Maternity to Neonatal – We all fall down

This is the concluding part of my birth story, following on from HELLP Syndrome Part One and Part Two…

The maternity ward was quite a shock to the system. After having five whole days constantly with a midwife every second of every day and night, and having not been capable of doing much at all for myself, or for the babies, I was suddenly completely on my own. Completely. After breastfeeding the twins, I called the midwives to help me cup feed them their top ups. They had to be topped up as they fell asleep after a few minutes of breastfeeding, which didn’t give them enough milk, especially as they had lost 10.7% of their birth weight already. I had a long wait each time, but eventually someone came to help me… most of the time.

May 18^{th (Day 6) …}

“I got 90 mins sleep, then I woke them both up, changed both nappies, latched both on and breastfed them both for 15 minutes before they fell asleep. Now the midwives have taken them off for their top ups so I can get some more sleep. I feel quite proud of myself”. This was how it went in hospital. Sleep was at one hour intervals most of the time. This was the only time the midwives took the babies for a few hours for me. I felt quite proud of myself or waking, changing and feeding them with no help as I’d not had the energy or been well enough to do it all myself before.

They were late bringing the babies back which made me panic about their feeding times. The midwives told me I was calculating my timings wrong. They said that I should be feeding them 3 hourly from finish to start, not from start to start. This made about an hour’s difference to their feeds. I didn’t think this sounded right, but having had very little help at all from the midwives with the top-up feeds, I was very tired, so I changed the feeds to the times they told me.

In the morning, the baby doctor told me off and said that I should be feeding 3 hourly start to start, not finish to start and so I’d been underfeeding my babies. I tried to tell him that that is what I had been doing but the midwives told me I was wrong. I felt absolutely devastated by this. I’d been doing it right all along and that stupid midwife had made me starve my babies. I kept crying as I felt like a total failure for not following my gut. The baby doctor then told me I needed to feed Tiny every 2 hours as she had lost so much weight (more than 12%).

My brother and dad visited me for the first time. They were my first real visitors, as before I’d been so sick I had only been allowed my mum and my husband in to see me. It was lovely to see them, but sad that they couldn’t stay long.

On May 19^th (Day 7) Tiny’s sickness got a lot worse. She was throwing up all over Fluffy, as well as herself. I was constantly changing their clothes and hubby was having to come in, grab their yellow vomit stained clothes, take them home to wash and bring them back the same day. We were getting through hospital blankets like there was no tomorrow and Tiny was losing more weight. I called for a paediatrician and they came to look her over. They said she wasn’t dehydrated but they’d need to keep an eye on her and would be back later.

I asked to borrow a baby bath, to which a midwife said to me “You shouldn’t be pushing that, you’ll tear your stitches”.

“I don’t have any stitches”, I replied.

To my surprise she said “But you’ve just come up from having a caesarean section!”

I was horrified… the midwives on this ward clearly didn’t know their arse from their elbow. “NO I DIDN’T. I had these babies vaginally SEVEN days ago and I DON’T have any stitches!!!”

She looked very confused but let me wheel the bath into my room. I felt very tempted to say “Bloody lucky I didn’t have a C-Section considering how you’ve totally ignored me since I’ve been up here!”. I didn’t even get a meal the first day I was on the Maternity ward, because despite ordering food, they “forgot” me.

I decided to keep myself to myself, enjoy the alone time, and bathed the babies by myself in my bathroom. At least I had a room and bathroom to myself.

(After their bath)

I wasn’t feeling at all well though. I was very weak and shaky. I had to grip the walls every time I walked to the sterilising room to get a breastpump or store my milk away in the fridge. I was very wobbly and very dizzy. They wanted me to get up and walk about, not stay in bed, but I felt so drained. I kept switching between sweating and shivering. I was pretty sure I had a fever, but I was already on antibiotics for a fever that kept coming and going, so I didn’t make a fuss about it.

In the very early hours of May 20^th a paediatrician came to see me. Between us we made the decision to admit Tiny to the Neonatal unit because I was so worried about her. I was getting stressed and upset about how sick she was and I wanted them to intervene and do what they could to make her feel better. I knew this meant I’d have to part with her, but that I’d be able to visit her. The paediatrician and the head midwife had a chat and weren’t happy about the possible emotional effects on me and Fluffy of being separated from Tiny as I was still very weak and crying a lot. So me and Fluffy were discharged from the Maternity ward and we were all moved (on my bed again – the porters were getting to know me pretty well by now!) to Transitional Care on the Neonatal Unit.

Transitional care was a four bed ward (the first time I’d had to share), where I got a bed next to Tiny, and Fluffy got a cot the other side of me. A nursery nurse was constantly in the room and I was told that a midwife would come down to visit me once every 8 hours to do my obs, but would come more often if I felt unwell. I shared the room with two other ladies who had one baby each. Their babies had been in Neonatal since birth and were in transitional care trying to establish breastfeeding and gain a little more weight, before they could be discharged.

As Tiny was a patient and Fluffy wasn’t, they weren’t allowed to share a cot anymore, which really upset me. They took Tiny’s temperature an hour after separating them and found she was dropping body heat. Despite the hot weather outside of the hospital, each baby had been wearing a vest, sleepsuit, cardigan, wooly hat and four blankets since they were born as they were so tiny. They now had to put a perspex dome over Tiny’s cot to keep the heat in. On the next check she was still dropping her temperature, so they moved her to an incubator. I felt like we were going backwards.

(Tiny under the dome)

I was exhausted but I couldn’t sleep. In fact I couldn’t do much other than cry. My milk had suddenly come in full force, my boobs hurt and my fever was raging. Clearly it had been Milk Fever all along causing the temperature… so I was taking the antibiotics for nothing. On my way to transitional care, my midwife had hit me with ten different drugs in one hit (the usual nine plus an anticoagulant injection in my stomach) and I was shaking. I had palpitations and blurry vision. I didn’t feel like I was really inside my own head. I sat there in the dark snacking on fruit pastilles, watching the girls sleep and worrying about the effect of separation on them. I alerted the nursery nurse that I was worried about Fluffy because she felt cold too. On checking her temperature we found that Fluffy was also losing body heat since the separation. A dome was put over her to keep her body heat in.

The nursery nurse was amazing. She was just so kind. She administered Tiny’s medicine right there in her incubator next to me so I didn’t have to spend any time away from her. She woke me up every time the girls were due a feed. She praised me for finding the time to express and she cuddled me when I cried. Not long after putting the dome over Fluffy, she checked again and found that Fluffy’s temperature was following the exact same pattern as Tiny’s. Another incubator was wheeled in, new foot tags were written out and Fluffy was re-admitted as a patient.

(Fluffy in an incubator)

I felt really down. My perfectly healthy babies that had avoided neonatal at birth, were now both in incubators in Neonatal. Had I done something wrong? Is it because I bathed them? Was the bath too cold? Is it because my milk took so long to come in that Tiny was sick? Were they both there because I’d selfishly requested to be induced early? I’d been told that if I hadn’t followed my gut and pushed to be induced early, I’d quite possibly be dead; or at the very least, needed organ transplant because my HELLP Syndrome would have been so much more critical. So it wasn’t like I’d had much choice, but I couldn’t help but wonder if it was my fault they were poorly.

The nursery nurse called the midwife down when I told her I wasn’t feeling well, but other than checking my obs and showing concern, the midwife didn’t do anything. I’d been given all my own drugs to administer myself so I decided to cut down a bit and see if that was what was causing the palpitations. I dropped the buscopan, I dropped the tramadol and I dropped the antihistimanes. I’d already refused the morphine as it wasn’t helping. I continued taking Paracetamol for my temperature, Ibuprofen to take the edge off my muscular pain, Iron tablets, Antibiotics and Lactulose (laxative). I started taking my prenatal vitamins and omegas again as they were also for breastfeeding.

In the morning I got a visit from R, one of my amazing midwives that I’d had on the Delivery Suite. She came in, sat on my bed and cuddled me while I had a good cry. She kept telling me that I was amazing for breastfeeding and expressing and coping with everything that was happening to me as well as my babies. I needed that. I needed her, I needed the cuddle and I needed those kind things she said to me. R said I was white as a sheet and perhaps I should reconsider the Iron Infusion.

My oldest and dearest friend Kerry, picked Bunny up from her grandparents for me and came to visit me with her husband, but she didn’t get to see me for long because they’re very strict on visitors in Neonatal. Only 2 allowed. Which meant her and Bunny could come in, but her husband and mine had to leave. I spent the whole time crying and conversation on my part was limited because I was so tired and weak that I couldn’t concentrate. I’d start a sentence and forget what I was talking about.

My other friend came to visit briefly too and left me some much appreciated flapjacks and brownies!

The nursery nurse persuaded the consultant paediatrician to consent to the twins sharing an incubator, instead of having one each, as she thought it would help me cope psychologically. She was right and I was so much happier seeing them sleeping together again. I was so grateful that she did that for me.

(reunited in an incubator)

That night I found it really hard to sleep despite the exhaustion, I felt like I’d been there for months. I called the midwife down again and a few hours later the nursery nurse called her down a second time because she was worried about me. The midwife told me the palpitations were due to my low iron count. They did a blood test and my HB was only 7. The lowest it had been. She said the lack of Iron meant I didn’t have the energy to turn over in bed. Even sleeping uses energy and I had literally none. The effort of just laying there was causing palpitations, as my body was having to work so hard to push the oxygen around my blood. This is what iron does (amongst other things)… it carries the oxygen around the blood. The fact I was breastfeeding too meant what little goodness I had left in my body was being given to the girls.

May 21^st “I’m considering having the iron transfusion. I can’t go on feeling like this. I’m no use to the twins while I’m this ill and my HB has dropped even further”.

This was mentally the lowest point of my ten days in hospital. I felt like I was dying. I didn’t know it was possible to feel so weak and helpless. My babies were poorly, I was poorly. I missed Hubby and Bunny like crazy. We’d been in hospital over a week but it felt like months and it seemed like we were all a long way from being well enough to leave. I heard that even hubby wasn’t coping well anymore but to keep the strain off me, he was struggling through it in private at home. To say it was my lowest point is an understatement. I could no longer cope. I was just a desperate crying mess. It was at this point I released a blog post called Love and Despair. A plea for help and support. I bared my soul completely. Click here to read that post.

I remember sitting at the table a few feet away from the incubator, with my hospital lunch in front of me, but I couldnt bring myself to eat it. I just sat there, sobbing my heart out.

I was re-visited by the midwife and two doctors and they told me something needed to be done as I was so weak. I said I’d consider the iron infusion and they told me they didn’t think it would be enough. They told me I needed more than just the iron and that they recommended I have more blood transfusions instead. This was a huge relief to me. I knew what a blood transfusion involved, there was less fear with that. I agreed and was moved back to the Delivery Suite. This time I did have to leave the babies. But since sharing an incubator, their body temperature had started to go back up and Tiny’s medicine was working. She hadn’t been sick at all while on it. With tears in my eyes I left my babies in the Neonatal unit.

On arriving back at the delivery suite, all my former midwives were crowded around the nurses’ station. They saw me and were all really REALLY surprised to see that, not only was I still in hospital, but that I was still so poorly I’d come back to them! They re-admitted me as patient and I got my own room again – this time with a tv! I sat watching Holby City, then a few hours of Come Dine with Me, while having my blood transfusion. Obviously I had the steroids and antihistamines again, I was given a new canula in my arm and I was hooked up with two more units of irradiated blood. This time they had to put the blood through a warmer, which heated it to body temperature. The reason being, that they had only been able to get a tiny canula in my bruised veins, so heating up the blood meant the blood could run through faster. If it had taken four hours or more, it would have to be disconnected due to viability of the blood – so we had to make sure that wouldn’t happen. I was given a saline drip after each unit too so that not a single drop of blood was wasted by being thrown away with the line. They had to stop the transfusion twice – once for my fever, as it’s dangerous to transfuse somebody with a fever, and once because I developed a rash on my neck. Eventually though I’d had my blood and the colour was coming back in my face.

I was starting to perk up and feel better, when the door opened and I was reunited with my beautiful babies. They’d been transferred to a cot and kept their temperatures for a set period of time, which meant they could be moved from neonatal and join me on delivery suite. I was absolutely delighted and for the first time, it felt like we were getting somewhere.

I spent a lot of time panicking about the twins temperatures and they had to have it checked before every feed, but we all slept on the delivery suite and were moved back to the Maternity ward in the morning.

So by now it was May 22^nd, our ninth day in hospital and a turning point in our bad fortune. I woke up feeling amazing. It’s crazy how much better I felt after two pints of blood. My milk fever had settled down too and my weaning off all the drugs and back onto vitamins made my head less fuzzy. I’d even managed a few hours sleep! The baby doctors told me that if the twins could control their own body temperatures for 24 hours, they could be discharged. I persuaded the midwives to agree to my discharge too. Although we knew my recovery would take many weeks, my liver wasn’t yet fully functioning and we’d probably have a constant panic over the twins’ temperature and weight… Hubby and I finally started getting excited!

At 2pm on May 23^rd 2012, after a gruelling and traumatic ten and a half days in Gloucester Royal Hospital, we stepped out into the hot sunshine with our new baby girls for the first time. We were a family of five now and could finally all go home. It was a glorious feeling and I will never forget that smell of freshly cut grass being the first scent of our new lives together.

Happy to be home