The final countdown

And the roller coaster never ends. Monday we get given our C-section date and my blood pressure is high. Wednesday I have a Doppler scan to check the umbilical cord blood flow. Thursday we get the not so good news. And Friday I’m back in hospital. But I’m getting ahead of myself, let’s start at the beginning.

As mentioned in my last post, on Monday the 7th, we had an appointment with our obstetrician and he surprises us with our C-section date mere minutes before taking my blood pressure. It’s high which then puts us on pre-eclampsia symptom watch. Obviously this is not so fun, especially when my first cankles experience shows up later that night adding to the worry and nervousness around symptoms. Personally I think it’s just the timing of having my blood pressure taken and spending too much time on my feet that has caused the symptoms but after going through so much to get where we are I can’t help but worry.

Roll on Wednesday and the cankles have pretty much gone (I’ve been trying my best to rest and keep my feet up). I head in for my Doppler scan praying I have a different sonographer to last time. Alas, it seems that no one is listening to my prayers today as the same lady comes out and calls my name. Doh! She seems slightly more competent this time but still flusters at the beginning and just can’t seem to get her head around the simple fact that our twins have swapped places, so the one who is now our leading twin (the one nearest the birth canal) is actually titled “twin 2” while “twin 1” who USED to be leading has now taken a backseat. Again it takes a while to get what we need but at least we don’t have to do growth measurements this time. The Doppler readings look ok to me, and the amniotic fluid, although borderline for our leading twin, is acceptable so off I trundle home again.

Thursday. On getting back to my car after lunch with a friend there’s a voice message from our obstetrician on my phone. “Not too urgent but can you give me a call back.” Oh-o this can’t be good. I return his call and am transferred straight through to him. That never happens so now my heart is racing. Turns out it’s not so bad (I must have just caught him between patients) but it’s not good either. Apparently the Doppler scans show the blood flow to at least one baby is becoming compromised. While not urgent at the moment, this will require much closer monitoring so I’m booked in for twice-weekly visits to the Day Assessment Unit at the hospital. Not so convenient unfortunately as it’s 20 minutes drive away (rather than the 5 minutes to our usual scan place) AND I’ll have to pay for parking (exorbitant prices versus free). None of this matters though, as long as our boys are safe.

At each visit they’ll do a CTG to check out the boys heartbeats, a Doppler ultrasound to check blood flow, my Obs to keep an eye on blood pressure, and every fortnight (although realistically this probably means only one more) a growth scan ultrasound to measure the boys growth. Theoretically this should all fit into roughly an hour, yikes! Our obstetrician has booked me in at the Day Assessment Unit the following Tuesday (for CTG and fluid/blood flow check) and the next Friday (for CTG and a growth scan) – it’s all go and I cancel my pre-booked growth scan at our private radiology clinic (yay, no more useless sonographer!).

Friday. I’m not sure if it was the events of the previous day but one of our twins has decided not to really move for a good 24 hours. I’m sure everything is ok but it’s hard not to worry, especially with the ups and downs we’ve had lately, so eventually we call our obstetrician and head back to the Women’s Assessment Unit for some monitoring. I arrive pretty promptly and am hooked up to the CTG. Bee has still been quiet so I’m still stressing but of course within 10 minutes of the sensors going on he’s wriggling around like a fish. Typical. I feel bad for wasting everyone’s time but it’s better to be safe then sorry. My blood pressure etc. also look good so I’m out of there again just over an hour later. Talk about dramas!

The weekend is pretty uneventful and we truck through a few more of the things on the list in order to get the house ready. On Tuesday I head into the Day Assessment Unit for my first monitoring session. The fluid around each baby looks ok, still a little marginal for Bee but better than the scan we last had at our private clinic. The CTG is eventually fine too although it takes a while to find the two boys as the midwife (who I later find out is just helping out due to a busy day) is a bit hopeless…she actually blames her incompetence on me a little saying “it helps when the mother knows where the babies are” – um, you try having twins, especially ones who have already swapped places, and then let me know if you can tell me which way they’re lying! Anyway, the good midwife who usually runs the clinic manages to get the monitor to pick them up and after about 45 minutes (someone wouldn’t stop wriggling!) we have a reading. Although the scan report hasn’t come through yet I’m allowed to go knowing that our obstetrician will call later in the day with the results.

He does eventually call, the scan report took AGES to come through, and the rollercoaster hits a dip again. The fluid is marginal as we knew but it’s also looking like the blood flow to the babies might be becoming further compromised. I’m advised to skip breakfast on Friday and take my hospital bag in with me when I attend Friday’s monitoring session, just in case they need to do an emergency caesarian on Friday afternoon. Oh my god I’m not ready! I mean my hospital bag is pretty much ready to go but mentally I’m not prepared for the boys to arrive that early. At 35 weeks on that day I know they’ll be in reasonable shape but I have my heart set on getting them just a little bit further.

Turns out I needn’t have worried as Friday’s scan and CTG results are great. The boys are still measuring a little small for their gestational age, with one at approximately 1800g and the other around the 2kg mark (3lb 15oz and 4lb 6oz) instead of the recommended 2250g (4lb 15oz) but they’re not too far off. I ask our OB about the weight difference between the two but he’s not concerned. They only worry about a difference of 20% or more and that’s ours is only 10% so we’re ok. The fluid looks good – the boys have moved a bit allowing better fluid measurement (Bumble, although not the leading twin anymore, is head down, and Bee is breach, bum first) – and the blood flow looks fine too. The CTG takes only 15 minutes, it seems everyone is behaving today, and my obs are fine too. All in all a great result and a good day! Up goes the rollercoaster again.

And then it plummets once more when on Saturday evening I notice some tinting when I go to the bathroom and by Sunday morning I’m spotting again. Will this drama never end?!? It’s old looking and there’s not too much of it but my hubby suggests we call our obstetrician just in case, so we do. He’s not too concerned and thinks it’s probably just left-over from my last bleed 5 weeks ago. He’s happy for me to stay at home and keep an eye on it, especially given our latest monitoring results were good. I’m happy with that, I’ve spent enough time in that hospital lately and it won’t be too much longer before I’m back in there for the big event with just over two weeks to go until our scheduled c-section.

It turns out that time is actually much shorter than we anticipated.   We have friends around for a Sunday afternoon tea and my husband’s phone goes with “No caller ID” displayed on the screen. He silences the call and goes to put the phone back in his pocket. “It might be N” (our obstetrician) I say so he ends up taking the call. I hear our obstetrician on the other end of the line confirming that it’s indeed him but then I hear no more. It’s torture to only hear half the conversation and I feel my skin prickle and my hands and feet sweat with nervousness. Our poor friends having to sit through me anxiously waiting to see what he has to say, I feel a bit rude but I can’t think straight until I know what’s up.

My hubby gets off the line and says “Friday.” My heart races. WTH?!? Apparently our OB has been reviewing our notes and with the spotting occurring this weekend he thinks it’s a good idea to pull our c-section forward to the next available elective slot this coming Friday. While I think that’s true I also think it has something to do with him being out of town on holiday the following week, secretly wanting to be the one to deliver our children (seeing as we’re his freakishly young USA donor egg patients – he’s never had anyone like us before) and not wanting to chance me needing a c-section from one of his off-siders while he’s away. He’s going to be on holiday the following week too but being back in the city was going to pop in to do our caesar on the 5th….see what I mean by I think he wants to deliver our babies!

Oh my gosh, I’m seriously sweating now and have gone into shock. Our friends think it’s funny and I guess it is. All that comes our of my mouth for the next wee while is “Oh my god” and various swear words, before I finally pull it together enough to return to a normal conversation. Our mates depart and I return to my panic. There’s still so much I want to get done before the boys arrive…not much that HAS to be done but definitely things I wanted to have crossed off my list purely for my piece of mind and satisfaction.

I start to work through the plan for the rest of the week and we let our parents and siblings know what’s going on. We decide not to tell our friends for the moment (other than the ones who were there when the news broke obviously, as there was no avoiding that), partially because it’s not guaranteed that the operation will go ahead on Friday – it depends on whether my scans continue to look good, on whether all the necessary staff line up, and whether there are spare beds for the boys in the hospital nursery (all things that will be confirmed later in the week), and partially because we want it to be a surprise for them. There hasn’t been much we’ve been able to surprise them with over this journey so it will be nice to be able to make the phone call/texts/emails that other ‘normal’ new parents get to make after the boys arrival.

Keeping it secret proves harder than I thought. Honesty is a value I hold dearly so feeling like I’m lying to my friends really grates me. I make a point of not outright lying to anyone as I just couldn’t handle that, but more skirt the tricky questions and answer in more general terms. “Next monitoring session on Friday?” gets a reply of “The Day Assessment Units monitoring days are Tuesday and Friday”, “Any chance they’d let you go longer if things are still really good a week from now?” gets “No, not a chance, our OB doesn’t want to risk anything.”, “Want to catch up next week?” = “Sure!” (I just won’t tell you it will be a catch up in hospital! I still feel bad doing this but for some reason I just need this to be a surprise.

I guess it’s a little to do with wanting to feel ‘normal’ and a little to do with buying ourselves some extra time to bond with the boys. I know how excited everyone is, how desperately many of them want to meet the twins, and understanding this (as well as being excited for them to meet the boys too) I know I would be hopeless at trying to delay people coming in. It’s a momentous occasion that hubby and I need to fully experience and accept without anyone else around. We’ve waited years for this.

The monitoring session on Tuesday goes well again; even more fluid around the boys (they’re obviously moving around), good blood flow, and a great CTG; and I think our obstetrician is slightly second guessing his decision to pull the c-section forward. In the end he decides it’s still the right call, we’re trading off a little extra prematurity (not too much at 36 weeks) for the boys arriving safely, and I tend to agree. The spotting isn’t really letting up, although it isn’t getting worse either, and I don’t want to risk anything going wrong at this late stage.

Following the monitoring session I’m booked into a pre-op admission session at the hospital across town so make the mad dash there for that. I meet with a nurse who measures my blood pressure (a little high from my dash across town), weight and height, and takes me through what I need to do the evening before and morning of my operation. Take a Ranitidine tablet (to reduce stomach acid) Thursday evening, nothing to eat after midnight, another Ranitidine on Friday morning, water only until I arrive at hospital, and be at the hospital day surgery unit (ORDA) at 8:30am. I can handle that.

Next I see the anesthetist. She’s not the one who will be there for my c-section but she performs all the checks and writes copious notes for the one who will be there on the day. She’s really lovely and walks me step-by-step through the operation including the people who will be there, how and when they’ll administer the anesthetic, what to expect in the operating theatre, and what will happen afterwards. She demonstrates how they find the correct place for the epidural/spinal and makes me feel better by commenting on how good my back is for finding the right spot.   She details post-op pain relief, possible side effects, and likely length of hospital stay, and I leave feeling pretty comfortable about everything.

Blood tests on Thursday to check that I’m ready to go and to identify the details they’ll need should I require a blood transfusion in theatre, and all that’s left is to await the confirmation call from my obstetrician to let us know that it’s full steam ahead. My husband and I head out for a nice yum cha lunch (probably our last for a while) and to check out a part of our local museum that they’re closing down and was always my favourite when I was a child (on a sidenote for Aucklanders – can you believe they’re actually closing the Colonial Auckland exhibit?!? Especially after all these years!)

The call from our OB comes around 2:45pm and we’re still all up in the air. There’s one spare bed in the nursery but not two. This could of course change overnight, for better or for worse, so he’s going to call again tomorrow and give me an update then. So the ideal plan is no food after midnight and it all goes ahead as we hope but, failing that, he’ll admit me to hospital for daily monitoring and we’ll take the first slot we can once beds are free. Plan B is far from ideal but I guess it’s a matter of whatever’s best for the boys (lucky we didn’t tell everyone it was tomorrow!). I’m disappointed. I like the 25th of September as a date, and I’d really like our OB to deliver the boys before he goes on holiday, but whatever will be will be and I just have to roll with it. The rollercoaster’s not quite done with us yet.

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