Farewell

We found the perfect pink casket

On October 29, 2011 we held the funeral for Katya and Ruby.  Katrina's dad conducted the service.  The opening prayer was given by Eric, Katrina's brother. The first speaker was Katrina's mom who also read the book "On the Night You Were Born" given to us by our friend Ali.  The first musical number was performed by our friend Erika.  She sang "Pioneer's Lullaby" (we included the lyrics at the end of this post with a small variation from Erika).  The next speaker was Tonio. Then, we played the song "Mary's Lullaby" from the Children's Songbook.  Katrina played the piano and Tonio the violin.  After the musical number, Katrina decided to say some words even though she was not on the program.  She was very brave.  Following Katrina, her dad closed with his remarks.  Finally, Tonio's mom said the closing prayer.

It was a wonderful service and an appropriate tribute to our girls.  We had great support from family, friends and even nurses and doctors who cared from our girls. Below are some pictures of the pink casket we found for the girls and the two dresses given to us by the hospital bereavement specialist. 

Dresses used for the girls' burial

Viewing setting

Below is a copy of Tonio's talk at the funeral service.  We wrote a little poem titled "Flying Sparrows" that Tonio read after his talk.  We included a laminated copy of the poem inside the girl's casket. 

Farewell (Tonio's Talk)

Huckleberries are a big part of Katrina’s family.  Since before we got married, Katrina would tell me of her yearly family tradition of going to the mountains to pick up Huckleberries.  They freeze them and make all kind of delicious food with them.  The funny thing about these berries is that they only grow in the wild so they are hard to get.  Finally, this past summer, after three years of marriage, Katrina’s family entrusted me with the secret location of their favorite Huckleberry spot.  As you can imagine I was honored and very excited to be part of this tradition.  

Katrina’s dad let us use his Ford Explorer as the road to the huckleberry spot is pretty rough and required an all-terrain vehicle.  After trying a few spots with little success, Katrina decided me to take me to a very remote and inaccessible spot.  There we found a great abundance of huckleberries.  We collected a little more than half a gallon worth of the precious berries.

On our return back home I was trying to turn the car around when I misjudged the distance to a nearby ditch.  Our truck front right wheel fell in the ditch and not even its four by four powers could take us out.  I was getting very concerned because we were so far away from anything and nothing we tried seemed to help. Half an hour later some people riding four wheelers came by. We asked for help and one of them returned for his pickup truck and got us out.   Our quest for huckleberries proved to be quite adventurous which made our huckleberries the more precious. 

When reflecting on our two little girls, Katya and Ruby, Katrina and I could not help to notice the similarities between them and these huckleberries; they were very small, very wild, and very precious.  Also, having them has been quite an adventure full of excitement, uncertainty, fear, and joy. 

Our adventure began in Virginia early this year as Katrina and I started the in vitro process.  Finding out the right specialist to perform this process was an adventure in itself.  Before our move back to Utah, Katrina was implanted with two embryos.  We were told that the possibility of one embryo dividing into twins was very unlikely. However, when we went back to perform our first ultrasound we were surprised to learn that only one of the implanted embryos took and that it had divided into two identical twins. 

After we moved across the country we had other ultrasounds that revealed that our twins were girls.  As we looked into the ultrasounds we could see how one twin was always more active than the other.  We laughed as we saw them kick and move.  It almost seemed like they were kicking each other on the head.  It was there that we began to notice how wild our two little girls were. 

As all of you know, our girls were born prematurely, on October 16.  They caught everybody by surprise.  We are grateful that when they came Katrina was already at the hospital and that a nurse was in the room when Katrina’s water broke.  Two minutes after her water broke came Katya.  The brave nurse was doing her best to help her as she was shouting for assistance.  Immediately a team of nurses came to help as Ruby was making her quick entrance.  Ruby just came shooting with such strength that the nurse barely caught her.  I want to take this time to thank all the nurses that have helped us with the care of our girls.  Words cannot express the gratitude we feel for such love and devotion.  There are two nurses in particular that have gone out of their way to help us: Jennifer and Shelly.  Thank you for taking even your day off to be with us and comfort us when our babies passed. 

Katya and Ruby, while identical genetically, were very different.  As little as they were, we could notice how Katya was the calm one.  She was easy going with the nurses and loved to remain with her legs and arms stretched out.  Ruby was the feisty one.  She would kick and let you know when you were bothering her.  She would get in trouble by getting her feet caught in the gausses or by fingerprinting the medication for her skin all over her body; however, she would almost always remain with her legs bent close to her chest as if trying to stay cozy within her blanket.

During the short ten days that our girls remained with us we learned to love them more than anything else.  They were examples to us of courage, perseverance, and unity.  When our girls passed, they left this earth together, at the exact same time.  One nurse told us that in her 26 years of working there, she had never seen twins leave in that way.  

Our girls also taught us to be less selfish and humble as we seek to accept the will of the Lord.  We are forever grateful for the time we spent with our babies.  Being able to hold them before their passing has become one of the happiest moments of our lives.  

We appreciate the love, prayers and support of our family and friends during this trying period.  We are also grateful for our Savior, His Sacrifice, and for making possible that families can be together forever.  We are grateful for the promises we have received in the temple that, if we are faithful, we will see our daughters again and we will see them grow old. We are grateful for the resurrection that came through Jesus Christ.  

Finally, we are grateful for the strength and peace that we have received from our Heavenly Father.  Katrina and I have been amazed at the comfort that came upon us after the passing of our girls.  We were terribly sad, but also very glad that they were not suffering anymore and that they were with family on the other side of the veil. 

As Katrina and I were thinking about what to say during this service, we decided that we wanted to pay tribute to our girls with a poem.  

Flying Sparrows

Before you were born we hoped to meet

Our two little girls with golden hair

With cute little hands and tiny feet

Skipping and running everywhere.

We prepared and planned for your arrival

We thought we had months before you’ll be here

The entrance you made, caused us to marvel

But coming so early filled us with fear.

You were so tiny, wild, and precious

Hoards of nurses swarmed around

Trying to save you made everyone nervous

While our love for you began to abound

Every day had its highs and lows

We looked at you with so much love

We came every day to say our hellos

You were a blessing from above.

You both had your mother’s nose

Cute as a button it adorned your faces

Your father’s feet and wiggling toes

You were blessed with many graces.

Like the morning dew of the meadows 

Your presence with us was brief

You flew together like little sparrows

We know now that you are at peace.

Farewell Katya and Ruby, farewell our girls

We will miss you fondly, day after day

You will forever be our two precious pearls

Farewell sweethearts, we will not delay.

-Love, Mom and Dad

Flowers from Grandma and Grandpa Jensen

Pioneer Lullaby 

Low, lie low, my dear little ones,
Under the starlight, under the sun.
Under the bluebells, under the grass.
Low, like low as the solemn wheels pass.

Yesterday, yesterday four little feet,
Visions of meadows and wildflowers sweet.
Snowtime and flowertime cover you deep.
Low, lie low as I lay you to sleep.

Blessed, oh blessed the day of our Lord,
Blessed the dead who rise at his word.
Blessed the angels who swing wide the door,
Blessed the time when I hold you once more.

Blessed the time when I hold you once more.

Burial Site

We have already been blessed with the support of many family members and friends. Some of you have even asked us whether a fund should be created to assist with some of the NICU and funeral expenses.  Our friend Emily took the initiative of opening a fund for that purpose through a Facebook application.  For anyone interested, it can be found at the following link:
http://goo.gl/fhnVZ

Thank you.

Saying Goodbye

Ruby and Katya together again

Monday, October 24: My mom and I went up to the hospital that morning. I tried to be there by 11:00 am so we could help change the girls’ diapers. We hadn’t been able to do so the last few days because the nurses were very worried about infection on the girls’ skin due to their open sores. They wanted to give their skin a break from the light. The nurses described that the ointment under the light acts like sun tan oil. It can damage their skin. Ruby was able to come off the light first but Katya’s bilirubin level was too high. That is the level that indicates the amount of jaundice in their skin. The nurses had to start giving Katya and Ruby morphine before they would change their dressings and diapers because they knew with the condition of their skin they were in pain. Tonio and I had noticed that the girls had been especially active and fidgety. It seemed like they had more pain. Ruby had bacteria in her blood that they had to treat with a new antibiotic. They needed to treat it to prevent it from spreading to her brain. This particular antibiotic could make it difficult for the valve in her heart to close. They told us that Ruby’s heart valve had reopened. Katya’s valve had also opened more than it had been the day before. This news was very discouraging. If medication doesn’t work to close the valve the only other option is surgery. Our girls are too fragile to withstand surgery. The valve pumps blood into their lungs. Then the heart has to work harder to pump it out which can lead to congestive heart failure.

Ruby getting a little of mommy's milk

The nurse practitioner, Brenda, told us that the doctors would meet again for their weekly meeting to discuss all the babies in the unit. She mentioned that one of the doctors would like to meet with us after the meeting to talk about future steps.

Katya's incubator and all her monitors

Ruby just loves her name tag!

That evening we met with Dr. Stoddard who is one of the directors of the NICU. One of the nurses told us that he is a stake president. It was comforting to know that many of the doctors shared our religious views. He started out asking us what we understood our girls’ condition to be. Tonio and I both explained our understanding of their condition and complications. He told us about what the doctors had discussed. During their meeting they review all the brain scans, heart ultrasounds, and all the details of our girls. Dr. Stoddard told us that all the doctors agreed that they were just prolonging the inevitable and that our girls would most likely not survive. He said that there have been many medical advances in the NICU field and they could probably keep them alive for some time but questioned whether that was that the right thing to do. The doctors came to a consensus that in their medical opinion it would be best to remove support and let the girls die naturally. The doctor showed us the girls’ brain scans. We could see that the blood was going into the brain tissue on at least one side of the brain. We could see bleeding on both sides of their brains. The doctor mentioned that if the girls were a few weeks older and if they only had one or two of these conditions they might have a chance to survive. Our girls had some complication with almost every major organ in their bodies. Their skin was a very real concern because at any moment they could get more infections. Their bone marrow is too immature to fight off these infections.

Tonio and I shed many tears during our hour plus conversation with Dr. Stoddard. Tonio asked him what he would decide if he were in our position. He told us that he did not know. He said that a few years ago his grand daughter was born premature. Even though he had been a NICU doctor for more than twenty years he said it was very different when it was his own flesh and blood. We wondered what we should do. He gave us counsel to talk about it between ourselves and come to a decision and then take that decision to the Lord in prayer.

We had two nurses come into the room with us. One of the nurses, Kris, told us about her son who was born premature. He was in the NICU for seven months. When he got home they faced many challenges. She said that they spent about 5 days a week at Primary Children’s Hospital. On the other days of the week they had occupational and speech therapists coming into their home. He was almost two years old and he struggled to sit up on his own and he could only say a few words. Unfortunately, he caught pneumonia and his health really declined. They had to come to a point where they had to decide to remove life support. She told us how strong they had fought to keep him alive. She had many priesthood blessing that told her to keep going. Ultimately, they did decide to remove support. It has been ten years since her son passed away. She thinks about him every day. After that she became a NICU nurse. It was nice to hear her story and perspective.

We left the hospital with very heavy hearts. We were not looking forward to making that decision. All along we had prayed for Heavenly Father’s will to be done. We were prepared for him to take them if that was according to his plan. We didn’t want to have to make that choice. We soberly went home. We talked about everything that doctors had told us. We cried. We both mentioned that we felt like our sweet girls were suffering. We felt that it was unfair for them to be in so much pain that they needed morphine to be calm. It hurt us tremendously to see them having to go through these trials and challenges. We decided to withdraw the support. We knelt beside our bed and Tonio offered a very sincere prayer asking if our decision was right. As he prayed, I stopped crying, and I felt peace. Tonio also felt peace and he saw an image of our little family running in a field. We knew the Lord had confirmed our decision to let the girls die naturally. Even though we felt peace we continue to cry and hold each other. We decided to talk to the doctors about our decision the next day and that perhaps Wednesday, October 26, would be the day we would withdraw support. Monday night was a long night.

Tonio helping with Katya's diaper change. We are training him already.

On Tuesday we went to the hospital in the morning. We wanted to spend as much time as we could with Katya and Ruby. We were able to help change their diapers. We spoke with Dr. Contreras about our decision. We said we would like to do it on Wednesday around 10:00 am. They said we could be in a private room with the girls and spend as much time with them as we wanted. Tonio asked her if all the doctors agreed that this is the best course of action. She said that it was unanimous that this would be for the best. We spent more time with the girls and then we went and had some lunch. We came home feeling exhausted.

Helping with Katya's weigh in.

In the evening I was able to help weigh the girls. I got to hold them up above the bed for a few seconds. Tonio helped change their diapers and I was able to swab their mouths with my breast milk. Ruby was making a funny face when I swabbed her mouth with water to clean it. When she is irritated she wrinkles her brow. Ruby was a little restless. Her nurse put her hand on her to calm her. She also tucked her legs under a blanket. That really calmed Ruby. She remained there for a few minutes. As we watched her in the incubator her little leg shot up out of the blanket. Tonio and I just laughed. Ruby doesn’t like to be told what to do. She likes to wiggle and she loves moving her legs and feet. We had our mothers, Ben, and Melissa visit the girls again.

Ruby making a funny face. She doesn't like having her mouth washed out.

Calm Katya. She keeps it cool.

On Wednesday, October 26, we went to the hospital. I wore a pink sweater because it is soft and pink. Tonio wore a nice blue shirt. We wanted to look our best for our girls. We arrived shortly after 10 am. We saw Dr. Minton and he was going over the girls’ status. He confirmed that he was in agreement with our decision. He asked us if we wanted to move the girls into a private room. We said that we did. He told us that when they remove support it may only be a few minutes that they remain with us. Two of the nurses, Jennifer and Shelly, gave up their day off to come and be with us. They had both looked after our girls. They knew that the nurses who were on the schedule to be with us didn’t know us. It was very considerate of them to take the time to be with us.

Holding Katya for the first time.

Our two little pearls

The nurses began with Katya. They had her morphine drip, a heart monitor, and a ventilator. They carried her into the private room. Two chairs were set up so we could sit and hold our girls. They hooked her up to a ventilator and I held her. Katya was wrapped in a cute blanket and had her pink and white hat on. The nurses gave me hand warmers to put around her body so she could stay warm. The girls have been in very warm conditions since their birth. They had to keep the humidity very high in their incubators to protect their skin. It was wonderful to hold her. Her little nose was so cute and it was great to snuggle her close. Next, the nurses brought in Ruby. We decided that I would hold them both first because Tonio had brought his violin to play for them. We thought the nurses would leave and we would be alone but they stayed to watch the monitors and make sure the girls were okay.

Katya Sophia

Ruby Alexandria

Tonio began by playing Cannon in D by Pachelbel. It was beautiful. Ruby squirmed a little bit on the really high notes. She looked so cute. Katya was very calm and peaceful. Originally we had decided not to have family in the room with us. We wanted it to be just the four of us. When the nurses stayed then I thought it would be nice to have our family join us for a little while. My mom was already at the hospital so she came in the room. Tonio played the hymns: I am a Child of God, Families Can Be Together Forever, and I Know that my Redeemer Lives. He also played Mary’s Lullaby from the Children’s Song Book. It was lovely. I think the girls loved it.

Katya compared to Tonio's violin

Tonio playing for his girls. Grandma Jensen came to give kisses.

After Tonio finished playing he sat down and we transferred the girls over to his lap. Our friend, Ali, had sent us a book called On the Night You Were Born. It was very sweet and I read it to our girls while Tonio held them. Tonio had to help me read it because I started to cry. I really hadn’t cried much that day because I was in bliss holding my girls. I also felt great peace from the Lord. Tonio was so tender with them and a little nervous because they were so small and fragile. We joked that they must be Italian because they are Fragile (A joke from the movie A Christmas’ Story). After that we each held one of the girls. We told them that they would have to be missionaries in heaven. Tonio said that we serve missions in our family. I said they could play around a little but then they had to get busy. We told them to say hello to all our family on the other side of the veil. I told Ruby to say hello to my great-aunt Ruby. We knew the girls would be well taken care of by our loved ones.

Proud Papa

The hospital has a person that is in charge of bereavement. Her name is Heather Walker and she lost an infant. She was very helpful and understanding. She was also with us throughout the day. She took pictures of us holding the girls. Later she did molds of their hands and feet. She made foot and hand prints for us to keep. She also brought dresses for the girls’ burial.

Tonio in bliss

The hours just passed away and we held them. We would occasionally take turns in holding each girl. It was a little tricky with their ventilators and tubes to do the switches but we were always assisted by the nurses. Tonio’s mother and brother came to see the girls. It was so nice to see them in our arms and not hooked up to ten machines. They could kiss them and touch their faces. Tonio’s brother left and then his wife came to see the girls. We wanted to hold them all day and into the night but we knew it was time.

We waited until 2:30 pm so the girls would officially be ten days old. Our family left the room and the nurses removed the tape that was holding the ventilator. It left a little residue so it looked like the girls had a milk moustache. We were prepared for them to go at any moment. They still had their heart and oxygen monitor so the nurses could tell when they were gone. Tonio and I just enjoyed holding them close. They were breathing on their own and their little hearts were beating strong. We held them for 30 minutes and then an hour passed. The nurses marveled that the girls were still holding on. Occasionally their monitor would beep and the nurse would check to see if they had a heartbeat. As they would come to check the girls would take another breath or they would still hear their heart. Eventually two hours had passed. We were so happy that they were with us. Katya’s monitor went off and Shelly checked her heartbeat. She couldn’t hear it. Then Jennifer checked it and she heard it but it was very faint. They called in Dr. Cheatham to make sure. The doctor could also hear it very faintly. We joked that the girls were competitive and Ruby wasn’t ready to go so Katya was hanging on. We visited with the nurses and we began to tell them about how Tonio and I had met. We were laughing and enjoying our time. Then at 4:58 pm both of their monitors went off at the exact same time. The nurses checked and both girls were gone. Shelly said that in her 26 years of working in the NICU she had never seen twins leave in that way at the exact same time. We were calm knowing that our girls were at peace. The nurses left the room and we got to spend a few more moments with Katya and Ruby alone.

Katya holding daddy's finger

Ruby with her mommy

Ruby and mommy

We both can say that it was one of the best days of our lives. We loved every minute of holding them and talking to them. We loved looking at their beautiful faces. Their skin was so soft. They both have my button nose. Tonio thinks they have his toes and long fingers. It was wonderful to see their different personalities come out even in ten short days of life. Katya was the calm and peaceful one. She usually seemed content and relaxed. Ruby was the feisty one. She would make a face if you were bothering her. She was more active and seemed to get into mischief. They both would stick out their tongues at us from time to time. We feel very blessed to have those precious days and hours with them. We know that we are an eternal family and they will be part of our family forever. We know we will see them again and we will always be their parents. It was hard to say goodbye but we know that they are running and jumping in heaven. We know they will be well taken care of. Now we have a goal to live our lives so we can be worthy to return home to them and Heavenly Father. The Lord has given us great peace and comfort. He has also blessed us with family and friends who have showered us with love. We feel very blessed indeed.

One Week Birthday

The first week (October 16 to 23) felt like a month at least. We had highs and lows and many tears shed. We were also overwhelmed with all of the support from family and friends. Thank you all.

Katya with her bottom up

On Monday we were informed that Ruby had a small brain bleed. They use a number system from 1 to 4. She was around a level 2. A level 4 is the worst. It is when blood has gone out of the ventricle and into the brain tissue. It can cause intellectual impairment, cerebral palsy, and other functional impairments. That was a devastating blow. They informed us that they would do another scan in two days.

Ruby ready to do a karate kick

On Tuesday the doctors sat down with us to talk about some survival numbers. On Sunday night someone had mentioned 70% chance of survival. The doctors had now run the numbers in the database. They put in the babies’ age at birth, birth weight, gender, and other statistics. They compare them with babies born 22 to 24 weeks. They now gave us a 15 to 25% chance of survival. The chance of them surviving without many complications was 5%. This was also a devastating blow to our hopes. We were glad that the doctors were being open and honest with us.

Ruby without her shades

Tonio gave Katya and Ruby a priesthood blessing on Tuesday night. He was able to put his finger on their head. He blessed them to have strength and to feel our love and the love of the Lord. He also prayed for the Lord’s will to be done.

Both girls have a valve in their heart that didn’t close called Patent Duct Arteriosus (PDA). It usually doesn’t close until after birth. The two options to close the valve are medication or surgery. They can’t survive a surgery at this point but the medication can aggravate the brain bleeds. When the valve is open it pumps blood into the lungs and increases the strain on their hearts.

Katya without sunglasses

On Wednesday, my good friend Emily came down to visit. She is a nurse practitioner so she was able to help me ask appropriate questions. We sat down with the doctors and they told us that the girls’ brain scan showed that they both had bleeds in both sides of their brains. They all seemed to be Level 3 or 4 bleeds. Tonio arrived right about that time so we were able to talk with the doctors again. The new developments in the brain bleeds have taken their 5% chance of survival with no complications to 0%. We decided to approve a Do Not Resuscitate Policy for both girls because they are so small and fragile we didn’t want them trying to perform chest compressions or other measures.

Ruby with Grandma Aida and us

On Thursday we met with Dr. Minton about the brain scans and he mentioned that there was a chance that Katya’s bleed was not as serious as we were originally told. He was a little more positive than past doctors but he said that we should take it one day at a time. In other words, make the choices for today. My friend Marissa came to visit us and see the girls. Our friend Emily had mentioned to Marissa our desire to make blankets for our babies and Marissa took it upon herself to help us by surprising us with a brand new sewing machine. She is a wonderful and kind friend.

Friday we arranged for Tonio to give the girls a name and a blessing which is a priesthood ordinance. Katrina’s dad, her brother, and Tonio’s brother were able to participate in the blessing. Tonio began with Katya since she is two minutes older. He named her Katya Sophia Uriarte. He blessed again with health and strength. He also blessed her to feel of our love and that she was born to parents who love her dearly. Next he blessed Ruby Alexandria Uriarte. It was a very sweet blessing. He reassured her of our love for her and the fact she is a special spirit daughter of our Heavenly Father. He blessed Ruby that she and Katya would be able to be together.

Katya with Grandma and Grandpa Jensen

Friday night they gave the girls the medication to try to close their heart PDA valves. On Saturday their ultrasounds showed that the valves were beginning to close. The doctors decided to try another dose of the medicine.

Sunday morning Tonio spoke in church. He was asked to choose a talk from General Conference. Originally he was scheduled to speak on October 16. He had to cancel so he could take me to the hospital. His talk was wonderful. He chose Sister Dalton’s talk about raising daughters. With courage he told about the birth of our girls. The talk focused on things a father can do for his daughters:

• First he can love their mother;
• Love her so that your marriage is celestial;
• Lead your family to the temple;
• Help her understand her identity as a daughter of God;
• Be a guardian of virtue in your home;
• Be present in your daughter’s life; and
• Share your testimony.

As Tonio spoke you could feel the love he has for our daughters. You could also sense the responsibility he feels to take care of his girls. I love him so much. I am very blessed to have a wonderful husband and a kind father for my sweet girls.

After church we went to see Katya and Ruby. We learned that Ruby’s valve had closed all the way! Katya’s was still open but not as far as it had been. This was the highlight of our day. When we came home we celebrated the girl’s week birthday by having dinner with Ben, Melissa, and Aida. We had stuffed bell peppers, baked potatoes, and green beans. I had made a brown sugar pecan apple pie for dessert. It was delicious.

A wonderful nurse, Jennifer, suggested that we take a picture with the girls and a familiar object like a dollar bill so we could remember their size. Tonio had a 100 dollar bill in his wallet so we held that up to the girls and took a picture for comparison. They were so small.

Katya rolling in the Benjamins

Tiny Ruby