Before and after

It's been 2 months since my tummy tuck, and 6 weeks since I had to undergo emergency surgery for complications. I've finally started feeling back to normal in the last week or two, and apparently I am looking back to normal, too: On Thursday my surgeon told me that my swelling is just about gone! Time to post the much-requested "before and after" (and after!) pics:

Left: 4 weeks pregnant with quadruplets
Center: At same weight, a year and a half after delivery
Right: 8 weeks after going in for repairs

Complications

Thursday night, I did something I rarely get to do: I sat down to watch a movie with my parents after the kids went to bed. During the show, I started feeling like my stomach was becoming rather hard and swollen, but I thought maybe it was because it was the end of a pretty active day. After all, things had been going swimmingly so far: I was 2 weeks out from my tummy tuck (during which the doctor removed 9 pounds of skin and fat!), and it had already been a week since I had put on my pre-quads clothes and amazed the doctor and his staff by walking into my post-op visit upright (rather than hunched over, as is usually the case after an abdominoplasty). The doc had examined me and called me a "toughie" for how well I was doing after what he termed "the worst thing we can do to you in this office." A few days after that appointment, I was running after my kids in the park and picking them up to pose for a family shot.

So I was surprised that I would be swelling so much and so quickly. I decided to get up, mid-movie, to check out what was going on, and was shocked by what I saw in the mirror: My lower abdomen was so distended that it appeared I was wearing an inner tube around my hips! I called the doctor right away, and after he listened to my symptoms, he said that I probably had a fluid collection, and that I should call the office in the morning so that they could use needles to aspirate the fluid. I asked what I could do between that night and the next morning to alleviate the problem, and he just said to get some rest.

I knew there was no way I'd be able to rest, though. My stomach was quickly growing larger, and I could feel my incision pulling as my skin stretched to accommodate the new bulk. I couldn't lay down and I wasn't comfortable in the recliner, but sitting in a chair or standing up all night weren't options, either. So I decided on the lesser of several evils, and sat down in the recliner with my laptop to ride out the night.

Around 1am, I finally dozed off. An hour later, I woke up in pain from the swelling. Just for an excuse to get up, I decided to visit the bathroom. On my way there, however, I started feeling nauseous. As soon as I got to the bathroom, I laid down on the counter, with my face over the sink, thinking I was going to be sick. The room was spinning, and I was so disoriented. I think that was the first time I passed out. Then I decided to sit down, but instead I passed out again and came to when I hit the ground hard. I laid there for a while, trying to regain full consciousness and figure out what was going on.

After a few minutes, I got up and told Ted what happened. We called the doctor, and he said he'd meet us at the ER. I was so relieved because this is what I'd wanted to do in the first place. Ted woke my parents (thank God, they were still here), and they came out in time to catch me in their arms as I blacked out again. This time, I thought I had died. It was the most peaceful feeling. Then I heard a voice saying, "Just a minute, just a minute," and I realized that my dad was holding me. I got a burst of energy and was able to walk quickly to the car for the half-hour ride to the ER.

At the ER, I threw up twice while they registered and evaluated me; my blood pressure was 70/40. The doctor determined that it was not fluid building up in my abdomen, but blood. He said that, very rarely (and, in his experience, never this long after surgery), a stitch can shear a blood vessel and cause internal bleeding. He said that he needed to perform exploratory surgery in order to find out whether this was the cause of the bleeding. At this point, I would have done anything for some relief, so at 4am I willingly submitted myself to my second surgery in as many weeks.

I woke up a few hours later to learn that an artery had been severed, and that's what had been causing my problems. The doctor was able to find it and close it up using the same incision he'd made during my tummy tuck. I lost a lot of blood (he ordered four units for me), but I hadn't needed a transfusion during surgery, after all. I stayed at the hospital another 24+ hours to heal up a little and make sure that I didn't need a transfusion before leaving. Thankfully, I recovered very well and was able to come home with all of my own blood this morning!

I still feel very weak, and my incision is very sore, but the doctor says that I should be back on my feet quicker than last time (since there was not any cutting of muscle in this surgery). My parents are here for another couple of days, and I'm hoping that I can get my energy back during that time. Please pray for me to make a quick recovery, and for Ted and my parents as they take over childcare duties in the next few days. We did not foresee this scary situation, but we are so glad for God's timing in this matter. It is perfect, all the time!

The leftovers

When you're pregnant with quadruplets, the only thing you really care about is getting those babies here safely. For me, that meant doing everything my maternal-fetal specialists recommended, including gaining a grand total of 80 pounds over the course of my 33-week-plus pregnancy. From the start, the doctors worried that my 63-inch-tall frame would not be able to accommodate the babies for as long as it needed to, but—as we all know—the Fab Four ignored conventional wisdom and made room. The five of us grew and grew and grew, and on the day I delivered, my waist measured 57 inches around:

More than ready for my C-section!

After the babies were born, my body did its best to remember what it used to look like. Indeed, on my very first day as a mother, I lost a whopping 35 pounds—fully half of which was babies! Within 5 months of the birth, I'd dropped another 35 pounds without even trying (call it the no-time-to-eat-or-sleep-because-I have-quadruplets diet). Now, 13 months after losing the first 70 pounds, I am actually back to my pre-pregnancy weight—but you certainly can't tell by looking!

On the day after I found out I was pregnant (left), and
at the same weight exactly 2 years later—pinching
and lifting my extra skin (center) and not (right)

Yep, carrying that much baby does a number on your midsection. The pregnancy twisted and rotated my pelvis (a condition that took 6 weeks of thrice-weekly chiropractor visits to fix), and my belly button is herniated. On top of that, my abdominal wall no longer connects in the center, which makes my belly protrude as if I were still pregnant. As for my skin, it looks like a big, deflated balloon—and I suppose that's exactly what it is. The stretch marks extend all the way up to my ribcage and around my sides, but they're nothing compared to the handfuls of wrinkly skin that hang from my belly.

What's really frustrating is that no amount of sit-ups can repair the damage to my muscles, and the more weight I lose, the more excess skin I have. In fact, I've been told by several doctors that, if I ever want to look "normal" again, I have only one option: a tummy tuck.

I never thought I'd consider plastic surgery, but I also never imagined that my body would be asked to do what it's done. And after nearly a year and a half of watching my post-quad body take shape, I know without a doubt that I do want to look normal again. Not just that—I want to feel like myself again.

So I've decided to take the plunge: On Wednesday morning, I am scheduled to undergo a circumferential abdominoplasty (look it up if you want to know how this is different from a regular tummy tuck). My mom is staying with us to help with the kids while I recover, Ted is taking some time off work to take care of me and help my mom, and a few friends and family members are graciously volunteering their time to fill in the gaps. If all goes well, I should be back on my feet after a week, and back in the trenches a week or two after that.

I'm a little (okay, very!) nervous about both the surgery and the recovery period, but I'm also getting more and more excited about the fact that I am so close to having something resembling my old body back again. After all, I already have four beautiful reminders of my extreme pregnancy—why hang on to the not-so-lovely leftovers?

Mi bella familia: Ted and I with
(l to r) Lucia, Isaac, Jude, and Dahlia

They're here!

We are proud to announce that the Fab Four made their debut this morning in the following order:

Isaac Nehiel at 8:40am, 4 lb. 11 oz.
Lucia Celeste at 8:40am, 4 lb. 5 oz.
Jude Wesley at 8:41am, 4 lb. 15 oz.
Dahlia Solis at 8:41am, 3 lb. 9 oz.

Ted got to see the babies in the resuscitation room while they were putting me back together, and then we were able to go up and see them in the NICU after I got out of recovery. They are all on CPAP machines for the time being to help them breathe, but otherwise they are doing great (as am I). I'm pretty sure they're super-cute, but it's hard to tell under all of those tubes and wires!

Thanks so much for all of your prayers this morning, and please keep them coming, as the nurses say that it's not unusual for preemies to backslide a bit in the first couple of days. Also, please be aware that the hospital staff has advised us that visitors are not a good idea until we can be sure that everyone is stable. For now, I am trying to rest as much as possible, but I'll keep everyone posted on how we're doing and will upload pictures after I've had a chance to go through them.

What a wonderful Christmas this is turning out to be!

It's go time!

Amnio results are back, and Dr. S says there's only a 5% chance that Baby A will need ventilation once he's born. This is a good sign that the other babies' lungs are also developed enough to function properly outside of the womb. Therefore, in the interest of getting little Baby D out of there before she gets into any trouble, I will be going into surgery tomorrow morning at 8am. That's right, folks: We're having some Christmas Eve quads!

The timing certainly couldn't have worked out better, as my parents flew in yesterday to spend Christmas with me, and my brother and his girlfriend are flying in tonight. I am beyond thrilled that my whole family will be here for the big event! Please pray with us that the babies are born healthy and stable, and also that I come through this riskier-than-usual C-section with no complications so that we can all enjoy our precious time together before my family flies back to Texas at the end of the week. Tomorrow promises to be hectic, but we'll post names, weights, and all that good stuff as soon circumstances allow!

What a difference a day makes

To everyone who prayed for my mom and me yesterday, thank you! I know that, without your intercession, I might not have been able to share with you today two pieces of great news:

First of all, my mom's surgery yesterday went perfectly. Not only that, but the sentinel node biopsy indicated that the cancer has not spread—HALLELUJAH! I was able to talk briefly with her this morning, and she sounded pretty good for someone pumped full of morphine. As I understand it, she should be going home later today to begin the healing process. Let's pray for a quick recovery so that she and Dad can fly up here when the babies come!

Secondly, the babies continue to cook ... despite giving us a big scare yesterday morning. It all started after I got another bolus in the middle of the night because I was once again having too many contractions. When Dr. E saw me in the morning, he told me that we were hitting a wall as far as boluses go and, since my contractions were becoming uncontrollable, he'd advised the nurses to get ready for some babies. Not long after he left my room, I began to feel very hot. The nurse turned on the fan and that helped, but I was still very uncomfortable. I started to feel like I was going to faint (which I never do) and no change in position provided relief. When I got up to use the commode, I thought I was going to pass out, so I called the nurse. Then I started having serious pain with my contractions. The doctor came back, they took away my food and drink, and the nurse drew blood to prepare for a possible C-section. I called Ted and told him that he needed to come now. The resident did an ultrasound to make sure the babies were okay (they were), but I was in so much pain that I didn't even open my eyes once to peek at them! The doctor then noted that I was a little dehydrated, so they increased my IV fluids. I think this must have been the problem because shortly thereafter my symptoms subsided and I began to feel more "normal." By the time Ted arrived, things didn't look so urgent, and he ended up sitting in my room all afternoon as I slept (I guess those big contractions really wore me out or something). By evening, my uterus had been quiet for several hours and it was clear that the crisis was over.

This morning I feel completely back to normal, which is good since the doctor just got done telling me that he really thought he was going to have to cut me open yesterday. He also told me that if I can hold out 2 more days (until the 30-week mark), he'll give me a B grade. If I can wait until 32 weeks, I'll get an A+. Those of you who know me well will know that this is exactly the type of motivation I need; I've always been a straight-A student and I certainly don't want to start breaking the pattern now! Plus, we still don't have names for the boys—I guess we'd better get on the stick, huh?

Uncertainty is the only certainty

Disappointingly, I believe that I am already approaching the limits of mag therapy. Why? Well, when I woke up this morning, my nurse informed me that I'd been administered yet another bolus in my sleep because the one I got last night just didn't do the trick. And then during my ultrasound this afternoon, the resident casually asked me what would be my "happy place" (weeks-wise) to deliver these babies, as if she were fishing to see how I would feel about going earlier than originally hoped. I answered that, although I've always wanted the babies to wait until at least the first of December, my mom's surgery and recovery time is pushing that wish back to mid-December now. It will be interesting to see if the doctor drops any more hints about an imminent delivery tomorrow. Regardless of whether the quads come next week or a month from now, I am quite anxious to see what their estimated weights are when they get scanned on Monday!

I am also very anxious about what tomorrow holds: My mother is going into the hospital early in the morning to get prepped for her double mastectomy, which is scheduled for around noon Eastern time. I wish so much that I could be there with her, and I am sick with worry about how her surgery will go (it's supposed to last 3 to 4 hours). Would you join me in praying for her tomorrow and also during the next couple of weeks as she recovers at home? We are hopeful that the mastectomy will get all the cancer and that she won't need further treatment; if all goes well, she should be well enough to travel here within a couple of weeks, if necessary. Whether we get good news or not so good, I am so thankful that she was able to fly out here last weekend to keep me company, help me feel a little pampered, and see in person how HUGE I really am—I absolutely dwarf her!

Suzy's big adventure

As most of you know by now, I came home yesterday around noon. What most of you don't know (because I forgot to include it in my last pre-op post) is that my mom was able to take time off to be with me for my surgery! Ted and I were so glad that she could come; it was exactly what I needed in order to feel completely serene and prepared. She flew in on Thursday afternoon and we did a little last-minute shopping to make sure I had everything I needed for my little "vacation." Then she stayed up with me until midnight so that I could eat and drink until the very last minute (I knew the babies would be so mad at me in the morning when I wasn't allowed to eat breakfast or even have a sip of water, so I wanted to keep them happy for as long as possible).

After a great night's sleep, I was completely ready to go. I got a nice surprise in the triage room when quad mom Jen showed up. She offered some firsthand advice, encouragement, and a prayer, all of which were greatly appreciated. Shortly after she left, they wheeled me into the OR (a little earlier than expected, but I didn't mind). They gave me my epidural and then did a quick ultrasound to make sure all the babies still had heartbeats (they did). The first epidural didn't take, so they gave me another one. Because my uterus had grown so much in the four days since my last appointment, the doctor had them wheel the ultrasound machine back in so that he could see where the top of my uterus was now, to verify that he could still get away with a horizontal cut rather than a vertical one (he could, whew!). The resident who was assisting him commented that I am measuring at 20 weeks, 7 weeks ahead of singleton schedule. Because of these detours, the actual TAC didn't get underway until probably closer to 2pm.

The rest of the procedure, which lasted a little over an hour, seemed to go off without a hitch. I had no pain from the actual surgery, although I did have what they call "referred pain" in my upper arm (not pleasant, but not the worst thing in the world). When all was said and done, the doctor told me that my uterus was "very conducive" before heading to the waiting area to tell my family that I'd lost only 6 tablespoons of blood (fantastic, considering how much the babies need every ounce of blood in my body) and that I had "the perfect anatomy" for this type of procedure (I'll take that as a compliment).

I was in recovery for about an hour, during which we got to see another ultrasound of the babies, kicking around and being more active than ever. I used the morphine pump a few times to relieve the burning sensation in my incision, and then I was wheeled to Room 237, my home for the weekend. I clicked the morphine pump once more (kind of out of habit, I think); I didn't have to use pain meds again for the rest of my stay. Mom stayed with me that night, and it was so nice to have her there! She's had several surgeries (including two C-sections) herself, so it seemed that she knew exactly what I needed when I needed it. Neither of us got much sleep due to the nurses coming in to check my vitals so often, but I was nevertheless glad to be in such a great hospital.

On Saturday morning the nurse took out my catheter and IV, and told me to call her when I needed to use the bathroom so that she could help me get up. Well, I was so uncomfortable in the bed that I called her before I needed to use the bathroom, just so she could show me how to get up and walk around the room. It felt so great to stand up and sit in a chair! The nurse was amazed and thrilled that I had started walking around so soon of my own volition. After that, it was just a matter of making sure that my temperature and blood pressure stayed down (they did) and that all my "systems" were back in working order (they were). I got plenty of rest on Saturday (listening to The Beatles on the iPod, watching Tootsie on the in-room DVD player) and made sure that I did a lot of walking around (which was much more comfortable than laying there, anyway). I got another nice surprise when Kristen stopped by to visit (after a big detour to the main St. V's hospital, HA!). Ted stayed with me that night and took me home when I got discharged on Sunday.

I won't see the doctor again until the 15th, which means that I won't see the babies until then, either. They definitely aren't letting me forget about them, though, considering how much my belly seems to have grown in the past few days. Hopefully my incision will continue to heal in record time so that I have minimal discomfort in the growing days ahead. I am thankful that everything went so well, and also that I had the chance to see the hospital and meet the wonderful staff. Knowing that I will be so well taken care of will surely make my inevitable return to the hospital much less stressful. Let's just hope it's not for a long, long time!

The surgery went great!

I thought Ted would have to post in my stead to let everyone know how things went today, but it turns out that I am feeling pretty good, post-TAC. Later this week, I'll fill everybody in on the details of the day, but for now I just wanted everybody to know that I am doing very well and my doctor says that the surgery couldn't have gone better. I am glad to have it behind me, and I cannot express how thankful I am for all your prayers and encouraging words in the past few days. If everything keeps going well, I'll go home on Sunday.

It is scheduled

I will be undergoing the aforementioned transabdominal cerclage (TAC) procedure on Friday at 1:30pm. It actually wasn't that hard of a call to make after I decided that I just cannot ignore all the good outcomes that my doctor has had with dozens of triplet/quad pregnancies. Plus, I figure that if I didn't go through with it and the babies came too early to have a chance at a normal life (or even at life, period), I would always wonder whether things would have turned out differently if I'd had the TAC.

Something else that made my decision a little easier was the opportunity I had to talk with a wonderful triplet mom named Linda (thanks for the contact, Christine!). She had the procedure done a few years ago with the same doctor and was able to answer a lot of my questions (most of which seemed too trivial to ask the doctor himself). I am all about studying up and having all the information beforehand, so my chat with Linda really set my mind at ease. And hearing about her once-tiny babies and how well they're doing three years on was really encouraging. I hope that a couple of years from now I can share my successful quad pregnancy story with a newbie!

In other news, I had my 12-week appointment with the doctor this morning. I got a full first-trimester screening, which means I got to look at my babies for a whole half-hour! For those keeping track, they now range from 5.5 to 6 centimeters in length (crown to rump). The ultrasound tech was excited when she stumbled upon the view below, which shows all four of them in one shot. She says not to expect it to ever happen again:



Part of the screening involved measuring the skin folds on the back of the babies' necks. To do this, the tech had to get a profile shot of each baby. To my delight, while she was measuring the distance between the neck muscles and skin, I got to get a good look at the faces of each of my babies. I think that Baby A looks just like Ted:


And Baby B looks like my brother did when he was little:



Babies C and D were harder to pin down, looks-wise, but it will be interesting to see if my first impressions of the other two babies turn out to be accurate. It's so exciting to see them looking more and more like little individuals!

My next ultrasound will be right before they wheel me into surgery, and then I'll have another one a few minutes after the procedure to reassure me that they all made it through okay. I will probably be too out of it to post, but Ted assures me that he will take advantage of his contributor status in order to let everyone know how things went. If all goes as planned, I'll be back in posting form by early next week!

This is where it starts to get hard

I had my second visit with the maternal-fetal specialist a couple of days ago. As the first order of business, we got to see the babies again. No measurements this time; the tech was just looking for heart tones. She focused on each baby individually and showed us the flicker of the heartbeat. It was very clear that the kiddos have done some growing in the last couple of weeks; we could see them moving around and even waving at us! It's amazing to think that there's all that movement in my body, and yet I can't feel any of it. I am sure that I will long for this kind of oblivion once I have eight tiny feet (and eight tiny fists) vying for room in my torso!

Here are a couple of snapshots from the latest ultrasound (the babies are shown at 10 weeks gestation):




The second part of the visit was less fun, as it involved hearing a little more about transabdominal cerclage (TAC). The TAC is an optional procedure in which the uterus is temporarily removed (with babies in it!) via a C-section-type incision so that a band can be placed around the top of the cervix. The surgery has serious risks (including, rarely, the loss of one or more babies); however, it appears that outcomes for triplet pregnancies are encouraging (there is not much data on quad pregnancies, for obvious reasons). According to my doctor, women who have the surgery are less likely to experience the degree of preterm labor that results in a much-too-early delivery. The babies will come early regardless, of course, but this could lengthen their time in the womb (which, in turn, would mean less time in the NICU—always a good thing).

If I decide to have the procedure (and I'm pretty sure I will), my surgery will be August 1. My doctor says that I can expect to be in the hospital for two nights, and then at home for a week. Please pray for me as I face this scary prospect, that I may have peace about the decision I make. My main goal is to do whatever is best for the babies.

To end on an up note, Ted and I will celebrate our eighth anniversary on Tuesday. That's two years of marriage per baby—and you guys thought we were waiting too long to have kids!