Update June 14 11:45 AM: Added each baby’s birth weight and length

An Eventful Start

The Very Beginning

This week actually started out a little different than most. Sam’s aunt and cousin let her know on Sunday that they had been visiting other family in nearby Sunnyside. They wondered if they could come visit for a few days. They came in Monday afternoon just to hang out for a bit and spent the night into Tuesday.

Tuesday is when things really started to get interesting. Sometime before lunch Sam coughed and felt a pain in her stomach. She also felt dizzy and felt like she might pass out (or at least how someone would imagine passing out feels) and developed a headache and bad “period cramps” (her words). We weren’t too concerned at this point, but we did make a few phone calls.

The best we got from one of the nurses was that perhaps a blood vessel had been “pushed” and had caused the symptoms. They were going to talk to the doctor, though, and get back to us.

Things Get Interesting

After lunch and while still waiting to hear back from the doctor, Sam decided to go lay on the bed and take a break. I also went back to work on our “office” in the bedroom next to our master. She mentioned to me that she was still feeling movement from the twins but that she just wasn’t feeling good.

At some point (approximately 1:40 PM) she came to the office doorway telling me that she thought her water had broken. We talked briefly and then noticed that there was blood in the fluid. At this point I grabbed a towel and we headed out the door. We were very fortunate to have the family staying as we were able to leave without having to be concerned about what to do with Waverly. With Covid-19 issues, we knew that she would not be able to come into the hospital with us.

Because of how early in gestation we were (31 weeks 3 days), we really hadn’t had an opportunity to get our bearings to the Birth Center, but we did know that we needed to start at the Main Entrance of the hospital (Kadlec Regional Medical Center, Richland, WA). I parked our van in a handicapped space thinking I would come out and move it quickly. Once inside, they immediately walked us up to the Birth Center (though they did give me the wrong badge; sorry Antonio).

Starting to Get Some Answers

Nurses have some impressive nerves. Despite that Sam was dripping bloody fluid, they seemed totally unconcerned when we were checking in. They took our information and finally walked us down to an exam room to get things started. The first order of business was just to get Sam into a gown and get all of her vitals (including monitors on the babies). They did finally bring in a doctor, but even she didn’t seem that concerned at this point. To help the girls develop their lungs as quickly as possible, the started a steroid treatment. After some difficulty getting baby ‘A’ to cooperate with the monitor and getting an ultrasound of the babies, they moved us down to a delivery room (though on a surgical bed; we had no intention of doing a vaginal birth at this point).

The doctor that did the exam (Dr. Tuck) had a pretty good sense of humor. While doing a quick check with the portable ultrasound, she managed to grab the image below showing their two heads together.

At this point, it was really a sit and wait and hope that we could wait as long as possible. At this point in gestation, every day counts. They did put Sam on some antibiotics to help prevent any infections due to the placenta being ruptured. We eventually learned that the “period cramps” were actually contractions. They weren’t super strong, but they were pretty consistent. Dr. Tuck wasn’t very excited about those, but so long as they didn’t get real strong she wasn’t too concerned.

Waiting…

Wednesday

Wednesday was mostly uneventful. The contractions faded away early in the morning and the day just didn’t do much.

We did have a little excitement in the evening. Sam’s temperature went up a bit (~100°F) and her blood pressure was elevated. Fortunately, those came down on their own within about an hour.

With the elevated temperature it was deemed a good idea to test her for Covid-19. I am happy to report that it came back negative!

Again, not much going on today.

Thursday

Thursday morning started out pretty calm. They were still keeping track, but had switched to only doing BPs and monitoring babies three times a day.

Because we seemed to be in a holding pattern, I headed home to eat something and take a shower. While I was home I got a message from Sam that she had some side pain and that they were going to hook up the monitors for the babies again. We still weren’t very concerned, so I continued and took my shower and grabbed some McDonald’s on my way back to the hospital.

Game On

Pre-Op

When I walked into the room, Sam mentioned that there was some blood when she used the restroom. The nurse was already in the room doing some checks. After doing a preliminary exam, she called in the doctor (Dr. Subramanian) to check. After doing a physical check and getting blood on her glove, she made the call to move forward with the delivery. She was not comfortable with what she saw.

At this point, they didn’t consider it an emergency situation, but definitely urgent. I overheard them talking about bumping the scheduled noon delivery to move us in to that spot.

We did everything to get prepped and they took Sam away to start getting prepped in the OR. I followed a ways behind to get some scrubs on and wait for them to get Sam’s spinal in and ready on the table.

Operating Room

C-Sections are such a strange thing to sit in on. First, everyone on the other side of the curtain is talking like they’re sitting around in the break room. The non-chalance is so weird in that situation. Second, the amount of physical effort going into the project.

Last, dang it’s fast! From first incision to first baby out is incredible.

It became clear that baby ‘A’ had a lot of amniotic fluid. This gave a pretty clear indication that baby ‘B’ was the one that had ruptured.

Baby ‘A’ was also the one who’s placenta had detached leading to Sam’s bleeding. She was the first one out (12:57 PM) and started crying right away. She seemed to be doing well right away.

Birth Weight: 6 lbs 3 oz
Length: 19 in

Baby ‘B’ came out at 12:58 PM and made a little noise, but clearly not as much as ‘A.’ After I got a picture with ‘A,’ I stepped over to ‘B’ and watched them work. The respiratory therapist was over there holding a mask over her face trying to get her oxygen saturation up. After a little trying he stuck a tube down into her stomach and discovered that she had swallowed quite a bit of blood on the way out. With that, they were able to start pushing enough oxygen to get her levels up, but she was clearly struggling a little more.

Birth Weight: 5 lbs 2 oz
Length: 18 ½ in

Once she had stabilized a bit, we made a procession down the hall to the NICU.

Now we move onto “the next stage.”

Now

Names

Alright, so, some of you may not already know the names, so now I’ll give them to you.

Baby ‘A’

Elizabeth Ira

The first name doesn’t have any specific background, it was just a name that we liked.

The middle name, on the other hand, does have some significance. Sam’s mom’s name was Irma. We decided not to go with the name exactly and like the sound of “Elizabeth Ira.” So, moral of story, that' where that came from.

Baby ‘B’

Aspen Kimber

Again, the first name doesn’t have any particular meaning, just something that we agreed on.

The middle name comes from my mom, Kimberly. Following the trend, we shortened it a bit and like the flow of “Aspen Kimber.”

NICU

It was a foregone conclusion at 31 weeks that we would be heading to the neonatal intensive care unit [NICU], so it was not concerning that they were brought straight there. Both of them, by this point, were mostly stable. I hung around with them for a few minutes while Sam was being patched up and moved to her new room.

Thursday (Day 1)

Both girls had very low blood sugars (<25) and immediately were given boluses of dextrose to try to bring them up. They were also hooked up to CPAPs to force pressurized air into their underdeveloped lungs

After seeing that there was going to be some work to get them both all settled into their new homes outside of the womb, I decided to go see if Sam was awake.

Sam had been moved to another room in a different section of the Birthing Center. The room was clearly not as modern or large, but since it was just a place to be for a few days, it was satisfactory.

Sam was intent on getting herself to see the girls and had been told that she should be able to see them Thursday night, and she was going to do everything in her power to make that happen! By about 8 PM she was able to get around enough that they would let me wheel her down there in a wheelchair. She was super excited to see them!

I had learned in the time before Sam was able to get down there that Elizabeth’s sugars had not come up high enough. This had prompted them to go for a more heavy-duty dose of dextrose than they’re able to push through a standard hand IV. I actually walked by while the Nurse Practitioner was finishing up putting in an umbilical line. This allows them to push higher concentrations of dextrose which enabled them to get her up to satisfactory blood sugar levels.

This “central line” did prevent us from holding Elizabeth today. The site of the insertion was leaking some and they needed it to stop doing that. Sam did get some good snuggle time with Aspen.

Friday (Day 2)

Friday saw some new things for Aspen. She has always seemed to have more difficulty with breathing than her sister. I’ve had it explained to me a few times, but I’m missing some of the details. In short, she seems to basically hold her breath. However, where a mature baby would have a reflex to release, the neurological development of the babies doesn’t quite get that far. That allowed her to have six charted events today with her O₂ saturations dropping into the 40s. It usually required jostling her and turning up the oxygen concentration in her air to get her numbers back up.

It was determined from all of those events that perhaps they should give her some caffeine. Apparently that is a fairly normal thing for babies of this age. They started with a “loading dose” to get things started and they’ll continue with a maintenance dose.

Both girls had good sugars throughout the day so no further work needed on that. They were also reduced on how much pressure was being applied for breathing. This actually meant that neither of them is still on a CPAP, now they’re just on something the nurses called “high-flow.” They’ve never needed (except for Aspen’s “events”) any extra oxygen over ambient.

Saturday (Day 3)

The big news for today is that Sam has been discharged. She was really looking forward to getting home to see Wavy and just be able to do what she wants when she wants. We can still get in to see the twins any time that we want 24 hours a day.

Future

Now that we’ve gotten through the first few days it’s all about maintenance while we allow them to mature. We do get to hold them, but they are limiting our times there so that they can both get as much phototherapy as possible. We’re currently doing two visits per day, one in the morning and one in the evening.

The nurses and doctors really have not been able to give us much in the way of expectations of when we can bring them home. The only thing they’ll tell us is that we should keep their due date (August 10) in mind and anything before that would just be icing on the cake.

We’ll try to do regular updates on any developments or thoughts. If you have any questions, try using the comment system below (I’ve never used it like this before, so we’ll see how it goes) and we’ll try to address them either in those comments or in an update post.

Last, below is a link to our registry on Amazon. We’re not in urgent need of anything since they won’t be coming home for at least several weeks, and we may still have a “baby shower” like event, but feel free to peruse.

Thanks to everyone that has sent us love and has been praying for us. We really do appreciate it and can’t wait until we can show them off!