Birth, Surgery, and Other Things That Happen in Hospitals

Samantha and Sarah, Jan. 13

Two weeks ago on January 10, we headed out early in the morning to University Hospital to be induced.  Junior and Carolyn stayed with David and Becky at their house, while Eric and my mom came with me to the hospital.  My labor was induced with Pitocin and when contractions became strong and regular I asked for an Epidural.  It turned out to be difficult to get because the twins made it near impossible for me to arch my back.  Once we were done, I was feeling better after a short time.  And then I wasn't.  It started with nausea and was soon joined by chills and just feeling really bad.  My blood pressure fell and the babies' heart rates went up, but I didn't have enough presence of mind to be worried.  They gave me oxygen and put me on my side.  I started to feel a little bit better.

Despite the epidural, I was feeling pain and pressure which made me want to push.  And it was, indeed, time to push.  They moved me to the OR (standard procedure for twins) where there were a ton of people rushing around.  It was all a little disconcerting. They put me on an operating table, and I was all set to start pushing.  After several pushes, Sarah was born.  I heard her cry, then she was passed through the window to the NICU to be checked over.  Now it was time for Samantha to be born.  Dr. Silver had planned to reach in and pull her out by her feet (since she was breech); he was very confident in this method.  However, when the doctor delivering the baby reached in and pulled her feet down, she found that her head was also down.  My uterus had contracted and Samantha was trying to come out all at once.  The doctor tried for another minute or two, but then her cord was caught in the mix and Dr. Silver, who was overseeing the delivery, decided it was time for her to come and it would be by c-section.  There was some more rushing around.  I cried; I think I was mostly worried about Samantha.  Then there was cutting, which felt like tugging, and Samantha too was born.  She was passed right through the window and I neither saw her nor heard her cry.  Soon Eric and my mom were allowed back in and I asked about Samantha.  They told me she was okay and asked NICU for an update.

After that I could only wait as I was stitched back up and my babies were evaluated.  Samantha was brought in for a bit then she left to be prepared for transfer to Primary Childrens Medical Center.  When my belly was all put back together, I was put back in my bed and moved back to my room. Soon the transport team brought Samantha to say goodbye and Eric went with her to th CICU at PCMC.  Sarah stayed with me and we were brought to our room in the Mother/Baby area where she roomed in with me.

The next days have sort of blurred together for me.  I was able to visit Samantha several times since University Hospital is connected to PCMC by a sky bridge.  Eric would push me in a wheelchair and Sarah would stay at University Hospital either with my mom in my room or with the nurses in the nursery.  Samantha was moved out of critical care in the CICU and to the 3rd floor CSU.  At some point there was an Echo (ultrasound of the heart) and it was decided she would need a surgery to place a band on her pulmonary artery (PA).  Eric or my mom would stay with Samantha while Sarah and I were still patients at University.  (Remember that emergency c-section I had?)

Marianne and Don brought Junior and Carolyn to visit.  I'm glad they got a chance to meet the babies.  Junior seemed to think it was interesting, but Carolyn was very put off by the whole experience and seemed afraid to see me as a patient.  It was understandable, but made me a bit sad.  When she came again the next day I was able to help her be more comfortable with everything and then she wanted to hold my hand as Eric pushed me in the wheelchair over to see Samantha.  It was so sweet.

My first time holding both Sarah and Samantha

After 3 nights at the UofU Hospital, on Monday, I was released from and Sarah and I went directly to PCMC to Samantha's room.  I stayed there with both babies full-time until Thursday morning when Samantha was taken for surgery.  During this time we were basically just waiting and spending time together as a family.

Samantha and Sarah the day before surgery

On the day of the surgery we spoke with the anesthesiologist and surgeon, signed our consent, and then off she went for open heart surgery at 6 days old.  Of course, that was very hard for me.  We went to a waiting room where we were told we would receive word every hour until the surgery was done and then the surgeon would come talk to us directly.

Waiting was not great.  We received our first call after 1-1/2 hours and were told that the surgeon had just made the incision.  The next call, an hour later, we found out that the surgeon did not place the PA band because after her PDA ligature her oxygen sats dropped and then when a band was applied very loosely, her sats dropped even more, way lower than they wanted, so they did not place the band.  After the surgery we found out that her blood pressure and O2 sats were both troubling during the surgery.

Samantha after surgery

Soon we were allowed to go to her room in the CICU to see her.  Sarah had to stay out with my mom because children are not allowed in the CICU during RSV season.  We sat with her for awhile.  Then a doctor came through worried that her liver was enlarged.  He wanted to check the blood flow through the ASD (a hole between her right and left atrium) and perhaps pull a balloon through it to enlarge it.  So within hours after her surgery, she was taken out for another procedure.  This procedure was done with a catheter.  They enter a vein in her leg and go up to her heart where they could check pressures and in the end did do the procedure to open up her ASD.

Samantha's doctors thought it would only take a couple days to recouperate from her surgery, but again, she did not respond as they predicted.  She took on a lot of fluid, including in her lungs.  She also had blood pressure that would drop too low.  The doctors would all come by for rounds and go over what was going on.  The attending doctor would say they were "puzzled" but that it wasn't an "emergency."  Basically they just had to treat her and wait for her to get better.  In the mean time, the time in the hospital was wearing on the whole family so my mom took Junior and Carolyn back home to Boise to stay with Eric's parents, Terry and Kelly, until we get back.  It was good for them to get to go home and get more into a routine.  Their time in Utah was fun as they got to spend time with lots of different cousins, but getting home was just what they needed.

Samantha and Sarah together again

Samantha ended up spending six days in the CICU and slowly got better.  Soon the doctors were all commenting on how much better she looked and on Wednesday we were moved up to CSU (Children's Surgical Unit) where we can all be together again since Sarah is allowed in this part of the hospital.  It's our last stop before coming home.  Here Samantha has a little more time to become stronger and to work on skills she will need to thrive like eating and calming herself.  She's pretty good at the later, but has some work to do on the former.  She is eating through a feeding tube and gradually has worked up to eating 40 ml every 2 hours.  Tonight she will begin taking 60 ml every 3 hours.  She resistered taking a bottle today.  The Speech Therapist has told us how important it is to follow her cues.  Hopefully when they come tomorrow, she will be more open to taking a bottle.

Eric and I also have some learning to do before Samantha can go home.  So far we've passed off infant CPR, but we are told we still have to learn to place her feeding tube and to feed her through it. Samantha also has to prove she can last the car ride by doing a car seat test.  They put her in the car seat and watch her oxygen sats to make sure the seat doesn't impede her breathing.  Once they can make sure we'll be okay on our own, we'll be able to take Samantha home.  As of Wednesday the doctor said that we can possibly go home on Sunday or Monday.  We are hopeful, but not counting on it since nothing is a sure thing here.

We are grateful for all of the prayers, visits and gifts from friends, family, and new friends from Intermountain Healing Hearts (http://www.ihhearts.org/) support group.  Your support is so appreciated and encouraging.  Thank you all!  We have also found the Ronald McDonald House to be a great help!