Day 3/4

Day 3 was a rough day, partly because everything was closed for a holy day, the ATM was broken, and Dr. Hitesh was not in the office. So it wasn't until day 4 I could get my money exchanged to pay the NICU bills and lab fees ($47,000 rupees approximately for 2 weeks)and  pay a deposit for what I vaguely understand is the next 10 days of care ($20,000 rupees each baby). I think Monday after I've adjusted more to the hours and weather and routine here I'll try to get my account straight with Dr. Patel. 

The toughest part of day 3 was doing kangaroo care in the early afternoon with Tara. It scared me so much that in the evening when I came back and they were sleeping peacefully I did not do kangaroo care and just let them rest.  She appeared to have a long de-sat episode but none of the nurses reacted. I patted her on the back and it helped only a little but she was so tiny it was hard to tell if she was breathing, though the apnea monitor did not go off. She had one earlier where the nurse stimulated her a bit by patting her and rubbing her, but seemed unconcerned. They moved her back to the crib and again adjusted the monitor on her foot that records pulse and oxygen saturation. Part of it is the language barrier that causes me to not have trust built in all the nurses yet, and part of it was that this was the very first de-sat I've witnessed and it is scary even though you know it is normal. but I think the biggest reason I reacted is that I have a lot of buried emotion built up the last few days. As soon as she appeared to be more stable I started quietly crying and couldn't seem to stop myself. I was embarassed and mad at myself for crying, and mad that I couldn't seem to shut it off...which is a skill that in so many years of emergency services I thought I'd mastered. But with your own children I guess it is different. The nurse Suvarna comforted me and explained why she was sure it was the foot monitor not touching the skin properly that was the problem, and that if something happened that was cause for worry she assured me she would tell me.

Soon after this I was summoned to go meet my surrogate, who was just upstairs in room 201. I was already worried because this flood of emotion was still trying to overwhelm me. As soon as the door opened and I saw Manju I began crying uncontrollably upon the sight of her. I told her "Ghano ghano dhanyavad" repeatedly (thank you very very much) and when I tried to touch her feet in a cultural gesture of abasement and gratitude she pulled them away and wouldn't let me. Nothing can really prepare you in life for a moment like this.  I somehow managed to pull myself together after a few minutes. We awkwardly tried to communicate despite a language barrier, and I was able to determine that both my children were born naturally and not via C-section. The South African couple with twins apparently spoke Hindi, so they were summoned in to translate. Awkward conversation ensued, but I told her the babies names. It turns out she is divorced and has a 3 year old son. She made a sign of victory when she talked about being divorced, so she is quite happy with her marital status I deduced. She lives in Ahmedabad and her mother takes care of her son while she was in Anand. The other surrogate who was also pumping for my babies was the more talkative and had questions. They said they get up 3 times a night to pump. I explained that I do too but am not producing near enough.  We agreed the babies are tiny but with time will get bigger. I explained that my husband was tall. We agreed Vivek likes to thrash and move his little arms all over the place. They asked me my room # at Rama Residency, and I lied and said I wasn't sure. I don't want my room # getting out there else people come and ask me for money as has happened in the past. I will visit Manju on occasion and perhaps bring some gifts for her and her son but I can't do as much as I'd like. I hope a store clerk can help me select an outfit that would fit a 3 year old boy, because I'm not all that sure about sizes.

I did wander into my favorite winding backstreet marketplace, and stumbled across a place and paid a bit too much for two shirts and two pants, but they button down the front and now I'll have about 5 outfits I can rotate for kangaroo care. I'm not looking forward to doing laundry in my room but tomorrow I can't put it off any longer given my new small rotation of outfits as everything else I brought are sarees that linger in the closet unused.

The highlight of day 3 was spending a nice hour chatting with Lakshmi and her husband Madhu(?). It was nice to chat and be sociable, and I got some great advice. Hearing everyone else's tales of infertility is staggering at times to ponder the horrors that they have been through, many times which far exceeds my own trials.  On day 4 as I waited to exchange money in Dr. Hitesh's office I met a gal from England who is on her 3rd try in Anand. However, her tale of infertility horror was absolutely shocking. After multiple failed IVF attempts in London, during an egg extraction procedure one of the top IVF clinics in London ruptures her artery. She almost dies on the table, has a stroke, and for the next two years she is disabled and has to learn to speak again. Her uterine lining is destroyed as a result and she will never be able to carry. She says if this last attempt in Anand doesn't work with her eggs, she is done.

I also meet a 21 year old gal and her sister from Montana in Dr. Hitesh's office. The blond is an egg donor who was flown in by an American couple. She says she wants to share the wealth because she gets pregnant so easily and already has 3 children. She had the first at 14years old. My mother told me if you can't say anything nice, don't say anything at all.

Moving on, here are a few pics:

Vivek foreground, Tara background



Sleepy Tara

Tara opens her eyes



Vivek stretched out



Vivek curled up

 Both babies gained 10 grams yesterday...I think . Tara is at 960, which is 40 over her birth weight. Vivek is still 10 a tad under his birth weight, I forgot by how much. But with all the numbers flying around in my head, the point is they are both gaining and still doing well. Other babies next to them are requiring more oxygen support and are full term or almost full term and several pounds bigger.

I'm trying to stay positive, but the honest truth is when I'm not with the babies I'm not that upbeat. It is sinking in that I'll be in this poor, dusty town for several months alone. I miss home. I miss my husband. I miss my family. I miss my friends. I miss my home. I miss my freedom. I miss being able to communicate clearly at all times. And God help me I want a hamburger so freaking bad. I didn't let myself think about the downside much on the way here, because none of my wants really matter in the bigger picture here. I won't feel sorry for myself, but I won't pretend that living here is super awesome either. I hope I can video chat with my husband soon to cheer me up a bit.

Day 2 in Anand

A fitful sleep and a massive migraine meant I only visited my babies twice today. However I did kangaroo care each time and it was almost an hour with each baby each time.

A couple of quick notes of things I've forgotten to mention. I have not resolved my account with Dr. Patel, but I was impressed that was only because they find discussion of money on my first days here distasteful. I agree...better things to focus on immediately and they are not trying to rush me.

Dr Hitesh did escort me in briefly to see Dr. Patel. She was busy as always so just a quick hello and thank you.

I have not yet met our surrogate but she is pumping for us at the hostpial nearby, so I should meet her soon.

Almost all the clothes and hats in the NICU are pink. I don't know if that color carries the same gender connotation here. So if you are wondering why my son is in pink, that's why. I have preemie clothes that he is still too small for, and they mostly don't use clothing aside from hats for better accessability and so that they can evaluate skin tone etc.

It is almost all twins right now. My babies next door neighbor's are Lakshmi's twin boy and girl, and across are another set whose parent's I haven't met. I the adjoining room are a set of boys and I've met the mother from South Africa. They brought in a singleton yesterday born full term but having a little more problems breathing than mine currently are at almost 29 weeks gestation.

I've read the premature baby book, and it says until a few weeks from now they will develop a sucking reflex and be able to coordinate sucking ,swallowing and breathing so that they can feed by an actual bottle and not from a gavage orogastric tube. Well...my babies must not have read the book because they have been making sucking motions since I got here and are feeding orally by a plastic syringe, and the nurse took two of my bottles yesterday to test out on them possibly today!

Quick post because I'm exhausted after my trip to Big Bazaar and ready for bed.

Day 1: The first time ever I saw your face...

The trip in the car to the hotel seemed to take forever. I was so excited to see my children I totally forgot to pay the driver!!! Why didn't he follow me and ask for payment? I'll see if Dr. Hitesh can get payment to him tomorrow.

I rush to my room and unpack tons of stuff I won't need for quite a while. It helps me to feel organized. I pack a small bag with little hats, tiny NICU outfits, diapers, formula, and wipes. (All they take are one pack of wipes and will tell me to bring diapers later.) I force myself to shower so that I'm clean after all this traveling before I see my babies. I force myself to eat breakfast and pump one more time. I try to pace myself but I eat so fast I almost choke. The staff recognizes me from last year and smiles. The front desk clerk congratulates me and shakes my hand. I stop on the way to the NICU to visit my new friend Lakshmi, and find out her twins are also a boy and girl and doing well too. I ask her what to expect in the NICU, and she also warns me how small they are but reassures me that they are taking great care of them both and they are doing well. Our babies are all next door neighbors. They tell me the NICU is small, and some folks seem to think it isn't that clean. However, we discuss that often cleanliness is a perception based off of how shiny and new things look, instead of actual cleanliness. When I do arrive at the NICU it certainly seems clean to me, and a man wipes down the floors and every inch of the isolette while I'm there.

I take the short walk that seems to take forever to the NICU. I find it no problem based  on HammockGuy's You Tube video:

I realize it is a full fledged hospital and the waiting room is packed and very sick folks line the rooms along the long hall you walk down to the double doors of the NICU. You must walk through the ICU to get to the NICU it appears, so just don't touch anything.

Words fail here. I was shocked at how small they were at first. Everyone tells you that, but somehow the camera must have added a few pounds because until that moment they didn't seem so small. After the shock wears off I begin weeping with joy. A group of all 5 nurses gather around and I do not experience this moment alone after all. They all realize the importance of this moment and it is all smiles as they realize this is the first time I'm seeing them. They tell me I can hold them after I wash my hands, and I'm thrilled that hope has come true so soon.

As I scrub up to the elbow vigorously before putting on a green gown, I greet Suvarna by name. She is shocked that I know her name. I explain to her that she is famous among the small group of Dr. Patel's patients who are NICU vets. I tell her that everyone says she is an incredible nurse, speaks English, and takes excellent care of the babies. I thank her, and she seems very pleased.

I had stared at my 6 pictures of my children every day for probably an hour or more daily grand total for  a week and a half, yet I wasn't sure who was who at first. I was a little overwhelmed. I held my daughter first, I couldn't tell you how long. She was so tiny, but somehow seemed content. Her every tiny movement fascinated me. It's true that seeing the nurses handle your babies so deftly convinces you that they are not as fragile as they seem. I held my son for longer because the nurses were busy doing something else, and even lost feeling in my hand. When they finally put him back in the isolette, I have no feeling in my left hand and I see that it is swollen considerably. I hide it behind my back and flex back and forth to regain sensation. I realize my biggest issue with this NICU will be the incredibly uncomfortable white plastic lawn chairs. I think I will grow to hate them, and sitting in them for long periods of time as they systematically cut off circulation to my limbs and aggravate my herniated disk will be a supreme test of will power.

They ask me their names, and I realize my email with their names to Dr. Kothiala never made it to the nurses. I write the names on their chart and they all seem to approve, but are as confused that I chose Indian names that are not family names as they are about why a white girl likes to wear sarees. They seem to expect me to speak Hindi, and I really wish I did! I tell them my husband speaks some. They seem confused again that my saree is folded Gujarati style when my husband's family is Punjabi, but when in Rome....

I offer them my specially selected bag of goodies, but all they take are a pack of wipes and they'll tell me when diapers are needed. I do give them my black and white zentangles from my ladies group at church, and after some explanation they realize what it is for and seem pleased and place them in the isolettes. I ask if I can take pictures but tell them I know to use no flash, and they agree. I take a test photo in the corner to make certain the flash is off.


Tara



Tara checking out Mommy's zentangle





Tara's gavage tube gives her an Elvis lip curl thing going on



Sleepy little boy



Vivek checking out my friend Nancy's zentangle




Vivek smiling for Daddy!




Brown eyed boy

 They tell me I can go talk to Dr. Kothiala, because I'd only met one of the other doctors that I'd forgotten the name of. I greet the doctor, and am pleased to see that she has grey hair. I find that level of experience comforting in this situation.  We discuss many things of which I'll try to recall as well as I can in my sleep weariness.

1. They are indeed doing very well, especially breathing well on room air with no assistance. Not even a blow by oxygen or nasal cannula, though Vivek has a little scab on his nose from when he last had the cannula last week. She tells me they don't let them get to the point they get apneic or bradycardic, which I find comforting but confusing because my understanding was that these are normal and will happen routinely. Vivek did desat once while I was doing kangaroo care later, but the nurse adjusted his head and he went right back up to normal at just under 100% O2 sats and heart rate from 120-140.

2. Tara was born at 920 grams, and as of today she hit 935 grams. It took her a week and a half to gain back her birth weight and then some. Every little gram counts.  Vivek had one rough day where his little tummy rejected some breast milk supplmentation, so for that one day he had issues and that is what set him a little behind. He is at 1 Kg right now.

3. She is a doctor who prefers minimal invasiveness, which is a philosophy I can get behind. However she assures me that she does what is necessary, but if a natural course (like breast milk or avoiding IV's) is possible she will do it.

4. She speaks with pride about how she was one of the first to do a particular style of surfactant therapy to coat the immature lungs, using a tube to administer directly to the lungs then remove as soon as possible. She explains that this way only 1 out of 10 babies in her experience even wind up needing a ventilator.

5. NEC (Necrolyzing Colitis) is something she says every neonatologist fears, which is why she approaches everything gently, and won't give anything but breast milk until at least 32 weeks gestation. Two surrogates including my own are at the hospital and are pumping for them, and they did get the colustrum to boost their underdeveloped immune systems. Breast milk is free the first 15 days, and later Dr. Hitesh tells me they have cut the cost to 750 rupees per day (thank goodness).

6. I tell her about my induced lactation, and she seems pleased. She says whenever I produce enough we can start using it but I explain right now 10 drops from a week and a half of pumping is all I produce. She tells me that kangaroo care will help and sucking, even if it is non-nutrative at first and for comfort only. I can't wait!!! Something about her reassuring me that this thing I have provoked my body to do to help my babies will be embraced here is so comforting. I expected it, but yet somehow I am still so relieved!

7. She says I can do kangaroo care as soon as I am ready, and my heart soars at the thought. There is only one problem. Of all the things I brought to India, it turns out American clothes instead of sarees would have been the best thing. I need shirts that button down the front for kangaroo care. Crap. Crappity crap crap crap. I have NOTHING that fits that description in my 2 week supply of clothing. I buy a man's shirt later in the day for $10 for this purpose, but it looks ridiculous and is not made for a short person with hips.

8. She agrees it is good that my husband is coming at the end, which is when he will be needed. This helps me to know that I did the smart thing.  Dr. Hitesh later echoes that sentiment.  I explain that my two mothers will be here also at the end, and this pleases her immensely because she says four to five people are necessary to care for these two babies upon discharge. I assure her there will be four, and am infinitely grateful that I have the two most wonderful mothers ever. I tell her my mother is amazing with babies.

I go see Dr. Hitesh and the birth certificates are already in the works and should arrive within the week! Our contract must be redone once my husband arrives because we did not know to initial every page, and the surrogate is single (which is suprising because I thought they had to be married) and her father's name is in the section for her husband's name. I realize our payment to her will be life changing even more than I thought.  He assures me the last minute contract signing won't raise eyebrows at the Mumbai consulate and they have done it plenty of times without a hitch. He says with egg donation a DNA test will be a given and will slow things down by about two weeks if I have my husband tested in the US beforehand, but that if we can convince them it is an emergency then the exit VISA process can go quite quickly. I meet another woman waiting in his office who is from Turkey and is on her 2nd try, and I share our good news and tell her it happened on our 2nd try with only 5 good eggs. She asks about induced lactation and I tell her all about the Newman Goldfarb protocol.

Later on I do kangaroo care and it is the most wonderful experience. Read more about it here: http://www.midwiferytoday.com/articles/kangaroocare.asp    Tara is sleepy and peaceful, which seems to be her usual state and it is pure bliss. I do it with Vivek first and longer actually, and partly because I sense he is having a little rougher time of it. He has been quite squirmy all day, which is great for photo and video ops, but I would prefer to see him more restful. He settles down once he is on my chest save the one de-sat. His tiny hands brushing against my skin make me feel more like his mother with every touch. Feeling like a mother and bonding is not instantaneous as I've been told, and now that I've been there I agree. They don't feel quite like mine yet but every interaction changes that more and more.

Suvarna tells me we will do kangaroo care every morning and evening, and I am thrilled!  Tomorrow after kangaroo care in the morning I will solve this clothing problem and make a trip to Big Bazaar to buy supplies for the long haul. I am hungry and have nothing to eat. Room service is 24 hrs but no one is answering the phone. I sneak into the kitchen and steal some cookies so I can get back to sleep.

So for the grand conclusion of the weak description of the best day of my life, here are videos....which are so much more powerful than words could ever be.

Flying Solo

So here I sit at the Dallas Fort Worth International airport. It has been a rush getting here and now everything has slowed down while I wait at the gate for two days of traveling. I paid $200 for a bag that was 3 lbs overweight, but every diaper and can of formula counts until my mother in law can arrive with the 2^nd bag full in a month. I pre-paid without complaint and was impressed with myself that my guess that my bag would be just over 50 lbs was deadly accurate. The TSA agent on the Xray machine didn’t blink an eye at my breast pump that I left inside my 2^nd carry on, so I guess that won’t raise eyebrows at Mumbai…..I hope.

I cried loudly enough to attract attention when I said goodbye to my husband, and I think he was trying not to get choked up too. I’m more worried about him than me. I’ve only gone about a week away from him since we’ve been married 8 years ago. Now I’ll go at least 2 months without seeing him!  It is very hard to say goodbye, but I know it is the smart thing to do. His VISA arrived this morning, so that is one thing off the list. I’ve left a critical “Honey Do” list so I’ll have to check in on his progress.  I’ve asked family not to call me at the hotel until the evening time on the 8^th so that all day I can focus on my babies and not missed calls and reporting back status to my family.

My mother-in-law’s wonderful sister Guddi Aunti has gifted us lots of baby clothes, which I can’t wait to see until I got back. Three more gifts were given my last night at work, and though I had frantically finished all the thank you notes from my shower I didn’t have time to get thank you cards to those generous three and I hope that an email will be okay.

A million thoughts and emotions run through my brain as I sip what will be my last Starbucks coffee for some time. I can’t wait to meet my babies. I’m worried about my babies. I’m worried I’m a bad mother because maybe I’m worrying too much about my babies. All indicators tell us that they are doing spectacular but still I fear they are waiting to tell me anything bad until I get there. Stop worrying. Stay positive. Quit thinking about your to do list when you get home and the fact that the nursery is still not painted. Babies don’t care what color the walls are. Quit worrying that there is one critical thing you forgot to pack. I look at the three new pictures of my babies, especially my little girl chilling under the bili-lights, and I follow her example to relax and live in the moment. I still can’t believe I finally am a mother. I have a son and a daughter.  A family of four forever. 

I know I must talk to Dr. Hitesh and Dr. Patel the day I arrive too in order to meet our surrogate (if she is still there and the one providing our breastmilk) and in order to settle payments, but I tell myself that can wait for a few hours and to meet my babies first and take my time.  That reminds me…I forgot to pack Kleenex and I’m going to cry. A lot. 

I read The Premature Baby Book by Dr. Sears at my side, partly because it is the one thing I could not fit in either of my two carry-ons. It is great preparatory reading and so far I’m feeling a little more confident in how I’ll handle myself and knowing what to expect.  I plan on taking the advice to not read the chapters of bad things that can happen unless they actually happen. I read some preemie blogs of 28 weekers and some born sooner at my last night of work, and mostly found encouragement but things that went wrong with some scared me. For the most part it seems like the ones that had problems of some sort it was apparent from birth or there were more delivery complications or they were born sooner or smaller than mine. The fact that mine were never on a ventilator and are now breathing on their own is the biggest reassurance of all. I just hope my little girl gets chunky soon because 2 lbs is pretty tiny and 2 ½ sounds a lot better. Plus I promised my mother at least two chubby rolls on their thighs for her to pinch on.

So here I still sit waiting at the DFW gate. I’m watching the drug dog make a 2^nd pass at my suitcase. I have a bag of fenugreek seed and a bag of fennel seed that look a lot like drugs and have a strong scent, but are just galactologue herbal supplements. Fortunately Rover seems to know the difference. (His actual name is Uno, because I can hear the handler calling his name and telling him “Good boy!”)  For a moment I watch him play with his rubber toy reward with pure elation, and it makes me miss my dog but also be grateful now that I finally know such joy in my own heart too.

I’d decided when I got to Newark I’m using the 3 hour layover to eat a steak. Hopefully it will tide me over enough that I don’t rush out into the street and go after one of the cows that wander loose. Mmmmm….sacred.  

So here I sit at the gate in Newark. It turns out when these Yankees think mighty highly of their steaks and charge twice as much for half the size as I can get in Texas. I have a bleu cheese burger instead, and it ain’t that great. I’m already missing Texas.

It takes me half an hour to get my saree on in the tiny bathroom. I’d forgotten one element of the Gujarati style of wrapping since I’m used to wrapping Punjabi style excepting my trip to Anand a year ago, but it comes to me in a flash after four attempts and I finally get it on.  The saree I had on top of my suitcase didn’t fit because I’d forgotten about the whole lactation thing and my chest is too large. So instead I select a very comfy pink one with a stretchy top. I befriend a young Indian gal who has been stuck at the airport for a day and compliments my saree, and she wishes me luck. Once I freshen up and brush my teeth I realize there is no electrical outlet to use my breast pump. Guess once I get on the plane I’ll turn to the side in my window seat and use the hand pump and hand expression like I did on the first flight.

The main reason I selected the window seat was to allow for some privacy for that purpose. And fortunately being in the last row and seated next to one old lady who didn’t speak English and minded her own business helped that effort. However I love window seats for other reasons. Mainly because you can look out upon the universe with sky and clouds and the magnificence and grandeur of God is overwhelming. It baffles me that everyone else I see has the window closed and is sleeping, reading, or watching the TV they charge you 7.99 to view. I just can’t fathom how you can’t even open your window a crack just once on the flight to see and enjoy the amazing scenery that brings on such a sense of wonder. It makes me ponder miracles, and feel an intense gratitude for the two miracles I’ve been granted.

So here I sit in the Mumbai airport during a 7 hour overnight layover, just like I did a year ago on my first trip to Anand to attempt surrogacy. I am calmer to some degree because the locations and signs are familiar and I am less worried that I’m going to the wrong place and know I have 7 hours to correct any navigational errors. I mostly worry envisioning my mother doing this on her own in a few months and I plan how to explain what to expect to her. The only snags so far are the bus guy pushing me hard for a tip. I don’t feel bad not tipping him because:

1. I can handle my own damn luggage but you wouldn’t let me. I’m stronger than I look.
2. I don’t have anything less than a 500 rupee bill and am not about to ask for change with a line of folks behind me.
3. He didn’t ask anyone else for a tip for picking up a piece of luggage and putting it in the bus directly next to him

The 2^nd snag is that when I go to get my new boarding pass since the one issued in the US must be exchanged for a local one. I also check in my luggage, and a 3 person debate in Hindi ensues for 30 minutes concerning it. Concerned about what is happening I show her a picture of my preemie girl and tell her “sick baby” and point to the bags and say “medical equipment.”  She seems to get the importance of what I’m trying to communicate and assures me the baggage can go but they are just debating what payment is due. I luckily had a printed receipt that I had paid for my overweight and extra bag already, and the think tank pores over and discusses it extensively. But the restrictions on Jet Airways for my connecting flight to Vadodora domestically are different than United that I used to get here, and the real problem becomes my 2^nd carry on. I neglected to research that in advance. My 2^nd carry on is 14 kg and only 7kg is allowed. She sees the look of panic on my face as I consider my options:

1. Dump half my clothes in a garbage can. My two large bags are all baby stuff, and my small carry on is my stuff only. I could always buy more clothes for me here, but baby stuff is harder to come buy.
2. See if I can refund my ticket and take a train or car to Anand. I’d really have to kick my resourcefulness into high gear, but it is an option though it might delay me. I really only considered this option when I thought that the baby luggage might not be allowed to go.

She tells me I can check it instead as a 3^rd bag and pay. I agree to do so. It is almost 3,000 rupees, or around $60. I figured if I’d bought new clothes that is about the same price so I pay willingly with a smile on my face. Kill ‘em with kindness and getting them to pity you is a better way to go here than being a demanding, self-entitled, stereotypical American.  

I get through the security screening at the final gate just fine, though they have to unpack my entire bag because I wasn’t clear than anything and everything metal needed to be separated out into a container. They expect my ignorance due to my overwhelmingly pale and obviously foreign appearance. The saree and mangalsutra necklace only go so far and people find it more charming that I wear them than an effective disguise. He did question my fenugreek seed, but I tell him “fenugreek herbal supplement” and he seems satisfied, thank goodness. If that didn’t work I wasn’t sure where we would go from there because galactologue doesn’t translate well.

I am starting to feel engorged and am now worried because my hand pump lost a part at some point from when I got off the plane that it may not work properly without. I decide to brave the bathroom and hope I can find an outlet with a bit of privacy. I find the working outlet, but have to unplug the hand dryer to do it.  As far as privacy goes, my semi-sheer saree draping across my front will have to do. I am pleased to find that I actually pump enough that it could probably be fed to a baby in a single spoon. This is progress to be proud of at this early stage. About 10 women come and go as I pump, most looking at me curiously. One custodian asks me what I am doing. I just say “breast pump” and point each index finger towards each breast. The look on her face is still confusion but she seems satisfied with that explanation. They probably only use babies or hand pumps for that purpose here, and $2000 electric double breast pumps are not something you see everyday.

I’m not sure how much I slept on the flight to Mumbai but it could have been around 10 solid hours. I slept at least an hour in this waiting room, though I’m not sure how because it was dreadfully uncomfortable. Some coffee wakes me up a bit, and I’m rather sure I’ll find the will and strength to get through an entire day before I sleep again as night falls. The sun will be up in a few hours, and I’m about to have one of the most important and happiest days of my life. It is odd to know that beforehand and have to wait for it consciously.

I read some more of my preemie book to help prepare myself. I know the hardest part of the day will be arriving at the hotel and unpacking and pumping first and forcing myself to wait a few more minutes to meet my children who are but a 2 minute walk away. Who are we kidding? It will be 1 minute cause I’m gonna speed walk. But I want to make sure I’m clean and showered for the NICU so I don’t bring in germs, and I want to organize the baby stuff and bring in a few items I know they need immediately. I plan to write the names on their diapers since I know the Huggies are better for boys and Pampers better for girls. This is the one think Dr. Kothiala did say on the phone I needed to bring, though she probably doesn’t realize I knew that already and have been systematically prepping for months to know in advance what is necessary to bring. I also want to walk in looking like the most prepared mother every to make a good impression upon these nurses I will depend on so heavily. I mustn’t forget to tie my hair back, and will wear something that is easily adapted to Kangaroo care in the hope I can hold them today. Waiting a week until they are more stabilized and developed will hopefully pay off in that respect. 

Marmet Technique

Thanks to a tip on a Yahoo group for support for adoptive lactation, I figured out that righty is very responsive to manual hand expression of breastmilk and now far out produces lefty, who still prefers the pump. Below are some instructions I found online on the Marmet hand expression technique.

How to Manually Express Breastmilk - The Marmet Technique

Draining the Milk Reservoirs
1. Position the thumb (above the nipple) and first two fingers (below the nipple) about 1” to 1–1/2” from the nipple, though not necessarily at the outer edges of the areola. Use this measurement as a guide, since breasts and areolas vary in size from one woman to another. Be sure the hand forms the letter “C” and the finger pads are at 6 and 12 o’clock in line with the nipple. Note the fingers are positioned so that the milk reservoirs lie beneath them.

• Avoid cupping the breast

2. Push straight into the chest wall

• Avoid spreading the fingers apart.
• For large breasts, first lift and then push into the chest wall

3. Roll thumb and fingers forward at the same time. This rolling motion compresses and empties milk reservoirs without injuring sensitive breast tissue.
Note the position of thumb and fingernails during the finish roll as shown in the illustration.

4. Repeat rhythmically to completely drain reservoirs.
• Position, push, roll...
• Position, push, roll...

5. Rotate the thumb and fingers to milk other reservoirs, using both hands on each breast.

 Avoid These Motions
1. Do not squeeze the breast, as this can cause bruising.

2. Sliding hands over the breast may cause painful skin burns.

3. Avoid pulling the nipple which may result in tissue damage.

Marmet Technique copyright 1978, revised 1979, 1981 and 1988. Used with permission of Chele Marmet and the Lactation Institute, 1616 Ventura Blvd., Suite 223, Encino, California 91436

Friends in far away places

So someone I met on the interwebs who is also having twins just arrived in Anand, and ever so graciously checked on my babies for me and fulfilled my request to email me some pictures of them! I just about fell out of bed and was yelling at my phone to load faster! It is so good to have a friend along this journey!

I have yet to see my baby boy not crying. My little girl is chilling in all 3 pics I have of her. All reports from the nurse Suvarna are good and it really emphasized that breathing without assistance at this point is very, very good.

The baby shower was yesterday, and I am overwhelmed with how many wonderful and and generous friends I have. Unfortunately I couldn't figure out how to work my new camera that my father-in-law gifted us, so I'll have to wait for my mother to email me her shots to post here. I had a wonderful time, and got some beautiful gifts. Most especially I got two little hand-knitted baby blankets with the alphabet on them, and two tiny knitted outfits with adorable fringed hats! Can't wait to dress them up for photos. My father bought us the Snuza Halo monitors so that I can have peace of mind.  I just was reading some Amazon reviews and there were several life saves reported, so this should help me to be a more relaxed Mom and sleep a bit deeper. As someone who has heard the screams of parents whose babies have died of SIDS...it changes you to the point you have to take every precaution because you know bad things can happen to good parents.

I got mandated to come in early on my last day of work before I leave, but fortunately they flexed me out and someone else took overtime so I can still work just 8 hours. I may get the nursery painted tonight after all...we'll see! The to do list for tonight is daunting, but I can sleep on the plane. I'm frustrated because I have a very small stack of items to take that I can't seem to fit in the suitcases. 4 of them are books, which I really don't want to sacrifice. The breast pump is really the problem because it is taking up so much space. I'll figure it out. I'll figure all this out. I can't wait to see my babies!!!!

Double trouble

All good news! My babies are now a week old. Both babies were off CPAP after the first 3 days, which is stupendous!!! They are breathing on their own, and the IV's have been taken out and they are on a gavage of breast milk only. They are crying heartily, and are already gaining weight back. I couldn't ask for anything more at this stage. After reading a little of www.rastalesstraveled.com I'm even more appreciative, and her twins were born at 30 weeks! This gal is a trooper who has been through so much more than I have just to have her babies, and her baby boy was born sick with lung problems and is still on CPAP four months later and she is out of money and unable to leave India.

Cleaning ladies left the house spic and span this morning, and  I am 95% ready to go to India.  It was the best $90 I've spent in forever. I wanted to kiss both the cleaning ladies on the mouth when it was done despite them being covered in dust bunnies and smelling like lysol. The four large suitcases (2 carry on) are loaded and ready to burst at any minute. I managed to cram in everything I wanted except my DVD player and P90X which was just a luxury item probably not worth taking in the first place. I should have family coming in with diaper reinforcements since the 16 packs of 31 diapers each I have in the first bag will likely run out, and I have 15 more packs in a suitcase ready to go along with items we'll need later. I plan on paying through the nose for being over the baggage weight limit for the first time in my life.  The nursery still has 3 walls that need painting and the living room has 2 walls....and with some luck on my side I'll get that done too.

We had a bad string of luck and the washer hose detached twice in 2 days and did some laminate damage due to 10 gallons of water spilling all over the place. I laughed it off despite the warped flooring next to the washer, thinking that everything in my life good or bad comes in two's now. But then we had a hot water pipe burst a day later, and my sense of humor disappeared and for a moment I did lose perespective and let my life overwhelm me. Frankly I just decided that I don't have the time or the inclination to deal with it right now, especially since the suspected pipe is not easy to get to. I'd rather save money for now and get my babies home. So we kicked the plumbers out who were charging $216 an hour, shut off the hot water, and my lovely husband will take cold showers until I get back. Insert joke here. But I'll be in a hotel in India living out of a suitcase, so this can be his way of showing solidarity with the trials I'll be enduring. And overall I've taken it as a lesson...two steps forward one step back is a lot like the NICU I'm told.

Baby shower is tomorrow! I am excited, but have been so busy I haven't had time to get really excited. I think this means tomorrow I will be really overwhelmed and emotional. I can't believe this many people are coming for us and I have such wonderful friend's hosting it. I never thought I would have something like this.

Since Tara broke the sac and was born first I'm thinking she may be an impatient little girl. Just like her Mommy. She'll just have to wait another 5 days! It feels like forever. It doesn't feel all that long until I leave, because I still have a short but time intensive list of things to do until then. But the journey will be long and starts on Monday at noon and ends on Wednesday on the other side of the planet after hours and hours of flying and layovers, including an all night layover in Mumbai. Same airport as last time. Will have 100 men staring at me again I'm sure. Uber creepy.

Now onto the trials of induced lactation. As soon as they were born and I rented the hospital breast pump (Medela Symphony), I've been pumping on an irregular schedule 8-10 times per day. I started off 4-5 times a day and built up, but with everything going on I can't schedule it every 3 hours like I would like to and at 2:30 am and 5:30 I press snooze a lot! I didn't expect much because I wasn't being consistent on times and am too rushed to worry about my diet and water intake just yet. I'm taking Alfafa and Blessed Thistle supplements, and chewing up Fennel and Fenugreek seeds three times a day. It is waaaaay cheaper to buy the latter two in the spice aisle and just chew them up. I ground up the Fenugreek seeds in my coffee grinder since they are pretty hard, and I would say the end result is good. Both spices taste fine, and in fact the fennel seed is commonly used as an after dinner mint in every Indian restaurant I've ever been to (mixed with a few sweet bits). I've had about four months of Domperidone instead of the recommended six, and will have pumped for 1 1/2 weeks before I see my babies instead of the recommended six.

But despite the inconsistency, left boob is getting the message and producing a few drops every pumping! Right boob however has not been getting with the program. It has produced a few drops, but the last few times nothing at all. Most women have one that is bigger than the other, and my right one is almost a full cup size larger. I expected more from you right boob! But tonight despite my massive production level of a 1/4 teaspoon, they started to hurt after a 5 hour gap in pumping since I had to work today. I considered this a good sign and finally got relief from my console to pump. I figured it out. Left boob is the laid back one and is cool with a 3-5 level of pressure. Right boob ain't listening until I'm at at least a 7. So either I pump them separately or put lefty in for a world of hurt. Yippie. Let's hope lefty toughens up or righty loosens up.

But I'm pleased that after only a week of pumping I have some results, and once I actually see and maybe hold my babies everything says the rest will happen naturally. I'm trying to relax and focus on my babies, but you can only stare at the sole 3 pictures you have for so long. 15 min 8-10 times a day it doesn't hold your attention the entire duration and give you the relaxing warm fuzzy you need. Especially when you are sleep deprived and stressed about everything you have to do to get ready! I trust that with this good of results this soon that in 3 weeks when I have time to sleep and be with my babies and eat and drink better and pump more consistently I will have something they can actually eat.