Complications | Post-delivery

The day I had my daughters was not story book like I had imagined. I mean let's be honest, laboring twins is generally not story book since it is done in an operating room instead of a laboring room. They do this just in case anything goes wrong. In my situation, I was in the hospital for pre-term labor and was within a half hour from being discharged to go home on strict bedrest when my uterus ruptured and the Zabies were delivered via emergency cesarians section. You can read about my birth story here.

After the Zabies were born my earliest memory was being wheeled out of the recovery unit and being told by Josh that he was cutting up the credit cards indicating that the babies were girls! I remember getting to ring the bell outside of the recovery unit. I rang it twice, once for each baby. The bell played twinkle twinkle little star and was rung every time a baby was born. 

They wheeled me up to the ninth floor where the NICU was located. I barely remember being wheeled past each of the girls beds. My eyes were so hazy that I couldn't focus on them to see what they looked like to save my life. They were just blurs to me causing me to cry on the trip to my room. I fell asleep somewhere between the ninth and eighth floors from the morphine that was given to me.  

Once I awoke, my OB stopped by to check on me. I had lost a lot of blood and she was very worried about me. I didn't understand the severity of things in that moment but soon realized that I was about to start one of the hardest fights of my life. 

There were doctors in and out of my room constantly. A different doctor each time but all with the same cold, stone-faced stare. Each of them walked in and place their stethoscope on my belly. This is pretty normal after having any kind of abdominal surgery. Each time they hovered in the same place for minutes. Not seconds. It was only suppose to be seconds. I was just about to take a bite of a cracker when the same 5th year resident that assisted in the delivery of the Zabies told me not to eat anything and placed me on NPO restrictions. NPO- Nothing per oral. NO FOOD. NO WATER. NO ORAL MEDICATIONS. I was livid to say the least. My mouth was dry and all I wanted was water or ice or something to dampen it. Why had he done this? I didn't understand. That is when I first heard the word that would haunt me for the rest of my life. Ileus.  "You have an ileus," he said. What the heck is that?? An ileus is an non-mechanical bowel obstruction. It is where your bowels stop working. There are many causes of an ileus, learn more here. In my case it was a combination of things, major abdominal surgery being one of them but mainly due to the lack of blood flow to my intestines and having major abdominal bleeding. Major.  With as much blood as I lost the remaining blood went to my heart and brain to preserve those vital, life-sustaining organs. It's just how our bodies are programmed. Every time a doctor came into my room they listened to my belly to see if they could hear bowel sounds and they heard nothing. Nada. Zilch!

Treatment? NPO until it resolved. 

What did all of this mean for me? Hell. I was living a torturous hell on earth and I wouldn't wish it on my worst enemy. Not necessarily because of the lack of food or water but because of the series of events that took place afterward.  Within an hour of this diagnosis I started vomiting. Not like your drunk hangover vomit or any vomit I had ever experienced in my life {I only vomited three times in my life that I remember from being sick: 5th grade and twice while pregnant.} I know weird that I remember that. I have a memory of an elephant. I digress. I mean 200-400 cc {sometimes 600 cc} {1cc=1ml} of vomit every half hour! Remember I wasn't eating or drinking anything. I was vomiting bile and stomach juices. It was awful! They continued to monitor me for following 24 hours listening to my belly in the same spots each time and continually asking me if I had passed gas. Every thirty minutes I tried my best to hold back the vomit but it had nowhere to go. It couldn't go down since my intestines weren't working which meant it had to come up. 

After the 24 hour mark one of my best friends who is an L&D nurse, Ashley, arrived from NYC to relieve Josh from trekking back and forth between floors that the girls and I were being housed. She was my life saver. She empowered me in ways I never knew she would. She advocated for me and helped me to identify when and how to advocate for myself. That night the residents tried placing an NG tube twice. Two times. The first time it coiled and ended up down my trachea causing them to suction my lungs. I gagged and vomited through the entire process. The second time they got it in and successfully suctioned my stomach for about 3 minutes as I continued to gag and vomit the entire time. Josh sat behind me silently rubbing my back. After the second time I expressed how I couldn't do that again and asked Ashley and another nurse what I should do. They both advised me that I had the right to refuse any treatment. So I did. I refused to let the 1st year resident place another NG tube and demanded they call my primary OB in to make the decisions of how to move forward. They did so and she came in around  1:00 AM. I'm sure I was her favorite patient that night. I told her to think outside of the box because an NG tube was not coming anywhere near me again. Ashley educated me on what medications would inhibit the recovery and which ones would help. I stopped the morphine and decline any pain medication from that point forward. NONE. 

I continued to painfully vomit for the next 12 hours, remember I had a c-section? I was starting to become numb to the abdominal pain. The burn of the gastric juices hurt worse at that point. Then my doctor came in with an outside of the box approach. She had consulted with a Gastrointestinal Specialist who shared with her that sometimes a CT scan with oral contrast can restart the intestines or get things moving along. So that's what we did! Within 15 minutes of drinking the oral contrast things were moving. The entire floor celebrated this small win and I cried. 

It was still a long road to recovery for me and took 10 days to resolve with no intervention such as an NG tube. I walked around and around the delivery floor trying to wake up my intestines since they say walking is the best "cure" for these things. There were many of nights that Josh and I walked together and I cried because other parents were walking the same walk only they were pushing a bassinet with their new baby in it. As I got stronger I walked up to the NICU and the staff on that floor celebrated with every improvement that I made. 

In 10 days I delivered two amazing, healthy miracle babies, lost over half of my volume of blood, had two blood transfusions, two nasogastric tubes placed and removed, vomited on average 400 cc every half-hour to hour, had two CT scans, an ultrasound and so many medications via IV that my vessels burned with every injection towards the end. All while recovering from major abdominal surgery. The hardest part for me looking back is that I felt like I was dying and all I was trying to do was survive. For days I didn't want to see my babies because I needed to focus my energy on not dying.  If it hadn't of been for Ashley I probably would have suffered more than I did. I am forever grateful for my sweet friend. She is an angel on earth. Without her I would have never successful breastfed my babies. At 3 days post-delivery she selflessly held each flange to my breasts and pumped for me, every three hours, while I focused on not dying. I'll never forget her words, "Tash, I know how important it is to you to breastfeed your babies. I'm going to hook up the pump and if you'll let me I'll hold them for you." I breastfed my babies to 1 year because she helped get me started. No words could ever express how thankful I am for her and her actions. 

I was discharged one week before the girls. The only silver lining to this story is that I was only one floor down from them for most of their stay in the NICU. 

That, my friends, is my post-delivery complications story. Everyone at the hospital where I delivered knows my story because it is so rare and the first time anyone had ever seen such a thing there. Of course it is a complication that can come with any abdominal surgery but not common at all. Would you believe me if I told you that I had another emergency surgery only two months later and heard the same word ileus, again?

Our First Family Photo taken by Ashley.

Above is a photo from the first night I saw the girls for the first time after the day they were born. It was on August 24th at 2:36 AM. Sixty-one hours after they were born.  Notice how bloated my stomach was? It is one of the symptoms of an ileus. Sure I just gave birth but that was being bloated. I lost all 40 lbs of weight I gained during pregnancy in my 10 day stay in the hospital. 

My Twin Birth Story...

This can also be found in the above link. 

I always imagined one day being pregnant and having the middle of the night wake-up call with close time-able contractions that would finally end the feeling of being huge and uncomfortable like so many women talk about or even being in the grocery store and having "the gush" indicating that my water had broken and it was game time. Unfortunately my birth story is far from normal. Actually it is as abnormal as they come, unprecedented even.

29 weeks. That was the view on my What to Expect when you're Expecting app the night that I felt tightening in my stomach. I felt as though I needed to urinate but I had just laid back down from attempting to do so two previous times with no success. Then I noticed every few minutes, at the same time that I had the urge to go, my stomach was tightening. This tightening wasn't painful or uncomfortable. It was only noticeable due to the pressure it was putting on my bladder. I started timing them out and quickly realized that they were time-able contractions which is one of the differences between Braxton-Hicks contractions and the real deal. Silly me decided that since I wasn't in enough pain to hinder me from falling back asleep that it was, in fact, just Braxton-Hicks contractions. The next morning I gave my OB a call and they had me come-in for a non-stress test which lead to heading down to the hospital for an ultrasound since theirs was booked until the end of the day. By the time I arrived my contractions had become noticeably more frequent and a little uncomfortable. After all of the usual questions they brought in the machine, completed the ultrasound and a cervix check. 3 centimeters and 80 % effaced. That was the results of the cervix check. A flood of emotions came over me. I was almost paralyzed by the words and all I could do was cry. It was too soon. They needed more time to develop and grow. Their lungs weren't developed yet. My mind went in a thousand different directions. Before I had the opportunity to ask any questions they had sent the Neonatal Intensive Care Unit (NICU) doctors down to answer all of our questions and give us survival rates while simultaneously starting a bolus of Magnesium Sulfate to mature their lungs. Scare was an understatement. I prayed every waking second that my babies stay inside me long enough to get both of the Magnesium doses. Forty-eight hours later we got the second shot and two days later I was sent home on strict bed-rest at 3 centimeters and 70% effacement.

32 weeks and 2 days is what my i-Phone screen was showing when my regular scheduled ultrasound technician told me, "Don't move. Let me go get the Doctor." From the looks of things I no longer had a cervix. They wouldn't let me stand or sit up. They didn't do an actual cervix check because I needed to get to the hospital immediately. My husband picked me up at my doctor's office and off we went to the hospital.  Upon arrival they immediately started an IV and checked my cervix. 4 centimeters and 90%. That was how far I had progressed. I wasn't terrified, worried or emotional this time. I knew in that moment that if my babies were making their entrance into this world that the world was ready and so were they. I had prayed for weeks for understanding and peace in whatever my birth story ended up being. If only I had known what God was preparing me for each time I prayed those prayers. 

My last pregnant belly picture at 32 weeks and 2 days.

  

"32 weeks and 4 days," the nurse said as she came in to do my morning non-stress test (NST). I hadn't had a contraction since an hour of arriving to the hospital two days prior.  With the lack of contractions it was only necessary to complete two NSTs a day and as long as everything/everyone looked good there was no need to wear all three of the belts to monitor my contractions and the Zabies heartbeats. An hour later my Doctor came in, she, too, is a mother of twins. She said,"You haven't had a contraction in days. I want to check your cervix one more time but as long as everything looks okay you can do strict bed-rest at home. I'll be back in just a minute to check you." I was going home again. Praise the Lord. Every day inside of my belly is two days (rule of thumb) the Zabies didn't have to spend in the NICU. I stood up put my freshly washed hair in a bun and the it hit. A tetanic contraction. I quickly sat back on my bed, called a nurse and while waiting on the nurse I called my husband who was working (no contractions for TWO days! We thought we were in the clear.) When the nurse beeped in I was screaming out in pain. "PLEASE!!! I just need pain meds! PLEASE! HELP ME!" My room was suddenly filled with doctors and nurses. Dr. G (my doctor) was confused because she had just been in my room less than five minutes prior. The nurses were pushing turbutaline injections to attempt to release the contraction while Dr. G and the 5th year resident were rolling me from side to side, on all fours, back on my back rolling again while trying to stimulate my Baby A. Baby A's heart rate dropped tremendously and was in danger. After what felt like a lifetime. Dr. G said, "We have to get these babies out! Stat C!" In the rush to the OR, while vomiting from the pain and crying from being so scared, I managed to text Josh...Emergency c.  The last thing I remember is Dr. G holding the knife just above my belly and me begging her to save my babies. "Please save my babies," I cried to her as everything went dark. 

Josh made it in time to see our GIRLS come out of the operating room. GIRLS!! He couldn't believe it and neither could I when I later awoke. One NICU team came rushing through the OR doors and said, "She's doing fine. We had to intubate her to get her breathing but she is breathing on her own now." Josh's response? "It's a SHE? We didn't find out. Do we know what Baby B is yet?" The Doctor replies with, "It's a she too!" "Are you sure?" Josh questioned the doctor. I'm sure he thought, oh boy (or girl), time to cut up all of the credit cards!  Shortly after he got the news that I was not doing so well. I had lost nearly half of my volume of blood and they were still trying to stop the bleeding. A vessel rupture on the posterior portion of my uterus is what caused the contraction and was causing the extreme amount of blood loss. Two hours later I went into recovery. I was alive with uterus in tact and BOTH of my daughters were alive. This was unprecedented. After much research it was found that my daughters and I are the only living case with a vessel rupture on the uterus causing a tetanic contraction while pregnant with twins. Most other resulted in either a total loss of babies or babies and mother. Although I was alive. I had the hardest fight of my life in the coming 10 days. I will go into greater detail in a later blog but, in short, my intestines shut down in what's called an ileus and was unable to eat or drink anything for 10 days! 

Although I had a horrible birthing experience and it is not anything like I always imagined I have happy and healthy daughters today and the joy that they bring me overshadows the unfortunate way they came into this world. My girls were right on time. They were ready for this world and the world was ready for them.  God has a way of preparing you for all things in your life. All of those days I prayed for understanding and peace. I needed wanted to understand why me? Why my babies might be born early. Why I couldn't carry them to full term or why I was having problems with pre-term labor. I needed peace. Peace in knowing that if my babies were born early that they would be just fine and that God was in control. I might not have had a clear understanding until recently. Now I understand that I was in preterm labor so that the doctors would keep a closer eye on me and my babies. I was in no pain the day I was admitted into the hospital at 32 weeks. If my doctors weren't seeing me two times a week I would have never been admitted into the hospital and would have been home when that vessel ruptured. Me and my girls wouldn't be here today. I understand that all of that was God's way of protecting me and guiding me exactly where hewanted needed me to be. My babies were born early to protect me. He makes no mistakes and his timing is perfect. 

The Zabies, Kensington Rose (Baby A) & Quinn Harper (Baby B) 
Taken within an hour of birth

Photo by: Nicole James Photography