The "play-by-play":
August 10, 2011
Wednesday started off like any other recent day. I went to work, Kathy was in bed; both of us hoping that she'd have a reasonable day. Around 2pm, she paged me letting me know that she thought she was having contractions. Since we both knew that at 34wks no one was going to be stopping things, we decided to watch and wait for a little while to see where it went. By late in the day, it was pretty clear that she was having a regular pattern of contractions, some of which were slowly intensifying, so after saying our goodbyes to the girls, we went off to the hospital.
Getting to Mount Nittany, we were welcomed by the nursing staff, who were wonderfully nice. They informed us that Dr Szabo had called roughly forty-three times to check on Kathy's status during the ~30mins it took from hanging up the phone with him to our arrival on the OB floor. Kari (our nurse that evening) found Kathy to be 4cm, Dr Szabo arrived and found the same - comparing it as a definite change to the 3cm she was the day before in the office. Given the change and the contraction pattern, he felt it best to send us down the road to Hershey, as MNMC's nursery isn't really equipped or comfortable handling babies under ~35wks. In another 45minutes, Kathy was loaded into an ambulance and we were on our way.
The trip to Hershey was as fast as I'll ever make it, following behind Tom the NASCAR-ambulance driver, who boldly predicted a 90 minute trip and came within sixty seconds of being correct. On arrival, neither Kathy or I knew what to expect - Kathy not knowing if she was making enough change to be a "keeper," me having a brief moment of doubt when I realized "oh crap, it's august, I wonder if we're going to get someone who's only been on the job about a month" before thinking further that there are layers of hierarchy in academic medicine, and that someone would be on who's "been to the rodeo before." On arrival, our team couldn't have been any nicer. Dr Roca, the OB resident, made my bedside manner look bristly (and interestingly, in his own choice of words, when surveying the situation, told Kathy that "we've been to the rodeo before." Odd, eh?). Between he, Dr Carter, his senior (a PGY8, I didn't quite catch what she did during the first four, but she was really nice and quite competent too), and Kelley (our nurse who never, NEVER, stopped smiling the whole night), Kathy was very well taken care of. The problem was, while the babies looked fantastic, Kathy got to 7cm and while continuing to contract, did not continue to make much progress. Knowing that her cervix was now an open channel to the outside world, while not nearly the risk of infection as if membranes were ruptured, there was still a slowly ticking clock. More importantly, at 7cm, we had clearly crossed the point of no return. We both had realized that our new babies, whoever they may be, would have the birthday 8/11/11.
That morning, the change of shift brought a new set for our team. Roca and Carter were replaced by the equally competant Dr Mike Mitri, and we met our attending, Dr Botti. Kelley was replaced by an almost as cheery Gabby. Still, Kathy stayed on no-man's-land, contracting but not progressing, babies looking great, point-of-no-return crossed, but finish line very much up in the air. Finally, around 1:45, baby A had descended far enough to break Kathy's water - and since delivery was now clearly inevitable, Dr Botti did just that. OB is sort of funny, in that once you do it, you never really forget the basics. As slow as she was going, but as small as the babies were, I had a gut feeling that she would reach a point of really rapid progression. This was it. By probably the next contraction after breaking her water, Kathy was really feeling it in spite of the epidural. By 2pm, she was ready to push.
Delivery at an academic medical center, especially with preterm twins (even overall stable, reasurring and mature preterm twins) is a bit of a carnival. It was interesting to see. At one point, not counting Kathy and I, i think there were 17 people in the room. 4 for each baby, the FP intern, Dr Mitri (the senior OB resident) another OB resident, Dr Botti, Gabby and another nurse (?or two) looking after Kathy, and several of the house staff from anesthesia at the head of the bed. I'm sure I'm forgetting someone. Despite the potential for chaos, everyone was orderly, professional but at the same time pleasant. It felt more like a "competant ship" than just a "tight ship." After only 45minutes of pushing (I say only by comparing to Leah, otherwise I do understand that I won't get it until/if I "only" take 45 minutes to pass a kidney stone someday) Madison Claire was born. I laughed out loud with delight in telling Kathy that we had another girl. She was quickly wisked over to the NICU staff who assessed her, dried her, and fortunately had to do little else. In between Kathy and I laughed and discussed who would be coming next. We both said Caleb. Clearly, we're quite good at this baby-predicting thing. 0/4. Don't take us to Vegas. Do take us to the prom - at 2:58 out came Kaitlyn and we both laughed with delight again. After getting to hold each for what felt like about 20 seconds, they were put in their isolettes and taken upstairs to the NICU. The carnival cleared (I think I saw a few empty bottles and some confetti in the corner), and Kathy was taken back to her room to recover. Our thanks to the excellent, hyper-competant staff down here that helped it all come off without a hitch. All of the NICU postings will follow
Here are the beautiful little girls who we waited to finally meet...
Madison Claire
2:50 pm
5 lb 4 oz
Kaitlyn Elizabeth
2:58 pm
5lb 5oz