Welcome to the universe.....

On Tuesday, at 32 weeks and 3 days, our ultrasound revealed low fluid around Baby A.  Past 32 weeks, our high-risk doctors suggested that we have C admitted to the hospital for monitoring.  In case we had to deliver early, steroids were administered to aid lung development in the twins.  C was given twice daily non-stress tests from Tuesday through Thursday, when she was also given another ultrasound.  NSTs were great, but the ultrasound confirmed the low fluid in Baby A's sac.  To our surprise, doctors recommended that we deliver that night via c-section.  

We had hoped for 34 weeks, but 32 weeks and 5 days was as far as we would get.  Doctors assured us that "32-weekers" routinely had "successful outcomes".  We called our families, who came as soon as they could.

At 8:19 on Thursday, October 15th, 2009, Truman Richard Kayne and Fisher Daniel Kayne were born.  Truman weighed 4.5 pounds and Fisher weighed 3.2 pounds.  Trying my best to be partial, these are damn good-looking boys.  Their Apgar scores were both 9 of 10 (Columbia doesn't give 10s, since newborns 'never' have full color in their hands and feet, so the boys are already testing well).  More on Apgar here: http://www.babycenter.com/0_the-apgar-score_3074.bc

Tru and Fish were whisked away to the Neo-natal Intensive Care Unit (NICU), where they were given some assistance breathing (standard care for preemies) and put on monitors.  It's a bit jarring to see the boys hooked up to machines, but they're receiving the best care on the planet and they're doing well.  The tubes hooked up to their noses help them breathe, as 32-weekers have trouble breathing on their own (again, this was to be expected).  They get their nutrients intravenously and are kept in isolettes (http://tinyurl.com/yf8ra8j).

As of today, Truman has been made to lay on his right side to treat a small pneumothorax (another minor complication common among preemies, pneumothorax is air around the lungs that prevents complete expansion.  Often, a pneumothorax will be reabsorbed easily.)  While adults breathe 21% oxygen, Truman's assisted breathing is pumping 40% oxygen, while Fisher has gotten as low as 25%.    The closer they get to 21%, the better...that's when they can start feeding.  Fisher has been doing well enough that he fed (on colostrum that C has been pumping...http://dictionary.webmd.com/terms/colostrum) today.  We're hoping that Truman will be able to feed soon, but we're not rushing him.

C, unfortunately, is still itchy as all heck.  What we had thought was Obstetric Cholestasis has turned out to be a pregancy rash called PUPPPS (http://dermatology.about.com/cs/pregnancy/a/puppp.htm).  Good news: it will go away on its own.  Bad news: it may take up to 2 weeks after delivery.  Carrie is toughing it out, but it's torture.  

We'll update periodically, and thank you all so much.  Our boys are doing well, though they may be in the NICU for around a month, we're happy to have them in the best hospital and with the best doctors.  We're hoping the parents aren't too shabby either.

thank you thank you thank you.

Obstetric Cholestasis, Non-Stress Tests, ugh...

Yet again, apologies for the delayed post. Things have become a bit hectic on our end.

Since the beginning of her 3rd trimester, C has been itching a bit, but as of a week ago the itching became unbearable and unremitting. Today marks the 6th consecutive day without sleep, and she is covered in self-inflicted scratch marks. Apparently, in roughly 7 of 1000 pregnancies, women develop a condition called Obstetric Cholestasis (OC). In OC, bile acids enter the blood stream and cause severe and unrelenting itching. OC is very rare, but more common in mothers of twins than in mothers of singletons. I have no idea what 6 days of sleeplessness is like, but I do know that sleep deprivation is form of torture used on enemy combatants. C has just been elevated from generally amazing to superhero/sainthood status.

There is an entire support group devoted to moms with OC (www.itchymoms.com) but most of the messages posted attest to the frustration of those who suffer from it: the itchiness, in many cases, does not subside until delivery.

After a week of normal ultrasounds and echo-cardiograms, Dr. Simpson recommended that we begin bi-weekly monitoring as we cross the 32 week threshold (which passed this weekend). Today, Baby A's fluid was low enough that C was again admitted to triage at the Labor and Delivery unit for Non-Stress Testing, which we passed without incident. However, Dr. Miller has asked C to be admitted to the hospital and receive steroid shots in case Baby A's fluid situation does not resolve, in which case we would probably deliver in the next few days. During this time, C will be monitored closely. At this point, we're unsure if she will be staying in the hospital for several days (or weeks?).

Still, we hold out hope that we'll make it to 34 weeks (10 days away), when risk of pre-term complications diminishes greatly. It's no great comfort that our primary doctor (Simpson) is out-of-town while these decisions are being made, but Dr. Miller has given us excellent, if cautious, care up to now. Simpson returns on Monday.

For now, C is in hospital, I'm at work, and one of her best friends is by her side. I'm heading home to grab stuff for this unexpected hospital stay and we'll play it by ear.

Thanks to everyone for everything. We're in the home stretch now.

Thursday's ultrasound

Nothing new to report on Thursday. Baby A still looks good, but with slightly low fluid...Baby B still looks a bit small, but with ample fluid. All dopplers still look perfectly normal.

On Tuesday we have another growth scan and echo-cardiogram. More then.