survive inside me for very long.  But, the ultrasound showed that his estimated weight was 450 grams (454 gms = 1 lb).  Anything under 500 gms is considered too small to survive (yes, babies smalled than that have survived, but it is very rare).  Colton was doing a little better - his weight was estimated to be in the high 800 gm range (nope, I can't even remember what the estimate was). 

On the morning of Decmeber 3rd, the perinatologist came to see me.  He had a plan.  We would check Sean by ultrasound every other day to see how he was doing.  When he had no umbilical artery blood flow, we would deliver the boys.  Or, if I was "ICU sick" we would deliver the boys.  The perinate told me that I was the sickest patient that had, I was the patient they were talking about at the nurses' station, and I was the patient they doctors in house would be calling him about. 

A few hours after speaking to the perinate, I had a little mental breakdown.  I was trying to get some sleep and I realized that the boys would be born before Christmas and I wasn't ready for their first Christmas. Yes, totally rational.  I know.  But, it was how I was dealing with things on 3 hours of sleep a night.  So, my friend Jen went to get my nurse to ask for an Ambien for me.  Tish comes in, practically climbs in bed with me, holds me and strokes my hair and tells me it's going to be okay.  And, then she hands me a that little sleeping pill. 

BIG MISTAKE!!!

I talked non-stop for three hours.

Yes.  Non-stop.  Three hours. 

It was described as me being a drunk Vegas party girl by someone who has seen me in drunk in Vegas partying!  The nurses admonished Jen and Jen for keeping me awake.  They assured her that they were not engaging in conversation with me.  I say they were, but whatever!  And, then I finally passed out and slept for 90 minutes!!  Yes, the Ambien gave me 90 minutes of sleep after a three hour talking fit.  I woke up and declared:

I FEEL GREAT!

Later, one of the Jen's confessed that I might have felt great, but I looked like HELL.  Um, thanks.  But, that's Jen, she's honest.

At the time, we didn't know it, but I was getting sick again . . .