National Prematurity Awareness Month: A Vandenberg Airman's birth story

VANDENBERG AIR FORCE BASE, Calif. -- Rocco Picariello, three-day-old son of Capt. Joseph Picariello and Staff Sgt. Erica Picariello, lounges under bili-lights in an isolate November 28, 2011. Rocco, and his twin brother, Enzo, was born 10 weeks early and stayed in a neonatal intensive care unit for six weeks. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Rocco Picariello, three-day-old son of Capt. Joseph Picariello and Staff Sgt. Erica Picariello, lounges under bili-lights in an isolate November 28, 2011. Rocco, and his twin brother, Enzo, was born 10 weeks early and stayed in a neonatal intensive care unit for six weeks. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Enzo Picariello, three-day-old son of Capt. Joseph Picariello and Staff Sgt. Erica Picariello, rests in an isolette November 28, 2011. Enzo, and his twin brother, Rocco, was born 10 weeks early and stayed in a neonatal intensive care unit for six weeks. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Enzo Picariello, three-day-old son of Capt. Joseph Picariello and Staff Sgt. Erica Picariello, rests in an isolette November 28, 2011. Enzo, and his twin brother, Rocco, was born 10 weeks early and stayed in a neonatal intensive care unit for six weeks. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Capt. Joseph Picariello, a 533rd Training Squadron flight commander, walks his almost two year-old twin sons, Rocco and Enzo, down a sidewalk in front of the Vandenberg Child Development Center Sept. 27. Rocco and Enzo were born 10 weeks premature and are now healthy young boys. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Capt. Joseph Picariello, a 533rd Training Squadron flight commander, walks his almost two year-old twin sons, Rocco and Enzo, down a sidewalk in front of the Vandenberg Child Development Center Sept. 27. Rocco and Enzo were born 10 weeks premature and are now healthy young boys. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- (Front to back) Rocco and Enzo Picariello, twin sons of Team V members, Capt. Joseph Picariello and Staff Sgt. Erica Picariello, ride a power wheel monster truck Sept. 14. Rocco and Enzo were born 10 weeks premature and are now healthy young boys. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- (Front to back) Rocco and Enzo Picariello, twin sons of Team V members, Capt. Joseph Picariello and Staff Sgt. Erica Picariello, ride a power wheel monster truck Sept. 14. Rocco and Enzo were born 10 weeks premature and are now healthy young boys. (Courtesy photo)

VANDENBERG AIR FORCE BASE, Calif. -- Editor's Note: November National Prematurity Awareness Month. This is one Airman's story about the birth of her premature twins.

I was 30 weeks pregnant with fraternal twin boys the day before Thanksgiving 2011. It was my first pregnancy and despite the surprise that I was carrying more than one baby -- it had been an uneventful pregnancy. My aunt asked us to visit with family a few hours away in Los Angeles and I thought that would be fine, contingent on what my doctor said. I took my bi-weekly trip up to San Luis Obispo to visit with my obstetrician. He checked my blood pressure and reviewed the notes from my visit with the perinatologist the day before. Based on all of their examinations I was doing great! The doctor told me I could call him at any time if I had any issues and I laughed and said, "I don't expect any." He laughed with me and said, "Me neither." Little did I know that the next 48 hours would irrevocably change my life.

We made it to the family Thanksgiving dinner and both of my sons were active in the womb. People were putting their hands on my belly to feel them do their acrobatics.
This, of course, led to a heated debate on what I was going to name little Baby B. Baby A we knew was going to be named Rocco and the only other name my husband and I could even begin to agree on was River. Many people hated this name and in my heart it wasn't up to debate - he was growing inside of me and I just knew he was a River... but I listened until I got sleepy.

Of course I couldn't sleep when we got home. I was exhausted but I was also huge and didn't have all of my pregnancy pillows with me. I rolled around until about 1:30 a.m. when I grabbed my pillow, let out an exasperated huff and told my husband I was going to read on the couch because I clearly wasn't going to sleep. I made myself a nest on my aunt's white, cloth couch and settled in to read a book. At around 2 a.m., I realized my water broke. I calmly told my husband to please wake up because we had to go to the hospital because my water just broke. He would tell you that the sight of me was hilarious with my big belly out, looking like Winnie the Pooh.

Very quickly after that we were all in the car and after a very brief conversation with Dr. Abraham Tzadik, a long-time family friend, she decided that we were heading to Santa Monica because St. John's hospital had a neonatal intensive care unit and would be our best option. It didn't take us very long to get there; I think I was admitted and hooked up to monitors by 2:30 a.m. The next few hours were a blur, but my husband told me the nurse said I was already four centimeters dilated when I got there. Apparently I had been in labor all day and had no idea! The on-call OB/GYN was on his way and suggested a cesarean section because I was only 30 weeks pregnant and the birth would be very traumatic for my little guys. I agreed and just as I was starting to feel the contractions, the anesthesiologist was in my room prepping me for an epidural. The nursing staff quickly gave me a steroid shot to help strengthen my sons' lungs. I was told they might not be strong enough to breathe on their own after birth.

I was wheeled into the operating room by 5 a.m. and by 5:28 a.m. Rocco Joseph Picariello entered the world. He came out screaming with a full head of hair! A minute later Vincenzo (Enzo) Stewart joined us, also screaming, but with less hair. They both scored high on their appearance, pulse, grimace, activity and respiration assessment so intubation wasn't necessary.

The next six weeks were the hardest, longest moments of my life. My husband went back up north to Vandenberg to save his leave for when the babies were able to come home and I stayed in L.A. spending longs days and nights at the NICU with our preemie sons. Enzo was what they call a, "feeder-grower" meaning, he didn't have any health issues besides needing more time to eat and grow. Rocco, on the other-hand, was born with a heart murmur, sleep apnea and developed sepsis during his stay. At one point he had to be limited to IV nutrition completely. His skin went gray and pallor; his breathing was shallow and choppy. I remember spending hours watching his monitors, taking comfort in the steady, rhythmic beeps that I knew meant his body was working. Every time he'd stop breathing in his sleep and his blood-oxygen level would dip too low, the monitors would blink and beep like crazy and tears would swell-up in my eyes. He was what they called a "self-resolving" apnea case meaning that though he would stop breathing, he would start again quickly without any doctor or nurse intervention.

While most parents were worried about breastfeeding or bottle-feeding schedules, I was worried about how many milliliters of breast milk my sons' tiny stomachs were digesting via a gastrostomy tube. They were too tiny and weak to even attempt breastfeeding for several weeks. While most babies gained pounds every week, we celebrated gaining grams. Every day I sat next to them, watching their tiny bodies fight against the tubing and wires and would long for the day they were healthy and free.

Six weeks later, their bodies strengthened and they gained enough weight to come home. Though the battle in the NICU was over, they still had a war to fight. At six weeks old they were both under six pounds and meeting developmental milestones of brand new babies. They had under developed immune systems, a poor suck/swallow/breathe reflex and who knows what kinds of other issues stemming from prematurity.

More than two dozen fevers, a dozen trips to the emergency room and a bout of pneumonia later, my husband and I are blessed to have two healthy 2 year old little miracles literally running our lives. (Side note: For those of you wondering, Enzo wasn't named for about two days. I took one look at him and realized he wasn't a River.)