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Wednesday, November 11, 2015

tiny blessings : a preemie story by Vicky Gudelot

Thank you so much to Vicky Gudelot for sharing her story of premature births with her twin boys (such handsome guys!) at 33 weeks 6 days. She has a story of pain, fear, and ultimate survival and bravery. I'm in awe of this story. She offers great advice also about focusing on YOU and how you feel, rather than supporting others around you. Thank you, Vicky!

Images shared from Vicky Gudelot

1.     How far along were you when your babies came early? 
I went to a routine appointment at 33 weeks. During my NST, I was pretty sure I was seeing regular contractions, but the labor and delivery nurse kept telling me no. However, an hour later at an internal check, I was already nearly 5 cm dilated! I was given drugs to stop labor, and though my water broke, I was able to “pause” labor until 33 weeks, 6 days, at which time I was given pitocin to restart my labor. I took ALL THE DRUGS.

2.     What were the first thoughts or feelings you had when you realized the babies were coming? 
I was in shock. Besides well-controlled gestational diabetes (common with multiples), I had been told I was having a “rockstar twin pregnancy” so this sudden change of events was startling to say the least. I didn't even have a bag packed! When the doctor told me I was going back to L and D, I blurted out “No, I can't do that, I'm going to Target to buy my crib sheets tonight!”. Also, we had booked a last fancy meal and date the next night and I was so sad I wouldn't be able to go! After those initial thoughts, though, I just got worried for my boys' health.

3.     Can you share that part of the story - what happened? where were you? what did doctors say? procedures, things they tried to prevent the babies from coming, etc.? 
I feel like I can say that I had EVERY procedure. I was planning to give birth locally, but they referred me to a larger Boston hospital to be safe. However, every hospital was filled with multiple births so we weren't even sure where I was going in the ambulance when I left! I was given magnesium sulfate to stop birth, which is an unpleasant drug which caused me to vomit heavily. The vomiting ultimately caused a P-PROM. Everyone was sure birth was imminent, so I received an epidural. And then... nothing. These stubborn little boys stayed put! At 33.6, they decided that the boys were now safer in the outside world than in, and I had an induction (and a second epidural, and a fifth replacement IV and so on...)

4.     What were your fears as you heard the babies would be premature? 
We had taken a class on multiple birth and I knew that statistically, my boys had a good survival chance at their gestational age. I knew they would be looking at a little NICU time, but I wasn't terrified, more concerned.

5.     What helped you through those initial scary moments? 
My husband was a wonderful advocate for me. I have an intense needle phobia and he helped me feel as safe as I could, and he insisted that the medical staff took my fears seriously. I actually had the head of anesthesiology place my first epidural and it went perfectly. I also had an amazing L and D nurse both on my initial entrance to the hospital and again on the actual delivery date. She went out of her way to be there for me during some of the worst moments of my life and I wrote a letter to her supervisor to say how much she helped me.

6.     How would you describe a premature baby's birth and labor process? 
Hell. Utter Hell. My neonatologist asked that I give birth vaginally as for boys especially, the pressure of being born can stimulate their lungs. My first was born vaginally after about 12 hours, but my second twin immediately went breech after his brother was born. Although this is not always a problem, I simultaneously suffered a placental abruption. After 15 of the most painful minutes of my life (I had an epidural placed but not on to aid in pushing) in which they tried to push him out (snapped a rib), pull him out (not fun) and otherwise remove my kid. Finally, the bleeding was becoming severe and my second twin's heart first became erratic and stopped. My husband was literally dragged out, and I was put under general anesthetic and an emergency c section was performed (in under a minute!!). My little C was resuscitated easily, thankfully and his apgar quickly rebounded. After the birth, I developed life threatening HELPP syndrome and was in serious condition for several days. It's funny, I went into the labour anxious, but largely unafraid but came out terrified... for my son's health, my health. These series of complications are very rare, yes, but they DO happen.

7.     Does anyone know why this premature situation happened? 
My boys were just big. They weighed 5'11 and 5'12. I think my poor body just couldn't sustain hauling them around anymore.

8.     How did those few weeks after babies were born go? 
After all that initial commotion, my twins were in good shape. They maintained a healthy blood pressure, a good temperature and they were eating. However, their large size meant that they struggled to eat enough to maintain that weight and were fed through a nasal tube. We had no serious complications with the boys, minus a little jaundice. They did so well! 

Emotionally, it was so much harder. I had been chastised by my family immediately after birth that I had “tried to kill my kids” by electing for a vaginal birth and I had tremendous guilt about my choice, plus the HELPP syndrome meant I did not really even see my twins for several days. I understand why; I was on potent drugs and was very, very ill, but it certainly hampered my bonding.

9.     How long did you and then your children stay in the hospital? What was that process like? 
Because of the difficulties of birth, I was hospitalized for six days and because he had legitimately terrified the medical staff during the precarious birth, the boys were kept in NICU (for observation of a brain injury) for the same amount of time. After that, they were transferred to a local hospital with a Special Care Unit for another 11 and 13 days, respectively. We liked the hospital but it was hard to feel like our sons belonged to us as the nurses made all the decisions regarding feeding, dressing, etc.

10.   Are there any complications now or health concerns your children face from being premature? 
We don't know. In many ways, the boys have thrived. They almost immediately left the “Preemie” growth chart and soared up the regular one. They have hit all milestones on schedule. But one twin, the one with the difficult birth has Sensory Processing Disorder and struggles with impulsivity, hyperactivity and some compulsive behaviors. It's very hard to know what caused these. Was he destined to have them, or did his crummy entrance to the world, or the drugs I was given to stop labor cause them? 

We will likely never know and though I am well aware of how lucky we are to have two happy, basically healthy kids, guilt is a hard emotion to leave behind.

11.   What helped you get through this time? What did others say, do, give you, etc. to help you through it? 
Hmmm, maybe just advice here. After I came home from the hospital, I got C.Diff (I had what was considered an “unclean” surgery and was given heavy doses of antibiotics) and I was terribly ill for weeks. But I had also had a major surgery, illness and untold stress. And yet I dragged myself into the hospital every day, almost every feeding. I should have rested! The boys were being cared for by the best and my husband visited every evening. I wish I had taken care of me so that when my twins came home I was ready to take care of them! I also would have loved real help. My mom came to “help” but refused to cook meals or tidy and was a total drama queen. I should have tossed her out and got a cleaning lady. We had a friend bring food one day and that was great. I would have appreciated a meal, or an offer of a ride to the hospital since I couldn't drive.

12.   What do you wish you had known about premature births before it happened to you? 
How emotionally devastating it could be for parents. We had taken a class on multiples and looked at pictures of preemies, learned about the medical interventions so we were prepared for that part. 

But I wasn't prepared for the fact that I never felt like their mom! I wish someone would have told me that prematurity would be a pause in our relationship, and that once we went home it would pick up again. Also, you don't “Just get over it.” I hate hearing that. It's always there, making me fearful of another pregnancy and so worried for the safety of any other babies I might have.

13.   What is your advice to other moms who go through this? 
Only have truly supportive people around. I spent way too much time comforting other people who should have been comforting me. Also, remember to take pictures. Tons of pictures. I was so tired that I kind of forgot, but oh I regret it. Maybe even consider getting a professional photographer in if you are allowed. My NICU did Halloween pictures with a professional and I cannot tell you how I cherish that photo.

14.   Anything else you'd like to share? 
If you are in a high risk situation, finish everything way, way earlier than you think. It was a pain to be buying stuff when I had little ones in the hospital. Also, take your body seriously and don't be afraid to admit that you need help. I had been in so much pain for so long that I just ignored this new discomfort that I now know was contractions. I really think that had I not had that routine appointment that day, I may well have given birth at home! 

15.   How does your story have a happy ending? 
Describe your child, how things are for you all now. Considering that the head of maternal-fetal medicine told my husband that he wasn't sure he was going to walk away with both a wife AND a son, it's a happy ending. We are home. Healthy, and for the most part well. My twins are smart and inquisitive and hyper-verbal, and I am perpetually amazed by their strength and tenacity (both in good ways and bad, lol). Also, are they not good looking kids??

16. What did you learn about yourself as a strong mother through this experience? 

I learned that I am not a strong mother. I am a mother who is flawed and terrified and feels like I am doing it all, all wrong. But I am also a mother wakes up every single morning determined to try again to do the best job and to make it the best day.

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