I believe further explanation of how we went from “status quo” to “the babies will be delivered within the next 45 minutes” is warranted. I was settling in for a day’s work on the morning of July 31st, when I felt like I wet my pants. Now to be honest, I just assumed little Theo was going to be controlling my bladder for the day. But, upon further investigation, I realized he had popped his little sac and I had “broken my water.” I called my doctor’s office, but since they were closed it directed my call to the physician on-call, which just so happened to be Dr. Elliott’s “bat phone.” I felt awful for bothering him on vacation, but he didn’t mind one bit. He encouraged me to pack a bag and head to Ob triage (the moms’ ER).
We arrived at the hospital and were quickly shuffled in for an assessment. They tested the fluid and confirmed that indeed it was amniotic fluid. Then, they discontinued my nifedipine (calcium-channel blocker), gave me a steroid shot (Betamethasone) to enhance fetal lung development, and started me on 3g of Magnesium sulfate. I was then whisked away to ultrasound to confirm the culprit. It was indeed little Theo (baby A) whose deepest vertical pocket went from around 5cm to about 1.6 cm, which indicated that he only had about 1.6 cm of fluid surrounding his little body in his sac. His head was now so low in my pelvis he appeared as though his little body stopped at his neck.
The nurses assured me that once my contractions stopped, it was entirely possible I could remain pregnant for several weeks. This amazed me but they said it happens all of the time. Unfortunately, this scenario is only true if 1) your contractions do stop, 2) you tolerate the medicinal anti-contraction regimen and 3) you do not develop an infection. My contractions did stop, thanks to the “mag.” But, it was clear after 24h on the magnesium sulfate that I was not tolerating it, and my lungs began to fill with fluid.
Magnesium sulfate is used for contraction management. It is thought to affect calcium channels to slow uterine contractions. Typical side-effects include water retention, muscle weakness, sweating/flushing, nausea, vomiting, constipation, and blurry vision. For most, these symptoms are tolerable and some mom’s of multiples can again remain on magnesium sulfate for several weeks, in order to prolong their gestation. Unfortunately, I hit the jackpot and experienced all of the symptoms noted above.
My body was only able to combat these side effects for about 3 days. I was placed on b-pap to increase my oxygen saturation and Lasix to try and rid my body and lungs of the extra fluid. On the morning of August 3, I was moved back to labor and delivery due to my pending diagnosis of pneumonia. When I spiked a fever and my white blood cell count shot up, we knew today was the day. It was then that we got the news that we would get to meet the quints within the next few hours.
They informed us that Dr. Elliott was speeding to the hospital, on his way back from vacation, and we were going to try and wait for him to arrive around 4pm. But, when he heard that I had a fever, he gave the go ahead to deliver in his absence.
Thus, they unraveled the most well-orchestrated delivery I have every heard of. With over 20 people in the delivery room (6 teams: one for me and one for each baby), they delivered the quints in about 3 minutes. The entire “operation” took about 45 minutes. I vaguely remember these moments, but Frank was right by my side to catalog it all.
Following delivery, Frank headed to the quints’ recovery room. By the time I arrived, all were gone and up to the NICU. My mom awaited me in the recovery room, and was over-joyed to see me safe and sound. I, unfortunately, could not see our little angels until my fever subsided and my breathing had stabilized.
Dr. Elliott arrived and it was clear he was upset that he could not deliver our babies, but we truly respected his decision. He shared with Frank that sometimes as a physician you have to make a decision with your head and not your heart. If we had waited even a moment longer my infection may have complicated the babies course.
Those 48 hours preceding the birth of our babies, were some of the worst of my life. But, I know that without that treatment regimen, our 5 little miracles would not have passed the “steroid efficacy window” and may have been at an even greater risk for serious complications.
Our heartfelt thanks goes out to Dr. Elliott and the teams at Banner Desert for their superb, patient-centered care, compassion and wisdom. For I know that if we were anywhere else, the circumstances and outcome may have been very different.
We have much more to share with everyone and are working on getting some fantastic pics of the quints, so look forward to some more baby updates in the near future!