Tuesday, July 31, 2012

Miracles Happen

Somedays we want to hole up in this house and hang out together, giving ourselves time to think and process; other days we want to keep as busy as possible so that we don't have time to think.  It doesn't work as well as it sounds.  Saturday was a keep busy day.

We headed down to the farmers market, something we do often.  It was finally less than 100+ degrees out so it was nice to get some fresh air.  Unfortunately, all I could think of the whole time we were there was the last time we were there.

The last time we were there was July 7th, the day after the doctors confirmed the babies were mono mono.  While we were walking around the market that day we were feeling at peace.  We ran across a booth that I had seen there a few times called Twinplicity.  I ventured in and marveled at all the cute onesies and shirts made for twins.  They were all pretty cute, but one stood out to me in particular and I picked it up and showed it to Jim.  I said that we were definitely going to have to get these for the babies.

You see, just the day before the perinatologist we were seeing, Dr. Drake, told us a story of the last set of mono-mono twins she had.  The babies made it to birth, and ended up not actually being mono mono.  She said that family gave her a sign that hangs in her office that says "Miracles Happen".  She said it was very special to her and one of the only items that she has kept and displayed because of its importance.  We really felt like we were the next miracle.

When we ran across the booth this week I still stepped in.  I glanced at the other cutesy twin onesies, but I stopped on the "miracles happen" ones.  I couldn't believe in the timespan of 2 short weeks things had changed so drastically.  I took a picture, bit my cheek, and joined Jim and the kids as Charlotte got some mini donuts.

Most of the farmers market was the the distraction we were looking for.  Charlotte played and danced with the musicians.  Oliver gawked at all of the sights.  We bought some food for baby food making.  Charlotte made a bee headband and watched them make honey.  Overall it was great.

I imagine it will be this way for quite some time, probably the rest of our lives.  Distraction followed by a reminder.  Happiness followed by heartbreak.  I know we will adjust with time, but I don't think it will ever fully go away.  To be honest, I am ok with that.  I don't ever want a time to come when we "forget" about our girls, and I know it won't.  

To everyone out there who is experiencing a miracle, savor it.  

Sunday, July 29, 2012

Bringing Them Home

This past week, or slightly over now, has been, by far, the most excruciating week I could have ever imagined.  I had no idea how much it would hurt.  When it comes down to it, I think we have been conditioned as a society to not understand the pain of miscarriage, fetal death or stillbirth.  That is something that Jim and I have really struggled with.

People say things like "just a miscarriage" or "at least you weren't further along" or "better now than after they were born".  Don't they get it?  Our children died.  Two, of our four precious little ones died. It is not the absence of living, they were living.  We saw them kicking, moving, squirming.  I felt them move and I lived for them. Their hearts were beating one day, and the next day they were not.  They did not simply fail to live.  Our children died.  It is hard.  It is more than hard.

I have to admit, even I didn't get it until it happened.  I had absolutely no idea how I would feel and how much it would hurt.  I have completely underestimated how much miscarriages must hurt those that go through them.  I don't know why I ever thought that that pain would be bearable.  Do I think our grief was compounded by the fact we had to give birth to our sweet babies?  Yes.  I would be lying if I said anything different.  But even so, any of us have been there have lost a child, not because they didn't live, but because they died.

We visited the funeral home on the Monday after the girls were born.  We had selected cremation and had spent some time over the weekend looking for urn possibilities.  Because the funeral home is so generous with families in circumstances like ours (a small nominal fee that basically covers the paperwork), we wanted to make sure we checked our possibilities there first.  To say that nothing fit the bill would be an understatement.  Part of it was because we were already hung up on one we found online, and part of it was because everything they had to offer was just too urn-y.  We wanted a vessel that meant something.  We wanted something that wasn't made to hide the girls, but rather to celebrate them.  We went home and ordered the urn we had seen online.

The urn arrived on Thursday, one week since our babies had come and gone.  It was perfect.
The bottom slides out and the vessels in the bottom hold the ashes.  We are so glad we made this choice.

On Friday we called the funeral home and set up a time that afternoon for us to come in and finally be able to bring our little girls home.  We dropped the kids off with our wonderful sitter for a bit and headed downtown.  We were led into a room where they had Ruthie and Imogene waiting.  We asked for them to be cremated together because that was all they had ever known was being together.  A teeny, tiny ziplock pouch held their ashes.  There was so little and it broke my heart.  We signed all of the necessary paperwork and I picked up the urn that now contained our babies.  The woman offered to get me a nice velvet bag to carry it in.  I declined.  I wanted to hold them, as close as I could, all the way home.  I cried as we left, knowing that this was the first time I was able to hold my girls.

We came home, selected a perfect spot, and got it all dusted and perfect for them.  We placed them on the shelf, where everyone could see them.  We can stare at them any time we want, and they can watch their family and know that we will all be together someday.  We know that we will likely be more attached to the urn then we should be, after all I talked to them (it) last night after blogging about their delivery.  It sounds crazy, but it provides comfort.

I can't thank the company enough who made the urn (www.heavensgain.com).  They are a company that provides caskets and urns to families that have suffered the loss of a miscarried baby or early stillbirth.  After enduring this pain themselves, they found a need for these items so that the handling and burial of a tiny baby is consistent with the way we handle other losses in our society.  I can't thank them enough for recognizing that they are our children, and should be treated as such.

Saturday, July 28, 2012

Ruthie Mae and Imogene James

We got the call that afternoon from our OB to set up the induction.  I remember her asking if I wanted to do it right away, or wait.  We elected right away.  Part of me now thinks, maybe I should have kept them with me longer, but nothing was going to change the outcome and in the end right away was definitely best.  They called the hospital and we heard back a very short while later.  We were scheduled to check in the following morning, July 19th, at 5 am.

It was still dark as we drove to the hospital that morning.  There is something about the dark right before the sun rises that I have always found beautiful.  As we headed down the deserted interstate the sky sort of glowed with pre-dawn sun but the stars were still out.  We were silent.  We pulled around the hospital to the familiar parking lot we had arrived at together two other times before.  Times when we also arrived to deliver babies.  Times when we got to take those babies home.  

We grabbed our bags and held hands as we walked in the hospital and headed up the elevator to the 6th floor.  We checked in at the desk and had to sign the admittance papers stating why we were there.  

"Fetal Demise-17 weeks"

So medical.  So cold.  So sad.  I signed the papers and, after being asked, we elceted to not have them list us in the patient directory if anyone asked if we were there.  I am addressing this because we got questions about it.  This meant that if we gave someone our room number, and they came and asked for that room number, they would be directed to us because they only could have gotten that information from us.  It did, however, also mean that those people who might call and ask for us or try to visit without talking with us first, would not be directed to us.  Jim and I both really felt like this was something we needed to do together.  We were confused about how we would be feeling and had no idea what the day might hold.  It was a time for us to work through some of our grief and emotions, to meet our babies, to mourn their loss.  It was not a time for us to worry about how those who came to visit were feeling or to try to comfort or cheer them.  It was also not a time where I wanted visitors wondering or judging how we acted.  There were tears and there was laughter, there was unease and there was rest, there was concern and there was comfort.  Needless to say, we needed to go through this process ourselves.  That does not negate the fact that we need people there for us, we just didn't need people literally THERE for us.  

The day began slowly.  We waited quite some time for the orders from the doctor on what medicine to start when.  After arriving before 5am, we did not receive our first dose of medicine for the induction until 9am.  We were told by many nurses and the doctor that the process would likely be very slow, requiring multiple doses of the medicine given over 6 hour intervals.  We were also warned on at least a dozen occasions that when the time came to deliver, it would come suddenly.  They said that time would go on and on with no progress and suddenly it would come so quickly that we likely needed to be prepared for no doctor or nurse to be in the room.  I found this a bit terrifying.

We spent the majority of the day sitting, talking, and visiting with our nurses.  The compassion they had was uplifting.   I would just talk and talk and talk with them, feeling comfort in being able to visit about different feelings and emotions I was having.  I think the phrase I said most commonly, which was usually accompanied with tears, was "people just shouldn't have to go through this".  It felt so awful to think about birthing these two little babies who we would never get to watch grow.  I talked about our pregnancy and the mono-mono debate that we carried for months until finally confirming it on the appt before they passed.  I kept saying that I felt jinxed.  Like if we would have never said they were for sure mono-mono, maybe everything would have continued to be fine.  We talked a lot, about their lives too.  It was a distraction, and a welcome one at that.

That afternoon we were encouraged to get some rest and to try to sleep for a bit since it would likely be a very long day, or two or three.  It was restless sleep and almost unwelcome.  I decided to sit up a while after 2 anticipating the next dose of medicine at 3.  My doctor came in and explained that because I was just 8 months out from a c-section they thought it would be best to administer the medicine on a different schedule so that they didn't cause any damage to my uterus.  Instead of two doses every 6 hours it would be one dose every 8 hours.  This ended up being quite a blessing, because right around the time I would have gotten a dose, things picked up.  I can't imagine how quick or painful it would have been if the medicine was administered.

Sparing all of the details, my back started aching right around 3:00.  By 4:00, I started realizing what was happening.  I literally broke down.  I had been ok most of the day but now that the time was upon us, I could not pull myself together.  I was in pain, physically and emotionally and I just couldn't wrap my mind around what was about to happen.  I was scared.  I was so, so scared.  I only calmed down when trying to focus on getting an epidural.  This was sometime between 4:30 and 4:50 that the anesthesiologist arrived.  Jim was sent out of the room for a couple of minutes.  During the process of inserting the epidural, my water broke.  I have never sat so still through such pain.  Jim walked back in the room at just the right time.  We knew that as soon as I laid back down, we would deliver our babies.

The nurses were amazing.  They swarmed our room and took control of a situation that I felt completely out of control with.  They helped keep me calm and prepared for the biggest heartbreak I would ever encounter.  Jim was by my side, holding my hand, we looked at each other and tears filled both our eyes.  It still, even in the moment, felt like it couldn't be happening.  

Baby A was born at 5:05pm.  They hadn't begun the epidural drip yet, but the line was in and ready so they went ahead and started it in case their were problems with the placenta coming out.  They delayed Baby B until our doctor arrived.  Baby B arrived at 5:23pm.  

If you look up pictures of mono mono twins at birth you will often see parents posting photos of the gigantic mess of knots that is their babies cords.  Ours weren't knotted.  They were as if you took two strings, and crossed them over and over until it was so tight that it could no longer supply the babies with what they needed.  I felt a little jealous.  Other babies got to live with far larger cord entanglements.  How are some chosen and others not?  That is a question I am sure I will be exploring over the next months, or more likely years.

They couldn't immediately tell the sex of the babies which was hard for us.  After trying for over an hour to remove the bits of remaining placenta they decided it would be necessary to have a D&C procedure.  Because I would have to be put under for that, we elected to have the babies baptized before heading into the operation.  One of the pastor's from our church came and we had the babies baptized.  Because we didn't know the sex yet, they were baptized as Baby Davis A and Baby Davis B.  More tears.  

Surgery went well and when I got back to the room we got to visit more with our babies.  They had cleaned them up and had them in some tiny blankets.  We took a few pictures for ourselves only.  We talked to them, prayed for them, and sang to them.  We told them we loved them.  We told them what their names would be, if they were girls or boys.  We told them the people that would take care of them in heaven.  We asked them to take care of each other.  We sang "You Are My Sunshine", because I always sing it to Charlotte and Oliver as well.  The second verse was hard, and will never again have the same meaning for me.  

There are so many more things I wish we would have said to them.  Things I didn't even think about until writing this post.  We knew the time would come for us to say good-bye.  How do you pick that time?  I am not sure how long it was, but I know the time came.  We knew once the took them out of our room, we couldn't ask for them back. I am glad at that point that we had made the decision to cremate them and bring them home.  For some reason, there was some consolation in knowing that we would be bringing them home.  It was late, I think we both cried ourselves to sleep that night.

We got a call from our doctor the next morning.  Pathology was able to confirm that our babies were sweet, identically beautiful, twin girls.  We already had names picked out and we knew immediately that they were Ruthie Mae Davis and Imogene James Davis, Baby A and Baby B respectively.  

I never imagined we would have two beautiful angels looking down on us from heaven.  We were released from the hospital the next day.  It seemed hard to understand.  How could we be leaving without babies in our arms?  That is not suppose to happen.  There were a few times over the course of the 30 or so hours we were there where you could hear a baby cry.  It was heartbreaking to know that we would never hear our girls cry.  They sent us out the back stairwell, as to avoid any uncomfortable encounters on the way out.  

On the way to the car, I told Jim I wanted to go to the gift shop and get the girls something.  The hospital gave us memory boxes with the girls' blankets, stats, hospital bands, etc... inside.  I wanted to add our own touch.  I wanted to go to the gift shop, they needed a gift.  A welcome to the world gift.  A happy birthday gift.  A you are just as important and a part of our lives as both of our other children gift.  We headed to the gift shop.  

I stood there looking at the shelves full of baby gear.  Nothing seemed right.  I poked around and prayed that something would stand out for me.  I was feeling wrong for wanting to find something so badly when nothing seemed to fit my need.  I turned to the left and looked down.  There, hanging low, were a bunch of initials with little girl angels clinging onto them.  Right there on the front was an R.  I kneeled down and hoped beyond hope that there would be an I.  I looked behind the first one, and there was the I.  I was beaming.  The perfect little gifts for our daughters.

We left the hospital.  Things seemed ok.  Little did I know that I was still in so much shock the hurt hadn't even begun.  Here is my favorite picture of our girls that I currently have.  I am hoping to request more pictures from our ultrasounds.

Friday, July 27, 2012

Our Dreaded News

During our pregnancy I felt like the milestone I needed to get through was our appointment on July 18th.  We were heading to Disney World the next day and we would be 17 weeks.  I really felt like after that appointment we could come back from vacation and tell the world.  Not to mention you just want everything to go ok so that we could relax and enjoy our vacation.

I didn't feel good about the appointment going into it.  I was telling Jim on the way there that I was worried and I didn't want the appointment to ruin vacation.  I couldn't explain it then, I can't explain it now, but I just knew something was wrong.

We headed in for the ultrasound and they asked if we wanted to know the sex.  Sure!  We were excited about that!  They began scanning and Charlotte was going on and on to the ultrasound tech about how we were going to Mommy's doctor's appointment, then going home to clean, then heading to Papa's and we were going to get up in the middle of the night to fly to Disney World.  She could recite that sequence in an instant.

While she was scanning I was watching the screen.  I didn't notice anything right away but I saw her move pretty quickly from one baby to the other and then she turned on the color to look for the blood flow.  I had a sinking feeling when she did that that something was wrong.  They didn't usually do that until much later in the ultrasound.  A minute later she grabbed my arm, looked down at me, and said"I'm going to go ahead and grab the doctor."  I said "it's not good?"  And she replied, "No, it's not".

She left the room and Jim and I looked at each other both knowing what it meant.  I was crushed, but somehow not surprised.  I had that bad feeling heading into the appointment, and think sometimes we know things, even when we don't want to admit them to ourselves.  She came back in and told us she had called the doctor who was heading in.  Apparently she was not yet at the office.  She asked us if we wanted to know what she saw.  All I asked is if it was one, or both.  She said it was both, and that was all we needed.

We had some time before the doctor got there.  I think I was in such shock that I couldn't manage emotion.  I just sat there.  Jim was tearing up and I just kept telling him it was going to be ok.  I had so whole heartedley believed until that point that whatever happened was the thing that was supposed to happen that I was some how hanging in there.  A week out from that I am not sure I agree with what I believed.  I was also absolutely so focused on what losing the babies meant, giving birth to two babies who would not be alive, that I am not sure I had anything to give until I made it through that obstacle.

The doctor arrived and confirmed that indeed, their little hearts were no longer beating.  We headed out of the room and to our doctor's office.  We talked briefly, although I am not sure what we talked about.  She gave Charlotte a shell from her desk, that I remember.  We gathered up the kiddos, walked stoically to the car, and went to McDonalds for breakfast.  I am not sure how that happened.  I think we had promised Charlotte that at some point during the morning, although I am not sure when.  Even so, it gave us a chance to sit and stare at each other while Charlotte climbed, blissfully unaware, through the PlayPlace.

We got home and waited for the call from our regular OB.  She would be the one scheduling the induction, and depending on how long it took, hopefully delivering our babies.  We explained to Charlotte that the schedule she could recite so eloquently that morning had changed.  We explained that we had to wait to go to Disney, because Mommy had to get the babies in her tummy up to heaven.  She later asked something about bringing them home.  I explained that they weren't well, and got to go straight to heaven.  She noted that Oliver came home, and I said that he was healthy when he was born, so he was able to come home, but this time I had to get these babies up to heaven.  "Oh", she said, "then can we go to Disney?"  I bit my cheek to try not to cry, little did I know that would be the first of many, many cheek bites over the next week.

Thursday, July 26, 2012

While Pregnant

Jim and I spent the large majority of our pregnancy being extremely guarded and cautious.  We told very few people we were expecting because the prospect of having to update a large number of people with every doctors appointment and bit of news seemed too much.  Especially because it felt like many of the people we did tell didn't seem to fully understand the gravity of the situation.  We were scared.  Our doctors were very honest with us (something I would not change) and our doctor appointments were trying, mentally and emotionally.  I was desperately seeking someone to understand the fear.  That never happened.

Somehow, even after we knew that the twins were mono mono for sure, we found ourselves starting to get a bit excited.  We had to go to the baby store to get some organic baby food for Oliver for our vacation.  While we were there we looked at cribs, strollers, and what color car seats we wanted to get.  We started getting hopeful and assuming that things would, of course, turn out in the best case scenario.  I mean, thats how things happen right?

We were still scared of the best case scenario, but I would give anything to be in that position right now.  I could be brought to tears thinking about having to leave Charlotte and Oliver for 6-8 weeks.  I was scared of our babies health having to be born so early.  I was absolutely terrified of the thought that Oliver might somehow get "lost" in the shuffle after the babies were home.  He would be just about 1, and with 2 babies to care for and a 3 year old who has no trouble saying, asking, demanding what she wants, we were both scared that Oliver would be the middle man.

There have been times over this last week that I regret having let my guard down and there are times when I am so absolutely thankful that I did take some time to get excited about their arrival, and not just scared.

Mono-Mono Twins

We were about 8 weeks along when our doctor told us she believed the babies to be mono mono.  The most basic explanation of mono-mono twins is that both babies are sharing one gestational sack, one amniotic sack and one placenta.  It is a very rare way to carry twins, occurring in only about 1 in 60,000 twin pregnancies.

There are a lot of risks involved in a mono mono pregnancy.  The main risk is that with both babies moving around in the same space cord entanglements can happen causing one or both of the babies to lose their blood flow.  The fact we were given from our doctor was the babies survive until birth about 50% of the time.  She told us then that if the babies were mono mono, we would likely be hospitalized at 24 weeks so that the babies could be monitored 100% of the time and if they showed distress they could be immediately delivered.  We were told to consider all of our options before seeing the perinatologist the following Tuesday (the day after Memorial Day).

We came home and did as much "research" as we could.  Some tears were shed, we did a lot talking, considering and thinking.  It was a lot to take in.  One of the hardest parts was that there is not a lot of valid medical information out there about mono mono twins because it is so rare.  There were many stories, both good and bad, and we read many of them.  It was all very scary.  The babies are always delivered at about 32 weeks.  Many had health problems from premature birth, NICU stays and more.  Many also ended up being healthy and happy little ones.  There was so much to think about and it was a very long weekend.

Tuesday came and we had no idea what to expect.  I was afraid to even look at the screen at first.  After a little bit time we finally saw it...a membrane!  It was amazing.  From multiple angles there it was.  We both cried happy tears.  When we walked into the perinatologist office she pulled up the picture on her screen, pointed to the line between the babies, and said "That has to be a membrane.  There is nothing else it could be."  Giant sighs of relief.

A membrane meant that the babies were mono-di.  Same gestational sack, separate amniotic sacks.  That was a huge deal because it removed the risk of cord entanglements, however there would be some different concerns as we went along, but those involved things that were still very scary (like twin to twin transfusion syndrome) but they were also fixable and our doctors were committed to keeping us very closely monitored.

We walked out of that office so thankful, yet still very scared about the idea of adding two babies to our family.  Even so it was fantastic to not have to make a difficult decision and to hope that the pregnancy would go much more smoothly.  We spent a little time talking and even decided to book a vacation, to Disney World, because we weren't sure after the babies came when exactly we would be able to do something like that.

The euphoria was relatively short lived.  A couple weeks later, at our next appointment with the perinatologist, they began with the standard ultrasound.  It went on and on and on.  They couldn't find a membrane.  We had 3 different ultrasound techs, plus our specialist, scanning at one point or another.  They scanned internally, externally and every which way.  They couldn't find it.

They were unsure what that meant at that point.  They couldn't make any final decisions just then as to how we were carrying the twins.  There was a chance that they just weren't seeing it because it was may be too wispy and thin.  There was also the chance that it wasn't there.  I was frustrated because the previous appointment the doctor specifically said "there is nothing else it could be".  Suddenly, they said it could have been an echo, or shadow.  We left very frustrated, but hopeful that the next appointment might show the membrane again.
Twin A Heart Rate
Twin B Heart Rate
The Babies
Two weeks later, after an appt. in the middle with our regular OB that didn't show a change, we visited again with the perinatologist.  The ultrasound began and it was evident pretty quickly, definitely no membrane.  In fact, the little babes were kicking each other, something that could never happen in separate sacks.  We marveled at our babies but were definitely sad with the diagnosis.  This definitely meant a hospital stay, for up to two months, before delivering.  It was super hard on me to consider being away from my two kiddos for that long.  We talked about our options and what everything meant.

The first goal was to get to 24 weeks.  That meant that the babies could be "salvageable" as the doctor said.  At that point we would decide on hospitalization, 100% monitoring, and steroid treatments.  Our Dr. called 28 weeks Mount Everest.  If we could just make it there, the hope was far greater that the babies would survive and eventually be healthy.  I asked if they currently saw any cord entanglements. The answer was no, however they couldn't even find the cord that lead to baby B so it was hard to be sure.  We were also reminded that it can change in an instant.  Not seeing entanglements now was no guarantee for subsequent appoints.  We were reminded, again, that the babies make it to birth about 50% of the time.  All we could do at this point was wait, hope and pray that we would make it.

Wednesday, July 25, 2012

When I Thought I Was Busy

It's been quite some time since I have been here.  I was under the assumption that my life was too busy. Oliver had just been born, Charlotte was keeping us very busy (and generally very entertained), coupled with my business and all the blogging I do (or don't do) there I thought focusing on only one blog would be the most beneficial to my time.

As 'busy' as I thought I was, life tail-spinned at the end of April.  Suddenly we found out we were expecting.  Oliver was 5 months old, and here I was, 4 weeks pregnant.  We were in utter shock.  We began worrying, but tried to remain sane.  People had 3 kids all of the time.  Certainly everything would be fine, and I definitely knew I wanted another child, I just never expected it to be so soon.

We warmed to the idea and made the inevitable first doctor's visit to confirm the pregnancy.  Jim had been out of town for business and was on his way back from Kansas City.  It didn't really dawn on me that I might not want to go to the appointment by myself.  It was supposed to go something like:

"Yep, you're pregnant.  You're due December 26th.  Congratulations!"

Instead it went something like this:

"Hmmm....I see something here.  I just want to get my partner to confirm we are both seeing the same thing.  Don't worry.  I just want to make sure that...well...sometimes very early the intestines are outside before they come inside the body, I think I am just going to grab my partner.  I don't want you to worry."

Partner comes in...

"Oh yeah.  I see it.  Hmmmm....let me look, yep I definitely see.  Here is one brain, here is another brain.  Here is one heartbeat, here is another heartbeat."

"Ohmigawd there's 2 in there!  I need my husband here.  I just want my husband!"  All while crying.  Yes, while crying.

Immediately after wrapping up my doctor and I began talking.  There was some concern.  There were 4 basic way to carry twins: very safe, mostly safe, pretty scary and conjoined.  They weren't sure where we were at on that spectrum, but they could only rule out the very safe option.  They asked us to come back in a week because things were still very early.

A week later we headed in for an ultrasound.  We saw both of them.  Moving around, doing their thing.  Definitely two little people in there.  It was surreal.  We were a little bit excited and a little bit scared.  That turned to definitely scared when we went to meet with our doctor.

The good news from our ultrasound was that the twins were not conjoined, something they needed to rule out from the first ultrasound.  The bad news was, our doctor believed them to be monochorionic and monoamniotic, in short, mono mono.