Delivery and hospital stay-the long version

WARNING: This is going to be lengthy and probably contain more information than you really wanted to know. Please try to make it through though, as there are many wonderful moments to share.

Saturday! We all knew the worst case scenario after collecting my urine for 24 hours was that I'd be admitted and have an immediate c-section. However, we were all feeling optimistic. I wasn't feeling bad and had no real symptoms of pre-eclampsia. STE & S were packed and ready for a flight if needed, unfortunately there were not a lot of flight options over the weekend. The last flight out was before I was to even return to the hospital. And the earliest flight the next day wouldn't put them to the hospital until around 11am.

I went in around 8pm Saturday night and got hooked up to the monitors. The babies still looked good, my initial urine dip only showed trace protein and my blood pressure was down and remained in a good range while being monitored for 2 hours. My weight was up 2-3 lbs since the day before, but no one seemed concerned about it. My cervix was still entirely closed and I had only 2 contractions right at the end of my monitoring.

I could hear the nurses talking about my situation and everything continued to remain really positive. Even my exam by the resident doctor led me to believe we were in the clear. I even sent STE a text telling her things looked great and I should be leaving soon.

Then Dr. Chu entered my room. Dr. Chu was the on call doctor for the weekend and had been the doctor to order the 24 hour urine collection the day before. He had gotten the results of my 24 hour collection and he was not pleased. Apparently the urine collection is the most accurate way to diagnose pre-eclampsia and my creatine levels were not good. Also he was not happy about my platelet levels. Friday they had been 210 and Saturday they were down to 180. If they fell below 100 I would have to be put under with general anesthesia rather than a spinal.

Our situation had already been noted in my file, so Dr. Chu was aware that I was hoping for a VBAC and hoping to hold off on delivery until Sunday around noon. Dr. Chu struck me as a very conservative doctor and he really wasn't comfortable doing a trial of labor with my cervix being entirely closed. He really would've preferred to just do an immediate c-section but conceded that we were not at a critical stage, YET. I offered to be monitored in any way necessary and to do anything to try to hold off until the next day, without putting my health in jeopardy.

They moved me into a labor and delivery suite with my own nurse for the night. I agreed to constant fetal monitoring and a continuous supply of mag to control my blood pressure. I spent the evening with a blood pressure cuff, fetal monitors and no food or drink. The last food or drink I'd had was at 7:00 pm on Saturday night, and it was only a bowl of Lucky Charms. They did concede and allow me to 'swish' my mouth with water and then spit it out. I was SO thankful for that concession.

Now, I've heard plenty of stories about how horrible the mag can be. The worst side effect of the mag for me was the hot flashes. They kept my room nice and cool though and my nurse was really wonderful. When I learned I was being admitted I called in Melissa to stay with me and as support in case we had to proceed with a c-section before STE & S could arrive. Brian and the kids had a full day of softball and soccer on Sunday and I knew I'd be OK without him. It had always been our plan for him to be with the kids and I would rely on hospital staff.

By midnight I had begun to contract pretty good. The contractions felt much different from the pitocin induced contractions I'd had with my kids. Mag is also what they use to help stop contractions, so nobody really expected that my contractions would be really effective. They were however becoming increasingly uncomfortable. At some point in the night I received a VERY effective dose of fentanyl. I was immediately able to get some rest. The babies responded appropriately and became more active again as the dose wore off. There were periods of intense contractions and then hours of virtually none.

The weather Sunday morning was not real cooperative. Their initial flight was cancelled, but they were able to get another flight just 30 minutes later. The earliest flight was into San Francisco and then they were going to drive up to Sacramento. It was very rainy, but they made great time. To be fair, I don't believe they got much sleep Saturday night either.

It was such a relief to see them walk through the door. All night I'd been mentally trying to prepare for them not being there and what to do for the babies. Now I didn't have to worry anymore. All decisions would now be up to mom and dad and I just had to 'get through surgery and recover'. It's amazing just how 'real' everything was suddenly becoming. These babies were going to be born within a matter of hours!

Things had gotten pretty busy at the hospital so we had to wait some once STE & S arrived. Within an hour Mom and Dad suited up and we all walked to the operating room. I'd been in bed for over 16 hours with monitors, so I was thankful for the chance to walk a bit before surgery. Mom and Dad were seated outside the OR to wait for me to be ready. We were told it'd be about 30 minutes. At this point we all thought the worst was behind us and the babies would be here soon. I was not nervous about the surgery, but very anxious to see these babies meet their parents.

The head anesthesiologist agreed to let both STE & S into the room. They had every right to only allow person and I am very grateful that they were both able to be there. They had both been there for the birth of P & L and it was only right that they should both be there this time. It was finally time to get things started, only they weren't getting started very smoothly. It took 4-5 tries to get the spinal in a good location. By the time they finally got it where it needed to be I was almost ready to agree to general anesthesia and forgo seeing STE & S meet their babies for the first time. If it hadn't been for the fact that the anesthesiologist said general anesthesia wasn't good for the babies I would've let them do it. It was VERY hard to bend at the angle he wanted for the length of time that was necessary. When we did it with P&L it was a piece of cake and silly me I was expecting it to be easy again. This was the 'head' guy, so it's not like he's never done this before. He admitted that it was one of the toughest times he's ever had (yeah me!).

After almost an hour (rather than 30 minutes) I'm finally on the table, numbed up, getting shaved and a catheter. I immediately start to feel like I need to throw up and that was OK with them. I remember asking "HOW" I was supposed to do that. She told me to just turn my head, that it'd be fine. It seemed odd to me that it would be OK for me to just puke on the operating room floor. They gave me something that quickly took away the nausea and I was fine. They went to put an oxygen mask on my nose and I thought I was going to suffocate. I'm not generally a claustrophobic person, but I could not handle the mask. They put a nose piece in instead and things were much better.

It was finally time to bring in STE & S. It was such a relief for them to be there. It gave me something to focus on and I knew we were FINALLY getting started. Plus STE does a great job of narrating the entire operation for me. I found it comforting with P&L to know what exactly they were doing as it happened. I just love hearing the awe in her voice as she narrates the action. Dr. Chu had agreed to repair my previous scar, so it took a bit longer than P & L's c-section, plus he's just so cautious and methodical about everything he does. Finally I could hear the change in STE's voice and I knew she must be seconds away from meeting her daughter. At 2:06 pm Baby A- "V" came out crying. She was then taken just outside of the OR to be checked and cleaned up. Mom and dad had already agreed that they would both stay to see both babies born. I'm not sure what the hold up was, but at 2:10 with a lot of tugging and twisting, Baby B- "B" was quickly rushed out of the OR. As he left the room he finally cried, but it was a bit scary how quickly he was taken out of the OR. I've been told he didn't stop crying for nearly an hour! It was so reassuring to hear his hearty lungs though. Both babies received an 8 and a 9 on their apgars and neither baby required a NICU visit!!

V weighed in at a whopping 6lbs 5 oz and was the longest and heaviest of the 4 children. B weighed in at 6lbs even and was the shortest of all 4 children (but not by much). It turns out their wasn't really a big size discrepancy between the two of them after all. When the babies were cleaned up STE came back into the OR with the babies co-swaddled so I could see them. I was not really able to see much of the babies' faces due to my position, but the look on STE's face was all I needed! She was in love, again and she would now do everything for those babies.

The anesthesiologist took over narrating for me as they closed me up. I let myself 'drift away' and rest for the remainder of the procedure. It took much longer to close me up this time and I don't really know why. I 'think' it's because Dr. Chu preferred to use stitches rather than staples and I think he was just very meticulous. I guess when I can finally see the scar I'll be thankful. They did 'redose' me twice as I was starting to feel 'something' a few times. This resulted in me being VERY out for the rest of the afternoon.

They wheeled me out to recovery where I let myself just sleep and not worry about anything. I came to a few times, but I don't remember much about that time period. S did come in to see me and gave me the scoop on the babies. It was then that I was reassured of their weights and that neither of them required NICU time. He said STE had been able to nurse them both as she had desired and they were just getting ready to be given a room. Our delivery nurse had acquired a double room for us to share, just like with P & L, although this time we didn't have to wait through a day in a tiny room first. By 6:30 I was finally ready to be wheeled into the room as well. They had been waiting for me to get some feeling back in my legs so I could help 'scoot' from one bed to the other. I was just barely able to help after 4 hours of recovery-I'm thinking I must've gotten a few good doses in my spinal.

Brian and the kids had been planning to come down to visit Sunday night, but I thought it made more sense to wait until Monday after school. I wasn't going to be able to move really Sunday night and the kids had school on Monday. So Sunday night it was just the 5 of us. I wish I could remember many details about the evening, but all I recall is a liquid dinner (with liquid restrictions) and being amazed at how easy STE makes caring for twins look. I'm sure we visited and laughed, but Sunday night is really sketchy in my mind.

The doctor wanted me to stay on the mag for 24 hours after the birth, so I also had to stay on the morphine and keep my catheter. My liquids were also restricted. I was allowed 1 cup of ice every 3 hours, but you can bet I asked for my ice at 3 hours on the dot. I was assured that at 2am my nurse would get me up from bed and let me 'dangle' my legs, but that I wouldn't be allowed up to walk until the following morning. I was very concerned about getting moving quickly this time. With P&L I was in bed for over 24 hours and walking and removing my catheter was the worst part of my recovery. This time it was MUCH easier and I felt a little silly for even worrying about it so much.

I'm not even going to get into the nursing situation other than to say, the delivery nurses were FAR more attentive than the recovery nurses. I believe the babies received good care though, and that's what really matters.

Monday afternoon they took me off the mag and I got to have real food and unlimited liquids for the remainder of my stay. Brian and the kids came to visit in the afternoon. Before the delivery we had all talked about the kids not having to come to the hospital if they didn't want to, that I wouldn't be upset and they'd get to see the babies before they left somehow. So I was very surprised to hear that they both chose to come see me. They looked at the babies, but neither of them really wanted to hold them. The fact that my kids aren't real 'baby people' is part of what makes it OK for me to do a surrogacy. Neither one of them regretted not holding the babies either. They told me about their day at school, as if we always get together at the hospital. They compared things in the room to the room we were in 2 years ago and although they didn't interact much, they were much more comfortable visiting this time.

We ended our second day with a visit from Melissa and Tara. I was feeling pretty good at this point. I'd been taken off the morphine and was put on Vicodin and Motrin. I was also able to move around fairly well. I was no speed racer, but I was moving.

Tuesday morning at 3:30/4, was my absolute low point. I awoke suddenly from a dream and I 'forgot' that things hurt. I had to go to the bathroom VERY badly and I was due for my Vicodin at 4 am. The nurse had not brought me a 2am dose of Motrin. My knee was also very stiff. It hurt so bad to get out of bed and to the bathroom on my own, plus the sink was on the other side of the room. I finally got finished and back in bed by 4. The nurse had assured me she'd bring me my Vicodin at 4. By 4:10 I'd had it and paged her. Apparently she did not hurt as badly as I did. by 5 I was feeling much better when my dr came in to check on me, but that 1 hour was the worst hour of the entire stay! I so surprised to hear my doctor tell me that I could go home if I wanted or I could stay for another day. The part of me that wanted to control when I got my medications wanted to check out immediately, but the realist knew that I might not physically be ready and I should wait until later in the day to make any decisions. Plus, we didn't know if the babies would be discharged or not yet. Obviously if they needed to stay another night than so would I, but the idea of staying without them didn't hold a whole lot of appeal (especially if I was going to get a new roommate).

I can't quite remember when it was said or to whom, but I recall S saying to someone that we would all leave together. "That we were a team." Now, I very much wanted them to be able to get home to P&L as quickly as possible, but to hear S say this was so special and heart warming-although entirely unnecessary. I knew I would have to work hard to convince them to leave before me, so I was pleased to know that the hospital was willing to discharge me if I wanted.

Tuesday I finally braved a shower. S had been thoughtful enough to pick up soft towels from Target that were big enough to dry off with (the hospital towels were tiny and thin). The shower was much easier than I expected and I felt so good afterwards.

We were waiting on a few test results for the babies before they could be discharged. They were concerned about B's weight loss and the possibility of jaundice in both of them. STE had already booked a follow-up appointment with her pediatrician back home for Wednesday morning for continuity of care in the event that they were discharged. Both babies were doing quite well with nursing, V better than B, but even B wasn't really struggling.

The lactation consultant came back to see us for the second time on Tuesday. This was the same woman that helped STE when P&L were born and it was really neat to see some of the same faces and for them to remember who we were. She was so thrilled to hear how wonderfully STE had done nursing P&L and she was so supportive of her efforts. I then got to speak with her about pumping. By Tuesday I was feeling very distraught about my ability to pump. I knew we were getting off on the wrong foot with the Mag and the restricted liquids. I was so afraid I wouldn't be able to get a supply going at all. I wanted to know what I 'really' needed to do to be successful. She assured me that with effort I'd be fine and that I really only needed to pump every 2 1/2 hours and that 15 minutes was more than sufficient. She explained a lot of things to me and gave me confidence that my milk would come in, eventually. By Tuesday I wasn't even getting enough colostrum to put in a syringe for the babies, so I had been really worried. She helped me to decide that a hospital grade pump would be the most effective way of gaining and maintaining a supply and would be worth the extra cost. She said my PISA would work just fine once I was established, but that a month on the Symphony would be the best bet.

The babies have other milk donors and I know I could help them find more milk if needed, but the thought of not being able to pump for them was very disappointing. What good was making it to 37 weeks if I couldn't even give them colostrum? Emotionally I could've really spun out of control without the reassurance I received from the lactation consultant. And for those that don't know, none of the pumping pressure comes from STE or S, it's all self-inflicted. I'm never really happy with a good outcome and always will wonder if I could've done better.

I finally gave the go ahead for visitors on Monday night, and I realize that I didn't leave much time before discharge for anyone to come visit. I really wanted to feel 'settled' before anyone came. Brian's family was very patient about waiting for me to be ready. I wanted to feel stable and I wanted to know that the babies were stable as well. When P&L were born, no one really got to see them, as they weren't stable right away, P was in the NICU and we really didn't have a room. Within hours of getting the go ahead, Brian's parents came to visit. I think it was really nice for them to get some time seeing "WHY" I chose to be a part of this family. It's been a while since we had little babies around, and I think my MIL really enjoyed holding V&B. Then my SIL and nephews came down with Brian. My nephews LOVE babies and really seemed to enjoy holding V&B. My SIL is very much a baby person and immediately jumped in to help and hold the babes.

While we had visitors the babies received their walking papers. My SIL was very helpful in getting everyone ready and out the door. She helped walk them to the car and it was really nice to have an extra pair of hands at that time. Of course there were the tears and hugs as we all parted, but I'm going to gloss right over all of that and skip to the two things that were done that surprised and touched me deeply. A few minutes after everyone had left I received a phone call from STE to let me know they were on the road and to make sure I was really OK with them leaving. A few minutes after that my SIL returned to my room. Apparently she had been asked to check on me just to make sure I was really OK. These are the sort of thoughtful gestures that really show just how much they care about me and my emotional well being.

After P&L were born I had been really caught off guard by these types of gestures. I really didn't know what to expect at that point and I was really touched by how concerned they were for me at a time in their lives that should've been all about them and the babies. So, I really thought I had prepared myself to not be surprised by their thoughtfulness. It was such a little thing to do, but it meant the world to me.

I'm not surprised this time when STE takes time from her day, each day, to call and touch bases with me, but I am still very thankful. We were all strangers when we first set out to create life together, and there are so many things that could've gone wrong. Brian and I are both so thankful and grateful that we are one of the lucky ones. We've been touched beyond expectation and welcomed into such a wonderful extended family. The only downside is we will never be able to spend as much time with them as we'd like, but we do know that they will be a part of our family forever.

Check back for an emotional outpouring of a post.