Tuesday, May 1, 2012

The night Hazel and Abby were born

Hello,

The Apologia

I have to recall that I have lost all perspective on the matter being so close to it.  There are a thousand things that Nancy and I have a keen attention for now.  We've also had moments that didn't care about our attention level, they simply hit us like a truck and left an indelible mark on our memory without our permission.

So this is your fair warning and apologia.  I will be honest and write how I write. Forgive if I am distracted to rant about the engineering quirks of a bassinet.  Have courage if I talk about life and death.  Ignore me if I make a snooty allusion to literature, or quote songs you've never heard.  Have patience if my emphasis lingers on crude biology (a lot of it is very indicative of health). Ask us if there's anything you really want to know that we haven't thought to include.  Thank you for caring.

Some Background

Finding out Nancy was in labor

A lot of you have asked about the story of what happened.  So here is the basic play by play.  The day Nancy went into labor was Sunday, March 11th.  Prior to that, we had done our research, been to all the doctor appointments, listened to directions, gotten enough rest, eaten the right food, and been given a clean bill of health on all accounts.  Knowing that twins tend to come early, we'd mentally prepared for a very short stint in the NICU, expecting something of an uneventful week or two there in early May.  Coming into the third trimester, things were all looking good.  The only risks were related to the fact we are a little older as parents, and twins are trickier to develop.  But given Nancy's health and the girl's steady reports, everything looked really good.  The Friday before Nancy went into labor, we even had confirmation from a specialist that everything was within expected and safe ranges (which they were at that time, they just suddenly changed). 

After the good report on Friday, we went into the weekend feeling pretty good.  But when we went to bed Saturday night around midnight, Nancy didn't sleep well.  She woke up on Sunday morning complaining that she didn't get a good night's sleep, struggling with discomfort and restlessness.  We slept in a little late that morning to catch up a bit.  After getting up and about, we went over to a local spot called Waterloo Ice House for something of a brunch.  We grabbed some breakfast-y fare, but Nancy only got through a bit of hers before putting her fork down.  She told me that she didn't feel well at all, and looked sick to her stomach.  So we called for the check and beat a hasty retreat out of there.  Nancy said something like she felt like just laying down, so we got her situated on the couch, and got her a tall glass of water.  I was feeling oddly tired myself after a fairly long week, so we both just took a nap.  Before nodding off, Nancy complained that she was feeling cramps, and that her lower back ached.  We were both aware that certain symptoms can indicate labor, and both of those were on the list.  However, she had experienced each of those before at different times during the pregnancy, and we were waiting to see if they were a temporary flare up. 

After taking it slow and getting some more rest, I was concerned that Nancy hadn't really eaten anything.  I make a quick frozen pizza so she could have something on her stomach.  I didn't like the idea of low blood sugar messing with her as long as she felt crappy to start.  But after taking a nap, she indicated that her symptoms hadn't really improved at all.  I asked if she could stand to eat just a little, and she did.  After finishing up the pizza, we talked for a bit.  We were both concerned that her symptoms hadn't let up.  It seemed like the obvious thing to do at that point was to call the nurse, since rest and time had no effect.  The nurse asked a few questions, and knowing the higher chance of premature birth associated with twins, recommended we go ahead and come in for a look.  The nurse said that they would likely observe Nancy for a while, so she recommended we bring a couple of essentials.  Given that it was Sunday night at that point, we could easily get held overnight.  We threw a couple of things into an overnight bag and headed up the freeway.  It was about 8:00 PM when we started out.

Even though Nancy had noticeable discomfort, it did not seem too severe.  If this had been a second pregnancy, it might have been recognizable to us as her going into labor.  As it was, we weren't certain that it was any more than a combination of Braxton-Hicks contractions, fatigue and soreness from a poor night's sleep, and an an upset stomach.  Both of us felt like the nurses would pat us on the back, give Nancy some antacid and tell us to come back in a few weeks. 

We checked in, and set up in a receiving room at the Women's Center, where we waited to be seen by a doctor.  There was a little paperwork, and the nurse did a standard vitals check, along with a brief series of questions.  They asked about the pregnancy so far, Nancy's doctor's name so he could be contacted, and so on.  Somewhere between 8:30 and 10 PM, we were seen by our first doctor.  Doctor Monk was the man on staff that night in the receiving area.  He has 8 kids, with two sets of twins among them.  Our first introduction to him was when he walked into the room across the hall and cheerfully exclaimed "Well, let's see, how is that cervix doing?"  The mood of his question was so bright, I half expected him to enter our room saying "Let's see what's behind cervix number two!" like a game show host.  Don't get me wrong, Dr. Monk is very professional, he simply is direct, and has a manner that seems built to break the tension common with stressed out, expectant mothers that show up in the middle of the night.  Instead, he introduced himself, asked us our names, and had Nancy rattle off what she had experienced that day with her symptoms.  He asked how far along the pregnancy was, to which Nancy replied 28 weeks.  He remained bright and energetic, explained what he would do to check Nancy out, related some things about his two sets of twins when we indicated that was what we were expecting.  He went through his assessment, and when he did examine Nancy's cervix, his tone dropped a little bit, expressing some resignation to a fact.  "Three centimeters and 90 percent effaced," he said to the nurse, "looks like preterm labor." 

Nancy and I both cut our eyes to each other at that, both concerned at what we'd just heard and trying to grasp how serious things were.  In the second between Dr. Monk confirming labor to the nurse and then turning to address us, we both had the usual flash that comes with these things.  As I said earlier, we'd been to all of the appointments and listened to the OB/GYN closely, so we knew that 24 weeks was an important milestone we'd already passed, and 28 weeks was another big one.  Still, we also knew that 24 weeks is basically the big turning point for survivability, and 28 mostly marked a reduction of the worst risks.  So we knew that even now, the girls could be OK, but it felt like everything was cutting it frightfully and awfully close.  Both of us were hoping for some sort of confirmation that as close as we were to this sort of milestone, twin A and twin B were ahead of the danger curve, and in store for nothing more than a long but uneventful time in the NICU finishing out their development to a full "baby". 

So here's where I'll digress into some human development, but lightly.  A baby goes through stages, moving in some order from a fertilized egg all the way to what we recognize as an infant.  Along the way are clusters of cells like blastulas and zygotes, but what most people associate with a recognizable child is the fetus stage.  A baby spends a fair amount of time as a developing fetus, and even at 40 weeks full term, a newborn still has some things in common with a fetus as much as it does to an infant.  It will still be some weeks as a newborn really settles into fully being a "baby" that is growing and thriving in the outside world.  So, at 28 weeks, you are not so much giving birth to a baby as you are giving birth to a fetus.  It is a rather startling thought, and I apologize if it's not pleasant, but that's exactly what we were faced with.  The silver lining here was that we were looking at giving birth to two reasonably advanced fetuses that were strong enough to survive outside of the womb provided care and assistance.  So when Dr. Monk said "preterm labor", this is what flashed through our minds instantaneously.  As with most situations that are associated with a fight or flight response, the world snapped into a place of the present, and we found ourselves very much in the moment.  Past and future seemed dim, and our attention was pretty focused on our immediate surroundings.  That would be the case for as long as I continued to be awake that night and day.

So there we were, locking eyes with a "what does it all actually mean?" expression on our faces, and Doc Monk breaks the spell with "OK, we're going to go ahead and get you admitted.  I'll be back in a moment, and you can ask me if you have any questions."  We had a few, but without further examination, most of the answers were general in nature.  We were going to be admitted, they may try to slow/stop the labor, they might go to C-section, the babies seem OK right now, there would be some things we needed to sign, and Nancy's doctor was not available, so we'd be doing this with one of his partner/associates in the practice, Dr. Capet.

Admitted into Labor and Delivery

So at this point, Nancy's and my account of the night begins to diverge somewhat.  I remain a spectator, while she goes through all the direct action.  I remain conscious the whole time, while she moves through varying stages of alertness in either magnesium therapy or anesthesia during the C-section surgery.  We spend some time apart for short durations.  And finally, only she can describe all that she noticed and what it felt like to go through everything.  So of course I'll leave it to her to fill in those details.  Read Nancy's account for the view from her eyes.  For my part, this is what I saw leading up to the birth of Hazel and Abigail.

Prior to all of this, Nancy and I had taken a tour of the facilities.  The hospital offers these on a regular basis to expecting parents, so that you know kind of how things work.  It's good to know how to ring yourself in after the doors lock at night, how to find your way around, how much cabinet space is in a labor room for your things, and what the standard procedures are for delivery, testing, visitors, security protocols, etc.  Now that we had confirmed that Nancy was well into labor, it at least felt a little familiar to what we'd learned on the tour.  She was wheeled right into a room where we were greeted by Lisa, who would be our nurse in labor and delivery that night assisting Dr. Capet.  However, although the room and reception felt familiar, things would be different than standard full term delivery, and Lisa explained what was about to happen.  She told us that Nancy should expect them to try magnesium therapy.  She went on to tell that magnesium relaxes the muscles in the body, and the hope was that the ones that drive labor would stop contracting so much and advancing the labor along so fast.  "I'm sorry to tell you, but honestly it will make you feel pretty miserable.  You will be pretty out of it, and mentally and physically you'll feel very bleh.  It will probably make you feel flushed and hot, and you could get nauseous."  Lisa is a pretty physically expressive person, so as she was speaking about how Nancy would feel, she aped out a very slouchy posture, and made sluggish motions, as though she were moving through a pool of thick liquid instead of air.  She made a dull and drugged sort of expression with her eyes drooping half closed, and then returned to her normal posture.  Nancy and I both nodded, and Lisa went on to explain more.  She told us that if the babies are going to come, then there is a steroid treatment that will help their lungs develop.  She and another nurse went on to hook Nancy into a monitor that charted her contractions, as well as set up equipment and prepare catheters and such. I found out a little later that Lisa had been in the Army.  Finding out that I was a Marine broke whatever ice remained.  Nurses have to deal with a variety of patients, who can react in all sorts of ways to stress.  Panic, bossiness, and the whole gamut of emotions can complicate things.  She was already warming to the fact that Nancy and I showed no imminent signs of going looney tunes, but service members share a culture and language, and from then on I could get the completely straight answer on things if I asked.

After a little while, we were seen by Dr. Christy Capet.  We had never met her before, since Nancy's regular OB/GYN is Dr. Cowan.  However, it didn't take her long to make an impression.  From reading her bio several days later, I found out that she ran track and field in college as a heptathlete, and she still runs half-marathons.  If you've ever spent much time around someone who is a doctor, or someone who had the skill and discipline to compete in athletics at the college level, you'll know that both doctors and athletes tend to carry themselves with certain varieties of self composure.  Dr. Capet has her measure of both and it was evident in her manner.  She was very much in control of herself, and seemed prepared to respond to any potential change in the environment or situation.  For lack of a better description, she seemed possessed of a great deal of balance.  In that manner, we were told that it was unlikely that we could do anything to halt labor, but "we'll do our darndest"(slipping into Texas vernacular for a moment).  The contingency was that we could at least slow it down enough to allow them to do the corticosteroid treatment to help the babies lungs.  If we can delay for 24-48 hours, then it would be possible to do more than one treatment (if I recall this correctly).  However, it was mostly important that we could get one in prior to a delivery (which we did).  As far as anyone was concerned at the moment, there was nothing more anyone could do except see what Nancy and the babies would do.  Their response would dictate the course of action. Dr. Capet asked if we had any questions, so I tried to be pragmatic.  My question was, what are the endgames?  My concern was that there were a few different ways this could turn out, so I might as well prepare a basic course of action for each.  "Obviously, one path is we do a C-section, and the babies are born tonight.  What is the other path?"  Dr. Capet's reply was that Nancy would continue on therapy for awhile, and then be ordered to strict bed rest.  There would be no release from the hospital until there was some proof she wouldn't go immediately into labor.  No way she'd be here any less than several days in either case.

So, Nancy was in labor, it was sometime close to midnight, and nobody knew what was happening outside of the hospital.  Being a geek and a tech professional, I'm always sure to bring some sort of computer along, but I hadn't packed any clothes.  Nancy only had and overnight bag with enough gear to brush her teeth and take a shower.  Her change of clothes consisted of some sweats and a T-shirt.  I had nothing to do for a couple of hours while Nancy would lay in a hospital bed feeling drugged and full of discomfort from both side effects and ongoing labor contractions.  So, I called up my best and oldest friend.  As late as it was, Steve picked up and I didn't waste too much time giving him the sitrep: Nancy is in preterm labor, there are a couple of ways it could go, and we'd need some help either way.  I didn't want to call people up at that hour just yet, because I didn't know what was going to happen.  So the plan was, if the babies are coming, he'd get another short call.  At that point he'd get in contact with our parents to let them know what was happening, since I would surely be too rushed at that point.  If the less likely thing happened and we ended up camped in the hospital with Nancy on bed rest, we'd need some clothes and gear the following morning, and maybe someone to get in touch with our workplaces as well.  "Anything we needed," Steve replied, "just let me know."  Plan set, everyone at the hospital went into watch Nancy mode, while Steve kept watch on the phone.

So watching Nancy for this whole period had had a few events.  At some point, there was some kind of treatment consent that Nancy had to sign.  It was after she'd been on the magnesium for awhile.  Some kind of staff member came in to summarize the purpose of a few documents and obtain signatures where applicable.  After outlining one of them, she queried about Nancy's consent, phrasing it with something to the effect of "what do you think?"  Struck with a surging wave of nausea, Nancy's gamely retort was "I think I'm going to throw up".  Despite this, the staffer didn't miss a beat.  She snatched the vomit baggie that had been placed by the bed and handed it to Nancy in one smooth motion, using her other hand to draw the documents out of the potential blast radius.  She patiently waited.  After the whole ordeal was through, she finished off the last of the forms and went on her way like this was completely commonplace.  I was rather stunned.  I don't think I've ever seen a vomit that looked so painful.  Seizing up like that on top of labor contractions and burning sensations from magnesium sulfate in your bloodstream looked agonizing.  My poor wife was so wracked with the spasms that I cringed at the sight.  Nancy maintained her sense of humor, remarking matter-of-factly "Well, there went the pizza."

Overall, Nancy spent about 4 hours on magnesium sulfate.  I spent a fair amount of that time holding her hand, or getting little pieces of information from the nursing staff.  An ultrasound technician came in and did a scan of the girls to see how they were doing.  Both had strong little heartbeats, and measured out at somewhere around 2 pounds and 10 ounces by the algorithm used in the measurements.  During the first two hours, Nancy held at 3 centimeters, but went from 90 to 100 percent effaced.  When the doctor came back about 2 hours after that, Nancy had jumped to 7 centimeters, having been through some strong and more rapid series of contractions.  Once Dr. Capet established the dilation at that measurement, it was time to move.  The babies were coming one way or another.  We had already consented to a c-section long ago, and wanted to avoid the risk of a lengthy or stressful delivery. 

There was no question on the call, and everything moved very quick and efficient.  Lisa handed me disposable coverall scrubs and a mask, and told me I could/should grab a camera.  "Things are going to move really fast, so get these on and be ready to move."  I put on the gear, grabbed a camera, stood in the corner, and called up Steve.  "Hey, Steve? It's happening, they are coming NOW.  I've got to go, so get ahold of our parents."  I hung up and shoved the phone in my pocket, then zipped up the goofy looking suit.  It was sometime about 2 AM.
The goofy looking temp scrubs. Picture taken in C-section recovery

In the OR for C-section delivery

Nancy got wheeled right into the OR, while I was asked to take a seat just outside as they did prep for the surgery.  Periodically, a new person would show up.  A nurse practitioner named Nancy, the neonatologist Dr. Breed, and a couple of NICU nurses.  It later struck me as funny that we had a Dr. Monk who had 8 children, and a neonatologist named Breed, of all things.  But at the time I was concerned with weightier matters.  Both nurse Nancy and Dr. Breed introduce themselves, asked if I was the father, and offered a greeting.  Nurse Nancy told me that they would let me know when to come in.  It could not have been much more than 15 or 20 minutes. 

It felt like a lot more.  It was strange being separated from Nancy, and it was actually extremely quiet in the anteroom to the OR, which didn't help.  I fidgeted with the camera, having the sense to at least test it.  It was a brand new one I'd never operated before, and I didn't know if Nancy had time to put a fresh battery in it.  But Nancy is meticulous with her photography equipment, and I am technically inclined.  So one minute down, camera check is a go.  It's still really quiet and I am trying not to think to much.  I look at the floor, it's still there.  I look at the camera.  Yup, that too.  I think "28 weeks", and start to worry.  I remember that worry is OK, but I am resolved not to give in to panic.  This carousel of thinking goes on for several minutes, and I return to the thought of 28 weeks a few times in that span.  I decide that its a good idea to pray.  I try to start, and have absolutely no idea how.  Because I am a dude, I am struck with inspiration by a prayer from Conan the Barbarian.  I tell God that I'm trying to find words, but I have no tongue for it.  There is something about how regardless of what happens, two fought against many, and valor pleases him. There are simply no group of words that are sufficient.  So I go without language, and offer up a giant wordless mess of thought.  I figure that being God, he'll have no trouble figuring it all out and knowing what to do with it.  A little more time passes, and I wonder what the girls will be like.  I'm worried, but also sort of anxious to meet them.  I think about playing with them in the sun.  I don't even know their names.

Lisa appears around the corner, and leads me right in to the OR.  It looks and smells sterile.  The whole place is some shade of white, blue, or silver of equipment.  So Nancy's brown hair and pretty face stand right out against it.  I am enormously relieved to see her, and say "God, it's so good to see you!" as though we've been apart for weeks.  She smiles and sincerely replies "It's good to see you too."  Then she proceeds to knock me on my heels.  Her brow crinkles a bit with concern, and asks "How are you doing?"  I answer "Oh sweetie I'm fine," but stand there astonished that with everything going on to her on the table, one of her first thoughts is for me.  A man introduces himself as Dr. Nelson, and offers me a chair right next to Nancy's head.  I see the tag on his scrubs and say "You're the anesthesiologist?" and he nods.  I sit down next to Nancy and stroke her hair a bit.  That makes her notice that she isn't wearing a haircap and she wonders at that for a moment.  She asks whether it's been long, and I tell her no, not very.  She said she went out for a bit, and when she woke there was this large blue screen.  She makes a dry joking comment that I now can't remember, except that it made me smile behind my mask.  We sit there silent for just a bit.

Dr. Nelson looks at me and asks, "Do you want to see them born?"  I look back to say "Yes", and he points across the screen and says, "Then stand up."  For as long as I live, I think I will find that moment just before seeing Hazel and Abigail to have it's own significance.  I have no idea if Dr. Nelson meant anything more than to indicate the viewpoint.  But his choice of words struck me, and I will always feel like that moment was my answer to a calling.  I stood up.

Hazel was coming out, butt first.  Dr. Breed was holding things open, and Dr. Capet was working Hazel steadily out.  I was pretty much in awe.  She was mottled, like link sausage, with thin skin that shows the blotchy colors underneath, though she would soon turn uniformly to a bright pink.  The docs wove their hands around and through, and set the umbilical cord to be cut.  Hazel went into a NICU nurse's care and I saw her carried to an isolette.  I turned my head and Abigail was on her way out, coming sideways.  She had the same colors.  They were both very small, but not the way I expected.  Although they were visibly small in size, they were almost as long as the newborn babies in the regular nursery.  They were just so much skinnier.  Instead of the chubby baby fat all over, they were fairly emaciated, like infomercials for starving children somewhere in the third world.  Some place I have also heard "alien-like", which is also true enough.  They were beautiful to me, and fascinating, and I was intent to anything that would tell me they were alright.  I watched them placed in open incubators, where three nurses apiece proceeded to work at various efforts to make the girls safe.  Dr. Capet made an announcement to note the times of birth, which were 2:44 and 2:45 AM, on the morning of March 12th. The nurse practitioner looked at me, and offered a firm and sincere "congratulations" with a nod, followed by the same from each doctor, before turning right back to work.  I'll return to something about this later.

Nancy spoke up.  She wanted to know if they were OK.  She didn't and couldn't see them from her vantage, and she had not heard any crying, which she told me.  I quickly turned to Lisa to see if she had some specifics. I had seen them coming out, and watched them squirm at the air, and react to the bright light.  I could see the nurses worked quickly, but in a paced manner without apparent alarm.  I hoped to offer a little more than that though. Lisa said calmly, "The nurses are stabilizing them now, so they can be moved." I turned back to Nancy and said "They're ok, they're just stabilizing them now." She seemed satisfied with that for the moment.  As tight as the whole situation looked, it felt like things were still under control.  I stood next to Nancy and we both watched the nurses flit around the isolettes in fairly coordinated motion.  The doctors were at work again on her, starting to put things back together.  Noticing that, my concern for Nancy returned, so I looked at what they were doing.

I had already seen the girls come out, and the part about seeing that much of Nancy hadn't affected me. That didn't change when I looked to see them doing the rest of the work.  I had thought that perhaps being so awed by the girls had kept my wife's guts merely peripheral to my attention.  But looking straight at things didn't create any new discomfort.  I was only curious at a couple of things that were different than I would have guessed.  There were more different and distinct colors of things, where I had expected most everything to be varied sorts of red.  I had thought that they would do all the finishing work on the inside.  It was curious that they actually pulled things out, and flopped them onto her stomach to do some work suturing and sealing where there was easier access.  It made sense, but was simply something I'd not considered until now.  The only thing that briefly concerned me was when they returned things into place.  I had expected a simple placement, but getting things back into proper alignment apparently takes more force.  They had to shove a bit to get things back home, but they were decisive in the doing, so I just looked to see if Nancy noticed.  The anesthesiologist had done his job well, and it was nothing more than a mere shifting of the table to her.

Over my shoulder, a nurse told me I could take a picture if I wanted.  Nancy glanced up and nodded at me, and I was already pulling out the camera.  I walked over, and took the very first pictures of our children.  Hazel was set to go to the NICU, and they were still finishing up with Abby.
Now bright pink, and still stuns me as beautiful
After only another minute, they set Abigail into the same isolette as Hazel.  While they wouldn't remain co-bedded, it was an efficient way to get them into the NICU together.  Abby was wrapped up a little more, with blankets around her instead of the plasic sheet over Hazel.
The sisters together, ready to roll
I had time for only the two pictures, and then had to step out of the way.  I went over and showed the pictures to Nancy, since that would be the best view she would have had of them the whole time. After a brief look, a nurse said "we're taking them to NICU, why don't you come."  I started up, but then turned, thinking to kiss Nancy before I left.  I had bent over to her cheek before realizing I still had a surgical mask on.  So I leaned to her ear and told her "I love you."  She said it back, and and then nodded as I said I had to go.  The staff was already out the door with the incubator, wasting no time.  So I strode out behind them to catch up.

Welcome to the NICU

As I mentioned earlier, the staff offered me congratulations.  I think I will always appreciate that they focused overwhelmingly on my wife and kids, but also took a single second to acknowledge me. From earlier days of sweating it out in a waiting room, access to birth is a lot different for fathers these days.  However, you are still an observer with little to offer, and helplessness threatens at your mind.  That has not changed, no matter where you are when things go down.  The single word of acknowledgement from them was simple, but the only reminder I needed that I was part of something wonderful, even as scary as everything was for us.

Still, there are no shortage of images that abound to put you on your heels.  Walking into the NICU, you go into a large, open room with stations along the wall.  Only curtains separate the incubators, and all of them are pulled back at that time of night.  If you are admitted during a more visitor heavy part of the day, you'll receive either polite attempts to ignore you, or strained and sympathetic looks from the parents of the NICU.  Only four days later, Nancy and I would watch another father come in with his newborn, this time as relative veterans already.  It was very, very bizarre.  There was this man, 6 foot 3, and his entire posture was frozen with tension.  He was sort of leaned in, like he wanted to move forward to act, and hunched over, with the realization that there was nothing he could do.  He stood there staring at the activity around his little girl, and wondering if everything was stable, and how long it would stay that way.  Watching that was like an out of body experience.  I saw myself in that guy, and it took me right back to the moment I stood there the same way.  It is frightening when a new child is admitted.  There is something very negatively cathartic about it.  You become reminded of a place where things were still on the edge, and that there are still events that could take you right back to that point.  I wanted to reach out to the man, but at that moment there was nothing I could do for him.  Things can be different only hours later, but at the time you will be absorbed by what is going on around your baby.  Speaking to another NICU parent, I was told they had watched as a new baby was admitted, but instead of the usual 2-3 nurses working around the incubator, there were seven.  Instead of a pace you would call "urgent", they were something approaching "frantic".  Even if your child is in strong shape, it is a horribly demoralizing thing to see another fighting so precariously.  For now though, we were the new ones, and nobody but staff was up at zero dark thirty to witness the admission.  If they had, it would be less scary and more sympathetic, as Hazel and Abby were pretty stable. Six nurses steadily settled two babies into separate isolettes.

There is a lot more to say about life in the NICU, especially when you spend many weeks there.  But that will be for another post.  At the time, it was obvious that things had settled down, and I was assured that things were in a stable place.  The twins were safe in isolettes, and hooked up to an array of instruments that reported continuously on their vitals.  Pulse oximeters, heart monitors, ventilators, thermometers, and heaters were all steadily going.  There are alarms attached to each one to indicate failure (which become a very familiar chorus).  But the pulses were steady, the oxygen saturation was normal, the temperature was holding, and the nurses had gone into an observation mode.  They asked me if I had any questions.  I shook my head, just wanting to look at the twins for awhile.

Back in C-section recovery

Before we had determined that Nancy was going surefire into birth, Lisa had given me a courtesy debrief.  I was told, "wink, wink", that I wasn't to "wink, wink" be told the combination to the snack/nutrition center in labor and delivery.  But she couldn't help it if smart guys saw the combo and remembered it while she wasn't looking.  Good looking out soldier, here's a hooah! from the Marines.  I didn't take gross advantage, but made a stop there to hydrate a little with some juice on the way back to C-section recovery.  Lisa had given me all the bearings to know where the OR was, which direction the NICU was, and where mothers were taken to recover from the abdominal surgery after delivery.  Once things were settled down in the NICU, I went back to see if I could meet Nancy and let her know anything there was to tell.  For the 15 minutes it took for Nancy to arrive, I overheard Lisa on a brief phone conversation with another staff member.  They went down a list of pre-existing conditions that could affect a preterm labor.  It was a list of no's all the way down.  I decided to call up my mom, to try and start talking to the new grandparents in person.  I was sure Steve had gotten a hold of them, but I was the only one with new information.  I was able to tell my mom that things were ok for now, we didn't know why things had happened, and I was still waiting on Nancy.  Very nearly on cue, the doors swung open and in she came on the rolling bed.  I hung up with Mom, and Nancy and I caught up.
We're glad at least no one was around to take a close up.

After that, Nancy stayed there until there were indications she was ready to move.  It was only a while, although I don't recall how long.  It must've been between an hour or two, as they watched her condition coming off of anesthesia.  At that point in the night, our sense of time was basically whacked anyway.  I took some time to get things together from our labor and delivery room, so it could be quickly moved into a post-partum hospital room when Nancy was ready.

I will recall in another post, some of the conversations I had with family over that time.  It was during Nancy's time in the recovery room that I was able to call all the new grandparents and Steve.  But know that they were given a report, and upon returning from those calls, it was only a short while until we were taken to Room 236, which would be our home for the remainder of Nancy's and my stay in the hospital.  Those four days are sort of a story of their own, but one already a lot more familiar to anyone who's done the drill.  There are vitals checks, sleep interruptions, paperwork, and medications to take.  Naming the babies was a process we had to finalize then as well, which deserves some record I'm sure.

But somewhere after a very long and strenuous 18-22 hours or so, Nancy and I just crashed.  We had slept our last restful night earlier that weekend.  This would be the sleep of a parent, which is characterized much differently by most.  But Hazel and Abigail were here (twins A and B for the time), and they were ok, and they were beautiful.  I have heard and read that it can take time for attachment to form with a baby, especially for fathers.  But for me I was instantly hooked.  I've been a father for all of 7 weeks now, and it is flat out marvelous, lack of sleep be damned.

But that concludes the major events of the night that the Pair of Scates were born.  I'm glad to have this account down.  It was my pleasure to share with all of you, and a relief that we have a record of things. I'm told that it's very easy to forget much of your entire first few months of parenthood.  But I'm short of sleep even now, as I'm back at work and new at Dad-hood and all its duties.  I'll be back with more for you all later.

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Matt Scates
Austin, TX

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