I Provide for My Babies

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I almost cried looking into my empty fridge. That is a single bottle of 20ml’s of milk, barely an ounce. I made that for my babies.

Having micro preemie babies in the NICU has more of an effect than anyone can imagine. It’s not just the emotions driving their care, safety, and lives, it’s also the feeling of not being good enough to care for them in one of the most important ways during the most crucial time – the first weeks of their lives.

I’ve finally come to terms with the fact that, since my girls came so soon (26/4, roughly 14 weeks before term), I will not be able to keep up with their demand (and how awesome that they have such demand now!). I’m not less than. I provided for my babies during their first days of life, and now on day 50 of their stay in this world, I will still give what I can until I cannot give anymore. What no one understands, unless you have had a NICU baby, is that your body is not ready to produce for your babies yet; it still thinks you are pregnant. You’re essentially forcing it to do what it was not ready to do. You don’t have a baby to constantly hold. You look at your baby or babies through double-paned incubators. You can change their diapers and stroke their soft skin…when you open the doors to their incubators. You can sometimes do skin-to-skin contact, but once per twelve hour shift. You can hear their muffled cries…through the double-paned windows of their incubators. You feel connected to these tiny human beings, want to hold and love and console them whenever they cry, but you can’t; not in the normal sense, anyway. You can’t hold them like a regular mother can to produce the nutrients they need. Instead, as a NICU mother, you sign waivers so that they can receive donor milk where you cannot give. When they can no longer receive donor milk, they switch to formula. In between all of those, you produce the tiniest amounts until it can fill up a single feed. And when you have twins, they have to share.

“Get some rest!”

(But make sure you pump every 3 hours)

You pump all you can. You’re exhausted. You’re at home or staying at a Ronald McDonald house away from your babies. You still produce 10mls per feed…maybe you luck out and hit 47mls. You give up. Your energy is focused on everything else but yourself, except that you are inadequate for being unable to produce for your babies. You’re pushed by hospital staff and friends.

“Look at pictures of your babies.”

“Wear their blankets while you pump so you are able to smell them.”

“Listen to clips of hungry, crying babies.”

“Consume galactogogues!”

I’ve bought powders and cookies and eaten oatmeal. It’s not the same. At 33 weeks and 5 days, my girls weren’t even supposed to be here, but instead are looking at me through the double-paned windows of their isolettes. I’ve realized that I’ve beaten myself up enough. I’ve let the doctors and nurses know that I will be pumping as much as I can for them, but I’ve had enough.

My sweet baby girls are getting so big now! I know that I still played a part in that. I still provide for my babies in the best way a NICU mother can – I’m there to console them during their shots, know exactly what is going on with their care, and speak up when I know something isn’t quite right. They know my smell and they know my voice and they know my touch. I know that they love their legs and piggies rubbed, and I happily oblige. I know that one does extremely well during shots if she has her pacifier, and the other prefers a hand over her chest and back. And they both like head rubs :).

I provide for my babies.

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Episodic Rage

If you know me, you know I can be dramatic. I’m a worrier; I get overwhelmed easily and can’t walk and chew gum at the same time. When I’m overwhelmed, the first thing to go is the cell phone. If I have zero time for me, I have zero time for you. Couple that with pregnancy hormones and you can get episodic rage. I work in an environment that, for the most part, has little stress. It comes in waves, my job. At times, it can be balls to the wall, feet to the fire type of busy. When it’s busy like that, people can be mean.

Well, at 19 weeks, 6 days pregnant, I had a meltdown at work because of that mean. I quietly shut my door, slowly took a seat at my desk, put my head in my hands, and bawled. I bawled carefully though because it takes me forever to do my makeup, but I bawled. Sticky and salty tears ran from my eyes to my desk (if you hold your head a certain way when you cry, the tears don’t run down your face, so your makeup doesn’t run) and watched the tears pool. At roughly 3:00 PM, I used the restroom (it’s not TMI if it’s part of the story) and saw blood. I panicked. Had my meltdown caused this bleed? I hope not. To be honest, I will never know.

I was terrified. I called hubby at around 4PM and was not able to get through. I texted him.

“Meet me at the hospital! Call me!”

I briskly walked to my car (cuz running is not an option for me at this point), having never been so scared before in my life. There were two lives in my belly that we worked so hard to obtain. I was one day away from being halfway through my pregnancy; I needed these two little girls to stay put!

I frantically drove to the hospital, which was normally a 15-20 minute drive. I stopped at red lights, looked both ways, and proceeded to go through them. Hubby called and spoke to me the rest of the way, trying to keep me as calm as possible as he frantically drove from work to meet me. To say I drove as frantic and safe as possible sounds like an oxymoron, but it is possible. I made it to my exit, but was stopped in my tracks by someone thinking they could teach me a lesson and that I was just being an impatient asshole (I was). They slammed on their breaks in front of me, sending me into the right lane to swerve around them and hit a left turn in front of them. Please – you know those assholes that are doing 90-100MPH on the expressway and especially don’t look like young punks just driving like jerks? I now know to leave them alone and not interfere because you have no idea what could be happening, and in my situation, it was an emergency. Leave them be and even stay in your lane to let them pass, or risk an accident.

I frantically parked in the front of the hospital and waddled inside with no regard to who was out there or what would happen to my car. Hubby ended up being right behind me. He took care of both our cars as I ran inside to labor and delivery.

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(It was about midnight at this point and this guy is trying to catch some zzz’s in an uncomfortable chair)

As the charge struggled to find the heartbeats of my girls because they were so small, she told me that they weren’t prepared for babies under 20 weeks. (DO NOT tell someone who is bleeding and has no idea what is going on that you are not prepared for 20 week babies). I worried and freaked out on the next nurse… The charge needed to work on her delivery.

They attempted to check my cervix, which was painful due to old scar tissue. It was still closed, which told us that the cerclage was still in place (or was it?). I was told that I was contracting and would need to be put on a drip of some medication called Magnesium Sulfate. I was given a rundown of how it may affect me and what its purpose was. It is a multiple-use medication, but in this instance, it is used to relax every muscle in your body. This means that it helps relax the uterus, along with your bladder and esophagus. You know what that means? No food, no water, and a catheter – I negotiated a bed pan…It also made me dreadfully ill.

You experience flu-like symptoms and extreme drowsiness. You’re not allowed to shower, either (you can’t walk, therefore, you cannot get up to bathe). This went on until Friday night when I was released at 20 weeks and 1 day.

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(The most uncomfortable love seat known to man. This guy has slept one too many nights like this with me)

During our stay, Dr. George Powers, Neonatologist and Chief of Staff, paid a visit to our room. His warm and jovial demeanor offered instant comfort to an otherwise stressful situation. He broke down percentages (which hubby loves) and potential outcomes for our babies. He has a way of breaking down situations that anyone can understand, offers a caring and kind attitude, and has a knack for delivering potential doom and gloom without making it sound that way – a truly gifted human being all around. We knew we were in the right place before, but especially knew now. He gave us another tour of the NICU during our stay, breaking down the various types of equipment and highlighting some of the tiny patients and how they are taken care of.

We were truly grateful for the decision to find a doctor locally. Had we stayed with Houston, we’d have been, for lack of a better term, up shit creek without a paddle. We had a game plan and felt comfortable with it…but life still throws you curveballs.

 

 

A Tour, a Meltdown, and a Precursor to Pre-Term Labor

For the week following our visit with Dr. Hill, we tried to get a tour of the hospital I’d be delivering at (conveniently across the street from my MFM Specialists). It was tough, to be honest, as there seemed to be all of these barriers to getting a damn tour. The hospital was just converted into a Children’s Hospital in 2012, with their NICU opened just this past April. It was “new”, but under construction. Labor and Delivery was on the 4th floor and the NICU supposedly on the 3rd. We were finally able to get in to see Labor and Delivery one day and, as soon as we got off the elevator, we saw ‘NICU’…but it was behind a bunch of plastic (that’s not good). Well, we were unable to get our tour at this time, and were certainly uneasy at seeing plastic covering over the NICU entrance.

Hubby and I discussed our experience over the next few days, rather, I had meltdowns over the stress of finding MORE new doctors/paying for appointments for new doctors. We know who won this battle (hubby)…We decided to touch base with other OB-GYNs in the area just in case, and we did. What we found was that, though the doctors were great, they did not have experience with this type of situation (no surprise here, and not said in a pejorative manner), nor did they give any warm fuzzies about the situation.

As an aside, at 12 weeks pregnant, Dr. Mildred Ramirez (my Houston MFM) told me no running for exercise. She described it like so… Imagine a balloon, tied off at the end, moving up and down. The only support the balloon has is the knot, and if enough pressure is put on that knot, the balloon pops. That makes absolute sense, right?! I was told that elliptical was fine, so that’s what I did – up until I was slapped in the face with the ‘high risk now’ comment.

We were onward bound at 18 weeks pregnant to a different OB/hospital just to try to have options. After having an episode of rage over parking at a structure at the new office (pregnancy apparently makes you have meltdowns and episodes of rage…who knew) because the hubby parked in some structure next to Mars, and I could not find him, we were at the next doctor’s appointment. Kudos to hubby for shrugging off and laughing at my episode of rage…

“I DON’T SEE YOUR CAR!”

“I’m right by the hospital.”

“I’ve gone all the way to the top of the structure and don’t see your car!”

“I’m standing by the doors.”

“WHAT DOORS?! THE DOOR TO THE OFFICE IS RIGHT IN FRONT OF ME AND I DON’T SEE YOU!” (Drives angrily out of the structure to find hubby. Never finds hubby and drives back to old structure because said structure was the right place to park.)

“WELL YOU’RE GONNA BE LATE THEN! I’LL MEET YOU INSIDE!” (Insert colorful expletives throughout my rage-laden outburst)

Though risky on his part to laugh at me, it did eventually calm me down.

So, let’s refer back to what the MFM in Houston told me about exercise. It made so much sense that I should not run, so I used this as a doctor test with all doctors moving forward to gauge whether or not I felt they were a match for our situation.

We met a wonderful OB at this appointment. She was top-rated in San Antonio, beautiful, and equally knowledgeable. Great time to test her.

“So, what do you think of exercise? Is running okay? Elliptical?”

“Running is absolutely fine! Elliptical makes your legs stretch too far, stretching the uterus and putting extra stress on the cerclage.”

Nope. That made little sense to me and my situation. I’m not poo-pooing this doctor’s expertise, as she is surely great for a regular pregnancy (she didn’t get high ratings for nothing)…but not mine. After that experience, I convinced hubby to do another tour at the Children’s Hospital with me. We were able to get in that day, thankfully! We were not especially blown away by the facilities, but what came next blew us away.

Our nurse, Rosemary, (who was as sweet as can be) took us on our tour of Labor and Delivery, then showed us the way to the NICU. As it turns out, what we thought was the NICU was actually area under construction for a newly-remodeled section of Labor and Delivery. She introduced us to Natalie in the NICU, a member of the transport team. You know those awesome people that ride in helicopters and rescue critical babies? She’s on that team. She was and is lovely. That is the only word for her. She took us through a brand new, state of the art NICU at the Children’s Hospital of San Antonio. We were in awe. Everyone we encountered was kind and accommodating. We knew we were in the right place just in case our girls came early.

You see, when choosing a hospital, especially if you are high risk or elevated high risk, it doesn’t matter what the labor and delivery facilities look like. The Children’s Hospital of San Antonio is in the process of renovating, but at the time the rooms were similar to the Golden Girls’ Miami pad – outdated with pinks, greens, valances, and flower borders. Bleh! It was the NICU that just blew us away. In case our girls came early, it wasn’t about me, it was about them. It was always about them.

Here’s the Boring Part of the Story

Shortly after speaking to the surgeon that performed the trachelectomy (probably on a spaceship somewhere just above Houston because that’s what aliens do to abductees probably), we realized that the trek to Houston from San Antonio may no longer be feasible. The “what ifs” started surfacing…We had initially planned on shacking me up in an AirBnB location in Houston at 24 weeks pregnant, but were really concerned with cost and travel at that point of my pregnancy. We also wondered, if my pregnancy was so high risk, what if there’s an emergency and we can’t get to Houston? No one in San Antonio knows us or our case, which could be dangerous! We had no idea just how high risk the pregnancy was…

Dr. Mildred Ramirez, the MFM at Texas Children’s Hospital, was amazing in the short time we met her. I met with nurses, a nutritionist, a geneticist…we just felt so at ease with the standard of care at the hospital. I mean, they house the number one Neonatal Intensive Care Unit specializing in Cardiology. Did I botch that name up? Probably. We voiced our concerns to her, asking for a referral to someone local. She linked us up with Dr. Peter Nielsen at the Children’s Hospital of San Antonio, which mirrored their standard of care to Texas Children’s since it was in the Baylor network.

Just a few weeks later (at 17 weeks pregnant), we walked through the doors of Maternal Fetal Medicine office for the Children’s Hospital of San Antonio. Dr. Nielsen was not in, so we met with Dr. James Hill (which did not immediately sit well with me since there was a switch made without us knowing). While we waited to meet with a strange, new face, I googled Dr. James Hill. West Point graduate and retired Colonel? Okay, yes. Went back for a MS at Stanford? Yup, right place. (Those aren’t his only credentials, but those are the familiar and quite impressive ones.)

Within seconds of meeting Dr. Hill, we knew we were in the right place. He listened intently as we spoke of our concerns and told our story. He is very methodical, which we appreciated, and also has a dry sense of humor, which was also appreciated. (If you ever see him, do not let his serious demeanor fool you…he’s awesome and can easily make you feel at ease!)

At this appointment, he really said something that drove it home for us. I mentioned our initial intent to stay in Houston at 24 weeks pregnant because we were high risk. His response was, “You’re high risk now“.

Ugh. Wow. 17 weeks pregnant and, to that point, everything was smooth sailing; little-to-no morning sickness (with twins, no less), no issues getting around (except the feeling of being a beached whale while on the couch Netflix and chilling), still going to the gym and walking or doing elliptical with light weights, and I was all belly with two, beefy baby girls. We were so pie in the sky to that point. Any time thereafter I tried to describe the situation, I was met with a look like I had two heads and was making it up that bed rest was needed and that I shouldn’t be driving. You can’t make this situation up and it’s most certainly not a relatable one to the normal baby maker.

We had no idea, but we were in for a wild ride that was yet to come… well, all things considered, our ride was about to turn into an amusement park ride at Cedar Point that hasn’t been considered yet – think Millennium Force meets Demon Drop meets Top Thrill Dragster (which is sinking deeper into the ground, by the way), all of which are combined to make a two-year-long ride. Boy were we happy we made the choice to stay in San Antonio…

Trachelectomy Sounds Like What an Alien Would Perform on an Abductee

Since I’m carrying twins and pregnancy scares the hell out of me, I found it important to gym it up as much as I reasonably could. This meant only elliptical and maybe light weights with the arms. No running, no sexy time, no baths, no swimming. So basically, have zero fun during your pregnancy and occasionally question whether or not you’re cut out for motherhood.

Anyway, after our experiences with two doctors mentioning selective reduction, I tried like hell to contact the surgeon that performed my trachelectomy and implanted the abdominal cerclage (sounds like I was abducted from my trailer in New Mexico and tested on by aliens with the names they have for these things). My first attempt was all for naught. MD Anderson has this really cool portal where you can ask questions. I thought I was clear, but I tend to write novels for questions. They told me that, although I was not asking for prenatal care questions, they would have to defer to the maternal fetal medicine specialist for any questions. I sat on that answer for about a week, lost sleep, probably had one of those shower epiphanies, and tried again.

One evening about one to two days after I posed my question once more (at 12 weeks pregnant), I received a phone call while I was working on my fitness (one of the last times I could do so for the duration of my pregnancy). It was the surgeon who performed the trachelectomy calling me from his personal phone. See a theme here? These doctors are top in the world, but take the time and care (cuz who knows if this bish is going to stalk them) to call me from their personal phones. It was Dr. Pedro T. Ramirez (ladies, hubbies, wives, boyfriends, or girlfriends – I hope you’re taking note of all of these doctors in the instance you experience any of this – you will not regret your experience with any of them). He was very kind and took his time to listen to me. He insisted that, although there is nothing documented, there have been successful multiple pregnancies with this abdominal cerclage. I was relieved. This, by no means, meant that our pregnancy journey would be easy, but it did mean that we made a great choice to keep our two little nuggets. (Imagine if we had not…)

I hurried over to hubby to tell him the news. We were both excited and happy to have heard from an amazing surgeon personally, and to have heard straight from the horse’s mouth that we made the right choice to proceed.

*Disclaimer – I don’t live in a trailer in New Mexico.

There Can Only Be One

If you were born in the early eighties, there’s a chance that you are familiar with the movie, ‘Highlander’. The main premise of the movie was, “There can only be one”. Well, I bring light to what I’m about to tell you because why not? Hubby and I made a choice that will remain on our clear conscience for the rest of our lives.

Remember me mentioning the important phone call from our fertility specialist? She stressed the importance of knowing that there was a potential for us to expect twins. She also mentioned the idea of selective reduction in the instance that twins do come up. If you don’t know what selective reduction is, it is a nice term used in the medical field to reduce a multiple pregnancy to one – by aborting a baby.

At 6.5 weeks pregnant, hubby and I went for our first ultrasound. We were so excited, forgetting the potential of twins. The likelihood of it happening was so low that we didn’t really keep it at the forefront of our minds. We happily and excitedly went to our appointment, ready to hear the heartbeat of our sweet little zygote.

“Congratulations, it’s twins!” says the sonographer.

Oh no. We look at each other in fear, tears immediately running down my cheeks. Our doctor warned us that I would not be able to carry the pregnancy successfully with only a cerclage in place. There are no studies or journals indicating any proven success with carrying twins to term with a cerclage and no cervix. Terrifying.

The sonographer was silent for the rest of our visit. She didn’t know what to say. I was in tears, scared that we would have a tough decision. Hubby wore a worried expression. After all, his own mother was faced with something similar – at 39 she found she was pregnant with him. To prevent seizures, she took anti-seizure medication. The doctor told her that she should abort the pregnancy because she needed that medication, and without it could potentially see fatal results. She ceased all medication and walked everywhere she needed to go for the duration of her pregnancy, having my sweet husband some months later. He knew personally what a decision like this could do.

My OB met with us immediately after our appointment. We could tell that she was not comfortable with the fact that we were told of selective reduction. We had no choice – we needed to seek assistance from doctors in Houston.

The wait for the maternal fetal medicine specialist was agonizing. After all, if we needed to reduce the pregnancy, it needed to be done fast. There were several calls made. I couldn’t enjoy my pregnancy, a pregnancy I worked so damn hard to achieve. Why could no one see me immediately? I sent the fertility specialist an urgent text in the hopes that there was something she could do to speed up the process of seeing the specialist in Houston. She did. Two days later, I received a call that there was an appointment available that Friday. We were there.

We really enjoyed speaking with the doctor. She was knowledgeable and non-biased, only stating facts. Again, there were no journal articles out there with statistics proving success with multiples and the type of cerclage that I have. She made a recommendation for a doctor in the city that performed selective reduction. At Baylor, you may or may not know that it is a Baptist hospital. In order to perform selective reduction, your case must go before a board. Who knows how long something like that would take?! I could never imagine aborting a baby later in pregnancy. And to choose! Do you have to choose what baby loses his/her life in order for you to see your pregnancy through successfully? How are you able to make and live with that choice?!

At that very appointment, we made the scary choice to proceed with twins. Hubby’s faith and devotion drove us to make that choice. He vowed to keep me and our future babies safe.

Though Highlander insisted that there could only be one, each movie in the series danced with the idea that more than one of them existed. I remember the theme song by Queen – The Show Must Go On. And so it must.

“Are you pregnant or not?” Includes fun pictures :)

You don’t realize it, but the whole fertility process happens quickly! Within ten days of an IUI or IVF procedure, you know if it worked or not. On February 10, 2017, we went in for our first IUI procedure. Within ten days, I was a little less optimistic. I felt crampy, which was a sure indicator that I was going to start my period. On day eleven, I had lost hope. The cramps were intense and so was my mood.

Normally, I could give two shits what people think about my personality. I’m quirky, weird, socially awkward, and oftentimes poke at people when I don’t want to be around them. Well, on Tuesday February 21, 2017, I sat in my office, bawling because I’m so goddamn weird. Stupid shit comes out of my mouth when I’m nervous, and to boot, that stupid shit came out during an interaction with an executive at my work. Good one, Ursula, you need to cry this one out.

“Why am I so @#$*ing awkward?!”

(sigh) This was later my first inclination that I needed to take a pregnancy test. Not wanting to jinx it, I waited. Hubby kept bugging me, “Are you gonna take a test?”

“No. I’m gonna wait and schedule an appointment with my OB to be sure it’s an accurate test.”

Lies. On the night of Wednesday February 22, hubby went out to the gym. I took action and did the whole, less-than-glamorous pee on a stick thing. Was that a solid line with a faint line? My heart dropped and I grinned from ear to ear. I took a pic of it and sent it to my dearest friend, Jenny.

“I’m shaking…is that a second, faint line?”

“It looks like it :).”

It said I was pregnant. Shaking, I hid the test and planned to take another in the morning. I was going to go to my OB to take, yet another, and plan my next steps to tell hubby the news.

That night, I dropped hints of a special lunch or dinner just to spend time with him during a stressful week. At first, he was ok with lunch. YES! I only have to keep a secret for a few more hours! Then, hubby drops a bomb on me – either dinner tomorrow or we wait until the weekend. COME ON! I CAN’T WAIT THAT LONG!

The next morning, since I have to get up so early to paint my face, I was up before hubby and took another test – when it is supposedly pure, concentrated pregnancy on a stick. Sure enough, this one read, clear as day, “Pregnant”.

Holy shinoly!

“Are you gonna take a pregnancy test today?” Hubby asked.

“Yeah, I’m going to see if they can do a blood test to be sure instead of taking an at-home test.”

Lies.

“Ok, call me as soon as you know!”

Well, the doctor’s office confirmed what I already knew – pregnant. I did have to go in for blood work that Saturday to run checks and balances, so the lie I was about to tell was only a white one.

After the appointment, over the phone:

“So, did you take a test?!”

“No, she wants me to go in to a lab Saturday morning for a blood test. They ensure 100% accuracy with blood tests. Do you wanna meet for lunch? It’s been a stressful week.”

“Ok. So we go Saturday?”

“Yup! Bright and early! Where do you wanna meet for lunch?”

Once it was decided, I worked fast. I went to the bookstore and acquired two books:

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I ran home, threw the pregnancy tests in a baggie, along with the sonogram card and books, and went to meet hubby for lunch.

Quick on my feet, I thought up my plan. Hubby was currently studying for a certification, so I knew exactly how I would tell him we were expecting. Once at the restaurant, I met him at his car with a bookstore bag with all of the loot in hand. He gets out and,

“So, I went to the bookstore and got you a couple things to help you study.”

I shakily hand him the bag. He looks inside and pulls out what he initially thought was a calculator and I grow silent.

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“WHAT?!”

“Yeah, I lied. I took a test last night, one this morning, and confirmed with my doctor that I am pregnant.”

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It worked. IUI worked the very first time. I hope he doesn’t hate me for sharing the next one, but his girls will love it when they are old enough. My guy is the best and this shows his raw emotion in the middle of a restaurant.

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Stay tuned, though…We are not in the clear yet.