May 29, 2006

It's been a few days since I've posted, but that doesn't mean that life in the Pruetz house has settled down any! We're still going a mile a minute around here.

The first and foremost news is that the girls are doing great. Today, Faith finally hit the 3 lb. mark again, weighing in at 3 lbs, .02 oz. It's not much over 3 lbs, but it's better than nothing! Grace is at 3 lbs, 8 oz and doing equally as well.

Both have gone up in their feedings and today, Faith's temperature was elevated. This, of course, gave me a minor heart attack, but apparently, this is a good thing (the temperature, not the heart attack). It's a sign that her body is starting to regulate its own temperature. Just one more step closer to home...

The girls were also seen today by the physical therapist. She was a wondefully kind woman who took a lot of time to talk with me about what she was doing and what she was looking for in each girl. Essentially, she was checking to see if they were doing what they were supposed to be doing at their gestation (which is 33 weeks, 1 day). She would streach a bent arm out and see if the owner would pull it back. She tracked their eye movements (even with their eyes closed!) and asked me a number of questions -- Am I seeing personality traits in them yet? What about their movements ... do the girls move a lot? What kinds of movements do they do? Kicking, stretching, patting?

After her assesment, she confirmed that both girls are right on track and doing great. They are starting to show signs of readiness to start trying bottle feeding, although they aren't quite there yet. She seemed to think they'll be ready to try next week, which is really right on track.

I'm quite the proud mom. I'm sure it's not apparent or anything.

I'm doing well, too. I'm finally starting to feel like myself again. For the first few days back here, I felt like a stranger in my own home. I just couldn't pull myself together to get a routine down or settle back into life. Finally, Saturday, I woke up feeling normal again and have been easing myself back into life. Tomorrow will be the real test.

"Why?" you ask? Well, I'm gonna tell you.

I've been spoiled this last week, having Todd at home. As many of you know, his company, Accenture, made the decision to move their San Antonio offices to Princeton, NJ. When we heard the news, we immediately said, "No thanks!" but that left Todd jobless as of July 7.

Not for long, though! Shortly after sending his resume out, one of the city's largest and most-respected employers, USAA, contact him for an interview. Days later, there was an offer. They were so impressed with him, in fact, that they created a position for him, as they weren't sure the position for which he applied was a perfect match, but they knew they wanted him to be a part of their team. As of tomorrow, he'll be a Web producer in their technology department. Again -- I couldn't be more proud.

So, my dad comes in tomorrow morning to help me out while Todd goes off to his new job. I can't drive until Friday, so I need someone to shuttle me to and from the hospital. I'm so glad to have my dad here, but it'll be hard to have Todd gone after so much good, quality family time with him this week.

Never without drama, right? :)

Stay tuned for more very exciting, leave-you-hanging-on-my-every-word news from my world. It just doesn't get any better than this, does it?

E

PS - Berta -- I got the beautiful jammies you sent for the girls, but I managed to throw away the card with your phone number on it! Please send me an email at erin_pruetz@hotmail.com so we can catch up! I'd love to talk with you and thank you personally for the very sweet gift and prayers!

May 25, 2006

Okay -- let's try this again. I think I've gotten most of the details in that I need and can just start focusing on the big pieces of information. I'm going to try, but I make no promises.

Saturday morning, both girls' lab work came back with elevated bilirubin levels, indicating jaundice. This meant a few days for each of them under the photo-therapy lights. It's just like a blacklight that goes over each of their incubators and helps to correct the elevated levels before it becomes dangerous. It's no big deal, but it does require the patient to wear these little protective eye pieces all day long. It made me so sad to see them there, having to have their eyes closed 24 hours a day. It seemed miserable to me. At least I was able to hold them, though, for a few minutes here and there. It made me feel like I was doing everything I could to make their lives a little happier.

The same day, Todd took Devin in to meet his new sisters. We wondered how it would go and how much he understood. I wasn't with them at the time, but apparently we've underestimated our little brain surgeon.

Todd first took Devin to meet Grace. He sat in Todd's arm and stared down at her, wondering what to ask first. I'm sure there were a hundred questions going through that kid's mind. The first question that he asked, though, was, "Where is Faith?"

WOW! He knew that there were two and which one was missing! At the time, the twins were on different sides of the NICU from one another.

He also asked about Grace's "boo-boos," referring to the many tubes, IVs and other things that made her pretty scary-looking. We told her that they were just small ouchies and that she was fine. His second question, "Did Faith hit her?" That kid just cracks me up.

Sunday came with a little more drama. I saw the girls in the morning and later on, Todd came to the hospital to see them before coming up to my room. He walked into my room and said, "We need to talk about Grace."

Those are words no mother wants to hear. What was wrong with her? What's wrong with my baby?

Apparently, Todd had just happened upon Grace's crib as the on-call doctor was checking her out. He asked the doctor the usual questions, but what came back was more than either of us expected.

Apparently, Grace's need for supplmental oxygen had gone up and that, along with some lab work, indicated a few things that could be wrong.

1. Infection
2. Blood vessle in the heart that had not closed all the way (PDA)
3. Repiratory distress syndrome (RDS)

I flew down to the NICU in record time and caught the doctor on his way out. He explained to me of all of these things, the infection was the worst-case scenario, as preemies have a hard time fighting infections. They hadn't even waited to test for infection -- they had already started her on antibiotics.

The PDA was a condition caused by a blood vessle that closes before birth, but is often left open in preemies. It often closes by itself, but needs to be watched just in case, as it could cause fluid build up in the lungs.

The RDS was something that would self-correct with time, but would need some special consideration with oxygen and drugs.

Now I admit that none of this is worth stressing a whole lot about, but I lost it regardless. After all they had been through, I didn't want either of them to suffer any more. I just wanted them to be healthy.

The doctor assured me that Grace would be fine, no matter the diagnosis, and that a cardiologist would be by the next day to take a look at her heart CT and make a recommendation.

It wasn't easy to wait to see Dr. Brownlee, the cardiologist. I asked questions and bugged the NICU nurses all night long, wondering if Dr. Brownlee had come by or called. I called before the NICU even opened on Monday and finally, Dr. Brownlee showed up in my room.

He told me that Grace did have PDA, but that it was so minor that they were just going to "wait and see." As long as her oxygen levels continued to improve, we would be in good shape. He also told me that she has an Atrial Septal Defect, which is a small hole between the two atria of the heart. As he put it, "It's like a freckle that you go see the dermatologist about."

I confirmed that the ASD was no big deal when ZZ told me, "Oh I have that. It's hereditary!"

Well now we know that not just my good looks and sparkling personality got handed down to my kids. So did my sister's bum ticker. :)

The rest of Monday was much the same, with good reports from both girls' nurses. Bilirubin levels were going down, weights were going up, both girls were pooping and peeing like pros, etc... I was very proud.

Tuesday brought great news -- I'd be going home and Faith had been taken off all supplemental oxygen! She was breathing on her own without any problems! I was so proud...

I left the hospital around 2:00 that afternoon and it was a very hard thing to do. I hated seeing the hosptial in my rear-view mirror, knowing my girls were there. On the other hand, though, I was looking forward to being home and spending some much-needed time with Devin and Todd.

I won't lie -- a lot of tears were shed that day, but I did okay. Todd went to go see the girls that night and it warmed my heart knowing he was there with them.

On Wednesday (yesterday! Wow! I never thought I'd get here!), Todd and Devin drove me to the hospital so I could spend some time with the girls doing Kangaroo Care. I got two-and-a-half hours of pure baby time. It was awesome.

For those of you who don't know what Kangaroo Care is, it's a way of bonding with a child, especially a preemie who spends a lot of time away from his or her parents.

It requires you to wear a button-down shirt and no undergarments. You unbutton your shirt about halfway down and put the baby, who is also sans any clothing but a diaper, inside your shirt. Then you swaddle them up in your shirt and blankets and kick back in a recliner. There you are -- just the two of you. Heartbeat to heartbeat, skin to skin. It's so perfect and the effects are immediate. Heartrates go down, breathing evens out, pulses becomes steady, etc. The long-term benefits go on and on, too. If you're interested, check it out at http://www.marchofdimes.com/prematurity/5430_6074.asp .

So I got some great bonding time with each girl, right there on my chest. An hour with one, an hour with the other. It just made my heart swell up.

Wednesday also brought more good news: weight gains for both girls, no more photo-therapy for Faith, only one more day of photo-therapy for Grace and, best of all, a move to the "white room!" Apparently, when you're in the "pink room," you're considered a sick baby -- the girls spent Friday-Wednesday there. But when you get moved into the "white room," you are just getting fat and are on your way out the door! The white room is just for babies who are learning to eat and maintain body temps. Again, I was as proud as a mama can be...

Wednesday night took Todd to the NICU as well where he swears he got a smile out of Faith. I think I saw one too. :)

And so here we are with today! My hormones are raging and I'm a basket case most of the day. But I did get to spend some time with my girls this morning and got even more good news: Grace is now off of all oxygen and the photo-therapy lights. Both girls have had all invasive lines removed (IVs, TPNs, etc) and the only wires that are attached to them are wires that monitor their vitals. They both still have feeding tubes, as they have not learned to coordinate the suck-swallow-breathe mechanism required for bottle and/or breast feeding. That is usually not present until 33 or 34 weeks, so we hope they'll be working on it soon!

Now that is one condensed version of the past week, but I'm proud of myself for only hitting the highlights. Now I can get back to posting the good stuff daily, instead of two or three days late!

Thanks for bearing with me!

May 25, 2006

Okay -- let's try this again. I think I've gotten most of the details in that I need and can just start focusing on the big pieces of information. I'm going to try, but I make no promises.

Saturday morning, both girls' lab work came back with elevated bilirubin levels, indicating jaundice. This meant a few days for each of them under the photo-therapy lights. It's just like a blacklight that goes over each of their incubators and helps to correct the elevated levels before it becomes dangerous. It's no big deal, but it does require the patient to wear these little protective eye pieces all day long. It made me so sad to see them there, having to have their eyes closed 24 hours a day. It seemed miserable to me. At least I was able to hold them, though, for a few minutes here and there. It made me feel like I was doing everything I could to make their lives a little happier.

The same day, Todd took Devin in to meet his new sisters. We wondered how it would go and how much he understood. I wasn't with them at the time, but apparently we've underestimated our little brain surgeon.

Todd first took Devin to meet Grace. He sat in Todd's arm and stared down at her, wondering what to ask first. I'm sure there were a hundred questions going through that kid's mind. The first question that he asked, though, was, "Where is Faith?"

WOW! He knew that there were two and which one was missing! At the time, the twins were on different sides of the NICU from one another.

He also asked about Grace's "boo-boos," referring to the many tubes, IVs and other things that made her pretty scary-looking. We told her that they were just small ouchies and that she was fine. His second question, "Did Faith hit her?" That kid just cracks me up.

Sunday came with a little more drama. I saw the girls in the morning and later on, Todd came to the hospital to see them before coming up to my room. He walked into my room and said, "We need to talk about Grace."

Those are words no mother wants to hear. What was wrong with her? What's wrong with my baby?

Apparently, Todd had just happened upon Grace's crib as the on-call doctor was checking her out. He asked the doctor the usual questions, but what came back was more than either of us expected.

Apparently, Grace's need for supplmental oxygen had gone up and that, along with some lab work, indicated a few things that could be wrong.

1. Infection
2. Blood vessel in the heart that had not closed all the way (PDA)
3. Repiratory distress syndrome (RDS)

I flew down to the NICU in record time and caught the doctor on his way out. He explained to me of all of these things, the infection was the worst-case scenario, as preemies have a hard time fighting infections. They hadn't even waited to test for infection -- they had already started her on antibiotics.

The PDA was a condition caused by a blood vessel that closes before birth, but is often left open in preemies. It often closes by itself, but needs to be watched just in case, as it could cause fluid build up in the lungs.

The RDS was something that would self-correct with time, but would need some special consideration with oxygen and drugs.

Now I admit that none of this is worth stressing a whole lot about, but I lost it regardless. After all they had been through, I didn't want either of them to suffer any more. I just wanted them to be healthy.

The doctor assured me that Grace would be fine, no matter the diagnosis, and that a cardiologist would be by the next day to take a look at her heart CT and make a recommendation.

It wasn't easy to wait to see Dr. Brownlee, the cardiologist. I asked questions and bugged the NICU nurses all night long, wondering if Dr. Brownlee had come by or called. I called before the NICU even opened on Monday and finally, Dr. Brownlee showed up in my room.

He told me that Grace did have PDA, but that it was so minor that they were just going to "wait and see." As long as her oxygen levels continued to improve, we would be in good shape. He also told me that she has an Atrial Septal Defect, which is a small hole between the two atria of the heart. As he put it, "It's like a freckle that you go see the dermatologist about."

I confirmed that the ASD was no big deal when ZZ told me, "Oh I have that. It's hereditary!"

Well now we know that not just my good looks and sparkling personality got handed down to my kids. So did my sister's bum ticker. :)

The rest of Monday was much the same, with good reports from both girls' nurses. Bilirubin levels were going down, weights were going up, both girls were pooping and peeing like pros, etc... I was very proud.

Tuesday brought great news -- I'd be going home and Faith had been taken off all supplemental oxygen! She was breathing on her own without any problems! I was so proud...

I left the hospital around 2:00 that afternoon and it was a very hard thing to do. I hated seeing the hosptial in my rear-view mirror, knowing my girls were there. On the other hand, though, I was looking forward to being home and spending some much-needed time with Devin and Todd.

I won't lie -- a lot of tears were shed that day, but I did okay. Todd went to go see the girls that night and it warmed my heart knowing he was there with them.

On Wednesday (yesterday! Wow! I never thought I'd get here!), Todd and Devin drove me to the hospital so I could spend some time with the girls doing Kangaroo Care. I got two-and-a-half hours of pure baby time. It was awesome.

For those of you who don't know what Kangaroo Care is, it's a way of bonding with a child, especially a preemie who spends a lot of time away from his or her parents.

It requires you to wear a button-down shirt and no undergarments. You unbutton your shirt about halfway down and put the baby, who is also sans any clothing but a diaper, inside your shirt. Then you swaddle them up in your shirt and blankets and kick back in a recliner. There you are -- just the two of you. Heartbeat to heartbeat, skin to skin. It's so perfect and the effects are immediate. Heartrates go down, breathing evens out, pulses becomes steady, etc. The long-term benefits go on and on, too. If you're interested, check it out at http://www.marchofdimes.com/prematurity/5430_6074.asp .

So I got some great bonding time with each girl, right there on my chest. An hour with one, an hour with the other. It just made my heart swell up.

Wednesday also brought more good news: weight gains for both girls, no more photo-therapy for Faith, only one more day of photo-therapy for Grace and, best of all, a move to the "white room!" Apparently, when you're in the "pink room," you're considered a sick baby -- the girls spent Friday-Wednesday there. But when you get moved into the "white room," you are just getting fat and are on your way out the door! The white room is just for babies who are learning to eat and maintain body temps. Again, I was as proud as a mama can be...

Wednesday night took Todd to the NICU as well where he swears he got a smile out of Faith. I think I saw one too. :)

And so here we are with today! My hormones are raging and I'm a basket case most of the day. But I did get to spend some time with my girls this morning and got even more good news: Grace is now off of all oxygen and the photo-therapy lights. Both girls have had all invasive lines removed (IVs, TPNs, etc) and the only wires that are attached to them are wires that monitor their vitals. They both still have feeding tubes, as they have not learned to coordinate the suck-swallow-breathe mechanism required for bottle and/or breast feeding. That is usually not present until 33 or 34 weeks, so we hope they'll be working on it soon!

Now that is one condensed version of the past week, but I'm proud of myself for only hitting the highlights. Now I can get back to posting the good stuff daily, instead of two or three days late!

Thanks for bearing with me!

May 24, 2006

Whew! Are you kidding me? I can't believe I typed that much last night and STILL only got to the recovery room. This is one heck of a story. I hope it's as interesting to everyone else as it is to me. If not, then I've got a lot of bored friends out there or a lot of people lying and saying, "I am always looking at your blog!" :)

Okay. Where was I? The nurses talking about the cords and how they wanted to see them, if they hadn't already been disposed of. How in the heck do you dispose of umblical cords, anyway? I shudder to think.

At one point, someone (I couldn't tell you who -- too many pain drugs) told me to not be surprised if I were asked to be in a medical journal. I guess it was that wild.

Hey -- when I screw something up, I make sure I go all the way with it.

After recovery, I was wheeled through the NICU to see the girls. Truth be told, I don't remember much of this, except that I was like a bull in a china shop. Here I was, still on the gurney, being wheeled through some of the tightest working conditions you've ever seen. They really work with so little space in there and how we got me through to see not one but TWO babies is beyond me.

I remember seeing Grace and noting that they had not replaced her intubation. I saw Faith and thought, "Why aren't my identical twins identical?" They looked nothing alike. They still don't.

I was taken to the 2nd floor for recovery and put in room 213 (I thought it was funny that the girls were born at 2:11 and 2:12 and I was in 213). Probably no one else finds that amusing.

I was hoisted into bed and Todd and I were left alone. I think. Most of this is pretty blurry to me. I was in shock (surgery will do that to you), I had lost more blood than expected (and you didn't think I could be any paler) and I was taking pain meds as the epidural/spinal wore off. I know Todd was running on fumes. My dad would later say it was like watching someone who had just done a pound of crack cocaine. He just couldn't sit still. He was nervous, happy, in shock and dealing with just about every other emotion available. He left shortly after I got into my room to go home and get some rest (by this time, it was evening and the sun was going down).

That night, Sylvia visited me and we had a nice talk about babies (hers and mine!) and everything else. It was the calm before the storm.

At 9:00 my nurse came in and said, "Okay -- it's time to walk!"

I'm sorry. What did you say? Did you say walk? I nearly looked her in the eye and said, with all honesty, "I'm a c-section patient," meaning, "I need to stay in bed for awhile."

She must have been the shock on my face and she said, "The faster you're up, the faster your incision will heal." Oh my Lord -- this wasn't a mistake.

Apparently, there is a technique to getting out of bed only five hours after a five-inch incision has been made in your lower abdomen.

1. Scootch all the way to the side of the bed
2. Raise the head of the bed all the way up
3. Push up on your elbow
4. Push up on your hand
5. Swing your legs over the side of the bed and use the rails to sit up
6. Put your feet flat on the floor
7. Stand up while holding onto the IV pole
8. Scream like hell

Okay, I added that last one, but I was not at all prepared for what this would feel like. It was awful. It was this burning, searing pain, especially on the left side where the clamp had gone. And I was going to make it clear across the room (about seven feet) to the bathroom? Who are YOU kidding, lady?

But I made it! The first steps were hard and each one got a little easier and a little easier. The nurse helped me to the bathroom and back (it was during that "and" part between "bathroom" and "back" that I lost any ounce of dignity that I had left) and I blissfully laid down again. It was time again to walk at 1:00 a.m., but true to the nurse's word, it was much easier the second time around. After the 1:00 trip, I was free to lie in bed until morning.

BIG MISTAKE.

I was awoken by a very brusk and hearty woman at 7:30 that morning who set down my breakfast tray and took my vital signs. Good morning, sunshine.

Shortly after, my nurse, Yasmin, walked in.

Now, for anyone who is planning to have a baby at Methodist Hospital (Med Center location), you need to commit this name to memory: Yasmin. Yasmin. YASMIN. Got it? If she is your nurse, run the other way. Or ask her to do so before she can get her hands on you. Yasmin, bad. No Yasmin, good.

First of all, Yasmin is a beautiful woman of Indian decent with a gorgeous accent. Very exotic and pretty. I hated her immediately.

No, actually, I liked her a lot. I though, "Oh good -- she'll be a good nurse." Usually I'm right about these things. Usually.

She had a very no muss, no fuss attitude and asked me immediately if I needed pain meds. I had been taking Nubane all night long to control the itching that is a side effect of the epidural, so I was feeling pretty good, lying there in bed.

"No thanks. I'm fine."

She instructed me to get up, move around, take a shower, etc and that after that, I could go to the NICU. I needed one more round of antibiotics, but we could take the IV out after the dose at 1:00 p.m. I was a little surprised by how little help she was offering and I asked, "Am I on my own with this?"

"Oh yes," she assured me. "You've already gotten up twice, so you're ready to do it on your own."

She left and I went through my instructions for getting out of bed. Once I was up, I decided to make my way to my bag and get my clothing for the day. Okay...first step.

Oh my God. The pain.

Second step.

The excrutiating pain.

Third step.

Shaking like a mental patient commences.

Fourth step.

Crying ensues.

Fifth step.

How in the hell will I get back to the bed?

Sixth step.

Where is the damn emergency button?

Seventh step.

Almost to the bed.

Eighth step.

Sit down.

I couldn't believe the pain. It was far worse than anything I have ever experienced. It was awful and I was totally unequipped to deal with it. I didn't believe then that I was ready to be doing this on my own and I will go to my death bed swearing that I should have had some assistance. I actually panicked, in that I didn't know how I was going to get help. It was just that bad.

I made it to the call button. I called Yasmin (please don't forget that name) and said, "I'm in so much pain. Please help me." It's all I could utter.

She walked in momentarily and fed me two Lortab and a Motrin. I asked if this was normal and she said, "Oh yes -- the first time is the hardest." I told her that I thought this was unusually painful and she said that I had just laid in bed too long and that my muscles had tensed up again. I needed to move more. And with that, she left.

I nearly slapped her. Obviously, this woman has never had a c-section, nor did she have any idea that saying stuff like that was not going to help me any. I needed a little bit of compassion here, but there was none. Not a bit.

I sat on the bed as the shaking subsided and the drugs took effect. I called Todd and asked if he was on his way. Luckily, he was and he was able to help me shower and get ready. I don't know what I would have done without him. He was my lifesaver.

Dad and Jean arrived and we talked for awhile. They left for the NICU and then back to Houston and I finished up hobbling around the room.

After this whole debacle, Todd wheeled me to the NICU to see the girls. This is the first, real memory I have of them. They were perfect. So small and helpless and yet so strong to survive such an ordeal. My heart filled with love and my eyes with tears. My daughters. Perfect and precious. My mind saw princess dresses and first days of school and dance lessons and Girl Scout initiations and first dates and broken hearts and proms and ... It was just too much. So much comes with girls. Was I up to this? I guess I'd find out.

We returned a little while later and Todd left to go meet his parents at our house. I was feeling a lot better by this time and managed to move around the room with the grace of Quasimodo. But at least I was moving.

After lunch, a new nurse came in. Where was Yasmin? Who cares? I asked this new woman, my new best friend, about the antibiotics. She said, "Oh - your doctor cancelled them. Didn't Yasmin tell you?" Chalk another one up to super nurse. I asked if the IV could come out and new nurse (name forgotten, I'm sorry) complied. Finally, I was free of it all!

Okay -- it's obvious to me that this is going nowhere fast. My ridiculous need for detail, combined with (or caused by) my obsessive-compulsive personality has bogged this blog down. It's a bogged blog. *Weak Smile Here*

So, I'm signing off for today. I'm going to give some thought to how I'm going to get everything in that I need to get in (I'm doing this for my own memory too) without robbing blogger.com of all of its memory.

Also, I'm aware that my link to the slideshow from yesterday isn't working, so I'm going to try to post some of the best photos here. We'll see. I'm never very good at this stuff.

Until then, thanks for bearing with me and the inane details of my c-section. It'll get better, I promise.

With love,
E

Moments later...

Yeah for me! I got the photos posted! Boo for me! They're all catty-wampus. I can fix them, but I'm just too tired now.

Here's the run down though.

- Umbilical cord debacle
- Precious babies (Grace is on the right, Faith on the left)
- Todd (I like to call this "Husband Debacle")
- Me being monitored. Yes, I'm wearing shorts, but they put a towel over them so that I would get transmission goop all over me. Such glamour...

May 23, 2006

I'm trying to decide if I'm going to bang this whole story out right here, tonight, or try to fit it in over the next few days. I guess we'll just see when my fingers turn blue.

At any rate, grab a sandwich, sit down and be prepared to read -- I have a LOT of catching up to do.

The last time I blogged was May 13, ten days ago. It was a Saturday and I came home the next day, as well, to celebrate Mother's Day. It was great. Todd fixed me a nice dinner of grilled salmon, mashed potatoes and fresh asparagus. The three of us spent some good, quality time together with a quiet afternoon at home.

San Antonio was seeing some interesting weather that day (stay with me -- I have a point here). Storms were rolling in from three sides of the city and everywhere you looked, there were dark clouds and gusty winds.

Apparently, changes in atmospheric pressure can cause severe changes in maternal pressure, too. I'm not 100% sure that maternal pressure is an actual term, but essentially, when the atmosphere changes in pressure, your body responds and that response includes pressures in amniotic fluid, etc. Makes sense to me.

It also makes sense to me in that I totally experienced this phenomenon on Mother's Day. I was miserable. I was cramping and contracting with only minutes in between. I loved being at home, but I even said to Todd at one point, "I may need to go back to the hospital." I couldn't move without a contraction coming on. All I could do was sit on the couch while Todd cooked, cleaned and brought me everything I needed. Bummer.

We returned to the hospital that afternoon and for the first time, I felt 100% sure that I was exactly where I needed to be. I didn't have that hint of, "Is this really necessary?" hanging out in the back of my mind.

Sure enough, the monitors don't lie and I was contracting like a wild woman. With twins, they allow you up to six contractions per hour before anyone panics and I was having less than that, but they had significantly increased in frequency, which was something to watch.

Everyone seemed to be fine and I settled back into another night in room 142. The storms passed through the area (without a drop of rain at our house, I might add) and everything went back to normal. Whatever that means.

Dr. Harden returned from her vacation on Monday morning and sat down with me to talk about the c-section. We were close enough to schedule it! Dr. Higby couldn't make it in for a 7:00 a.m. surgery, so we'd have to do it at 5:30 p.m. on Monday, May 22. I didn't care -- I was just happy to see a light at the end of the tunnel, although I was scared that it might be a train.

This was a big treat for me, too, in that I started to realize what a big deal it is to have Dr. Higby in your c-section. He's a perinatologist, which means he's in the business to get high-risk babies here safely, leaving the actual delivery for the patient's OB. Every single nurse (I kid you not -- every one) to whom I mentioned Dr. Higby's presence just got this surprised look on her face and said, "Wow! He never does deliveries! This must be one special pregnancy!"

In a way this warmed my heart and in a way it scared the hell out of me. Why can't this just be your run-of-the-mill c-section? How did I get here, anyway?

Moving on, though, Dr. Harden and I also discussed my contractions the day before. She was not thrilled to hear about them and said, "I think this weekend we should skip the 'going-home' passes." I told her I agreed, that Sunday had scared me.

"Okay -- we have a date on Monday the 22nd!" I was thrilled!

We also agreed to start the second round of steroids that increase lung development that same day so that they could be on board if I went into labor early.

Tuesday and Wednesday brought more of the same -- some uterine activity (ie: contractions) and the usual decels from both girls. Faith was her usual easy-to-find and easy-to-keep-on-the-monitor self while Grace managed to elude everyone in the unit, while also experiencing a heartrate variations. I wondered if their personalities would be the same out of the womb as they were inside. I wouldn't be let down.

Thursday rolled around and the misery of late pregnancy with twins was totally realized. I woke up that morning and all I could tell my nurse was, "I feel horrible." I couldn't give specifics (outside of contractions), but nothing felt right. Everything hurt. I ached like I had the flu, was tired like I had run a marathon and had the appetite of a mouse (this is not something that happens often, folks, so it's worth mentioning). I could do nothing more than take Tylenol and lie in bed. I didn't want to watch TV, talk on the phone, take visitors or even walk around. All I wanted to do was sleep to give myself the small escape that only a nap could provide.

Dr. Harden visited me and recommended Lortab to help dull the overall pain and achiness and then sat and looked at me pensively.

"I am tempted to get the girls, Erin. But four days can make a huge difference in babies this premature and I'd like to see how long we can go."

I agreed. As miserable as I was, life was at stake here and the longer the girls cooked, the better. I could hang on.

I had my Dr. Higby sonogram that night and while we didn't do a growth analysis, we were assured that all looked well and that everything that needed to be happening was happening. It was a little relief in an otherwise stressful day.

That night's monitoring brought more contractions, more cramps, more uterine activity, more decels from the girls, etc. It was like everything had suddenly been sped up about four or five times.

Now this next part strikes me with a lot of irony. If you'd like to refresh yourself in my pregnancy, go to http://thepruetzfamily.blogspot.com/2005_12_01_thepruetzfamily_archive.html and read the ninth paragraph down. If you don't want to, I'll explain:

This whole thing started with one, arbitrary question that would totally change the course of our pregnancy: Were you taking any fertility drugs?

With that one question, we found out that we'd have not one but TWO babies and that our lives would never be the same.

Friday started much the same. I woke up in the same misery as Thursday, having barely slept the night before and being able to do little more than just lie there like a slug. My nurse walked in to ask me how I was feeling and I reported that life was just about the same. She left and returned a few moments later to ask the question that would change our lives forever: Have you had anything to eat or drink today?

What a stupid question! Duh! It's like 7:15 a.m. and the breakfast trays aren't even here! Of course I haven't! Why would you ask such a...

Oh.

Dr. Harden walked in, again with that concerned look on her face and said, "How about having some babies today?"

My response, "Okay." What else was I supposed to say???

"I don't know why you're so miserable. It may just be pregnancy and early labor, but Dr. Higby and I agree that there might be something going on that we're not seeing. We don't want to go into a weekend wondering if you'll go emergent at any moment and wondering if we'll get here in time. We'd rather just take these girls today, so we're scheduled for a 2:00 c-section."

And that was it. With one, quick question, I was having the girls on Friday, May 19 at 2:00 p.m. I was given the schedule (you'll do this at this time, this at that time, be taken back at that time, etc...) and left to make phone calls.

I called Todd first, of course, and he made it to the hospital in record time. ZZ was there too and all together we talked and prayed for the safety of the girls. It was nice.

And just like a well-oiled machine, everything was done when it was supposed to be done. They shaved my belly at 12:00 noon, started my IV at 12:30 and wheeled me out of the room at 1:05.

Z, Todd and I were taken first to the c-section recovery area where I talked with the anesthesiologist, Dr. Chapa (who, by the way, was awesome) and where Todd and ZZ "suited" up for their presence in the room.

I was rolled into the OR (OR #5, same room where ZZ's twins were born!) and was sat upon the table. Dr. Chapa came in to start the epidural/spinal block. I had to sit very still (of course) and my shoulders began to ache like an SOB as I sat hunched over while he put a catheter in my spine. It must have taken 20 minutes, but when it was done...oh man... All of the aches and pains I had felt for seven months were suddenly cured and I could lie comfortably. It was amazing.

I could feel movement going on down at my feet -- nurses moving me around to the best position, Dr. Chapa looking for circulation, etc -- but I could feel absolutely no pain or pressure. Only the sensation of being moved without moving. Does that make sense?

It was wild.

ZZ and Todd were led in and the screen was put up in front of me. Both Drs. Higby and Harden were in good, jovial moods (relieved of the stress of this pregnancy!), as was Dr. Chapa and we were all having a very fun time joking about what they were and were not doing to me. I asked how it was fair that ZZ and Todd got to watch, but I didn't...

ZZ gave me the play-by-play. "They're cutting. They're burning through the flesh with the burn tool." Etc, etc. It was crazy. She'd take a photo and then show it to me on the digital camera screen, so I was getting to see it all, with a two-or-three second delay.

Todd just stood there going, "Oh wow..." It really is a cool thing to see.

Suddenly, though, as I was watching Z and T, their faces went from, "COOL!" to "OH MY GOSH!" Apparently, there are some clamps that are put into the small incision and that pull your muscles apart, stretching you way wide. I don't recall this from ZZ's c-section, but it was obviously worth missing. The two of them were just horrified to see what was happening!

A few more tugs, a few more organs pushed around and T and Z both yelled out, "Oh here she comes!"

Out popped Faith and Z snapped a photo. 3 lbs, 1.2 oz at 2:11 p.m. A perfect little cry that sounded more like a kitten than a baby.

Moments later, Grace arrived. 3 lbs, 12.5 oz at 2:12 p.m. But no cry. Silence.

There was a team of about seven people from the Neonatal Intensive Care Unit (NICU) there to assist each girl and the respiratory therapist went to work on Gracie. She was immediately intubated and bagged and within minutes, a small cry was heard. What a sigh of relief.

Now while all of this was going on to my left, Drs. H and H were having their own conversation about the umbilical cords.

"Oh my gosh. Look at that. I've never seen anything like this in my life. How did these babies survive?"

"I'm so glad we took them today. I don't know how they did it. These girls shouldn't have made it."

Apparently, the knots in the cords had knots. And those knots had knots. When I asked how many knots there were, fully expecting to hear, "Two or three," like all of my other mo/mo moms had heard, they said, "There's no way to tell. There are just too many."

Truth be told, though, this just made me all the more relieved. They almost didn't make it. They should have died. But they didn't -- God's grace and the prayers of so many got these girls here safely. They were here, they were breathing and they were doing just fine (for 32 weekers, of course). I actually felt dizzy at this point. I thought I would faint. So many months of worrying and wondering what to do. Turns out, we did the right thing, even though we had no idea.

The girls were taken to the NICU and I was taken to recovery, where I stayed for about two hours. I wouldn't see the girls until later that night, but Todd spent time running back and forth, giving me the play-by-play on the girls. Grace had pulled out her intubation, but was doing fine without it. Faith was smaller, but seemed stronger. Both girls were getting "Excellent" reports.

During the times that I was alone, I could overhear the recovery nurses talking about the umbilical cords. They were aghast at how horrific they were, apparently. One even asked if they could go see them. YUCK!

The drama doesn't end there, but only good things happen from this point on, with a setback here or there. I've been typing for 90 minutes now and I really need a break. Hopefully this will give you something to discuss over the water cooler on Wednesday. :)

Below is the link to the kodakgallery.com slideshow that ZZ created. All of the photos I've talked about here are in the slideshow, but I think you have to be a kodakgallery.com subscriber to view. It's free. Be CAREFUL! These are gorey c-section photos with a lot of blood and a lot of internal organs. Don't say I didn't warn you.

http://www.kodakgallery.com/Slideshow.jsp?&mode=fromsite&collid=529684029105.965573446305.1148437438838&conn_speed=1

Your prayers, thoughts and love are appreciated more than you'll ever know. If you'll send one last one to God -- a prayer of Thanksgiving, to let Him know how thankful we are that Faith and Grace are safely here.

Erin
Mommy, x3

May 13, 2006

Well, I didn't think it would happen this week, but once again the fetal gods have smiled on me and I am at home for a few hours. It's been quite a seven days.

The first of the week started out just fine. In fact, I even commented to favorite nurse Paula that things were going too well and that I fully expected all hell to break loose at any time.

The girls were consistently doing well in their monitoring, staying still for the duration of the hour and moving at the opportune times. All looked well with me, too, with minimal swelling and strong vital signs.

But lo and behold, Thursday rolled around and my blood pressure shot up to a totally unusual ~180/90. Now I'm a 105/40 kind of girl, so this was more than a little bit alarming. My nurse at the time took my pressure a number of times, in a number of positions (apparently lying on your left side is the way to achieve the lowest blood pressure possible), but it still stayed elevated. The doctor on call (mine is on vacation) saw me first thing in the morning and still my pressure was up. So labs were ordered to check for elevated enzymes and proteins. Should either or both come up too high, the diagnosis would be preeclampsia or pregnancy-induced hypertension.

I made sure to ask a lot of questions (who? me?) and found out a few things about preeclampsia. Of course, I am sure that these things are common knowledge to a lot of people (even those who've never had it), but I'd never bothered to look into the disease.

1. It's not caused by anything -- it's a disease of pregnancy that can strike anyone without regard to their normal blood pressure.
2. The risks are not on the babies (at least not primarily or even secondarily), but rather on the mom.
3. There is no cure. Mild and moderate preeclampsia are treated with strict bedrest. Severe preeclampsia is treated with delivery.

Okay, so, where did that leave me? Waiting on tests that took 24 hours, that's where. It was a long 24 hours, with most of my time spent in bed, lying down. Thank God for narcotics -- I don't know how I could have survived the back pain otherwise.

Thursday afternoon brought results from the first round of tests and while my enzymes were elevated, they were not in the "risky" zone. It would be up to the protein results to tell the rest of the story and they weren't due until mid-morning on Friday.

Thankfully, that night, was my bi-weekly ultrasound and Dr. Higby arrived around 7:00. Ahhh...a change in scenery! I was wheeled (apparently preeclampsia brings the need for a wheelchair) down to the ultrasound room with Todd in tow and we saw the usual stuff. Thankfully, once again, there is nothing to report but increased weights and growth. I was 30 weeks and 4 days at the time, and the girls looked like this:

Faith: 3 lbs, 2 oz, 29.0 weeks
Grace: 3 lbs, 6 oz, 29.0 weeks

We discussed the c-section and Dr. Higby reminded himself that he needed to schedule the operating room for the 22nd. Ummmm...hello? Please do it NOW! I'm so afraid that they won't have a space for me in the OR that day and that I'll be pushed to the 23rd or further!

It's normal for twins at this age to fall behind in gestational growth, we were told, and an hour later, I was back in my room. Luckily, it's sweeps week so all of the Thursday night shows on NBC were new episodes. "The Office" was one of the best season finales I've ever seen and Todd stayed through "ER" to make sure we caught all of the action. A brief reprieve from the monotony that is my recent life.

Friday morning I awoke to high blood pressure again and was told to stay put and don't sit up too much. Ugh...the misery!

The protein test came back around 10:00, though, and like the enzyme test, the proteins were elevated, but not indicative of preeclampsia. However, I was still having the high pressure, so I was told that I needed to take it easy. I had to cancel the volleyball tournament I was in that afternoon and take myself off the list for the marathon I was going to run today, but it's all for the best I, guess.

What else was I to do but take it easy??? I've become a freakin' expert on it!

By this morning, though, my pressure was back to closer to my norm... 117/72 and around there. The doc-on-call told me that if all looked well by afternoon, I could leave on my weekend pass. Freedom, albeit temporary!

We did monitoring around 11:00 and both girls started out looking good. A contraction here (they're more frequent and boy, when they come, they arrive with a vengence!) and a variable (dip in heartrate for one or both of the girls) there, but everything was good.

Of course, 15 minutes before I was to come off the monitor and be release for four hours, Grace decided to act up. Her heartrate is usually in the mid-150s with variables to 120 or 115. Well, today she wanted to show off and did something or another to increase her heartrate to the 180s and 190s with accelerations into the 200s. That meant more monitoring, to make sure that her heartrate came down. So we waited. And waited. And waited.

My nurse was in and out of my room with obvious concern for our little devil child (I say that with a lot of love, of course) and informed me that I wouldn't be able to leave until her rate went down and stayed down. As much as I hated to hear it, I knew it was the right thing to do. Thankfully, accelerations are less harmful that decelerations, although certainly not something to take lightly.

Finally, after about 30 minutes, her rate came down to her usual 150s. We breathed a sigh of relief (Todd and Devin were there) and I was told I could leave as long as I kept track of the girls, making sure they were kicking and moving about. It makes me laugh that they think it's something that could be ignored.

So here I am -- two close calls that nearly kept me from my weekly sabatical, but rising above the challenge anyway. :)

I guess I've expected this from the beginnning. There was no way I was going to be watching these girls nearly constantly for five weeks without seeing some drama here or there. I mean, it's just not feasible for my life or for theirs. :)

As of tomorrow, I'm 31 weeks, giving me only one week to go. Of course, the longer the girls cook, the better off they'll be, but I'm pretty ready for all of this to be over. I'm miserable and uncomfortable and home sick. If you will, please say a prayer that the 23rd will be open for my c-section and that the girls arrive without incident.

If, for some reason, I can't come home next weekend (I'm not sure why I won't, but I'm trying to cover all of my bases), I'll make sure Todd posts for me. It's exciting to think we're as close as we are and the Pruetz family is anxiously awaiting becoming the Pruetz Five in a week.

Love to all and thanks for everything...

E

May 6, 2006

Another Saturday afternoon, another blissful blog entry from my home computer! Ahh...the joy of sitting in a chair that isn't upholstered in vinyl or taking a nap in a bed whose feet and head don't go up and down...

As I am sure it is clear, the girls are doing great! It hasn't been a week without a little bit of excitement, but I wouldn't be blogging this entire pregnancy (and beyond) if there weren't at least a few interesting tidbits here and there.

The most interesting part of my week was last Sunday. I didn't have a chance to come home that day, but I did get to go to Mass at the chapel inside Methodist Hospital. I returned shortly after 4:00 and was promptly put on the monitors. Both girls seemed to be doing well, with Faith running in the 170s and Grace making her signature little dips from the 160s to the 130s and back. Nothing to be worried about -- in fact, all good signs.

Now I never nap while being monitored. I'm way too much of a control freak for that. If I'm not watching and one of the girls dips way, way, way low, what will happen? I may be in the hospital to be monitored, but ulimately the girls are my responsibility.

Of course, there's always the exception to the rule. Remember, I'm technically about 45 weeks pregnant (and for those of you who aren't familiar with pregnancy, it only lasts 40 weeks). I'm huge (or "yooge" as Donald Trump would say) and just about everything I do makes me tired. Even walking more than a 20 yards or so gives my hamstrings the feeling that I've just done a few sets of squats. No kidding.

So going to Mass was very tiring for me. First the walk to the chapel, then the sitting and standing (I forewent the kneeling for fear I'd never get up) and walking back. I know it seems like no big deal, but let me tell you, it's the equivalent to running a few miles in my book.

So I dozed while monitoring. I didn't mean to, but it happened. I couldn't have been asleep more than four or five minutes when I awoke to my nurse, Paula, running (yes, running) into my room saying, "Where is that baby???"

"WHAT?" I shot up in bed, wondering if I had given birth without my knowledge...

Just behind Paula were two other nurses and before I could get a, "What is going on?" out of my mouth, one was picking up the phone to call my doctor, one was reading the monitoring strip and one was taking my pulse.

I tried to shake off the sleepiness to ask what was going on, but another nurse ran in and my adrenaline shot through the roof. It finally dawned on me -- something was terribly wrong with one of the girls.

I took a peak at the monitoring strip between two nurses and realized that Grace (of course) had slipped into the 80s from the 160s in a matter of seconds. I mean seconds -- like two or three. Paula had seen it from the central monitoring center at the nurses' station.

By this time, the nurses were calming down and I was starting to regain the ability to speak. To put it into perspective, it had only been about 45 seconds since the first three nurses had shot into my room at break-neck speed.

It seemed that they had figured out what had happened. Apparently, Grace had artfully slipped out from under the monitor in one of her signature flips and the monitor, instead of going blank (which would have been no big deal), picked up my heartrate. Hence the taking of my pulse. Moments later, she slipped back underneath and the monitor was picking up a heartrate in the 160s again. It didn't take long for the nurses to figure it out, thankfully, since if they had panicked, I would be the mother of three right now.

They kept me on the monitor for another hour or so, which was fine with me, and we all laughed at how the girls' heartrates both went up and stayed up for quite awhile the scare, as the adrenaline that I produced caused them to take a leap, too. Needless to say, when all was done and I was peeled off the ceiling, I slept very well that night.

The rest of the week went off without a hitch. A blip here, a dip there, but nothing alarming. A few times I was monitored for more than an hour at a time for precaution's sake, but, obviously, all went well. It's to be expected and I'm learning to not panic at every little variation.

Yesterday marked my halfway point, assuming we make it to May 21. It was a good day that gave me a new outlook on this whole thing -- I'm on the downhill side of my incarceration.

To top the good day off, we had a biophysical profile done on both babies. It's a standard procedure for high-risk pregnancies and it measures the babies on five different criteria: Monitoring strips (heartrate, essentially), movement, breathing motions, tone (ie: flexing of a hand or foot) and amniotic fluid. The profile essentially tells the doctor just how prepared the kiddos are for the outside world, since oftentimes multiples are a somewhat delayed in their fetal development. In short, it lets the doctor know just how mature the baby is without taking into account gestational age. I was 29 weeks, 5 days when we had ours done.

The profile results in up to eight points (don't ask how they divided five into eight...wouldn't ten have been easier?) and I was told by a number of nurses to not be worried if the girls scored a 6/8 because at this age, breathing motions may not be present. It's not a sign, they assured me, of their ability to breathe once out of the womb, it's just a sign to indicate if they have started to learn the breathing process.

Well, I'm more than proud to say that my little overachievers both scored 8/8! Breathing motions were present in both, as were all of the other criteria! Dr. Higby took a quick look at all of the other stuff, too, like their kidney functions, bladder functions, etc. In his words, "They look perfect." Well duh, Dr. H ... of course they're perfect. :)

So that was a good top-off to the week. I had a little high all day yesterday, knowing that the girls are doing so well and was even happy to talk to both of my doctors about scheduling my c-section since we're getting so close to 32 weeks. Anything could happen between now and then, but we've come so, so far.

I got tears in my eyes when I recalled our first appointment on February 2 when we were diagnosed with mo/mo twins. We were so terrified by the diagnosis and couldn't believe that we were in a situation where abortion is often considered therapeutic. It just seemed like we'd never get to this point and yet, here we are, still pregnant with two little angels. God is so good.

As for news from the home front...Devin spent the week at Todd's parents' house and had a great time getting to rule the roost. Todd drove to Yoakum this morning to pick him up and was in my room at the hospital before noon. It was great to see Devin, but there is a little bit of "reprogramming" that will need to be done, as someone may have had a little too much freedom while away from home. But as he put his head down for his nap today, he did say something to the effect of, "I'm glad to be home."

I can relate to that comment 100%.