This was my alarm this morning.
It’s not my birthday. My birthday was in January. It was a bit of a doozy.
It is, however, Alice and Celia’s birthday, and I guess when you’re three and it’s not only your birthday, but also your sister’s, it seems like it must be everyone else’s too.
About this time, three years ago, I was lying in my perinatologist’s office (that’s a fancy word for really expensive OB that you get to go to if you have a complicated pregnancy; two babies in one placenta is considered complicated, by the way) listening to the tech tell me that my babies were measuring at slightly different sizes. Up until that appointment they had always measured within an ounce of each other, but now there appeared to be about half a pound difference between them. This was concerning because it indicated that the twins could be developing Twin to Twin Transfusion Syndrome, a potentially life-threatening complication of identical twins where one baby “donates” all her blood and nutrition to the other baby. Because the babies were only slightly different sizes, the tech thought I’d probably just be monitored more frequently (I was already going once a week) though the ultimate decision was up to the doctor.
Oh the doctor. She was not my favorite. The day we met, she asked if these twins would be my first children. I said, oh no, I had three others: 8, 5, and 9 months.
“Nine months?! Oh no! That poor baby, she’s about to have her whole world turned upside down!” she exclaimed.
I wanted to turn the doctor upside down. Seriously, who says something like that to a terrified pregnant woman? Didn’t this doctor deal with hormonal women everyday? Where was her bedside manner? I had yet to learn that it was a common deficit in specialized medicine. Not to worry, I’d soon be schooled.
Anyway, on March 27th, 2012, Dr. Dumbass walked in and asked me how I felt. I felt tired. I felt huge. I had carpal tunnel in both hands and had to drive using my wrists. My ankles were as big as my knees. This was way too long an answer so I just said, “Well, I’m 34 weeks pregnant with twins. I feel like shit.”
Whoops. I’d spend the next two weeks wishing I’d held my tongue.
The doctor decided I looked like shit too. Thanks. She said my face was puffy. It wasn’t. She said she was worried I had preeclampsia even though my blood pressure was normal. I didn’t. She said she was calling my OB so we could “have babies today!!! Aren’t you excited?!” Um. No.
I went directly to my regular OB’s office where they hooked me up to the monitors and I tried to talk my way out of delivering six weeks early. My wonderful doctor wasn’t concerned about me. She listened to me explain that I didn’t trust the perinatologist, that I didn’t really feel that bad, that my husband was in the middle of the last week of filming The Importance of Being Earnest and it would nearly impossible for him to get away, that my mother wasn’t even in town yet. She said she thought we could wait. I stopped freaking out.
I was a little too late. According to the monitor, I was in labor.
At 9:16pm she began the C-section. I was terrified. Earlier that morning both babies had been head down and Dr. Amazing gave me the option of a vaginal delivery or a Cesarian. I flipped, I flopped. I had always planned on a well-medicated vaginal delivery, but I had also counted on being full term. I asked her what she would do if she were me. Reticently, she confessed she’d go with the surgery because it reduced the variables.
That’s what I did. Thank God.
Baby A, Alice, was head down and delivered at 9:17pm. Baby B, Celia, had flipped during the day and was wedged in under my ribcage so tightly that it took both the doctor and an assistant a full 60 seconds to tug her free.
Suddenly, I was the mother of five. At least I thought so. I couldn’t see them. Both babies had a cloud of neonatologists swarming around them. Mike held his phone over his head, pointed roughly in their direction, and took a few shots. We didn’t look at the pictures right away. Turns out that was for the best.
The next thing I knew, everyone was running out of the room pushing the baby carts. It looked like something from TV.
I was confused. I was scared. But thank goodness a nice doctor came and stood by my head to reassure me. She said,
“Your babies are not doing nearly as well as we would expect them to be doing. We are taking them to the NICU to see if there is anything we can do to help them. Right now they are as blue as squid.”
Yes she did.
I know this because I asked, just to be sure the drugs weren’t screwing with my hearing.
“I’m sorry, did you just tell me that my babies are as blue as squid? What?”
And she said, “I just call it like I see it.”
I told you I’d be schooled.
If we had looked at the pictures Mike was taking, this is what we would have seen:
That, my friends, is infant CPR in action.
I assumed that this woman was telling me it was hopeless, that my babies were going to die. She’d done everything but come right out and say it. After all, she was a neonatologist, she dealt with situations like this everyday. She knew what the chances were and she wasn’t sure they could be helped. I told myself that if she was blunt and harsh, it was because she was trying to prepare me for the brutal truth. I tried to be grateful for her honesty. I should’ve just allowed myself to be mad. After all, if someone is about to lose two babies, she deserves a little more tact than a flippant comparison to sea creatures.
Alice and Celia, who did not die, were intubated overnight and treated with surfactants. That basically means the doctors (all the rest of whom were wonderful and sweet, by the way) sprayed some medical version of Pam into their lungs so the little air sacs (alveoli) could inflate without sticking together and therefore allow them to breathe. This is very common. The survival rate is excellent. One of the nurses told me this. It was the same sweet nurse who told me that my babies’ bruised feet were probably just the result of some minor birth trauma and would heal quickly, and thereby shielded my exhausted, terrified self from learning the truth until later: smacking a baby’s feet is the first step of infant resuscitation.
I wasn’t allowed to see them until the next day, but when I did, this is what I saw:
They were big (5 lbs. 11oz and 6 lbs.) but their little lungs just weren’t developed. Later, someone told me that most twins at 34 weeks have fully functioning lungs because the stress of the environment causes them to develop at an accelerated rate. My girls had just been too laid back. They weren’t under enough pressure. Ha!
Today, they are still pretty laid back. After all, they are more than willing to share their birthday with everyone they meet. So, from Alice and Celia, my new three-year-olds, here’s a short slideshow of those first few days. If you happen to be expecting to have premature identical twins by emergency C-section (or you know, you’re just curious) it’s a pretty good overview of the highs and lows of the NICU, and it’s a darn good song.