CLIMB

My name is Brina


My name is Brina and my husband is Eric. We began dating in 1992 and got married in 1997. We didn’t begin trying to conceive until the fall of 1999, as we wanted to make sure I could stay home with the baby. We also knew it might take awhile for us to get pregnant because I never had regular cycles. I would go a year or more without having one. I was finally diagnosed with Polycystic Ovarian Syndrome (PCOS) in the fall of 1995. Then, in the fall of 1996, after a routine Pap test, it was determined that I had cervical carcinoma in situ. After a biopsy, it was increased to cervical cancer, class 5 stage IB. A few days later, I had surgery to remove it. We were so thankful at the time that it was all removed and that the cancer had not spread.

When we decided to try to conceive, we began seeing my OB/Gyn. He put me on Provera to induce a cycle, then on 50 mg of Clomid. After that first cycle, my progesterone was .04, a very low number to say the least! We decided to move on to a Reproductive Endocrinologist (RE). My first appointment with him was in May of 2000. We continued on Clomid until we got to 250 mg a day. It was impairing my vision and it wasn’t making me ovulate. It just didn’t work for me.

Our RE wanted us to try the injections to get pregnant. He said that it usually works very well for someone with PCOS. I began the shots (Gonal F and Pregnyl) and was inseminated on January 19, 2001. I took a home pregnancy test on January 30, 2001 (just 11 days after the insemination) and it was positive! We were ecstatic!! We had started to believe that I would never get pregnant, so this was overwhelming for us. I had blood work done that day (HCG 154), four days before I should have had a “missed period”, and then again on February 1, 2001 (HCG 459). My numbers looked high then, but our RE wouldn’t speculate about multiples just yet.

We went in for our first ultrasound on February 21, 2001, when I was approximately 4-1/2 weeks pregnant. I remember the technician being very quiet. I asked her if she saw two. She said that she saw four sacs and that she needed more time to scan before talking to us. Eric looked like he was going to throw up. I started to cry. The technician showed us all four of our babies and their placement within my uterus. She named them A, B, C and D. A was very low, B was mid level on the right side of my uterus, C was high and D was in the middle of my uterus on the left side.

During our pre-cycle injection class, our RE discussed with us the possibility of multiples. He said that because of the past surgeries on my cervix, I would not be able to carry supertwins and that Eric and I needed to discuss the possibility of selective reduction prior to starting the injection cycle. This was immediately brought up after the ultrasound was completed. You could see it on his face…how grave the situation was. He said that we must consider Multifetal Selective Reduction, in order to preserve part of the pregnancy.

I remember feeling outside of my body that night. I couldn’t even look Eric in the eye. I felt like I couldn’t breathe. I wanted to die. Why me? Why did this have to happen to us? We are good people. We are spiritual, we love each other, we are married, we have a nice home, can financially afford a family, and we pay our taxes. We were perplexed about how this had happened and wanted to know why us.

I stayed home for the next few days. I couldn’t bear to tell anyone except a couple of close friends and family members. We ended up telling everyone about what happened, but not until later, when we could digest it ourselves.

My first appointment with our perinatologist was on March 6, 2001. He concurred with our RE that having the reduction was the only way to continue with the pregnancy. Therefore, we scheduled the reduction for March 29, 2001 with a doctor in Philadelphia. That was the closest doctor who could perform the surgery (we live in St Louis, MO). We had to actually get on a plane and travel to a different city/state to have this done. It was so hard to make myself get on that plane. I was so sick the entire flight. In addition, people kept asking me how far along I was because I was so huge. I was only 12 weeks, but because there were four babies in there, I looked like I was 40 weeks.

We arrived at the office for the reduction and were made to wait for 45 minutes until the doctor was out of his meeting. Can you believe that? We are there to have two of our babies reduced and he’s late?!? We were out of our minds. I kept thinking that I could just run away. Leave the office and Eric and never look back. I was so sick to my stomach. I wanted all four of my babies. I didn’t want to kill them. I kept wishing that I could take two out and save them for later. I wished that all of this was a sick joke and that I could even go back to just trying to conceive again. I just didn’t want to kill my babies.

Finally, the doctor arrived and we began the procedure. All involved were cold to say the least. I really didn’t feel much compassion from the doctor or any of the nurses. Maybe they have to act that way to save a little of themselves because of the work they do. I didn’t care much about that anyway as I had my husband there stroking my hair and telling me how much he loved me. That is the only thing that kept me sane those minutes during the reduction.

They scanned my uterus for the placement and to see if all of the babies were still ok. They decided to take Baby B and Baby D because A and C were the farthest from each other. I had always known in my heart that A and D were boys, and B and C were girls. I was right about A and C, so I’m sure I was right about B and D. I also had a feeling they were going to take Baby D. For some strange reason, I had an immediate connection with Baby D because he was so alone on the left side. I loved him from the moment I saw him on the ultrasound screen. I loved all of them, but I did have a special place for him in my heart. It was extremely hard to let him/both of them go.

The needle was huge but the mental pain is much more intense than the physical pain could ever be. It looked like an amniocentesis needle. They placed it in the baby’s heart and injected it with potassium chloride. It just made the baby’s heart stop. I can say this now, but I don’t know if anyone will believe me, but…I swear, I could tell the moment they died and left my body. I just felt it somehow. I cried so hard. It was almost guttural. I had never felt so sad in my whole life. After it was over, I wanted to get out of there as fast as I could. We had to pay though (out of pocket) and that took awhile. We went back to the hotel and I slept most of the afternoon. We flew home the next day.

I never bled or had contractions after the reduction, but I did have to go for an ultrasound one week after the procedure to make sure the remaining babies were ok. The radiologist came in with the technician and she said she didn’t see the heartbeats of two of the four babies. I had to explain to her that we’d had a reduction and that the information should be in our chart. This wasn’t an isolated occurrence though. I felt as though I had to repeatedly tell the staff that I’d had a reduction. I felt it was very insensitive.

We finally felt as though things were going smoothly with the pregnancy, and that we were “out of the woods”. We were gravely wrong.

I had my last regular appointment with my perinatologist on May 30, 2001. He told me that my amniotic sac was funneling into my cervix and that I needed to stay off my feet. He also sent me home with orders for a home uterine monitor and Indomethacin (to take Wednesday and Thursday, then every other day after that). The monitor didn’t arrive until Thursday. I wasn’t having very many contractions according to the monitor, but by Friday, I wasn’t feeling well. I told the nurse with the home uterine monitoring company that I wasn’t feeling well and that I was feeling a lot of pressure. She told me that it was probably because I was constipated and to drink more water. I had already been drinking a lot of water, which I do while pregnant or not. I felt that they must know what was going on. I went to bed that night still thinking that I might be having contractions, but trusting the medical personnel that was “helping” me.

Saturday morning I woke up at 6 a.m. I slept horribly. I had pains in my stomach all night off and on. To someone who had been pregnant before this would be a huge red flag. However, I wasn’t sure what they were and thought I’d see if they were contractions and show up on the monitor this time. I strapped it on and within 20 minutes, the water for Baby A broke. It was a huge gush of water and my mucus plug dropped to the floor when I stood up. Eric immediately got dressed and helped me put my robe on. We got in the car and he drove us to the local hospital.

We should have kept driving to the larger hospital that is 25 minutes away. I knew that as soon as we got in the door. I felt like they didn’t know what to do. They wouldn’t explain to me what was going on. I felt so terrified. My perinatologist was contacted and told them to have me transferred to the larger hospital. I was transferred by ambulance.

The ambulance ride was probably one of the worst experiences of my life. It was bumpy and loud. I thought the babies were going to come out at any time. The paramedic kept checking me because I was still contracting. I was terrified. I don’t know that I’ve ever been so scared in all of my life. Eric had to drive separately so he’d have a car at the hospital. I felt so alone.

Once we arrived at the hospital, they put me into a labor and delivery room. I was given magnesium sulfate to stop the contractions and they put in a catheter. My bladder emptied almost 2 liters of urine. My uterus kept contracting all afternoon until they gave me an epidural. That finally slowed things down. I was so groggy from the magnesium sulfate that I slept most of the day. All ultrasounds and monitors said that both babies were fine.

That night, I sang to my babies. It was as though I knew Baby A was going to die. They checked me that morning with an ultrasound and Baby A had died. My cervix dilated and Baby A’s cord prolapsed. I remember one of the residents tell me that he could feel feet in my birth canal. He looked at me with such sympathy, but I already knew he was gone. I delivered Bradley Jacob at 8:31 am on June 3, 2001. He was 15.2 ounces and 11-1/2 inches long. They left the placenta and cord in order to stave off labor of Baby B.

I am grateful for having delivered him naturally though because that was the only time I will ever experience that. During the delivery, I kept telling the nurse that I wanted to see him. I was so scared that they would take him away and that I wouldn’t have a chance to see him. After the delivery, she talked to us about how he looked. She said that very premature babies have very thin skin and that he was bruised from his trip down the birth canal.

He was so tiny, but so very perfect in everyway. We counted all 10 fingers and toes and kissed him all over. He was so beautiful. He even had a little hair. We held him for about 45 minutes before the nurse took him away. They didn’t want me to get too upset because I was still pregnant and my cervix was still open. If my cervix closed, I could possibly carry the other baby longer. I didn’t even cry. I was so excited to see him. Eric was very distraught. I think it was harder for him to see Jacob than it was for me.

That next week, my cervix did close and I had a rescue vaginal cerclage placed. I was transferred to the Antepartum unit and was placed on complete hospitalized bed rest. I finally got shower privileges after being in the hospital for two weeks. Eric went back to work after the first week, but he came to see me every night after work and spent the night on the weekends. Therefore, I spent my days watching bad TV and talking on the phone or to visitors. I was just so happy that I still had one baby who was ok.

At week 24, I had to be transferred back to labor and delivery. I was contracting again. I had a PIC line placed and was on Magnesium Sulfate again. I had some horrible nights of labor and was in a lot of pain, but my water never broke. The night of June 25th, I was having some mild contractions and my water broke. The baby’s heart rate dropped with every contraction, so they decided to do an emergency c-section. Emme Renee was born on June 26, 2001 at 7:44 am. She weighed 1 pound 8 ounces and was 12-1/2 inches long.

The transport team from the local Children’s Hospital was in the delivery room and took her as soon as she was out (after she peed all over the doctors!). I was able to see her for a second before they transferred her to Children’s. I reached my hand into the incubator and she grabbed my finger! It literally took my breath away. I choked. I was not prepared for her to do that. I guess I expected her to lie there like Jacob did. She was moving and alive! It seemed like forever for them to take out my rescue cerclage. It had torn up one side of my cervix during my labor. Finally, I was back into my room and Eric was able to walk over to Children’s Hospital to see Emme.

When Eric returned he told me all about Emme and how tiny she was. He was visibly upset and I could tell he was scared. Honestly, I was relieved that she was no longer inside of me. I felt like my body killed all three of my other babies and now with Emme outside, it couldn’t kill her too.

I was released after three days and we worked ourselves into a routine. Eric went back to work and I began, what I thought would be a long few months until we could bring her home. That isn’t what I thought at first though. I really didn’t know what to think about her coming home, but after talking to the doctors during her second week, I really started to believe that she would make it. She had no brain bleeds and her PDA (Patent Ductus Areriosus) had closed. She was on a ventilator, but was taking quite a few breaths on her own.

On July 8, 2001 (she was 13 days old), she opened her eyes for the first time. Her right eye had begun to open several times the past few days, but never fully opened. We were so excited. I cried though, because I would have to look into her eyes and then leave each night to go home. It seemed like it was harder to leave that night. We got home at about 8 p.m. and got ready for bed. We called her nurse that night at about 10:30 p.m. to check in. She told us that every thing was fine and that they’d found Emme had gained weight during the nightly weight check.

The phone rang at 1:38 a.m. I knew immediately that something was wrong. Eric didn’t even have to tell me. We threw some clothes on and got in the car. Eric drove as fast as possible and I begged God to save her. I cried repeatedly, “Please don’t take her too!” I felt like we’d already given up so much. How could God take her too? I really didn’t even think it was possible. I never imagined such cruelty.

We arrived at the hospital and had immediate trouble getting in. We had to wait for a security guard to double check that we actually had a child in the hospital.

When we got to the NICU, Emme’s resident doctor was waiting for us. He met us outside of her room. He said that her right lung had ruptured and that they had tried a chest tube but it failed. Oxygen kept coming out. He said that he was sorry, but she was not going to make it. I remember asking him if he was sure. I was in disbelief. I didn’t believe it until I saw her. Her skin was gray and her heart rate was in the 60-80’s. I told her that Mommy and Daddy were here and that we loved her. The doctor asked us if we’d like to stay there or if we’d like her to be brought to a private room. We said that we wanted the private room. They took us there and we had to wait for them to bring Emme to us. I kept asking the nurse what was taking so long. She finally left to see where Emme was. When she came back, she was holding Emme in a receiving blanket. Without tubes and wires all over her face and body.

She placed Emme in my arms and I began to cry. I felt as though I would never stop. I wanted to die along with her. I remember telling her that we loved her very much and that it was ok to go. I gave her to Eric and it was then that I heard her last breath. Eric still isn’t sure that that’s what we heard, but I am. I heard it. I knew that’s when she died. The doctor and nurse came in about 15 minutes later and pronounced her dead. It was 2:30 a.m.

We took turns holding her while the other cried. I had never felt such sorrow and have never felt whole since. Emme’s nurse helped us bathe her and put on clothes. We even took some photographs. We didn’t want to at the time, but now I’m glad we did. They are hard to look at because she had already passed away, but I’m still glad to have them. After her bath, I kissed every part of her body. Her little calves, her tiny neck, ears, her tummy, palms/soles of her feet, and each finger and toe. I sang the babies’ song to her, “I Will” by the Beatles. My favorite part of that song is “Love you whenever we’re together, love you when we’re apart”. The nurse made a plaster hand and foot cast for us and got her handprint and footprint done. We also took a small clipping of Emme’s hair. I’m so grateful for those hours we spent with her. I know now that some grieving parents get much less. We were able to keep her with us until 6:15 a.m.

Eric’s Dad and stepmother arrived at 6:30 a.m. and helped us leave the hospital. I felt like my legs were going to give out at any moment. We drove home in silence. I went straight to bed and didn’t stop crying until the Xanax that my perinatologist prescribed took over. Eric and his Dad went to our local funeral home to arrange for Emme’s body to be picked up.

The following day, Eric and I went to the funeral home to identify Emme’s body and to pick out an urn (something no parent should ever have to do). I was extremely distraught, but was elated to see Emme again. Her body was so cold. I knew she was gone, but didn’t want to leave her little body. I kissed her all over again and told her how much we loved her. It was so hard to leave her again.

We were able to pick up her ashes on Friday. I finally felt like she was with us. We brought her home and have felt so grateful ever since for being able to have her with us. Jacob’s ashes are spread at Memorial Grove here in St. Louis, but that doesn’t stop me from wishing he was here at home with us.

It’s been two years this week, since Emme was born. I guess the months of June and July, for the rest of my life, will be hard. People have forgotten, or at least they don’t tell us they remember. Only one family member remembered Jacob’s birthday this year. It hurts, but I guess that’s what I should come to expect. I sometimes think that they don’t say anything for fear that I will get upset and cry. However, that’s what heals my wounds. How can I get them to understand that?

Somehow, after all of the trials of infertility, we got pregnant on our own three months after Emme’s death. During that pregnancy, I had an abdominal cerclage placed, was on bed rest for almost 6 months, and was on four different Tocolytic drugs to stop the constant contractions. Not to mention gestational diabetes, which required three insulin shots a day! Jonathan Quinn was born at 33 weeks due to a thinning of my uterine wall and possible rupture of my uterus. We will never forget how lucky we are to have him.

I am still angry with God. Our children’s deaths have permanently changed the way I view organized religion. I know I will never feel the same. I am a changed person who lives with the pain. It is not as intense as it once was, but it will never go away. It’s just something we’ve learned to live with. I talk to God, and have come to believe that it was not God that “did this to us”. Personally, I can’t fathom that God could be so cruel. Nor do I believe that it was God’s will or that it was fate/meant to be. I believe that it’s just nature. My body has trouble handling one baby, let alone four.

I hope that one day, I will be able to talk more about our babies without the constant guilt and feelings of utter sadness. It truly helps me to share my experiences and to do special things in memory of my quadruplets. Each year, we donate four blankets, four disposable cameras, and four handprint kits to the Children’s NICU Bereavement program. It is something that means so much to me. I am helping to make sure other bereaved families have special keepsakes if their baby (ies) dies too. I also plan to interview myself for a future CLIMB newsletter in the “Remembrance” section that I write for. Lastly, we recently decided to name Baby B and Baby D. It has helped me so much to give them that. It truly makes them part of our family. They deserved that, as do we.

In memory of Bradley Jacob (born still 6/3/01), Beth Danielle (SR 3/29/01), Emme Renee (6/26/01-7/9/01) and Daniel John (SR 3/29/01).