Tubeless and Officially Discharged from the Hospital

It has been a full week since either of our monoamniotic twins has had a feeding tube in her nose. The final medical equipment from their time in the neonatal unit is gone and my babies are just babies. As each cord, wire or tube was removed while we were in the hospital a bit of relief set in. I felt happy that the removal of equipment meant the babies were doing well and happy that it was incrementally easier to hold my babies without fear of hurting them, disconecting monitors or tangling cords. When I took Aviva's feeding tube out last Tuesday and could look at my little girls' faces without funny tubes taped to them, it felt fantastic.

No more tubes means that the girls are eating all they need on their own. They are growing and thriving. Violet weighs just over 6 lbs and Aviva is catching up quickly at about 5.8 lbs. This Tuesday we received our final visit from the neonatal nurse and she officially discharged the girls from the hospital. With a hug and good wishes for our future, Lise walked out of our apartment and closed the hospital chapter of Aviva and Violet's story. (Hopefully permanently)

I am more exhausted now as I am solely responsible for all the feedings, but it's a good kind of exhaustion that only comes with new babies. Soon, we will introduce some bottles and start using our milk supply in the freezer from all the pumping I did before they could eat on their own. It will be nice to have a little more freedom to do things without worrying the girls will go hungry.

Because we are in Denmark, we will have a home health visitor (a nurse trained to work with babies who comes to check on Violet and Aviva every week or so. Unlike in the US, where we had to take Riley out to the pediatrician for check ups when he was really small, here the healthcare professionals come to us as much as possible. I remember having Riley at the pediatrician when he was a few days old and feeling incredibly uncomfortable and nervous about him getting germs from one of the sick kids in the waiting room. The system here is so much better in this way.

As the weather improves and Danes are getting outside and occupying every spec of bare grass in the parks, Aviva, Violet and I are getting out more, too. Hopefully we will get a few more nice days before the rainy summer begins. In a way, it feels like my life is beginning again as I climb out from the shadow of worry that nearly consumed me since last fall. It's nice to feel this way and have it complimented by sunny weather.

One month old

Hooray! We are one month old! (Aviva on the left, Violet in yellow)

My adorable girls are a month old. We have been home with them for two weeks and it has been exhausting but fantastic. The beeps and alarms of the NICU are fading from our memories, we aren't kept awake by other people's screaming kids and we get to have our family together.

Violet and Aviva are still gaining strength and getting bigger. We think they will be eating all their food on their own within a couple weeks and the feeding tubes can finally be a thing of the past.

I am loving being in my own home and with Riley and Neil more. It is crazy to think that I was living at a hospital for nearly nine weeks. I miss some of the midwives who cared for me while I was there, but not enough to move back in.

The reality of being a mom of twins is slowly sinking in. I didn't let myself think about it too much during pregnancy because I wanted to get the babies out alive first. But as we inch toward being finished with the feeding tubes and the nurse visits, we are coming out of being in a rare and perilous situation - monoamniotic twins! Premature babies! Extended stay in the neonatal unit! to being a normal family with newborn twins. Turns out, this isn't very easy. We have three kids under three years old. It is a zoo around here.

The girls eat and get diapers changed every three hours, and until they are done with the feeding tubes, I pump every three hours at different times from their meals. This basically gives me 30 min between things to do things like nap, eat, and shower. It is brutal. And yet, I feel it has all been worth it and will continue to be so as long as I am blessed to be these little girls' mom.

I must now give into my exhaustion and get some sleep.

Gratitude and Going Home

During my nearly nine weeks (NINE WEEKS!!!) in the hospital I have met dozens of amazing health care professionals. From the committed team of midwives who helped find my squirmy babies' heartbeats three times a day for six weeks, to the team of doctors, anesthesiologists and nurses who cared for me during my c-section. From the incredibly gentle and patient NICU nurses, to the pediatricians who saved Violet's life when her lung collapsed and have watched over the girls since they were born.

One of the privileges of being a patient here for so long is that I was able to form relationships with several of the people who have cared for me and the girls. I will truly miss the midwives and nurses here. One of the more special relationships for me and for Neil is with the gifted and committed doctor who watched our girls grow and carefully examined them with twice weekly ultrasounds and then performed the c-section when they were born. Anne Marie is a tall Finnish woman who we first met on a tour of the maternity ward of the hospital when we were deciding if we would stay in Denmark for the pregnancy or move back to the US. Our relationship started out tentatively. We had met many ultrasound doctors already in this pregnancy and at least two of them had offered options to terminate the pregnancy.

Any fears we had about Anne Marie were completely unfounded. She was so kind and so thorough each scan, always checking each girl's blood flow at critical places in her body, all the organs, and of course, the cords. After six weeks and twelve or thirteen lengthy ultrasounds, we knew each other pretty well. During all the measuring and monitoring, Anne Marie would occasionally point out things like hair on the babies heads, good images of their faces and their lungs moving in practice breaths. I got the feeling that not only did Anne Marie understand why I checked into the hospital so early in the pregnancy (26 weeks) but that she also let out a breath of relief each scan when things still looked as good as they could for the babies.

A week or two before the scheduled c-section, Anne Marie told us she would be doing the surgery. We didn't even know she was also a surgeon at that point, but having the doctor who knew the twins best perform the surgery seemed perfect.

I am not sure when exactly Anne Marie worked her way into my heart. Was it during my six weeks of hospital time before the girls were born? Was it the moment when I realized she was invested in the outcome of my pregnancy and was rooting for us? Was it when she safely delivered the girls? Maybe it was when she came to the neonatal unit to check on me and the babies a day or two after the operation? I can't be sure, but at some point I realized how big a part she played in the miracle of our girls' lives. She helped watch over them and then brought them into the world. We could never repay her for all that she has done for our family. But, of course, she wouldn't allow it if we could.

A few nights ago we ran into her and began talking about how incredible it is that the umbilical cords were not entangled when the girls were born and how miraculous the whole pregnancy really was - how week after week there were no problems. As Neil was saying this, I could see that Anne Marie agreed. Her eyes got a little misty. I then tried to thank her and got about halfway through before bursting into tears. (I am sure some of these tears can be blamed on post-partum hormones, but I think I may have cried even if hormones weren't a factor.) She gave me a huge hug.

How do you thank someone like Anne Marie? I have been grappling with this. How do I tell her that she will always be with us, always be a major character in our family's story? I am sure we could have had a fantastic outcome with less personalized medicine. We could have had 12 different ultrasound technicians and a surgeon and still ended up with the same positive result, but the personal connection and continuous care we received here was so much better, its value unquantifiable.

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In other news, after nearly three weeks in the NICU (and a total of almost nine weeks for me in the hospital) we are going home on Saturday!!!! The hospital has a fantastic early release program that allows us to go home and remain there while the girls get stronger and learn to eat on their own. A nurse will visit twice a week to make sure we're on the right track and we get to bring our family together at long last. We are thrilled. It is, of course, a little scary to take on all the night feedings and all the care of the girls, but we are ready.

For several days now (since Monday night, I think), the girls have been off the heart and oxygen monitors that kept them tethered near their beds and are only connected to small hand-held apnea monitors. Today we took them around the hospital to meet some of our favorite midwives and visit an old roommate of mine. Being able to carry our babies around is fantastic as is not worrying about the numbers on the monitors and just focusing on the babies to determine how they are doing.

When we go home we will have the monitors for a few days and then the nurse will visit and remove them! At that point, the only remaining piece of equipment on our babies will be the small feeding tubes that run through their noses to their tummies. Neil learned how to put one in today because the girls have become fond of pulling them out. As soon as Aviva and Violet can eat all that they need to keep growing on their own, the tubes will come out and the nurses will officially discharge the babies from the hospital. Until then, we get lots of support and get to be in our own home.

My own home, with Riley and Neil and Aviva and Violet. (And my mom and dad who are here to help.) I cannot wait...

A week and a day in the Neonatal Intensive Care Unit

So much has happened in the past week that I am not even sure where to begin. I woke up on March 26th feeling trepidatious about having major abdominal surgery and about the well-being of the twins after being born at 32 weeks and 3 days gestation. I was also excited and just wanted the surgery to be on time. Unlike many things in my 6-week hospital stay, the surgery happened promptly at 9:30 in the morning. They wheeled my bed to the operating room, I sat on the table and, after a team of very friendly anestesiologists had numbed me from the middle down, our twins were born almost simultaneously - fitting for two girls who had been sharing the same space for the past 32 weeks.

Other than the relief of hearing two tiny cries and getting to kiss my babies on the heads before the doctors took them to the NICU, I remember a few things about the surgery. One: The doctors and nurses were incredibly kind. They were professional and business-like, and also had unbelieveable bedside manner. I wasn't expecting anyone to be mean to me, but I didn't expect the added level of compassion either. Two: I could not stand the feeling of my legs and feet going numb. It was extremely bothersome to me to be unable to move my lower extremeties and yet somehow still able to feel them. Three: I am pretty positive they were hitting my uterus to make it contract after they sewed it up. This was disturbing.

And then we had babies. I had to spend time in a recovery room regaining my feeling, but as soon as I could competently move my feet, I was wheeled to the NICU to see the twins. Aside from one night in my old room, I have been sleeping beside Aviva and Violet ever since.

It has been a very eventful week. Violet had a collapsed lung her first night which led to a drain in her chest to remove air and a ventilator to help her breathe. It was excruciating to see her lying in her bed in pain (mostly from the drain). Fortunately, her lung healed quickly and within a few days (which felt a bit like an eternity to me) the drain and ventilator were removed. For the past several days she has been breathing room air on her own and her sister Aviva got the annoying CPAP (which puffs air in babies noses to remind them to breathe) removed today. I can now look at both of my babies' faces and see their noses. It has been a really good day.

I think that because I knew these babies would be born early no matter what, I was prepared for a certain amount of blood draws and needle pricks and tubes to help them in the early days. I have been much tougher than I ever thought I could be. I am the mom who broke down in sobs when Riley had to have a heel prick on his thrid or fourth day of life. But being in the NICU is on a whole other level.

It is very warm in our room and nurses and doctors come in at all hours to check on the babies. The lights are always on and many nights the door is left ajar. I am sure my lack of sleep has slowed my c-section recovery a bit, but it is amazing that both Neil and I have been able to sleep here since the babies were born. Our lives have taken on a rhythm of checking oxygen levels and every 3 hour feedings. We have become used to the whirr of the various machines and all the different beeps and other noises.

For all of the commotion and intensity of the NICU, it is also proving to be a very peaceful place. The highlights of my days so far are hours spent holding the babies. As more tubes and wires are removed, it has become easier to hold them together which is pretty fantastic.

Such a weight was lifted from my shoulders on March 26th when my girls were born and no longer in peril in my belly that I think in some ways, I am still floating through my days with relief. Next steps, teach the babies to eat on their own and fatten them up. Then, soon after that, we can finally go home and be a family. That is the day I am longing for most. I hope it will come soon.

Welcome Aviva Juliet and Violet Behira - 3.26.13

We did it! Aviva Juliet and Violet Behira were born on Tuesday the 26th of March. My perfect little monoamniotic girls both came out crying at around 10 in the morning. I survived the c-section (but I much prefer giving birth the other way). And aside from a couple minor setbacks which have since been overcome, the girls are doing very well in the neonatal unit.

The girls' cords were not tangled or knotted. Neil, who saw the babies come out, said the cords crossed over each other a time or two, but once the cords were cut, they quickly untangled. We are so incredibly fortunate.

I keep looking over at my little babies in their bed and being in awe that they were both in my belly and that they are both here with us and beginning to thrive. Having them in our lives is truly a miracle. I am already feeling the exhaustion that will come from caring for two newborns, but I also know it will all be worth it. It has all been worth it already and they have only been here five days.

Tomorrow

Tomorrow morning if all goes well I get to meet my baby girls. It is incredibly hard for me to believe, but it is starting to feel real. Today we had our final ultrasound and met with a maternity ward doctor and an anesthesiologist. I also had a long conversation with a midwife and I think I am as ready as I will ever be to have my body sliced open. It is funny because I know so many women who have had c-sections, and they have all survived and said it wasn't a big deal, but to me it seems like a big deal because I have not experienced anything like it before. I am not totally freaking out, but it will be best for me not to think of it between now and then.

In about two hours, I will have my final monitoring session where we watch both babies' heartbeats for about 30 to 40 minutes. Since checking in on February 11, we have monitored them 128 times. Tonight will mark the 129th heart rate monitoring session of my inpatient stay and we had one session before I checked in making a nice 130 times these babies have been followed on fetal heart rate monitors, 130 times I will have had big straps around my belly securing the ultrasound-gel slathered monitors against my skin. Ah, memories.

We have had approximately 32 ultrasounds during this pregnancy! When we started out and still thought it was a normal one-baby pregnancy, I remember feeling bummed that in Denmark they typically only do two ultrasounds each pregnancy. I certainly did not need to worry about that.

I have gone through two tubes of Locoid 0.1% hydrocortisone cream to keep my PUPPS rash in check. And, as of today, I have been in the hospital for six weeks.

Tonight marks the first night of Passover and Neil, Riley and my mom brought a Seder to the hospital. Considering the fact that we were in a hospital with a 2.5 year old, it was a really nice Passover meal. Yesterday, the Copenhagen Chabbad rabbi, Yitzi, paid me a surprise visit. He gave me some matzah and told me that Passover is a good holiday to have surgery and to have new babies because there is extra protection at this time of year. I am holding onto that idea going into tomorrow morning. (Thank you, Yitzi)

Thanks again to everyone who has been supporting us in a myriad of ways through this whole crazy time. Thanks for your continued good wishes and healing thoughts as we go into tomorrow. It feels almost crazy to take these babies out now, while they are so little and still growing, but I keep reminding myself that from this point on they are safer outside than in. I can't wait to meet them and we will do our best to share news of their birth with all of you soon.

32 weeks! 4 pound babies!

When I wake tomorrow morning I will officially be 32 weeks pregnant with my monoamniotic/monochorionic twins. This has been the goal since we first learned about our precarious pregnancy in early November. To make it to late March, to survive all the gut-wrenching ultrasounds when we didn't know if there would still be two hearts beating, to get through six weeks of hospitalization with close monitoring, to survive my separation from Riley and Neil and my home, all seemed nearly impossible in November. But here we are. We've almost made it.

According to the most recent estimate, both babies are nearly 4 pounds (1800 grams). Hopefully by the time they are born Tuesday morning, they will have packed on a few more grams. This weight exceeds the goal I had of 1500 grams by the time the babies are born. Apparently all the protein I have been choking down has made a difference. And I am sure my nightly ice cream habit that lasted all of December and most of January had to help, too.

I am getting really excited to meet these baby girls. In fact, it seems that most of the staff at the hospital are excited to meet them too. I have really grown to love most of the midwives here. I know some better than others, but they are all fairly fantastic. I feel incredibly fortunate.

The head doctor of the whole maternity department will be doing my c-section along with the amazing doctor who has been doing our twice-weekly ultrasounds since I checked in. We just learned that she doubles as a labor and delivery doctor. I trust and feel good about both doctors. I suppose having a super-rare pregnancy has some benefits, one of them being high level professionals want to be involved in my care.

At this point I would really like to fast forward the next few days, go right past my operation and stop at the point when I get to meet my babies. We don't know how they will be doing, or how soon we will be able to hold them, but hopefully they will be strong and healthy from the start.

 A lot of friends and family have been remarking on how very strong we seem. (We being me, Neil, Riley and my mom). I will not dispute that. This experience has certainly tested my strength and the strength of my family and we are holding up really well. But I would like to confess to some imperfection. Finding the strength to get through this has not been easy and I have not always been a model of positivity and serenity. I spent much of November and the bulk of December watching every stupid romantic comedy on Danish Netflix and playing Plants vs. Zombies on my iPad. I was hiding. I am not proud of this, but it definitely helped me get through. I have not always been as nice as I should have been to my mom or to Neil. I am sure a large part of the reason for my lack of niceness was a need to release some of the stress I have been feeling, but it was unfair of me to release it in that way.

I am pointing these things out because I do not want to paint too rosy a picture of myself during this time. There was lots of crying in the beginning and many an asked but unanswered "Why me?"  The point being, it took a while to find this strength that I now seem to have, it hasn't been easy and I have not always been the best version of myself. I am hopeful that I can maintain my strength and improve upon it as we head towards the NICU chapter of this journey.

Thanks again for all the positive thoughts and kind words. Please keep it up as we head toward Tuesday. Lots of milestones yet to reach, but it is looking good.