Thanks to my sister Jenny, you are likely already aware that Merilee had our twins the week before last. Here's the whole story, unabridged, as I remember it. If you want to just look at the pictures, that's fine too.
Our OB had us doing NST's (non-stress tests) twice a week since 34 weeks. We did them at French hospital since the doctor's office doesn't have a monitor for twins, and Sierra Vista (the other hospital in town) is out of network. This sounds like a boring detail, but it will become more important later on. Note that French is like 7 minutes from our house, and Sierra Vista is like 2 minutes. So really it didn't matter to us that much.
Since nurses have to work on the 4th anyways, we had an NST scheduled for noon that Tuesday. At each one they would hook Mer up to three monitors - Two to monitor the babies and one to track contractions. It was kind of a lot strapped around her sensitive belly, making it hard to get comfortable. We already had experiences with fetal monitoring from the multiple previous hospital trips thanks to Merilee’s consistent bouts of early contractions. Thankfully Bruce and Cordelia's heart rates were always stable and the contractions eventually calmed down.
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| Wired |
Knowing we might be there for a while (an NST should really only take 20-30 minutes but they had kept us for five hours at our first one since Mer started contracting), we ate lunch before heading over. Soon after getting hooked up to the monitors, she started going into labor with stronger contractions than she had felt before, the kind you really have to breathe through. There were a couple frustrating things about it (besides just Mer being in pain)
- The nurse wouldn't let her re-position herself. I understand that because Mer was pre-term with twins that they had certain protocols to stick to, but she was incredibly uncomfortable and I think that wasn't helping her uterine irritability. We had always just let Mer do what she felt was best at home and contractions always eventually stopped. Later, when she was lying down on her side on an ambulance stretcher without any of those belts around her to hold monitors she started feeling a lot better.
- Even with painful contractions, labor wasn't progressing. Although we weren't hoping she'd deliver that day, the fact that her pain was doing nothing (she only dilated to a 1.5) was obnoxious.
- In the classes they told us (besides saying that you can move around during labor which is a lie if you're pre-term with twins) about 511. You're supposed to go to the hospital when your contractions are 5 minutes apart and 1 minute long for one hour. Mer sometimes got like a 10-20 minute break, but for the most part the contractions were fairly constant. We got two beautiful babies out of this but sometimes I feel like we can't get any breaks. 511 my B-U-M.
At French, they tried giving her IV fluids and some oral medication that was supposed to relax her uterus and stop the contractions. It didn't work. After about five fun hours, the nurse told us that Merilee would be transferred to Sierra Vista via ambulance. Hoping to save ourselves an ambulance bill, we asked if I could drive her over. They wouldn't let me, so they brought in the ambulance crew to transport her while I drove separately
We got there around 6:30 pm I think. We were supposed to go to a BBQ that night and I arranged to pick up a plate after the on-call doctor had been by to talk with us. It took forever - 3 hours - and I was starving but I knew that the doctor would show up as soon as I left.
When we arrived, they continued IV fluids and added magnesium sulfate to try and stop the labor. They also gave her some leggings to prevent clotting while she laid in bed. They then gave her the steroid shot that helps babies' lungs progress rapidly. It's most effective 48 hours after the first shot, so the plan was to try and hold off labor until Thursday evening.
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| My corner of the room in labor and delivery |
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| Monitor for the babies' heart rates and contractions. Mer loved being hooked up to this and the IV for hours and hours. |
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| Fancy calf attire not available in stores |
Assuming she was still pregnant, Merilee was slated to go off of the MgSO4 and either deliver or go home. They also did an ultrasound to check and see how the babies were positioned. As usual, the girl was head down and the boy was breach. Additionally, it appeared that neither had descended any farther than the other. Without either dropping, it was impossible to tell if our goal of a vaginal birth was still possible (if the first one coming out is breach, they have to do a C-section).
Hours later, the doctor came and we had a chat. After that, I left to grab my 4th of July BBQ dinner from our friends and then got some things from our apartment. As much nesting as I had done, I still hadn't packed our hospital bag. We did have a list of what to take, however, so that was good.
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| Fancy hospital table and a nightstand |
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| Catching a break, time to make more progress in this book. |
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| One benefit of labor not progressing - you're not having surgery in 12 hours so you can eat! |
As the hours went by, Merilee hadn't dilated any more despite the contractions staying strong. She had brief periods of relief, maybe for about 20 minutes or so, but it was a pretty bad night. The next morning, a different doctor was on duty and was making her rounds. I thought it was pretty rude of her, but she was telling us all about how we should have a C-section. We had a birth plan and had discussed our intentions with our OB and the plan was to do a vaginal delivery if it were possible. She didn't really ask us about any of that and just told us that we should do a C-section before disappearing.
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| Waiting for the Zofran to kick in while the Fentanyl wears off - a vicious cycle |
Though they had been giving Merilee lots of IV fluids, she hadn't been peeing that much. She was starting to retain a lot of water in her legs and feet, and her lab results were showing signs of pre-eclampsia. Her blood pressure was normal, though. Due to the complications and the positioning of the babes, agreeing to a C-section around 12:30PM the next day (Thursday) seemed like the safest thing to do.
I should mention that this whole time we had been in contact with only a select few people. Texting/calling around wasn't a huge priority for me at the time (sorry, not sorry). I let my work know that I needed to start my family leave, and we were fortunate to have two people be points of contact for people locally and for our families/facebook. That way we didn't have tons of people calling us while we were dealing with stuff in the hospital.
After another very rough night, they decided to switch our scheduled time with another C-section that was scheduled for 7:30 in the morning. We certainly didn't have any complaints. It's not like we were sleeping in. Eventually it was time to suit up. They carted Merilee off and put me in a waiting room. I swear I was there for way too long. Obviously my mind was going through a lot, but it really felt like I was in there for at least 20, perhaps 30, minutes. Before my mind had been racing for too long, however, they finally came and got me.
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| Last pregnancy photo at almost 36 weeks. Great job hanging in there, Merilee! Only hours of pregnancy left. You have done so great and I just love you. |
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| She won't be pregnant in the next picture |
***I recommend skipping these two paragraphs***
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| Clenching the pole as she tries not to throw up during surgery. |
Bruce came out first but his head got stuck, so the OB played a game of tug-a-war with Mer's uterus. I was sure he was dead. Why else would you handle a baby like that? Cordelia came head first, but Mer's uterus was still having some issues letting go, so they were about to use a vacuum but it slipped and bumped into someone's non-sterile headgear and she came out all by herself before they could get a new one. They were so purple. I was not expecting that. Oh I should also mention that Merilee had been throwing up most of the time this was happening. I guess whatever the anesthesiologist gave her made her nauseous. Surprise!
And then suddenly, we had two babies. While they were putting Merilee back together I was watching the two teams as they worked with Bruce and Cordelia. Cordelia was squirming around, but Bruce wasn't moving. I remember thinking how sweet Cordelia's first cries were. She was breathing. Eventually they got Bruce to complain too, and I felt relieved. They wrapped the girl up and let me hold her. I'd like to tell you that I instantly felt a rush of fatherly love for this 10 minute old baby, but I honestly just think I was in a bit of shock.
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| Bruce getting some help breathing |
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| I got to cut Cordelia's cord. It was so gristly. |
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| Hey! Check out this thing that was inside of you, kicking your ribs for 8 months. |
I had been up for two days straight and just watched my wife get cut open. Between the swaddling blanket and beanie was a face I'd never seen before. I showed her to Merilee but couldn't lay her down since Mer was still getting stitched up. Eventually they brought Bruce over to show to us. He had his CPAP on and was going straight up to the NICU. Eventually they transferred Merilee to her hospital bed from the table and started wheeling her over to recovery.
There's been some disagreement as to where Cordelia was as we were moved from the operating room. Since Mer was on drugs, we'll go with my story that Cordelia was on the bed with Merilee. They wouldn't let anyone hold babies in the hallways. Plus, it was too long a trip to risk dropping a baby. She didn't have a crib until we left recovery. At least I'm pretty sure.
More on drugs: did you know how many drugs they will give you in the hospital? So many drugs. It's like they don't hold back at all. I was so glad that Mer finally had professionals handling her drugs instead of me because I was in no state to keep track of anything. The first few days she was still pretty loopy. I don't know how much she realized it, or maybe it was more from the sleep deprivation but she was noticeably not all there and had even lost her voice.
Anyways, we spent some time in recovery. The nurses helped apply pressure to Merilee's uterus to help it contract and took Cordelia's vitals. I didn't know where my breakfast had gone so I stepped out to find some food and came back with a sandwich. Meanwhile we got a surprise call from the infertility clinic. I figured that they must have had an alarm that went off each time one of their former patients gave birth. Turns out they were just checking in and seeing how we were doing, and didn't actually know that we were in the hospital.
During this time, I also made a trip up to see Bruce. At the NICU you call a number from the phone outside the door, then while someone comes to let you in, you wash and then sanitize your hands. I came over to where he was and a couple of the nurses re-introduced themselves. It turns out that they were in the OR during Mer's C-section but with masks it's hard to recognize people.
I met with the NICU doctor who explained several things to me about what was going on. First, he assured me that Bruce would be fine, and with time would catch up to the point that he would be indistinguishable from a child that was born at full term. He also explained that much of what needed to happen wasn't teachable, rather that it was pre-programming. It turns out development-wise that boys are usually behind girls about a week, and twins usually lag behind singletons about a week as well. The CPAP was applying pressure to his lungs so he could breathe, but he wouldn't be on it for long and he'd likely be back with us soon. He just needed time.
I really don't understand why, maybe because I was still in shock, or maybe it was the sleep deprivation, but I could feel a lump in my throat whenever I was in the NICU. Even thinking about it now I still get that a little. Knowing that Bruce would be fine, it was still hard to see him there strapped to the monitors and plugged in with his IV, CPAP, and other things. They still needed to get him settled in and hooked into his IV and such so I went back down to Merilee and Cordelia.
We spent a little more time in recovery before going to our room in Mother-Baby. Apparently we had the best room. It was definitely much better than the room we had in labor and delivery. They used to not let you have your own space, rather you shared it with another family. Now they have sofa-beds where the second hospital bed used to be so you get the whole room to yourselves. It was pretty nice.
It was there that I got to get better acquainted with Cordelia. All wrapped up in her swaddling blanket, she would open her eyes a lot to cast shady glances at the corners of the room. She was so tiny, inspiring nicknames such as "My Little Burrito" and "Little Peanut." The first time I wanted to take a picture of her on my lap, I got out my phone and forgot to turn off the flash - from only about a foot away from her face. I was so worried it might have damaged her possibly sensitive eyes (great, I've had a baby for 2 minutes and I've already broken it). She eventually opened her eyes again, and so Merilee and I began to fall in love with her.
Later that day I realized that I hadn't taken any pictures of Bruce to show Merilee, so I went back up to the NICU. I seemed to have missed my chance at good pictures, because now all hooked up he was a lot harder to see. Cordelia was feeding about every three hours. We'd try to have her nurse for 10 minutes, then supplement with bottle feeding. We tried using donor breast milk, but she was having difficulty keeping her blood sugar up, so we had to switch to formula which worked a lot better for that. Meanwhile Merilee was pumping after Cordelia would try to nurse. Any colostrum we got we sent up to Bruce, or when there was enough to share we'd split it with Cordelia.
The nurses would change every twelve hours, and would stop by periodically to take vitals of mom and the baby and give Merilee pain medication. She did still get nauseous, but it wasn't nearly as bad as before. During this time, we began to explore new depths of sleep deprivation. Between nurses coming and going, feedings and pumpings, eating for ourselves, etc. we hadn't really slept since before we went in for the NST on Tuesday.
On Friday, Merilee got to go upstairs to hold Bruce for the first time. I think it was either then or on Saturday after she had been feeding him that she was gone for a while and missed a dose of her pain meds, causing her to get a little overwhelmed. The nurse strongly suggested finally putting the do not disturb sign up on our door and taking a well-deserved nap while Cordelia spent some time in the nursery. We ended up going an extra hour without pumping in the process but the sleep benefit definitely out-weighted that.
I had tried to nap a little bit on the sofa-bed, but sharing Mer's hospital bed was much better for both of us. Waking up when you're so sleep-deprived is confusing and terrifying and painful. I had fallen asleep with a weird pressure on my leg so I woke up in the middle of a nap freaking out and so confused because my entire right leg was numb. Other times I woke up I just had a strange sense of urgent danger. I would try and count how many hours of sleep we had gotten since our NST and between that Tuesday and Saturday I think I counted hours slept to be around 10.
Eventually we got the hang of things: Cordelia was feeding really well, Merilee's milk supply was just starting to come in, and we had both been able to shower at least once. I left the hospital a couple times to run some errands, but otherwise we were both holed up in the hospital spending time with Cordelia and enjoying all the help from the nurses. We often felt terrible about having Bruce upstairs in the NICU by himself. Once Merilee was doing better, she started to go up more often. It was still sad to be separated from him, even though it was only one floor up and despite the fact that we already had our hands full with the one baby in our room.
Then Friday afternoon, we were told that they were going to take Bruce to another hospital outside the county. Remember how this hospital (Sierra Vista) wasn't in-network? French was in-network, but they couldn't deliver twins, and their NICU wasn't yet licensed. The insurance company's solution was to take Bruce to Marian, which is about 45 minutes away. The workers at our hospital objected to the transfer, but were told that if he wasn't transferred by Monday that the insurance wouldn't cover any of his NICU stay at Sierra Vista.
I called our insurance company but it was close to the end of the day and I couldn't make much progress before it was 5PM. We tried not to worry about it and prayed that Bruce could leave the NICU before he had to be transferred. We would be discharged on Monday and would rather take both of our babies home than be separated again. Being one floor below him was hard enough for us.
Saturday things were looking up when Bruce came off of his CPAP. I asked our friend Mario (who had also been our POC for our friends here in SLO) to come help me give Bruce a blessing that evening. That day and night, Bruce was feeding very well (his last requirement before being able to come home) so they took out his IV. Sometime Sunday, however, he was testing to be borderline jaundice, so he needed to go under the light. He started to not feed as well after that due to being so tired.
Monday we had some time before the crew from Marian came by around 3PM to pick Bruce up. I spent the morning on the phone with the medical group. Things are so ambiguous with insurance, and we'll never know how much Sierra Vista was actually fighting to keep Bruce there (they told us they were at least). Anyway, the bottom line was that we had the choice either to refuse the transfer (our parental right) and get sent the NICU bill, or accept the transfer and save the insurance company money while separating a four-day-old child from his mother.
Those that I talked with on the phone couldn't verbally tell me what to do, but when I explained everything to them I could tell that they thought that ours was a good case for an appeal or a grievance. I told them that a child that young shouldn't be separated from his mother without a medical reason. I explained that driving 45 minutes to deliver colostrum and breastfeed would likely mean choosing which child to be with and which to be separated from. Their mother was recovering from a C-section, so travel was difficult. I pointed out that we were rushed to this out-of-network hospital in an ambulance from an in-network hospital because the hospital contracted with the medical group wasn't equipped to treat my wife nor my children. We were suffering the consequences of that, and we shouldn't have to just because the medical group and the hospital couldn't settle their game of chicken so families don't have to be separated within days of a twin birth.
Anyways, it turns out that no one at the hospital had actually submitted an authorization for Bruce to be at the NICU. They always send out "reviews" which I guess are reports of what they're doing, and when the lead NICU doctor at Marian saw that Bruce was being treated here, he informed them that there was no way that our insurance would pay for it. So instead of submitting an authorization, it sounds like they tried to negotiate with this doctor. I don't think we'll ever know what was really going on.
Since there was no authorization that had been denied, we couldn't file an appeal. The only way at that point to keep Bruce at the hospital 2 minutes from our house was to deny the transfer, get billed for his stay at the NICU, then file a grievance and be at the mercy of the insurance company who hadn't thus far given us a family-friendly vibe. When I ended the call with the grievance specialist, my plan was to go and have a talk with the case workers and NICU doctor who had more experience with this kind of stuff and might provide some insight.
My plans were thwarted, however, when I arrived at the NICU. Merilee had already been there to nurse Bruce. While I was downstairs trying to find a solution to keep him with us, there was a different NICU doctor upstairs telling Merilee that she should sign the consent to have Bruce transferred to avoid getting the NICU bill. It's so great that she and the nurses were able to corner Merilee and tell her what to do without me there. So awesome!
Then when I arrived, I attempted to share what I had learned from being on the phone for hours between Friday and that morning. I couldn't get two words out without the doctor stopping me to say "but NICU bills are expensive," "but it's not worth the stress," "yeah but you don't want to do that because _____," or some other discouraging statement. You doctors do amazing things to care for people but holy crap you suck at listening sometimes. I know on one hand that a lot of people (myself included) are not as smart as you are, but that doesn't mean that we aren't equipped to make our own decisions about what's right for us. If I ask you a question about something, please answer it honestly and don't use it as an opportunity to steer me in the direction you want. Whether it's the decision to have a C-section or battle insurance companies, we should have felt like it was our choice, not yours.
Anyways, Merilee had signed the consent without me realizing it, and it was done. In all honesty, as non-ideal for us (and wrong of the insurance company/hospitals) as it was to send him to Marian, everything worked out in the end. However, what the transfer crew said when they got there really, as Merilee puts it, steamed my bacon. Several hours later, after we had some time back in our room packing and preparing to be discharged, we came back up to talk with the nurse and doctor from the Marian NICU. In making conversation they said a few things that perhaps they should have censored.
The first was the nurse who said that she wasn't even scheduled for that day. She got a call and ignored it since it was her day off. But they then sent her a text so she decided to come in to work. I didn't tell her what I wanted to say which was that she should stay home next time. These people were caring for my son, however, and it wasn't their fault. The next thing was the doctor saying that their NICU was full to the brim. In fact, they didn't have room for him in their regular NICU area, but that he'd be put in a side room called "The Isolation Room." Really, your NICU is full? How many babies are you guys taking away from their mothers? I'm glad I didn't think of that question at the time.
We said goodbye to Bruce and headed back down and tried not to cry too much about the whole situation. I finished packing the car, we had our last visitor who talked with us about mediCal or something like that, and we had our last meal (the food was pretty good actually). We said goodbye to the nurses and put Cordelia in her car seat. We almost couldn't take her home though. Cordelia the day before had had her car seat test (they just monitor them while they hang out in the car seat for a couple hours) and passed. However, since we were only going home with one baby instead of two, I didn't bother reinstalling the car seat that Cordelia had used for the test. The one that was still buckled in had a slightly looser loosest setting on the straps and it was big for her. So, I had to unpack a few things, switch the car seats, and we were on our way.
I called Jenny during the 2 minute car ride. Our friends had picked her up from the airport and dropped her off at our house and I think she was recording when we came home or something. We got settled in, went out to buy some formula for that night, and Merilee probably pumped. Then, we were off to Marian to see Bruce. Marian is a very nice looking hospital. In fact I'd probably never choose to go there out of fear of it being too expensive - that's how nice it looks.
We found Bruce in his little isolation room and got to feed him. He was doing the same thing he was doing at Sierra Vista, or really what could have been done in a nursery - getting the jaundice light between feedings. Between his jaundice supposedly being borderline, and the fact that we are perfectly capable of feeding him, it was only a little bit ridiculous that he was transferred there. I've heard that NICUs typically keep babies longer than they really need to just to make sure they stay out after they leave. Oh and get this - the nurse even asked us why he was transferred there when the care he was receiving is available at French (to which we did respond, "good question!"). A hospital 7 minutes from our house would be much preferable to a hospital 45 minutes from our house.
On the way home it was difficult to stay awake. I remember Merilee trying to talk to me and rub my shoulders but I could still feel my eyelids dropping. I think I was even singing something while my eyes were shutting. I swore if Bruce and Cordelia became orphaned because we had to commute to that stupid hospital after so much sleep deprivation that I'd somehow make those responsible pay. At least hopefully it'd be all over the news and they'd feel terrible about it. Luckily though, none of that happened.
Getting to sleep in our own bed was really nice. The next day (Tuesday) we did a field trip. We called to see when a good feeding time for Bruce was and headed over around then. With only one car seat in the car, Jenny was able to fit next to Cordelia in her car seat. It was a bit soon to take Cordelia on a trip, but at least I felt like it was important to have the four of us together (plus that way, Jenny could meet Bruce too!). In the Sierra Vista NICU, Cordelia couldn't go upstairs to see Bruce since she was admitted and had to stay in Mother Baby, so this was the first time that they'd be together since sharing Merilee's womb.
It was either that day or the night previous that one of the NICU doctors explained to us about the "Milk Fairy." Basically, once this mythical creature comes, the baby will start feeding better and can then go home. I think the engineer in me likes the pre-programming analogy better but alright. Bruce was feeding better but of course they still couldn't tell us when he'd be coming home. On our way back we picked up some pizzas thanks to T-mobile Tuesdays.
The next morning, Merilee got a call from the NICU saying that Bruce would be discharged that day. We were thrilled. We left Cordelia and Jenny at home this time and took Bruce's car seat in for his test while we watched a terrifying infant CPR video and went through other parts of the discharge process. We were so excited to bring him home finally (I say finally knowing that it actually wasn't that long).
More on drugs: did you know how many drugs they will give you in the hospital? So many drugs. It's like they don't hold back at all. I was so glad that Mer finally had professionals handling her drugs instead of me because I was in no state to keep track of anything. The first few days she was still pretty loopy. I don't know how much she realized it, or maybe it was more from the sleep deprivation but she was noticeably not all there and had even lost her voice.
Anyways, we spent some time in recovery. The nurses helped apply pressure to Merilee's uterus to help it contract and took Cordelia's vitals. I didn't know where my breakfast had gone so I stepped out to find some food and came back with a sandwich. Meanwhile we got a surprise call from the infertility clinic. I figured that they must have had an alarm that went off each time one of their former patients gave birth. Turns out they were just checking in and seeing how we were doing, and didn't actually know that we were in the hospital.
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| Bruce in his BYU football helmet |
I met with the NICU doctor who explained several things to me about what was going on. First, he assured me that Bruce would be fine, and with time would catch up to the point that he would be indistinguishable from a child that was born at full term. He also explained that much of what needed to happen wasn't teachable, rather that it was pre-programming. It turns out development-wise that boys are usually behind girls about a week, and twins usually lag behind singletons about a week as well. The CPAP was applying pressure to his lungs so he could breathe, but he wouldn't be on it for long and he'd likely be back with us soon. He just needed time.
I really don't understand why, maybe because I was still in shock, or maybe it was the sleep deprivation, but I could feel a lump in my throat whenever I was in the NICU. Even thinking about it now I still get that a little. Knowing that Bruce would be fine, it was still hard to see him there strapped to the monitors and plugged in with his IV, CPAP, and other things. They still needed to get him settled in and hooked into his IV and such so I went back down to Merilee and Cordelia.
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| I remember when he was just minutes old in the NICU he kept squirming around and opening and closing his mouth. The NICU nurse said he was just "exploring the world." |
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| I took a lot of pictures when he was like this because it was so hard to capture what he was like due to all of the equipment he had on. |
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| I wanted to make sure I could remember what he looked like after I left. |
It was there that I got to get better acquainted with Cordelia. All wrapped up in her swaddling blanket, she would open her eyes a lot to cast shady glances at the corners of the room. She was so tiny, inspiring nicknames such as "My Little Burrito" and "Little Peanut." The first time I wanted to take a picture of her on my lap, I got out my phone and forgot to turn off the flash - from only about a foot away from her face. I was so worried it might have damaged her possibly sensitive eyes (great, I've had a baby for 2 minutes and I've already broken it). She eventually opened her eyes again, and so Merilee and I began to fall in love with her.
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| The burrito |
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| The burrito lover |
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| Shady glances for everyone! |
The nurses would change every twelve hours, and would stop by periodically to take vitals of mom and the baby and give Merilee pain medication. She did still get nauseous, but it wasn't nearly as bad as before. During this time, we began to explore new depths of sleep deprivation. Between nurses coming and going, feedings and pumpings, eating for ourselves, etc. we hadn't really slept since before we went in for the NST on Tuesday.
On Friday, Merilee got to go upstairs to hold Bruce for the first time. I think it was either then or on Saturday after she had been feeding him that she was gone for a while and missed a dose of her pain meds, causing her to get a little overwhelmed. The nurse strongly suggested finally putting the do not disturb sign up on our door and taking a well-deserved nap while Cordelia spent some time in the nursery. We ended up going an extra hour without pumping in the process but the sleep benefit definitely out-weighted that.
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| Check out that blonde hair. |
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| Cuddles with mom. |
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| Sleepy baby. Bruce was tired too I suppose. |
I had tried to nap a little bit on the sofa-bed, but sharing Mer's hospital bed was much better for both of us. Waking up when you're so sleep-deprived is confusing and terrifying and painful. I had fallen asleep with a weird pressure on my leg so I woke up in the middle of a nap freaking out and so confused because my entire right leg was numb. Other times I woke up I just had a strange sense of urgent danger. I would try and count how many hours of sleep we had gotten since our NST and between that Tuesday and Saturday I think I counted hours slept to be around 10.
Eventually we got the hang of things: Cordelia was feeding really well, Merilee's milk supply was just starting to come in, and we had both been able to shower at least once. I left the hospital a couple times to run some errands, but otherwise we were both holed up in the hospital spending time with Cordelia and enjoying all the help from the nurses. We often felt terrible about having Bruce upstairs in the NICU by himself. Once Merilee was doing better, she started to go up more often. It was still sad to be separated from him, even though it was only one floor up and despite the fact that we already had our hands full with the one baby in our room.
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| You pick which meal you want to be your "celebratory meal" where you get something special. Mer ordered the shrimp Alfredo and I ordered the bacon wrapped steak. They gave us both chocolate cheesecake for dessert. The hospital food was good in general but this was especially delicious. |
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| Dreaming of milk |
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| Squashed! |
Then Friday afternoon, we were told that they were going to take Bruce to another hospital outside the county. Remember how this hospital (Sierra Vista) wasn't in-network? French was in-network, but they couldn't deliver twins, and their NICU wasn't yet licensed. The insurance company's solution was to take Bruce to Marian, which is about 45 minutes away. The workers at our hospital objected to the transfer, but were told that if he wasn't transferred by Monday that the insurance wouldn't cover any of his NICU stay at Sierra Vista.
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| Bruce at the night club |
Saturday things were looking up when Bruce came off of his CPAP. I asked our friend Mario (who had also been our POC for our friends here in SLO) to come help me give Bruce a blessing that evening. That day and night, Bruce was feeding very well (his last requirement before being able to come home) so they took out his IV. Sometime Sunday, however, he was testing to be borderline jaundice, so he needed to go under the light. He started to not feed as well after that due to being so tired.
Monday we had some time before the crew from Marian came by around 3PM to pick Bruce up. I spent the morning on the phone with the medical group. Things are so ambiguous with insurance, and we'll never know how much Sierra Vista was actually fighting to keep Bruce there (they told us they were at least). Anyway, the bottom line was that we had the choice either to refuse the transfer (our parental right) and get sent the NICU bill, or accept the transfer and save the insurance company money while separating a four-day-old child from his mother.
Those that I talked with on the phone couldn't verbally tell me what to do, but when I explained everything to them I could tell that they thought that ours was a good case for an appeal or a grievance. I told them that a child that young shouldn't be separated from his mother without a medical reason. I explained that driving 45 minutes to deliver colostrum and breastfeed would likely mean choosing which child to be with and which to be separated from. Their mother was recovering from a C-section, so travel was difficult. I pointed out that we were rushed to this out-of-network hospital in an ambulance from an in-network hospital because the hospital contracted with the medical group wasn't equipped to treat my wife nor my children. We were suffering the consequences of that, and we shouldn't have to just because the medical group and the hospital couldn't settle their game of chicken so families don't have to be separated within days of a twin birth.
Anyways, it turns out that no one at the hospital had actually submitted an authorization for Bruce to be at the NICU. They always send out "reviews" which I guess are reports of what they're doing, and when the lead NICU doctor at Marian saw that Bruce was being treated here, he informed them that there was no way that our insurance would pay for it. So instead of submitting an authorization, it sounds like they tried to negotiate with this doctor. I don't think we'll ever know what was really going on.
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| Milk goatee |
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| Falling asleep |
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| Good job to Merilee for growing two precious babies. |
Since there was no authorization that had been denied, we couldn't file an appeal. The only way at that point to keep Bruce at the hospital 2 minutes from our house was to deny the transfer, get billed for his stay at the NICU, then file a grievance and be at the mercy of the insurance company who hadn't thus far given us a family-friendly vibe. When I ended the call with the grievance specialist, my plan was to go and have a talk with the case workers and NICU doctor who had more experience with this kind of stuff and might provide some insight.
My plans were thwarted, however, when I arrived at the NICU. Merilee had already been there to nurse Bruce. While I was downstairs trying to find a solution to keep him with us, there was a different NICU doctor upstairs telling Merilee that she should sign the consent to have Bruce transferred to avoid getting the NICU bill. It's so great that she and the nurses were able to corner Merilee and tell her what to do without me there. So awesome!
Then when I arrived, I attempted to share what I had learned from being on the phone for hours between Friday and that morning. I couldn't get two words out without the doctor stopping me to say "but NICU bills are expensive," "but it's not worth the stress," "yeah but you don't want to do that because _____," or some other discouraging statement. You doctors do amazing things to care for people but holy crap you suck at listening sometimes. I know on one hand that a lot of people (myself included) are not as smart as you are, but that doesn't mean that we aren't equipped to make our own decisions about what's right for us. If I ask you a question about something, please answer it honestly and don't use it as an opportunity to steer me in the direction you want. Whether it's the decision to have a C-section or battle insurance companies, we should have felt like it was our choice, not yours.
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| Feeding him at Marian that night |
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| We got to keep this blanket |
The first was the nurse who said that she wasn't even scheduled for that day. She got a call and ignored it since it was her day off. But they then sent her a text so she decided to come in to work. I didn't tell her what I wanted to say which was that she should stay home next time. These people were caring for my son, however, and it wasn't their fault. The next thing was the doctor saying that their NICU was full to the brim. In fact, they didn't have room for him in their regular NICU area, but that he'd be put in a side room called "The Isolation Room." Really, your NICU is full? How many babies are you guys taking away from their mothers? I'm glad I didn't think of that question at the time.
We said goodbye to Bruce and headed back down and tried not to cry too much about the whole situation. I finished packing the car, we had our last visitor who talked with us about mediCal or something like that, and we had our last meal (the food was pretty good actually). We said goodbye to the nurses and put Cordelia in her car seat. We almost couldn't take her home though. Cordelia the day before had had her car seat test (they just monitor them while they hang out in the car seat for a couple hours) and passed. However, since we were only going home with one baby instead of two, I didn't bother reinstalling the car seat that Cordelia had used for the test. The one that was still buckled in had a slightly looser loosest setting on the straps and it was big for her. So, I had to unpack a few things, switch the car seats, and we were on our way.
I called Jenny during the 2 minute car ride. Our friends had picked her up from the airport and dropped her off at our house and I think she was recording when we came home or something. We got settled in, went out to buy some formula for that night, and Merilee probably pumped. Then, we were off to Marian to see Bruce. Marian is a very nice looking hospital. In fact I'd probably never choose to go there out of fear of it being too expensive - that's how nice it looks.
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| May I introduce you to my brest friend. |
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| So much milk to drink and not enough energy. |
We found Bruce in his little isolation room and got to feed him. He was doing the same thing he was doing at Sierra Vista, or really what could have been done in a nursery - getting the jaundice light between feedings. Between his jaundice supposedly being borderline, and the fact that we are perfectly capable of feeding him, it was only a little bit ridiculous that he was transferred there. I've heard that NICUs typically keep babies longer than they really need to just to make sure they stay out after they leave. Oh and get this - the nurse even asked us why he was transferred there when the care he was receiving is available at French (to which we did respond, "good question!"). A hospital 7 minutes from our house would be much preferable to a hospital 45 minutes from our house.
On the way home it was difficult to stay awake. I remember Merilee trying to talk to me and rub my shoulders but I could still feel my eyelids dropping. I think I was even singing something while my eyes were shutting. I swore if Bruce and Cordelia became orphaned because we had to commute to that stupid hospital after so much sleep deprivation that I'd somehow make those responsible pay. At least hopefully it'd be all over the news and they'd feel terrible about it. Luckily though, none of that happened.
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| Dual-wielding babies |
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| First picture of all four of us I think |
It was either that day or the night previous that one of the NICU doctors explained to us about the "Milk Fairy." Basically, once this mythical creature comes, the baby will start feeding better and can then go home. I think the engineer in me likes the pre-programming analogy better but alright. Bruce was feeding better but of course they still couldn't tell us when he'd be coming home. On our way back we picked up some pizzas thanks to T-mobile Tuesdays.
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| One baby |
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| Two babies |
The next morning, Merilee got a call from the NICU saying that Bruce would be discharged that day. We were thrilled. We left Cordelia and Jenny at home this time and took Bruce's car seat in for his test while we watched a terrifying infant CPR video and went through other parts of the discharge process. We were so excited to bring him home finally (I say finally knowing that it actually wasn't that long).
There are several people that I'd like to thank for all the help and love that they've shown us during this incredible time of need:
- My sister Jenny and her family. Jenny came out for the first two weeks after preparing her own household in advance so they'd survive her absence. She cooked amazing meals, helped around the house and with the babes. She also posted a million pictures of the kiddos on Facebook for our friends to marvel at.
- Our points of contact for our family and for our local friends. It was/still is really hard sometimes to keep everyone updated on what's going on. Things as you can imagine have been turned upside down. Having fewer people be our voices has helped a lot.
- Thanks to those who have signed up to come and help Merilee while I am gone for 7 weeks on my internship. You and your families are making sacrifices so Mer can have the support she needs while I'm away. So, thanks!
- Our support base has been incredibly strong due to our friends from church. We've received so much help (mainly in the form of laundry and meals) that has made life a lot less hectic since the babies arrived.
- Medical professionals
- We were blessed to be patients of a caring team of doctors and nurses at Dr. Steinleitner's office here in SLO. It was thanks to their help that we were able to get pregnant after almost giving up our dream of becoming parents. I think I can speak for Merilee when I say that I don’t think we’ve ever had a doctor’s office care so much for their patients.
- Since arriving at the hospital, Merilee and the twins received excellent care from doctors and nurses at Sierra Vista. During our brief stint there, I was amazed at the work that they do each and every day. The nurses work 12 hour shifts helping first time parents figure out what the heck they are doing. The NICU nurses help early and otherwise sick babies grow and to be able to go home with their families.
- I'd like to thank our employers who have supported us either through helping us keep our benefits, allowing me to have a shortened internship, or just ordering flowers or cookies to our house.
- All our friends who enjoy adoring our little ones when they appear on Facebook. One of Merilee's fears in life was having ugly babies, so it's good that everyone else thinks they're beautiful too.
- All of our friends and family who have supported us during our struggles both with IVF and with pregnancy (and now - with parenthood). Thank you!
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