They're here!

We've had a hectic day or two: Micah and Spencer (or more correctly, Spencer and Micah... more on that later) arrive yesterday afternoon, Monday the 5th, at 1:24 and 1:25 PM.

During her daily non-stress test on Sunday, Melissa's nurse noticed that she was contracting regularly and pretty significantly. That's nothing new: the NSTs always brought out the best in Melissa's contractions. What was new was the timing. Melissa has her weekend NSTs in the afternoon. This one took place at about 3:30, just half an hour after her afternoon dose of nifedipine, which is designed to quash contractions.

Guessing that something might be afoot, the nurse called for the resident on duty in Labor & Delivery to check Melissa for dilation. He determined that she'd dilated to 4 cm and recommended an immediate move to L&D for monitoring. To make a long story short (it's late, and I'm tired), Melissa labored on for about 20 hours--through a regimen of nifedipine intended to stop her labor, through an epidural, and finally through a regimen of oxytocin intended to encourage labor. She continued to dilate, but Micah (who occupied the pole position) refused to move down and engage for delivery. His copious swimming pool probably had something to do with the problem.

In the end, the docs elected to break Micah's water-bag. And chaos ensued immediately. Micah's heart-rate immediately dropped from the 160s into the 60s, and the placenta ablated (that is, pulled away from the uterine wall). Melissa lost a lot of blood in a big hurry. The delivery team whisked her away to the operating room (which they'd fortunately prepared in advance, just in case), put her under general anesthesia, and delivered the babies via rapid C-section.

Both babies looked good upon delivery. Spencer (who was delivered first because he was closest to hand when the docs reached in post-incision) weighed in at 1 lb, 9 oz. Micah measured a healthy 3 lbs. Both received an initial Apgar score of 8 (1-9 scale, 9 = best) from the team in the Newborn Intensive Care Unit (NICU).

And today, Melissa's feeling much better. The boys had a tough day, predictably (the first day outside of mom is almost always rough for preemies like Micah and Spencer). Micah had trouble taking up oxygen: his blood / oxygen saturation rates dipped as low as 45% (100% is best) this morning. As of 2:00 this afternoon, though, he was doing somewhat better (oxygen saturation at 80%+).

Both boys seem to have some shunting issues in their hearts. All babies have an "extra" vessel in their hearts that allows blood to move from the right ventricle to the left without passing through their lungs. In utero, this is OK since Mom oxygenates the blood anyhow. After birth, this obviously isn't OK. In full-term babies, this "extra" vessel closes off just before or shortly after birth. In preemies, the vessel sometimes doesn't close off on its own. There are various things docs can do to fix the issue, but that's news for another day. Suffice it to say that both boys are in critical but stable condition at the moment.

I've attached lots of pictures...