Yesterday, we were actually on the verge of discharge. Not as a vague hypothetical, but scheduled in a few hours after the completion of the normal testing for the day. Part of that normal testing was an NST (nonstress test) which Lefty has been looking good on for about three weeks and Righty overall for a week. You guessed it, BOTH had late decels (3 or 4) and then they BOTH had a thirty-plus minute episode of tachycardia. One of the decels was interesting because they did it at the same time, but from different baselines, so perhaps they are already working on their synchronized swimming?
This was bad enough to get our discharge yesterday cancelled, but not bad enough to deliver right then (yeah!).
This morning the on-call OB came and actually made a plan clear. Part 1 of the plan is we will stay inpatient. Had we actually been discharged, they were going to have me come into the office Monday through Friday and up to L&D on Saturdays and Sundays, but the theory is it's easier to stay here than to have to get sent back, so might as well stay in. It also facilitates them delivering unscheduled.
That leads us to Part 2. There is a scheduled c-section at 37&1 (July 19) and they would prefer that date, but apparently the tolerance for decels will drop with each passing day and they will play it by ear, but very well may decide to section them ahead of that date based on a strip. She apparently was very close to delivering them yesterday and let them know that she would have if they had been 34 weeks (they were 33&5), so the girls are definitely on notice.
My OB is back on Monday, July 2. I think that's all the dates.
They had a growth scan today which also confirmed that my sensations are correct and instead of breech/breech, they are transverse/transverse. So Lefty is now more bottomy and Righty is now more toppy, but I'm sticking with Lefty and Righty. Lefty continues to be more petite than her sister, weighing in at 2077 grams (4lb, 9oz) while Righty is a hefty 2420 grams (5lb, 5oz). These are obviously ultrasound weights and have a large range of error, but it is safe to draw from these that they are good-sized! 4497 grams total!
While 34 is obviously great and awesome, more is better and I'm starting to get greedy and want more and more gestational time. I was playing with a prematurity risk calculator on perinatology.com and getting from 34 to 37 decreases the risk of respiratory distress syndrome from almost 20% to 3.5%! And the risk of NEC drops from 1.57% to 0% and the sepsis risk from 4.69% to 0%. The risk of grade III and IV IVHs already drops to 0% at 34 weeks, so I really feel comfortable and happy with any gestational age from here forward, but would LOVE them to make the July 19 date.
However, these girls will likely be leaving the hospital in diapers and the long-sleeve hospital white shirts if they do make it that long because the clothes are all organized and sorted in the garage rather than in the house or packed to bring to them or anything ;-).
Last thought is that it is really quite odd that I'm here on some level. I feel great and am really symptomless. If they'd let me, I'm still completely capable of walking, maneuvering and generally am still very mobile, flexible and all of that. I sleep fine, I'm not in pain, I'm not grumpy, I'm not swollen. I've got friends who are more like 20 weeks with singletons who seem much more uncomfortable and are having to waddle and dealing with pain and sleep issues and all that. So, excepting the whole being stuck in the hospital, I'm in great shape! We will see how well I handle going from two to three months of total bedrest to keeping up with four kids with an abdominal incision healing though...
Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts
Tuesday, June 26, 2012
Friday, June 22, 2012
Passive Superstition Be Gone
I think I have not been posting through a mix of passive superstition, by not typing things it is totally logical that I'm not tempting fate (right?), and honestly just not wanting to process some thoughts. Neither of these was a conscious move, just kind of happened. But I got forced to a few thoughts, including realizing that I wasn't writing anything for silly/nonexistent reasons, so here I am.
First thought: at some point in the last week or so, my expectation has changed from this could result in 0, 1 or 2 babies to there will be 2. Yesterday morning, my OB was as usual sitting in the rocking chair beside my bed chatting and writing up my chart and when she finished she asked if I had anything else. And then said that she thought there was something else and that I sometimes get a look where she knows I'm thinking something, but she just doesn't know what it was. I felt oddly stressed, but couldn't identify what it was. In thinking after, I think it really was just that I'd made the transition to expecting 2, and thus exposing myself.
That's my big thought. Figure I should give a status update and summary now since I have been so non-communicative. However, just like with Chiron/Aurelia, I've actually done a good job through Facebook and it's hard to keep straight what I've said where, so figure I'll just go general here.
Two new things were declared by the OBs this week: next baby who pulls a hijink is getting born at that time and bring her sister with her and we are staying through delivery. Why, you ask? Well, Monday when we actually were at the point of considering discharge in the next couple days, Righty aka baby A, started having late decels followed by tachycardia on our normal morning strip. Initially responded with trying positional changes while a nurse got the oxygen setup in place. Then she called the OB and had her look at the strip just to be sure she knew what was going on and the OB told the nurse that we were going to c-section them and to start an IV, get labs drawn and get me moving towards L&D. Then in the thirty minutes all that was going on little miss behaved perfectly and so my OB backtracked and said we would do 24 hours of monitoring. No more incidents occurred after that, so was shipped back to stable antepartum, but it was declared that these two were out of chances.
Background: at 25 weeks, I had a cold and my body started contracting/dilating in response to there is stress on the system, lets do something to simplify. Stayed in-patient for ten days, things calmed down and was discharged to home bedrest at 26&2. Then at 28&5 I was at the perinatologist for normal BPP and Lefty, aka baby B, was having variable decelerations and some moderate bradycardia on her NST. He wasn't worried, but wanted to make sure that it stopped rather than continued and since it was 5 pm, sent me over to L&D for two hours of monitoring. Instead of discharge after two hours, I instead got another 2 rounds of steroid shots and was admitted. She continued having some of these events until the morning of 30&5 when there was some insane fetal motion and I again started having contractions. Had dilated more and so went over to L&D. By middle of the day, I was having beautiful, rhythmic contractions of mountains and values every 2.5 minutes and it looked like we were heading towards birth. Then it just petered out. Stayed in monitoring in L&D another day and a half and then back to stable antepartum. Good news of that event was the huge motion was Lefty moving from transverse to breech and as a result seemed to have gotten her leg or whatever out of the cord loop and we haven't seen variables at all, much less bradycardia from her since. Then on Monday, at 32&5 we had the late decels event with Righty.
So, now I'm back to hanging out in stable antepartum. Looking pretty stable and while I have a couple rounds of regularish contractions a day, nothing significant. Both babies are behaving on their strips and so we continue on. The delivery date barring someone misbehaving ahead of then is July 19 at 37&1. My OB, who you may remember is really amazing, competent and just a good human, just left my room and is heading out on vacation and will be out of town until July 2. Of course, there will be other OBs on call and I know them all, but I am spoiled and really prefer MY OB, so think behaving thoughts through at least July 2. That would also get us to 34&5, which I would count as pretty awesome.
That's my ramble and now some random pictures because captions are fun.
First thought: at some point in the last week or so, my expectation has changed from this could result in 0, 1 or 2 babies to there will be 2. Yesterday morning, my OB was as usual sitting in the rocking chair beside my bed chatting and writing up my chart and when she finished she asked if I had anything else. And then said that she thought there was something else and that I sometimes get a look where she knows I'm thinking something, but she just doesn't know what it was. I felt oddly stressed, but couldn't identify what it was. In thinking after, I think it really was just that I'd made the transition to expecting 2, and thus exposing myself.
That's my big thought. Figure I should give a status update and summary now since I have been so non-communicative. However, just like with Chiron/Aurelia, I've actually done a good job through Facebook and it's hard to keep straight what I've said where, so figure I'll just go general here.
Two new things were declared by the OBs this week: next baby who pulls a hijink is getting born at that time and bring her sister with her and we are staying through delivery. Why, you ask? Well, Monday when we actually were at the point of considering discharge in the next couple days, Righty aka baby A, started having late decels followed by tachycardia on our normal morning strip. Initially responded with trying positional changes while a nurse got the oxygen setup in place. Then she called the OB and had her look at the strip just to be sure she knew what was going on and the OB told the nurse that we were going to c-section them and to start an IV, get labs drawn and get me moving towards L&D. Then in the thirty minutes all that was going on little miss behaved perfectly and so my OB backtracked and said we would do 24 hours of monitoring. No more incidents occurred after that, so was shipped back to stable antepartum, but it was declared that these two were out of chances.
Background: at 25 weeks, I had a cold and my body started contracting/dilating in response to there is stress on the system, lets do something to simplify. Stayed in-patient for ten days, things calmed down and was discharged to home bedrest at 26&2. Then at 28&5 I was at the perinatologist for normal BPP and Lefty, aka baby B, was having variable decelerations and some moderate bradycardia on her NST. He wasn't worried, but wanted to make sure that it stopped rather than continued and since it was 5 pm, sent me over to L&D for two hours of monitoring. Instead of discharge after two hours, I instead got another 2 rounds of steroid shots and was admitted. She continued having some of these events until the morning of 30&5 when there was some insane fetal motion and I again started having contractions. Had dilated more and so went over to L&D. By middle of the day, I was having beautiful, rhythmic contractions of mountains and values every 2.5 minutes and it looked like we were heading towards birth. Then it just petered out. Stayed in monitoring in L&D another day and a half and then back to stable antepartum. Good news of that event was the huge motion was Lefty moving from transverse to breech and as a result seemed to have gotten her leg or whatever out of the cord loop and we haven't seen variables at all, much less bradycardia from her since. Then on Monday, at 32&5 we had the late decels event with Righty.
So, now I'm back to hanging out in stable antepartum. Looking pretty stable and while I have a couple rounds of regularish contractions a day, nothing significant. Both babies are behaving on their strips and so we continue on. The delivery date barring someone misbehaving ahead of then is July 19 at 37&1. My OB, who you may remember is really amazing, competent and just a good human, just left my room and is heading out on vacation and will be out of town until July 2. Of course, there will be other OBs on call and I know them all, but I am spoiled and really prefer MY OB, so think behaving thoughts through at least July 2. That would also get us to 34&5, which I would count as pretty awesome.
That's my ramble and now some random pictures because captions are fun.
 |
| Chiron playing around with one of the new strollers while hanging out at Trajan's swim lesson. |
 |
| Trajan is by the rail waiting at swim. |
 |
| Amusing nurses with hijinks and jocularity make the world better. |
 |
| So do nurses drawing fun pictures. |
 |
| And awesome coworkers who bring amusing things as well as folding zombies out of paper! |
 |
| And grandparents who come into town and amuse boys and generally help. |
 |
| As well as hold little boys with colds when the pass out. |
 |
| Friends coming by, talking, bringing food, amusement and even making a five-foot tall kangaroo makes the world a lot better as well. |
 |
| So do wonderful friends who I've actually never met in person who amuse me every single day on multiple occasions and have sent more surprises, notes and thoughts than I ever would have imagined. |
 |
| Even being challenged to a massive hamburger eating contest is pretty cool. And as a bonus, you see here the pictures that some amazing friends I work with thought to print and bring up (and some of the zombies!). |
 |
| This little man loves wandering around the hospital on our 30-minute wheelchair privileges and is amazing us with all he's mastered. |
 |
| This little man prefers to be silly and luckily there are some great nurses who go along with it! |
 |
| These three are pretty awesome and photographic evidence that Trajan may come here to play iPad almost as much as to see me. |
 |
| Happy, loving boys |
 |
| Everyone |
 |
| I don't have an innie or an outie now, I have a flattie. Also, tell the kids at home not to pierce their belly button because even if it's only for two days due to some impulsivity and fun with roommates, it will stretch to impressive size as a scar. And my first two skin marks ever appear below on diagonals on each side. |
Tuesday, May 8, 2012
Mensch
You know how sometimes a word pops into your head? Well, this happened to me the other day with the word mensch and I've decided to run with it. I looked it up to check that my meaning was right and it was "a decent, upright, mature, and responsible person." It's Yiddish, so I have no idea where I came across it, but I think it's a great summation of my goal in terms of my attitude and actions.
Rather than whining at restrictions, I think it's best that I be a responsible adult who can balance the needs of multiple people and timeframes and gets the significance of avoiding as much NICU time as humanly possible at essentially any cost.
I was discharged Friday and all is going really quite well with home bedrest. Paul and my parents got me set up with a minifridge and a microwave upstairs and stocked with food, cutlery, drinks and more. I've also got a serious number and variety of pillows to arrange different positions. Add that I was planner and last pregnancy had purchased a hospital bedside table and a lap table in preparation (before everything changed), and I'm in great shape. I've got a printer set up here and a friend who works at my office brought me out some things I need, so I'm in shape working as well.
Having Poppins definitely helps as she and Chiron are here throughout the day. They go for walks and to the park and to the grocery store, but it really results in about two hours being the longest duration I go without Paul or Poppins being here. Add friends who have helped with all kinds of things and life is pretty good! It's also nice because Chiron stops by a couple times a day and plays which really brightens the day and being home allows me to read to Trajan before bed like normal which I couldn't do from the hospital. And I've got pretty cute coworkers here:
Besides helping with boys, being home allows me to be useful as I can go through the mail and sort things that have been pulled out for goodwill including getting them entered into itsdeductible and lots of little things like that. Feel much less useless.
On the girls front, all is looking well. I should confess that I was secretly hoping/expecting that when I went to the preterm nurse Monday she would say that she thought the covering OB was in error and I hadn't had any cervical change, but she if anything actually identified more cervical change dubbing me one-plus, 30-50% effaced and soft where I had been completely closed when I had seen her before going into the hospital. Since the covering OB had done a cervical exam at 8 am and then 5:30 pm of the same day, it was probably a silly hope, but oh well.
The good news is that I still have 4.4 cm of cervix which is enough cervix for two pregnancies and close enough to the 4.9 value in the hospital last Wednesday. That and both girls aced their modified BPP, so we are really in good shape. The perinatologist did think that I needed to stay on as complete a bedrest as possible as I was contracting some while I was there and if just medical trips are enough to make irritable, running around free could equal instability. He also didn't like that preterm labor nurse noticed some pink blood after the cervical exam, but since I haven't seen any after, I'm going to go with that was just due to the exam.
We got a profile of Righty who is back to being the presenting baby. She is vertex in the center/left (name is based on her placenta) and then Lefty is sprawled transverse up in my ribcage. Note: I am not 8 weeks currently as the ultrasound is labelled. 8, 27, what's the real difference, huh?
I thought I'd fixed the orientation in iPhoto, but apparently not... oh well!
The one thing I really miss from the hospital (well, besides some nice and amusing nurses) is the monitoring. Seeing those lines a couple times a day just is nice:
BUT, these faces are nicer:
I'm blaming the Chiron bias here on the fact that he's much more cooperative than the others.
But in tying back to my mensch theme, yesterday one of the techs at the perinatologist said something that startled me, but also made me glad: "you're always in such a good mood and kind. You're our best patient." And this is a woman who has seen me at one of the worst moments in my life. This made me glad. Because really the best we can do is live our lives :-). What will be will be, I'm here to celebrate it and optimize it!
Rather than whining at restrictions, I think it's best that I be a responsible adult who can balance the needs of multiple people and timeframes and gets the significance of avoiding as much NICU time as humanly possible at essentially any cost.
I was discharged Friday and all is going really quite well with home bedrest. Paul and my parents got me set up with a minifridge and a microwave upstairs and stocked with food, cutlery, drinks and more. I've also got a serious number and variety of pillows to arrange different positions. Add that I was planner and last pregnancy had purchased a hospital bedside table and a lap table in preparation (before everything changed), and I'm in great shape. I've got a printer set up here and a friend who works at my office brought me out some things I need, so I'm in shape working as well.
Having Poppins definitely helps as she and Chiron are here throughout the day. They go for walks and to the park and to the grocery store, but it really results in about two hours being the longest duration I go without Paul or Poppins being here. Add friends who have helped with all kinds of things and life is pretty good! It's also nice because Chiron stops by a couple times a day and plays which really brightens the day and being home allows me to read to Trajan before bed like normal which I couldn't do from the hospital. And I've got pretty cute coworkers here:
On the girls front, all is looking well. I should confess that I was secretly hoping/expecting that when I went to the preterm nurse Monday she would say that she thought the covering OB was in error and I hadn't had any cervical change, but she if anything actually identified more cervical change dubbing me one-plus, 30-50% effaced and soft where I had been completely closed when I had seen her before going into the hospital. Since the covering OB had done a cervical exam at 8 am and then 5:30 pm of the same day, it was probably a silly hope, but oh well.
The good news is that I still have 4.4 cm of cervix which is enough cervix for two pregnancies and close enough to the 4.9 value in the hospital last Wednesday. That and both girls aced their modified BPP, so we are really in good shape. The perinatologist did think that I needed to stay on as complete a bedrest as possible as I was contracting some while I was there and if just medical trips are enough to make irritable, running around free could equal instability. He also didn't like that preterm labor nurse noticed some pink blood after the cervical exam, but since I haven't seen any after, I'm going to go with that was just due to the exam.
We got a profile of Righty who is back to being the presenting baby. She is vertex in the center/left (name is based on her placenta) and then Lefty is sprawled transverse up in my ribcage. Note: I am not 8 weeks currently as the ultrasound is labelled. 8, 27, what's the real difference, huh?
The one thing I really miss from the hospital (well, besides some nice and amusing nurses) is the monitoring. Seeing those lines a couple times a day just is nice:
But in tying back to my mensch theme, yesterday one of the techs at the perinatologist said something that startled me, but also made me glad: "you're always in such a good mood and kind. You're our best patient." And this is a woman who has seen me at one of the worst moments in my life. This made me glad. Because really the best we can do is live our lives :-). What will be will be, I'm here to celebrate it and optimize it!
Monday, April 23, 2012
New Territory
So, I wrote the title for this about a week and a half ago, but haven't updated anything. Not because anything is wrong, but just been too frantic with work getting things done to have any time between work and the boys and life.
All is good.
On the girls' front, I actually ended up calling my OB's nurse the next morning and talking to her about the preterm clinic. And totally lost the capacity to speak without crying which is something that happens to me about once every half-dozen years. Luckily, she's a very patient and kind soul and waited me out and helped me get the whole story out. The end result was that she talked with the OB and they declared that I didn't have to go to preterm clinic anymore. However, by that point I'd come to the conclusion that anyone could say something stupid and perhaps I should give her another chance. So I went ahead and went the next Monday morning and it was fine. I figure that it makes more sense to follow the recommended protocol as long as it isn't causing me to stress out unnecessarily. Went again today and I would actually go so far as to say that it was a positive experience with the preterm nurse, so hopefully things will stay that way.
With my flipout I actually ended up seeing my OB last Thursday where she patiently dealt with me 25 item long list of questions that I'd developed as part of my flipout. This was not the first time I'd done this to her, but the first time she saw it printed out instead of just on my phone or laptop screen. I kind of thought maybe we'd just get through a few of them and save the rest for next time, but she actually did the whole dang list!
She also talked with the perinatologist and got me set up for weekly ultrasounds with the perinatologist who strikes me as the best. Until 28 weeks, he is just going to assess their amniotic fluid, look at their heartbeat patterns and generally assess their movement. Then, starting at 28 weeks he will do a BPP each week. And at some point NSTs get added in.
While there is definitely a risk of recurrence in stillbirth due to cord accidents, I'm pretty sure they are doing most of this extra monitoring to keep me sane more than because they think it will make a difference in the girls' outcome. Honestly, I'm ok with that.
Here's their heads this morning. We are definitely in new territory as we are past the point of the demise in the last pregnancy. ALso, these girls move around a LOT. At 20 weeks, they were stacked both transverse with the right one lower. Then at 24 weeks, they had switched and the left one was presenting and she was vertex along the left side of my uterus with the right one stretched across the top transverse with her head to the right. And then a week later, the right one was back to being presenting and she is breech on the right side of the uterus with the left one transverse across the top of the uterus! It's anybody's guess where they are going to end up!
All is good.
On the girls' front, I actually ended up calling my OB's nurse the next morning and talking to her about the preterm clinic. And totally lost the capacity to speak without crying which is something that happens to me about once every half-dozen years. Luckily, she's a very patient and kind soul and waited me out and helped me get the whole story out. The end result was that she talked with the OB and they declared that I didn't have to go to preterm clinic anymore. However, by that point I'd come to the conclusion that anyone could say something stupid and perhaps I should give her another chance. So I went ahead and went the next Monday morning and it was fine. I figure that it makes more sense to follow the recommended protocol as long as it isn't causing me to stress out unnecessarily. Went again today and I would actually go so far as to say that it was a positive experience with the preterm nurse, so hopefully things will stay that way.
With my flipout I actually ended up seeing my OB last Thursday where she patiently dealt with me 25 item long list of questions that I'd developed as part of my flipout. This was not the first time I'd done this to her, but the first time she saw it printed out instead of just on my phone or laptop screen. I kind of thought maybe we'd just get through a few of them and save the rest for next time, but she actually did the whole dang list!
She also talked with the perinatologist and got me set up for weekly ultrasounds with the perinatologist who strikes me as the best. Until 28 weeks, he is just going to assess their amniotic fluid, look at their heartbeat patterns and generally assess their movement. Then, starting at 28 weeks he will do a BPP each week. And at some point NSTs get added in.
While there is definitely a risk of recurrence in stillbirth due to cord accidents, I'm pretty sure they are doing most of this extra monitoring to keep me sane more than because they think it will make a difference in the girls' outcome. Honestly, I'm ok with that.
Here's their heads this morning. We are definitely in new territory as we are past the point of the demise in the last pregnancy. ALso, these girls move around a LOT. At 20 weeks, they were stacked both transverse with the right one lower. Then at 24 weeks, they had switched and the left one was presenting and she was vertex along the left side of my uterus with the right one stretched across the top transverse with her head to the right. And then a week later, the right one was back to being presenting and she is breech on the right side of the uterus with the left one transverse across the top of the uterus! It's anybody's guess where they are going to end up!
We dropped our boys' 0-12 month clothing off with friends yesterday, it was impressive. Still pretty amazed by that purchase.
On the boys' front, it's surgery week. Chiron is getting tubes tomorrow and then Trajan is getting his tonsillectomy/adenoidectomy on Thursday.
Chiron is still adorable:
Trajan was an adorable ringbearer:
Poppins is still going great. I had a great time chaperoning Trajan's field trip a few weeks ago and CHiron went to his first birthday party for one of his friends.
Life is good, and perhaps now that I've acknowledged I've failed to write about all kinds of things, I'll get back on an updating schedule. I think it was largely trying to get work ready for me to be out for both surgeries that was kicking me backside, but I do still have a lot of work for the next few weeks, so it's entirely possible that I'll fail as an updater.
Random note: we have now had 19 or 20 ultrasounds this pregnancy and I'm not even remembering to take pictures of all the shots we get, much less upload them. How's that for crazy?
In conclusion, I'm sticking with the idea I opened with, all is good.
Friday, April 13, 2012
And I lost it...
So, I've held it together very well. Hell, I'm not even sure I'd say I've been holding it together, because it's been pretty easy. I'm rational. I understand things happen. And that doesn't mean it will happen again. So, I've been very fine. I've taken to thinking of these two as going to be here at some point. I've entertained the idea that it will be via the NICU possibly, but really expecting them by 37-40 weeks as a part of our day-to-day life.
Then I lost it.
I don't know if it's being at the same gestational age or realizing that I'm going to have to go for the longest stretch in the history of this entire pregnancy without an ultrasound or the preterm labor nurse upsetting me, but I've lost it. It was definitely the preterm labor nurse as the trigger, but I don't want to put it all on her.
How do I know I lost it? I called my OB's nurse this morning to confirm that something the preterm labor nurse said I didn't need to worry about and I ended up where I could barely (if that) talk because I was crying and just had lost control. I'm sitting here typing with tears running down my face. Thus, I say I've lost it.
To backtrack: yesterday I had an appointment with the preterm labor nurse and then an OB appointment. The preterm labor appointment was in the morning and went great in terms of the babies and my status as a pregnant person. Both had good heartbeats. Blood pressure was good. Cervix is long and closed, yeah! OB appointment also went well with both looking good on the quickie ultrasound and she also checked out my cervix and agreed it looked great. Four cervical checks in 88 hours, I declare my cervix to be pageant queen popular. Everything medical and related to this pregnancy at both appointments could not have been improved upon.
So, why the crazy? Well, the preterm nurse took me back to last time. I had an appointment with the perinatologist and her scheduled for a Thursday, but after feeling jumangi drums and just so much absurd amounts of motion that it distressed me, they had me come in Wednesday to check them out. They did the 24 week anatomy growth scan (24 weeks would be Friday) and everything looked great. Viable and perfect were words used. Yeah, ain't that almost funny?
She brought up this appointment and what I had felt and brought up that this was likely Aurelia doing her best to try to get oxygen. The nurse even said to communicate "hey mom, I'm not getting air." Yup, said that to me.
Yeah, that's a kick in the ass. But you know what, there's nothing we could have done differently. There's nothing we could have done to help her. And if I'm being completely honest, the outcome of two 24&0 weekers one of whom has been experiencing oxygen deprivation likely would not have been a better outcome than where we have ended up. But still, having someone say that yes, that meant something was wrong and I was the only one capable of getting the message makes me sick. And now I'm supposed to be watching for fetal thrashing?
I meant to ask the OB about it yesterday and we got to the point of saying that the preterm labor nurse had upset me (though I kept it completely together with her oddly), but got distracted and never got into why. Go attention deficit.
Also, the OB had convinced me early on this pregnancy that we weren't certain this was a cord accident. And this I think helped with my piece, because cord accidents are one of the causes of stillbirth that has recurrence where many stillbirth causes are flukes. So, now I'm back to that worry about the recurrence rate.
Oddly, I just realized that I never changed the little summary box of "our world" that's in the border of the blog page to not say cord accident when the OB convinced me that the neonatal nurse practitioner told me it as a certain cause to make me feel better, but they couldn't be certain. I will say that cord compressions definitely fit well with the symptoms and the experience of her motion.
And I'm feeling much better post this rant/ramble and a conversation with my OB's nurse, who is an amazingly patient and kind soul, this morning.
I have the 24 week anatomy/growth scan with these two on Monday and then I will see the preterm lady again. And then I enter my new distress as the OB set my next appointment for four weeks and the perinatologist will set my next appointment for four weeks, so I will have to go almost four weeks without seeing them on an ultrasound when I haven't gone even two weeks so far this pregnancy. The preterm labor clinic will do the Doppler, but even she has said that she's not 100% certain she's identifying them separately. It may seem odd, but the idea of possibly not knowing one is dead for weeks is almost more upsetting than the idea of one being dead. So, I anticipate some basketcaseness for the next four weeks.
I'm not ok, but I'll make it.
Afterthought: I am very lucky that I'm signed up to work pizza Friday at Trajan's school today. Two hours of serving up pizza and fruit and talking and playing with three lunches of kids and the world is always a better place. I'm still convinced I'm pretty blessed and lucky, even if I'm a bit crazy today.
Then I lost it.
I don't know if it's being at the same gestational age or realizing that I'm going to have to go for the longest stretch in the history of this entire pregnancy without an ultrasound or the preterm labor nurse upsetting me, but I've lost it. It was definitely the preterm labor nurse as the trigger, but I don't want to put it all on her.
How do I know I lost it? I called my OB's nurse this morning to confirm that something the preterm labor nurse said I didn't need to worry about and I ended up where I could barely (if that) talk because I was crying and just had lost control. I'm sitting here typing with tears running down my face. Thus, I say I've lost it.
To backtrack: yesterday I had an appointment with the preterm labor nurse and then an OB appointment. The preterm labor appointment was in the morning and went great in terms of the babies and my status as a pregnant person. Both had good heartbeats. Blood pressure was good. Cervix is long and closed, yeah! OB appointment also went well with both looking good on the quickie ultrasound and she also checked out my cervix and agreed it looked great. Four cervical checks in 88 hours, I declare my cervix to be pageant queen popular. Everything medical and related to this pregnancy at both appointments could not have been improved upon.
So, why the crazy? Well, the preterm nurse took me back to last time. I had an appointment with the perinatologist and her scheduled for a Thursday, but after feeling jumangi drums and just so much absurd amounts of motion that it distressed me, they had me come in Wednesday to check them out. They did the 24 week anatomy growth scan (24 weeks would be Friday) and everything looked great. Viable and perfect were words used. Yeah, ain't that almost funny?
She brought up this appointment and what I had felt and brought up that this was likely Aurelia doing her best to try to get oxygen. The nurse even said to communicate "hey mom, I'm not getting air." Yup, said that to me.
Yeah, that's a kick in the ass. But you know what, there's nothing we could have done differently. There's nothing we could have done to help her. And if I'm being completely honest, the outcome of two 24&0 weekers one of whom has been experiencing oxygen deprivation likely would not have been a better outcome than where we have ended up. But still, having someone say that yes, that meant something was wrong and I was the only one capable of getting the message makes me sick. And now I'm supposed to be watching for fetal thrashing?
I meant to ask the OB about it yesterday and we got to the point of saying that the preterm labor nurse had upset me (though I kept it completely together with her oddly), but got distracted and never got into why. Go attention deficit.
Also, the OB had convinced me early on this pregnancy that we weren't certain this was a cord accident. And this I think helped with my piece, because cord accidents are one of the causes of stillbirth that has recurrence where many stillbirth causes are flukes. So, now I'm back to that worry about the recurrence rate.
Oddly, I just realized that I never changed the little summary box of "our world" that's in the border of the blog page to not say cord accident when the OB convinced me that the neonatal nurse practitioner told me it as a certain cause to make me feel better, but they couldn't be certain. I will say that cord compressions definitely fit well with the symptoms and the experience of her motion.
And I'm feeling much better post this rant/ramble and a conversation with my OB's nurse, who is an amazingly patient and kind soul, this morning.
I have the 24 week anatomy/growth scan with these two on Monday and then I will see the preterm lady again. And then I enter my new distress as the OB set my next appointment for four weeks and the perinatologist will set my next appointment for four weeks, so I will have to go almost four weeks without seeing them on an ultrasound when I haven't gone even two weeks so far this pregnancy. The preterm labor clinic will do the Doppler, but even she has said that she's not 100% certain she's identifying them separately. It may seem odd, but the idea of possibly not knowing one is dead for weeks is almost more upsetting than the idea of one being dead. So, I anticipate some basketcaseness for the next four weeks.
I'm not ok, but I'll make it.
Afterthought: I am very lucky that I'm signed up to work pizza Friday at Trajan's school today. Two hours of serving up pizza and fruit and talking and playing with three lunches of kids and the world is always a better place. I'm still convinced I'm pretty blessed and lucky, even if I'm a bit crazy today.
Thursday, April 5, 2012
Preterm Labor Clinic Begins...
My OB's practice sends their twin pregnancies to the preterm labor clinic at the perinatologist starting at 22 weeks. I did it last time, but only made it to three visits before "it all changed." Had the first appointment for this go round today and it went well. Was greeted with a deja vu comment.
I'm up 15 pounds now, which is less than they'd ideally want, but is enough that she isn't worried and says to just to keep up working on it! I'm 22 weeks and I'm measuring 31 weeks based on fundal height which interestingly is the exact same measurement that I got last time at 22 weeks with her!
We talked through all the activity guidelines and reviewed preterm labor symptoms. She wants me to work towards working part of each day from the house sooner rather than later, so I need to get my technological ducks in a row. She also wants me to really minimize my carrying of Chiron as much as possible. Don't need to eliminate entirely, but cut back as much as I can.
After the discussion, she had me leave a urine sample and then she measured the fundal height, listened to the heartbeats with a Doppler and then did an internal exam. My urine was excellent, an odd phrase to hear, but I'll definitely take it. And that coupled with a 120/60 blood pressure (which I think is great for me in a OB/perinatologist setting at this point) indicates all is well on the preeclampsia type front. Righty had a heartbeat at about 150 while Lefty was around 160. And my cervix is still very long, she said she would believe it's still around the 5 cm that it was the last time we measured, and the inner part is completely closed. The outer is open, but that's just because I've had a kid before.
The only thing she absolutely ruled out is that she says I am NOT to be the one to stay with Trajan for getting the tonsils out. She says that that would be a perfect storm nightmare to cause preterm labor. She actually had her son's out at the exact same place with the same surgeon a few months before and she adamantly said no. I can be there during the day for the procedure and all that, but I need to leave for the evening hours. I'll need to talk with Paul (he has a webcast at work this morning), but I imagine this isn't really an issue and he can just stay with him. She also recommended that we do get the alcohol-free version of the pain meds for a reason I hadn't thought of. It burns less when they swallow it, so kids are more willing to take it, so it's less likely that we will fall behind his pain and have issues with that.
Everyone I talk to is making me more and more nervous (not sure that's the exact right word) about getting the tonsils/adenoids out and the degree of discomfort, pain and just plain suffering Trajan will experience with it. I'm cautiously optimistic that at 4.5 he is much more capable of reasoning and discussing than most of the kids who are at 3 and so perhaps that will help.
Look for another ENT update this afternoon or tomorrow on the Chiron front! (and no, that isn't really an exclamation point of excitement, but it's kind of like the theory of you either have to laugh or cry. I am going with laughing and living. And glad that Poppins is in place so both of us have been able to work this time).
And to finish up the preterm labor thoughts, I will see her weekly until 37 weeks or things hit the fan. She is looking for continued weight gain, clean urine, good heartbeats, cervix staying long and closed and me reporting that I'm cutting back more and more on activities.
She gave me a sheet just like last time that outlines the key dates (I'd already converted my old one, but just for fun, here they are:)
And one last thought. I was wrong about something. I'd written before I got pregnant that the reason that I wouldn't ride this ride of pregnancy again for a round three is that my sanity couldn't handle it if something went wrong and in particular if we last another baby. It turns out that I'm pretty sure that that is not true. I obviously am not rooting for it, but I have had time to really think about what that would be like and I think I can say with pretty high confidence that I would make it. That I would process it, work through it and come through it still me, just a little bit different. I am strong enough. This may seem a warped thought, but knowing it helps me.
I'm up 15 pounds now, which is less than they'd ideally want, but is enough that she isn't worried and says to just to keep up working on it! I'm 22 weeks and I'm measuring 31 weeks based on fundal height which interestingly is the exact same measurement that I got last time at 22 weeks with her!
We talked through all the activity guidelines and reviewed preterm labor symptoms. She wants me to work towards working part of each day from the house sooner rather than later, so I need to get my technological ducks in a row. She also wants me to really minimize my carrying of Chiron as much as possible. Don't need to eliminate entirely, but cut back as much as I can.
After the discussion, she had me leave a urine sample and then she measured the fundal height, listened to the heartbeats with a Doppler and then did an internal exam. My urine was excellent, an odd phrase to hear, but I'll definitely take it. And that coupled with a 120/60 blood pressure (which I think is great for me in a OB/perinatologist setting at this point) indicates all is well on the preeclampsia type front. Righty had a heartbeat at about 150 while Lefty was around 160. And my cervix is still very long, she said she would believe it's still around the 5 cm that it was the last time we measured, and the inner part is completely closed. The outer is open, but that's just because I've had a kid before.
The only thing she absolutely ruled out is that she says I am NOT to be the one to stay with Trajan for getting the tonsils out. She says that that would be a perfect storm nightmare to cause preterm labor. She actually had her son's out at the exact same place with the same surgeon a few months before and she adamantly said no. I can be there during the day for the procedure and all that, but I need to leave for the evening hours. I'll need to talk with Paul (he has a webcast at work this morning), but I imagine this isn't really an issue and he can just stay with him. She also recommended that we do get the alcohol-free version of the pain meds for a reason I hadn't thought of. It burns less when they swallow it, so kids are more willing to take it, so it's less likely that we will fall behind his pain and have issues with that.
Everyone I talk to is making me more and more nervous (not sure that's the exact right word) about getting the tonsils/adenoids out and the degree of discomfort, pain and just plain suffering Trajan will experience with it. I'm cautiously optimistic that at 4.5 he is much more capable of reasoning and discussing than most of the kids who are at 3 and so perhaps that will help.
Look for another ENT update this afternoon or tomorrow on the Chiron front! (and no, that isn't really an exclamation point of excitement, but it's kind of like the theory of you either have to laugh or cry. I am going with laughing and living. And glad that Poppins is in place so both of us have been able to work this time).
And to finish up the preterm labor thoughts, I will see her weekly until 37 weeks or things hit the fan. She is looking for continued weight gain, clean urine, good heartbeats, cervix staying long and closed and me reporting that I'm cutting back more and more on activities.
She gave me a sheet just like last time that outlines the key dates (I'd already converted my old one, but just for fun, here they are:)
- April 4 - 22 weeks : Need to be resting a minimum of 1 hour midday and 2 hours early evening and begin decreasing all activities at home and work.
- May 16 - 28 weeks: Uterus will be full-term size and contractions more common. Need to work a maximum of 4 hours a day in office (if no appreciable work at home). Can work more hours from a reclined position. Minimum rest intervals of 2 hours midday and 2 hours early evening. Curtail activities much further
- June 13 - 32 weeks: "Big Goal to Pass" aka it's all bonus from here. Moms can tolerate very little activity and no activities of any type should be undertaken lasting over 2 hours. Work should solely be from home and a reclined position. (She said I could run up and get stuff, putter around the office for possible an hour a day depending how I'm tolerating)
- June 27: 34 weeks: Will not need steroids to mature babies' lungs, will not give medications to stop labor and babies likely in NICU about 2 weeks
- July 11: 36 weeks: Typically no NICU time
- July 18: 37 weeks: Ideal delivery timing
And one last thought. I was wrong about something. I'd written before I got pregnant that the reason that I wouldn't ride this ride of pregnancy again for a round three is that my sanity couldn't handle it if something went wrong and in particular if we last another baby. It turns out that I'm pretty sure that that is not true. I obviously am not rooting for it, but I have had time to really think about what that would be like and I think I can say with pretty high confidence that I would make it. That I would process it, work through it and come through it still me, just a little bit different. I am strong enough. This may seem a warped thought, but knowing it helps me.
Thursday, March 29, 2012
Keep Your Pants Up, Maternity Edition
I've been having trouble this whole pregnancy with keeping my pants up. Doesn't matter if they are low-rider maternity, larger normal pants, pants with elastic, pants with buttons or even the over belly pants, I've been in near constant need of suspenders. My solution had been to walk while holding onto them. Which both looks awesome and doesn't really work that well.
Then I was in Pea in the Pod because I needed to grab some additional clothes as I needed to be a little nicer than business casual for four days at a conference. I ended up deciding that I would get cut enough slack that I didn't need suits, but I did need some additional non-worn out business clothing. And while I was there I remembered the secret!
Here's the secret. You know Spanx? Holds your fat in and reshapes your lines normally? Well, there's a product called Mama Spanx and that is not really what it does. What it does is give your pants something to adhere to! When I saw it on the rack I immediately remembered that this is the magic trick!
So I grabbed some. And it was brilliant. Pants stayed where pants should be!
However, I was struck one day by the amount of layers that were over my belly and so I took a series of shots to document the semi-absurdity of it.
Image 1: this is fully covered.
Image 2: this is with the top sheer shirt pulled up
Image 3: this is with the pants that had stretched over the belly pulled all the way down
Image 4: this is with the fitted tank that I wore under the sheer shirt pulled up. (Note to self: I should probably stop wearing my nice theory suit tanks before the growing belly ruins them for future wear)
Image 5: this is the Mama Spanx pulled down as well. Yes, four full layers with two going each direction over the belly is what we just saw there.
So, it might seem a bit absurd, but it's brilliant and makes you able to walk, talk, laugh, dance, jiggle, and climb an aircraft carrier all without having to hike your pants!
And yes, I literally mean hiking and climbing all over a low-rider. Did all the tours of the USS Lexington in this, including the 4-inch heels and the pants stayed up!
I tested it the last day with a pair of low-riders (I'd broken down and just accepted the over the belly all the previous days) and it worked!
Apparently having the hotel full-length mirror inspires me to examine how my clothes stay up! These are all at just before, exactly and just after 21 weeks.
And for fun, here's one of my feet after I forgot about the hiking part of dinner on an aircraft cruiser when I got dressed:
And for more random biological shots:
As I have a very deep belly button normally, this is a bit freaky. And on occasion, you can catch a dancing baby here. Not sure if you can tell if you don't know when to watch, but this is definitely the earliest I've seen motion from the outside.
And last, just to round out with cuteness and awesomeness, here is Trajan this morning at the dentist. Trajan loves him and so do I. Except he said we should talk to our pedi about having him seen by the ENT again and possibly pulling out his tonsils as part of a strategy to help his overbite which does not excite me.
Then I was in Pea in the Pod because I needed to grab some additional clothes as I needed to be a little nicer than business casual for four days at a conference. I ended up deciding that I would get cut enough slack that I didn't need suits, but I did need some additional non-worn out business clothing. And while I was there I remembered the secret!
Here's the secret. You know Spanx? Holds your fat in and reshapes your lines normally? Well, there's a product called Mama Spanx and that is not really what it does. What it does is give your pants something to adhere to! When I saw it on the rack I immediately remembered that this is the magic trick!
So I grabbed some. And it was brilliant. Pants stayed where pants should be!
However, I was struck one day by the amount of layers that were over my belly and so I took a series of shots to document the semi-absurdity of it.
So, it might seem a bit absurd, but it's brilliant and makes you able to walk, talk, laugh, dance, jiggle, and climb an aircraft carrier all without having to hike your pants!
And yes, I literally mean hiking and climbing all over a low-rider. Did all the tours of the USS Lexington in this, including the 4-inch heels and the pants stayed up!
I tested it the last day with a pair of low-riders (I'd broken down and just accepted the over the belly all the previous days) and it worked!
And for fun, here's one of my feet after I forgot about the hiking part of dinner on an aircraft cruiser when I got dressed:
And last, just to round out with cuteness and awesomeness, here is Trajan this morning at the dentist. Trajan loves him and so do I. Except he said we should talk to our pedi about having him seen by the ENT again and possibly pulling out his tonsils as part of a strategy to help his overbite which does not excite me.
Tuesday, March 20, 2012
Reflection @ 20 Weeks
I don't know when exactly it happened, but my mindset has changed at some point.
Not only am I not thinking that these two girls are dead, I'm acting based on an underlying assumption that they will be here, alive and relatively close to when we expect. I'm employing a whole person based on this belief. Changing rooms and schedules and things like that.
Not only that, but I realized this week with my 20-week OB and perinatologist appointments that I am not expecting bad news. I am not ramping up my blood pressure for appointments.
I know that bad things can and do happen, but I'm not EXPECTING them.
Everything I've read and heard from professionals makes me think this is weird. I'm supposed to be getting more worked up as we near the point in the pregnancy that Aurelia died. But I'm not. At all.
Maybe in part it's because I know she died at a really unusual point in the pregnancy. If you look at the fetal mortality curves, her dying at 24 weeks was just odd. So, maybe that's part of why I'm not worried?
Or maybe it's just the nature of the human spirit to be naive almost and expect a good outcome?
I still looked for their heartbeats and was glad to see them, but I had zero of the feeling of desperation as I waited. I had zero feeling of they are going to be dead. Appointments involved some jokes and calmness.
Maybe part of the early nervousness came from the fact that these two girls are such a surprise and so I wasn't mentally already worked up to be pregnant? And so I had to process that?
Maybe I'm just a stupid naive fool?
But I don't think so.
And what's interesting is the doctors seem to have arrived at this place at the same time. I scheduled FOUR-week appointments with both of them. I've been doing weekly or biweekly, so this is a huge jump. No longer worried about cervix, placenta location, implications of the iud being there at conception... I know they are still going to be doing more BPPs and monitoring the placentas and some stuff like that, but the language is starting to sound like these actions are to be cautious and to take the conservative approach more than because something bad is expected.
The next appointments are at 24-weeks. Last time, that was the perinatologist appointment where they both labelled perfect and viable and the obstetrician appointment of the word catastrophic. I imagine I will have some anxiety at this point, but I completely know that it is not rational fear and I think that will help me. And I will have the perinatologist that I like and the OB who is truly probably the best practicing doctor of any specialty that I have ever known. That and a little faith and I'm expecting even my blood pressure will be ok.
One last thought I had today. I was leaving work when I realized that these two will count as people rather than medical waste now even if they do not stay alive. This may sound dark to you, but this was a very happy and peaceful thought to me.
Life is good, I am very blessed and that's really pretty much it.
- Posted using BlogPress from my iPhone
Not only am I not thinking that these two girls are dead, I'm acting based on an underlying assumption that they will be here, alive and relatively close to when we expect. I'm employing a whole person based on this belief. Changing rooms and schedules and things like that.
Not only that, but I realized this week with my 20-week OB and perinatologist appointments that I am not expecting bad news. I am not ramping up my blood pressure for appointments.
I know that bad things can and do happen, but I'm not EXPECTING them.
Everything I've read and heard from professionals makes me think this is weird. I'm supposed to be getting more worked up as we near the point in the pregnancy that Aurelia died. But I'm not. At all.
Maybe in part it's because I know she died at a really unusual point in the pregnancy. If you look at the fetal mortality curves, her dying at 24 weeks was just odd. So, maybe that's part of why I'm not worried?
Or maybe it's just the nature of the human spirit to be naive almost and expect a good outcome?
I still looked for their heartbeats and was glad to see them, but I had zero of the feeling of desperation as I waited. I had zero feeling of they are going to be dead. Appointments involved some jokes and calmness.
Maybe part of the early nervousness came from the fact that these two girls are such a surprise and so I wasn't mentally already worked up to be pregnant? And so I had to process that?
Maybe I'm just a stupid naive fool?
But I don't think so.
And what's interesting is the doctors seem to have arrived at this place at the same time. I scheduled FOUR-week appointments with both of them. I've been doing weekly or biweekly, so this is a huge jump. No longer worried about cervix, placenta location, implications of the iud being there at conception... I know they are still going to be doing more BPPs and monitoring the placentas and some stuff like that, but the language is starting to sound like these actions are to be cautious and to take the conservative approach more than because something bad is expected.
The next appointments are at 24-weeks. Last time, that was the perinatologist appointment where they both labelled perfect and viable and the obstetrician appointment of the word catastrophic. I imagine I will have some anxiety at this point, but I completely know that it is not rational fear and I think that will help me. And I will have the perinatologist that I like and the OB who is truly probably the best practicing doctor of any specialty that I have ever known. That and a little faith and I'm expecting even my blood pressure will be ok.
One last thought I had today. I was leaving work when I realized that these two will count as people rather than medical waste now even if they do not stay alive. This may sound dark to you, but this was a very happy and peaceful thought to me.
Life is good, I am very blessed and that's really pretty much it.
- Posted using BlogPress from my iPhone
Monday, February 20, 2012
XX Variety
Baby on the left gave us a clear verdict on how they looked: "thumbs up!"
Both babies looked great on anatomy. They checked more, but things I can remember include: 2 brains measuring right sizes with right spaces, two 3-vessel cords with attachments looking good (to the degree they can see this at this point), two 4-chamber hearts, four kidneys, two bladders, 20 toes, 20 fingers, no clefts, good fluid on both babies and good spines. The size discrepancy is less than 1% and both currently measure at 5 ounces! The size discrepancy plus their continued perfect growth for passage of time is a huge thing.
The baby on the right has an anterior placenta and the girl on the left has a posterior placenta and he does not anticipate them fusing together. One baby's placenta is low enough that he and the tech looked at it extra when they did the transvaginal for cervical length. The perinatologist is not worried, but did have her make sure and note it because he does want to follow it a bit more closely.
Today was the perinatologist who I prefer (last time, I'd gotten shifted to a different one) and he was much more in line with what I had gotten from the obstetrician in terms of extra monitoring and risks and all of that. Actually made me feel better having him sound that way rather than bring back my sense of impending doom :-). As a result, he said he wants to see me back in 2 weeks rather than four for a cervical check.
Speaking of cervical length, it dropped down to 3.8 cm from the 4.5 cm that it was at 12 weeks (we all have agreed that the measurements the OB tech who wasn't used to doing them took at 8 weeks were so inaccurate that we won't even consider it). To contrast, I was at 4.38 cm last time at 24 weeks and then 3.7 at 28 weeks after four weeks of pre-term labor and having dilated to a 2 or 3 (note: I didn't have a single cervical measurement with Trajan, what simple times!). 3.8 cm is still more than sufficient, but any drop is a little worrisome, so he definitely wanted to followup in 2 weeks. He isn't adding any restrictions at this time, but did recommend that I try to pay attention to my body and when I feel contractions, take that as a sign to drink and rest rather than just blowing it off and accepting contractions as something that naturally happens in pregnancy. While it is true that contractions will occur, it's pretty much impossible to tell if they are contractions changing your cervix or not when they happen, so it's best to treat all as significant.
And another plus is the favored perinatologist agreed with the OB that I should be seeing him in particular instead of just whichever one of them is there and so I am scheduled with him for both the 18 week and 20 week scan.
And in further evidence that I'm a genius, I thought to call the OB's nurse after he switched me to biweekly appointments and have her move my appointments there to the odd weeks (i.e. 17, 19) so that I will see someone each week and get confirmation of continued growth and cardiac activity rather than getting double confirmation every two weeks!
Since I seem to be getting what I'm rooting for, I'd like to officially let it be known that I'm rooting for two babies born alive at 36-37 weeks (since this is where they are capping it). If the universe really wants to keep being nice to me, let's also add them not needing NICU time, having better jaundice recovery than their brothers and maybe even successfully being born as a VBAC with the rupturing that my OB has said she'll do if they're heads down? And maybe even add not having to spend any time in the hospital other than when they are born (I'm thinking bed rest, but as long as I'm rooting, perhaps they can avoid the one-week GI stay each brother got) and just the typical twin restrictions? To be clear though, in case the universe decides I'm getting too greedy in my rooting, live-live is still the real thing I'm rooting for.
The perinatologist isn't using A&B at all and I probably shouldn't admit it, but I really like this. First off, calling them right and left helps me keep track better of who we are looking at. Right now they are pretty much side-by-side with the baby on the right just a smidge lower and the girl on the right vertex and the one on the left transverse. Second, it helps downplay the deja vu sense since the perinatologist always labelled them A&B last time.
I was a bit giddy, smiley this morning after, as they really do look great!
Wednesday, January 25, 2012
Eating ad nauseum
Ad nauseum roughly means to the point of nausea, right?
So, my purpose in writing this post is hoping that you, the wise elders of the internet, can identify a gap or something in my eating schedule and help with some weight packing on. As I alluded to in my last post, I'm needing to work on my weight gain.
With twins, the powers that be dictate that they want you to have gained twenty pounds by twenty weeks. Didn't pull this off at all last time, particularly as I lost almost twenty pounds with two GI bugs at 15-17 weeks, but am really trying to play things by the book this time. So, you may be asking, how much are you up now? One pound according to one doctor and two according to the other. And this is at 12 weeks and change, so I need to gain 2.5 pounds each week to hope to make it by twenty.
Current eating schedule:
One of the Boost Plus recommended protein things plus a yogurt and some of whatever the boys are eating around 6:45 along with my 14 vitamin and minerals
A breakfast at 7:45 or 8 consisting of brisket tacos, cheesesteaks, chicken sandwiches or something similar
Snack around 9:30 that is often cheese and crackers
First lunch at 11
Second lunch at 1 and both lunches are full meals
Try to plan some leftovers from dinner or one of the lunches for about 3
Dinner at 5:45 or so at the house
Put Chiron down and come down every night to a smoothie that Paul has made with protein powder in it.
Often another snack late as well as typically eating at least once during the night
So, what else should I be doing? I've even added some eggs, which I am NOT a fan of since Barbara Luke is such a fan of them. I've tried adding quantity such as taking a cheeseburger up from two patties to three and that's not enough. So, experienced folks, what do you have for me? I've been keeping a pretty good protein emphasis in line with "the book", but should I perhaps try more carbs for a weight effect?
Chiron's weight was fantastic at 29&6, so I think I did a good enough job last time and I know I'm making even more of a conscious effort this time, so I'm not greatly concerned, but I would love to see that weight jumping up a few pounds. But again on the flip side, Aurelia was dead, so perhaps doing things different is something I should really concentrate on.
Also, anyone have any good during the night food ideas? I really feel this is where I could be putting more calories into my day, but it's just a hassle. Last time I mainly did protein bars at this time. This time I've been just doing things like nuts, triscuits, dried fruit and other easy to just have in the drawer foods. There is a fridge in Chiron's room, so I could put more of the Boost Plus things up there, but those disturb me as primarily corn syrup despite being sworn to in lots of twin resources.
And I think I may love cheesesteaks more than any other food on this planet. Last time it was gyros, but this love is more convenient as there are close options including one that starts serving cheesesteaks at eight am!
P.S. I had weight gain problems with Trajan as well. So, I'm definitely not a pro at the gaining weight while pregnant game even with a singleton metabolic issues.
So, my purpose in writing this post is hoping that you, the wise elders of the internet, can identify a gap or something in my eating schedule and help with some weight packing on. As I alluded to in my last post, I'm needing to work on my weight gain.
With twins, the powers that be dictate that they want you to have gained twenty pounds by twenty weeks. Didn't pull this off at all last time, particularly as I lost almost twenty pounds with two GI bugs at 15-17 weeks, but am really trying to play things by the book this time. So, you may be asking, how much are you up now? One pound according to one doctor and two according to the other. And this is at 12 weeks and change, so I need to gain 2.5 pounds each week to hope to make it by twenty.
Current eating schedule:
One of the Boost Plus recommended protein things plus a yogurt and some of whatever the boys are eating around 6:45 along with my 14 vitamin and minerals
A breakfast at 7:45 or 8 consisting of brisket tacos, cheesesteaks, chicken sandwiches or something similar
Snack around 9:30 that is often cheese and crackers
First lunch at 11
Second lunch at 1 and both lunches are full meals
Try to plan some leftovers from dinner or one of the lunches for about 3
Dinner at 5:45 or so at the house
Put Chiron down and come down every night to a smoothie that Paul has made with protein powder in it.
Often another snack late as well as typically eating at least once during the night
So, what else should I be doing? I've even added some eggs, which I am NOT a fan of since Barbara Luke is such a fan of them. I've tried adding quantity such as taking a cheeseburger up from two patties to three and that's not enough. So, experienced folks, what do you have for me? I've been keeping a pretty good protein emphasis in line with "the book", but should I perhaps try more carbs for a weight effect?
Chiron's weight was fantastic at 29&6, so I think I did a good enough job last time and I know I'm making even more of a conscious effort this time, so I'm not greatly concerned, but I would love to see that weight jumping up a few pounds. But again on the flip side, Aurelia was dead, so perhaps doing things different is something I should really concentrate on.
Also, anyone have any good during the night food ideas? I really feel this is where I could be putting more calories into my day, but it's just a hassle. Last time I mainly did protein bars at this time. This time I've been just doing things like nuts, triscuits, dried fruit and other easy to just have in the drawer foods. There is a fridge in Chiron's room, so I could put more of the Boost Plus things up there, but those disturb me as primarily corn syrup despite being sworn to in lots of twin resources.
And I think I may love cheesesteaks more than any other food on this planet. Last time it was gyros, but this love is more convenient as there are close options including one that starts serving cheesesteaks at eight am!
P.S. I had weight gain problems with Trajan as well. So, I'm definitely not a pro at the gaining weight while pregnant game even with a singleton metabolic issues.
Tuesday, January 24, 2012
Sense of impending doom, lifted!
May sound a bit overdramatic, but the feeling was also very dramatic. My sense of impending doom has lifted. Feel calm and at peace and amazingly free from an expectation of being struck down. Crazy, huh?
So yesterday went to the OB and they both looked good. A who is on the right and a smidge lower measured 12 even and B, on the left, measured 11 and 5. My OB described them as putting on a cirque de soleil show in there as they were waving in sync. Nice fact about this is they were so active that I was able to feel confident they were both alive at the same time rather than waiting for the second heart flicker.
Big improvement from last time is the fact that the OB and the perinatologist are calling the same baby A as each other. Last time, the OB's A was the perinatologist's B and vice versa. This was even more obvious after we knew genders since they were boy/girl.
Speaking of genders, the perinatologist said that he'll likely be able to tell their genders at my 16 week anatomy scan there.
Today, A measured 12 weeks and 1 day and B measured 11 weeks and 6 days, so both exactly one day bigger than yesterday!
It really is odd the degree to which the sense of impending doom has lifted. Here's to hoping that it doesn't return. Next OB appointment is in two weeks and then next perinatologist is in four. Maybe not back to naivete, but cloud of doom definitely dispersed.
And must gain more weight. Must. It shall be done, rawr!
So yesterday went to the OB and they both looked good. A who is on the right and a smidge lower measured 12 even and B, on the left, measured 11 and 5. My OB described them as putting on a cirque de soleil show in there as they were waving in sync. Nice fact about this is they were so active that I was able to feel confident they were both alive at the same time rather than waiting for the second heart flicker.
Speaking of genders, the perinatologist said that he'll likely be able to tell their genders at my 16 week anatomy scan there.
Today, A measured 12 weeks and 1 day and B measured 11 weeks and 6 days, so both exactly one day bigger than yesterday!
They're up to 5.54 cm and 5.04 cm measured from crown to rump. He also did a cervical length check, because the tech at my OB's office had gotten a short measurement at 8 weeks. Both my OB and I thought the tech was just in error, but to be safe, we had them check today. It was 4.5 cm though, so all is good on that front for now!
The peri did blow my confidence that they were fraternal out of the water. My theory was that between my previously producing a set of fraternal twins and 8 out of 9 di-di twins being fraternal, seemed pretty likely. Apparently those stats on 8 out of 9 include IVF and other ART procedures and the percentage of di-di twins that are identical among spontaneous twins is higher. I still feel they are likely fraternal though.
He seemed much less concerned about any of the causes for concern (multiples pregnancy, short gestational interval, history of preterm delivery, history of fetal demise, conception occurring with an IUD in place) that I'd gotten from the OB. Seemed pretty laid back even. Said we would do a little more monitoring and he might be slightly more inclined to pull them early with good biophysical profiles, but that was about it.
Their nuchal translucencies looked good, I think. They were bigger than I remember the previous three times being, but at 1.8 and 2.3, they are still not in the abnormal range and are just a bit above the 50th percentile. The blood part adds more info as well.
And, I forced myself to work through my weird psychological hangup over a place called The Coffee Bean. On my way to the catastrophic appointment, I had stopped there to get a rooibos latte. I left it in the car to cool off when I went up for my OB appointment because I was used to them being so quick. I never saw that drink again. And somehow I just got a hangup that I couldn't go there. I figure it's much better than the OB or the perinatologist or the hospital, but I'm not a fan of myself having irrational hangups. So I decided this morning that I could do it. And I did! And it was good.
And must gain more weight. Must. It shall be done, rawr!
Friday, January 13, 2012
I smell like cabbage...
My body is apparently constitutionally incapable of being typical. Conceiving twins, who are likely fraternal, with a Mirena IUD in place is a good example of this, but the current issue is actually perhaps even a bit weirder.
Two nights ago when I went to change out of work clothes before dinner I noticed that my right breast hurt and doing things with that arm was a bit off. I explored a bit and came to the conclusion that I somehow had a blocked duct. Now, I haven't pumped AT ALL in over three months and it has been a bit over four since I was exclusively breastfeeding, so this struck me as a bit odd. The OB had mentioned leaving my breasts entirely alone and being careful to avoid any sort of nipple stimulation, so I found myself in a bit of a quandary. I had a visibly hard area on my breast that was full of milk. Those of you who have breastfed probably know the big risk of this, mastitis. The normal treatment? Getting the milk worked out. But I wasn't supposed to interact with my nipples at all!
So, I called the on-call nurse who said to go ahead and hand express it as the risk of mastitis was worse than the stimulation. She also said to call my nurse in the morning and they might want to see me. I did and they did.
My OB remarked how weird it was, but her best theory was that my body had decided it was time to start producing milk. She said to NOT hand express any more as that was likely to encourage the production of more milk and instead to wear a very tight sports bra with cabbage on the breasts and replace the cabbage every three hours. Her goal is to get me to stop producing and dry up. As I'm just past ten weeks, this sounds like a wise idea. The only other aspect of the plan is that we will add Bactrim DS if I show any signs of mastitis.
Thus, I smell like cabbage. So far it doesn't seem to be working at getting my breast to stop producing the milk [TMI warning: I'm slow to completely stop lactating, so both breasts were capable of producing a couple drops, but the right one is currently capable of producing an across the room stream -- not what you are looking for in a non-breastfeeding mother with a history of a preterm delivery], but the cool of the cabbage does make the painful area feel a lot better.
That's the end of my ramble on my breasts, aren't you glad you now know more than you ever wanted? But I learned some other interesting information at this appointment.
I was taken to a room without an ultrasound and the medical assistant took my blood pressure. It was 120/65, more or less normal. Then, my OB came in and said that based on my blood pressure she was guessing that I didn't want her to look at the babies, but she was planning on it and only wouldn't if I asked her not to. I agreed that my blood pressure was lower because I had no expectation of seeing them and thus no need to prep myself for information on their possible demise, but said that I was fine with getting an ultrasound. They brought in the quickie machine then and while they didn't check it, I'm thinking my blood pressure went up.
I'm glad my OB did this experiment as it helped give her more evidence that I don't have hypertension and also because it helps me to know that the reaction should be within my control. It's physiological and fight or flight, but if I can get myself to not be as worried about protecting myself, perhaps I can keep it down. Going to try to play with that.
Both babies were beating their hearts like pros and while I didn't expect there to be much change from the ultrasound I'd had three days earlier, there was. They are now moving their limbs and bodies obviously! Was great to see.
It's a bit wacky that I've now had five ultrasounds of them at 10 weeks and change and have two more scheduled for a week and a half from now. I find it reassuring, in perhaps a morbid way, that if something bad does happen, I won't have to live on for a long period of time not knowing.
And I really do smell a bit like cabbage.
Two nights ago when I went to change out of work clothes before dinner I noticed that my right breast hurt and doing things with that arm was a bit off. I explored a bit and came to the conclusion that I somehow had a blocked duct. Now, I haven't pumped AT ALL in over three months and it has been a bit over four since I was exclusively breastfeeding, so this struck me as a bit odd. The OB had mentioned leaving my breasts entirely alone and being careful to avoid any sort of nipple stimulation, so I found myself in a bit of a quandary. I had a visibly hard area on my breast that was full of milk. Those of you who have breastfed probably know the big risk of this, mastitis. The normal treatment? Getting the milk worked out. But I wasn't supposed to interact with my nipples at all!
So, I called the on-call nurse who said to go ahead and hand express it as the risk of mastitis was worse than the stimulation. She also said to call my nurse in the morning and they might want to see me. I did and they did.
My OB remarked how weird it was, but her best theory was that my body had decided it was time to start producing milk. She said to NOT hand express any more as that was likely to encourage the production of more milk and instead to wear a very tight sports bra with cabbage on the breasts and replace the cabbage every three hours. Her goal is to get me to stop producing and dry up. As I'm just past ten weeks, this sounds like a wise idea. The only other aspect of the plan is that we will add Bactrim DS if I show any signs of mastitis.
Thus, I smell like cabbage. So far it doesn't seem to be working at getting my breast to stop producing the milk [TMI warning: I'm slow to completely stop lactating, so both breasts were capable of producing a couple drops, but the right one is currently capable of producing an across the room stream -- not what you are looking for in a non-breastfeeding mother with a history of a preterm delivery], but the cool of the cabbage does make the painful area feel a lot better.
That's the end of my ramble on my breasts, aren't you glad you now know more than you ever wanted? But I learned some other interesting information at this appointment.
I was taken to a room without an ultrasound and the medical assistant took my blood pressure. It was 120/65, more or less normal. Then, my OB came in and said that based on my blood pressure she was guessing that I didn't want her to look at the babies, but she was planning on it and only wouldn't if I asked her not to. I agreed that my blood pressure was lower because I had no expectation of seeing them and thus no need to prep myself for information on their possible demise, but said that I was fine with getting an ultrasound. They brought in the quickie machine then and while they didn't check it, I'm thinking my blood pressure went up.
I'm glad my OB did this experiment as it helped give her more evidence that I don't have hypertension and also because it helps me to know that the reaction should be within my control. It's physiological and fight or flight, but if I can get myself to not be as worried about protecting myself, perhaps I can keep it down. Going to try to play with that.
Both babies were beating their hearts like pros and while I didn't expect there to be much change from the ultrasound I'd had three days earlier, there was. They are now moving their limbs and bodies obviously! Was great to see.
It's a bit wacky that I've now had five ultrasounds of them at 10 weeks and change and have two more scheduled for a week and a half from now. I find it reassuring, in perhaps a morbid way, that if something bad does happen, I won't have to live on for a long period of time not knowing.
And I really do smell a bit like cabbage.
Monday, January 9, 2012
They're Alive!
The shot of the ultrasound might be odd to you, but this is my friend the quickie ultrasound. Since you can't distinguish between the heartbeats of two babies, my practice does a quick ultrasound each appointment to confirm cardiac activity.
Next appointment is in 2 weeks and also going in for first appointment with the perinatologist around that time. My OB actually offered me either 2 or 4 weeks. I said 2 and then said that perhaps 4 would work since I was seeing the perinatologist, but she said I might as well just do the 2. Blood pressure is improving in their office as well, was only 135/78 this time!
Now for a real leap of faith, I think I need to tell my boss.
I actually do not have an impessive bump at this time, contrary to popular belief regarding back to back twin pregnancies. But, I still think it likely will look comical at some point with Chiron's diminuitive size.
Here's baseline:
Some pudge, but not bump per se. Oh, and this is about 8 weeks pregnant on the last set of twins. I do NOT have any pre-pregnancy shots at all this time, since this is a bit of a surprise.
Here's almost 22 weeks pregnant with twins last time:
And here I was this time at 8 and a half (this was December 30):
I'll try to remember to take a shot in the next day or two just for giggles. I'm guessing it'll be at least another month before will qualify as a bump.
Also, aren't we all proud of myself for being willing to consider a month from now? And I was flatout assuming they'd be alive, I really think I've made great mental progress. I know I've been mainly mocking it, but I think I really am coming more to terms with things. The only bad side of that is once I really get my mind wrapped around the pregnancy, I'll have to start thinking much more about logistics.
One last OB note: she also told me today that 37 weeks is the farthest out that we are willing to consider. In my head, I already knew this, but was thinking 38 or even 38 and change where she said 37 is the farthest. She did follow it up with "even if a bit earlier than that, we will still be a lot past 29!" It's such a hard balance between the safety of removing them and the risks of gestating outside of the uterus. But twin pregnancies have a bad rap for cords and placentas anyway, so I think I'm ok with this idea of early even if it ends up meaning some NICU time for babies who appeared to be doing find in-utero. Also, she hasn't said it (in fact she said she'd call it 50/50), but I feel pretty certain I'm earning myself another c-section.
Subscribe to:
Posts (Atom)