Monday, January 11, 2010

The Boys' Birthday

It has been a crazy few months. Crystal hasn’t been able to update the blog because we have a desktop at home and it wasn’t worth setting upwireless to update while she was on bed rest and since the boys have been home, who’s had time to sit at the computer? She has been good about journaling through all of this, so she is going to update the blog in pieces and hopefully be able to fill everyone in with the information about what has happened for the past 4 months. We’ll start with late August and go from there.

Bed rest at home went really well. We had a doctor’s appointment once a week that included and ultrasound and then had non-stress tests (NSTs) twice a week. These monitor for contractions as well as the babies heartrates. On Tuesday, August 24th, we went in for our final cervical length ultrasound and our final doctor’s appointment with the perinatologist. Crystal had begun having contractions the week before, but they weren’t painful and would only happen occassionally. At the appointment, she was released to go back to the regular OB’s office and forget about their place. This was because we were halfway through our 32nd week of the pregnancy and everything was looking great. We had an NST that day as well and Crystal had a few contractions, so they gave her a shot of Turbutaline to help stop them. She’d had this before and it worked, so we weren’t concerned at all. The worst part about the turbutaline is that it gives Crystal the shakes and it stings pretty bad going in. Since things looked so good, we headed home, excited that we’d made it to the point where we could go to our regular doctor.

Unfortunately, things started to change later that afternoon and evening. Previously, the turbutaline had stopped contractions for about 5 hours and spaced them out to only a few, if any in an hour. This day, though, the contractions came back within an hour. They were still spaced apart, but around 7 p.m. things started to pick up and we started timing them. After an hour, Crystal had about 15 contractions, so we called labor and delivery to see what they wanted us to do. They said to come on up, so we headed to the hospital. We got there around 9 p.m. and they immediately put Crystal on the monitor. The contractions were very regular, so the doctor ordered more turb. The first dose didn’t really work, so they ordered a second dose. That didn’t appear to help either, so the doctor decided to give Crystal an oral medication called ProCardia. That didn’t help immediately either, so he went back to the turb and followed it with another dose of ProCardia 15 minutes later. This combination did the trick and the contractions spaced out to 20 minutes. We finally got the okay to go home at 3 a.m. Wednesday morning if we wanted to. We decided that we would, with the oral prescription to help keep the contractions spaced out. Crystal had to schedule a follow-up appointment in the office for Thursday and closely monitor contractions to make sure they didn’t start up again. If they did, we were to call the office or Labor and Delivery.

Wednesday morning was a restful morning because we both desperately needed it after the night we had. Crystal got her appointment scheduled, but around 3 p.m. that afternoon, the contractions started coming back. She called the doctor’s office, but since it was so late, they said if they got worse, to head to the hospital. Kenny was preparing to go to work, so Crystal was going to ride into Kalamazoo with him and stay with friends in case things got worse. We were questioning whether or not we should just go to the hospital, so Kenny decided that since we didn’t know what to do, it would be best just to head up to triage again.

We got there around 4:30 p.m. on Wednesday night. After monitoring again for a while, they decided that they were readmitting Crystal with failed home tocolitis (bedrest at home). Crystal was crushed after all we’ve been through and knew as we drove to the hospital that she probably wouldn’t be coming home until the boys were born, but that didn’t make it any easier to hear. After another shot of turb with no luck, they started an IV on Crystal and began giving her a medicine called magnesium sulfate. They called this medicine the “Big Guns.” Needless to say it wasn’t a pleasant experience for Crystal. When you are on this medication your fluids in and out have to be measured, and it makes you have to go to the bathroom more frequently. Wednesday night/Thursday morning were really rough. At times, the monitor showed that the contraction had stopped, but Crystal was still feeling incredible pressure and tightening on her sides. They also had to increase the amount given to the maximum just to get the contractions under control to start with. There were stretches of time where there was just no relief. Thankfully, this slowed and we were both able to get some rest that night. Thursday during the day went much better, they were able to decrease the dosage. One side effect of this medicine is also that it makes you very warm and lethargic. Kenny had the thermostat in the room set a 55 degrees and Crystal still felt like she was on fire. Crystal’s sister, Tennille decided to come up Thursday night to be available in case something happened. Thursday night was a very rough night. Contractions continued at about every 10 minutes and Crystal was up and down every 30 minutes to go to the bathroom, so her sleep was in small segments. That also meant Kenny’s sleep was in 30 minute segments because Crystal needed help getting up to walk to the bathroom.

Even though it was a fairly rough night, we anticipated just more of the same for Friday. The nurses would be available to help Crystal with her bathroom breaks and things, so we decided to have Kenny go to work. He had to be there at 7 a.m. so he left for work around 6:45. Around 7:25, Crystal had 3 really rough contractions, so she called her nurse at 7:35 and asked to be put on the monitors. The nurse put everyone on the monitor, then got Dr. Hendricks from the desk outside. Immediately, the decision was made to take Crystal down to triage. On the way downstairs, we met up with the ultrasound folks who pushed ahead of us to get the machine plugged in and warmed up to look at the babies. At this point, Crystal really didn’t know what was going on, so emotions were running wild. She just knew that something was wrong. Later on, her nurse said that she was giving off some strong signals that things weren’t right and the nurse went by those to figure out what to do. We don’t know if she would have been able to determine those signals if Crystal hadn’t already spent so much time up in antepartum.

Dr. Hendricks did a quick ultrasound looking at Baby B because Crystal told her that he’d been moving less than Baby A. After the ultrasound, Dr. Hendricks immediately told the nurses to prep Crystal for surgery. She was so calm and just told Crystal that everything was fine right now, but we had to go get het boys now. While the nurses were prepping Crystal, she asked one to call both Kenny and Tennille to get both of them here. They were on top of it right away. Crystal was quickly taken to the OR, got to move herself to the table and was finished getting prepped for an emergency Cesearean section. She remembers telling Dr. Hendricks that the boys names were Dane and Nyle and whoever was born first would be Dane. After that, the anesthisiologist told Crystal to close her eyes and think of sweet dreams and when she woke up she’d be a mother.

Crystal’s nurse was able to reach Kenny and Tennille. Of course Kenny “flew” to the hospital from Gander Mountain, but thankfully, arrived safely. He got changed into scrubs and was able to get into the OR just in time to see Nyle being born. He was told if he wanted to go see them he could. Dane was already on the warming table when Kenny got in the room.

While the doctor and nurses finished up with Crystal, Kenny went with the boys to the NICU. Doctors and nurses were running back and forth between the boys two rooms getting them stabilized and all set up on the respirators and making sure there were no major complications with them that needed addressed.

So, we were blessed with two beautiful baby boys:
Dane Richard Sattler – 4 lb. 14 oz, 17.25 in. long, born 8:17, August 28, 2009

Nyle Andrew Sattler – 3 lb. 8 oz., 16.5 in. long, born 8:18, August 28, 2009

Crystal was moved to recovery while Kenny spent some time with the boys. Dr. Hendricks came in to tell her that although she probably wouldn’t remember too much of the conversation, but that everything went really well during the delivery. The reason for the emergency was that Nyle’s placenta abrupted, causing his heartrate to drop. During delivery, Dane then swallowed a bunch of blood from the abruption, so he had a few issues at the start, but was doing well. She said the boys looked great and told Crystal their weights.

Once the boys were stable and Crystal was stable enough in recovery, Kenny came into recovery to be with Crystal. The nurse got her morphine set up for pain and Kenny got to feed Crystal ice chips since they wouldn’t let her have any water. They allowed Crystal to sit up in stages, but she began to feel light-headed and her blood pressure plummetted. The nurse called the doctor and they determined that Crystal’s hemoglobin levels should be checked. Of course, they were extremely low, so she was going to have to have some blood. They decided, however, that they would wait to do that until they got Crystal up to her room in the Mother/Baby unit. On the way up to the room, they took us through the NICU so that Crystal could see the boys. At the time, the boys were still on the respirators and were in separate rooms that were next to each other. The visit was only brief with the promise that as soon as Crystal’s hemoglobin levels were acceptable, she could come back down to see them.

Once in Mother/Baby, the nurses started with 2 units of blood. Unfortunately, after the blood was all in and flushed, we had to wait 2 hours before doing the blood draw for testing and the results took about 1-1/2 hours to get back. During this time, Crystal’s mom had made it up from Indiana and Kenny was able to take both her mom and Tennille down to see the babies. During one of these visits, the boys had been removed from the respirators and started on CPAP machines for apnea. Doctors had told us to expect them to be on the CPAP machines for 2-3 days.

Crystal’s blood work came back and her hemoglobin levels were still pretty low, so she was told that she would have to take 2 more units of blood. At this point, it was already into night shift (after 7:30). It took about 1.5 hours per unit of blood, so that meant it would be a long time still before we could go back down together to the NICU. Thankfully, my nurse said we could go down once the blood was in and we didn’t have to wait until after the blood draw and results were back (they weren’t going to draw blood until 6 a.m. the next morning) Finally at about 2 a.m. Saturday morning, we were done with the blood and could get set to go downstairs. At this point, Crystal now had 2 IVs, each with a pump. One had morphine in it for her pain from the surgery and the other was still flushing for the blood. It took some dancing and work, but Crystal’s very patient nurse finally got everything set-up and connected to the wheelchair poles so that Kenny could push Crystal downstairs to see the boys.

The NICU was very intimidating with lots of machines, monitors, wires, and teeny tiny IVs. Even with all the wires on the boys and all the wires on Crystal, the nurse pulled Dane out and let Crystal hold him for a while.

Here’s Mom and Dad with Dane

Here’s Mom with Dane

The boys’ nurse taught us about care times. Basically, every 4 hours, the nurses would tend to the boys. This is when they would change diapers, take temperatures, poke the boys for blood sugar, measure blood pressure, and check the boys’ IVs. Obviously if they need something else prior to their hour, the nurse would tend to that, but the idea is that once their care is complete, they should be able to rest for as long as possible so they can grow and get healthy. She taught us about their isolettes (basically an incubator). These were set up to automatically adjust the temperature surrounding the boys based on their body temperature. If they are cold, it will warm up and if they are hot, it will cool down. The boys are also not on the same schedule. Dane is one hour and Nyle is another. This allows us to spend time with each of them. The parents are encouraged to participate in the baby’s care time. We are allowed to change diapers and take temperatures as well as help with calming the boys during any other poking and prodding, and we can always snuggle with them for a bit as long as their temperature stays up.

This pretty much sums up the boys birth. It was very eventful and stressful, but they arrived safe and sound with minimal issues. We are just so blessed to have these two tiny boys in our lives.

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