National Premature Awareness Day

If you're reading this, it is November 17 and today is National Premature Awareness Day. Below is the blog posting I submitted to Bloggers Unite!

Today, November 17, is National Premature Awareness Day. To start things off, I would like for you all to meet Little C:



Little C is my daughter. In June 2007 she was born about 6.5 weeks early due to a rare condition called HELLP Syndrome in my wife. She was 4-lbs, 13-oz; a good size given her arrival date. Have you ever heard of preeclampsia? Multiply it by 100 and you'll have an idea of HELLP Syndrome. Basically, dangerously high blood pressure levels, low platelet counts, and a few other nasty details thrown in. Much like preeclampsia, the only cure is delivery. However, the risk factor for fatality in both mother and child is much, much higher. The only problem with HELLP is that it occurs in less than 1% of all pregnancies, so very little is known about it. Little C spent a mere 11 days in the NICU before coming home to her family.

Now meet Little G:



Little G was born in July 2009 almost 8 weeks early. He weighed in at 4-lbs. The HELLP syndrome was being monitored and maintained; my wife's blood pressure was steady and normal. It seemed we would be having a term baby this time around. The c-section was scheduled for 10 days before her due date. Her body had other plans. Without notice she started bleeding. A lot. One of her employees drove her to the hospital and I met them there. Less than two hours after the bleeding had started, Little G made his quiet entrance into the world. He was barely breathing; each little breath short and sharp. He was immediately whisked to the NICU. He fought for every breath until he tore a hole in his left lung. He was intubated; a chest tube inserted between his tiny ribs to alleviate the pressure. When the first ventilator wasn't working, the doctor switched him to an oscillating vent; it's supposed to be much gentler. His whole little 4-pound body was vibrating, like he was laying on a vibrating bed. It was awful. He rebounded; he gained weight; he started eating; he came home after only 26 days. A miracle if there ever was one. Five weeks after he left the hospital, my wife saw one of his main NICU nurses with her daughter. The nurse introduced my wife as "the mother of that baby I told you about; that baby that was as sick as could be and not die."

The strange thing is that with our first child, there was no way my wife would be classified as a high risk pregnancy; Master's Degree educated, prenatal care, income, race, age, no known medical conditions; nothing would put her in the high risk category. With number two, the only thing that changed was that that she'd had a preemie previously; all other indicators would rule out a high risk pregnancy again.

There is a website called Bloggers Unite where bloggers can sign up to blog about specific events on specific days. Today is the Fight for Preemies sponsored by March of Dimes. The main idea behind this event is to raise awareness about premature births. Around the world each year, 13 million babies are born premature. 1 million of them will die from the simple fact that they were born early. It's easy to think that the majority of premature births happen in un- and underdeveloped countries. North America has over 500,000 premature births each year. 28% of the 4 million annual neonatal deaths are due to preterm birth. The rate of preterm births in the United States alone has increased 36% over the last 25 years.

I know this next part will rub people the wrong way, but I'm putting it out there anyway. If you don't like it, you can go about your business, and thank you for listening. March of Dimes has partnered with MasterCard through December 31, 2009 to raise funds to fight for both better recording and reporting of statistical data and for proper medical care for those areas most in need of medical equipment, technology, and supplies. If you make a donation to March of Dimes using a credit card with a MasterCard logo on it, MasterCard will double the donation to March of Dimes. If you feel willing and able to support the cause, please CLICK HERE.

I understand that some people are not willing or able to donate, and that is entirely up to you; your decision. I won't say anything if you do or look down on you if you can't/don't. Today is about raising awareness; anything else is gravy.

I thank you for your kind attention during this announcement. And if you feel able to do so, please pass on this link so that others might read as well. I leave you with one final thought:

"The probability that we may fail in the struggle ought not to deter us from the support of a cause we believe to be just." -Abraham Lincoln

This is not to say that probablility is against us, only to say that the struggle to raise awareness and support for the cause we believe in should not be enough to stop us in the pursuit.

Apparently it Takes 4 Months

I have been so emotional about my dear little Gavin lately. I do think it's that my emotional wall that kept things together when times were tough is starting to crumble. I have been downright weepy at times. It helps that this picture shows you what I'm looking at while I write this. He is an amazing and happy baby. He's cooing loudly right now - trying so hard to talk!

I was shopping with Gavin this morning, and the woman behind me in the checkout line started asking me about Gavin. Turns out she's a NICU nurse at a local hospital - not the one where both my kids were born. She said "Oh - 32 weeks is nothing. I mean, I know it wasn't nothing, but it is nothing to really worry about." I smiled and told her about the many complications Gavin faced in his first week. The pneumo, going septic, and being on the oscillating ventilator. Her response was "Oh! He went through SO much! And he looks so good! They did such a great job taking care of him."

And I agree. And I know it's true. And I agree with her that even the shape of his head is perfect. She kept saying how impressed she is with him and how he clearly got such good care.

I'm reminded of Gavin's 4 month well visit. His pediatrician kept saying "look at his growth chart! I mean look at it!". Our little man went from about the 2nd percentile to almost the 50th in just 4 months.

But then, I'm watching Hero's. And a side story shows a kid with a pneumo, about to die, and they make a hole in her chest cavity to uncollapse her lung. And I cry. I cry because I know that a pneumo is a collapsed lung caused by a hole in the lung. I cry because I know why making a hole through the rib cage alleviates the air pressure that has leaked out the hole in the lung and is trapped between the lung and the chest cavity, making it impossible for the lung to reinflate. And I cry because that happened to my son when he was just days old. I walked in the NICU around 2am that night. I just had to go see him, and I walked in on 5 nurses surrounding Gavin's bed, talking through his symptoms, making a diagnosis, and creating plans for an emergency procedure.

I'm not much of a blog reader. I look at 2 new to me ones today found through an Amazon book search. One ends up being about a girl who was a preemie - who passed away at 17 months old due to an upper respiratory infection that her scarred lungs couldn't handle.

I'm grateful that Gavin's first RSV shot is finally scheduled for tomorrow, and my germaphobe tendencies are reinforced.

Now the weepy feelings have passed, as has my need for reflection. Right now I've got 2 very happy kids in my lap, and we've got too much fun stuff to do and life to live to spend time sitting around feeling bad about what has happened or worrying about what might be in the future.

Plus, we've got a party to attend this afternoon. With lots and lots of hand sanitizer.

Lena

Dig Deep!!!

Okay, I'm going to stand on a soapbox for a few moments and ask everyone out there to dig deep. Especially anyone out there with a MasterCard credit card.

March of Dimes and MasterCard have partnered through the end of this year to help raise funds for this very worthy cause; a cause close to our hearts. For every donation made to March of Dimes using a MasterCard credit card, MasterCard will double that donation. $25 becomes $50, $50 becomes $100, etc., etc. They'll double anything up to $225,000 so if any of you out there have that much, please do it. But they'll take anything they can get. See the link included below for more information.

March of Dimes - MasterCard Double Donation

Thank you for your kind attention.

-Josh

Addendum

Josh here. I have another blog that I keep up daily. In my mind it's the stuff that I can rant or talk about that Lena doesn't care about; I don't mean it like that, but you get the idea. It's actually pretty good; I can talk about whatever and she doesn't have to hear it. Mostly just me be wierd. The point is, I posted a letter I wrote today to the benefits people at work. You can read it here. Oh yeah, read the previous post first; the one Lena wrote.

That is all.

Causes

Many of you know that I am not big on asking people for money; it's the main reason I got out of the development side of non-profit work. However, you'll pardon me as I make a little pitch. Get your tissues ready.

Did you know that every year 13 million babies worldwide are born too soon?

In the United States alone, the rate of premature birth has increased 36% over the last 25 years?

Unless you've been living under a rock, you've probably heard the name for the organization March of Dimes. Unless you've interacted with them or read about them, you may not know what they do.

Our mission is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. We carry out this mission through research, community services, education and advocacy to save babies' lives. March of Dimes researchers, volunteers, educators, outreach workers and advocates work together to give all babies a fighting chance against the threats to their health: prematurity, birth defects, low birthweight.

As many organizations do, they could always use help. Please consider clicking the banner above to visit them.

This comes on the heels of my late knowledge that yesterday was Pregnancy and Infant Loss Remembrance Day. But just because it was yesterday doesn't mean that people don't remember every day the loss of a child. It was only yesterday that I learned that the daughter of a woman I went to Hope College with lost her 5-month-old daughter to SIDS one month ago today. It's heartbreaking in a way I don't have words to express, which is a big deal for someone who writes. And if you click this link - http://www.rememberingcicely.com/ - to Cicely's remembrance page, you'll see pictures of a beautiful baby and her loving parents. I'll put the disclaimer on it: very few words, mostly pictures, bring tissues. And if you can find it in your heart to donate the cost of your morning coffee or energy drink or whatever, I know they'd appreciate it. Deanna, we're thinking of you.

I'm going to close my mouth now.

-Josh

I've Created a 9-lb Monster

Well...Gavin is finally really nursing. And has decided that's really all he wants to do. Whether or not he's hungry. He's like a little pushy customer at a 24-hour-all-you-can-eat buffet...that doesn't tip the waitress. I'm spending a lot more time on our couch these days.

I'm back to work on Friday. This should be interesting!

Lena

Chloe's Perspective

I've been thinking a lot lately about what I assume to be Chloe's perspective of the last 2 months. I wish I had gotten a picture of one of her perspectives - laying down looking like a giant on the infant gym (fancy name for a play mat) with a pacifier in her mouth. A new habit she picked up just 2 weeks ago after wanting to have nothing to do with one when she was a baby. I am choosing my battles on that one and assuming that it will only become a big deal if I make it one. Instead I laugh and tell her she looks silly. She laughs, too.

So - here are some observations of Chloe's experience and realities:

We did a big sibling training at the hospital just under 2 weeks from when Gavin was born. I had two concerns - it was too far from his anticipated birth date (HA!), and I was worried Chloe wouldn't remember much. The class included a tour. When she came in to see me in the hospital, she walked into my room and immediately realized that the baby's bed wasn't there like it was in the tour. She asked about it for awhile and was confused why the baby and bed were missing when she had been told they would be right by Mommy's bed.

Gavin has been out of the hospital for almost 5 weeks now! Chloe has finally stopped washing her hands up to her elbows NICU style, most of the time. I appreciate the sterile aspirations, but at home it means water everywhere!

My c-section recovery has been of major interest to her, as mentioned in a previous post that I won't repeat again now.

Chloe has her own extra set of pump parts to keep her away from mine. She tells us that mommy milk comes from armpits. She even made up a song once about it.

Feeding a baby as a whole seems to be a little confusing since she's witnessed a feeding tube, NICU bottles, mommy using the breast pump, and now nursing. Pretty complicated, and Chloe is always full of questions. And seems to not quite know how to feed her dolls! Watching her creativity in trying different methods is hilarious. I'm sure her seeing us struggle to get Gavin to eat only adds to her inspiration.

She thinks babies stay in the hospital for awhile, which makes total sense. And she's witnessed and participated in crying and wanting to take her baby home.

She's gone back and forth between talking about being a doctor or being a nurse. Unlike most 2 year olds, she actually has a sense of what she's talking about.

We have 2 books about babies and becoming a big sibling. She's always looking for the boo boo's on the babies (and any other pictures of newborns). One of them actually addresses prematurity in just one sentence, and the illustration has a baby in an isolette.

All this, and she turned 2 just 2 weeks before Gavin was born! I'm shocked at what she remembers from weeks ago even. I wonder what she'll remember from this experience and how it will affect her perspective long term. I'm a big fan of the phrase "perspective is reality" and use it probably too often with our staff (but I've also heard them repeat it, which is awesome). Chloe's reality as it relates to childbirth has been an unusual perspective for sure.

Lena

This Week in Review

Josh mentioned that we've been busy this week. Nothing too exciting, but I thought I'd take this quiet moment to elaborate. Chloe's watching Fraggle Rock, Josh and Gavin are asleep in our room, and I am enjoying a big cup of coffee. Last night was a long one! Both kids were up for much of it (of course at different times!).

I've been saying in past entries that getting to Gavin's due date is a big milestone. It means getting to the point that his little body is developed enough to be ready for the outside world. Since 37 weeks is technically considered full term, some babies catch on a little sooner. You may also remember that our little guy is laid back and takes his time.

If catching up to newborn behavior is any indication of his personality, we've got a procrastinator on our hands that makes it just under the wire (he'll fit right in with our family). Gavin finally started nursing on Monday, his due date! We need to supplement with higher calorie bottles to help him grow, and he hasn't mastered it enough to go more than 3-4 feedings a day anyway. Which is totally fine. It means my life when I go back to work and bring him with me will be way simpler than it could be.

He's also acting a lot more like a newborn in general. That means he's awake more, he's started getting a little fussy, and he seems to have developed some opinions as to how he spends his time. So far the bouncy chair and the swing are no substitute for mommy's arms. Which are getting tired!

As for going back to work, I was originally planning on taking 8 weeks which would have me back yesterday. I'm grateful that our board of directors is allowing me to take an additional 2 weeks because while I'm suffering from cabin fever, Gavin just isn't ready to not have his mommy home all day. BUT...the staff at Dad's Garage has been beyond amazing during my absence, and there are a few projects I need to help with while I'm out (part of my maternity plans all along). I had a lot to do this week, and Gavin even went to his first business meeting!

Chloe is back in gymnastics again on Monday mornings. She really likes it, and I think it's important for her to still be able to do it. This session ends the beginning of October, and I am keeping her out of the October-December session. I'll be taking Gavin with us, and we need to keep our germ exposure to a minimum during that time.

And our dear Chloe is being a handful. She really seems to be testing is to make sure she's important enough to be disciplined when she misbehaves. Which has meant a lot of time in the corner!

We've spent some time walking with our neighbors. I'm finally off of medical restrictions, and I'm eager to get rid of this belly fat. And I love the company! Though the walk ending with a stop at the ice cream place may not be helpful with my goals...

Other excitement - we had our Children First appointment. Gavin's considered high risk because of his prematurity. That's the entry point for services through the state as well as a resource for identifying both public and private resources. I'm hoping Gavin will be like his sister and not need to take advantages of anything other than the wealth of informational handouts that the nurse dropped off. She will call periodically to check on his development. The only thing I'm really worried about is making it through the flu and RSV season safe and sound. Gavin's considered high risk for both.

And last but certainly not least - we visited with a friend of mine from high school. Her daughter was born 2 days before Gavin and weighed 9 lbs 14 oz! It was a little funny to see the two babies together, but Gavin will catch up soon enough!

So that's how we spent our week. Not too terribly exciting, but that's a good thing!

Lena

A Very Merry Unbirthday To You!

Today is Gavin's due date! If you remember from a post from a while back, preemies have two ages - chronological age and adjusted age. Each one is used, so we have to remember both. For example, shots are given on the normal timeline based on chronological age. Most developmental milestones are instead judged based on adjusted age. I just realized that means we have 3 months starting from today to hope that he sleeps through the night!

So, Gavin - congrats on turning zero! You're no longer zero minus X days and weeks!

Now catch on to nursing already, would ya!?!

Lena

A Lot To Be Thankful For

Our time in the NICU is already starting to fade in my memory. Much faster since Gavin's pediatrician has taken him off of the apnea monitor. Being able to walk around the house carrying my baby without having to first unplug him from the wall and lug around a heavy and awkward pack goes a long way toward feeling normal. It makes it feel like we have a newborn instead of a sick and fragile baby.

I am so thankful that after what we went through, we're already closing in on normal. We'll continue to have some challenges during the first year or two due to prematurity, but hopefully they will be kept to a minimum and be free of long-term implications. We don't anticipate any surgeries like both sets of our neighbors have endured. We don't anticipate daily breathing treatments like a few kids we know. Even our long hospital stay pales in comparison to the experience of so many other NICU families. Little Elizabeth - our first preemie friend and inspiration - shared so many similarities to Gavin's health early on, and she was in the NICU for 45 days, which is our equivalent to this Sunday. It breaks my heart to even think about it. One of the twins that lived across the street was in for 10 weeks - they were only 2 weeks younger than Gavin at birth.

I'm thankful that we live close to my family, which has made this whole experience so much easier than it could have been. I'm thankful that my mom's work schedule will allow her to keep Gavin twice a week when I go back to work. I'm thankful that I can take him to work with me when he's not with Nana. So important while we make it through this first flu and RSV season.

Of the many things we have to be thankful for, I've been particularly touched by the love and support that we've received from you. It has made such a world of difference and I know has helped so much with our speedy physical and emotional healing. So...thank you!

And speaking of thanks...we're finally starting to get thank you notes sent out. If you sent over a gift and don't get one in the next week or so, please let me know. Things got to be a bit of a blur for awhile there, and I'm sure not everything made it on my list!

Lena

Save the Date!

There will be a big party on Sunday, October 11 to celebrate little Gavin's life. It will start with his baptism that morning. I've been looking forward to announcing this special day, and I'm looking forward even more to planning it!

I apologize to those of you that dealt with me being crazy about the subject of baptism when Gavin was in the NICU. I was a bit out of my mind by suggestions of having an "emergency" baptism in the hospital. One of the deacons from church even showed up at the hospital ready to do it. I told him that wasn't necessary.

The idea of an emergency baptism made me nuts because in my mind, it suggested that people didn't have faith in Gavin's ability to fight through the challenges he faced particularly in his first week of life. To me, discussing an emergency baptism was a fine line from preparing for his death. It hurt me so much to even consider that as a possibility, though I now can recognize in hindsight that things were pretty touch and go for awhile there.

With that behind us, I'm ready to have Gavin baptized as a celebration of his current and future life. If you'd like to come to the ceremony or party or both, just let Josh or I know and we'll give you the details. You can even just post a comment requesting to be added to the list if that's easier.

Yay Gavin!

-Lena

Feeding Frustrations

I hear that when babies are hungry, they open their mouths to drink from a bottle. Some even nurse! Or so I'm told.

That's not our experience with Gavin. Nor was it with Chloe for that matter. Both showed "typical preemie behavior." The abnormality of our normal is more apparent when we're around other people. We braved leaving the house to say hello to my co-workers and to see a friend on Friday, and we even went to a wedding with Gavin in tow on Saturday. Seeing other people that are used to more typical feeding experiences react to what it's like to feed Gavin is enlightening.

I did have one woman at the wedding try to tell me how babies work and what I should be doing with Gavin which was entertaining. Oh, honey - thanks, but stick with what you know. I'm pretty confident that what our doctor tells us is more valid than your opinion and experience as a nanny. It was a good exercise in patience for me, which isn't my strong suit.

Chloe caught on to the whole eating concept faster and easier than Gavin did, so the curiosity from others about Gavin is a bit new. As first time parents, we were probably a little more hesitant to have her around other people as well.

These are all tips by the way from Gavin's doctors and nurses as well as general things to know about feeding a baby like Gavin:

• If you cradle him in your arms, he might get too comfortable and sleep instead of eat. Unless he's really alert, best bet is to hold him out in front of you facing you. This would be uncomfortable if he were full size, but at a great big 6.5 lbs, it is pretty easy to do.


• He has started crying when he's hungry just in the last week. Before then, we had to set an alarm to wake him to eat.


• Preemies often have trouble with locking their tongues up to the roof of the mouth. When Gavin does that, he can have a bottle in his mouth and even seem to suck on it for awhile (like 20 minutes!) without actually getting any milk. It can be really hard to tell if the bottle nipple is over or under his tongue.


• He can be crying with hunger and still not open his darn mouth for a bottle. We talked to his pediatrician about it. As we've said before, we really like her. This conversation was particularly memorable and hysterical. Her response: "It's easy. You just have to pry his mouth open and shove the bottle in. Here. I'll show you." She then got the Gavin work over. Her first comment as she was trying to juggle a baby, a bottle, and a free hand to pry his mouth open: "Do you usually have two people available to feed him?" Us: "No..." Followed by "Wow, this is hard!" Yea...we know.


• So to recap, getting a bottle in Gavin's mouth usually involves prying his mouth open and coaxing his tongue down from the roof of his mouth. And then practicing a series of tricks to get him to take it. They include twisting the bottle, stroking his cheek, manipulating his jaw, tickling his feet, and a few more.


• Keeping Gavin from falling asleep before he's full is a challenge.


• It usually takes him 30 minutes to take 2 ounces.


• Nursing is still too difficult for him, and we talked to his doctor about it. He gets worn out without actually eating much and is in danger of burning more calories than he's getting. She doesn't want me to try to have him nurse more than once or twice a day at this point.


• What does that mean? I'm spending time feeding him a bottle and also spending time pumping to have something to put in it. Basically, it takes a lot of time. And is a total pain. Josh helps with bottle feeding a lot. Lots and lots of preemie moms don't keep up with pumping for many valid reasons. I really believe that the antibodies contained in breast milk can help keep Gavin healthy especially during cold and flu season. I don't know reasonably how long I can keep this up, though!


• Gavin's doctor said that she knows and appreciates that what we go through to get him to eat is very challenging, but that it's obviously working. He's putting on a lot of weight, and as he grows, he'll hopefully outgrow some of the difficulties.

I wanted to do this post in part because several people have asked how things are going. Amazing and leaps and bounds better then they could be. I worry about sounding ungrateful for our many blessings by complaining that our otherwise healthy boy is a pain to feed. I guess I just felt the need to explain myself after having a few difficult feeding sessions in a public setting. So if you see a mom or a dad wrestling a tiny baby's mouth open followed by physically forcing a bottle in, please don't assume they are bad parents or don't know what they are doing. As bizarre as it can be to witness, their baby might just be a preemie.

Lena

Today Was Supposed to be Your Birthday

I caught myself saying that to Gavin earlier. I was scheduled originally to have a c section this morning. Instead I have a beautiful preemie that is getting bigger everyday.

The little write up below was sent out on a listserve that I'm on for women that have had HELLP syndrome. (Editor Note: this is an altered version of a poem; the original was "The Special Mother" by Erma Bombeck)

On mothers of preemies.

Did you ever wonder how the mothers of premature babies are chosen?

Somehow, I visualize God hovering over Earth, selecting his instruments for propagation with great care and deliberation. As He observes, He instructs His angels to take notes in a giant ledger.

"Beth Armstrong: son. Patron Saint, Matthew.

"Marjorie Forrest: daughter. Patron Saint, Celia.

"Carrie Rutledge, twins. Patron Saint... give her Gerard. H's used to profanity."

Finally, He passes a name to an angel and smiles. "Give her a preemie."

The angel is curious. "Why this one, God? She's so happy."

"Exactly," smiles God. "Could I give a premature baby a mother who knows no laughter? That would be cruel."

"But does she have the patience?" asks the angel.

"I don't want her to have too much patience, or she'll drown in a sea of self-pity and despair. Once the shock and resentment wear off, she'll handle it. I watched her today. She has that sense of self and independence so rare and so necessary in a mother. You see, the child I'm going to give her has a world of its own. She has to make it live in her world, and that's not going to be easy."

"But Lord, I don't think she even believes in you."

God smiled. "No matter, I can fix that. This one is perfect. She has just the right amount of selfishness."

The angel gasps, "Selfishness?! Is that a virtue?"

God nods. "If she can't separate herself from the child occasionally, she will never survive. Yes, here is a woman whom I will bless with a child less than perfect. She doesn't know it yet, but she is to be envied. She will never take for granted a spoken word. She will never consider a step ordinary. When her child says "mama" for the first time, she will be witness to a miracle and know it. I will permit her to see clearly the things I see – ignorance, cruelty, prejudice – and allow her to rise above them. She will never be alone. I will be at her side every minute of every day of her life because she is doing my work as surely as she is here by my side."

"And what about her Patron Saint?" asks the angel, his pen poised in the air.

God smiles. "A mirror will suffice."

Unsolved Mysteries

So...for those of you counting, we have two kids, and both deliveries were surrounded by frightening and potentially fatal complications. How did this happen? I wish I knew. I'd settle for just the doctors knowing! As one of the more sensitive Ensemble members at Dad's Garage put it, it's a good thing I can't have more kids as my last two tried to kill me! In the moment, the comment was really funny, I promise.

If you have time, you can go back to June 2007 entries to read about Chloe's dramatic entrance into the world. With Chloe. I developed pre eclempsia and later HELLP Syndrome. Which means my liver started failing and was in danger of rupturing, my platelets got down to 48 (one doc told me they couldn't do a c section with a count under 50, but they did!), major clotting once she was born, and other generally bad things.

With Gavin, I saw a high risk doctor the whole time. HELLP survivors (as they call themselves on blogs, list serves, etc) have a high risk of getting it again. As long as you know that and are actively monitoring the pregnancy, it should be okay. The symptoms can be misleading (one doc told me it was just heartburn), so the primary danger is in being misdiagnosed or of course not getting prenatal care. There isn't any proven treatment to prevent the onset, but I was taking baby aspirin, which may or may not help.

So, I had an appointment on a Tuesday, and each appointment includes an ultrasound. Everything looked great including my placenta. I started having some cramping during the night Wednesday night/Thursday morning. It didn't feel like anything to worry about, and I had already gone to the hospital once with it, and it wasn't anything. A bit more cramping at work that morning. Bleeding. Rush to the hospital. Found out I was in active labor with signs of fetal distress (meaning Gavin's heart rate wasn't steady). Emergency c section within an hour of arriving at the hospital. Followed by emergency hysterectomy to try to stop the bleeding. I'm not super sure what the numbers mean, but my hemoglobin was 7 and my hematocrit level was 20, which apparently is really bad. I had 2 blood transfusions with 4 units total. Gavin also ended up getting 2 transfusions as well.

The medical community generally has no idea as to what causes a placental abruption. There doesn't seem to be any connection to HELLP, and my unscientific survey of other HELLP "survivors" didn't find many people that have experienced both. At my Tuesday appointment, the only thing slightly resembling a red flag was that my amniotic fluid was still low, even though I had been drinking 100+ ounces a day.

I had no physical activity really from Tuesday to Thursday. I was having mixed success at keeping my stress level down, which is a contributor for a lot of complications. Per doctor's orders, I was either sitting at my desk or laying in bed or on the couch at home. No heavy lifting. I did crack jokes about going to term along the lines of I know how to have a 4 lb baby, but a 9 or 10 lb one is terrifying to me. But I also said I was up for the challenge. My neighbor also reminded me that I had just said a few days earlier that I wasn't going back to the hospital unless I was delivering, having been embarrassed by 2 visits that found nothing (First was cramping. Second was Chloe jumping on my belly, which could cause a placental abruption, but doc says 2 weeks between incidents is too long to connect them). Josh's folks were in town 2 weeks prior for Chloe's bday, and my MIL and I joked about how Chloe was born 2 weeks after a visit from them and that if it happened again, no more pregnancy visits! For the record, I don't think there is any correlation, and in hindsight, I think the conversation was funny - Mom, I hope you do, too!!!

And I had a preemie again despite best intentions. And while I will be more aware of what I say in the future, I don't think any of those comments pushed baby Gavin from his warm home. I also was pretty well prepared for my maternity leave with our amazing staff, with the idea that if we were prepared this time, we wouldn't need to be ready 6 weeks ahead of my scheduled c section. Which is also almost 8 weeks before his due date.

I'll probably never know why both my babies were so early. But I have a "matching set" as many people put it. We have an incredible little family unit, and I'm just counting the days until we can all be home together. Which is the next mystery - it's been 16 days so far, and the doctors haven't even started talking yet about when little Gavin will be able to join us here.

Lena