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contractions

A note of caution: If you are currently pregnant, this story is one you may want to wait and read after you’ve delivered. By reading further you agree that neither the author nor Wiser Mom nor anyone connected with the blog may be held liable for contact PTSD symptoms, nightmares, hysteria or other undesirable effects incurred from reading the following account.

There is a huge backstory leading up to this, some of it was documented in real time on this blog. But for those of you who need a refresher or are new to the story, this post drops into it when Myg was exactly 35 weeks pregnant. She had been in the hospital for a week with mild preeclampsia after a third trimester filled with ER visits and two other hospital stays—one overnight and one five days long. Unexpectedly—we had been told a few hours earlier that it would be another week—the OBGYN team decided on the morning of week 34 and 6 days that it would be best to induce labor immediately and not let Myg’s condition deteriorate. The babies were healthy in utero and would most likely be fine after delivery, whereas Myg would only get sicker and not begin to recover until afterward. We catch up with our protagonists at 4 a.m., January 22, 2009:

Myg is being rolled into the operating room for delivery and I am right behind her in disposable scrubs and surgical mask. Twins are considered high risk, so all twin deliveries are done in the OR, just in case. A Pitocin drip to induce labor was started about nine hours earlier, and she was given an epidural at 11:30 p.m. that worked just as you’d want—she has gone through transition smoothly with not too much discomfort and is now 9 cm dilated. She has also been given magnesium sulfate—known in the medical parlance as “mag”—to control her preeclampsia symptoms. Mag will keep her blood pressure, already high and spiky, from getting out of control. It also has a host of nasty side effects, including the possibility of hot flashes that some recipients have said feel as if you’re burning from the insides and your eyeballs are melting. The other effect is that it is a powerful muscle relaxant. Exactly what you don’t want when you’re about to deliver a couple of babies.

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The last belly pic

My previous experience with operating rooms is that they are cold. But as Myg is wheeled into the OR to deliver our twins, I don’t notice the temperature. I notice the table. The scene is like something out of David Cronenberg’s Dead Ringers, which should put a chill into anyone who has seen the film and anyone who doesn’t get the reference should be thankful they don’t. The operating/delivery table has padded swivel legs and stirrups that my memory says are stainless steel, but that sounds unnecessarily cruel, maybe they were just worn leather. Like the straps you’d find on an electric chair in Texas. Overhead, a large array of klieg lights dangle at the end of an articulated arm looking oddly like a female mantis with the severed head of her lover held in the caress of her deadly mandibles. A wall made of monitors and other machines that go bing! stacked about twelve-high is teetering dangerously close to the table. The only man in the 11-person delivery team sits next to them in oversized glasses holding a clipboard or notebook or tablet computer. He is unmistakably Hell’s bookkeeper. Other odd apparatus are arranged about the room but my attention is focused on Myg as she is helped onto the table, still strapped in, and her feet are arranged in the stirrups and a flimsy sheet is arranged over her.

Once again, Myg explains to the doctor and the nurses that we’ve had no birthing classes, no Lamaze, nothing, because she’s been on bedrest since week 26 and no one at the hospital could find any resources that would come to the house, other than the midwife/dula team we can’t afford because I’m in grad school and Myg’s on disability and frankly, we’re as poor as we’ve ever been and thought that it was the best time to have twins because we plan everything and it always works out—just not how we plan it, or we would have gone to birth classes in the second trimester when Myg felt well enough to go on vacation—therefore, we’ve only read about delivery. Yes, in a book. Oh, and online, too. (This works for me, give me a book with instructions and I’m golden, not so much for Myg, and she’s the one that has to do it, so I’m nervous but keeping a good attitude.) No, Myg hasn’t watched A Baby Story, because she’s terrified. (Five months after delivery she still can’t bring herself to watch it.) We need some coaching, please. The staff says not to worry and explains that when she feels a contraction she needs to take a deep breath and hold it and when they tell her to push she needs to push like she’s shitting a watermelon and keep pushing as long as she can—they’ll count to ten—and then she can relax until she feels the next contraction or like she wants to push.

And that’s it. Ready for your skydive/bungee jump/moon launch? Good, me too.

I sit at my wife’s head, looking down at the part in her hair. I want to kiss it, but my mouth is covered by the mask. The delivery team sees a contraction begin on the monitors and they all say in disjointed unison like a girls’ rugby scrum: take a deep breath, now PUSH, hold it keep pushing don’t let it out one … two… three… four… don’t let it out keep pushing and Myg lets it out and stops pushing around seven.

She looks at me with a holy shit expression that says this is not fun I do not want to do this but I have no choice oh fuck…

I whisper sweetly into her ear and she tries to relax for the brief couple of minutes before the next contraction. I try to say encouraging things. I hold her hand. I feed her ice chips. And it goes on and on and on. Myg gets tireder and tireder but continues to labor. Labor. The word in its most radical form. She labors.

Of all the things I am in relationship to Myg, at this moment I am nothing but an ice machine.

I am an ice machine.
I am the best ice machine.
That is all.

The iceman. I’m good with a Styrofoam cup and chips of ice. See? I can get them out of the cup and put them into your mouth where they melt and soothe and if I knew where the crushed ice machine was I could refill the cup all by myself. And when you stop to think about it, what else does one need in life but some ice chips? All your needs can be met with a foam cup full of ice.

With every contraction the routine is the same. It goes on and on. The mag has made it next to impossible. Myg gets tired. I just want to sleep, she says. Can someone else take over for a bit? She tries not to think about the fact that this is Baby A, nicknamed “Doot” in utero, and that after she gets this done she has to do it all over again for Baby B, “Bing.” She’s ready to be a mother. Or, she really wants to be done with pregnancy and wants these kids out of her, at least.

The team all cheer her on with every contraction and it’s annoying. If it’s annoying to me, I know it has to be irritating her. Myg, amazingly diplomatic, says, okay, I only want one of you to count. She points to the resident. You. You get to count. Everyone else has to be quiet.

I know inside she is thinking along the lines of: Shut up, you dumb fucks, I know the routine now. It’s not complicated. I hold my breath, I push for an eternity, the kid doesn’t budge. I do it again. You had to go to med school for this? If you have any suggestions besides “push” and demonstrating that you watched enough Sesame Street to count to ten as a group, then please enlighten me. Otherwise, I’m coming off this table and there will be carnage that will require a SWAT team and weeks of forensic analysis.

The diplomatic tack works for about two more contractions. But now it’s clear that Doot is moving, they can see his head, everyone is more excited and seems certain that he is about to come out on the next push. Everyone but the bookkeeper starts shouting “encouragement” again. Myg looks at me and says, we’re done with this. I nod and agree. If we want more children, adoption, as we have often discussed, will be the way to go. We’re finished with the biological imperative. The Team tells me to come around to look from their angle. Doot is nearly here.

I walk around and look up between my wife’s legs at the mystery of mysteries, the holy of holies, the place I like to think is my playground and not anything that involves spectators. I’m a guy, I love sex. But I’m also a pretty waspy guy who was brought up right and went to church as a kid. Sex works best in the bedroom. Without a team of specialists with instruments and years of expensive training. And I know, I know, this is not sex—this is the end result of sex when all the pieces of the biological Rube Goldberg contraption fall into place. And we’re in a hospital. Everything is sterile and clinical and has nothing to do with my sex life with my wife and OHMYGODWHATTHEFUCKISTHATTHING? An angry red maw of engorged flesh has replaced Myg’s lady parts, and it’s being stretched wide by a red playground ball with wet black hair that I can just see a crescent of—no way is that thing coming out of that hole. It’s not happening. Meanwhile, the Team is grinning at me like they’ve just shown me the fountain of youth.

I admit, the miracle of life and childbirth are beautiful things, perhaps the essence of beauty—but it’s this as a concept, as an abstract. All the great and mysterious things about the universe, they are summed up by these moments but only metaphorically. In reality, it’s a gruesome visceral experience. It’s difficult, painful, and fraught with a lot of danger that modern hygiene and medical technology have mitigated but not eliminated. Sure, I love the primality. Put someone else’s spouse there and I’ll come in with a camera crew and wax eloquent like David Attenborough and win the Palme d’Or. But when it’s my beloved and my immanent offspring, I’d take no pain, no blood, and no risk if it were offered. Something antiseptic and external—stork delivery, even. I back away from the Team trying to appear nonchalant and not like I’m retreating from the mob at Bedlam.

Back around at Myg’s head, I smile and hold her hand. I lie. Just a couple of more pushes, babe. He’s almost here.

Myg pushes again. She has stopped paying attention to the cheering section. They’re doing it wrong. She has figured out that when she lets her breath out during the contractions and pushes not just with her stomach and bowel muscles, but even with her chest and neck, that they scream more encouragement and the baby moves better.

And I am also happily wrong. In just a few pushes, Doot arrives at 6:52 a.m. and gives a little cry as they hold him up and I look at my son—a weird red lizard dripping stringy white mucous, with what appears to be a version of Winston Churchill’s head run through a Play-Doh Fun Factory. They put him on the heat table and begin wiping him off and sticking his feet onto ink pads and making footprints. They put him in Myg’s arms for just a second and she is overjoyed and I’m choked up and she cries a little and then they take him back to the table where they swaddle him up and at the same time the doc is telling Myg she needs to get ready for round two.

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Doot chilling on the warming table, 30 minutes old

They break Bing’s water and ask Myg to give a push just to get him down into position. Myg is in a daze. She has successfully delivered a baby. She knows she can do it again, how about in 18 months? It’s about 7 a.m. The doc has her hand inside Myg, a contraction comes and Myg pushes and I see a slight look of surprise on the doctor’s face. I felt the cord, she says. She looks up at the monitor and says, okay, Myg just give me one more push, and I’m going to see if I can get his head into position. Myg pushes. No, I feel the cord. The doctor shakes her head and she gives some unseen unheard command.

The operating room, already burgeoning with attention to Doot’s birth, blossoms. The 11-person team moves in complex synchronous harmony about twice as fast as they had been. What’s going on? Myg asks. The anesthesiologist begins turning dials and jams a mask over her face. Are we doing a C? There is worry in her voice and I realize something has happened, something with Bing and they’re going to do an emergency C-section.

A nurse flags my attention calling me “Dad” and it seems strange but I know it’s me.  Follow me, Dad. She leads me out into the hallway with some rehearsed reason for why I can no longer stay in the room with Myg. You might faint, she says. Wait here. She points to a spot on the carpet in front of the delivery OR doors and leaves me there. I do as I’m told. After five minutes I begin pacing. I am worried but have faith in the Team that the C-section will go smoothly. I call my mother and tell her about the arrival of her grandson and let her know that the second is on his way. The doors slide apart and someone notices me as he moves past carrying arcane medical devices. The second baby is out, he says. I am relieved. He doesn’t say anything about Bing’s condition. I assume everything is fine. A manx cat appears pushing a small cart bearing Doot. The cat speaks. Do you want to come with me to the nursery? Apparently, it’s a nurse.

It’s not until hours later that I understand that when Myg pushed and the doctor felt Bing’s umbilical cord that it was a fairly rare and serious situation known as a prolapsed cord. The monitors showed his heart rate had dramatically dropped to 80 bpm when Myg had pushed. He would not have survived a vaginal delivery. Now I go cold when I write those words. On that day, I was supremely confident and ecstatic.

What they did not tell me and part of the reason I was in the hall during the emergency C-section is that because Bing’s heartrate was dropping they had to open Myg up immediately. As in before the anesthesia was in full effect. Myg apologized later to the surgical team for all the screaming. I didn’t hear a thing two sets of doors away in the hallway. Are you numb? The doc asked. You’re numb enough. Myg says the cut wasn’t painful, but that having her guts moved out of the way in a hurry was like having a wild animal pawing at her insides. The doctor knew she’d survive that trauma okay—the important thing was to get the baby out.

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Bing joins his brother in the nursery after escaping the womb via a window

Both of our sons arrived healthy and whole. Neither required any time in the NICU. They even made it through the bilirubin spike without needing light table treatment. As of this writing, they’ve quadrupled their birth weights. They smile and laugh and roll over. They grab hold of fingers and toys and eat solid-er food. They’re delighted to see me every time I enter the room. Because of my wonderful sons, these five sleepless months full of diaper changes and spit up and two babies crying in tandem at a 4 a.m. that lasts forever have been the greatest five months of my life.

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Husband becomes Dad

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First snuggle

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Status Quo

by Myg on December 2, 2008

Just a note to let you all know things have been mercifully quiet with my uterus the last few days. That’s not to say the boys aren’t rocking out in there. In fact, it feels like they’ve been throwing a sock hop.

One of two things seems to be happening. Either a) I’m NOT having very many contractions anymore or B) I’ve managed to successfully ignore them. I don’t think it’s B, or at least I hope not. It’s tough because the entire ordeal has made me a lot less trustworthy of my body, and that’s exactly what I have to be right now.

But every little twitch or flutter, I find myself pressing on my belly. Is it hard? Is it starting to ball up? Is that a contraction or is the baby just moving around?

It doesn’t help that different doctors tell me different things about this. For example, one doctor told me that if I felt just one part of my belly getting hard, it was the baby moving. On a different day, a different doctor told me that was a localized contraction and I should monitor it. He said if I felt the baby moving, then no. But you know what? I don’t always feel them when they move. I am not sure how that can be at this point, but when I was hooked up to monitors I heard a lot more movement than I felt.

So I’m just, well, I just kind of don’t know.

I do know that overall I feel better, and I feel less tightening in my uterus, so I think the bedrest has really made a positive difference. Though I look at the weeks stretching out ahead and the walls of my bedroom and think, “AFFFHHSJSJAALALLLPASAAADRRRGFGHHHHH!” That’s shorthand for, “Oh my fucking god I can’t wait to do dishes and walk the dog and clean the house and go out of the house for any reason besides the doctor and this room so needs to be painted and holy crap I still have unfinished work stuff I need to take care of and oh shit I didn’t bring the disability forms with me yesterday and I need to get those filled out and argh I should really be more productive than lying in bed all day on the internet I should read a good novel and catch up on some phone calls but I really hate talking on the phone and don’t want to explain this shit all over again and again and I haven’t even started any Christmas shopping oh fuck it we’re broke anyway can we get a pass on Christmas this year or what and oh that reminds me we need to send a gift to our nephew who just had a birthday and “ALEX???? Can you bring me some ______________?”

That’s pretty much how it is with me these days.

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Replay

by Myg on November 22, 2008

I’ve had almost no sleep since 4pm yesterday. Pardon me if I’m a little edgy.

I started having more mild contractions again yesterday. Again, they weren’t painful. I just had a lot of them in a short period of time. No other preterm labor symptoms though. But all the same I had to go back to the hospital.

They poked me, prodded me, stuck things in me. Early this morning I had the roughest pelvic exam of my life and at this point, that’s really saying something significant. Sweet Jesus, this doctor (a stout grey haired man I’d never seen before) was barbaric. It’s 15 hours later and I’m still sore. Sure, he wanted to be certain my cervix was closed but WTF? Men like that have NO place in gynecology, I’m sorry. I’d really like to give him a reciprocal rectal exam while he’s constipated, shoving a fist up his ass with all of the vigor he employed with me this morning. Actually, no, I wouldn’t like to do that. Not at all. But I would appreciate it if  someone, preferably big fisted, would do it to him. Let me know if there are any takers.

Other than the contractions, which I kept having, all was well. In fact, they thought they’d send me home last night. But to be safe, they repeated the Fetal Fibronectin Test (fFN) and the result was positive. A refresher on what this means, from the March of Dimes:

Fetal fibronectin (fFN) is a protein produced during pregnancy and functions as a biological glue, attaching the fetal sac to the uterine lining. During the first trimester and for about half of the second trimester (up to 22 weeks of gestation), fFN is normally present in the cervico-vaginal secretions of pregnant women. In most pregnancies, after 22 weeks, this protein is no longer detected until the end of the last trimester (one to three weeks before labor).

The presence of fFN during weeks 24-34 of a high-risk pregnancy, along with symptoms of labor, suggests that the “glue” may be disintegrating ahead of schedule and alerts doctors to a possibility of preterm delivery.

and…

The greatest value of the fFN test is the high level of reliability of a negative test result. According to ACOG, “Fetal fibronectin testing may be useful in women with symptoms of preterm labor to identify those with negative values and a reduced risk of preterm birth, thereby avoiding unnecessary intervention” (1)

In women with symptoms of preterm labor, a positive fFN result, while less reliable, allows doctors and patients to take preventive measures to delay labor for as long as possible and to consider labor-suppressing (tocolytic) medications.

They were fairly surprised. I was upset. They reassured me, a positive is not something to get terribly worked up over. But since I did have it and I had two episodes of contractions within a week, they decided to give me steroid shots to help the development of Doot’s and Bing’s lungs along, just in case. It wasn’t a tough decision, but it was a recommendation that scared the crap out of me. Like, there was enough of a chance of the boys coming early that I needed to do this. That’s not what I want to hear right about now. I got my first shot yesterday and my second and final shot tonight, 24 hours later.

Today the very nice, and very gentle, and might I add, FEMALE High-Risk Maternal Fetal Medicine doctor came to visit early this afternoon and did an ultrasound of the boys and a very gentle transvaginal ultrasound. “Your cervix is the size of Kentucky” she said. Apparently, this is a compliment. It’s a very good thing. Especially when carrying twins. The boys looked “perfect.” So all in all it looks as though things are okay. I am not, repeat, not having preterm labor. Not at this point, anyway. They just want to be sure and do whatever they can to prevent preterm labor from happening and god forbid it happens in the next week or two, give Doot and Bing every chance.

“You’re pregnant with twins – your body is not going to act the same as if you were carrying one baby.” the nice lady high-risk doc said. “How can we expect you not to contract with two babies in there at this point? Your body has stress on it more like you’re 30 weeks along, not 26.”

Well, that was a good point and made me feel much better.

Still they’re keeping me. At least until tomorrow morning, possibly through the weekend. I’m now officially out of work. But I am less freaked out by the contractions and that’s a good thing.

I keep telling myself, I’m just along for the ride now. I’m trying to let go into this experience while still remaining a strong advocate for myself. It’s a delicate balance. And it may or may not be obvious at this point, but “delicate” is not my strong suit. With two boys on the way, that’s probably a good thing though.

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(Eds note of caution: Another post so long it should have chapters, really.)

This is where I spent Friday night and Saturday morning:

It’s room 7 of the Labor and Delivery Unit at my hospital. See the cute little newborn tray across the way? I apologize for the crap photo, but it was all I could muster from my cell phone at 6 am after hardly any sleep.

No, thank God, I didn’t have the babies. Though it was pretty damned hilarious that mere hours had passed after I’d written about the milestone of potential viability for the boys when I started to notice a lot of tightening across my belly. I counted seven times in 45 minutes and thought, “huh, well I should probably call the doctor.”

I did and they said COME IN RIGHT NOW.

At this moment, the boys were at 25 weeks 1 day in development. It was about 10:30 at night. “They’ll probably just do a cervical check and send me home,” I thought. Wrong.

Walking into the Labor and Delivery unit for the first time under these circumstances felt like stepping into a starring role in a movie without ever seeing the script. It was something completely unreal for which I was utterly unprepared. Then the frightening reality hit me. At some point, I’d be delivering these two boys into the world. This was the place it would be happening. Maybe even this room.

“Not this room. We do all twin deliveries in the OR just in case we need to do a C-section.”

Okay, not in that room. But near that room, for sure.

“Wow, you really are contracting,” the nurse assured me after she hooked me up with fat hard plastic nipple-looking monitors on my belly. One each for the boys and one to monitor the contractions. And by the way, having those monitors strapped around my gut didn’t do much to ease the tightening feeling I was having. My first thought was, “SHIT” and my second was “So, this is what contractions feel like.”

Gallons upon gallons of blood collected. Peed in a cup. Then, a parade of folks came into the room. A happy trio of obstetrical staff greeted me as my “team” for the evening. It consisted of two high school aged residents (okay, they were probably late twenties) with a 12 year old boy turned medical student in tow (okay, he was probably 23). They – the team – were to going to perform the cervical exam.

“When is the last time you had sexual intercourse?” Three young pairs of expectant eyes searched mine. Alex looked up.

“Uh…” (Now, I apologize for the few of you who may read this who actually know me because a little TMI is headed your way. You can skip the next few paragraphs. In fact, I encourage you to do so.)

See, Alex and I had been so cautious since IVF (yep, that’s JUNE) we had really begged off sex in a way that was starting to make us feel inhuman. Or too sibling like. I’d never been told not to have sex once I hit that positive pregnancy test. I just had a feeling, like, maybe we shouldn’t take the chance. But last week, after such good news at the ultrasound, I figured what the hell. I wanted to celebrate. So we did it – on Wednesday night – just a couple of days before this whole thing started.

“Did you know that sex can cause contractions?”

And here I was blaming the whole thing on the #1 Value Meal from Burger King I’d had a few hours earlier. I happen to think fast food is disgusting, but I’d had the strangest craving for Burger King that night. Now they said it could have been the sex? Regardless, I vow to never eat Burger King again.

Anyway, since it had been more than 24 hours since the sex they were able to do the cervical exam. Luckily.

“Then, you just take the swab and swipe it around the outside of the vagina,” the resident said, as I watched the med student looking intently at the space between my legs. “Have you been itching? You look like maybe you have a little yeast infection here.” Lovely. Times like these make me real glad I’m not the shy type.

They performed two ultrasounds, one vaginal to check cervical length and one abdominal to check the boys. Cervix normal – between 3-4cm long. Closed, drum tight. Boys looked great. Heartbeats were just fine. All the fluid was there, where it was supposed to be.

They cultured (like a Pap Smear) for what’s called the Fetal Fibronectin (fFN) test. From the March of Dimes:

The presence of fFN during weeks 24-34 of a high-risk pregnancy, along with symptoms of labor, suggests that the “glue” may be disintegrating ahead of schedule and alerts doctors to a possibility of preterm delivery.

A negative result is highly reliable, and means that you are not generally going to go into labor within the next two weeks. That culture would have to go to the lab so we’d need to wait on that for awhile.

I was still contracting. Not hard, mind you, but it was happening. I tried to will it to stop. And I think – maybe it sounds crazy – I was able to get it to ease up a little bit. I just kept imagining my uterus as a soft pillow the babies were nestled into. I tried to think of the softest, snuggliest things I could and then imagined my uterus was made of that: clouds, Mason’s ears, jello, cool wHip, and then it finally hit me.

The little blankie bunneh and puppeh that Doot and Bing had gotten as a shower gift from my neice. When I lifted them to my face and felt those little baby blankies the first time I declared them the snuggliest, softest little toys I’d ever felt. So it may sound weird, but I imagined my uterus was made out of them. Every time I began to feel my belly tighten, I’d think of the puppeh/bunneh material and believe it or not, if I did it early enough, I’d feel my abdomen just relax and get soft. It didn’t work every time, but it did help. Amazing the weird little tricks you can do with your brain.

The real doctor came in and caught me up on what they knew. So far I was not showing any signs of preterm labor. Thank god. If I had been, they’d give me a steroid shot to help my babies develop their lungs to give them a better chance of survival should they – GOD FORBID – be born soon. But since, as she explained, they can really only give that shot once it was better to do it closer to when they actually suspected a delivery. That sounded fine to me.

She then told me that since everything looked good they were going to wait for the fFN test to come back and then probably transfer me to another room. All of my bloodwork was normal. No infections, no signs of pre-eclampsia. No major issues here. I was just contracting. “Some women just contract throughout their pregnancy,” she said. Great.

They gave me a 20mg dose of Procardia at around 12:30. Procardia is actually a heart drug that lowers the blood pressure, but it also helps relax the uterus. I received the most painful IV of my life – so bad that I begged the nurse to take it out. The IV was for hydration only, not meds. Luckily the doctor came in to talk to me right then and I bargained out of the IV – let me drink water. Given that everything else looked fine, they agreed and brought me a pitcher.

Eventually, my contractions did stop and my fFN test came back at 3am – negative. They took me off the monitors so I could get some proper rest. I sent Alex home to make sure Mason hadn’t destroyed the house and waited for transfer to my new room.

But then at around 4am, I felt the tightening in my uterus again. Fuck. The nurse returned with a wheelchair to take me to the new room, but instead called the doctor. They strapped the monitors back on. I’d be spending the night where I was. Stuck on my back, strapped like so much old luggage. They were going to give me another dose of Procardia, but I asked the nurse to check my blood pressure first. Sure enough, it had dropped from 137/70 (which is real high for me – this is where it was when I first arrived) to 105/58. They skipped the Procardia. Boy am I glad I asked. Another example where, no matter how much you like your medical team or how confident you are in the quality of care you are getting, you can never assume they’ve thought of everything – especially at 4am. If you’ve got a question or any reservation ask, ask, ask.

I could not sleep. I don’t know if it was my nerves, the Procardia, or the position I was lying in, but my PVCs (heart palpitations) were fucking terrible all night. I had near constant thumping in my chest. I felt like I was having an unending panic attack without the panic. Then the boys were jumping, kicking, rolling nonstop. Maybe they do that all night and I don’t notice it because I’m asleep, but hooked up to the monitor (which for some dumb reason, the volume was turned up in my room) every kick was THUD, BOOM, THRASH loud as hell. I could hear their heartbeats all night too, which at first was reassuring and then annoying, as they’d invariably wander away from where the monitor was strapped so that you then suddenly couldn’t hear their hearts. Hearing the steady heartbeats of your babies stop is not something to fall asleep by.

To bargain my way out of the IV, I drank that entire pitcher of water. So I had to pee every hour on the half hour. All in all I probably slept a total of 20-30 minutes every hour until Alex got there at 10am. Maybe it’s good practice for what’s to come.

I started contracting again at 6am. The doctor came in the morning and said, “You were so quiet all night I was going to just discharge you! But since it’s starting again I’m going to have the high risk OB/GYN come and take a look at you so we can decide what we need to do.” And I was fine with this. I did not want to go home with intermittent contractions without having every last person of expertise weigh in on the situation. Because that’s how I am.

7:30 am was change of shift. Alex was not back to the hospital yet but I was starting to really miss him. My new doctor came in and introduced herself and told me they wanted to give me the Steroid shot. “Huh what?” was my response. “But I’m not having preterm labor and I thought you could only give that shot once, and it was better to do it closer to – within a week of – delivery and my fFN test was negative so don’t I have at least two weeks minimum before that would be an issue?”

The nurse came in with the shot as the doctor was explaining her feelings. “As a mother of a pre-term child myself, let me just say this. It’s the worst thing you’ll ever go through, watching your baby in the NICU. If we give you the shot now, it will definitely help – just in case – you do go into labor within the next week. It will help lung development and help prevent brain bleeds. We can’t at this point guarantee that you won’t go into labor within a week or so. And that doesn’t mean you can’t have another shot later if it doesn’t – it just means that the second may not do as much good, but there are a lot of ways to interpret the data around this. I think this would be the safest thing to do now, but it’s up to you.”

“But Dr. S____ (the doctor from the night before) said she didn’t think I needed the shot or that I should have it now.”

“Look, if you get 100 different doctors in here you will get 50 doctors who say do it, and 50 who say don’t. But as someone who’s lived through it, I’m telling you it’s what I would do.”

“Um…ok…I guess…if you really think I need it.”

“Do you want to wait to talk to the high-risk doctor first?”

“Yeah, and I’d like to be able to talk to my husband about it. He’ll be here in a little bit so can we do the shot later?”

“Sure.”

Now here’s why that little exchange is so important. See how close I came to getting that shot? I had this chat on almost no sleep. I had become more confident that I was going to be okay until this doctor – nice as she was – came in with her spiel about why this was so important and how despite absolutely no signs of preterm labor and a negative fFN screen, I might even go into labor within a week or so anyway. The nurse was standing there, shot preparation in hand. I was armed only with my groggy recollection of the rationale my other doctor had given me. My anxiety went through the roof. Of course – of course – I wanted to take every precaution I could to protect my babies.

Luckily, the doctor picked up on my hesitation and didn’t push it – actually gave me an out of talking to another doctor. Otherwise in my state of mind I might have just shown my ass and taken the shot and explained it to Alex when he got there. And that would have been bad, because of this (from Babycenter.com:

Because the benefits of the steroids are greatest during the first seven days after treatment, it used to be common practice to repeat steroid treatment weekly for women who continued to be at high risk for preterm delivery and were still pregnant after the first treatment. But experts now think the risks of repeated treatments probably outweigh the benefits. They’ve been associated in some studies with decreased fetal growth, suppressed adrenal gland function, and adverse effects on long-term lung development….

…Another thing to note is that even a single dose of steroids may have some short-term adverse effects on you. Although it doesn’t happen often, corticosteroids can raise your blood sugar to levels that require you to take insulin for a little while even if you don’t have diabetes. If you do have diabetes or gestational diabetes, corticosteroids may require you to increase your insulin dosage.

I saw the high risk doctor just after Alex got there. I really, really liked her. I actually liked all of the staff – that was one very good thing about the experience. Even the doctor who scared the shit out of me seemed very professional and on top of it. But here’s the rub with that. The high risk doctor again did a bunch of ultrasounds and saw my cervix was totally normal – 3cm long. The babies looked great. No signs of preterm labor. Other than “take it easy” and “watch for these other problems” I was given virtually no take-home instructions or restrictions. “So should I get that steroid shot now?” I asked.

“Definitely not.”

Huh. I explained what the other doctor had said, yadda, yadda, yadda. The high risk doc said, “She thought you were 3-4 centimeters dialated, when the chart said your cervix was 3-4 cm long. It was just some miscommunication. I cleared it up with her.”

Fucking A, man. That was my response to that. In fact, that IS my response to that. Fucking A. A major medical decision almost made on totally wrong information. In more dire circumstances, this is how relatively healthy people die in hospitals.

Stay vigilant with your healthcare providers, no matter how much you like or trust them. It bears repeating. Even at 7:30 a.m. on no sleep, stay vigilant. More vigilant than I was.

They were going to let me go home. Oh hooray! Then came the new resident, “We’re going to send you home with a script for Procardia.”

“Are you sure? Are you going to advise me to check my blood pressure somehow then because my blood pressure dropped a lot last night after I took it and I have no way of checking it at home.”

“Huh” was her response. “Let me check with the doctor.”

No, I did NOT go home with a prescription for Procardia. Vigilance.

Here’s what I went home with: advice.

  • Take it easy this weekend and don’t go back to work until you see your regular Ob/GYN on Tuesday.
  • Track the contractions. If you have a bunch, drink some water and lay down for an hour. If they still get worse, call us right away.
  • If you have any bleeding, spotting, discharge of any kind, call us right away.
  • You’re pregnant with twins, so just get used to the idea of coming here between now and delivery as things come up. It’s not a big deal – it’s expected.
  • NO SEX!

As we were driving home I asked Alex, “Do you think we caused this to happen because we had sex?”

“I say it was the Burger King.”

Whether it was or not, who’s to say. But that’s one whopper I won’t miss.

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