Little Miracles

First, THANKS!  We’ve been overwhelmed by your flood of comments/wall posts/messages in the last 36 hours.  This morning I read aloud everything that you all have written so that Lisa could hear all the encouraging things you were sending along – it’s been an incredible celebration!

Second, you want more pictures, right?  I wish that I had some to post, but they’re at the hospital and I’m not.  I left Lisa at the hospital this afternoon so I could sneak home and see the kiddos; we didn’t want them to think we had left them forever. =) I left the camera so that Lisa could take some more pictures and left the computer so that the kids could see her tonight via Skype.  And those were good ideas, except no more pics to post. =( Sorry.  Maybe the next couple updates will have more pictures than words.

Third, I need to explain the title.  In some sense, it’s pretty obvious – it’s what the majority of you have recognized these little girls to be: little miracles.  But there’s more to the story from Monday’s delivery that I haven’t yet shared… and it requires a bit of last week’s story, too.

Many of you know that we started out in Crown Point with our fantastic nurse midwife, Sheryl Behnke.  She was very helpful during the pregnancy with Daylia and coached Lisa through delivery.  We’ve raved to others about her before, and I’m doing it again right now. =)

But when we had the surgery in Cincinnati, we were told that we couldn’t have a nurse midwife; instead, we had to “move up to an MD,” according to the surgeon.  We went a step further and doctored with an MFM – an MD who specializes in maternal fetal medicine (“MFM”).  We had 10 or so weekly ultrasounds/meetings with him in the time between surgery and delivery.

In addition to those weekly ultrasounds, we were also instructed to have a non-stress test (NST) twice every week, beginning at 28 weeks.  Rather than make the long commute to the University of Chicago on Thursdays and Mondays, we merely went to the nurse midwife’s office in Crown Point on Mondays.

And that’s where we had a 9:00 a.m. appointment this past Monday.

We’re glad we didn’t go.  Let me explain.

Last Thursday (the 13^th) we had our regular NST, ultrasound, and doctor appointment in Chicago.  Since we knew that we would likely be checked into the hospital the following Thursday (the 20^th), I asked if we should just come to Chicago for our Monday appointment – I figured it would be worth the drive since we were getting closer to the due date and it would be the only time that we’d have to drive to Chicago twice in one week for appointments.  The advantage to coming to Chicago meant having a higher level of care and being onsite in case we needed to deliver – we’ve heard that high risk babies who are delivered at the hospital where they will stay (as opposed to being airlifted after delivery) do statistically-significantly better than those who are transferred.  Dr. Ismail agreed to have us come to Chicago on Monday, then discussed the possibility of giving Lisa a second set of steroid shots.  He finally decided that he would give the first one Monday (the 17^th) and the second on the next day.  He wanted to keep Lisa overnight after the first one to monitor her blood sugar, because it could spike (because of her gestational diabetes) and cause Lisa to go into labor.  He even talked about doing the set of shots last Thursday/Friday.  We’re thankful he didn’t on those days, because had he done so (and had there been a spike in her blood sugar and ensuing labor) her water could have broken and the vasa previa could have torn, immediately causing the babies to bleed to death.  A big little miracle.

Between this past Friday and Monday, quite a few things happened.  Lisa prepared for two weeks in the hospital and (we can’t lie about it) she probably overdid it.  Making preparations for the hospital stay, maternal nesting (it would be the last time at home before the babies were born), and spending more time with (and taking more care of) the kids were a perfect storm for overdoing it.  We’re thankful that overdoing it didn’t cause her to go into labor, which could have caused the vasa previa to tear and would have immediately caused the babies to bleed to death.  Another big little miracle.

Also between this past Friday and Monday, quite a few phone calls were made.  We were unsure about the wisdom of a second set of steroid shots – call it parental instinct.  We called contacts in Cincinnati (thanks, Dr. Paul!), contacts in Crown Point (thanks, Sheryl!), and anyone else we could think of for advice (thanks, everyone else!) and concluded that we’d be willing to exercise our patient’s option to not have the second set of steroids – lungs are pretty well developed by 34 weeks and there seemed to be little benefit (perhaps even a little harm could be done) with having shots after 34 weeks.  Thankfully, our doctor didn’t push the issue and the residents at the hospital didn’t either – had they done so, we could lost both babies due to a torn vasa previa.

The vasa previa ended up being very severe – I’m not sure how many of you would want to see pictures (our doctor – who is also a professor – made sure I took pictures just to document the severity of it), but let me attempt to describe it: there were two vessels growing into the amniotic sac on A’s (Gloriana’s) side of the placenta, and each one was thicker than a pencil in diameter.  There was another (that hadn’t been seen on ultrasounds) vessel on B’s (Belladia’s) side of the placenta that was just a bit thinner than a pencil in diameter.  Each of those three vessels were about three inches in length.  I can’t remember whether I mentioned this in yesterday’s post, but our doctor told us that if one of the vessels tore, it would only take about two tablespoons of blood loss in each twin for them to lose half of their bodies’ blood volume.  As I said, had Lisa gone into labor, both twins could have bled to death immediately.  A HUGE miracle.

But there’s more.  When we were initially checked into the hospital, we had the attitude of wanting to prolong the pregnancy as much as possible.  I think it was so engrained in our minds that “every week counts, every day counts” that we really believed it.  Plus, Lisa wasn’t showing any signs of labor (not many (any?) contractions), so we figured, “What are the odds that her water would break without showing signs of labor?”  But we thought more about it… and one little interjection may have made a doubly vital difference.  At about 8 p.m., our doctor seemed pretty comfortable about coming back in the morning to perform the c-section.  I used a phrase that he used often in the past few weeks with regard to prolonging the pregnancy; often, he would say, “You could convince me to wait until 36 weeks before delivering the babies.”  I said, “You could convince us to have the surgery tonight if that’s an option.”  “Okay,” he said, “we’ll have the surgery in an hour, I’ll tell the anesthesiologist.” 

What difference could 12 hours have made?  It may have been the difference between life and death for our girls.  In the middle of the surgery, our doctor said, “Lisa, it’s very good that we decided to have the surgery tonight – there’s some blood in the amniotic fluid, which indicates the beginning of placental abruption.”  A quick webMD search shows that a placental abruption is the breaking away of the placenta from the wall of the uterus, and it causes – you guessed it – premature birth.  The blood in the amniotic fluid indicated it could have been very little time – perhaps the hours when Lisa would have sleeping and waiting for the c-section in the morning – just a very little time until the onset of labor and ensuing breaking of her water.  You know what the result would have been; we’d be on the very opposite end of the emotional spectrum right now.  A shake-your-head-in-wonder-and-amazement-of-our-great-God miracle.

Now you know why I ended up sleeping twelve hours on Tuesday night. =) All that emotion and stress and elation adds up.

So, how are these miracles doing now?  Really well.  Bella (baby B – B is for Bella) continues to have a very small amount of oxygen given to her, along with the standard feeding tube, vitals monitors, and IV.  She had an IV into her umbilical cord to start, but now that’s been taken out – that means that we can finally hold her! =) She spent today and yesterday under a spotlight to deal with a little bit of jaundice, which is very normal for preemies.  She’s been sucking on a pacifier, which is a good developmental sign.  She had a bit of Mom’s milk and formula put into her feeding tube for nourishment, but she wasn’t a big fan of the bottle today.  They’ll likely try again tomorrow and may even try a bit of nursing, too.

Glori (or it is “Glory” – hmm, y or an i for the abbreviation?) is a little fireball.  She is still holding her own without any help with oxygen.  She began sucking on a pacifier soon after birth; again, very good news.  They’re deciding still how soon it will be until she tries to nurse.  She’s wearing a blanket to help deal with slight jaundice and looks remarkably like a glowworm – remember those? =) She’s been held quite a bit since yesterday afternoon, and that’s a huge blessing from such a little girl.

Some of you asked about the VSD in Gloriana… it turns our that both girls have a small hole in each of their hearts.  I understand that Gloriana’s is a little bit bigger than Belladia’s, but it sounds like no immediate action is needed; they’ll likely keep an eye on them and see whether surgery is necessary in 3-6 months.  Surgery wouldn’t be a big deal, as it’s rather routine.

The ultrasound of the kidneys (renal ultrasound) was scheduled for later this afternoon, and it will probably be read in the next day or so.  In the meantime, we know that both girls are having wet diapers, so the kidneys (if nothing else) are functioning quite well. =)

How about Lisa?  She’s incredible.  Sometimes guys talk about marrying out of their league, but it’s not an exaggeration for me.  Seriously.  I couldn’t be more proud of her.

Yesterday morning she felt very ill – we figure that the medicine from the c-section affected her quite adversely.  And understandably so – Lisa doesn’t ever take Tylenol at home, and even caffeine makes her a little shaky.  Imagine, then, what happens when you put the strong narcotics of an epidural and the post-surgery morphine into her system.  Of course, she wanted to go see the girls first thing yesterday morning, but the room was spinning so much that she couldn’t get on her feet.  Poor thing.  But she got back to her regular self yesterday afternoon and doted on the girls the rest of the afternoon. =)  (Yes, she “dotes, devoutly dotes,” to quote Shakespeare.)  My parents joined her in that yesterday afternoon, with my sister and grandparents doing so today.  Despite a bit of soreness, Lisa is doing quite well – needless to say, the kids LOVED seeing her on Skype tonight.

As you can tell, we’re cherishing it all.  The plan is for me to rejoin Lisa in the hospital tomorrow, and then I’ll take Lisa home on Friday.  We’ll likely take Lisa’s parents to see the girls on Saturday and figure out a plan to see these girls as often as we can.  As I mentioned earlier, we’re on the extreme end of the emotional spectrum – as our little one’s name implies, God’s glorious grace brings joy.  Thanks for reading (and praying and perpetually smiling and passing on the amazing news) and rejoicing with us.  The over 2000 words in this post just scratch the surface of how great our God is.  Miraculous, isn’t it?