Thursday, June 30, 2011

A Little Rumbly in the Tummy

Last night I'm driving home at around 11:30pm and Joy calls me to tell me that her contractions are pretty consistent and a bit stronger than normal.  So, the doctor and nurses are concerned.  I told her to keep me posted and told her goodnight.  A few minutes later she called and said they are going to move her back to the 5th floor.  Oh boy! So I headed back because they were going to do an IV to try and stop the contractions.  In addition, I needed to collect all of her stuff and move it down stairs.

By about midnight they had an IV in her and were taking blood etc.  Poor Joy was so nervous.  She hates IVs and drawing blood.  In addition, we didn't know if we were going to deliver or not.  It all depended on what was going on and they didn't have enough information.  The doctor checked her cervix and she was 1cm.  They set the IV to wide open and pumped 1L of fluid into her.  This didn't really seem to help the contractions.  They were still 1-3 minutes apart.

The next step was to give her a drug to try and calm the contractions down.  I think this eventually helped but she was still having them.  I can't remember if it was the nurse or doctor who told us, but they said they would not be delivering and they were going to try and manage the contractions.  Our perinatal happened to be on staff that night and dropped in.  He kept an eye on the NST strip and at one point there was a decel on Baby B which concerned them.  So they kept her on the NST monitor until 7 or 8 this morning I suppose.  I got home around 330am or so to take care of the dogs and get some rest for work.

Poor Joy, she was tossed into a gown, stuck in bed with an IV she hates, and the monitoring bands wrapped on her for about 8-9 hours last night.  The doctor gave her a slight pain killer to try and dull the contractions a little.  I don't recall if that helped or not.  The contractions are not terribly painful, but it was enough to make her back feel a little sore and so frequent she could hardly sleep.  Not to mention the nerves of everything going on and not knowing what will happen.  In the end she only got about 1 hour of sleep and this morning she was still just 1cm dilated.  I believe this means she is probably not in pre-term labor. The doctor said she touched one of the babies' heads while checking and that they moved out of the way (um creepy!).

It is not unusual for multiples to cause contractions.  The uterus is growing like crazy and I guess this is how it shows its displeasure with growing so fast.  I suppose the concern is the frequency and that they have gotten a little stronger over the past few days.  We are still shooting for July 11th, but things just got a little more interesting.  I don't know if Joy will be on bed rest now.  I know if she does it will become a really hard stay.  It has already been 4.5 weeks and to wrap up with 1.5 weeks of bed rest, followed by the 4 days after the c-section would really stink.  So let's hope they can calm down the contractions and at least let her move around.

In addition, they moved her back to the room they just moved her from so she is back to the 7th floor.  I guess I didn't really need to move everything.  I did bring home a few bags of stuff, since she could be in a constant state of shuffle now.  I don't know why they were okay with her staying on the 5th floor for 3 weeks doing just routine NST monitoring and such.  Now she is a little more progressed and they send her back to the 7th floor?  I don't follow the logic there.

Tuesday, June 28, 2011

Two Weeks To Go (Plus Recovery)





Things have improved since Jim's last posting. They were able to move my room again (although I am still on the wrong floor) and this room has windows and it is overall a very nice room. The bed is much more comfortable and I have a refrigerator so that is nice. The doctor's and nurses keep assuring us that in an emergency they can get us back to the 5th floor in time (lets hope they are right).
I let the doctors know about how I was not very impressed with the slow response time last week and about the nurse that tried to give me a pill for a different patient. I now have the organizational chart so I know who to call if anything like that happens again. It really was a blow to our confidence level for this hospital.
I was watching the news the other night (bad thing to do) and they were talking about the worst time to be in the hospital is July. They said that if you can to make sure not to have any surgeries in the month of July as the mortality rate goes up by 10%. Nice just what I wanted to hear!! The reason is that doctors graduate and start their residency in July and they make a lot of mistakes. So I asked who was performing my C-section and thankfully it is the medical director!!!
I had an ultrasound yesterday and things are looking good. The babies are belly to belly and they are thinking it is because they are so tangled they can not move that far apart. They remain active so lets hope they do not pull those cords tight. The growth scan is not until next week but they are thinking that baby A has gained on baby B and may not be growth restriced anymore (meaning they are looking close in size which is great news). We hope they break 3 lbs. next week. Jim was hoping they would be 4 lbs. at birth but that is most likely not going to happen.
I have started to have pretty regular contractions (every 2 to 3 minutes) which has been a little interesting. They are slightly concerned but not overally concerned. As long as they do not get more painful then we should be ok. Of course the worry is pre term labor when you have multiples. However, with multiples the chances of having Braxton Hicks contractions go up as well.
They did finally put me on the scale and I have gained a total of 27 lbs. total. Jim thought that was not enough and I thought it was too much. In looking it up though it seems to be just about right for how far along we are.
The nurses are different on this floor but I must be doing something right as I have had some nurses switch floors so that they can work with me. That is so sweet! There is one nurse in particular who comes in each day to see where I am and then asks to be assigned to me. She said she enjoys my pleasant attitude and talking to me (it is a good thing she did not see me last week on the "bad" day when I was super angry and then super emotional).
Jim has been doing a fantastic job of taking care of me. He is the best husband ever. He brings me food, washes my laundry and comes every day. He is getting pretty tired though - the poor guy. On Sunday he actually took a several hour nap in the hospital bed because he was so tired. This is taking a toll on him as well. Last week was his birthday and he brought dinner and a cake so that we could celebrate. I feel terrible that we could not do something better but in the end these two little girls will be worth it.
I have also had a lot of visitors and I wanted to say thank you to all of you. It really helps break up the days/weeks. I keep telling myself you do not have that much longer you can do it. Some days though Jim is right I just want to run out screaming and yelling "I am free".
Thank you to everyone! We look forward to July 11th and our babies arrival! We still are not 100% on the names but we have been working on them.

Thursday, June 23, 2011

A Bumpy Day

So the ultra sound on Monday went well. The cord dopplers apparently had a slight elevation in S/D ratio, but they never told us what they were and didn't give us those results until the next morning. Joy was pretty tired as usual since it is so hard to sleep so she didn't think to ask what that meant. A quick google and it appears that when the S/D ratio is high there could be some sort of blockage in the cords. It sounds like they still have "normal" numbers. However, after hearing this news the morning NST wasn't as good as usual. Meaning the twins didn't have lots of spikes in heart rate. There was nothing to be alarmed about really. The heart rates were in range and looked normal, but not the norm for our hyperactive little ones.

Last night was a crazy one for Joy. At around 4am Joy got up to use the restroom and noticed some blood. She notified the nurses immediately. One because this is not normal and two they seem to be obsessed with the question (and some others) everytime they check-in. Well 30 minutes later Joy had to call again and they said something to the effect of "Oh, the nurse will be there soon". Eventually, the nurse showed up and told Joy that she was never notified about the first call at around 4am. At this point you can imagine Joy is pretty frazled. Sitting there tired and super concerned with no answers about what is going on.

The nurse said she would tell the doctor, but they didn't think it was anything major. So Joy stayed up another hour or so waiting for a doctor to come by. The doctor never showed and Joy finally fell back to sleep. In the morning, Joy said to the day doctor "Did you hear about what happened last night?" The doctor had no idea and even so didn't even exam her as she would have expected.

Then she got a nurse who generally drives her a little nuts. Joy didn't get her Zofran until about 10am this morning and that was an event too. The nurse read off the patient id and the pill etc. Joy confirmed and looked at the pill. Fortunately, Joy has taken a lot of Zofran and noticed it was no where near the right pill. Thank goodness she was on the ball and didn't take it as it was a pill for a different patient. They had to go back and get the right one.

Then her NST which is suppose to be at 8am didn't happen until 10:30am. She has also been told they need her room and are going to move her to the 7th floor. Our question is how will they monitor up there? It is a post partum floor so they probably don't have an NST machine up there right? They seemed to want her on the 5th floor incase something happens during a monitoring session. Our doctor stated several times that it was so important for her to stay on the 5th floor in case of any emergencies since that is where any C-sections would happen. They moved her to a terrible room that was dark, small and super depressing.

I guess the one bright side is that she will have a better bed in post partum.

I feel really bad. She is exhausted and nothing seems to be going right for her today. This doesn't bode well really. Joy still has 20 day to go and I can tell today is a really frustating mental blow. I think she wants to run out the front door screaming but she can't. Let's hope she can get some rest and find a second wind to make it the last 20 days.

Friday, June 17, 2011

7-Eleven

I can't believe it. We are approaching the completion of 28 weeks. We are so lucky things are going well. A few scary NSTs and that is about all that has happened so far. With all of the risk involved with momo twins we can't believe how smooth this has gone and how lucky Joy has been to not have any complications. It seems everyday that has passed since January has been "I can't believe it". Since February when we found out we had the twins there has been a bit more inflection on that statement.

Joy got confirmation that we are on the schedule for Monday July 11th. So providing nothing happens between now and then we will have some 7-Eleven girls. I wonder if they're going to be slurpee fans? or have a lot of gas? It's kind of a cool birthday 7-11-11.

As far as names...everyone wants to know including us. We have a short list, but we don't love them. In part because we either know some little girls with the same name or the name is in the top 100. So, it looks like we may end up giving in and going with a common name for their generation. Quite frankly it is sort of a pain to pick out names. At least they don't have horrible last names like that NY rep who's "A. Wiener."

I'm glad Joy has been posting, because I haven't had much time to. It's pretty hard trying to keep up with everything she does around the house plus what little I do around the house. I can't wait for her to come home, because it is also pretty quiet and lonely here. Although the pets keep me company they don't really talk back like this talking dog.

Well back to the ole grind.

Tuesday, June 14, 2011

Week 28 - Growth Ultrasound






Week 28!!! The NICU is so excited that the girls have gotten to week 28. While they both still could have some serious health issues the chance of survival is now very good. We had a very long growth ultrasound yesterday. It took a long time because both babies were head down and very very low. They were never able to measure Baby B's head very well. They pushed and poked very hard on her to see if she would move her head but she would not cooperate. I am now very sore from the almost 2 hr. ultrasound. The good news is they are both looking pretty good. Baby A has moved up from the <5th percentile to the 8th percentile. While that is still extremely small it is an improvement. They are estimating her at 2 lbs. 3 ozs (988 g) and Baby B is showing 2 lbs. 5 ozs (1055 g) and the 17th percentile. Baby A has an average heart rate of 142bpm and Baby B 134bpm. During the BPP they both show normal activity (a little on the high side) and they are both practicing to breathe. They both scored a perfect 8 out of 8 for the BPP. The other thing they measure is blood flow through the cords to make sure they are both getting enough and they both are and they do not see any evidence of twin to twin tranfusion. Baby A had a S/D ratio of 3.1 and Baby B a ratio of 2.7. All of their organs appear normal and they both have HAIR! It was cute to see the fuzz on their heads. Baby B is like Jim and had decided she likes to cuddle and crowd Baby A. She has moved to the middle and touches the face of Baby A all of the time. Baby A then kicks to get some room but Baby B just kicks back and stays where she is. It will be great to see if we can see some of these traits after they are born. For example Baby B is also a night owl in the womb (again like her Dad).
We did have two scares over the weekend. Baby A decided to get a little too excited and her heart rate was in the 190's/200's for an extended period of time. The doctors did come in to do an ultrasound to make sure she was not in distress. She ended up calming down and everything was ok. The other scare was that I had pain in my right leg. They rushed me down for an ultrasound on my leg as they were worried I had a blood clot. Everything ended up being ok on that front as well but it was scary.
I guess that is all for now. Enjoy the pictures.

Thursday, June 9, 2011

Week 2 at Duke - Twins 27 Weeks

Well I have been at Duke for 9 days (who is counting?). It has not been terrible but I am still struggling to get enough sleep. The bed is a birthing bed so it is very uncomfortable. With the extra weight of the twins I wake up all night long with sore hips. I have been adding more and more pillows to sleep on and while that helps some it makes for moving around very difficult. I am growing by the day and I have a hard time believing I still have weeks to go. I have no idea how I am going to carry my belly around if they grow much bigger. The mornings fly here as I have NST's, doctor visits, housekeeping, food delivery (the food is still terrible) and some students and other doctors who want to do case studies about our journey/twins. Then the afternoons drag and the evenings fly as I usually have visitors. It is nice that I am not on bed rest so most evenings when Jim gets here we go either to the courtyard or to the cafeteria just so I can get out of my room.
We did have one scare this week. Tuesday night about 12:30 in the morning during my NST baby A took two dips on the monitor. They left the monitor on for a lot longer and luckily baby A recovered. It scared me though as I thought here we go for an emergency C-section and the babies are only 27 weeks old. As everyone knows we are trying to get to 32 weeks but getting to 28 improves their odds a lot and then getting to week 30 is another great milestone. Other then that the twins have looked great on the monitors. All of the nurses and doctors are excited about how active they are and they feel they are ahead of the game developmentally wise. That is such a good sign - although with all that movement it does increase their odds of getting tangled. I had an ultrasound on Monday and one today. They are both growing nicely. We will know a lot more next Monday as that will be the growth ultrasound but she did quickly measure Baby B's foot and it was about 2 inches. It was so cute to see the foot and the toes. We watched them move around for awhile. I can not believe how they kick and hit each other. Baby A at one time was resting her head on Baby B's stomach. Then Baby B gave her a kick in the privates. Baby A did not even move so they must be really use to each others movements.
Jim is doing a great job of taking care of everything although he is getting pretty tired. He has been doing a great job of bringing me anything I need and visiting me every day. I know it is hard as he is trying to take care of the dogs, his Mom and trying to get a new lawn to grow. Benz (my dog) seems to be having the roughest time with all of this. Jim said he just is not himself and he is laying at the top of the stairs instead of on the floor next to the bed. Jim thinks he is waiting for me to come home. He also is not eating all of his food - ever. He leaves most of the dish every time. Benz is either really missing me or he is afraid Jim will not feed him again anytime soon. Poor Benz. I will have to video chat with him to see if I can cheer him up.




I did think I would get a lot more done in the hospital then I have been able to. I have a huge list (Stryker's always have a list) and I have barely crossed anything off of it. It is just hard to be productive with little sleep and constant interruptions. Oh well that is life I guess.
I guess that is all for now. I hope everyone is doing well.

Here is one picture from Monday's ultrasound.












Sunday, June 5, 2011

Counting the Days

So this is Joy's 5th day. She has had visitors almost everyday (not including me) which has been awesome. She really does appreciate the company and chatting. For the most part Joy seems pretty positive with 5 weeks to go (not including C-section recovery). I've noticed she is more bubbly when she gets a pleasant chatty nurse. She really liked one of her nurses this week. It was a bit of a slow day so the nurse came in and chatted about stuff with Joy and walked the hall a little with her.

The NSTs have been going well. The girls frequently have hiccups and are very active for their age. They are already showing that stubborn, over achieving, can't sit still Stryker DNA off :). They are going to need it too.

We took a tour of the ICN (Duke's NICU). It was frightening to see just how small these babies will be. There was one born at 32 weeks which was just about 3.5 lbs. We were allowed to see a 26 week baby from a slightly closer distance. I swear their foot was about half or 3/4 the size of my thumb. We couldn't get a good look because the baby wasn't ours. Oh well, you have to respect that.

I asked about benchmarks. Yet again I got the answer I was expecting, but not the answer I wanted. It still looks like they will likely be there until their gestational age which is about Labor Day weekend. Let's also hope they come home at the same time or we will be very busy since we are not allowed to bring the other one in if their sister is still at the hospital. That will take some coordination and baby sitting plans.

So far the worst things are that Joy has to keep on her toes with the meds. She does not have many and nothing too important. So far it just seems that she has to remind them of a vitamin or two. The biggest issue seems to be the hospital cuisine aka "dog food". The selection is blah and many items are not good for a pregnant woman who is following many of the diet rules of what to eat. For instance tuna fish sand salad (high mercury), cold cut sandwiches etc. I don't think she has had an order yet come completely correct. They either forget items or bring the entirely wrong plate. The waffles were like bricks, the pot pie was more like a teacup pie, the oatmeal is in editable, and for some reason they can't remember to bring her a snack menu to save their life. Sadly this leads to some frustration. Joy said yesterday she feels like she needs to go down there and organize the food folks. I guess that is the customer service manager coming out who thrives on making things more efficient. At least it would giver her a job right?

Well, I guess I can't think of much else to say. If you plan to visit some fruit like precut watermelon, grapes, and fruit in general are good. If she has a heads up a meal from anywhere but Duke would be good too. If all else fails, just bring yourself.

Overall, Joy's spirits seems to still be up and she seems to be bubbly despite the 5 hours of sleep a night. A few nurses may try to sneak her a better bed if they can. It is just hard to move things around like that. They just don't have good places to store extra beds so it is really hard to accommodate a better bed.