A Pivotal Moment

I've noticed a human tendency, especially among athletes or people whose identity is found in their physical fitness, to equate health with achievement. Having just spent a couple of days sleeping on my cold bathroom floor, I'm certain that health is a gift.

I've thought lately about pivotal points in my life. Every person has them, the moments that separate your life into before and after, and certainly having preemies must rank somewhere near the top of mine. But, as I sort through memories that play like horror movie reels, what one moment stands alone?

J's delivery was so rushed. Once the doctors and nurses realized that my labor could not be stopped, they prepped me for not just an emergency C-section but for emergency surgery with full anesthesia. As I lay tipped back in the hospital bed, practically standing on my head with my feet toward the ceiling, controlled chaos was all around me, a rotating door of people handing me waivers, advising me of my rights, asking me to choose a NICU downtown, explaining the procedure, taking my blood pressure, informing me on all the ways they would try to save J's life. It was too much way too fast. My mind was whirling around in on itself, stuck trying to process: I am having this tiny baby now. As they rushed me to the operating room, I was completely disoriented. Someone forgot to tell the interior decorator that if the ceiling is white and the bedsheets are white and the hospital gowns are mostly white, all the patient can see as she's wheeled to her fate is white, as if she's already dead and on her way to Heaven. As they popped open the operating room doors and the bright light hit my eyes, I yelled back to my husband a goodbye, a pathetic, last-second, nearly-forgotten goodbye, and I had a pivotal moment. I was lying on an operating room table. All I saw was white and steel. All I could feel was cold. Would I live? Would J live? Would both of us meet on the other side?

Three things strike me about that moment. The first is that you don't know how many moments you get in life like that, moments when you are certain that your life is either about to be spared or ended. Most of us don't have many. And when you are spared, nothing in life ever looks the same again. I would say that moment marks the loss of the girl in me and the birth of the woman.

The second thing that strikes me is that I wasn't alone. An army of people buzzed around me, prepping me for surgery. My doctor was there readying herself to perform one of the more dramatic deliveries of her career, since it's not everyday you deliver a surprise 26-weeker in the middle of the night to someone you've never met. But, I felt more alone than I've ever felt. The anesthesiologist and the nurse anesthetist did more than perform their clinical duty; they stepped in for my loved ones. They stroked my cheeks with their fingertips and calmed me with gentle words. I'm glad I didn't know that some of the best and most challenging work anesthesiologists do is emergency surgery on pregnant women. They made me feel like their only job was to soothe me, to give me some peace. They were incredibly compassionate in a dark place for me. As I waited to fall asleep, all I could see were their eyes. Their smiling eyes I'll never forget. Their eyes, as I went to sleep. We should all be so compassionate, in whatever it is that we do in life. So much in this world doesn't matter. It is people who matter, and each one of us deserves love, respect, and compassion.

The last thing that strikes me about that moment is that should I be on an operating table like that again in my life, I want to know that I did the important things and I did them well. Maybe I'm not famous. Maybe my life's achievements don't win any awards. But, awards aren't the measure of a life well lived. Recognition is icing, but it's not the cake.

Which brings me back to my original point:

Health is a gift. Our choice is what we do with it.

A Photo I Hate

You know how sometimes you remember exactly what you were thinking when a photo was taken? I was organizing some photos yesterday, and I came across this one. It was taken just a few days after M's birth, the first time I was able to hold her. 

I didn't want my mom to take the picture because I was about to cry. I was looking into M's starved, skinny, sunken little face, and I was thinking, "I have failed. I have failed you!" This should have been a special moment, the first time I had M in my arms. But, when I see it, I feel a crush of sadness. I can see the pain I was trying to hide. It is right there, on my face.

This photo breaks my heart.

The Way It Is

Why is it that other people need to find a reason for my preemies? I'm not talking about my mother or my father. Not my husband. Not my best friend. Of course, people so close to the situation want to hash and rehash what happened, both times, in the hopes that maybe we'll finally figure out what went wrong...twice. I really love that my friends and family want to talk it out with me because their support helps bring closure to the two most traumatic events of my life.

I think I'll always wonder what went wrong. And I don't think I'll ever know the medical reasons. I look at my miracle babies. J would have died just a few decades ago because he relied on respiratory surfactants to help him breathe. And M and I both could have died from preeclampsia. So, yes all three of us are phenomenally lucky, and that is beginning to be enough of an answer for me. I had these crazy things happen, but look at the joy that has come from it.

I love that people ask questions. I love when people are curious about my preemies. But, I'm always amazed that they feel there must be some reason. Was there a family history? No. Were there warning signs? No. Was I over-weight, under-weight, too old, too young? No, no, no and no. The question that hurt the most was when I was still so vulnerable over my son's birth. He had only been home a month or two, and I was emotionally raw from the first NICU experience. A friend told me her doula wanted to know if I'd been taking my prenatal vitamins. I was too fragile to even get mad, but now the question irritates me. On one hand I want to scream, "Of course I was freaking taking my prenatal vitamins!" On the other hand, I'm amazed that anyone who is frequently present at births could fail to realize that much of the good and bad of labor is out of our hands. And when I think back to how rapidly my body spiraled out of control both times, I can't help but be a little snotty, "You really think a prenatal vitamin would have stopped that train wreck?!" Of course, that's in my head, but maybe I should have said it.

No, I didn't do anything to deserve those labors, just like I don't deserve the two precious babies who came from them. The only answer I have, the only one that gives me any satisfaction, is that this is how it's supposed to be. I am supposed to be the mother of preemies. I have tiny babies. And that's just the way it is.

M's Birth Story

I keep flashing back to a moment of desperation when my son was five months old, and life with a preemie was stressful. It was Christmas Day, and I was walking in a dusting of snow talking to my best friend on the phone. “I cannot EVER do this again,” I whined. And she told me that this time in my life wouldn’t last forever. She was right. I had several more long months ahead of me, but things did get better. So much better that my husband and I considered having another baby.

I wanted my son to have a sibling, and I had always thought—before I had a preemie—that I’d have three children.

And as much as I adored my son, I wanted a little girl too.

It didn’t take long before we leaped off of a cliff on the faith that another pregnancy would be different from my son’s when I unexpectedly had him 14 weeks early.

It was different.

The first part was easy, just like with my son, and at 13 weeks I started seeing a high-risk doctor, who monitored me for signs of early labor. Every week, I had an internal ultrasound, and I saw my baby on an incredibly clear flat-screen TV. And one advantage of the weekly visits: I found out at 15 weeks that I was carrying a baby girl!

I resolved not to worry between appointments, and as one week blended into the next, I began to relax. Once we passed the 26-week mark when I had my son, I told my husband that at least we wouldn’t have a repeat of that horror of having him so early. Christmas came, and in all the bustle of the holidays, I didn’t pay much attention to the swelling in my feet. I had to start sleeping propped up so that I could breathe, but since I’d never made it to my third trimester before, I blamed my baby’s growth spurt for it. What a cruel joke! It turns out M was growth-restricted and probably hadn’t grown after Week 26 or 27.

We went to spend a few days with my husband’s family in Texas after Christmas. I felt really big and bloated and tired, none of which is much of a cause for concern in your 7^th month of pregnancy. My high-risk doctors had seen me just before the trip and okayed me venturing out of the state one last time. But, after a few days in Texas when I couldn’t put on my wedding rings any more, I started having a nagging feeling that something wasn’t right. The only time in my life when I’ve swelled at all was after my C-section with my son. Finally, on the evening of December 30, I asked my mother-in-law for a blood pressure monitor, and I was shocked by the reading. Normal blood pressure is around 120/80, and high blood pressure in pregnancy is 130/90. My blood pressure was 185/105, which is stroke-level. Given that I was pregnant and had no prior history with high blood pressure at all, I knew this was really bad. I called my regular OB, and she told me to get to an emergency room immediately.

I cried.

I cried because I knew.

I knew because I’ve had things go haywire with a pregnancy before, and though the circumstances were totally different, the feeling was the same. I was on a high-speed train racing out of control, and I knew it was headed off the tracks. I knew we were going to have another preemie. And I cried out of that feeling of dread and defeat and fear you feel when you know your health is in jeopardy and your baby’s health hangs in the balance.

On the way to the hospital, my husband held my hand, and we gave each other a sad look but didn’t say much.

It didn’t take long to confirm that I had preeclampsia, and the test results showed it was severe. There really was no chance that we could stop it or change it. The doctors and nurses just tried to stabilize me in the hopes that we could get back home and to a familiar NICU. For that night and the whole next day, I laid flat on my left side to promote blood flow to the baby and reduce my blood pressure. The doctors were so kind. They kept checking on me with the intent to get me home if they could.

My husband and I rang in the New Year in the hospital. Afraid. Away from home. And wondering what in the world we’d do with a baby in the NICU in a different state. All I prayed for was to get home. I knew we’d have M early. I knew she’d be small, and I knew she’d be in the NICU for a while. But, I just didn’t want our family to be separated with my husband and son at home and me in another state in the hospital with M.

Around 8 a.m. on January 1, the doctor on-call came into my room, and he pulled a chair up to my bedside. He said he’d woken up thinking about me and my situation. What would he want for his wife? He said that my blood pressure was steady and that I had a short window of time before the preeclampsia took over. He wanted to release me with the understanding that I would drive the eight hours straight to my hospital at home. I still feel amazed that given my diagnosis, a doctor would do something so radical and so unlikely and so incredibly kind.

Our family loaded our stuff into our car, and the hospital released me. We spent January 1 racing across a few states. I’ll never forget that trip for many reasons, only one of them being that I knew I’d never be pregnant again. Another lovely pregnancy was coming to an abrupt and unlikely end. As I walked out of a rest stop, I held my belly and thought, “I’ll never be pregnant again, and I’ll remember this moment and what it feels like forever.”

My parents met us at the hospital, and they took my son to our home. I actually felt pretty good that night and most of the following day. When they weighed me in the hospital, I told them their scale was broken, and I meant it. I had gained 20 pounds in 29 weeks of pregnancy, and then in one week I had gained 20 more. I looked puffy, but even the doctors said I didn’t look like most women with preeclampsia. I wasn’t flushed. I didn’t look swollen. And after days of liquid diets, I was scarfing down food and chilling out on my left side, watching TV to pass the time.

That day I had the last of many ultrasounds. There she was, the tiny star of the show. And she was tiny. They estimated she was about three pounds, and she was so low on the growth chart, that they deemed she had not been faring well while my blood pressure was high. The free flow of nutrients into the placenta depends upon healthy blood pressure, so I was starving her, even as a horrible witch of a charge nurse told me I should pray for my baby who would be in the NICU until her due date. As if I could do anything about my situation, and as if I hadn’t already had a preemie in the NICU for 91 days! There is just nothing nice to be said about someone who judges other people during a health crisis.

In a matter of hours, I went downhill quickly. My body had given subtle warning signs for about 10 days, but all of the sudden I felt my body fall apart. I was tired. My blood pressure was outrageously high and uncontrollable. My head felt like it was splitting, and all of the fluid that had accumulated in my abdomen was pressing on my lungs so I couldn’t breathe. My body ached from lying for so long on the left side, and as they started pumping me full of magnesium sulfate and labetalol for my blood pressure, I knew we’d reached the end. In fact, I begged for the C-section because I was starting to get really scared.

My first C-section was unfortunate because I was asleep and missed the birth of my son, but my second C-section was unfortunate because I was awake! I consider myself to be tough, but it’s unnerving to feel people cutting on you and to hear them discussing how they can’t get the baby out the original incision because of excessive scar tissue and how they’re making an additional incision. But, it was worth the odd sensations because I heard M cry. She sounded like a kitten mewing, but I was there to hear it. And my husband witnessed her birth. Her parents were there to welcome her to the world.

I asked my husband how big she was. Three pounds? And what day was she born? Did I make it to 30 weeks? Nope. She was born less than an hour from the 30-week mark, and she only weighed an ounce more than our son. Another 2.5-pound baby.

I wish I could say my children’s births were beautiful. They were terrifying. They were the worst days my husband and I have survived to date. I really hate that. But, they were also spectacular for one simple fact. Our tiny babies lived. Both of them. And that is beautiful.

The Beginning

My pregnancy with J was so easy: no morning sickness, no major weight gain, no diabetes, no risk factors for anything at all. I loved knowing I was carrying a new life. Every ultrasound was thrilling. During the first ultrasound, I remember being amazed that something so tiny had a heartbeat. The whole world was shifting, our priorities were changing, our lives were being irrevocably reshaped. We bought our first house; we moved to a new state; we bought some baby furniture. I took long walks, just my baby and me. My mom said something almost prophetic when I was four or five months pregnant. “I hope you don’t have problems later on because the first part has been so easy.”

We had lived in our new home in a new city for six weeks when I started feeling pressure. I thought about the next three months. How would I survive it if I already felt so uncomfortable? I was naïve, and I had no idea that things were spiraling out of control.

Two days before my son was born I went for a check-up. Everything seemed fine, and I didn’t complain about how uncomfortable I was feeling.

Saturday morning we went to the Farmers’ Market, but by the afternoon, I was feeling off, odd, and really uncomfortable. We canceled our dinner plans, I researched contractions online, and I took a bath to relax. I also hydrated myself, thinking maybe I had just gotten dehydrated in the summer heat. At dinnertime, I just knew something bad was wrong. I packed an overnight bag. I called the doctor, and we hurried to the hospital. The ER lost my paperwork and failed to rush me to labor and delivery until my husband complained. By the time they started monitoring my contractions, it was about 10 pm.

They didn’t tell me something I didn’t already know. I definitely had contractions. In my heart, I knew they were wasting their time hydrating me, but I hoped the muscle relaxer would help. After an hour or two, I thought the contractions were better because I couldn’t feel them. My husband, who could see the monitor, told me they weren’t.

When the nurse finally checked me in the wee hours of the morning, I could tell she was upset. She hurried off, saying she was calling the doctor, whom I met for the very first time in the middle of the biggest health crisis of my life. She told me the news. Not only was I dilated to a 3 out of 10 but my son was breech. His foot was actually pushing the sac through the birth canal. I was at risk of his foot breaking the sac, allowing the amniotic fluid to rush out and pulling parts of him with it. He was in immediate risk, and an emergency C-section was our only option. They tilted the hospital bed until I was practically on my head to use gravity to keep my son inside me. The anesthesiologist consulted with the doctor, and they decided there was no safe way to give me an epidural or a spinal block. They would have to put me under. This meant that not only would I miss our son’s birth but also my husband would be alone in the waiting room during the surgery praying for both of our lives.

I was 26 weeks and 4 days pregnant.

I was beyond terrified because it wasn’t just about me. I had no way of knowing how my son would tolerate the surgery. Would he even live? Everything moved so fast, with me signing waivers, talking to doctors and nurses, and being prepped for surgery that I didn’t have time to call my parents. As an after-thought I told my husband to call our parents and my best friend and give them the middle-of-the-night shock everyone dreads: someone you love is being rushed into emergency surgery. My poor Daddy threw on clothes, hopped in the car, and left my mom and sister at their house because they were taking too long; he shaved nearly an hour off of a four-hour drive.

Everything was such a blur that I didn’t even tell my husband I loved him. On the operating room table while I waited for the anesthesia, I begged my nurse to tell him I loved him because I was afraid I might not wake up. I’d never even had major surgery before. As we waited for me to drift off to sleep, the anesthesiologist started stroking one of my cheeks, while the nurse anesthetist patted the other, and I will always be grateful for that kindness, that human touch during a dark time. I was staring into their eyes, and then nothing.

I woke up enough to ask if my baby lived. The answer was yes. Thank the Lord! I asked where my husband was—he was on his way into the room—and then I fell asleep again.

The next thing I remember was being roused to see my son before they transported him to a NICU 20 minutes away. I was mesmerized by his tininess. I had never seen anything like it. He was a kitten in a glass box. I looked at his miniscule hands and feet, the size of my fingertips. I studied his face, his dark hair, the length of him, all 13 inches. I looked for myself in him and only found my husband. “How unfair!” I joked with him, a moment of joy in a sea of sorrow. And then they whisked my baby away, no cuddling, no touching, no more of his mother’s love. I didn’t see him for another two days.

It was the beginning of his 91 days in the NICU.