On Being Prepared

Sitting in my babies' NICU room with a breast pump strapped to myself seems like the perfect place to write these boys' birth story.  Where to begin the story is a tougher question.
Should I start it that morning in the ultrasound room when we learned that Colin was likely anemic, had very little amniotic fluid left, and had not grown at all in three weeks, unlike his brother who had gained at least a pound?
Or six days before that at Aunt Caroline and Uncle Ward's wedding, when we thought we were still weeks away from delivering?

 

Or way back when we first found out there would be two babies?

It would be easy to say we were not prepared to deliver on January 17th.  But that would not be true.  We had been thoroughly prepared, though not by any of our own efforts.
In the fall, after we moved, we got next door neighbors with twins.  Not just twins, identical twins.  Not just identical twins, but identical twin boys.  Not just identical twin boys, but spontaneous, monochorionic, diamniotic twin boys.  In other words, the mother right next door to me had experienced the exact same high risk pregnancy that I was experiencing.  She knew all the medical terms that had been thrown around during my numerous visits with specialists; all the potentially scary outcomes; all the calories I was being told to ingest; everything.  The chances of conceiving identical twins is about 0.4%.  I have no idea how to calculate the odds of two sets of identical twin boys living right next door to each other, but common sense tells me that they're probably not too high.  My faith leads to only one explanation for this incredible coincidence:  To prepare me to carry these babies, God knew I needed a guide and gave me one.
Including the six year old twins next door and their seven year old brother, there are about twelve children on our block within one or two years of my girls' ages.  Nearly every afternoon on our very low traffic, dead end street, you will find serious games of scooter tag, secret backyard meetings, and hours long hide-and-seek competitions.  There is no doubt in my mind that we landed on the best street in the neighborhood to raise our growing family.  
(Only a small group of kids was playing outside on this 40 degree day...)

Now let's back up even further, to Amanda's birthday:  November 18, 2006.  I had been enduring an increasingly painful labor at home for about 12 hours when we finally went to the hospital.  There we were assigned a labor and delivery nurse named Jada.  Jada, as it turns out, was not only a very skilled and very kind nurse, but she also was a classmate of mine from Teague Middle School.  Somehow, in that moment, after laboring for that long only to find out that I was dilated to a whopping 1 cm, having this person from my past show up on my team gave me this incredible feeling of peace.  I don't know why, but it did.
Two years later, I was delivering Elizabeth.  It was a scheduled induction at the same hospital.  And after not being in contact with her since we left the hospital two years before, who was assigned to help me deliver Elizabeth?  Jada, again.  And again she brought with her a feeling of peace and calm that everything was going to be fine.
For this pregnancy, I had switched hospitals.  I would be delivering at the new Texas Children's Pavilion for Women.  Five years had passed since I had last given birth.  And on Friday, January 17, about an hour after my maternal fetal medicine specialist had calmly but resolutely declared that my babies needed to be delivered that very day, and no, there was no time for a vaginal birth, I was upstairs getting prepped for a c-section when a nurse was assigned to me.  And who was this nurse?  Jada, again.  Jada, who I had not been in contact with since she helped me deliver Elizabeth.  She had switched hospitals a few months prior; she only works two shifts per week; and she was an hour and a half late to work that day.  Had she been on time, our paths would not have crossed.   I would be having my first c-section, which was more than a little bit scary for me; I would be delivering at 32 weeks because Colin's life depended on it, which was terrifying; and again, Jada appeared.  She would be the calming influence she had been on my two previous deliveries.  My faith leads to no other possible explanation for this than that to prepare me to deliver these babies, God had brought us together again.
Jada is behind me in this supremely horrible photo:


So about four and a half hours after my ultrasound appointment, we are in the operating room.  Dr. Bolt is performing the surgery, and Brian is sitting in a chair next to my head.  Two teams of neonatologists wait to work on each baby when each is delivered, and two flat screen tv's flank my head with a video feed to these groups of doctors so Brian and I can watch them work.  After a few minutes of action on the opposite side of the curtain, Colin emerges first.  He is pale as a ghost, completely silent, and limp.  He is immediately passed to the neonatologists who begin the process of getting him to breathe.
Here is a taste of what I was seeing:


Eventually they stabilize Colin enough to take him upstairs.  There is no time to bring him to me for a moment; there is no time to get a measurement of his length.  We still don't know how long he was when he was born.
Less than a minute after Colin was born, J.J. emerged.  He was bright red and screaming.  The contrast with his brother was stark.  Their difference in color alone eliminated any remaining doubts that twin to twin transfusion syndrome had been happening. They worked on him briefly and brought him over to me for a picture:


I told Brian to follow the boys to the NICU while Dr. Bolt finished up with me.  Colin would end up needing several interventions to stabilize him.  He would get two tubes in his sides, to drain air that had collected between his lungs and his chest wall.  He would be put on a ventilator.  And he would need a blood transfusion.  When I saw him for the first time after he left the operating room, he looked like this:


After two days he no longer needed the ventilator; after three days he no longer needed the tubes in his sides; and after four days he was breathing room air completely on his own, and he looked like this.   Meanwhile J.J. spent a few days under lights to deal with jaundice, but beyond that he was just a low priority "feeder/grower" baby, as the NICU parlance goes.  Colin is on the left, J.J. is on the right. 

We could not be more thankful for these two little miracles.