Oh September

I haven't really done much "this time last year" posting, though lately it's been on my mind, a LOT. Pretty expected since Eliza's birthday is in 4 days and my pregnancy leading up to the babies birth was, in the kindest of descriptions, tumultuous. We were pretty quiet on the blog this time last year (similar to now!) using all of our energy to just hold on to the pregnancy for just a few more days or weeks. Glenn did take time to email out to family and friends some status updates while I was laid up in the hospital bed vacillating between magnesium drip torture and lucidity (although watching nonstop reruns of "A Baby Story" and "I didn't know I was Pregnant" with my mom may not be considered lucid). I read through the emails the other day and one thing that really stood out to me was just how optimistic we were. I miss that about us. I think our optimism has been battered to oblivion.

The email updates started after I had been admitted to the hospital for the last time. I was admitted after one of my routine 3 hour OB checkups. It was a Friday. I had been having some mild cramping all morning and let the doctors know at the beginning of my appointments but for some reason taking a peek at my cervix was saved until the end of my 1.5 hour ultrasound. That's when the doctor saw that I had started dilating past my cerclage (stitch keeping my cervix closed) and the membranes were beginning to push through. Thankfully my mom and granny were both with me for the news and to drive me quickly to the ER. I will always remember all of us standing in the ultrasound room waiting for the Dr. to give us the go ahead to rush out. I think I said some unpleasant words.

Somewhere between that point and getting admitted into the labor & delivery I started going into labor. The next several hours were a blur. A lot people asking me if I was in pain and me trying to tell them that that wasn't the important part.. I just wanted them to stop the babies from coming!  Twenty two weeks was far too early for babies to be born. Eventually they did stop it. I saw a lot of doctors over the next couple days. At first they were very somber about the reality of giving birth to babies at 22 weeks. Really no chance, but make it to 23 weeks? The discussion would change.

I made it to exactly 23 weeks and Eliza's water broke. That's where Glenn's emails begin:

8/30/10
Hi all,

Mixed status to report today. 

Heather woke up at 4:30 this morning to find that baby A's water had broken. Surprisingly to me, this doesn't necessarily mean that baby A is doomed or that delivery has to happen now - apparently if Heather doesn't go into labor irreversibly, baby A can hang out in there and keep growing for a while yet, but the lack of the protective amniotic sac puts Heather and baby at much greater risk of uterine infection, which *would* require that Heather deliver immediately. Therefore, the doctors immediately started Heather on a 7-day course of antibiotics as a preventative measure. They've also started her on a set of steroid injections which are supposed to help the babies' lungs develop a bit more quickly in case we do have to deliver soon.

Heather did start having major contractions and cramping (the worst she's had yet) after the water broke, so we've been spending most of the day trying to get that settled back down, and at the moment (4:30 PM) the combination of IV magnesium sulfate and high-dose ibuprofen seem to have finally done the trick. "Mag" is an unpleasant medication to be on, as side effects include lengthy hot flashes, grogginess, pain at the injection site, and nausea, and Heather can't eat or drink while she's on it, but it seems to be the drug of choice for stopping/preventing pre-term labor. Ibuprofen, interestingly enough, is even more effective, but it can only be used for short periods of time (2 days or so) without introducing a whole nother set of risks to the babies.

Today marks 23 weeks, so we're now officially far enough along for the babies to have a chance of survival if they deliver today, but the numbers are still pretty grim (about 40% survival rate, IIRC), so we're obviously hoping for many more days of pregnancy yet. We've had meetings yesterday and today with staff from the NICU (neonatal intensive care unit) to make sure we understand the statistics and the kinds/degrees of intervention that they may perform to keep the babies alive if they deliver soon. I also went on a tour of the NICU last night in order to get some idea what to expect, since even if we make it many more weeks it's virtually certain that our babies will spend at least some time in there. Seems like a very well-run place - lots of teeny tiny infants hooked up to various machines, but quiet and peaceful and staffed with lots of doctors and nurses who obviously care a lot. We feel really fortunate to be at Duke, given the situation we're in, as Duke's NICU has some of the best outcomes in the country.

That's all for now - I'll do my best to keep y'all in the loop as things continue to develop.

Glenn
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8/31/10
Hi all,

Today (day 5 at the hospital)  has been a quiet one, and at this point no news is definitely good news! Heather got her second steroid shot this morning, and they've taken her off the magnesium sulfate for now, which has her feeling MUCH better (especially since being off "mag" means she can eat real food again), though I think she may have missed its grogginess/drowsiness side effects just a bit when she was trying to nap between checkups this afternoon.  Very few contractions today, and Heather's been feeling well enough to let her mom wash her hair and paint her toenails, which I think also helped. :-) She's still on the ibuprofen for a bit longer to keep the contractions down, but if the contractions start back up again in the future, she'll be going back on the magnesium again. Heather has also been getting regular ultrasounds to check the babies' heart rates, and so far they're continuing to all look strong and healthy. I think I've mentioned this before to most of you, but in case I haven't, Heather will definitely be in the hospital for the rest of the pregnancy. Here's hoping that's a long time!

Glenn

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9/1/10
Hi all,

The contractions started back up a little before breakfast this morning, so Heather was put back on the magnesium sulfate again. This settled things back down again pretty quickly and kept them so throughout the day, but with the usual unpleasant side effects (drowsiness/exhaustion, overheating, and a diet of clear liquids only - jello, chicken broth, and popsicles for every meal, ugh!). Heather's dad made the drive up from Georgia today to join her mom here and stay with us until the weekend, which we really appreciate. Ultrasounds are continuing to look good - even though baby A doesn't have much fluid to protect her at this point, all three babies still have good strong heartbeats and are quite the little squirmers. Heather is hanging in there really well through all the ups and downs so far (on magnesium, off magnesium; on solid foods, on clear liquids only; no contractions, cramps only, contractions and cramps; etc.) but it's naturally pretty exhausting for her to handle it all. She was taken back off the magnesium around 8 tonight, and although some cramps have returned the contractions seem to be staying away for now - hopefully she'll be able to get a good night's sleep tonight!

Glenn
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9/2/10
Hi all,

Today was a great day! A good night's sleep last night, and today, fewer cramps, very few contractions, and no magnesium sulfate! Heather has been doing so well today that they've been gradually unhooking her from the various sensors, monitors, and IV drips - as I write this the only thing she's still connected to is an IV for fluids, since that is really helping her stay hydrated. Heather had a detailed ultrasound today and the babies are all well. I went into the office today for some meetings, leaving Heather's mom to look after Heather during the day. Having her here all week has been a tremendous benefit to Heather's peace of mind, and she has taken great care of us both and kept an eye on the house while we've been away.

Thank you all for all of your kind words, prayers, offers of support, and thoughts. It has really meant a lot to us as we've been going through all of this!

Glenn
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9/6/10
Hi all,

Happy (non-)Labor Day! This weekend has been a fairly quiet one, for which we are very thankful, although not without the usual various ups, downs, and scares from day to day. As long as there keep being more ups than downs, and we keep coming out on the other side still pregnant and healthy, we can't really ask for anything more!

Heather's mother and father went home on Saturday to attend to some things at home. Heather's sister and brother-in-law stayed here from Friday night through this morning, and Heather's mom came back this evening. The companionship of her family has been much appreciated throughout all that has been happening.

Today marks 24 weeks, which is another major milestone for us. Statistically speaking, it's the point at which a baby has a better than 50% chance of long-term survival if born today (although given that we're at Duke, hopefully the numbers are a bit better for us...). It's still a scary time, but the numbers just keep getting better every day.

Thanks again for all of your thoughts, prayers, and support,

Glenn 
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9/8/10
THE BABIES HAVE ARRIVED! 

At around 9:55 AM today, September 8 2010, Heather and I became the proud parents of:
Eliza (1 lb, 4 oz)
Charlotte (1 lb, 1 oz)
Oliver (1 lb, 3 oz)

Around midnight last night, the cramps and contractions started up again in force. The doctors started Heather on magnesium sulfate again, and by around 3:30 AM they had settled back down enough for us to get a couple of hours of sleep. Then, around 5:30, they started back up again. After a couple of hours with no relief and no response to magnesium and terbutaline, the doctors decided that at this point, the risks of continuing to try to stop the labor (especially since they thought it likely the labor might be caused by a developing infection) outweighed the risks of delivering the babies (since we were now past the magic 24 week milestone), and so they scheduled Heather for a C-section this morning. Heather went into the operating room around 9 for her epidural, I was allowed to join her at 9:30, the babies were delivered in rapid succession at about 9:53, 9:54, and 9:55 (and then whisked off to the NICU by the neonatologists), and we were in the surgical recovery room by 10:30. 

After Heather had finished recovering from her epidural, we helped her into a wheelchair and took a trip to the NICU to visit the babies. They're really tiny, and as 24-week preemies, there's a lot that can go wrong for them, but they seem to be stable at the moment and being well looked after by the NICU staff. At the moment, they're each in individual isolettes (incubators), hooked up to ventilators and heart monitors, and swaddled in little blankets. Their eyelids haven't opened yet, and probably won't open for a couple of weeks. They'll undoubtedly be in the NICU for many weeks, but we're hopeful that they will grow and thrive in there and come home to us in due time. 

Today has been a lot for us to process, and it still feels very surreal and unreal in many ways, and there are still many uncertain times ahead, but right now we're just happy that the babies are alive and relatively healthy, and we're looking forward to getting to know them better in the days to come.

Thank you all for your care and support!

Glenn

P.S. By a happy coincidence, today is also Heather's mother's birthday - so she and her first grandkids share the same birthday. Isn't that wonderful?


Whew, it's hard to even recognize ourselves in these emails. 'Ignorance is bliss' I suppose. I was planning to go through and add my comments and perspectives on things from what I remember but I honestly just don't have the capacity right now.