Watching Airplanes

One of our favorite ways to wind down in the evening is to watch airplanes before putting the boys to bed. We go out onto the deck and the boys arrange the furniture just right, then we lay down and the boys climb on top of us. We talk about the stars we see or the way the moon looks and then we wait for the airplanes to fly over us. Monday night I was doing solo bedtime duty and we hadn't done this ritual in a long time so I suggested we head outside and the boys were happy to oblige. I laid down, Dean climbed up on my left side and Jack perched on my right. We talked about the stars and watched for airplanes. We saw a little one that was taking off at the private airport to the east of us. Then one of the big jets came in from the west, heading towards Burbank airport. I told the boys, "look, here comes a big one". Jack looked at me, put his finger to his lips and whispered,"shhhhhh. You have to be quiet. That airplane berry, berry loud." So earnest. So sweet.

A Valiant Effort

We went to a birthday party at the El Capitan theater on Saturday for a viewing of "VALIANT" followed by ice cream at the Disney Studio Store and Soda Fountain. We arrived at around 3:40 and sat next to the birthday boy while the theater organist played Disney tunes. At 4:00 the pre-movie show was supposed to begin. Unfortunately, they were having technical difficulties with the organ (it's supposed to lower into the stage) and were delayed by 20 minutes. Thus, the pre-show didn't get started until 4:20. You see how this is playing out? The actual movie got started somewhere around 4:50. By then, the boys were not that interested in watching a movie. We made it through about half the film before finally giving up. We then headed next door to have the birthday celebration with ice cream sundaes for all. Just walking in the door was a treat. Ahh, the smell of waffle cones being made - reminds me of the old days working at TCBY. Anyway, after waiting for a little while they pulled 3 tables together and we ordered all the kids ice cream sundaes. Dean takes his ice cream eating very seriously. That kid was on a mission to get to the bottom of his dish. His spoon was in constant motion and at the end, there was barely a dribble on his shirt. No sticky ice cream hands, no pools of dairy on the table - it was fascinating to watch. Jack - not so much. Our waitress brought over a plate to put under his dish because there was so much ice cream pooled around it. After the ice cream had been eaten, the birthday boy opened his presents and after the oohing and ahhing, we left. It was a nice time but I don't think the boys are ready for the El Cap.

Wondering what I did?

Well, hang onto your hats folks because - it's pretty darn exciting. First, I stayed at work until 6:30pm. Then I took work home with me and sat on my couch reading - work. Boys got home at 8:00pm and were limp, sandy, sticky noodles.

Then we went to bed.

Jealous?

Life's a Beach

So my husband just came by to switch cars with me so he could pick up the boys and go out to the beach. He told me he doesn't know when he'll be home what with traffic and all and that I should enjoy my free evening. Isn't that nice?

I don't know what to do with myself! Should I go to a movie? Should I call a girlfriend? Should I have a drink? Should I have a Six Feet Under marathon since I've only seen episode 1? See, I feel like I should do all those things - make it an all-nighter!! But, what I really want to do is go to a bookstore and browwwwwse at my leisure. Have a cup of tea, curl up on a sofa and read. But out of my house so there's the illusion of being social without having to talk to anyone. It sounds glorious. Except that I'd wind up slumped over asleep with drool spilling out of my mouth and some poor Barnes and Noble fellow will be assigned the task of waking me up.

Too many prospects!! Paralyzed with indecision!!

Birthday Wishes

Happy, Happy Birthday Tom. I love you so much. Thank you for making me a better person and for being such a wonderful daddy to Jack and Dean. To my greatest friend, love and partner - I love you.
Kelsi

NICU/Homecoming

Thursday, January 2, 2003
The boys are breathing on their own. Jack gets nipple feedings twice in a row, then one tube feeing, and so on. Nipple feedings are bottle feedings that teaches the baby how to suck, drink and breathe at the same time. One of the complications for preemies is that they’re too weak to suck and all their strength needs to go to gaining and maintaining weight. So, they’re given tube feedings until they are strong enough to suck but it requires a lot of energy so it needs to be done gradually. Jack weighs 5 pounds 2 ounces and the next big step for him is to increase his nipple feedings to every feeding. Hopefully, that will be ordered within the next day or so. Once he has a few days of successful nippling, he’ll get to come home. Dean gets 3 nipple feedings per day and weighs in at 4 pounds 5 ounces. He’ll likely come home a few days after Jack since he’s not as successful with his bottle feedings. He just doesn’t want to do the work – he forgets to breathe and then his monitor goes nuts.
I wish I had written down all of the progress over the 30 days. There’s been so many milestones that I’ve missed.
Monday, January 27, 2003
Both boys are home now. Jack came home on Monday, January 13. He’s on an apnea monitor for a minimum of 1 month and then the doctors will re-evaluate. He’s also on 5 different medications: aminophylline (a medication that speeds the heart up and keeps the airways open), diuril and aladactone (diuretics), and sodium and potassium (electrolytes). They’re all given at different times of the day and in different doses. It’s a challenge to keep up and I’ll be glad when we can discontinue them. Dean came home on Thursday, January 16. He’s also on an apnea monitor but no medications. Secretly, I don’t mind the monitors even though they weigh 10 pounds each! But, I sleep easier knowing that they’ll go off if their heart rate drops or they stop breathing. We’re pretty much just camped out in the living room. It’s easier than moving all their equipment to our bedroom each night. Jack acclimated to being home pretty easily but Dean was a little upset. He kind of acted like he didn’t trust us. Now they seem to be a little more comfortable. Getting Dean to eat has been a bit of a struggle. He just can’t get latched on like Jack does. Finally, my mom suggested I nurse them at the same time and, unbelievably, Dean latched on without any problem. Now I nurse them simultaneously with every feeding and Dean seems to be doing much better.

This picture of Dean was taken on November 27, 2002. He's off the ventilator but still has the nasal canula for oxygen. Notice the size of the pacifier? It's a preemie pacifier. At this point Dean was receiving 3 cc's of half-strength breast milk. I held him for 30 minutes that day.








This picture of Jack was taken the same day. That's my hand on the left. I held him for 45 minutes that day. At this point he wasn't receiving any breast milk at all - just the fats and lipids. We were hoping that he would start getting some breast milk the next day.

NICU Part One

As chronicled in my written journal:

Wed. November 20, 2002
Jack is doing well. They took him off the respirator today and he’s only on 26% oxygen. He’s had 2 doses of indocin which will hopefully cause his pulmonary artery to close. He’s on dopamine to help his kidneys process the indocin. He’s receiving some lipids because he lost 4.5 ounces and they need to keep his weight up as much as possible. His color is good and he’s not being sedated very much. He’s a little jaundiced but he’s on phototherapy to break up the bilirubins.
Dean is still on the respirator. Yesterday morning his chest x-ray showed that there was a lot of excess air surrounding his left lung. That means there is a leak in the lung. They put a needle into his chest to extract the air which allows the lung to expand. Then later they did another chest x-ray and it looked much better. But, it happened again later in the evening and this time they had to put in a chest tube. It will be left in for a few days to allow time for the lung to heal. I’ll never forget the sinking feeling I had when the nurse practitioner came into my room to tell me. I thought the world had ended. Dean also has had 2 doses of indocin and is a little jaundiced so he’s on phototherapy, like Jack. He’s on about 44% oxygen but yesterday he was on 54% so this is an improvement. He’s more sedated than Jack because of the chest tube, they want to make sure he doesn’t pull it out.

Fri. November 22, 2002
I’m going home today and I’m so ready. I’m tired of having to ask for my pain medicine and being awakened throughout the night. I’ve gotten a lot grumpier since I moved to post-partum. The boys are doing well. Dean got a bath last night and now he looks really blond. He was down to 22% oxygen last night. His chest tube might come out today. He looks really good. Jack is really stable. He’s still off the ventilator and the nurse had him sucking on a pacifier last night.

First Picture

Dean is in front and Jack is in the back.

Birth Story

My water broke at 4:30am on Sunday, November 17th, 2002. Tom happened to be sleeping in my room at the hospital because he had torn the bathroom apart and couldn’t sleep with all the dust in the house. I had been in the hospital since September 29th. My doctor had visited me the day before and was thrilled to see that I was hardly having any contractions and she felt that I would make it to December. Clearly, she jinxed me.

So, after my water broke, I called the nurse who checked it out and said, yep, you’re ruptured. She told Tom and I to try to get as much rest as possible because it was going to be a long day and she went off to call Dr. Reyes. Tom and I didn’t know what to feel – on the one hand happy and excited that we’d finally get to see our boys but also terrified because I was only 30 weeks, 5 days pregnant. Tom couldn’t relax because he was so worried about - everything. He went home at 5:30am to meet a contractor about the bathroom and to assess the damage. Remembering this, I can’t believe I let him go but I was doing ok at the time and I was in really good hands with the nursing staff so, I let him go.

By now I had started having contractions that hurt and they were coming about every 7 minutes. By 7:00am they were coming even faster and they really, really hurt. Since I had gone into the hospital when I was 23 weeks, I never went to the birthing classes so I had no idea how to cope with the pain. One of my nurses, Stacy, told me to softly hit my forehead with my hand over and over and over. So, I did. And cursed – A LOT. At 9:00am, Stacy came in to check on me and saw that I was in a lot of pain and that the contractions were about every 3-4 minutes. She announced that she was going to call the doctor to schedule the c-section. See, they wanted me to go as long as I could manage the pain because every second counts when you’re delivering that early. Plus, being in active labor increases the hormone that matures the babies lungs. Stacy came back in my room and said that my surgery was scheduled for 11:00am. I called Tom and told him to get his butt back to the hospital! He arrived at 10:25am, just as they were wheeling me down to get prepped for surgery. He kissed me as they whisked me away and then he went off to get prepped, too.

Once in the operating room, they put me on the table and had me sit up. While I curled my enormous belly over a pillow and the nurses held my hands, the anesthesiologist put a needle in my spine to administer the anesthesia. It wasn’t that bad and of all the medical things that were done to me, that procedure would rank nearer the bottom than the top – the top being the worst. Then, they laid me down and strapped my wrists down. The anesthesiologist kept poking me with needles from my lower belly to my chest to see what I could feel or not feel. Then my doctor came in with her assistant and they got to work. Tom came in at about 11:05 and Thomas Jackson was born at 11:06am. Henry Dean followed at 11:07am. Tom videotaped everything and remained so calm throughout. Dean was crying weakly but I didn’t hear anything from Jack. Each baby had his own team of NICU nurses and respiratory therapists. Finally, after what seemed like hours, Jack gave a little squeal. They wrapped them up and brought them over to me. Their little faces were about the size of apples. I got to look at them for about a minute and then they put them together in an isolette to wheel them down to the NICU. Jack weighed 3 lbs 5 oz and was 16 inches long. Dean weighed 2 lbs 13 oz and was 16 ¼ inches long.

Pregnancy Complications

I began having complications with my pregnancy in August of 2000. One day I just wasn’t feeling well. My pelvis felt low, sore and heavy. I called the doctor and she said to come in right away. But, I didn’t have a car that day – I had dropped it off at the dealer to get serviced and then I took the shuttle to work. So, since the Doctor’s office is only a block from my office, I walked. That was dumb. Anyway, she examined me and then put a uterine monitor on me for a while. It showed that there was some uterine instability. It was nothing serious but caused enough concern that she wanted me to go to the hospital for further monitoring. Ok, but I don’t have a car and while the hospital was only 2 blocks away from the doctor’s office, it didn’t seem like a good choice to walk there. Nor did it seem like a good idea to ask my husband to swing by and pick me up on the motorcycle. I called one of my coworkers and she drove me to the hospital. The nurses set me up in the room, put a big pitcher of water on my bedside table and strapped me to two fetal monitors and a uterine monitor. The babies were doing fine and Tom and I watched the uterine monitor anxiously. They did a urine culture and discovered that I had a bladder infection. They monitored me for a few more hours, then sent me home with some antibiotics and a drug called terbutaline which stops contractions. I was having Braxton hicks contractions which don’t hurt and aren’t labor contractions but if they happen often enough can progress into labor contractions.

I stayed home for 2 weeks. My doctor told me that if my perinatalogist said I could go back to work, then she would write the order. At my next perinatalogist appointment I was given the ok to go back to work, which I did the next day – Wednesday, September 11, 2002. On September 20th, my birthday, I wasn’t feeling well. I called my doctor because it felt like one of the babies was pushing on my pelvis. She told me to take it easy and call the next day if it persisted. The next day, I was having Braxton hicks contractions again so I called the doctor. She told me to take one terbutaline (which had been discontinued) and if I felt even one contraction to go straight to the hospital. I did what she said and yet, continued to have contractions so we packed up and drove to the hospital. Again, they hooked me up to the fetal monitors and uterine monitors and set a big pitcher of water next to my bed. They gave me a shot of terbutaline, which seemed to calm things down and we were sent home. This time I was told that I would not be going to back to work until after the babies were born. On Tuesday, September 24th I started feeling contractions again. I remember staring intently at the clock, watching the time tick away and counting every tightening I felt and hoping, hoping that it would stop. But it didn’t. My friend and neighbor, Kelly drove me to the hospital. This time, they weren’t fooling around. They inserted a catheter into my urethra and started an I.V. line of fluids to make sure I was hydrated enough. They strapped the fetal monitors and uterine monitor onto my belly and watched. I was having Braxton hicks contractions about 10 times per hour. They told me that my strip looked like a regular labor patient, which scared me. I was 23 weeks pregnant. My doctor ordered that I be put on magnesium sulfate, a smooth muscle relaxer that can calm the uterus and stop the contractions. When you’re on mag, especially high doses, your vision gets a little blurry, you feel a little sleepy and very, very hot. My room temp was lowered to 65 degrees and I was never cold. I kept all my blankets on the chair next to my bed so that my visitors could bundle up and stay warm. By Thursday, Sept. 26th they had lowered my dose of mag and were hoping to put me on oral medications by the next day. On Friday, Sept. 27th they moved me from the labor and delivery ward to post-partum and put me on oral medication. On Saturday, Sept. 28th they sent me home with orders to stay in bed and if I had 4 contractions in an hour I had to go right back to the hospital. Driving home, I felt very uneasy. I still felt contractions and was nervously counting them. I couldn’t relax. I kept drinking water and then I’d be up every hour to go to the bathroom. I didn’t sleep at all, just watched the clock and counted contractions. Finally, at 11:00am on Sunday, Sept. 29th I told Tom that we had to go back to the hospital.

Back at the hospital, they inserted the dreaded catheter and started the I.V. of magnesium sulfate and fluids. They strapped the fetal monitors and uterine monitor on my belly and told me the most important thing was getting to 24 weeks which was the earliest that the babies would be viable. They checked my cervix and found that it was still closed (good). On Tuesday, Oct. 1 they gave me a shot of beta-methasone, a steroid that helps to mature the babies lungs, and performed a test called fetal fibronectin, also known as FFN. A positive result from this test means that you’re 85% more likely to give birth prematurely. I was absolutely certain that my test would come back negative. They administered it in the morning and told me I’d have the results by 2:00pm. When my nurse came in with my lunch, I asked if she’d heard about the test yet. She broke the news that the result had come in and it was positive. I felt my face crumple. Then she did the nicest thing in the world. She came right to my bed, gave me a hug and told me that I had to remain positive. That every moment, every hour, every day mattered and that I couldn’t lose hope, that those babies needed me. She was such a kind nurse. The next two weeks went by fairly uneventfully. I stayed on mag, got blood tests every 8 hours to check the toxicity in my blood, still on the catheter, still unable to get out of bed for anything – not to shower, not to poop, nothing. My baby shower was cancelled – it had been scheduled for October 5th. My mom came out to visit anyway and she stayed with me in my room all day, every day. We did crossword puzzles and watched Oprah.
She left on the 10th.

On Sunday, October 27th, I woke up very late. My nurse chided me for sleeping in. I was usually awake by 7:30am and they’d bring my breakfast at 8:00am. On this day, I slept until 9:30am. I was in a lot of pain. My back was hurting and I thought it was from being in bed for 3 weeks. My nurses let me get into a rocking chair while they changed the bed. I felt a little better but was barely able to keep my breakfast down. They took my temperature and it was a little elevated. I got back in bed and noticed that my urine looked really cloudy and junky. I mentioned it to my nurses and they said they’d do a culture. Later, Tom came to visit and I felt worse and worse. My contractions started getting more frequent and painful and my nurse came in and announced that I was in active labor. She notified my doctor who came directly to the hospital and started ordering tests. First, she said I wasn’t allowed to eat or drink anything else in case I had to go into surgery. Then, she ordered an ultrasound of my gall bladder, kidneys, liver and appendix. The ultrasound tech couldn’t get a read on the appendix but he said the gall bladder and liver were fine. He barely touched my kidney area with the wand and I about went through the roof it was so excruciating. Um, I’d say there might be something wrong with my kidneys? She also had the tech do an ultrasound of the babies to see how they were acting. They were doing just fine. That was a relief. Given my upwardly mobile body temperature, the junky urine and the pain in my kidneys – it wasn’t a surprise to get the urine culture back positive for an infection. They put me on 3 different antibiotics, increased my mag and put an ice blanket on me to get the temperature down. My doctor had the anesthesiologist consult in case I had to have a c-section and she also had the surgeon come in. A hematologist (blood doctor) was called in and ordered several blood cultures. They took 7 vials of blood from an artery on my left arm and 7 vials of blood from a vein in my right. Meanwhile, the contractions continued getting more and more painful and more and more frequent. My doctor kept calling the perinatalogist to see if there was any other medication that I could take to stop the labor from progressing. Finally, he told her she could give me one shot of terbutaline but if that didn’t stop it, we would have to just see what happened. The nurse administered the shot in my left arm and within 30 minutes my contractions began to slow. An hour later, my doctor felt I was stable enough that she could leave. Finally, we settled in to get some sleep. We both slept fitfully but woke the next morning feeling relieved and that we really dodged the bullet. On Monday, October 28th they removed the catheter and told me I would have to request the bedpan when I needed to urinate. Believe it or not – that was a victory. On Tuesday, October 29th I reached the 28 week milestone. We felt this was a truly hard fought victory. My doctor ordered a second round of the beta methasone shots hoping that it would help the boys lungs develop faster. By Wednesday, October 30th I was beginning to feel like my old self again. On Thursday, October 31st I asked to get a tour of the NICU. They put me in a wheelchair and I got to talk to a nurse and see what the NICU was all about.

When I returned to my bed, the hematologist was there to tell me that I was severely anemic. My hg levels were around 7 and they should be between 12-14. If they couldn’t get them up I would have to have blood transfusions. To boost my hg levels, he ordered weekly shots of epogen, a red blood cell booster, as well as, 1800mg of iron per day. I called Tom to let him know that I may need a transfusion. He called my friend and neighbor Kelly who then organized a blood drive with all her friends. People I didn’t know or hardly knew came to the hospital in droves to donate blood just in case I needed a transfusion. That way I’d have “friendly” blood instead of the unknown. It’s at times like that when you find out what kind of friends you have and the generosity of the human spirit. My hg levels were checked daily and by the next week, I was out of the danger zone.

But, there was a new danger. Also on Thursday, October 31st I suddenly felt a little fluid leaking from me. The nurse checked it and it tested positive as being amniotic fluid. This meant I had a leak and that it presented the danger that the amniotic sac could become infected. They did an ultrasound to see how much fluid was surrounding the babies. They looked fine, plenty of fluid. The doctor said the sac could eventually seal over and that we’d just have to wait. The babies would be monitored continuously from now on rather than for a couple of hours a day.

On November 7th I received my final shot of epogen. On November 14th, I was no longer leaking fluid and the doctor determined that the rupture had sealed over. By this time I was having fewer and fewer contractions and they started lowering the mag dose. On Saturday, November 16th my doctor visited me and commented that I was hardly having any contractions. She said that they’d get me to 32 weeks, then discontinue the magnesium. I’d have to stay in the hospital but she thought they would deliver me at Christmastime when I’d be at about 36 weeks.

My water broke the next day and the boys were born at 11:06am and 11:07am.

A Tale of Infertility

Tom and I started “trying” to get pregnant in July of 2000. That is, no longer actively preventing. Anyway, when I didn’t get a period in August I bought a pregnancy test. It came up negative. OH well, I thought – it’s just the first month. After a year, with still no period, I asked my doctor who nonchalantly replied, “it could take a month or it could take 18 months. You just have to wait.” I waited another six months and then asked to see a fertility specialist. She took some blood, asked some questions, did an exam and diagnosed me with a case of “arrested development”. It was her feeling that my reproductive development was somewhat stunted by a very athletic teenage-hood. In my case, the pituitary gland wasn’t getting the message to the ovaries to make the eggs. She ordered an MRI of my pituitary to rule out a tumor or blockage, as well as, a hysterosalpingogram, which is an x-ray of the uterus to make sure there was no blockage in the fallopian tubes. She also performed an ultrasound of the ovaries to make sure there were no cysts. All tests came back negative, meaning there were no problems with the uterus, pituitary or ovaries. Good news! Then she checked Tom’s sperm count. He had a somewhat low count and low mobility, which basically means they didn’t travel well.

So for us, the question was: How do we get Kelsi to ovulate? And, how do we get Tom’s sperm where they need to be? The answer: hormones for Kelsi and then, artificial insemination for Kelsi.

We started with Clomid, a medication in pill form that is designed to send a message to the brain to send a message to the ovaries to make eggs. The doctor didn’t think it would work since the trouble seemed to be my brain (no jokes, please) but she wanted to give it a try since it was the least invasive. I started my dose in January of 2002 and ovulated right on schedule after 14 days. But, we didn’t get pregnant. After my period (my first in over 18 months), we tried it again. After 16 days, I still hadn’t ovulated. 17, 18, 19, 20. Still, no ovulation. The doctor told us that she hadn’t expected the Clomid to work and here was the proof so let’s begin the injectable hormones. We did a little tutorial in the office so Tom could learn how to give me a shot and away we went with a batch of needles and little jars of hormones. Tom gave me shots daily for several days and I went into the doctor’s office about every 3rd day for an ultrasound to see how many eggs were being created. Nothing was happening. Doc was perplexed. She increased the medication. A few days passed and during one ultrasound she announced that I had spontaneously ovulated and it must have been due to the Clomid. BIZARRE!!! She liked me because I was a challenge. She told us to discontinue the shots until after I got my period, then start ‘em up again. We did as instructed and more ultrasounds followed. It was now the middle of April, 2002. After a few days with very little happening, she increased my dosage and monkeyed around a little with different medications. Then we started to see some eggs! First there were 2 that were growing at about the same rate. A few days later, a third one seemed to be catching up. A few days later, there was a veritable easter basket of eggs in each ovary with 13 in one and 15 in the other. She eased up on my dosage to keep the first 3 growing but to slow the growth of the other 25. Then one day she announced that it was time to trigger the release of the 3 eggs. It was still going to be a shot but with different medication. Tom and I were at a party in Woodland Hills and at 6:00pm sharp we sneaked off to a back bedroom to trigger the release. That was Sunday, April 28. On Tuesday, April 30, 2002 I drove to the doctor’s office with very precious cargo in my passenger seat – Tom’s sperm. I dropped it off with the doctor to be prepped and I killed some time in the drug store across the street. At 9:00am, I walked back to the office and was shown into a room. The doctor inserted the catheter into my vagina and injected the sperm into my uterus. Then I was left to rest for 20 minutes. Ok, so there was no candlelight or romantic music but at that moment, life was created and that’s magic. From then on, it was a waiting game. On Monday, May 13, 2002 I woke up, quietly walked into the bathroom and peed on a stick. Two faint blue lines appeared. I went back into the bedroom and whispered to Tom, “I think we’re pregnant.” After I had showered and dressed, I went to the doctor’s office for the blood test, then went to work. I told everyone in the doctor’s office that I had taken a pregnancy test that morning and seen two faint lines. Later, while on the one line with Tom, the doctor called on my other line to say, “You saw a FAINT line? You are very, very pregnant!” I clicked over to Tom and said, “we did it!”

Two weeks later, we went into the doctor’s office for an ultrasound to see if we could see exactly how pregnant I was. The doctor was pretty certain that we had more than one baby because my hcg levels were much higher than they would be with just one. Sure enough, we saw 2 sacs on the ultrasound which confirmed that we were pregnant with twins. Our due date was January 21, 2003. We were positively overjoyed and felt so very lucky. Even though we experienced infertility, the treatment worked for us and relatively quickly. Other friends of ours spent years exhausting treatment after treatment, not to mention their bank accounts so what we went through was easy by comparison.