Thursday, May 31, 2007

The Birth Story

(Not the most flattering picture of me, but this is E and L about an hour and half before they were born).

Okay, you can stop holding your breath. Here it is. (While you wait for Erin and Elliot to post James's story, here's E and L's to tide you over). So after Dr. N told us we were on for the next day, we immediately began to freak out. The week before, she had told me I could get my hair cut and take ½ an hour a day to get ready for the babies, so a lot of the nesting work around the house was done (and my hair looked better). But I hadn’t really left the house for anything other than doctor visits for over eight weeks, so there were a few things I needed to get done. Like eating at our favorite Mexican food restaurant, for example. Each week at the beginning of the week, Rob would promise me that if I was really diligent about my bed rest and very cautious to do nothing, he would take me to Uncle Julio’s Casa Grande after my doctor visit the following week. And every week, after the visit, he would say, “I don’t feel good about your being up and around so much today. Maybe next week.” And I would say that he was being mean and we were going anyway, but he would drive us on home and back to the couch, because I wasn’t supposed to be driving and my balance was thrown a little by the 6 zillion pounds of baby I was carrying and the prolonged bed rest and was consequently unable to wrest control of the car from him. So you can imagine how excited I was for Robert to no longer have any excuse for his cruel oppression. But first, before the chips and salsa, I felt that if I was having major abdominal surgery the next day, I was definitely going to need a pedicure. Fortunately, there was a spot open at the day spa near the doctor’s office an hour after our 9:00 appointment had ended. So we had just enough time to run to the mall for a nursing bra (let’s all have a hearty laugh at this point about how necessary that ended up being). Then to the spa. Now keep in mind that I’d been lying with my feet even with my heart for about 8 weeks and that I had been very disciplined about getting off my feet for about 10 weeks before that, plus, the doctors had scared me into drinking a ridiculous amount of water each day, so I hadn’t swollen at all. In fact, instead of the cankles every one else who was pregnant along with me were getting, I had these comically skinny ankles that didn’t look like they could support my normal weight, let alone the whole “two baby figure” I’d developed. But when I emerged from the warm water soak and foot massage part of the pedicure, I had the most swollen feet and ankles I had ever seen. My toes were kind of numb where the skin had stretched so quickly. It was the first thing Robert noticed when I emerged from the treatment room- normally he says something kind about my feet, but all he could manage was “Wow-your feet…” However, there was no time for chit chat about my grotesque looking lower legs, because we were off to Casa Grande! Which was everything I’d dreamed that it would be, except that I could only eat three bites because E (then known as Baby A to her friends and family) took the precaution of keeping her head under my ribs crushing my stomach so as to avoid being kicked in the head by L (known to her significant other as Baby B).

We went home and had naps- I needed to rest, as this was the most activity I’d been involved in since before Christmas-did the pre-op stuff by phone with the hospital and headed to our last community group meeting with the Tim and Rhiannas (although it might have been held at the Phil and Christys, I’m fuzzy on that point. It was a great way to spend our last baby free evening-with our wonderful friends who had supported and prayed with us until God brought our babies into being. But I was beginning to feel very uncomfortable. I hadn’t taken the Brethine since that morning before our appointment and I was having contractions probably every seven to 10 minutes, plus my fingers were beginning to swell, too. So we borrowed the Mill’s video camera (and we’re so grateful now that we did) and headed home so I could lie around and feel swollen. We had called my Mom as we were leaving the doctor’s office (it was her birthday) and she and Dad immediately got tickets and headed out. Since I hadn’t been able to go on the hospital tour (just Rob and the other expectant couples), I wasn’t really sure about the hospital waiting room arrangements for surgical births, so I my parents them Rob would just call them at their hotel when the girls arrived –I’m not sure what I was thinking- but they said no, they’d come wait in the hospital lobby if necessary, thank you. And again, I’m so glad they were there.

I had contractions all through the night, but I slept pretty well, considering. We got up early, got the house ready to bring babies home, set up the pack and play bassinet at the foot of our bed and got ready to go. As Rob was loading the car, his Mom called and said that she had decided that she would probably need to come out and meet the babies the next day and we were so glad that she’d be able to- it hadn’t looked like as much of a possibility when we had initially called and we wanted both families to be there and be a part of the girls’ first few days. So that was a really happy moment for us. We headed for the hospital around 11:30. Rob dropped me off at the Women’s Pavilion lobby and I did the initial check in work and waited for him while I waited for them to call me back. I was watching all the other women coming in labor and remembering that night in January when Robert was still in Egypt when I was bleeding and sitting in those same seats, praying the girls wouldn’t come at 24 weeks- that they would at least wait until their dad could get home. And at that moment and ambulance pulled up at the door and they unloaded a woman- I heard the EMTs giving the background to the nurses that met the stretcher- she was 24 weeks and her water had broken. We made eye contact and she just looked so terrified and I remembered the much smaller taste of that terror that I’d had and I sat there in the check in area and cried until Rob came in. I prayed for her all through my hospital stay and still find myself praying that her baby made it and is a happy, healthy one year old somewhere today.

As soon as Robert had parked and gotten back in the building, they took us back to the obstetrical surgery prep area. We were third couple having twins that day, so the nurses were excited for us and made us feel really comfortable- both nurses had had c-sections in the past, and that was reassuring. We took a few last belly pictures and the anesthesiologist came in to give me the epidural. He said as he was working that he had his first baby eight weeks before- I think if I had realized at the time how sleep deprived he must have been, I might have been more nervous about his inserting a needle into my spine, but you know what they say about ignorance being bliss. I was so surprised at how heady the epidural made me feel, but also shocked at how good I felt. I hadn’t realized how much my back and legs had been hurting the last trimester or so and how uncomfortable the constant low-grade contractions had been. I kept saying over and over how great I felt, so while I hadn’t wanted the medicated birth, I definitely loved the medication.

They left us alone for half and hour to make sure I was thoroughly numb and I told the babies how much I’d loved carrying them around the last eight and half months and then we told them how excited we were to meet them in person and what we’d be wearing so they’d recognize us (“I’ll be the one in the hair net cap and blue, tie back hospital gown. With glasses”). It was then, in the prep room that we decided for sure whose name would be whose. Robert said, “I’ve been kind of wondering if we should go ahead and name them. We feel like we already know them pretty well.” And it turned out we both agreed Baby A (always what the doctors call the twin closest to the cervix who’s going to come first) was E and Baby B was L. We had chosen both of the girls full names based on their meaning. E. means “Christ has mercy” and her middle names means “clear and full of light” and L means “crowned with glory” and her middle name means “consecrated to God.” It was one of the most moving moments for me of the whole day. By 3:00, they were wheeling us into the operating suite. It was quite the party with the surgeon, the assistant surgeon, the neonatalogist, the nurse anesthetist, the two respiratory techs (one for each baby), and the team of nurses for me and the two nurses for each baby. Rob points out that, given the number of medical personnel that were involved in their conception, it only seemed right that there be at least an equal number present at their birth. I asked them to tell me when they began cutting and Dr. N. said she already had and that I would feel a little pressure and suddenly (at 3:12) she said “The first baby is here!” and she held her up and she (E) started to cry- and so did I. I don’t think I truly believed until that moment that I was going to have two, live, healthy, take-home babies and I was overwhelmed with the anxiety and fear that had clouded so much of the pregnancy and how quickly it all dissipated with her angry little cry. Robert went over to the incubator where they were rubbing her off and suctioning her out and doing her Apgar, but Dr. N said “Dad, you’d better get back here! We’re getting ready to deliver the next baby!” I remember calling across the room, because I needed him there to tell me about her when she was born. He ran back, and at 3:14, Dr. N. held up L. and said “She’s so much bigger!” And she was-she weighed a full pound more than E at birth. L. was crying, too-she’s had a very distinctive cry since birth- and I felt so relieved and grateful. When we had planned the surgery, I had initially thought that I might want Rob to stay with me while they finished the suturing. But once I saw them, there was just no way I wanted them to have to be away from at least one of us at, so there was no question that Rob would go across the hall to the surgical recovery suite and wait for me with the babies. Before he went, though, the nurses brought them over and let me hold them for a few minutes. They were indescribably beautiful and they were looking at me with their tiny eyes and they got so quiet and I knew they knew I was their Mom. It was probably the helpful physical description I had given them earlier. We called them by their names for the first time and Rob went with them over to the recovery room.

One of the neat things about the surgery- if it can be said that any aspect of a procedure that involves your organs being removed from your body is neat- was that the assistant surgeon recognized me from my pre-in vitro laparoscopy he had assisted on the year before with another surgeon (actually, my OB’s uncle, who is an endometriosis specialist). He said that he had taken such care to minimize my scarring last time that he wanted to take extra time to make sure my section scar was not noticeable- and he really did. He gave me great sutures and I didn’t have any of the numbness and all of that that a lot of people I know have had. (***unsolicited advice warning: if you ever for some reason require a c-section, request that your surgeon do a double closure on your uterus and do NOT let them just through in staples. That’s faster for him or her, but the outcome in terms of incisional pain is much worse in the controlled studies that have been done. So you’ll feel better more quickly with stitches. Just so you know***). While all of this was going on, I got to listen to the fascinating surgical talk as he and my OB debated the name of the movie with Michael Douglas, Gwyneth Paltrow and that “guy from Lord of the Rings.” It went on for so long that I finally had to speak up and tell them “A Perfect Murder” because I definitely wanted to hear about something else while I was lying there, shaking as a result of the epidural. I remember getting sick from the medication and the nurse anesthetist telling me it was a common shock reaction to the trauma caused by the surgery and the handling of major organs that the process involved. She hit me with a little Z*fran and I felt a lot better. My last major memory of the surgical suite is a nurse using my abdomen as a desk for her clipboard as she made a few last notes before she moved me. Then it was onto the recovery room. I’ve written elsewhere about getting to hold and nurse E. They wouldn’t let me hold L. because I couldn’t do kangaroo care in the recovery room, as they were about ten minutes from moving me to my postpartum room and she was having a hard time maintaining her body temperature. But they let me see her in the incubator before they wheeled her off to the special care nursery for an hour or so. We were moved pretty quickly to our new room and my parents met us there. I introduced them to E and, a few minutes later L was wheeled back in and we got to introduce her.

As I look back on the day, I know that I was too in shock, in such a good way, to have processed it all at the time. I think that’s a big part of the reason that it’s taken me so long to commit the story to paper. It’s not beautifully written and the OCD part of me hates that. I want the girls to know their birth story and I don’t ever want to forget, but it’s really hard to wrap everything we experienced that day into words. One of the nurses offered to videotape the birth for us so Rob could concentrate on helping me and focusing on the babies and she held the camera up so high that, well, if you’re ever planning a c-section, so don’t rely on mere descriptions in books about what exactly they’ll do, but call me and I’ll send you a tape. I couldn’t watch it until November and I still cry every time I do. I see so much of God’s hand in our story-His bringing our babies into being, His protecting them during a complicated pregnancy, even His perfect timing in their delivery. While they scheduled my surgery to avoid complications from the choleostasis, by the time I arrived at the hospital, I was swelling and my blood pressure, which was perfect the whole pregnancy was very high. Even the epidural, which normally causes blood pressure to drop didn’t help and I know that, if we hadn’t been scheduled that day, I wouldn’t have recognized that I was developing some serious symptoms that could have been devastating for me. And I’m so grateful. I’m grateful for an end to that particular season of infertility, I’m grateful for the blessing of two beautiful, healthy children and I’m grateful because in the midst of a world in which everything can and so often does go wrong, Christ had mercy and granted us those days of complete joy and grace. I know that when I’m in another season of suffering I’ll probably forget-I always do- but I pray that Rob and I will be able to look at our children, remember why we named them what we did, remember that beautiful day they were born and know that God is powerful and that Christ is merciful and try to order our lives in the knowledge of those two things.

Welcome, Tiny James!

I wanted to post a quick note to welcome James Oscar, my sister Erin (of the Erin and Elliots at left) and my brother-in-law's new baby. He weighed 7lbs and 110zs, was 21 inches long and has a head full of black hair. Plus, he is ridiculously cute. Elliot should be posting a few pictures on their blog, but I think you can visit his dad's blog through the link on their site and see some photos now. We're so glad he's here and the girls are excited about passing on their Razorback gear that they've outgrown so he'll have something to wear when football season rolls around.

Saturday, May 26, 2007

On Call*

The job I have now is the first one where I have had to take regular emergency call. I work for a decently sized practice, so I’m only on about once every four or five weeks for a week at a time. Some of the other therapists whose practices are extremely specialized, (i.e. they only see people with eating disorders or dog phobias or something like that) don’t have to take call. Which makes perfect sense- you’d hate to call our emergency on-call number because your wife just left you and you don’t know what to do and end up talking to someone whose instinct is to ask “Are you wanting to binge eat?” So it’s not an unfair system. And before this week, I typically got about one call every other day for my week and usually only a middle of the night call about every six months; all in all ,it hasn’t been so bad. In fact, when I was on bed rest last year, I still took call, my rationale being that, hey, I was doing something besides researching things that could go wrong with the pregnancy on the internet or watching TV. It was during this time that I learned something interesting about adrenaline during pregnancy. I got paged at 4:00am one morning and woke up feeling a little panicked. The girls were asleep, too (I was about 7 months along at this point), but it took only about 45 seconds before they were up and obviously feeling panicky themselves and writhing around in there like they were trying to escape, which I thought was kind of funny. Anyway- back to my point. Basically, I’m trying to say that I don’t get paged that often and , when I do, I find that I’m usually explaining the whole “emergency” concept to whoever is calling. In case there is any doubt, let me review some situations that are not, in fact, emergencies and that I would prefer not to be paged out of bed for: your teenage daughter telling you she hates you; your child waking up one night having a night terror; your wife coming home drunk; your therapist not returning you call within 20 minutes; feeling that our office has billed you in error; and so on. I’m not trying to be insensitive; I understand that each of these events can be distressing; they do not, however constitute what I call an emergency. What I generally consider an emergency is something that most people would recognize as resulting in immediate harm or permanent damage if not dealt with this minute, like a teenagers troubling, recurring thoughts of suicide; an almost irresistible temptation to swing the sledgehammer you’re holding over your ex-spouse’s windshield in violation of your restraining order; that panicky, awful empty feeling that often goes along with depression-please pick up the phone and call the emergency on call therapist if you‘re experiencing these symptoms. Actually, if you know me, feel free to call me at home if you’re experiencing these symptoms, night or day.
But this week was different. I received an emergency call every single day and not one was a real emergency. And while I’m so glad there weren’t seven people in our practice experiencing life or marriage crises, but I am as tired as I have been since the babies were 5 months old and consistently sleeping through the night today. And it’s due in part to the fact that I was paged at 3:00 this morning for a situation that WAS NOT AN EMERGENCY. I feel empathy (but only a little) for the father of the teenage girl who called because she caught him reading her e-mail and she told him she hated him. Truly I do. But I myself was not experiencing great love for him myself when my returning his call at that hour in my formerly silent, 1200 square foot ranch style home awakened my two sleeping daughters, who mistakenly then assumed if Mommy was on the phone, it must be morning and, by golly, they were going to be forced to yell until somebody served them breakfast. While I was explaining to the caller that while, yes, it is very upsetting that your 19 year old daughter claims to hate you for invading her privacy, this is probably a matter best taken up with your therapist who knows your family dynamics in the morning, he must have noticed the background weeping and gnashing of teeth, because he asked in a irritated tone of voice “Is that a baby crying? Are you able to pay attention to my problem over all of that?” I assured him that I was, but had to reign in my desire to ask him if he thought I sat up all night in a quiet room in an office somewhere waiting for non-emergency calls all night or to assure him that I would punish the offending baby appropriately as soon as I was off the phone. As we discussed contacting his therapist, he asked me “Can you promise me she’ll call me right back tomorrow morning?” Again, I wanted to say, “Actually, I can’t, but I’ll call her at home right now and try and extract a promise that she will.” But what I said was “No, but I’ve never known her not to return a call.” So I got off the phone and went to prepare E and L’s 3:30 breakfast and help them back to sleep. But not before whispering a prayer of thanks that this is my last day of call .

*All identifying information and exact dialogue have been changed to ensure client confidentiality and to comply with all HIPAA regulations.

Monday, May 21, 2007

The First Swim

Long time, no blogging. Today, though, the pictures are too much fun to put off posting them until I can do writing of substance. I hear you all breathing a sigh of relief that this might be a reasonable length-ed post. I'll have to come up with something extra long next time to pay you back for your sarcastic attitudes toward me. Anyway, today my friend Brea and her son Skeezix* called (well, technically, Brea did the calling) and suggested that L, E and I come over and go swimming in Skeezix's new pool. Given that it was ridiculously hot here for May, we were delighted. We were even more excited to arrive and find that the girls' other good friend, Julio Eduardo* had just arrived to swim as well. It was a great time for the girls to try out their new suits. L wasn't a huge fan of the water, preferring as she does that the bodies of water in which she chooses to soak be warm. E, however really liked the whole pool idea and spent a good portion of our time there climbing in and out and attempting to drink the water face first like a puppy. You would have guessed by the way she acted that we never provided her with anything to drink. They both also got a kick out of playing with some of Skeezix's fun toys that we don't have. All and all, it was a good first swimming experience for the girls.

*As per Christy's custom, names changed to protect the innocent.

E playing with Skeezix:
















L. attempting to climb out of the pool:




















Here are the girls playing with Skeexiz's toys:















And a final shot of the most adorable Julio Eduardo and the handsome Skeezix practicing their splashing together: