Tuesday, June 18, 2013

The End of the End

The End of The End

On Thursday night my beautiful Bobby and my sweet Rosalyn both got very sick at the same time. The chief neo was called out of bed to attend and he worked valiantly through the night to save them both. Rosie was diagnosed with respiratory distress and a possible infection. Bobby was diagnosed with a perforated bowel and scheduled for emergency surgery the next day. The details of Friday the 14th will haunt me for the rest of my life and are much too close to my heart to share. I will share this that I wrote Saturday:

"We are at the hospital. Bobby went septic around 2:00. It progressed very rapidly. At 2:45 or so they woke us up. We were given the choice to unplug and let him go quickly or leave him as is and let him take his time. I felt distinctly impressed that he wanted to hear my heartbeat one last time, and that was what he had been fighting for; the opportunity for us to do comfort care without having to be subjected to emergency responders who would have prohibited my ability to share those last sacred moments in his life. He was scared of dying on the operating table without his mommy. We unplugged him, swaddled him, passed him to daddy for kisses. Then I held him on my chest, sang him his favorite song, and let him hear my heartbeat until he slipped peacefully to sleep at 3:15 a.m. on the 15th of June. It was peaceful and beautiful. They had given him medicine so he felt no pain."

There is nothing left that I am capable of saying about my son right now except for this: when I was pregnant I could feel Rosie. I knew her as a person intimately the way only a mother can. For many months, however, I could not feel my little Robert, which made me very sad. One day I was inspired to pray to have the privilege of becoming acquainted with him. Upon finishing my prayer a feeling came over me that I can only describe as the sun exploding with joy and I heard a voice say "I love music!" It was so jubilant that it took my breath away and then made me laugh. That's Bobby. Think of the purest, happiest, most joyful moment of you life and you'll understand who that boy is. 

This morning, driving to the hospital to spend the day with Rosie, three songs came on the radio in this order:

I will miss my son until the day I die, but I know that he is not really gone. Some way, someday we will be together again. 

Monday, June 10, 2013

100 Hours


100 hours ago I was relaxing peacefully in bed I my new home away from home: the Antepartum Suite at Utah Valley Regional Medical Center. I was all ready to settle into my new life of hospital bedrest. Tuesday had been scary but Wednesday was peaceful and boring, and my only major complaint was that I had some indigestion and gas. 
That night after work, Luis came to visit with his sister and niece. They chatted while I lay there eyeballing the contractions monitor and whining about indigestion. They had hooked me up to the monitor about 36 hours earlier and I refused to let them take me off of it because I was so afraid of going in to pre term labor, even though they told me I was not at risk. 
Lu left around 10:30 to go to his weekly "Boy's Night" (XBox games and manly bonding time with a few of his oldest friends). I was taking care of my bedtime routine when my indigestion started to get pretty uncomfortable. It really felt like I had overdone it with dinner! I called the nurse who got me some heartburn medications and a Gas-X. I took them and decided to get out of bed to go to the restroom one last time before bed. When I sat down, Baby A's amniotic sac fell out. This was the end of my bed rest. It was 11:20 p.m. on Wednesday June 5th.
The next few hours are a blur, but at the moment it felt as if I was frozen in time. I waddled back to bed and yelled for the nurse (who had only left about 5 minutes prior). I explained to her, and she incredulously checked me out. After discovering, to her shock, that I was not in fact exaggerating, she ran to get the on call doctor who had just arrived for duty. He and I had never met. 
It was 11:30 p.m. I was told that I had two choices: wait until my water broke or go for a caesarean. The situation as it stood was that baby a was head down and ready to enter the birth canal. Baby B was breach and nowhere near close to coming out. The odds of Baby B surviving a vaginal delivery were close to nothing, but A would still have a shot if it moved quickly enough. I would also be able to save myself from an ugly c section and preserve my ability to have normal deliveries in the future. The other choice was an emergency classical cesarean. That's when the cut you vertically instead of horizontally. It is not a good thing because it takes longer to heal, is at greater risk for splitting open in the future, and you have to have a section with all future pregnancies. If we did that, we could get both babies out without trauma, quickly. The odds of them surviving delivery were much higher. 
Either way, I was delivering within hours. I was dilated to 6 and fully effaced. The cerclage had ripped out without pain or blood. I had not had a single contraction. There was no decision to be made. I was wheeled into the OR at 11:35, in the same bed I'd been laying in for two days. Luis arrived at 11:45 right as they were finishing my spinal block.  At that point I was dilated to a 7 or 8.
At 11:58 p.m. on Wednesday June 5th, Rosalyn Esperanza Farias came into the world, weighing 1 pound 4 ounces. She was pink and beautiful, and was received by a team of two nurses, a neonatologist, and a respiratory therapist. Luis only got a glimpse of his daughter, but through tears he kissed me and whispered "she's perfect."
They had a harder time getting Baby B out, all squished up and tucked away into a difficult to reach back corner. The doctor had to reach way inside of me and yank the baby out. At 12:02 a.m. on Thursday June 6th, Robert Armando Farias came fighting into this world. Still emotional, Luis followed him into the resuscitation room, where my baby boy had his own team of doctor's nurses, and respiratory therapists waiting for him. Luis says the baby cried as they rushed to intubate him. Babies born at 24 weeks can't cry. They are too small and underdeveloped, but even at 1 pound 2 ounces, my son likes to do things his own way.
 As they cleaned me out and stitched me up, Luis came back to report that the babies had both been successfully intubated and were breathing with the help of a ventilator. They were alive, and despite being impossibly small, they were perfectly formed and surprisingly strong. I had promised them a thousand times throughout my horrible pregnancy that if they really wanted a chance to live, I would walk through the fires of hell to get them far enough along that they'd be given the chance to make that choice themselves. They had fought through multiple hemorrahges, an incompetent cervix, and 11 weeks of stressful bed rest. The were born at the very limit of fetal viability. They fought to stay in long enough to be considered worth saving. Now they are fighting every day for a chance to keep living.
Having micro-preemies is a world in and of itself, full of dark fears, heartbreaking statistics, and moments of sheer terror. I thank you all for you prayers and your vigilance. We have witnessed a thousand miracles and tender mercies from The Lord in the past 100 hours.
 I apologize for not going into details right now. We are living in a state of grace, being cradled in the hands of both earthly and heavenly angels. I don't like talking about the daily battle for survival that my precious babies are facing. It's too close to me. Too powerful, and much too sacred. For this purpose, I have decided not to post pictures, stories, or updates about them on the Internet, and I'd like to ask you to avoid talking about out Babies on line as well. I don't want to cheapen something so tremendous, so beautiful, and so important with Social Media. Please know that prayers are being answered every hour of the day, but that the sustaining prayer is still needed just as much now as they were the twins' first day of life. You can just assume that the situation is always intensive; even when it looks like everything is going fine, there is always something new lurking in the shadows threatening to upset our delicate equilibrium and throw us into a nightmarish situation. You just can't tell if any given day is going to be good, bad, or just ugly. I hold my breath every day until the chief neonatologist does his rounds and reports on the Babies status, then I exhale, try to absorb the newest triumphs and obstacles, and breathe.
We welcome any opportunity to share our blessings with you.  If you wish to visit the babies in the NICU we'd be happy to work with your schedule. We can take up to two visitors at a time, although under 18 is not allowed, and non family members are encouraged to keep visits brief. If you are too far to visit, email and text are the best way to get in touch, although I probably won't be able to answer a ton of questions like "how are they doing." Stuff like that changes from minute to minute.
In response to your offers and questions about what do we need, the answer is honestly that the usual home visits to new moms bearing brownies and onesies aren't much good right now (I will take you up on it in a few months when I'm in need of support at home, promise).  My schedule currently revolves around as much baby time as I can get. I literally have to force myself to leave to eat and sleep. If you live around here and want to run errands or mow our neglected lawn, we'd be thrilled. Otherwise, just please join us in our prayers daily that the Babies' hearts, lungs, brains, and other organs develop, and that they don't get any infections. Your faith and prayers really and truly are the best gift you can give us. It's what our Babies need and we actually need to hold ourselves together right now. 
Thank you for the ocean of support you've given us. We truly appreciate your thoughts and concern. Your prayers carry us from one day to the next. We would sink without you. 
Until we cross this bridge and get to the other side...
With love, 
Camille, Luis, Andrei, Robert, and Rosalyn

Tuesday, June 4, 2013

Details

So if you want the whole story regarding team Farias, here's the abbreviated version. Warning: gynecological terms will be used because, well, we are talking about child birth here.

Background: it's been a sloppy pregnancy. I've had unexplained bleeding for essentially the entire time. At 5 weeks I was bleeding so badly and passing such large clots I was sure I had miscarried. It was actually at an appointment to confirm my miscarriage that I found out I wasn't miscarrying but in fact preggo with twins.
More bleeding at 10,12, &13.5 weeks. That time they found a mystery blood clot measuring 4 mm and I was put on bed rest. I came off of bed rest for 1 week then went back on at 17 weeks after it was discovered that my cervix was shortening and a cervical cerclage was put in to sew me shut.
Since then, my cervix has continued to deteriorate. At the time of the cerclage I had about 2.4 cm remaining. At 20 weeks we were down to 1.4.
This Saturday I noticed some light pink spotting. I called the on call OB and he sent me over to Labor and Delivery at Amican Fork Hospital. They checked the babies (who are always fine because they are Vikings) and checked me. I wasn't contracting and my cervix was closed from the outside so they called it good and sent me home. Prognosis: burst capillary on my cervix.
As a precaution I moved my Thursday OB appointment up to Monday afternoon. At my appointment they gave me my first round of steroids to help mature babies lungs and sent me on my way,declining to check my cervix again for fear of stirring up trouble. That was yesterday.
Last night I woke up to more spotting. It was still very light pink, but my gut told me we were dealing    with more than capillaries. I waited until 7:30 and then called the on-call doctor, who happened to be the same gentleman who consulted with me on Saturday.
He asked me to come in for an ultrasound to rule out placental problems and check my stitch. Good news: placentas fine. Bad news: my stitch appears to have torn loose in at least two places and I'm down to about 1-2 mm of cervix keeping me shut and keeping baby A's amniotic sac in. Since I was there, they gave me my second round of steroids.
So here I am. I've been transferred to the nearest hospital with a level III NICU, which is in Provo. I've also been transferred to a new OB practice since my guy only delivers in American Fork and Orem, and AF has no NICU and Orem won't accept our insurance.
I'm currently on bed rest with bathroom privileges until my water breaks or I start contracting, both of which could happen any minute or not at all for weeks to come. I'm scared, but grateful that we caught it before it was a dire emergency. I'm also glad for a change of food, scenery, and the extra company of the hospital staff
I'm 23 weeks and 5 days today. That's the very limit of fetal viability. If the babies came today they'd have about a 30-40 % chance of making it. And odds are that they'd have severe lifelong disabilities if they did. Every day they stay inside me from here on out gives them a 2-3% bett chance of making it. Our biggest goal right now is 28 weeks, when the odds of survival shoot up to 95% and the odds of severe disability drop down to about 15-20%. If you're the praying kind, pray for 28 with us.
In the mean time I'll try to update this as appropriate.
Thanks!