Tuesday, September 21, 2010

Breastfeeding Rules Broken

So I broke the rules with breastfeeding.  Well first the hospital broke the rules, we tried to get back on track, then I broke the rules.

As I mentioned in the birth story, the twins had to go to the Special Care Nursery for 48 hours after they were born. Not only did I not get to breastfeed them during that time, but they were bottle-fed formula.  Once I was able to breastfeed in the hospital, I asked for a lactation consultant or a nurse to help me with every feeding.  One of the LCs asked me why they were given a bottle and not cup fed in the SCN to which I had no answer for.  Fortunately for me they still did breastfeed and once they made it to the regular nursery, the nurses brought them to my room every three hours for feedings.  They would nurse a little and then had to have a formula supplement in order to put on weight. A few of the nurses had me tandem feeding them and were very excited when it worked but the reality was I was just laying there and the nurses were doing all the work.  Once I was on my own, I could only focus on one baby at a time.

Since we've been home, I tried to nurse every three hours but still had to supplement every feeding per the pediatrician.  I was never sure how much they were getting and they always fell asleep at the breast.  I tried the tricks they showed me in the hospital to wake them up but once they were woke back up, they had trouble latching back on.

The first rule I broke was eliminating nursing at night.  Once I moved to my bedroom from the family room and put the twins in their bassinets, it was too hard to get situated on my bed and nurse them without them getting frustrated fast.  I know I should have tried harder but to keep my sanity, I switched to straight formula at night and try to nurse + formula supplement during the day.  This cuts down the time it takes to feed them and makes for less angry babies at night.  And, admittedly, I get more sleep at night too.

The twins are quite popular and we get a lot of visitors.  Which I love but there are only a few I will nurse in front of.  So I slowed down during the day too.  Broken rule #2 (which is technically the same rule as #1 just more broken.)

I rented a hospital grade pump but haven't pumped as much as I should have.  And it wasn't until I started pumping that I realized how little I was producing.  Forty-five minutes on one breast with suction as high as it can go yields a little more than one ounce.  I'm still pumping and storing at least twice a day and nurse during the day when I can and I'm going to try to pump more to see if the milk production improves.  My OB, who is also a mother to twins told me basically the goal is to get them fed be it breast or bottle.

Broken rule #3 happened when I introduced the forbidden binky -or in my case, the Soothie.  I was told during my breastfeeding class no pacifiers for at least four weeks and it would be better to never introduce them.  The pediatrician said wait at least two weeks.  I made it twelve days.  The twins are not huge fans of the binky but it does soothe them occasionally.

I told myself I would try to breastfeed and if it didn't work out, that would be okay.  The truth is I do feel a little bit guilty that I haven't worked harder at it.  Mel wrote a great post yesterday that, along with the comments, has helped ease my guilt.  I'll keep at it the best I can though.  For now.

Sunday, September 19, 2010

Little Men in Pants!

After my super long birth story post, I thought I'd write this quickie with some pics. :)

I broke out a "newborn" outfit (they are getting bigger every day!) to celebrate the twins three-week birthday and my due date yesterday.  This was the first time they wore pants!  Too cute although Sweet Potato is not happy being forced to "sit" for a rare photo of both boys together.

The celebration included a walk around the neighborhood.  They love the stroller!

Wednesday, September 15, 2010

The 3 Heathers, A.K.A. The Birth Story

To share the birth story, I need to go back a few days before the big event. Without knowing it at the time, things started getting interesting on Tuesday, August 24th after my NST, ultrasound and check-up.  The doctor had me go to the lab with borderline pre-eclampsia symptoms – lots of fluid, protein in my urine, elevated blood pressure.  I mentioned in an earlier post – Tuesday night was rough – nausea, unable to sleep and abdomen pain* no matter which way I moved.  Tylenol seemed to help but I called in sick to work on Wednesday. 

The doctor’s office called with my lab results Wednesday and I told them how I was feeling. Without saying much, the nurse said to come back in on Thursday for another BP check and more lab work.  I wasn’t on the schedule, just stop in sometime in the morning like it was no big deal.  When I got there, my BP was back to normal but the other symptoms were still there.  One of the nurses said I looked like hell so they scrambled around to get me in with a doctor.

The doctor I saw wasn’t concerned at first; even said I could go back to work if I was up to it, until he flipped a page in my file: “Oh...  no, you can’t go back to work.  The best thing for you right now is rest.  Your platelet counts are low (whatever that meant). You won’t be on the regular schedule anymore – we’ll call you after we get your lab results and probably have you back in on Monday for another check.

Friday’s call was more vague than Wednesday’s – the doctor wanted me to do a 24-hour urine collection on Sunday and come in Monday for a check-up.  I never made it that far.  Friday night was another Tuesday night – really rough and Tylenol wasn’t helping.

I just wanted to feel better so I held out until 8 AM on Saturday and called the doctor’s office.  The weekend doctor on-call, Heather #1, called back and I asked her if there was a prescription she could write me that was a stronger than Tylenol.  She ignored my question and suggested I come in to the hospital and get on the monitors.  I told her about the next day’s urine collection and Monday’s check-up and she said by looking at my records she didn’t need a urine collection to know that I had “severe” pre-eclampsia, my platelets were dropping and something about my liver enzymes.  She gave me more information in that five minute phone call than my doctor’s office had given me all week.  Admittedly, I didn’t ask a lot of questions of them but I had no idea the seriousness of the situation.

I called Fabulous D and by 9:30 we were at the hospital.  I had no idea I would be staying – I didn’t bring my hospital bag; I didn’t call my mom right away; I really thought I would go to Triage, listen to the heartbeats, get some medication and go home to rest.  It wasn’t until they took me straight to a labor room and put me in a gown that I started to get it.

My first nurse was awesome - Heather #2, and she was the one to tell me I was staying put and there was a good chance these babies would be born soon.  The babies were doing great, thank God, and throughout the day and night had strong heartbeats.

Heather #1, came in and explained everything that was happening.  Besides the pre-eclampsia, I had HELLP Syndrome with a risk of having a seizure, would need to go on magnesium sulfate and my platelets were so low that there was a chance I would not be able to get pain medication through an epidural.  If my blood didn’t clot properly, the risk of damage from the catheter to my spine was too great.  It was either no pain management or go under general anesthesia and have a c-section.  She said it was at the discretion of the anesthesiologist as to what level he would be comfortable with to insert the catheter.

My attitude for the entire pregnancy was to listen to the doctors advice, take it day-by-day and do whatever was necessary for the babies’ health but I’m no super-hero.  I was not opposed to a c-section but wanted to be awake for it and Fabulous D would not be allowed to be in the operating room with me if I had to go under.  I was sure this was punishment for not going to that damn breathing class and even said that out loud to Heather #2.

Heather #1 also explained to me over and over again that the best course of action for my condition was a vaginal delivery, “push, push, push!”  A c-section would be too risky for excessive blood loss (or something like that).  Great = vaginal delivery with the chance of zero pain medication.  Luckily, my levels had not dropped that much since the last check and the anesthesiologist was comfortable with the catheter insertion for the epidural.  My platelet count was  at 101,000 (?) and he wanted to do it quickly before they dropped further.  Shortly after the insertion, fluid began draining from the catheter so much that my sheets and gown were soaked.  After determining that, no, it was not back sweat, there was concern it was spinal fluid leaking.  It turned out to be fluid leaking from the edema.

Things relaxed a little until the cervical check.  I had not had a cervical exam the entire pregnancy.  And Heather #1 has short fingers.  The check was the most painful thing I had experienced so far.  My cervix was pointing down and Sweet Potato’s head was in the way.  It was so bad that for the first time ever, Heather #1 had to get someone else to do it.  She found a mid-wife with longer fingers and she was able to determine I was 1 centimeter dilated.  I was induced and after a little while (really no idea how long), asked for the pain medicine through the epidural.  The minute I asked, I began to feel pain – you know before the twenty or so minutes it would take to kick in after it was administered.

Everyone says you should feel at least one contraction.  Got it, felt it, give me the drugs.  Well they tried.  At first, I was pain free but after a short while, it wore off.  I sat up in bed at one point and felt a gush – my water broke on its own and both Heathers were very happy about this.  For the next hour, I went from one centimeter to five and the epidural was barely managing my pain.  Heather #1 had said she wanted me to feel no pain and to be able to push these babies out.  Well I felt pain.  The anesthesiologist tried four or five different medicines through the epidural – all of them wore off.  The end result was that the contractions were shorter and I was only feeling them at the peak but I was sure feeling them.  For someone who didn’t have HELLP Syndrome, they would re-do the epidural but my platelet counts were now in the 70,000 range so that was not an option.

Heather #1 was now suggesting nubain to “take the edge off”.  I was starting to get frustrated with all the different medications and wanted some reassurance that this would help.  She couldn’t promise anything but convinced me to try it.  I’m not sure if it helped the pain but it sure made me loopy which would later piss me off.

While in one hour I went from one to five centimeters dilated, the next hour I stalled completely and didn’t progress even on pitocin.  I kept feeling gushes and was told it was my water and normal and Heather #1 didn’t want to irritate the cervix with too many checks.

I’m not sure the order of events after this but I spiked a fever and when my cervix was checked again, it was discovered that I was not leaking fluid but bleeding.  I was still out of if from the nubain and now Heather #1 was going into great detail about the importance of me delivering soon.  All I could think at the time was that I was in pain and she was all push, push, push – how was I going to do that?  After several minutes of her re-explaining her position (I think perhaps to convince herself?) the decision was made to do a c-section. I found out days later she was concerned with placental abruption.

The c-section was a breeze.  They gave me a spinal since the epidural could not be “juiced up” and just before midnight on 8/28, my babies were delivered.  Peeing.  And crying.  In fact, the Dynamo peed on my drape while they held him over it for me to see.  When the catheter for the epidural was removed, they discovered it was not in the proper place which is why I felt the contractions. 

Because of my fever, the boys had to go on antibiotics and stay in the Special Care Nursery for 48-hours.  After my initial hour and a half recovery, I was wheeled into the nursery in my bed to see them and fell asleep next to their bassinets. 

I had to stay on the magnesium sulfate, which the nurses called “nasty stuff”, for 48-hours and be checked every hour.  Luckily, even though they were in the Special Care Nursery, the twins were able to visit me in my room for the first time late Sunday afternoon and “graduated” to the regular nursery Monday night at 1 AM.

My recovery after the births lasted four days and during that time, I had many different nurses.  Each new shift brought on a new nurse, sometimes three nurses in one day, and only once did I have the same nurse twice - Heather #3.

Heather #3 was not warm and fuzzy.  In fact, I found her to be a bit abrupt and well, a little mean.  After the percoset they gave me made me feel ill, they switched it to vicodin and when I asked if it was okay for me to take that while breastfeeding, Heather #3 made a crack about no one giving me anything I couldn't take while breastfeeding.  Okay, point taken.  But I'm on multiple meds, just had major surgery and am a little loopy - give me a break.  Not to mention, each nurse had to press on my uterus during their "checks" and while every other nurse was gentle in this painful pressing, Heather #3 pressed hard!  Seriously, EVERY time.  I mentioned it to one of the other nurses and she said something to Heather #3 which only made it more uncomfortable between us when she was assigned to me again.

To top it off, my boss had flowers delivered to me in the hospital which I never received and the florist confirmed that "Heather" signed for them!  Do I think she stole my flowers?  No.  But it is suspicious,

All in all, my stay was okay.  I'm recovering very well from the c-section and am back to my body weight before I started fertility treatments!  I'm sure I'll gain more in the days to come - especially since I am back on carbs and sugar! - but I love the fact that I can wear regular clothes again!

*The ab pain I was feeling for the week or two before the births is one of the many symptoms I had from HELLP Syndrome.  Makes me wonder why my doctors didn't look into that sooner and makes me very glad I called the office that Saturday morning.

Monday, September 6, 2010

Quick Post and Pictures

I'm not ready to write the birth story but wanted to share some pictures and some details!

Things are going well so far.  After five days in the hospital, I've had five nights at home with my little superstars and my mom's help.  My original plan to keep them in their bassinets next to my bed hasn't worked out so the three of us are spending our evenings in the family room with them sleeping in the Pack N Play, swing, or bouncy seat and me sleeping on the sofa.  It turned out to be easier to physically get up with them, nurse them, feed them a formula supplement (they dropped just under 5 pounds since the births) and change them from this one room that is open to the kitchen rather than gather all the supplies and do it all upstairs in my room and the nursery.  I do miss my bed though so I will attempt the bassinets again soon - especially since I am feeling so much better physically and am more able to get in and out of bed now than I was five nights ago.

And I'm in love!!  Athough I went through some unexpected complications for the births, the reward was so worth it!

Baby A,  Known on this blog as Sweet Potato
Born 8/28/10 at 11:55 PM.  5 pounds, 3.6 ounces, 18.5 inches long.

Baby B,  Known on this blog as the Dynamo.
Born 8/28/10 at 11:56 PM.  5 pounds, 1.6 ounces, 19 inches long.

Wednesday, September 1, 2010


Baby boys arrived at 37 weeks on 8/28 at 11:55 PM and 11:56 PM.  Birth story to follow soon!