Tuesday, March 22, 2011

Birth Story Anyone?

Is this the post you all have been waiting for all this time? I think I have some energy restored to me so that I can make a clear post.

At my last post, we were heading into the OR to deliver some babies. It was somewhat of a hurried moment since we were bumped on the schedule by a few hours. I barely finished the last blog entry before the hubby was taking the laptop out of my hands as the anesthesiology team began to give me the initial prepping medicines. In fact, the operating crew (nurses, anesthesia, etc) wheeled me out before C & M even arrived at the hospital. It all felt pretty fast.

I spent the first 20-30 minutes in the OR alone with the team of nurses and anesthesiologists while they continued to push meds through my IV and of course get me all set up with my pain medication. I had a spinal/epidural combination, then placed on the table I was. I was also given a 24 hour dose of Duramorph (for post op pain control) as well as a shot of Remifentanil (narcotic pain reliever).

The combination of the Duramorph and the Remifentanil made me very dizzy and nauseated. So much so that I actually got sick while on the table. My anesthesiology team was so encouraging and supportive to me during all this (as I was having anxiety thanks to the effects of those medicines), and I honestly don't know what I would have done with them. By the time the hubby arrived at my side, I was very much "out of it" and quite the loopy patient.

C & M were graciously allowed to be in the OR as well to witness the birth of their little ones. I'm so grateful that my OB advocated for them to be present. Once they were settled and my hubby was settled, the surgery got underway.

Baby A arrived at 10:20a, weighing 4lbs, 5oz -- IT'S A BOY!
Baby B arrived at 10:21a, weighing 2lbs, 15oz -- IT'S A GIRL!

I was able to see the sweet babes for a few seconds over the drape before the neonatal team began their assessment. C & M were able to see and hold their little ones in the OR before they were both taken to the NICU, with C & M following right behind. I, of course, was being stitched back together during all this.

I didn't get to see the little ones until the next day due to them being cared for in the NICU as well as my adverse reaction to all the medicines used during the surgery. I will spare you the details, but it was indeed a rough night for me. I should have probably warned someone how I react to narcotic med pains and things of that nature. Basically, if "dizziness" or "nausea" is a side effect, I have no tolerance for it and it should be kept far, far away from me. Wonder if they would have let me go through the c-section without the morphine and fentanil?

I am on the mend currently (from my first ever cesarean section) and although it has been quite the tough 48 hours, I feel like I might finally be showing signs of healing and a general leaning towards feeling better, at least better than the first 48 hours. I'm walking the halls with slightly more ease - not pain free though - and I am hoping to be released today. Oh, how I hope to go home today.

The little babes have been in NICU since birth and the doctors are very impressed with the progress they continue to make. They will have their oxygen completely removed today and are even being formula fed. C & M have been allowed to bathe them, change them, and feed them once a day. They are only allowed to hold them and have physical contact with them for only a few minutes each day. I know they are looking forward to the day they can snuggle and hold them without all the restrictions. There is no word yet on how long they may need NICU care, but it is likely it will be for at least another 2 weeks, and possibly longer. I will continue to visit C & M and the babes after I have been discharged. I have not held them or gotten a photo of us all together, so that is a big "must do" before they are released and return home.

I'm sure I have plenty more information, but after the whooziness from all the drugs, I may be missing some things. I have plenty of photos, but C & M have respectfully requested that I keep those off any public venues (ie: blogs).

This ends this surrogacy journey for me, aside from recovery, and it begins a whole new life for C & M and their family! I have so many emotions at this point -- way too many to add to this post for sure. Perhaps another post for that, folks.

I'm off to finish recovering and resting. I'll check in with you all soon.

Sunday, March 20, 2011

The Big Day

Today's the day, folks! We're meeting the twin babes in about an hour! We were originally scheduled for a noon-ish time c-section, but got bumped ahead so we're getting things in order to head to the OR.

C & M should be here shortly as well, and we'll get this show on the road!

Obviously, my body did not kick itself into labor overnight.

Being bumped up in our time does make me a little nervous, but perhaps it's better that I'm not going to be spending the next few hours "waiting in worry" beforehand. Plus, it means I'll get to eat and drink sooner, yay! Well, I'm excited about those ice-chips I'm promised in recovery. :)

Nurses are in now to hook me up with some fluids and antibitotics, so we are on the move!

Sorry for the short post. Later, peoples!

Saturday, March 19, 2011

Last One

Yes, stalkers, this is your very last belly shot, snapped yesterday at 33 weeks, 4 days.

Currently, I am blogging atcha' from a not so comfy hospital bed, AGAIN! Any one else tired of me being here *raises hand*. At yesterday afternoon's ultrasound appointment, Baby B was found to have absent-end diastolic flow (signaling that the placenta is no longer functioning properly), so I was sent for monitoring. This was expected to eventually happen, so while not surprising, we were certainly holding out hope that the decline would hold off a couple of more weeks. When I arrived at the hospital, the MFM (Maternal Fetal Medicine) doctor informed me that we would receive another round of steroids to mature babies' lungs and that delivery would happen this weekend. Wow!

Basically, with the B's condition, there is no reason to take any unnecessary risks, so while we have generally said the longer we bake the better, the time has come where the high-risk doctors feel that B would be better served outside the womb. No decision has been made as to whether delivery will occur today or tomorrow, although I suspect tomorrow is the hope in order to complete the round of steroids. However, if there is any concern with the babes as they monitor heart rates - I'm being constantly monitored, so I'm all wired up: 3 monitors on the belly, an IV in one arm, and a BP cuff on the other - or I go into actual labor, then we will deliver at that time.

My cervix was checked yesterday evening and I was found to be 4cm and 70% effaced. Recap from Tuesday's check: 1cm and 40% effaced. It seems some changes have been taking place. I also have been having regular contractions, but only from time to time rather than continuous. It is my hope and prayer that I can go into labor before B's heart rate changes (should it change, that is) and before they decide to whisk me away for a c-section tomorrow. As I mentioned in an earlier post, I have a wonderful MFM doctor will is willing to deliver both breech babies, as she feels this would be easy since the babes will be small, and she would like to see me avoid major surgery if possible.She is working hospital rotation this week, but we have to tell my body to cooperate during her working hours, gah!

C & M are in town now, and they WILL get their babies this time. I asked many, many times so I could be sure before letting them get on that plane.

We shall see what today holds. Perhaps my next update with have delivery info or even announce the arrive of the little babes! Stay tuned...

Tuesday, March 15, 2011

I'm an Information Machine!

Gosh, I feel like I'm updating too often -- is that possible?!?!

In any case, I do have more news to share with you all. AND I get to share it from the comfort of my cozy couch. :)

Today's ultrasound showed Baby B to be the same as on Sunday morning, consistent with what we've seen over the last month: blood flow is still slightly elevated. Biophysical profile was great. B is quite the squirmy wormy and appears to be a little fighter, hanging on strong! Baby A is right where A should be, as usual.

And in even more interesting news: we have a delivery date scheduled! I am on the calendar for April 4 at 10:30a. I will be officially 36 weeks on that date. The reason we are not pushing for 38 weeks is due to B's growth. The OB explained it to me that it would be better to take B early in order to avoid any extra stress from the blood flow concern; with B's growth, it would be better to assess the situation from outside the womb at 36 weeks. 36 weeks is a very acceptable "term" delivery for twins. She also told me that twins do not grow very much from week 36 to week 38, so we would really not be losing any growth or development.

And in even more exciting news (I mean, did you even think that was possible?!?!): The OB who treated me today said that if I were to go into labor on my own, she would be more than happy to deliver me naturally. She is experienced and comfortable performing a breech delivery, and even encouraged me to call her if I went into full labor, and she would come to the hospital to deliver me even if she wasn't on hospital rotation. She said that I am an excellent candidate for breech, and delivering a smaller baby who is breech is much easier than delivering a larger baby who is breech. She is actually on the hospital rotation for next week, so while I wouldn't encourage labor, it wouldn't necesaarily be a bad thing if I did spontaneoulsy go into labor next week...during the day of course since the OBs at this office only rotate hospital hours during that time. Also, if I happen to be in labor when I come in on April 4, then we could attempt a vaginal delivery at that time, otherwise a c-section is the way we'll go.

A bit more info, if you haven't had enough information yet ;) --- I am still dilated to 1 cm, but my cervix is starting to thin, making me 50% effaced. Perhaps, my body is already starting to show signs of changes that can lead to labor. I also had my uterus measured for fundal height. Fundal height measurement is taken from the top of the uterus to the top of the pubic bone and can aid in determing fetal growth and development. Although this measurement isn't as accurate as ultrasound, it can be useful in assessing when a pregnancy may be nearing it's end, read: labor may begin soon. My fundal height was 40cm, and it is sometimes thought that anything 40cm or above may indicate that the uterus may begin contracting to begin labor. This isn't always the case of course, but I might just cross my fingers that it is for me.

Being on twice weekly appointments now certainly gives me much more reason to come back here and update often, but if the appointments and ultrasounds are unchanged, I may wait until I have more news to share before popping into the blog o'sphere. Thanks for keeping up with me, friends!

Monday, March 14, 2011

What's the Deal?

Here's the deal: I'm home, yay! I was discharged from the hospital late yesterday afternoon and now come blogging to you from the comfort of my recliner. :)

Yesterday morning at the hospital, the attending physician decided it would be good to have one more ultrasound before determining if I should be released to go home. Babies were doing very well on the belly monitors that measure their heart rates, but an ultrasound to check on blood flow and  complete biophysical profiles (a test during the ultrasound to assess the babies' well-being: fluid levels, practice breathing, muscle tone, movement, heartbeat) would determine when the babies should be monitored again.

This ultrasound resulted in more great news, similar to what we have been seeing over the last few weeks, with the exception of the early morning ultrasound on Friday. Baby B's blood flow was slightly elevated and both babies' biophysical profiles came back perfect! Heart rates were strong and steady, both were definitely practicing their breathing (that was so neat to see!), wiggle worms they were, and amniotic fluid levels were great. The only concern was the elevated blood flow as it has been for the few weeks. It seems even my cervix is growing a bit and is not near as short as it once was. All good things!

I was released home on modified bedrest rather than on the previous stricter rest. That means I have a little more freedom to move about the house now. My specific instructions state that I must take 2 hours of rest after every meal, and then I am permitted to do some light activity: light housework, light cooking, etc. Although I won't be vacuuming, scrubbing bathtubs, or bounding up the stairs, I will be able to relieve some of the household duties that have burdened the hubby for the last month. If I stick to simple, quick meals I can even cook dinners for the family now. I must be off my feet completely from 8p until morning. No problem! Despite the lifting of some of the restrictions though, I am still continuing to keep my two youngest in their respective childcare situations. I think that would be the best in order for to continue to required resting during the day not to mention that I still cannot lift anything over 20 pounds, so the little guys will have to wait a bit longer before Mommy can pick them again.

C & M were so wonderful during this whole ordeal. I was so worried about the many ways this situation must have inconvenienced them, and they had to head back home without the babies they thought they were coming to get. They were so kind and understanding. I'm so very thankful for that.

I will have another ultrasound to check on the babies, especially little B that has caused us so much concern, tomorrow morning. It seems I will be having ultrasounds twice weekly for perhaps the rest of the pregnancy. What a nice treat that will be: getting outside of my four walls twice a week. ;)

Until tomorrow, blog groupies...

Saturday, March 12, 2011

Where do I start?!

I'm seriously not even sure where to start with this update. It's a super long roller-coaster of a story, so I'll take a few deep breaths and try to walk you all through it without being too talky-talky.
I had my regularly scheduled appointment early yesterday morning. During the ultrasound, the tech told me that I would likely be going to the hospital, and she immediately left the room to call the perinatologist to send him the findings on the ultrasound. A few short minutes later, my OB came into the room and told me, "Today's the day." They were telling me we were delivering babies that day!! Can you imagine my shock?!?!

I immediately called IP's to be sure they could try to get to their babies in time; called my mother so she could make the long drive to be here with my kiddos; called the hubby so he could head over to the hospital asap. After texting and notifying multiple people about this last minute scenario, my OB came into my room and notified me that the NICU was full. I would have to transfer to another hospital.

Strapped onto a stretcher I was and given an ambulance ride to another hospital a bit further way. I was admitted at this hospital and given a complete workup: blood draws, slew o'questions about my medical history, etc, and IV'd up to receive fluids. The delivering doctors came in to talk to me, the anesthesiologist came in for her spiel, the social worker came into confirm legal paperwork....I must have had 15 people in and out of that room in the first hour I was there.

I also had another ultrasound. The doctors at the "new" hospital wanted to confirm what they were told was seen in my OB's office. An hour later, the ultrasound was complete. And by that I mean, the actual ultrasound took an hour, an ENTIRE hour! A bit of time passed and the high-risk doctor came in to tell me what the findings were of that ultrasound. They did NOT see the same thing that was seen earlier. In fact, they saw something completely different. In my OB's office, I was told B's blood flow was reversed and B needed to be delivered immediately; after the 2nd ultrasound, I was told the B's blood was slightly elevated, consistent with the ultrasounds over the last few weeks.

Now, if you're confused here, you are not alone. But for the time being, there would be no delivery of the babies. I was admitted for overnight stay for monitoring with another ultrasound coming the next morning. This decision came only after IP's were in the air, coming to me, expecting to meet their babies.

Fast forward to this morning:
The ultrasound this morning showed that Baby B's bloodflow was slightly elevated from yesterday's ultrasound (but still not reversed, yay!), so I am remaining in the hospital for another 24 hours to monitor the babies' heartrates to make sure that the increased elevation is not affecting fetal heart rate. Also, the physicians here took me off the Procardia I was taking to help relax the uterus to avoid contractions, so they want to make sure I'm stable without that for 24 hours before they send me home. If the babies' heart rates remain good as they have been and I don't have regular contractions, then I *should* be able to go home tomorrow sometime after lunch. I will then be seen again on Monday or Tuesday for another ultrasound, and will likely be moved to twice weekly scans.

IP's are on their way home now, but know that is a possibility they may have to return asap based on next week's ultrasounds. Our hope is to continue the pregnancy for 3 more weeks if B's blood flow and growth will allow. My bed rest continues, hopefully at home tomorrow.

Did you get all that? I know, it's a lot to process. Imagine being on this end of it.

And while I know this is the least important part of this post, I wanted to leave you with another tummy shot @ 32 weeks, 4 days:

And if you're really brave, you're welcome to view a bare belly shot -- and if you're not so much with the bravery, you are now free to leave this blog as this post is finished for you. ;) For the rest of you, here's a feast for your eyes maybe:

Thursday, March 3, 2011

I am convinced...

...that there comes time in every pregnancy - perhaps earlier in a multiples pregnancy - that the cute little belly that everyone has "awwww'd" at for so long is now the receipeint of a lot of "Wow!'s, "Good Lord!'s," "You must be so uncomfortable" and "Looks like you you're counting down the days." I think that time has come for me:

It is no longer a cute "bump." It a big ol' belly! :) But in case you were wondering, that's supposed to happen. Hello! Babies grow and as such, so does the belly.
Now, for what you really came here for: a baby update ------>
After spending nearly 3 hours in a doctor's office, I am back at home, blogging to you all. Yay! Although the appointment took a considerable amount of time, the outcome was pretty simple: everything is the same as it was last week! (That's good news, people!!) The blood flow again showed no instance of intermittent or absent end diastolic flow; B's blood flow is still elevated as it was previously. And I learned what that meant as well. Basically, placental blood flow concerns will take this progression:
Normal -Elevated - Intermittent-Absent-Reversed
Once blood flow is reversed, intervention is required = delivery. So, although we would love to see normal blood flow, elevated blood flow (meaning there is some resistance in sending/receiving blood to Baby B) is definitely better than what we saw 3 weeks ago with the intermittent and absent end. The growth scan also showed that both babies grew at the appropriate intervals. B is still a couple of weeks behind, but the important thing is the interval growth. According to the ultrasound, Baby A weighs approximately 3.6lbs and Baby B weighs approximately 2.8lbs. The tech was able to get a 4D photo of Baby A as well; I'm excited to send that to C!
The weekly cervical check also showed my cervix measuring at 16mm, so we're still doing well with that as well.
I also spent quite a bit of time asking the OB about the c-section procedure as I have never had one before. I won't bore you with all those questions (some are TMI, anyway, ha!), but I do feel much better knowing what to expect. And my OB has assured both C and I that she will make it work so that my husband as well as C & M will be able to be in the OR during the procedure. Normally, only one person is allowed, but given our situation, the OB is going to make an exception for us. I can't tell you all how truly blessed I am to have such a wonderful and supportive OB throughout this surrogacy.
I was sent home to continue bedrest and meds. I'll go back on Friday of next week to check B's blood flow again. On that date, I will be 3 days shy of 33 weeks -- I never thought I'd consider every week golden, but I'm so happy at the idea of baking these babies for at least 33 weeks, with a very probable chance at carrying them longer!