The 12 Steps of a MoMo Pregnancy by Adam McKim

1) THE TWO TINY PINK LINES

And this is where the world of normal ends for this particular story.

2) LADY PUKESALOT

The horror. The horror. I will here speak of it only in the detached form of mathematics. Morning Sickness x 24hrs/day + 10 to 15 daily vomits x 3months = 30 lost pounds. Ugh.

3) THE DOUBLEMINT ULTRASOUND

Have you ever had an ultrasound technician, without looking up, nonchalantly say, "Well, there's two in there." Jenny and I were planning to have a pair of children together and were honestly thrilled at the news; This was efficiency redefined.

4) THE HUNT FOR THIN CLEAR MEMBRANE

So apparently even identical twins have this tough little barrier wall that protects them from each others' umbilical cords. Well, 99% of them do anyway. About 1 in 50,000 pregnancies, however, result in Monoamniotic/Monochorionic twins: Mortality rate: About 50%. After literally spending hours watching Twin Tv through the ultrasound cable box, the doctor is now sure of three things: They are girls... they are identical... and they are in in danger.

5) THE WORRY AND THE WONDER

The only way to reduce that terrifying 50% statistic is to regularly monitor heartbeats and cord status. If things go south and won't come back, the c-section that is automatically scheduled for 8 weeks early happens, well, earlier. For obvious though arguable reasons, Canada traditionally doesn't start such monitoring until 28 weeks. Our MoMo news came at 24 weeks. Jenny (my hero) was admitted to the hospital at 27 weeks... hence the title of this segment.

6) THE SOUNDS OF SURVEILLANCE

The shrill screams of full term baby after baby. The clunking wheels of fetal assessment machines. The sweet rhythm of heartbeats.

7) THE MAD DASH

Thursday, March 19th, 10:06am. The hospital is on my office phone. Ruby is "acting up." This means her heart rate is decelerating and they want me to come in. The escape from school is clean but the giant laundry truck blocking my car is not. The story of the ensuing five minutes is worth hearing in person but here are the basics: Honking my horn, honking HIS horn, attempting to move truck after starting it (failure), attempting to not fatally strangle man slowly walking to my rescue who stops to debate legality of his parking job. (success)

8) THE DOCTOR IS IN(DECISIVE?)

We are at 30 weeks and 4 days. Ruby's heart was "acting up" all morning but stable for hours afterward. She also stopped growing two weeks prior. So better IN or better OUT? The doc is in sync with us... these MoMos are coming out ASAP.

9) THE C-SECTION

I suppose this segment is almost as "normal" as step 1, and I simply could not be happier about that particular truth. Charlotte Elizabeth is yanked out by the head at 2:44pm. She weighs 3 pounds and 8 ounces. Ruby Jane follows at 2:45pm. She is 2 pounds, 14 ounces. We desperately want to hold them but obviously are not allowed. I tell Dr. Sanderson that he is a Rock Star and thanked all the brilliant people that helped.

10) TWISTED SISTERS

They were the ominous x-factor from the moment we learned of their unfortunately interactive nature. Minutes after the births we were told the cords had been photographed for the medical files and were offered a look at them; They lived up to their billing. Tightly twisted for the six or so inches closest to the placenta, they then formed an impressive knot with the thickest cord hanging a full eight or so inches beneath... this would be the part that was apparently wrapped around Charlotte's neck four times. You know, the official Atheist slogan states that "There probably is no God, so quit worrying and enjoy your life." There is a reason the word "probably" is in there.

11) THE NICU FOR TWO

As any parent knows, when their kid skins a knee, has a nightmare, or narrowly avoids a nasty spill, sometimes the best medicine is a simple hug. So despite the simply incredible news that was gushing our way (breathing air on night one, gaining weight, strong colour) Jenny and I, after thanking our lucky stars, couldn't help ourselves from wanting more.

12) KANGAROO CARE

As I wrap up this note one full week after Charlotte and Ruby entered this bright world, I can now happily report skin to skin contact for over an hour with each of them. The experts say this will really help with emotional and physical well being. I can only assume they are referring to all four of us.

OUR BABIES ARE HERE

Most of you already know that our little girls have arrived.
March 19th I went to my regular fetal assessment stress
monitoring, and during the monitoring, Baby B (Ruby) kept
having heart rate decelerations down to 50 and staying there
for about a minute at a time and then going up really high
to 200 trying to recover. This was the first time in the three
plus weeks I had been in the hospital that either of our
little girls had any decelerations during monitoring.
Lucky for all of us, my specialist happen to be on call that
day and happen to walk into the room when Ruby was
having her first deceleration. He requested I stay on the
monitors longer and when we called him to tell him they
were continuing to happen, he advised to have me brought
over to labour and delivery. Kathy (who was the lady who
did all my monitoring in the morning) was trying REALLY
hard to keep herself calm, and to keep me calm at the same
time.

Over to labour and delivery I went. Got hooked back up to

the monitors.

Adam was at work because we were all set for the

March 30th date for the scheduled C-Section and we

were really hoping to get to 32 weeks.

One of the labor and delivery ladies called Adam at the

high school and told him everything was fine but also let

him know the situation and that the girls might be coming

out today. He has a funny story about his adventures in

getting to the hospital which I might try to convince him

to tell about the day from him perspective.

Dr Sanderson, my perinatal specialist who we really

came to respect and totally adore came to visit after

the continued decelerations. Since I had eaten

breakfast and it was about 1130 am, they were going to

have to wait until 2pm before they could give me any

type of spinal as they wanted to avoid putting me under,

they decided to get the OR ready and keep a close eye

on the babies. Ruby rolled over and off her own cord,

and the decelerations stopped. So the decision about

2pm had to be made by Dr Sanderson to take them out

or leave them in and keep me on 24 hour monitoring.

Obviously we know what the decision was.

It all happened SO fast getting me ready for the OR.

I will admit, having to leave Adam in the labour and

delivery room and walk down to the OR without him

was one of the hardest parts of the day. For me, and I

know for him. The look on his face when he found out

he had to wait there for them to get him while they

prepared me for surgery was sad enough.

So, into the FREEZING OR, quickly was given my

Spinal, which was extremely odd feeling. It was

not even 10 seconds before I could not feel my legs

and they had to move me into position because I

no longer had any feeling up to my chest. The OR

had plenty of people in it, as we needed two teams,

one for each baby.

I was amazed at how fast everything was happening.

Adam finally was brought into the OR as they were

just getting ready to start. I admit that I started

"crying" a little bit at this point when I knew that our

little ones were going to be taken out soon.

My specialist (who was also the surgeon) pinched me

and said they were ready to begin.

Charlotte Elizabeth came out first weighing 3 pounds

8 ounces. I heard her little cry and of course I cried

even harder. Less than a minute later, little Ruby Jane

was born weighing 2 pounds 14 ounces. I was lucky

enough to be able to see her for a few seconds before

they took her away to the NICU to check her out.

They sewed me up and wheeled me away to recovery.

In recovery we were told just how twisted the cords

of the girls were and it was quite fascinating really.

Most of you already know that the major risk to our

little girls was cord entanglement.

Their cords were twisted like to telephone cords so

tightly right down to the insertion to my placenta that

aside from the fact that one was a lot thinner than the

other it was difficult to tell that it was two cords and

not just one big one, add to that a huge knot in the

middle of them. Also Charlotte had the cord

wrapped around her neck 4 times. As gross as it

might sound to some people, we really wanted to see

the cords, so after the OR was finished taking photos

for their records (as this is really rare) we were able

to see the cords for ourselves... It really was unique

to see them and made my heart skip a beat or two

thinking about how blessed we were that our little

girls made it as far as they did in my womb and did

not have to come out even earlier.

SO, after I could finally move my legs again, I was

wheeled in my bed to the NICU so that we could see

our little girls.

They really are beautiful and so precious. It melts

my heart to see them every time and it breaks my

heart some nights to not have them sleeping in the

room next to us and to have to go up the hospital to

see them. However, they are doing REALLY well and

are gaining weight now instead of losing it. They are

no longer getting any formula and completely on my

breast milk fed to them through their little NG tubes.

They are not on any breathing assistance and both

of them are very stable. They have a little bit of

heart apnea where their hearts drop down lower for

a bit and they pick themselves back up, which they

tell us is VERY normal for babies of their gestation.

They are so identical even at such a small size.

They look quite HARVEY, but we shall see how that

continues to go. They totally have my nose and my ears

and feet, and rather look like my father and brother.

Their toes are the cutest little things I think I have ever

seen.

Thankfully for us we live REALLY close to the hospital

(Like a minute away) so it makes it easier for us to

visit them often and made it a little bit easier for me to

leave the hospital after 4 weeks.

It is hard emotionally to not have them with us, and

some nights I cry, and some days I break down a little,

but I know they are VERY well taken care of where they

are and we have been truly blessed with how healthy

they are so far. They have a wonderful Doctor, Dr Ojah

and a fantastic group of nurses who take care of them

and love them as well. They do a great job of keeping us

informed as to how our girls are doing.

All in all it has been such a roller coaster of emotions

that sometimes I just have to stop and take a few

deep breaths and realize that the first stage of stress

is over with them being out of my womb. They are

doing well, but having our babies in the NICU for at

least 6-8 weeks is certainly not void of stress either.

We are looking SO forward to when they are going to

be able to come home with us.

We will keep you updated on their progress and

anything else that might come up.

Personally I am doing well enough. I am still sore

but trying to get up and around as much as possible.

I was SO happy to sleep in my own bed and next to

my husband last night. Some people would say for

me to enjoy my interruption free nights, but I am up

a few times a night pumping right now to feed them

so I really don't get to sleep the whole night through.

I do not in any way mind because at least I feel as

though I am able to do something for our little girls.

Thank you all for your prayers, love and support.

They really are little miracle babies and our lives have

been so blessed to have been given them..

RUBY

FOOT OF RUBY

CHARLOTTE

RUBY

Hospital/baby updates

Having a hard time posting from my iPhone.
Hopefully this will work.
It's been a long three weeks but I really
have not been super bored. I have read
A LOT of books and try to keep myself busy
with shows and movies.
Visitors certainly help pass the time much faster.

The babies are doing well. Their cords are
twisted like two garden hoses but without knots
which is promising.
At my ultrasound yesterday I was told that Ruby
is not growing right now. However, it is safer
for Charlotte to stay in for the next two weeks
so the date is still March 30th at 8am.
Yesterday was a rough day as
I tried to figure out if we were picking one over the
other but it is more that Charlotte is thebigger one
so the specialist wants to give her the best chance
seeing how Ruby is going to have to fight as she
is only going to be a little over two pounds and
her sister is almost 4 already. I am nervous and
extra worried but they will be fighters.
I had a blessing from Dad today so I am calm
right now.
Thank you for all your prayers and thoughts.
Two more weeks until we meet our very little
angels.