I See The Light!

Kendall is close to coming home.  Her last day of antibiotics is Friday so, unless she experiences another complication, she'll be discharged on Saturday.

She is looking better with each day, eating and gaining weight.  She was 5.7 lbs yesterday morning. They did another ultrasound of her leg and the blood clot is still there but it showed there is more blood flow getting through the vein so it's getting better.  She has been holding her temperature consistently over the last 2 days.

After all of the fuss in my last post, I haven't received any additional information on her "swallow study" or any results from the "blood doctor".  Were they just looking to cash in with my insurance company?  I'll have to remember to ask her attending doctor this afternoon.

Here's a few pictures that we took of Kendall the other night.  Sorry for the quality, they were taken with a cell phone.

And, I would be a bad mommy if I didn't include a few pictures of Christopher.  He's doing great and weighed exactly 6 pounds at the pediatrician's last week.

I Cry "Uncle"

I'm tired of going to the hospital.  I just want my baby girl to come home. Every time we go, another potential problem is explained to us. 

They removed the central IV line the other night and we're hoping the smaller peripheral IV will continue to work for the next 7 days so we can continue her antibiotics and fluids.  Her leg looked a little better to me but it's still pretty swollen. 

They also decided to do an ultrasound of her head and found a small, Grade 1 brain bleed.  I know it is common in preemies but for the love of God, can we get a freakin' break?  The doctors don't seem overly concerned about it and said they don't expect any long-term effects.  There's no treatment so I guess it just stops bleeding on its own?

While I was visiting her last night, someone from speech therapy came in to evaluate her feeding.  They are concerned she might be aspirating (food going into her lungs) while she eats.  Personally, I think they are starting to overevaluate things at this point.  They called in the consult a few days ago because she wasn't eating that great.

Uh, duh?  She's been sick?  Who the hell eats when they are sick?

Since then, she has picked it up and has been taking about 2 oz at every feeding.  So now, they are recommending a swallow study for Monday.  They'll put barium in her milk and track where the fluid goes when she eats.

And then last night while she was being evaluated for that, another doctor comes in and introduces himself as the "blood doctor".  They are also concerned she might have a clotting disorder called Thombophilia because the clot in her leg developed so quickly.

When I asked the doctor if clotting after that procedure was extremely uncommon, he said "no".   I'm thinking, "Then why are you here"?  We have no family history of blood disorders and according to the March of Dimes website, that condition only occurs in about 2% of the population.

I guess I'm starting to get a little aggrevated.  I know they are only looking out for Kendall's health and best interests but it would be nice to go for a visit and not have another doctor telling me that something else could be wrong with her.

On the brightside, she is now in an open-air crib again and got moved back down to the regular pediatric unit.  She looked good last night and was the most active and alert that I've seen her since this started.  I even got a few smiles.

God, I love those smiles.

New Update on Kendall

I decided to change the look of my blog.  Ever since I changed it last time, it seems like I've had nothing but bad luck.  Maybe this will help change my luck?

Kendall is still stable.  She was still having a hard time regulating her body temperature so they moved her to the Intermediate Care Unit and placed her in an isolette (incubator).  As of 8 am this morning, she was doing better with her temperature.

The spinal fluid that was taken the other night did not grow any bacteria so it appears that we now have the meningitis in check.  Her antibiotic may be decreased to just penicillin today.  She is eating again and took 2 oz of formula at 2 am, another 20 mL at 3 am and then another 2 oz at 5 am.  Wonderful news that she's eating!

There were some new developments over night though.  A small blood clot has developed at the end of the IV and they are monitoring it closely.  Her leg is really swollen but the IV line is still open and her circulation to the leg and foot is still good.  If things worsen, they will pull the IV line.  If that happens, she'll have to have another line surgically inserted and that's not what we want to have happen (especially if yesterday's episode was related to sedation).

She also received a blood transfusion last night.  The doctor explained that preemies aren't that great at making blood and when they are sick, it's even harder.  Her red blood cell count has been in the low-normal range since she was admitted so, they gave her 40 cc of blood to re-oxygenate her. 

I did manage to get some sleep last night, or at least the most that I could.  I slept from 11:30 pm - 1:00 am, 2:30 am - 5:00 am and 6:00 am - 8:00 am.  It's not consecutive hours but it's still sleep.

DH & I will head up to the hospital this afternoon.  My sister has offered to watch Christopher so we can both visit her together.  Please continue to pray for my little angel.

One Step Forward and One Step Back

Kendall had her central IV line inserted today and it required sedation.  She did fine during the procedure and recovered well.  I left the hospital around 12:30 so I could get Christopher to his doctor's appointment and just as I was pulling in front of my house, the hospital called.

Kendall had another "breathing episode" right after I left.  Her heart rate, blood pressure and respirations dropped suddenly.  The doctor said they were still investigating and trying to figure out what was going on but warned me that she might be moved back to the ICU.  Her body temperature also dropped all the way down to 92.  That's lower than what it was when she got first got admitted.

I immediately burst into tears.  I don't know how much more of this I can take.  She is so little and has already endured so much.  I just want my baby to come home.

I called the doctor back about 30 minutes later and they placed her in a warming bed and got her body temperature back up.  He also suspected that she had a reaction to the medicine used to sedate her and he administered some meds to reverse the effects.  He said once he did that, she pinked up, perked up and started crying.

As of 5pm EST, she was still stable and was able to take 1 oz of formula so hopefully this was a temporary setback and she'll be back to recovering.

We did get some good news on Christopher.  His labwork came back normal so as of today, he does not appear to be infected.  He also made some significant progress with his weight gain and weighed exactly 6 lbs today.  Such a big boy!

I'm feeling so torn.  I feel like I need to stay with her at the hospital but I also feel guilty for leaving Christopher.  I feel guilty for being able to hold, hug and kiss Christopher while she's still so sick.  If there were a way to clone myself, I'd be first in line.  I'm operating on fumes at this point.  I'm fortunate to get 3 hours of sleep a day and my life is based in 3-4 hour increments.  I'm living for the next task - pumping, feeding, driving to the hospital.  I didn't eat anything today until 4:00. I'm so tired but I can't spare the time to sleep.  I have to keep going for my babies.

Your Prayers Are Working!

Thank you so much to everyone for your thoughts and prayers.  They are working!

Kendall was moved out of the PICU last night and into a regular bed in the pediatrics ward.  Her vitals have remained stable and she is now off oxygen.  She's still getting 2 antibiotics every 6  hours.  Her color has come back now but I can tell she still isn't herself.  She's 1,000 times better than Friday night but it's only been 4 days and she still seems weak and fussy.

Our biggest obstacle right now is keeping an IV in tact.  When she was admitted, they put the IV in her arm but that fell out last night.  The doctor explained to me they like to insert a PICC line when they expect to do fluids and/or antibiotics for an extended period of time.  We know she'll be on antibiotics for at least 2 weeks.  A PICC line is another IV line that is inserted in the arm and feeds into a larger vein in the chest, near the heart. The PICC team evaluated her and said she wasn't a candidate because her veins are too small.  They consulted with the NICU but it sounds like they are completely overwhelmed and didn't want to "treat" a patient that wasn't in their area (risk of infection, taking something back from Peds to the NICU, etc.). 

So, tomorrow morning, they will do another procedure that will be similar to a PICC line and they're hoping to insert a line near her subclavian vein or in her groin.  They will need to sedate her so she doesn't move during the procedure but there shouldn't be any major complications from it.

I still don't have a timeline for when she might come home.  At one point, the doctor said if they could get the PICC line in, she could potentially come home on Saturday and they would let us administer the 2nd week of antibiotics from home.  With this other line, I don't know if that's still a possibility.

They also did another spinal tap last night to see if the fluid is becoming sterile and is clear of bacteria.  As of this afternoon, it wasn't growing anything but the doctor said it's not conclusive until closer to 48 hours so we should know something by tomorrow morning or afternoon.  If the fluid is sterile, she'll go down to one antibiotic which will mean less blood draws and less fluid being pushed through the IV.

The highlight of my day yesterday was the doctor's response to my question, "Do you expect her to have any long-term effects"?  He said he thinks we caught it early enough and that they've been able to stay ahead of it so he thinks she'll make a full recovery with no side effects.  Of course, only time will tell if he's right but it was reassuring nonetheless.

We've been keeping a close eye on Christopher since we don't know if Kendall got the Strep B from me or environmentally.  So far, he hasn't shown any symptoms.  We did have some baseline blood drawn on Monday and we should get the results of that tomorrow. Since we haven't heard anything by now, I'm assuming it came back fine. 

I definitely feel like I have been initiated into the world of motherhood.  But, seriously?  We couldn't get a cold or ear infection first?! It had to be a life-threatening infection? 

I hope I NEVER have to endure another night like that night.  The feelings of helplessness and fear were overwhelming.  She was so sick and I couldn't help her.  Thank God for the doctors and nurses that were in the ER that night.  They recognized it was an infection within 20 minutes of seeing her and started her on antibiotics immediately.  I'm convinced that saved her life.

My Worst Nightmare

Kendall is sick.  Really sick.  She's in the Pediatric Intensive Care Unit (PICU) with bacterial meningitis caused by Group B Strep. 

For right now, she is stable but not out of the woods yet.  If she makes it through this, she may still be faced with some other complications like hearing loss or learning disabilities.  We're hoping we caught it in time and she'll make a full recovery.

Please pray for my little Kendall.

Birth Story and Thankful

Now that things have calmed down a bit, I've had some time to reflect on the events of the past 3 weeks.  I hinted at my birth story when I announced the twins' arrival but I still haven't given details.  So, here goes:

I noticed an increase in Braxton-Hicks contractions starting Thursday, 10/01.  I was generally uncomfortable with some pelvic pressure and lower back ache.  I knew Christopher was lying really low so I just figured it was him pressing on my bladder.  I decided to take the following day off from work but I woke up feeling better.

That Saturday, I spent the day with my family at my sister's house and still felt fine all day.  Sunday, the pelvic pressure and back ache returned but it was intermittent.  The one change I did notice was that I constantly felt like I had to pee but when I tried to go, it was barely worth the effort.  As the day went on, the back ache became a little more uncomfortable but not unbearable.  I still didn't think anything of the "symptoms" and figured I had reached that point of pregnancy where I was going to miserable.

Around 4:30 pm, I got up to go to the bathroom (again) and again, barely anything.  I leaned forward to make sure my bladder was empty and started peeing like crazy.  Like I drank a 6-pack and held it for 10 days.  After a minute, I thought, "What in the world?!"  so I looked in the water and it was bright red.

Thank God I knew about the placenta previa so I wasn't caught completely off-guard but it still scared the crap out of me.  It was a lot of blood.

I opened the bathroom door and yelled to DH, "I need you to grab a pad - I'm bleeding and I think my water just broke - we're going to the hospital NOW!"

We were out the door in 5 minutes and walking through the hospital doors within 10 minutes.  I was taken to a Triage room where I was hooked up to monitors to track the babies' heart rates.  I was most worried about Christopher.  Was there fluid left around him?  Was his placenta detaching?   The nurse announced they both looked good but I was still so scared.  She kept saying, "It's going to be OK.  They are 32 weeks and they'll be fine."

At that point, I wasn't having any contractions but still feeling the pelvic pressure.  They ordered an ultrasound to measure the fluid and to view the placenta previa.  Christopher's head was in the way of viewing the placenta so they had a really hard time telling whether I was just bleeding or if my water really broke.  Since I was diagnosed with a complete previa, my water shouldn't have broken so the doctor was really confused.  They finally had to do a transvaginal u/s and could see that the previa was partial and that my cervix had dilated enough for my water to break.  Once they figured that out, I was admitted to the hospital.

During the ultrasound, I noticed some cramping and the back ache came back but it wasn't bad.  On a scale of 1-10, I gave it a 2.  The doctor said it was normal when bleeding occurs and he thought it would subside.  I was wheeled to a permanent room and he told me that I was now on complete bed rest and that I wouldn't be leaving the hospital until I delivered.  He wanted to try to make it to 34 weeks and would only do a c-section if 1) I went into labor, 2) I developed an infection or 3) the babies became distressed.

About an hour after he left, the contractions started picking up.  The nurse came in and asked, "Are you feeling all of those contractions?".  I said, "yes" and she said, "You're really knocking them out - you're having them every 1-2 minutes".  At that point, I was rating them a 6-7 on a scale of 10.  They continued to monitor me for another 30 minutes or so and then the nurse said she was going to call the doctor back - it was obvious that it wasn't going away.  She came back a few minutes later and said we were doing the c-section in 30 minutes.

I was wheeled into the operating room and given the epidural.  Todd came in about 10 minutes later and they got started.  Within minutes, I heard Christopher crying and I looked at Todd and said, "That's the best sound ever".  A minute later, we heard Kendall.  Todd got up and went over to their cribs and I was trying to see them but all of these people were in the way and I had a sheet pulled up that was about 2 inches from my nose.

At that point, I thought everything was still going according to plan. I heard the doctor say, "Suction, please" and then about 5 minutes later, he said, "I need a mop, 2 units of blood and my hysterectomy kit."  I heard it but still didn't think anything was wrong.  Everyone in the room stayed very calm.  I could only see the anesthesiologist so I finally asked, "Am I having a hysterectomy?".  He said, "yes, you've had some complications and lost a lot of blood".  Then, I heard him say, "Her blood pressure is 80/30" and he named about 4 different medications that he needed plus another unit of blood.

About that time, I started shaking really bad and felt really cold.  I tried and tried to stop shaking but I couldn't.  And then I got really sleepy.  I remember the anesthesiologist asking how I was feeling and I said, "I feel really sleepy.  Can I go to sleep?" and then I was sort of in and out.  I remember another anesthesiologist coming into the room to help and he put another IV in my hand to start the blood transfusion.  I remember asking if the epidural was still working and that gave the anesthesiologist quite a laugh.  Clearly, it was.

It seemed like I layed on the operating table forever.  And, then it was done and I was moved to a bed and taken to recovery.  I stayed in recovery for 2 hours and they kept checking to see if the epidural was wearing off.  The nurse would take a pin and start at my neck and ask, "Can you feel that?" and then work her way down until I couldn't feel it.   I have to say that it is the weirdest feeling.  She kept asking if I could move my feet and I would try really hard but nothing would happen. 

At that point, I still didn't know the severity of what happened.  Everyone who saw me kept saying that I lost a lot of blood but I didn't really know what that meant.  I continued to get blood throughout the night and was closely monitored every 30 minutes.

The next morning, the doctor came in to check on me and gave me more details.  The placenta previa was a placenta accreta and had implanted so deeply in my uterine wall that it became intertwined with my blood vessels.  When he tried to remove it, he cut into my blood vessels and that's when I hemorrhaged. He apologized for having to do the hysterectomy and said, "I had to do it to save your life" and then he told me the average person has 5,000 cc of blood and I lost 2,500 in about 20 minutes. 

The hysterectomy part of it hasn't bothered me.  I mentioned before that we decided we were done trying to conceive after the last cycle, regardless of whether I got pregnant.  He left my ovaries and cervix so I shouldn't need any hormone support.  I just won't have any more periods.  Who could get mad at that?

I never thought in a million years that the delivery would go the way it did.  The words, "to save your life" have haunted me.  I'm so thankful to have healthy kids and to be here.  I've heard of people dying during childbirth but always thought, "How does that happen?".  Now I know. 

Thinking that things could have gone differently plays in my mind and I can't imagine not being here to see the babies smile. 

I'm just so thankful.