The NICU is a study in opposites: calming and frightening; happy and agonizing; warm and sterile. Even the acronym sounds cute when you pronounce it, but when you draw it out to its full and intimidating length -- Neonatal Intensive Care Unit -- it's a hard kick to the knees, because you realize they're not playing around in there. Those are sick babies. Even yours.
My birth story is a little dramatic, but it also gets harder and harder for me to tell it because my brain gets bogged down in how close I might have come to losing my boys, and I can't process it. I know it's pointless to dwell on the tragic what-ifs, but it's also impossible not to let my mind drift to that dark place when I'm already on such an emotional roller-coaster. I will try.
I picked Kevin up at the airport on Monday night. His flight landed at 10:15 p.m., and at 4:30 a.m. -- only a couple hours after we finally got to sleep -- I woke up with my usual need to pee. Except this time there was also a tiny bit of blood. And for whatever reason, I couldn't decide if they merited an urgent message to the doctor, or just a call to the regular voice mail -- see, I had an appointment that afternoon already, so I figured I'd just tell them I needed to come in early, which has been the usual procedure if something weird happened. (They had yet to tell me to come RIGHT in for anything except my weird Braxton-Hicks episode.) He'd mentioned I would need to call if there was red blood, but never, "Call me on my urgent line," and so of course I overthought that to death and we consulted the books and decided not to overreact unless something else happened.
Then I got back in bed, and felt something akin to a gush. A light gush, but a gush. Assuming it was blood, I checked... but, nothing. This, I decided, might just be regular pregnancy hoo-ha -- there is a lot of varying lady hoo-ha when you are knocked up, and it's all maddeningly vaguely detailed in books -- so I tried going back to bed. It would happen when I climbed in, and again when I climbed out; after an hour of this, I moved into the living room to kill time with a bowl of cereal and some TV. No way I was sleeping. My stomach had tied itself up in knots that felt like ladycramps and I needed to distract myself.
Come 6:30, though, my stomach was knotting itself tighter and tighter, with varying degrees of intensity. I finally gave up and called my doctor on the urgent line at about 6:45, and he called back around 7 to tell me that I should go straight to Labor & Delivery, check in there, and he'd meet me. He seemed calm, and most intrigued by the gushy sensations than anything.
So I did what every practical girl would do: freaked out that I hadn't shaved my legs yet, because that was on the docket for my Tuesday morning shower, and promptly turned on the spray, cleaned up, and shaved up to my knees. I moaned my way out of the shower -- my abdomen felt so heavy and my cramps were bad -- as Kevin threw a bag or two together just in case. We assumed I'd be admitted for hospital bedrest, so we didn't try too hard; just an extra pair of sweats, my mini-computer for getting work done while I languished in bed, a bunch of clean underwear, and an extra t-shirt. I remembered thinking to myself last week, "I need to pack a bag, because the quickest way to go into premature labor is not to have that thing waiting by the door." I looked at the Father's Day card I had just gotten Kevin, in which Bart Simpson cackled that Homer should be thrilled Bart wasn't twins, and which I'd signed, "Get ready! Love, The Beans." Then I shook it off and stumbled to the car.
En route, I felt queasy. That, coupled with the fact that I had earlier that morning been having -- to put it delicately -- the exact opposite intestinal issues that had plagued me the rest of the pregnancy, I convinced myself that, yes, my water probably had broken, but that I also had food poisoning. Water breaking doesn't always mean you're having the baby in two seconds, so I quite rationally -- while inhaling sharply every time we hit a bump in the road, attempting to calm myself via Lamaze breathing, and then declaring that Lamaze is for shit -- concluded that I must have eaten something bad.
I hopped out of the car at the hospital and puked heartily in a trashcan while Kevin went to get me a wheelchair.
This was at about 8 a.m. He wheeled me up to L&D, where they admitted me, got me to a room, and gowned me up before settling me in a bed. The nurse calmly strapped on fetal heart monitors and located both babies' pulses, then did a litmus test to determine whether my water had broken. It turned blue practically within an inch of touching me. So then she reassuringly told me they needed to check my cervix. We bantered about how uncomfortable I've heard that can be, and then suddenly she said, "Oh. OH."
I had walked in the door 10 cm dilated. "I feel the head. That is definitely a full head of hair," she said. But she got a second opinion just in case. "Looks like we're having these babies right now," the nurse said, squeezing my hand. "And they're both head down, so it may happen vaginally."
My doctor wasn't even there yet. Looking up at her, I choked, "I AM GOING TO NEED DRUGS."
She smiled down at me, as kindly as anyone ever has, and said, "We will do everything we can to get you drugs, but if we need you to push and they're not working or they're not here yet, we will GET YOU THROUGH THIS. I promise."
Then, it was a flurry of activity. Full marks to the hospital for making me feel like the only patient in the world; it wasn't until after that I learned they admitted six babies to the NICU that morning, and that we'd bumped from the OR a scheduled c-section of a woman 33 weeks pregnant with twins. The nurses calmly noted that they'd be doing a bunch of stuff very fast and all at the same time, and that none of it was anything but typical and that they'd try to explain it all as best they could. Kevin had to sign paperwork of all sorts, like agreeing to transfusions if necessary, and he had to run out and contact our parents. And Jess, who needed to know that I wasn't going to be showing up online to work.
A nurse came running in: "Good news. I just got off the phone with your doctor. You're going to get your drugs, because he wants to do a c-section anyway."
"Thank God," I said. "Wait, is that bad?" I didn't have anything against a vaginal birth; in the moment, though, I was too scared to do anything without numbing agents.
She laughed. "Not even a little."
Suddenly I was in the OR. The anesthesiologist, a complete angel to me that day, chatted comfortably with me, explaining what would happen as casually as if we were talking about something we watched on TV last night. We made jokes. I rolled over and got anesthesia injected at the spine, then my arms pinned down on either side of my body, fully extended and not to move from that spot. The drape went up; my doctor and his colleague were on the other side. "The area" was being prepped. I got poked lightly with paper clips until I was numb from the boobs down, all the while mildly terrified they'd make a cut I could feel. I had the sense of bustling activity around me but all I could think about was the blue curtain a few feet from my nose and what was about to happen on the other side. Apparently there were about 15 people standing over there that I couldn't see, whose presence I never knew of until it was relayed to me later, including a team per baby and several assistants for the doctors, who conducted the birthing business in low voices.
Kevin appeared, gowned up, and took my right hand. That's when it hit me.
"They're not ready," I whispered, welling up a bit. "They're not done. It's too soon."
He squeezed my fingers. "I know." His eyes got wet.
We just looked at each other for a few seconds, maybe even a minute -- I don't know. It was so fast and an eternity all at once. It said a lot even as we said nothing. Then we both nodded, almost as if to say, "Well, this is happening. So let's just do it."
The next part is a bit of a blur. I recall some small talk with the doctors, who were deeply impressed this had all waited to happen until Kevin got back from his trip. Then the anesthesiologist leaned over and said, "I see a foot."
"WHERE?" I asked, completely discombobulated.
"Over there," she said, pointing to the side.
"He's OUT?" I asked. Kevin peeked around the drape. "Why isn't he crying?"
"I hear something," Kevin said. "And he's pink, and he's moving."
Then he was directed to peek around the curtain. Baby B was out, too, and just a split-second after Baby A finally decided to cry, Baby B joined him in a chorus. I've never heard anything more beautiful in my life: wan, gentle, needy, but very much alive.
Tears rolled down my cheeks, and Kevin and I smiled at each other as he shed some, too. They'd made it through the first stage.
A nurse handed A -- soon to become Dylan -- to Kevin, swaddled in a blanket. Dylan's face was terrible, all bruised around the eyes and swollen lips. He looked like he'd had bad plastic surgery. We affectionately nicknamed him Crazyface, knowing it would all go down soon, but when I look back on that first picture it pings in my heart a little to think that, even indirectly and certainly not intentionally, my body did that to him as he struggled to get out. Kevin put him on my shoulder so I could say hi, and then both babies were gone. And so was he. Everyone rushed to the NICU -- I had told Kevin he should go, and I knew he felt torn but it was the right thing -- and left me there with the doctor to be mended.
Somewhere in here, we found out the birthweights from the NICU. My OB was shocked to hear Dylan's was lower than we thought and Liam's was so much higher. Now, I'm guessing it's because when they calculate the weights based on ultrasounds, they're using measurements of bones and head circumference and all that, and my boys aren't that different in length or noggin size. It's their bodies that hold the key, the baby fat that in Dylan's case wasn't there, and that's tougher to quantify with a mouse and a cursor on an ultrasound screen. It looks like they had developed Twin To Twin Transfusion Syndrome, where one baby essentially hogs a higher percentage of nutrients from the shared placenta. Dylan maybe just realized, hey, I need out. And that's why a vaginal birth isn't as safe -- for one thing, it's risky with twins anyway, but if the TTTS is particularly acute then sometimes the baby that's still inside waiting for its moment, which often isn't immediate with vaginal twin deliveries, overfeeds on the placenta and dies. If it was indeed really TTTS, and it seems to have been, I probably needed to have these babies soon and for sure by c-section. And I'm glad my baby boy was smart enough to know that, because I didn't have a clue it was happening. In retrospect, with that plus the circumstances of my labor, it's hard for me to think about everything without realizing I maybe came closer than I'd realized, and way too close for comfort, to losing my beans.
The first few days, Dylan emerged as the champ, eating everything they fed him through his nasal tube and never needing breathing help. He went under the bili lights -- a treatment for infant jaundice, which is normal in preemies -- on Thursday and is still under them now, but his numbers are dropping for the moment so at least that's progress. Meanwhile, Liam -- also under the lights at one point, but not for as long -- had a murmur near his heart. They suspected it was a vein that was supposed to close at birth and didn't, and it wasn't bothering him, so they let it go to see if it fixed itself. He also wouldn't tolerate food. So we didn't worry about Dylan as much as about Liam, even though Dylan is so much smaller.
Now, though, things have flipped. Liam is back on food and eating like mad, he's out from the lights, his IV is out, the murmur repaired itself, and his coloring is normalizing. We've even gotten to cuddle two days in a row. But today, their one-week birthday, we learned Dylan lost 40 grams overnight. Basically, he'd gotten up to within 5 grams of his birth weight, and now he's back to a full two ounces lighter. This despite eating, AND getting a calorie boost stirred into his milk. The nurse said it might be the slightly stronger bili light they put him under two days ago that's making him lose weight, but they can't deny that if he loses again tonight, it's a worry.
It's not the end of the world. But it's a setback. And we knew there would be some, but the emotion of it still smacks me down in pretty potent waves. When we arrived for our visit this morning, I looked at him in his incubator -- you can see in his face where he's lost weight; his eyes were open, his cheeks were gaunt, he was looking in my direction (even though I know he doesn't see me yet), he was so cute and wee and frail and without body fat... my little guy needs to get bigger and I don't know how to make it happen. It was the most intense feeling of love and powerlessness, which I suppose they call "parenthood," and I started crying silently. It just hurt so much to see him there, and know he is trying and probably confused and wondering why he isn't feeling stronger and what the hell is happening and where the hell is his brother, and I couldn't keep it together. I have to learn to be tougher in there for him, for BOTH of them, but today wasn't that day. Kevin calmed me down as only he can, but I also need to be strong sometimes for him. He is going to have bad days, too, and he's going to need my shoulder, and I have to be able to give it to him.
The recovery period has been pretty benign for me. It hurts to sit and stand, and when I have to go to the bathroom my full bladder is really uncomfortable against the incisions. Last night I had some burning twinges; today, none. It comes and goes. I'm actually very proud of myself for how well the recovery went, and I'm sure I owe that in large part to the news from the NICU being relatively undramatic. Much easier to chill and take it slow and coddle myself when my boys are doing as well as can be expected.
But now I'm home, and it's a bit harder. We're not a floor away from them any more. Couple that with churning, burning emotions changing on me at every turn, and it gets pretty wearing. We're getting by just fine -- the hospital isn't that far, I'm still able to pitch in with work to distract myself, and I'm managing to pump every three hours without feeling so tired I am afraid I will keel over on the spot. But it's a long road and if today's teeny bump in it set me off that badly, what will happen when a real one comes?
All I can do is remind myself that they're exactly where they need to be. And we're doing everything we can to be there for them. And we have to believe they'll both bounce back from these things -- that Dylan will rebound with some fat on his bones and that nothing more serious than his basic prematurity is keeping him from absorbing all his food; that the routine brain scans of tonight will yield nothing but healthy photographs; that the days ahead will give us more chances to hold our sons and promise them the world in the future if they can just battle a little harder now.