It's been over a week since this all happened so I may have forgotten some of the details, but I wanted to memorialize my experience so that I can one day tell my children how much grief they gave me before they were even born.
At home on bedrest
After my last post, I was at home on bed rest with a pretty positive attitude. We still had a great chance of making it to 36 weeks, and the outlook was as good as any of us could have hoped for. I was 25.5 weeks. On Thursday and Friday I felt awesome - barely any contractions, and I even was able to lay on my back for a few minutes without causing a contraction. That's all I really wanted in life at that point - to be able to lay flat and stretch out for a few minutes a day!
My family is amazing and someone came every day to take care of me. My brother Jason came and basically lived with us for 3 days. Boris slept on the couch (since my hospital bed was downstairs and I couldn't get upstairs) and took care of me at night, and my brother or my mom took care of me during the day. My brother was especially good at feeding me - we wanted to fatten up these babies so his goal was to get me to eat 3,000 calories a day (2600-3000 is the expected range for twins, depending on who you talk to). I ate well and my spirits were up.
On Saturday my mom came by for a little while before heading to my aunt's house to prep for my cousin's baby shower (she is due in April!). Everything was still great when she left.
Around 2pm I started noticing contractions a bit more regularly. They never really went away during the preceding days or weeks so I wasn't surprised, but I started counting them. At 2pm there were only 2-3 per hour, which was pretty normal for me at he hospital. But by 7pm, there were more than 5 in an hour and I started to get worried. Boris tried to calm me down, but even when I was in my sloth mode (which usually helped to slow contractions), they kept coming. I knew they would probably go away soon, but I also knew I would be worried all night so I called the doctor. The doctor on call was my doctor's brother. He said that because of my history (ie the recent hospital stay) I should come in to be monitored. Since I had only been home for a few days, that was pretty discouraging. Our perinatologist had given us a prescription for indomethacin (the more effective anti-contraction drug) with the instruction to only take it if we were coming back in (ie don't just self medicate and think things will be okay), so we took a dose of that and headed back to the hospital.
Sequoia hospital
A few minutes later we were back at Sequoia. I had texted my mom so she was there minutes later. Luckily for us, my doctor apparently has no personal life so he was already at the hospital and was able to see us pretty quickly.
Once again, the look on my doctors face when he performed the exam was horrifying. Before he said anything, Boris grabbed my hand because we could tell it probably was not good news. My doctor said to the nurse "we need to get her tilted backwards. I see bulging membranes." Then he looked at us and said the dreaded words: "We need to transfer you to Stanford."
When he said that, it was probably the worst thing I had ever heard in my life, and was also one of the worst moments of my life. At our previous stay at sequoia, nurses and doctors would reassure us by saying that if it was serious, or if we were really going to deliver, we would not be at sequoia - they would send us to Stanford. So when we realized that's what was happening, we also realized that this meant the babies were probably coming... Soon.
My doctor told me that I was now dilated to 2 cm and that he could see membranes bulging out. Not good. Needless to say I immediately began balling hysterically.
The sequoia team started me on magnesium again. Not fun, but again I was glad to have it. 45 minutes later the transport team from Stanford arrived. They prepped me and got me in the ambulance and 30 minutes later I was at Stanford.
When I finally saw the doctor at Stanford, the resident examined me again and determined that I was already 4cm dilated, even though I was only 2cm an hour before. So that was pretty bad news. We spoke to the high-risk specialist and he said that he would finish out the course of medication that sequoia had given me, but would not give us any more than that, because "studies show that they are only effective for 24-48 hours." My doctor has quoted few same studies, but reached a different conclusion - he said hat even though studies show that on average they are not effective over the long-term, everyone is different and they may be effective for me. Since the risks and side effects were minimal, why not try? The Stanford doctor basically just said no. We were... Upset. I told him that I could accept that treatment plan, but not until he spoke to both my OB and perinatologist and they all could agree that it was the best treatment plan. He came back later and agreed to give us one more dose.
That first night, we were visited by a doctor from anesthesiology and from the nicu. Both told us what to expect. The anesthesiologist explained that since the babies were so tiny, I might have to have a "classical c-section," where they cut vertically instead of horizontally. This would mean I could never have a vaginal delivery for any subsequent children (no VBAC option at all). The nicu doctor explained the mortality rates for kids at 26 weeks, the types of health problems they typically encounter, etc. As you can imagine, none of this was easy to hear, especially at 1am. Five hours earlier I had thought we were going to get to 36 weeks, so it was a rude awakening.
We made it through the first night, which seemed huge because we hit the 26 week mark the next day. I found out the next morning that my mom and Boris's parents were still there, sleeping in the waiting room (or more likely just not sleeping at all). My mom stayed all day. I felt bad because that meant she missed my cousins baby shower - I was already bummed that I had to miss it myself! My siblings all came to visit that day too. It was a really scary time and I think none of us were in a "good place" emotionally at the time.
We made it through another day, which at this point was already longer than the doctors had predicted. They checked me again and determined that I was still 4cm dilated, so we had stopped the downward spiral at least! That was the best news of the week. I got a new room (previously I was in more of a waiting room that is right next to the nurses), which was shared but I didn't have a roommate. [A few days later I got my own private room - its small but that's okay.]
Ultrasound... Attempt #1
The next day, a nurse came up and said she was taking me for an ultrasound upstairs. I didn't know why, but we went (my mom was with me). They took us upstairs to the Stanford maternal fetal medicine unit in a wheelchair and dumped me there to wait. Minutes later we still didn't even know why we were there. At this point, it was be longest I had been upright in weeks. It did not feel good. I started getting lightheaded and really a stressed out. When they finally came for me, I asked why we were there and they explained that they wanted to do the detailed anatomy scan. I already did that weeks before, so I knew it was a TWO HOUR test. I was contracting like crazy, felt like shit, and they want to probe my belly for 2 hours? No thanks. We bickered for a few minutes and I eventually just told them I wanted to go back to my room immediately. The doctor later explained that they needed their own scan, because it is their "policy" not to accept the scans from elsewhere. I was unimpressed with this rationale, since I was very confident in my perinatologist (and she trained at Stanford after all...).
Ultrasound... Attempt #2
Later, a different doctor gave me a more convincing reason for the ultrasound - that if I delivered (which they still considered to be "imminent,") it would help the nicu to know exactly how big they are, and have a recent ultrasound to know what to expect. I reluctantly agreed to the scan because that made more sense to me. When we went again, I wasn't having as many contractions so it was a much better experience overall. That's when we learned that the babies were 2 pounds each!!
Steroid shots
On Tuesday, the perinatologist and residents came by on rounds and said that they wanted to give me a second "rescue" dose of the steroid shot that helps the babies' lungs. I had my first dose at sequoia 11 days before. They only work for about 14 days though. The tricky part is that you only get two doses - so this would be my last one, and it would be out of my system if they were born more than 15 days later. I agreed to he second dose because as they explained, even though it's very good for babies to have the steroid shot, a baby born at 28.5 weeks is already much better off than a baby born at 26.5 weeks, so they don't need it as much. It was scary to get the shot again because it meant that the doctors thought delivery was likely within the next 3 days, but at least we knew there babies would have the best possible shot of survival if they were born.
Life at Stanford hospital
As I mentioned before, the folks at Stanford have very different philosophies than the docs at sequoia. I wasn't thrilled with their treatment plan at the beginning, but after making it a few days, it got better. While scary, my life at Stanford significantly improved. I'm no longer at a 6 degree backward incline, I'm allowed to walk to the bathroom, I'm not on any more medication, and the food is WAY better. So overall, my quality of life is better now.
27 weeks!
Almost exactly a week after arriving at Stanford, we made it to 27 weeks! That was so so exciting for us! The doctors even began referring to me as "stable"!! Of course they haven't performed an exam to check how dilated I am since those first few days so we don't really know how stable I am, but still, it's a much better description than the "imminent delivery" that people had been using for the previous week.
Now, my doctors say that if things start getting worse, they will even put me back on the magnesium to try to "break the cycle" of contractions if they get much worse. Who knows if that will do anything, but at least we know it's an option.
Shattered pregnancy dreams.
One of the hardest things about this process has been adjusting my expectations... Downward. When we found out we were having twins, we gave up on the idea of a 40 week pregnancy, and accepted that we would only go to 36. When I went to the hospital, I realized even 36 weeks would be tricky, but thought we could still get close, and I was hopeful that we could get to 36. After being transferred to Stanford, I had to again adjust my expectations - that now, we are aiming for survival, not perfection. That was a hard adjustment, but we came so close to delivering at 26 weeks that we adjusted quickly. There were many tears and many days where I couldn't think about anything without wanting to cry. Boris and our families were similarly stressed which made it even harder. It's hard to watch your spouse lose weight and never sleep because of anxiety.
I also feel like I kinda got ripped off. I didn't enjoy my first trimester and sure, I had my complaints during the second, but for the most part I was legitimately enjoying my pregnancy. I liked that I could finally out-eat Boris, I liked wearing cute maternity clothes, and We just had so much to look forward to. I feel like the rug was pulled out from under me. I was barely pregnant for 6 months before I had to start living in a hospital gown. I never really even got fat enough to be truly uncomfortable.
I also never got to transition my work load before I left. Instead I basically disappeared after sending a few emails via iPhone while heavily drugged. It's not how I wanted to leave things, especially on "my" case (the one I had been managing). Luckily other folks on the team stepped up and one key coworker returned from maternity leave, but it was very frustrating to just leave in the middle of everything.
Thank you!
I really have to say thank you to everyone who has been thinking of us and praying for us. I have never been religious, but I felt a lot better hearing about all the prayers out there for us. The success stories were incredibly inspirational, and got is through that first horrible week at Stanford. Every comment and "like" on Facebook is important to us. We feel so blessed to have so many pekoe out there rooting for us. I am fully convinced that this is why we have already made it this far. So thank you to everyone for your thoughts and prayers!!
Today I am 27w3d. We are counting down to 28w, and hopefully further. Now you are all caught up!
Sent from my iPhone
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