Babies: Baby A and Baby B
Lauren wanted to share her story to raise awareness towards a scary condition called HELLP Syndrome. This is a hard read, but it ends well!
On an uncharacteristically dreary Thursday in late May of last year, I woke up much earlier than I wanted to. People who know me well know that I am not in the least bit a morning person. But being pregnant with twins means you always get the early morning appointments. So I hauled my big ole pregnant self into the bathroom to get ready. Once on my feet I knew something was off. My back and head were KILLING me. I figured it probably had something to do with being 5'2" and measuring 45 weeks pregnant already at just 33 weeks and 3 days. Or maybe it was because I scrubbed the showers yesterday (nesting makes you do really strange things). I didn't know for sure why I was in pain but I knew I had to do something about it. So I took a bath (which I never do in the morning) and the pain melted away.
Eventually I drove myself to the hospital, checked in at 8 am, and waited a bit. As I waddled to the maternity ward, following one of the hospital registrars, I wondered why the heck she had to walk so fast. Nothing makes you more self-conscious than a much older lady pausing to wait for you to catch up. When we finally we made it to my room, I got hooked up to all the monitors. One for me, one for Baby A, and one for Baby B. And then began the nearly impossible task of monitoring both boys for 30 minutes straight. This was my 3rd time being monitored, so I knew that it could take up to 5 hours to get clear readings. I watched helplessly as each boy kicked his monitor out of place and a nurse rushed in to reposition things. Finally 2 hours later we got a clear reading. The nurse looked at me funny and asked if I was feeling any pain. I told her that I was uncomfortable from laying on my back. To my surprise, she told me I was having contractions and said she'd be right back. She came back with a pill (Procardia) that would stop my contractions. After taking it, we waited 30 minutes and I was rechecked. They were waning, but still concerning, so they gave me another dose. Thirty more minutes passed and she checked again. Almost gone, but I got another precautionary dose (the max daily dose, I was told). Thirty more minutes passed and they were all but gone. I was being discharged.
As I got up out of the bed I got very lightheaded and realized just how much my back hurt. Clearly I didn't look well, because the nurse asked me if I was ok. I said I just needed to eat and that my back hurt from laying down for nearly 4 hours. She got me a snack and water and asked if I wanted to stay a bit longer. Definitely not, I wanted lunch and a nap in my own nice comfy bed. So I told her I'd be fine, and waddled my way back to the car.
By the time I got to the car I was spent. And by the time I was half way home (a mere 7 minutes later), I knew I should've stayed at the hospital. The pain was mounting quickly, I could hardly take it. I was dizzy and oh so very, very nauseous. I could hardly see straight, but I knew I had to get myself home. And when I did, I projectile vomited. Twice. I grabbed my phone and called my husband, Ben. He told me he was on the way and to call my doctor. The nurse said to come in to the clinic and get checked. Two minutes later she called to say go straight to the maternity ward. Ben got home in record time. He rushed me to the hospital. I felt like my back was ripping apart, every little bump was like a knife to my spine.
We made it back to the hospital just 30 minutes after I had left. I could barely speak or stand. I was huffing and puffing. The registrar from earlier saw me and came out of her office. Concerned she decided to find me a wheelchair. It felt like it took her 10 years. And it felt like an eternity while she pushed me to maternity. How could this be the same lady I struggled to keep pace with?
We finally made it and the nurse from earlier in the day got me setup in my room. My doctor, came in to tell me she had been monitoring me all morning. She was concerned. Especially when she found I was dilated to a 2 and 50% effaced. And there was blood. They immediately started me on a magnesium sulfate drip. It was like fire through my veins. I remember everyone being a bit frantic, but I was strangely calm. I still couldn't feel the contractions and my back pain was subsiding. The magnesium was making me more nauseated. After an hour on the magnesium with little change, my doctor decided I needed to be airlifted from our small hospital to a better equipped hospital. Unfortunately the weather was bad that day. It took her 4 hours to find a way for me to get out of our hospital. No one would airlift me unless I went to a hospital a 6+ hour drive north instead of just 2 hours south (where I had been seeing a specialist). Ben and I had to choose between the short flight north (with him having to drive 6 hours alone) or the 2 hour long drive in the ambulance (with the risk I'd deliver on the way).
I remember feeling so sure that everyone was making a bigger deal of the situation than was really needed. I wasn't at all concerned that I'd deliver in the ambulance, honestly I thought they were all nuts. I didn't even fell like I was in labor, I had no idea until later that my contractions were less than a minute apart at this point! Ben and I decided on the ambulance ride. Once we made the decision everyone started rushing. They prepped me to leave-- I had more blood tests, new IV ports placed, switched gurneys, met hospital administrators, was told that it was unprecedented that a doctor and nurse would volunteer to ride with me, met the transport team, and was rolled to the ambulance.
Somewhere in the jumble Ben asked what I need from home. I told him some clothes and my glasses, and added "you should maybe grab the car seats and diaper bag just in case". I was convinced that bigger hospital would be able to stop my labor and we'd be back home the next day. It was the weirdest thing, everyone clearly thought this was an emergency. Everyone but me. I remember time passing so slowly, it felt like I was in a dream.
In the ambulance they asked my doctor if she agreed we should run a "code 3," puzzled she asked what he meant. He explained that a “code 3” was the highest level of emergency transport with lights and sirens the whole way. She agreed it was necessary. Again I felt like they were making a big deal out of nothing. I felt fine, my pain was completely tolerable at this point. My doctor prayed for me and off we went.
We finally arrived at the hospital at 7 pm, 11 hours after my day began. As I was wheeled in I saw my sister in the waiting room. My parents were on their way from 6 hours away. And I still had no inkling of how serious things actually were.
I was hooked up to monitors, had my IVs replaced yet again, and was checked. Still 2 cm, still contracting. They switched my meds, because the mag sulfate could cause damage if taken too long. More tests. No answers. The babies were beginning to showing signs of distress. This was when doubt began to trickle into my mind. Maybe the babies were trying to tell us something. I decided all I could do was breathe deeply and pray.
At this point I started singing to myself (in my head...lest people think I'd lost it completely). One song replayed over and over in my head, "You call me out upon the waters, the great unknown where feet may fail, and there I find you in the mystery in oceans deep... When oceans rise my soul will rest in your embrace, for I am Yours and You are mine..." (Oceans (Where Feet May Fail) by Hillsong UNITED, listen below). It was God speaking softly to me, telling me everything was in His hands. I prayed fervently.
Finally at 2 am we got answers. I had HELLP Syndrome-
H: Hemolysis (my red blood cells were being destroyed)
EL: Elevated liver proteins (my liver was shutting down)
LP: Low platelets (I was losing the ability to form blood clots)
The resident who’d been overseeing my care apologized over and over for not catching it sooner. She said none of my symptoms indicated preeclampsia, which is typically (but not always) a precursor of HELLP. My blood pressure was perfectly normal, and there wasn't any protein in my urine. Nothing indicated the underlying issue until one of the blood tests finally revealed the symptoms of HELLP. Later I found out I had the most severe form of HELLP, and that I had been well on my way to liver and kidney failure. After her apologies, the resident said the only cure for HELLP is immediate delivery. This is the moment I finally got scared. Not for me, but for Ben and my boys. I remember looking at Ben and seeing him register that he was very close to losing me. That's when I started to pray that God would give Ben the courage to get through this, even if I didn't. I prayed that God would take care of Ben and my boys no matter what was about to happen. I prayed that their little lungs would grow quickly. I thanked God that we had made it to one of the best NICUs (Neonatal Intensive Care Unit) in the area. I honestly never felt the urge to pray for myself, I was completely at peace with whatever God had in store for me. I just wanted Ben and my boys taken care of.
My platelets were so low that it was too dangerous to do the surgery right away, I’d likely bleed out on the operating table. But it was also too late to get my natural labor restarted... (This is where things get a bit fuzzy for me, these are details I've pieced together from my broken memories and from others who were there...)
Before my surgery I was given two platelet transfusions to bring my counts up (it may have been more than 2... normal platelet count is 150-400 bil/L, mine was 35). Once I reached the minimum for surgery, I was prepped. I remember my mom and Ben being with me. Ben said we needed to pick Baby B's name before I went in (Baby A's name had been chosen weeks ago). We settled on one of our choices, which meant laughter. And boy did we need some laughter just then. I was put under general anesthesia and the boys were delivered at 9:05 and 9:06 am Friday morning. Just 25 hours after I had arrived for a routine appointment.
I remember waking in recovery. I felt as though I'd been hit by a truck. I was in and out of consciousness, never fully aware of what was happening. I was vomiting and crying out for pain medication. My mom was frantically pushing the pain pump button for me. Nurses were scrambling around me. My husband was splitting his time between me and the twins. The pain was UNREAL.
I didn't know it but I was hemorrhaging BADLY. I've been told I lost at least 3 liters of blood. To put that in perspective, women on average have a total blood volume of a bit less than 5 liters. I received at least 6 units of blood. I remember the team of doctors joking about my "six pack" as I was being prepped for surgery- my "six pack" being a cooler with 6 units of blood matching my blood type just in case I needed it. More than enough, they thought (boy were they wrong). Apparently at some point while I was hemorrhaging, some of my "six pack" even went missing and they had to scramble to get me more blood.
When I next remember waking, I was in my own room. The awful magnesium sulfate was burning through my veins again. I was so very thirsty, begging for water and ice (you're not allowed fluids while on mag sulfate). My family was there. I remember being surprised to see my aunt had come all the way from Texas. I was still struggling to stay awake. Honestly I don't remember most of that day. I got to see pictures of my boys- pictures that broke my heart. They were in the NICU-- so tiny and covered in wires. My body had failed them, they weren't ready for this. I remember feeling extremely disappointed that I wasn't the first person to meet them. I don't even quite know how to put into words what it feels like to be a mother unable to hold or even visit her own babies. I felt utterly disconnected.
I remember waking the next day, feeling more coherent. I had a really "busy" nurse that day who I hardly understood due to her broken English. She was appalled that I hadn't been taken to the babies. I told her they didn't want me moving while on the magnesium. She requested that the doctor stop the mag drip. Once I was off it she wheeled me to the NICU. Ben was confused because he knew there were specific protocols, and he wasn't sure they were being followed. But he assumed she knew what she was doing and went along with it. As we scrubbed in and rounded the corner, I remember hearing the alarms and thinking that the NICU was much louder than I expected. Little did I know that I was hearing the alarms for my own sweet little ones. We got to the room they shared with 6 other babies. It was frantic. I was confused. A nurse recognized Ben and told us we needed to leave. It hit me...Our babies were the ones crashing. Their doctor explained something to us, but her words fell on deaf ears. I was completely numb.
I felt apart when we returned to my room. This was so not the plan. I had had a great pregnancy. Both boys were in prime position for a natural delivery. I was planning to try to avoid pain medications. I was just 3 weeks away from my induction date. But somehow it all went wrong. I FAILED. I prayed so hard for those little boys. I asked God to spare them and to prepare us for what lay ahead.
Later (that night, I think) I was finally able to meet my boys. They had recovered from their unexplained heart issues. But they were on breathing tubes and in isolettes when I met them. So fragile, so helpless. It was too much to take in. I was overwhelmed and heart broken. All I could do was apologize to them. I was so afraid to touch them for fear that I would make things even worse
Sunday was a blur of visiting with family, pumping milk for my boys, and visiting the NICU. I was starting to feel myself again, and was recovering fairly well. Monday morning I got a treat, the AWESOME nurses arranged for me to hold both boys at the same time. They got the miles of cords and piles of monitors situated so that my boys could meet each other again. It was such a precious moment. And it finally sunk in... they were ours, our sweet boys --and by God's grace we were all going to get through this.
That day all the family left to return to their homes and it was just Ben and I. Reality was slowly sinking in... I had been so, so close to death. But quite miraculously I recovered very quickly. The doctors couldn't explain why I was doing so well despite still having very low iron and platelets. When I was released both were still quite low, but I was showing no signs of lingering complications. And I was discharged on Tuesday afternoon. Nothing stings more than seeing the empty car seats in the back seat as you leave the hospital. I wept for hours.
My boys were just 33 weeks and 4 days when they were born. They were so small and having a really hard time keeping their heart rates up. They also had some breathing issues, but thankfully that all passed within a few days. The graduated to being "growers and feeders," once they could eat on their own and showed steady growth they'd be released. After 19 days Baby A was released, and two days later so was Baby B. We were finally headed home.
And now with just days to go before their 1st birthday, you would never know my boys had such a dramatic entry into the world. They are happy little bundles of energy. We've definitely had bumps along the way, but we are so very thankful to God that we all made it through. He has been faithful and has healed my guilt and feelings of failure. I may never understand exactly why this happened to us, but I know that God was there with me, and I am thankful for the perspective it's given me. Things like nap troubles pale in comparison to wondering if your babies will survive the night…