Oh my goodness, Twins!!! (August 2015)

     I was about 20 weeks pregnant when I went to my first pregnancy appointment with my OB.  Since this was my sixth pregnancy, I felt like I knew what to expect, so didn’t feel the need to make any appointments earlier in the pregnancy.  My doctor joked with me about my being too busy to bother with appointments, since I work full time.  I complained to her about my new health insurance, which had a high deductible, so she commented that we’ll have to make sure this is a vaginal delivery (cheaper than a c-section), and I remember thinking, “Of course it will be vaginal, all of my others were...”  Then she started doing the ultrasound scan, and she turned to me and said, “There’s two”, and I responded, “You’re joking, right?”, thinking that she was teasing me.  She turned the monitor to me so I could see the two fetuses, at which point I said “But, twins don’t run in my family”.  “They’re identical; it’s not genetic, just chance” was her reply.  I was so surprised, I think I said “But it should be genetic!”  As my doctor kept scanning, her entire demeanor changed from the light, friendly attitude, to a very serious one.  She told me that she didn’t see a dividing membrane, but at that point, I really had no idea what the implications of that were.  She hurried me out of her room and called a maternal fetal specialist for me, and got me an appointment the next day for the 20 week detailed anatomy scan.

     I went to the anatomy scan blissfully unaware of the high risks of my pregnancy.  After a long appointment, during which both fetuses were scanned very carefully and were thank God found to healthy and defect-free, the doctor came in and explained in a very matter-of-fact manner that my twins were monochorionic monoamniotic, which is high risk for cord entanglement that can lead to fetal death, and if one twin dies in utero, that frequently causes brain damage to the other twin.  He told me there is no treatment or “fix”, we just monitor weekly until ~28 weeks, at which point in-patient monitoring is recommended, and that delivery is via c-section between 32-34 weeks.  I remember my head was kind of in a whirl after the appointment.  I went out to my car, called my husband, and told him the whole thing.  Then, wanting to share with someone else, but not yet ready to freak out my mother, I called my friend, who happens to be a nurse.  We talked, and I was feeling a little better, until I checked out a link that she had emailed to me, which quoted a 40-50% fetal mortality rate.  That’s when I remember that it really hit me, “Oh my goodness, my babies can really die in utero at any second!”  I spent the rest of the day, although I was at work, googling monoamniotic twins.  I also read a lot of case studies and articles published in medical journals, since I have access to those via my workplace.

     For the next eight weeks, I went to weekly ultrasounds, praying each time that the babies would be alive.  At 28 weeks, I checked in to the hospital for in patient fetal heart rate monitoring.  It was really weird checking in to the hospital, since I felt totally healthy, and wasn’t in labor, so it felt wrong to be in a hospital.  But I kept reminding myself that this isn’t for me, it’s for the babies.  Initially, I was on intermittent monitoring for one hour, three times a day.  Every evening I would pray that my babies would survive through the night, and every morning, when the heart beats were found on the monitor, I would thank God that they were alive.  I also had weekly ultrasounds in the hospital, and got steroid shots when I first arrived.

     Although it was much more comfortable to be monitored only three times a day for one hour, I didn’t completely understand how that would help if the babies were in distress at some off-monitor time, and I had lengthy discussions with my OB and the specialists about whether cord knotting is sudden, or are there detectable signs of fetal distress prior to something catastrophic.  The difficulty is that since monoamniotic twins are so rare, there’s just not a lot of data.  Also, my specialist group had three doctors, and each had a slightly different opinion, which added to my confusion.  One felt that the way the cords were tangled in my particular case, which was a big ball, not a long twisted braid, was actually more favorable, and he felt one hour 3x a day was sufficient.  Another doctor felt, the more monitoring the better.  I actually found out that my friend’s cousin had monoamniotic twins a few years ago, and I spoke to her to hear her experience.  She was in a top hospital in NY, with a top doctor, and she was monitored basically 24/7, with only 5 minute breaks here and there for bathroom, etc.  Hearing that actually made me more nervous, since it seemed like my monitoring protocol was too lax relative to that!  In the end, my OB and I settled on as much monitoring as I could tolerate, with freedom to unplug whenever I wanted, for however long, and no monitoring at night.  I kept myself busy with lots of reading, talking on the phone, surfing the web, and praying.

It was really hard being in the hospital away from my husband and kids, and I missed them terribly, especially at nights.  They came twice a week to visit, but when they left, it exacerbated the loneliness.  They would call me every evening, and I would read them a bedtime story that I found online.  That was my virtual parenting, and I even told the nurses that I coined a new term “teleparenting”.

     After I passed the 29, then 30 week mark uneventfully, thank God, I started pressuring my OB about a decision as to whether to deliver at 32 or 34 weeks.  She wanted a wait and see approach, but I’m very goal oriented, and needed a date to look forward to.  My OB pretty much left it up to me, so I asked for a consult with the neonatologist to hear about the difference, both short and long term, between a “32 weeker” and a “34 weeker”.  In the middle of the consult, when I was 31 weeks, Baby B began to have decelerations.   There’s nothing as nerve wracking as hearing from the monitor the sound of your baby’s heart rate drop.  The nurse rushed in, put me on oxygen, rolled me on my side, and was grabbing for the phone to call the attendant OB.  I remember thinking “Oh my, it’s too early, I’m not ready!” and praying to God that my babies stay in a little longer.  After a tense minute or so, Baby B’s hear rate picked back up.  I was put on IV to increase fluid intake, and remained on the monitor the rest of the day.  Thank God, both babies heart rates looked fine for the rest of the entire day, so the decision was made not to deliver.  Based in the discussion with the neonatologist, and after reading whatever relevant journal articles I could find, my OB and I kind of settled on delivery at 33 weeks.

     At 32 weeks, I got another round of steroid shots.  The next day I had an ultrasound, and though the heart rates and blood flow looked OK, both babies appeared to be sleeping, as there was no movement, and no visible chest rise indicating breathing.  We waited about 40 minutes, which is the typical in utero “nap time”, and we prodded and vibrated, but got only minimal movements.  The specialist concluded that since the main risk in my case was cord entanglement, and blood flow and heart rate look good, we don’t need to be concerned.  He mentioned something about steroid shots potentially making the fetuses sleepy, so he dismissed me back to my room.  The heart rate tracings for the rest of the day were in the right range, but had much less variability (rises and falls) than before, which isn’t a good sign.  I went to sleep praying that my babies will be OK.

The next morning, at 32 weeks and 4 days, the specialist turned up in my room with the portable ultrasound machine.  I remember thinking, “Wait, you said yesterday that you weren’t concerned, so why are you here now?”.  He scanned me, and it was much the same as the day before - good heart rates and blood flow, but minor movement and no breathing.  Again, he reached the same conclusion as before, and left.  About an hour later, Baby B had a decel, and I was rolled on my side and put on oxygen.  At this point, my OB was getting worried about the whole situation, and decided that was it, I was being delivered.  I remember thinking “wait, we wanted to get to 33 weeks, it’s still early!”, but I trusted her call.  

     I called my husband and informed him that they wanted to deliver me now.  He didn’t realize that now meant “now”, and by the time he dropped off the kids at various locations, he arrived after the delivery.  Meanwhile, I was prepped for a c-section, given some terrible tasting antacid to drink, since I had eaten lunch (a no-no for anesthesia, but we hadn’t planned on delivering today!), then rushed into the OR for delivery.  Everything was super quick, and within the same minute, doctors delivered two 3 lb. baby girls.  I didn’t hear the babies cry, and wasn’t given the babies to see or hold, so I was a little concerned.  At that point, my husband showed up, and told me that the neonatologists said the babies seemed “stunned” and not very responsive.  Both babies had very low initial APGAR scores (I think 1 and 2), and were put on CPAP right away.  Later, I was wheeled in to the NICU to see them in their isolettes- it was so hard not being able to hold them after the whole stressful pregnancy!

    The next morning, I got the report from the neonatologist, and thank God, both girls had perked up after their first few hours of life, and become more responsive.  At one point during the night, they thought they might have to intubate Baby A, but then she started breathing OK again with the CPAP.  After about 2 days on CPAP, they were switched to room air.  After a head ultrasound at two days of age, I was finally able to “kangaroo” them, though only one at a time.  They stayed in the NICU for only two and a half weeks to learn how to feed and gain weight.  They went home on the same day, weighing approximately 4 lbs.  And they’ve been doing amazing ever since!  Every day, when I look at them, I thank god for my miracle girls!

A Dad's Perspective

The story in the link below is a dad's perspective of a monoamniotic pregnancy that was published on Esquire.com. We just had to share! It's a great read about a mo/mo pregnancy and life after babies come home.

I LIVED THROUGH THE MOST NERVE-WRACKING BIRTH STORY YOU MAY EVER READ

Aeden and Noah's Story

     I found out that I was pregnant New Year's Day.  We were surprised and excited and anxious.  Of course, we had to wait several weeks before we actually got to see a doctor, so 28 days later we made our way to the doctor excited to hear our baby's heartbeat for the first time.

      At our first appointment we went in for the sonogram and it was very exciting until the technician said, ,"Oh...wait a minute..."  It got very scary for a few seconds until she identified a second heartbeat.  We were having twins.  Next the technician checked for several other things and was worried that she could not find a septum (the line between the babies indicating that they were in two separate amniotic sacs).  However, she and our doctor assured us that they would probably be able to see it at our next appointment  and scheduled a follow up for one month later.

     At our next appointment, one month later (13 weeks gestation) they were only really concerned with finding the septum.  I was amazed at how my little beans had turned into little people and looked like they were boxing each other.  When the technician excused herself to get the doctor we got worried.  It was kind of like one of those moments in movies when the doctor gets a concerned look on their face and give the parents terrible news.  The doctor came back to the room with the technician and started giving her instructions.  After a few minutes the news came..."We can not find a septum between your babies.  Let's go over to the exam room so we can talk about what this means."

      The details were scary.  Mono-amniotic/Mono-chorionic twins happen in only one in 10,000 twin pregnancies.  There was a 50-60% chance that one or both babies would be still born.  In addition, because they were split from one egg, there was a high chance that one of the babies would be born with some sort of defect ranging from heart, lung, spinal, renal, or brain defect.  It was a lot of scary stuff to hear, but there was still a chance that there was a septum and the ultrasound equipment was just not advanced enough to locate the divide.  We were referred to a perinatal specialist in Shreveport, LA (which was two hours from our home) first in hopes that their advanced equipment would find the septum, and second to give us a physician would could properly care for our very high risk pregnancy if they did not find the septum.

      The following week we made the trek to Shreveport to find out for sure what we were dealing with.  They did not find a septum.  The doctor also gave the ultrasound technician a series of directives, "check the hips, check the stomach, check the back, check the chest, etc." and then finally informed us that he was worried that they were conjoined based on the photos he had been sent.  What?!?  We had no idea that was even a concern.  Immediately following the ultrasound we met with the doctor where he gave us all the gruesome details again.  He also offered a selective termination in which they could terminate one of the babies in order to give the other a better chance of survival.  No Way!  I responded by simply saying, "no...that's actually isn't an option."  He warned us of the tough road ahead.  I would see him in Shreveport monthly, unless something more serious arose, I would see my doctor at home every two weeks.  I would go on bed rest at home at 20 weeks and begin seeing my home doctor every week.  At 24 weeks I would be admitted into the hospital for continuous monitoring and would remain there until the babies were born.

      Then the fun began.  We continued living our lives knowing that one way or the other our lives were going to change.  We both still had the stress of our jobs, preparing and taking bands to contest, in addition to the stress of the pregnancy.  Everything went along without a hitch until our appointment at 20 weeks in Shreveport when they began to check out organs.  The organs looked fine, but they did discover a single umbilical artery in twin a which could be a sign of defects that could not be detected on the ultrasound.  We would just have to wait until they were born to find out.  (This is probably the reason for Aaden's hemi-vertebrae and horseshoe kidney)

      I also began bed rest at home at 20 weeks and so instead of my days being filled with the stress of my job it was filled with the what ifs of my pregnancy.  The only thing that kept me sane was feeling them move and the security of having weekly appointments to be sure they were both okay.

      At 24 weeks I was admitted into the hospital where they monitored the boys twice a day for a few hours.  At first they were still small enough to move around quite a bit so it was very difficult to monitor them effectively so many times the monitoring sessions took quite a long time.  Things went along nicely for two weeks, then one night, right at 26 weeks, the boys began having issues.  Twin A's heart rate was dropping pretty low and staying down for too long so they began to prep me for surgery and gave me the steroid shots to speed along the boys' lung development.  For about a week I stayed hooked up to an IV while they continued to monitor the boys 24 hours a day.  I also began having contractions during this time so they gave me all sorts of drugs to try to keep them at bay.  When I was finally taken off continuous monitoring and allowed restroom privileges again (and allowed to take a real shower!) things seemed better.  I was at 27 weeks and had only 5 weeks left until they would take the boys.  Things seemed fine.  My parents came to visit and my mom was going to stay with me for a couple of weeks.  She just had to make one trip back home for a doctor's appointment and then she would be back for the long haul. Josh was busy doing drama camp in Henderson during this time so the plan was that mom would keep me entertained so that Josh wouldn't have to travel back and forth so much.  Mom left on a Sunday for her appointment (Father's day actually).  The next day I was feeling down so I called Josh to ask if he would come for the night.  He agreed without any argument and I immediately felt better.  He brought me food (it's difficult to live on hospital food) and I enjoyed that before I began an unusually late monitoring (there had been a ton of births that day so I didn't start my first monitoring until late, moving my second monitoring back later).  This turned out to be a blessing in disguise.  About 8pm Twin A went into distress and stayed that way for too long.  The next hour was one of the craziest hours of my life.  People were in and out of my room, nurses, doctors, anesthesiologists, all the while all I can think about is my baby being in distress.  I was finally wheeled (ran really) down to the operating room and within 15 minutes my babies were born and I entered the most stressful time of my life.

 Noah at 28 weeks gestation

Aeden at 28 weeks gestation

      Aaden was born with an APGAR of 0 and had to be revived. His umbilical cord was completely white and the doctors had no idea how long he had not been receiving blood. His 5 minute APGAR was a 3.  Noah was born with an APGAR 3 and his 5 minute APGAR was an 8.  Noah was only on the vent for a few hours, Aaden for a few days.  It was so difficult to see my babies hooked up to so much equipment and not be able to hold or comfort them in any way.  The first week was pretty uneventful until Sunday.  We had just left the hospital for the night and decided to go to Henderson and stay with Josh's parents.  We got a phone call from the NICU before we got there telling us to come back immediately.  We got no other info except to come back.  I have never prayed or cried as hard as I did during the 45 minute drive back to the hospital.  We called once during the trip to get the same info, keep coming.  When we arrived we ran to the NICU and the doctor met us at the door.  Aaden had been in distress.  He had fluid on his lungs and he had almost died.  He was stable, but still considered critical.  I'm still unclear as to what happened, but it had to do with his pic line.  He was returned to the vent and that was how we experienced our first thrill on the roller coaster ride of the NICU.  I still get teary when I think about it.

      Noah had a similar scare later that week, but it did not escalate to the same level that Aaden did because the nurses were much more attentive because it had happened to Aaden.  The boys continued to slowly improve.  They had good days and bad days and our days directly correlated with theirs.  The were in the NICU for three months and came home one week before their due date.  They were still on heart monitors when they came home, but they were home.  Besides some developmental delays they have been great.  They are perfect.

      This is why I march for babies.  If I can help prevent even one family from experiencing the same scary things we went through then it is worth it.  Since the boys were born, just three years ago, they have upgraded the percentage from 50-60% chance of stillbirth to 70-80% chance of survival in mono mono twins with proper care and monitoring.  March of Dimes helped with that and so I will continue to march so that one day maybe mono mono twins will no longer be a high risk pregnancy.

     I never thought I would experience something like this, but it happened to me and it could happen to anyone.  I am thankful for all the people who donated and marched before me, and I will continue to pay it forward as long as I am able.

My Momo Miracles

I had never thought I was going to be a mother.  I'd been diagnosed with polycystic kidney disease when I was twenty-one.  Due to the kidney disease I had high blood pressure, and I also have chronic migraines.  I had been told by every doctor for ten years that I should not have children.  Not that I couldn't have children but that I shouldn't have them.  I told myself that I didn't want children so as to not have to confront the idea of not being able to have them.  Then, about six months after getting married,  I found myself pregnant and everything changed.

After embracing the idea of being a mother, I was then devastated when I had a miscarriage at the beginning of my second trimester.  We tried again right away but were unsuccessful.  Due to my health issues (and the increased chance of multiples) we decided against fertility treatment and just left it up to Mother Nature.  After four years waiting, I finally found myself pregnant in September 2010.

While waiting for our first real ultrasound (around nine or ten weeks,) my husband and I were amused by the couple who come out into the waiting room very excited that they were having twins.  My husband jokingly said, "What if we are having twins?" Not amused, I said, "Don't even say that.  That is NOT going to happen."  

Ten minutes later I found myself lying on the table, stomach covered in ooze when the tech exclaimed, “Oh wow, its twins!”  Thinking (or hoping) she had made a mistake I asked if she somehow got the other lady’s ultrasound mixed up with mine!  But no, there was no mistake.  I was carrying twins.

The doctor could see right away that the separating membrane was missing and he referred us to the best--and, I think the only--perinatologist in the state.  My biggest fear was that the twins would be conjoined and I spent every minute of the next couple weeks worrying about it.

Upon meeting my perinatologist, I knew I liked him.  He had such a peaceful, quiet, reassuring way about him that I felt very comfortable.  He soon confirmed that the membrane was missing and diagnosed it as a momo pregnancy, NOT conjoined.  My relief was tempered when the doctor began explaining exactly what a momo pregnancy entailed.  Hearing that my babies only had a 50% of even being born, I had flashbacks to the pain of my miscarriage.  How could I go through that again?  The doctor explained that there were options but I had already decided that, no matter what, I wasn't giving up on the baby (now babies) that I had waited four years for.  Regardless of the odds stacked against us, I just felt that these babies were meant to be.

The first half of my pregnancy was miserable yet uneventful.  I literally spent most of my time trying to keep food down and being unsuccessful.  It was the middle of winter and my perinatologist was 100 miles away so I went into my high-risk ObGyn for check-ups, along with many long drives to see the specialist.  Each appointment, I had to hold my breath until I heard the two heart-beats and saw them on the monitor.  While I felt that the babies were doing well and would be fine if I just stayed positive, I had a difficult time bonding with the babies growing inside of me.  I needed to build a wall to protect myself in case things didn't work out.

At 22 weeks, my blood pressure spiked and I was hospitalized in an attempt to prevent pre-eclampsia.  We all knew that 22 weeks was far too early to deliver but it was a possibility.  After several days in the hospital and some serious manipulation of my blood pressure medication, we did get things under control.  I was discharged to home on modified bed rest until I was scheduled to go inpatient at twenty-eight weeks.  However, at my twenty-six week appointment with the specialist the blood flow in the cords looked dangerously constricted so I was quickly admitted and began my inpatient stay.  

The first few days in 'Mommy Jail' were stressful.  I was immediately given steroid injections to stimulate the babies' lung development.  The pressure in the cords was rather high, indicating  something (a knot) was restricting the blood flow.  At one point, Baby A dropped off the monitor and the doctor nearly delivered them at twenty-six weeks four days.  Fortunately, upon hearing that, the boys decided to settle down and from that point on, their numbers got better every day. 

 I was monitored for three one-hour blocks each day, which translated into lying flat on my back for the better part of every day and night as the nurses chased the babies around my stomach trying to get a good read.  I also had an ultra-sound every second day to monitor the blood flow in the cords.  My husband and I soon settled into a routine where he spent half the week with me in the hospital and half the week at home going to work.  Things were looking good until, around twenty-nine weeks, my blood pressure began to rise again.

After several days of trying to get my blood pressure under control, everyone could see it wasn't working.  I was officially 'pre-eclamptic', I had become swollen in places I didn't know could swell and had to spend nearly all my time in bed, lying on my left side.  The day I reached the thirty week mark, the doctor came in early and--to no one's surprise--said things were just getting too dangerous and it was time to deliver.  Within the hour, after a flurry of phone calls to family back home and a quick shower, I had an IV put in and was ready to be wheeled into the operating room.

At 12:14 p.m. February 27, 2010 Casey Li came into the world, weighing 2 lbs. 4 ozs with the umbilical cord wrapped around his neck twice.  At the same time Casey was brought out, Foster John's feet came out with his brother.  Seconds later, he too was welcomed into the world weighing 2 lbs 5 ozs.  The doctor had everyone in the room come look at the umbilical knot the boys had created, not quite believing the mess they had made of it.  Each baby had a four-member NICU team who, after letting me look at each baby for a second, quickly had them intubated and whisked them away to the NICU.  

 Umbilical cord knot

It was nearly 8:00 p.m. before I was able to crawl into a wheelchair to see my babies for the first time outside the two seconds I'd seen them in the OR.  Not even the drug-induced fog I was in could contain my joy and fear upon entering the NICU and seeing them for the first.  They were impossibly tiny, yet perfect in every way.  They were even breathing on their own with just room level oxygen!  

 Casey Li  4 days old.  First ‘kangaroo care’!!

I had always felt that my children were going to be fighters, but even I was surprised by how tough they turned out to be.  My doctor attributed it to being stressed in the womb, which forced them to develop quickly and be resilient.  After dropping to 1 lb 15 ozs, the boys soon began to gain weight steadily.  The only setback they suffered was, after about a week, both boys were desatting regularly so they were put on a nasal canulla for a couple weeks.  Other than that, they made great progress every day, while I used my NICU time to learn as much as I could from the best caregivers around--the NICU nurses.

  Foster John  10 days old

We were told to expect the boys to go home around their due date, which had been May 6th.  By the beginning of April, it was clear the boys wouldn't be in the NICU that long.  The doctors said they usually never discharged a baby weighing less than five pounds, but our boys were doing so well they didn't need to stay any longer.  As one doctor put it, "They are the valedictorians of the NICU." 

 

On April 15, 2010, after an eight week stay, our boys were finally discharged.  At the time, both boys were 3 lb 13 oz and were too small to fit into a car seat so we were one of the few people ever to use the special 'car beds' the NICU had.  The boys actually had to ride in those for more than a month before finally getting large enough for a regular infant car seat!!

The first few months at home with the boys were a bit of a roller coaster.  While we were lucky and the boys were exceptionally healthy for preemies, they were still preemies and still faced preemie problems.  We were under strict orders not to take the boys anywhere or allow many people in and out of our home for at least six months so I became rather stir-crazy.  Neither boy slept well, grunting and fussing even when they did sleep, and we struggled with terrifying spit-up/choking episodes for months.  Our days were filled with visits from the county nurse, many visits to the pediatrician, trips out-of-town to see specialists, visits from our Family Outreach counselor, and even physical therapy evaluations.  Still, somehow we managed to get through every day. 

My boys are now two and doing incredibly well.  We have graduated from the Family Outreach (Early Intervention) program and the boys are developing very well.  The only stumbling block we’ve had recently is with speech.  They are a bit behind in learning to speak English but have mastered their own language “Twinglish.”  We have started therapy and have been learning sing language, which is helping them communicate without getting frustrated.  They have now started making up their own sign language, which is a fun challenge to decipher. 

 I could not be prouder of my little men.  Every step of their journey to be with us was quite a challenge and they proved to be such fighters!  Their strength amazes me.  Late at night, I sneak into their room to watch them sleep and remember them as tiny 2 lb preemies who couldn’t even keep themselves warm and often find myself crying.  I am so very, very blessed.

 Foster John (left) & Casey Li (right) 2 years old!

There's more than one!

Simon and I were very excited about our first baby scan at 11 weeks.  We couldn't wait to see our little one for the first time. Just before the scan started Simon told the OB that my sister has triplets so it would be interesting to see if we were having twins (or more!). I confidently told the OB that we were just having one baby thank you very much! As soon as the scan started Simon and I could see a baby and something else.... The OB announced "There's more than one!". There was a lot of nervous laughter and exclamations such as "no way!", "really?", "are you sure", “there’s only 2 right?”, etc. My legs started to shake as the shock set in. Almost straight away the OB told us he thought there was no dividing membrane and they looked like what are called monoamniotic twins. He then spent a while trying to work out whether they were conjoined.  I think I almost fainted.  He said he was sure that they were not conjoined but explained that this type of twinning is extremely high risk. Suddenly our low risk singleton pregnancy had turned into something very different.....

  

Treatment Plan

My OB refused to tell me the mortality rate (well, that’s telling you something!!!).  I reviewed the research myself and no one agrees on what the mortality rate is or the best way to manage this type of pregnancy because it is so rare and not much research has been done.  It is routine in the US for mothers to be admitted to hospital for inpatient monitoring from viability but that is not the case in Australia and I did not go inpatient.  I had regular high resolution scans that increased with frequency towards the end of my pregnancy.  I worked until I was 28 weeks pregnant and then I was on (self imposed) bed rest until delivery.

Coping with a High Risk Pregnancy 

I didn't know whether I was going to have 2, 1 or 0 babies in my future so it was hard to know whether to be happy, anxious, sad or....just feel nothing. I didn't know whether I should have a baby shower. Celebrating their impending birth when their chances of survival weren't great was a little odd.

I made a decision to try to be optimistic and ignore the horrible statistics. My babies were healthy according to the scans and I'm healthy so there's no use worrying! I hated people telling me to not get my hopes up and telling me not to buy baby furniture until after they were born. I wanted to pretend there were no risks - that's how I coped. My OB would tell me all the risks at every appointment leading up to viability which depressed me every time. Once I reached 26 weeks he became more optimistic and told me he was confident I would make it to the magic 32 weeks.

However, reality would set it, especially when we went for scans. I had 10 high resolution scans that took 1-2 hours each. I had a panic attack at every scan (a real one – I’m not exaggerating!). The first one was the worst - I had to take 6 breaks in one hour. From then on I closed my eyes for the majority of the time and I distracted myself by eating and drinking. Even after the sonographer assured me she had found 2 heartbeats I would still be very, very anxious. Seeing them was extremely emotional and overwhelming. All of the scans came back with excellent results. The flow of blood from the placenta to the babies was always good which reassured us that any knots weren't restricting the flow of nutrients.

However, good scan results didn't guarantee that we were going to take home two babies. My husband and I had a few awful but necessary conversations about what we wanted to do if one or both didn't make it. We had a plan in place and we had even picked out special names. Not that we didn't want to use "Phoebe" and "Sophia" but we wanted special names with meanings that were appropriate for the situation.

The Final Countdown

During the last 4 weeks of my pregnancy I had weekly scans and OB appointments. The last two scans showed that Sophia, the smaller girl was quite a bit smaller than Phoebe and had not grown much in the 33rd week. Week 33 I had an appointment with a different OB as mine was on holidays. This other OB told me with confidence that I would make it to 34 weeks and both babies would be fine. I asked him over and over again at the last appointment whether Sophia was going to be ok because I was so worried about her but he said she would be fine.

I tried not to obsess too much about feeling the babies move but I couldn't help making sure I felt both of them kick each day towards the end. The problem with babies in the same amniotic sac is that it is very hard to tell which baby is kicking and whether it is just one or two kicking! I would sometimes wake in the middle of the night just wishing the babies would move. So I would get up, walk around and eat something just to feel them move. Once they got going I tried to relax again and go to sleep. However, it is hard going to sleep with two babies all excited inside you!

We visited the hospital for antenatal classes and asked all sorts of questions - how often can we see our babies, who can touch the babies, how long are they are likely to be admitted for if they are healthy, should I bring clothes/blankets for them, what happens if they need to be transferred to another hospital, which type of breast pumping equipment is available?  I also got a tour of the Special Care nursery to get a feel for the place and I started to picture myself breastfeeding in the feeding areas. All this information helped us to prepare us for what was to come... 

Phoebe and Sophia's Birth Day 

The girls were born healthy via cesarean January 2010 measuring 2008 grams and 2318 grams. Immediately after they were born my OB inspected the umbilical cords and said "someone was looking after these girls". There were several knots in their cords and I believe God was definitely looking after us!

They had APGARS of 9 and were only in humidity cribs for 19 hours. They didn't need continuous O2 but they had breathing apnoea for a week. Apnoea is when they forget to breath and need to be given O2 briefly. They were fully tube fed formula (and a tiny amount of breastmilk) for 3 days and then we started to slowly introduce breastfeeding.  It’s amazing that we had all the risks but ended up with our perfectly healthy children.  We felt truly blessed.  Words cannot describe the relief we felt when they came out screaming. We couldn't stop smiling (except for when I was vomiting from the anaesthetic!).

The substitute OB that saw me the week before the birth rang my OB from Hawaii (he was on holidays!) to ask if my girls were alright. He was quite concerned about whether he had made the right decision to let me have them out at 34 weeks rather than 33 weeks. Turns out he was right but gosh - talk about "obstetrician's bluff!"

Straight after surgery I was able to hold Sophia for about 10 minutes. They would've let me hold her longer but I was feeling very dizzy and nauseous from the anaesthetic and chose to give back Sophia for fear of dropping her! About 2 hours after birth I was wheeled into the special care nursery and got to stroke Phoebe and Sophia's heads for 5 minutes each. My husband took lots of videos and photos of the girls so that I could look at them while I was recovering in my room which helped enormously. I didn't get to hold Phoebe until 29 hours after birth.  The first time I held her was so magical and it brings tears to my eyes 2 years on!  I know some mums don’t get to hold their premmie baby for weeks after birth so I was just utterly grateful it was only 1 day for me.

Our Special Care Experience

We loved special care. Probably because every time we went there we got to see our gorgeous girls! I loved the smell of the antibacterial lotion they make you wash your hands with because I associated it with seeing them. I also loved the smell of the baby shampoo in the nursery and bought a bottle at the pharmacy so I could smell that gorgeous baby scent when I wasn't with them.

Phoebe and Sophia were in special care for 3 weeks. For the first week I was also in hospital and Simon was staying in my room. Simon would visit the girls every 3 hours to feed them through the nasal gastric tube and I mean EVERY 3 hours. He was so in love :). I couldn't go every 3 hours but tried to get there 2-4 times a day. At first we were only allowed to cuddle them every 6 hours but as they gained strength we were able to cuddle them every 3 hours. It sounds strange to restrict physical contact with a baby but it really wore them out. Going home at the end of the first week was hard. We had to leave them behind :(. Every mum has that moment...commonly known as the 3^rd day blues where things get a little emotional.  Well, I had my moment the second time I had to leave the hospital and go home to two empty bassinets.  I was crying uncontrollably and asking why I had to leave them behind.  Luckily a kind nurse and the mother of the little girl next to Phoebe comforted me and assured me they would be well looked after overnight.

At first we came back to the hospital for two feeds a day, then three, then four and then I was in there all day doing 5 feeds during the day. We then stayed overnight at the hospital for 2 nights to show they were able to be fully bottle and breastfed 24/7. We took them home at 4 weeks old.  When they came home they were pretty easy to look after.  They fed, they pooped, they slept.  Yes, there wasn’t much sleep for mum or dad but they were content most of the time.  Little did I realise that this was the “easy” stage!!!  I will leave the reflux, colic, RSV, gastro, bottle and breast refusal, overtiredness, overstimulation, etc. for my personal blog :).  I really wish someone had told me about silent reflux - it's so common in preemies! 

Two Years On

My girls are now loud, vivacious 2 year olds that are just like every other two year old...except there’s two of them of course!  You would never know they were a high risk pregnancy or premature.  They are healthy and happy - we are so incredibly blessed.

The Overstreet Twins ~ It was Meant to Be!

August 2007
My husband and I were shocked to find out I was pregnant in August 2007. We had a 3 year old son and an 18 month old daughter and we didn't plan on having any more children. I had some issues with birth control after having my daughter and actually had an appointment to have an IUD placed at the end of August. Imagine our surprise to be pregnant. After the initial shock wore off we were both very excited to have a 3rd coming. It was simply meant to be....

My first appointment @ 9 weeks went well. Having been through this two times before, I went to the appointment alone thinking it was going to be no big deal. When I had the ultrasound to see the baby's heartbeat the tech asked me if this was my first pregnancy. I laughed & replied "No, my third and it was a surprise." Then she laughed and said "Here's another surprise, this is your 3rd & 4th!" I said "HOLY SH**!! I saw the two little heartbeats on the screen and couldn't believe it. I called my husband at work and he thought I was joking. I think we were in shock, again, for about a week. We were then referred to a perinatologist at Maternal Fetal Medicine for a routine first trimester screening the next week. That's the first time we heard the words "monoamniotic" and "high-risk". The only thing we knew about twins was that you could have identical or fraternal. We certainly got a crash course at that appointment. I remember getting home and doing some research on the computer (big mistake at the time). I was terrified by what I read.  I called my Ob/Gyn and he was able to calm me down, telling me that we were in this together and that I had to be strong. I didn't have facebook at that time and I looked for support groups but couldn't find any. I joined a twin website and my first post was "Pregnant with monoamniotic twins and scared", to which I got NO replies. I was even more scared and felt so alone. After two days I finally got a reply from a woman who told me that her hairdresser's cousin had monoamniotic twins and she was kind enough to pass my info on to this momo mom. This was the first person I was able to ask questions, a million of them, via email, and I am so thankful for her. She also told me about monoamniotic.org and I finally felt like I could relate my questions and fears to others who would understand.

We went back to MFM at 12 weeks and we were told that they thought the twins were possibly conjoined, another blow. The next appointment at 14 weeks the doctor suggested we abort the pregnancy because the cords were already tangled and it was going to be "an emotional roller coaster".  I was so upset and refused to see that doctor ever again. At our 16 week appointment we got the confirmation that there was no membrane, but the  good news that the twins were not conjoined, they were just moving in tandem because of the cords. Our MFM doctor was great and very informative during the 16 week appointment. This is when we learned of our treatment course, what to expect and when. The 18 week appointment brought the news that we were having girls, and that one of them had club feet, a small blow that my husband and I took in stride. From 18 weeks until 24 weeks I was seen by MFM every 2 weeks for ultrasounds and Doppler studies. MFM wanted me to begin inpatient monitoring at 24 weeks but my Ob/Gyn pushed to start inpatient at 28 weeks. We had 2 small children at home and the thought of leaving them and my husband was devastating. I also had a full time job and my husband was working full time and doing an accelerated Master's Degree program at night. We agreed on a compromise of outpatient monitoring from 24 to 26 weeks, and checked in to the hospital at 26 weeks for inpatient monitoring with a scheduled c-section at 32 weeks.

The first 2 weeks of my inpatient stay were the hardest of my life up to that point. Being there alone was awful.  My husband could only visit on the weekends because of our kids, his job, and his school. With the help of our family and friends we managed to work out a routine for the kids. Because my husband had class until 11:00pm three nights a week, the kids slept over my sister's on Tuesday and Wednesday, and she took a half day from work every Wednesday so she could bring them in for a visit and dinner with me. Wednesdays were the best. My parents and my mother in law took turns keeping the kids overnight on the weekends so my husband could sleep over with me at the hospital every Saturday night. So I saw my children every Wednesday, and my husband would bring them in early every Saturday to spend the day, then my sister would pick them up from the hospital so my husband could stay over with me. Then my sister would bring them back to the hospital on Sunday mornings to have breakfast with us, and my husband would leave with them around 1:00pm every Sunday. Sunday afternoons were the hardest for me. But that was our schedule and it worked.

During my stay I spent a lot of time at the nurses station, read a ton of books, used my laptop (wish I had Facebook back then), made a great friend with another pregnant mom on the unit, watched TV, napped, had tons of visitors, walked around the whole hospital, got a tour of the NICU, had Reikki, massages, a pedicure, and tried to relax as much as possible. I had a refrigerator in my room which was great for midnight snacks. I had a goal calendar marked for 28 weeks, 30 weeks,  and 32 weeks. It always felt great to scratch one of them off. I also started a CaringBridge website to keep all of our family and friends updated and to help pass the time.

Medically my inpatient stay consisted of one hour monitoring sessions 3 times a day. The monitoring sessions would usually go longer than an hour because it was hard to get both babies on the monitor, and keep them on. It became a routine of having an ultrasound with almost every monitoring session because the girls' hearts would beat in unison and the nurses could never tell if they had both babies on. I also had Doppler studies and growth scans at the MFM office every 2 weeks until 30 weeks, then once a week until I delivered. I called it my field trip for the day and I enjoyed being taken over to the MFM office in a wheelchair. My growth scans showed a slight difference in the size of the babies, so I was encouraged to drink Ensure for almost all of my stay. I was able to walk around almost the whole time I was in the hospital, up until the last 2 weeks. The girls never had any serious decels, but one of them had a scary accel around 29 weeks that lasted about a minute and the doctors were called in to see if they needed to deliver the girls. She recovered and it didn't happen again. On Valentine's Day I woke up at 4:00am with very painful contractions. I was 30 weeks and was sent down to labor and delivery for the day but thankfully they were able to stop the contractions. At this point I was put on complete bed rest because walking around irritated my uterus and started contractions.

My c-section was scheduled for Leap year, Friday, March 29th, 2008. I was 32 weeks 1 day. The day before, one of the neonatologists came to tell me that there was no room in the NICU for my babies, they were full. I was very upset. My Ob/Gyn was upset too. So we had to wait it out one last weekend, the longest weekend of my life, until Monday March 3rd, 2008 which brought me to 32 weeks 4 days.

March 3rd, 2008

Teagan Kathleen was born at 1:45pm, weighing 3lbs 15oz and 16 inches.

Taryn Cynthia was born at 1:47pm, weighing 3lbs 14oz and 16.5 inches.

The NICU was another emotional roller coaster, but in the end it was worth every bit of emotion. We have two miracle babies that have taught us more about life and love then we ever imagined. It changed our lives for the better. I have made life long friends with the nurses who took such great care of  me and the girls. My husband and I learned more about each other during this pregnancy and birth of our girls than we ever knew before, and for that I am so thankful. Small things that others may take for granted are cherished by us. We learned that you can't be afraid to ask questions or challenge a doctor, they don't know everything. If something doesn't feel right, don't be afraid to speak up? Always go with your gut. Most important, we learned how to be advocates for our children.  If you find a great doctor who knows about monoamniotic twins, you will be in great hands.

At this point our girls are almost 4. Sometimes I can't believe it. My husband and I joke all the time about having four kids, especially having twins. And then we say....it was simply meant to be.

Why YES, twins DO run in our family!!!

April 2009

My son was 15 months old and we decided to start trying for another baby....well... I had my IUD removed in March because we were talking about getting pregnant again... I didn't realize that I would get pregnant so soon.  I found out I was pregnant in the middle of April.  My first appointment with my doctor was just a sit down appointment where she asked me questions about my medical history, etc.  During the appointment she asked about history of twins and I don't know if that is what got me thinking about twins or what, because my sisters are fraternal twins.  I kept thinking "I'm probably having twins" but then thought "that's stupid, you're not having twins" right after.  Well, at my next appointment, the doctor did an ultrasound.  I was only about 9 weeks pregnant, so she did the trans vaginal ultrasound.  The first thing she said was "Guess how many are in there..."  I couldn't believe that my suspicions were correct.  I thought, "no way, I AM having twins!"  Thinking they would be fraternal, like my sisters, b/c that is what runs in families....  The next thing the doctor said was that she didn't see a membrane so she would be sending me to an ultrasound technician to have a complete ultrasound done.  She said, "this may be a type of twin pregnancy called 'monoamniotic monochorionic' which is high risk."  I asked what that meant.  She said "we will cross that bridge IF we come to it.... don't go look it up on the Internet when you get home"  WHY DO THEY ALWAYS SAY THAT?!  OF COURSE I looked it up and thought for sure my babies were going to die they minute I saw 50% chance of survival....

May 2009

At my complete ultrasound, the ultrasound technician wouldn't give me details but he did say he saw two yolk sacs... but he also said he couldn't find a dividing membrane.  When I read more stuff on the Internet, I think on the monoamniotic.org site, it said something about if there are two yolk sacs, there will also be two amniotic sacs... so I felt relieved, I thought, for sure there must be a dividing membrane, they just aren't seeing it.  Well, no, the ultrasound tech was either wrong or it just didn't work out like that for us, because there was only one amniotic sac. The doctor told us that the ultrasound did not show a membrane and that they would need to be monitored closely and that I would go inpatient at 24-26 weeks to be monitored. 

June-September 2009

In the middle of all of this, my husband decided to go back to his old job.  That meant changing insurance companies.  I got back to my insurance through my work and had to change doctors.  I knew what doctor I wanted to go to, he was a perinatologist who was highly recommended.  Of course the people at his office didn't know what momo twins were b/c they are so rare.  I called to make an appointment and explained the situation to the office workers.  They said "twins, no big deal"  basically.  When I finally had my appointment with him, the nurse practitioner came in instead of the doctor.  She did my appointment and when I brought up the plan about going inpatient and weekly ultrasounds and everything, she looked like she had no idea what I was talking about.  She said "no, we don't need to do all that... it's just twins...."  I said "No, it is monoamniotic twins, they are in the same sac and they can get asphyxiated by their cords." She then decided to go ask the doctor, probably thinking I was some over worrying pregnant mom.  But when she came back, she must have realized that she didn't know everything.  She said "Oh, yes, I spoke with the doctor and you are right."  Finally, I met the doctor.  He was great, he had just delivered another set of monoamniotic twins a few months before (apparently they were not actually his patient, but he was on call when she delivered)  He actually knew what monoamniotic twins were and that they were very rare and needed monitoring and early delivery.  I went inpatient on September 19, 2009, thinking I would be inpatient for up to 6 weeks, not knowing I would deliver my babies in just 8 days. 

September 27, 2009

My mom and my sisters were taking my nieces and nephews to Disneyland to celebrate their birthdays (my mom's bday and nephew's bday)  The night before I thought "these twins are going to want to come tomorrow..." just b/c everyone was actually doing something and I wouldn't have visitors to the hospital that day.  And, of course, during my morning NST, baby A started to have decelerations.  She would recover but then her heart rate would go back down again.  My nurse said "your doctor just called... he said don't eat breakfast, he's going to come in..." I burst into tears, I knew it was time, and I knew it was still too early.  The girls were 28 weeks and 1 day gestation.  I called my mom and my husband.  They were planning on meeting my mom and sisters at Disneyland.  My sister-in-law had already left to take my son to Disneyland, so my husband was able to come to the hospital without him.  Everyone came to meet me at the hospital and that is when my doctor showed up too.  He had been watching my NST from his computer at home.  He saw the decelerations and called the nurse, that is how cool my doctor was!  So I was prepped for C-section and my babies were born at 12:00 noon (both of them had the same time on their birth certificates, they were seconds apart).  Their cords were knotted together twice and were wrapped around Baby A's neck twice.  Both of my daughters were intubated after birth b/c they were having apnea.  

NICU experience

28 weeks is a pretty good time, the chances of survival go up to about 80%.  I felt pretty helpless though, all I could do for my babies at this point was pump my milk!  Baby A was the one having decelerations.  On the first day, I was more worried about her.  Day 1 was the honeymoon phase...  On day 2, Baby B started to have problems.  She first developed a pneumothorax.  They had to put in a chest tube.  Then a few hours later, her other lung also developed a pneumothorax and she needed another chest tube.  Her oxygen saturations continued to drop and she needed to be put on the oscillator ventilator and nitric oxide.  She developed pulmonary hypertension and pulmonary interstitial emphysema.  The doctor said her lungs looked really bad for a two day old preemie.  After the nitric oxide was started, she did start to improve.  After a few days she was switched back to the conventional ventilator and then extubated to room air!  But then she had to have a PDA ligation because her kidney function was not good enough to give her indocin for her PDA (like her sister got).  (Even since then, there have been studies that Indocin and neoprofin for PDA closures are causing Necrotizing enterocolitis so that is not always the treatment of choice today).  Both of the girls were off and on Bubble CPAP for weeks.  Then it was just working on feeds.  There were a few scares that they weren't tolerating their feeds, they got worked up for sepsis a couple times.  The NICU experience is kind of a blur now....even though I am now a NICU nurse, I forget a lot of their experience until something similar happens in my job.  

December 2009

After 11 weeks in the NICU, my daughters came home about a week before their actual due date.  We were very lucky that there were no major issues (aside from Baby B's first few days of life)  Baby B has some lung issues and paralyzed left vocal cord from the PDA ligation.  She sounds raspy and can make a good "wookie" sound when she is whining.    They are crazy, wild 2 1/4 year olds now! 

Our long journey to meeting Janie & Sophie

At 3 weeks and 2 days I knew I was pregnant. I took a test and quickly popped up a positive. I called my doctor as 5 months before I had had a miscarriage. I went in and had the pregnancy confirmed.
 
I had my 1st drs appt on March 30th, I was 7 wks and 6 days.
I swear I am already showing at this point. First we do the Ultrasound and the technician wants to try to do one on my belly at first. She starts it up and gets it all going, looks around for a couple of minutes and says that things are still a little small. So she sends me to the bathroom & tells me to take off my clothes. She leaves. I come back to the room and get on the chair/bed thing. and we wait for about 5 or 10 minutes. I am convinced at this point that I have had another miscarriage, though I do not mention it to my husband. She comes back and she asks if this is our last or if we are gonna try to round it off? (While she is getting everything ready to do a vaginal ultrasound) I say we are definately done, no more for me. And she says, I ask because I see 2 of them in here.. We are slightly shocked.. But very happy. I had an inckling that I might have twins & Stephen had apparently joked at work that my pregnancy test was positive so quickly & early it must be twins.. She did say that they would be identical, they were in the same sac, sharing everything. We would either have 2 girls or 2 boys. We are only the 2nd case of this particular twin to come into the office, it is very rare. There are many different types of twins our particular case is Monochoriotic Monoamniotic Twins. I ask for her to write down the whole name. She did, but asked me if I was the type to go home & google?? And yes, I am, lol. So she asked that I not go on there and read all the bad stuff, that isn't totally correct alot of the times… Well, I headed straight home, did all kinds of googling and eventually found my saving grace: www.monoamniotic.org

At my next appt on April 29th, my dr was out on maternity leave, so I saw another dr in the practice. The dr was not able to tell me anything that I didn't already know. Said to lay out a plan is a good idea.If the babies were born early & Sparks couldn't handle their care they would be going to Children's Hospital in Little Rock. Depending on the situation, I could give birth there as well. Just depends how it all goes.. I honestly left that appt feeling like I knew less, then before I went in there. At this point I knew I only had God to rely on and I held onto that as tightly as I could!!
 
At the next couple of appts, basically the dr is promising me whatever I want. She had no expectations of the babies surviving, as the other case that came thru this office hadn’t survived. I was so very tired. And I was so nauseated, all the time. I had the worst smell adversions, I could hardly cook anything… My mom and dad hired a babysitter to come in and care for my 2 older children. 
 
17 week & 6 day appt - June 9th
I had been having feeling at night of needing to go pee, very very badly, but when I would go I would push like I was having a bm to go pee & I would barely get any out. (I am getting up 2 - 3 other times a night to go potty with no difficulty) The dr said I was having contractions. And for me to be ready at any time for her to tell me to stop doing stuff, because at one of my appt she will tell me that. I see a perinatologist at my appt on the 15th, I am to call her after that appt to tell her how it went. I start going to see them every other week from here on out. I asked her when we would start the fetal monitoring & she said around the 24th week or so, I will probaby go in every day in the week.
#7 We talked about the hopitalization again, I told her how open I was too that - whatever I have to do I will do with NO hesitation. She said she was glad to know how serious I was and she now knows I understand how serious this pregnancy is. That was a relief to her & she won't hesitate at all when telling me what's best for me to do. We found out we are having girls!!
June 23^rd, 20 weeks we were told to stop having relations.
At the next few appts the dr is wishy washy. She isn’t wanting to do what we had agreed on. She is trying to treat it as a regular twin pregnancy and I am pushing for more. She’s even telling me we will try for a natural birth. She is supposed to contact the local children’s hospital and get their recommendations. Took a good month for her to finally do that. At this point, I read another blog, written my momo parents and lived by this quote until the end of the pregnancy! "I have NOTHING to complain about. I HAVE TWINS! I've always wanted twins. God is growing me up. God is strengthening our marriage. This is an adventure. Complaints would just be a waste of time. Worry would just be an insult to God. I am living life in the here and now, and excited about where God is taking me."
July 24^th, 24 weeks we find out I am being transferred to the children’s hospital, that is 3 hours from home.
At 25 weeks and 3 days I have a level 2 ultrasound. They estimate the babies are 2 lbs a piece and rave about how the girls are beating expectations. They said this was the best momo pregnancy they had ever seen. Man, I was feeling good that day J
August 4^th - 26 weeks we have the 1^st appt @ the children’s hospital. This was the best appt I had had up to this point. Because these drs had looked over my charts, did their research and knew what they were talking about!! I saw the head specialist and a plan was laid out. I was to go home this week, come back week 27 they’d check us out- send me home and then week 28 they'll put me in the hospital. I'll stay in the hospital for a whole week, with monitoring to figure out the girls schedules & such. Then the hospital has a plan in place with a hotel down the road, they call it Camp. So they shuttle you between a hotel and the hospital, they’re about 5 min apart. They give you food vouchers to eat with. I am ecstatic as this is close enough to the plan I was wanting. We leave happy.

I went to Little Rock for my week 27 appt, I had some contractions, they check me & I am dialated to 1. They monitor the girls, things seemed fine (once they found them) They decide to keep me in Little Rock that week, August 12th. I had a small bag, just in case, but I hadn't thought to take my phone charger or much else, other than a change of clothes & tooth brush. I spent about a week in the hospital. 2 days into the hospital stay, my dad passes away, I get to go home for the weekend and I come back on Monday. I stay a few more days in the hospital. They monitor me & the girls every 3 hours. There were times that the girls were extremely hard to find, it would take forever for the nurses to find the 2 girls' heartbeats. There were times that a nurse would give in & hold the "monitor" in place. In these instances, most of the time, I had to be monitored between 30 min to an hour, there were times I was even monitored for 2 hours
At 28 weeks they sent me to "camp" . I would eat breakfast at the hotel, lunch & dinner would be sent from a deli nearby. The hotel shuttle would take me to my appt every other day. (Monday, Wednesday & Friday) I monitored myself at the hotel, every 3 hours & once a day I had a nurse call me & check in, answer questions, take notes, ect. There were times I couldn't find their heartbeats & I would have the shuttle take me to labor & delivery (happened mostly around midnight for some reason) and I would be monitored for about 3 hours. These monitorings were the worst. At that time of night the nurses weren't the best, they couldn't find the 2 heartbeats, couldn't keep them on the machine, we would end up doing ultrasounds just about every time I went. And I was just exhausted & mostly I could monitor better than the nurses, so it was hard for me to sit back & let them do their job, lol. It didn’t help at this point that I was only getting to see my family on the weekends, such trying times. At each of these appts there was a certain dr that I always ended up seeing. He felt the need to constantly remind me that they girls could pass away at any moment. Just because we were doing all these monitoring did not mean that the next time I came in they would be alive.. What a great way to end each drs appt.
At 31 weeks and 2 days, they think they see a knot, a loose knot, but a knot just the same. They monitor, the heartbeats are slightly irregular, it is decided to try to make it to 32 weeks, if we do, then we’ll be having a c-section the following Monday. We make it to week 32. I made a few midnight labor & delivery visits, but nothing major. 1 month after my dad passed away the girls were born. There were at least 25 people with us in the delivery room. Not many momo’s had made it to the point we had, here. So we were a big deal and they had quite a few student drs in the room with us. They were born with NO knots in their cords!! 

 
Janie Antoinette was born @ 12:43 - 4 lbs 4 ozs 16 1/8 inches long
She was born with club foot. She was breach with her legs crossed, explaining why she had club foot, it wasn't hereditary. Also explaining why I didn't feel her move much.
No other health issues, she was the healthier of the two. She had a feeding tube for a little while, She was on oxygen for 2 days. Janie had a lot of issue’s with juandice, we did the billy light on & off for all 3 weeks for hospitalization.

 
Sophie Rose was born @ 12:44 - 4 lbs 13 ozs 17 inches long
She was born with 2 heart murmers. 1 was one that should grow up on it's own and the other 1 she'll have her whole life, but a large part of the population has and never knows it. It is no big deal. She as well was on a feeding tube for a little while. She was on oxygen as soon as she was born, as she sucked in some amniotic fluid during the csection. She did that for about 1 week.

They took turns having ups and downs. They were in the hospital in Little Rock for 2 weeks and they transfered her to a hospital in the town we live in, she was there for 1 week. So October 10th was their 1st night @ home. :) 5 weeks before their official due date.