Thursday, May 28, 2009

More than you needed to know about my cervix

Last night around dinnertime, I started to feel really awful. A aching, heavy pressure was surrounding my pelvis and I started to get worried (surprised?). After guzzling a ton of water and laying on my side for two hours, I called the MFM clinic and spoke to a wonderful Dr. G on the phone. He said he thought it was just uterine growing pains, but to head in to the clinic to have my cervix measured today.

I slept horribly, still sore, and dreaming of lost babies. I continued feeling crampy and must've Googled "incompotent cervix" and "preterm labor" ten times. It bothered me the feeling was not going away. I have had two friends who had cerclages placed at about 16-18 weeks and carried to full term. I think I am especially paranoid about it... and I don't know why. I am just glad it can be measured by ultrasound.

I saw my regular Dr. P this morning, and they measured my cervix at a "nice, long" 3-4 cm. She told me the following about cervical measurement and what to expect:

-A measurement of over 3 cm is always good
-It will probably get a little longer before 16 weeks as the lower uterus develops. To this I thought, "I didn't know there was a "lower" uterus!
-If it shortens in a week or ever gets below 2.5, she'd be concerned.
-Below 2 cm and it would most likely get a cerclage

She said she thinks it is because I am growing so quickly that the pain was mostly round ligament and uterine stretching. Both she and Dr. G told me some variation of the comment, "this pregnancy will be much more painful than your pregnancy with your daughter." They told me to just "take it easy" which is easier said than done. We will be checking in on the babies again in 10 days, and my cervix too.

Coming soon, a new feature: "People Say the Darndest Things!" (when one is pregnant with multiples...)

Monday, May 25, 2009

12 Week Triplet Belly Picture

Until I saw the comparison of 11 and 12 week belly pictures, I didn't think I had expanded much, but well, I have! I do not generally run around in bikini tops, but we had just taken A swimming at Gramma's house, and I was hot. I am often hot now, and not in a Sports-Illustrated-Swimsuit-Issue kind of way. More like who-turned-on-the-heat-hormonal kind of way. Not as attractive.

On the weight gain front, I am proud to say that I have gained 9 pounds or so! I never thought I would be happy about it, but all the doctors and nurses stress it to me about every 2 minutes, so I am eating when I can, and trying to get a good amount of protein, too. My thighs are starting to show it, and it is not pretty. I knew that early weight gain to build up fat stores had to go somewhere, I just hoped it would be my breasts and my belly... not so much. Today when I put on my bikini, I was saying I looked like my hips and thighs had grown (in a sad voice) and my daughter comes in and says, "Oh Mommy! You haven't grown. You are still short, so don't worry!" She always yanks me right back to what matters. In this case, baby-growing, not looking toned in a bikini.

The Post with the Gender Predictions

Thanks for to everyone who participated in the poll and made your guess! 53% of you were right. Our sonographer seemed pretty confident when she gave us this prediction:

Identical twin GIRLS and a BOY!

We were so excited to know that they are all healthy and so far, free from any abnormalities, but having a guess at their gender was extra special! I always hoped there was at least one more girl as I have saved every item of clothing, pink receiving blanket and decoration from my daughter, and would be bummed if I had to donate about 8 large totes of baby girl things.

We will see if she is right! I will have an ultrasound every two weeks to ensure the babies are all growing at the same rate, and that my cervix is not shortening. Honestly (a bit of Wemberly here) I am very worried about cervical shortening. I wish they could just put a cerclage in now (stitch my cervix shut) but my doctor says it is best to monitor it closely and frequently and then have it done if necessary. She said I am at an advantage as I carried my daughter to 41 weeks, and my cervix was SLOW to open. I am going to my final RE visit this week and the doctor I am seeing is a mom of twins, and very knowledgeable so I am hoping she'll measure my cervix to reassure me, and tell me if every other week is often enough for now.

The belly continues to grow, and I promise to post a 12 week belly picture later. Thank you so much to everyone who sent their congrats on a good NT scan, and their kind wishes for us!

Friday, May 22, 2009

Nuchal Transulcency Scan Results...

Are in!

Babies A and B: 1 in 17,000 of having an chromosomal abnormality
Baby C: 1 in 16,000 of having an chromosomal abnormality

WOO HOO! Absolutely thrilled with their NT measurements! Some other good things we saw on the ultrasound: all have visible stomachs and bladders, strong heartbeats, visible nasal bones, and are very active. Dr. P was super happy and said the babies are perfectly healthy and normal as far as we can tell. I absolutely loved our sonographer, who was 31 weeks pregnant, because she narrated the whole scan, telling me what was what, how everything looked good, and made a gender prediction, which she said was early, but she was "pretty sure." I will post a Blogspot poll so you can all make your best guess and the answer will be revealed on Sunday.

They record full DVD's of the whole ultrasound, so I only got a few pictures, but cute they are. I will make my husband (AKA: Tech Support) figure out how to post a bit of the video.

I am full of gratitude, and so happy they are well inside of me. I loved seeing each nose, wiggly body and face. These are our children, and they are healthy. Grateful does not begin to cover it.

Here is C, looking adorable:

Here are all of them in one shot. 3 perfect little heads, snuggling together!

Thursday, May 21, 2009

NT Scan Jitters

Anyone who knows me or reads my blog knows I am, by nature, a worrier. Each day that this pregnancy passes and the babies stay inside, hearts beating away gives me more hope and takes away some of the fear.

However, I am a little nervous (read: nightmares, can't-sleep-nervous) about tomorrows Nuchal Translucency scan. For those who don't know, it is a high definition ultrasound that measures the fluid pocket in the back of each baby's neck. If it is over a certain measurement (2.5 mm I think) the baby is at a higher risk for Down's or other Trisomies. The scan will take 2 hours for three babies (with a full bladder!) but they will tell us what they see as they are scanning. I am really flipping out.

This seems to be one of the last big hurdles to ensure the babies themselves are okay in there. I know we'll have possible TTTS, pre-term labor and all kinds of other things, but this is a big obstacle to make it over. It is so hard for me to believe that I'd be lucky enough to have all of them be okay... it has been such a long, hard road to have a healthy pregnancy, and I am so scared that tomorrow will bring tough news.

I do have my age (26) on my side, which helps decrease the risk, but I also have a trisomy 18 pregnancy in my past (usually a fluke). I've read up on the testing and the usual results, and overall, 95% of results are normal. Please, please let ours be normal. If the results indicate a higher risk, we may do a CVS to find out for sure, but I don't know. We will cross that bridge if (hopefully we never) come to it.

I am so glad the test is on a Friday... and hopefully, the results will give me a nice, long, sunny weekend of comfort and peace.

Monday, May 18, 2009

11 Week Triplet Belly Picture promised.

Now you can see what I am talking about...big for 11 weeks! When I was pregnant with my daughter, I did not look like this until month five. Seriously.

The nausea has eased tremendously, making it much easier to get close to my calorie goal. I am getting good at eating when I am not hungry, eating protein bars while driving, drinking whole milk. Basically everything they tell you NOT to do when trying to lose weight. I am up about seven pounds! That is great for me, and I am actually working hard on it. Never in my life have I wanted the scale to go that direction. Every bite I take, I think of heavy, healthy triplets who can breathe and eat on their own. This is my goal.

NT scan is on Friday. I feel like this is a real milestone, and after this I can get more comfortable, tell more people. We have told some close friends, and it is pretty obvious when people see me, but we haven't made any announcements yet. They will be able to tell us with a pretty good amount of certainty what our chances are of one of the babies having a chromosomal abnormality. I had a pregnancy with Trisomy 18, but I read, and am told that one Trisomy pregnancy does NOT increase our risk for more. I know I have my age on my side, but I am terrified something will be wrong with our babies who we love so much. Please hold a good thought for us.

I continue to be in puppy love with my Doppler. We listen to them every day and can usually hear the piggy-back-racing sound of the twins, usually in the 170's and then a single one in the 160's. It is kind of our new party trick... and it has given me a new optimism and comfort that I am so grateful for. It is amazing to know they are okay inside. Such a gift. Those Babybeat people are going to get a big cookie basket soon.

Thursday, May 14, 2009

Window Shopping

A few favorites... which maternity shirt do you like?

And really, anyone who has paid for IVF knows this one his FUNNY:

Since I am still anxious, I won't be placing any orders until after our NT scan in 8 days (but WHO is counting?)... and if all is well, then I might start really spending.

Happy Thursday!

Tuesday, May 12, 2009

I Heart My Doppler

Love, love, love my Doppler.

I heard the babies' heartbeats for the first time tonight! The most beautiful sound to a worrying expectant mom like me. We found a nice 170's heartbeat right away! It is hard to tell if we are hearing more than one or if we are picking up the one closest to the probe. The directions said even doctors don't do multiple heartbeats by Doppler often because it is hard to tell who is who! Later I called my mother-in-law in Texas and my mom to hear it too, and they loved it.

My hubby was so happy to hear them too, and may have muttered something like, "Now we won't need to get an ultrasound every five days..." It is so comforting to know I can check in on them whenever I feel anxious, and know that we can hear someone doing well inside.

I am taking a belly picture and posting later, I promise. It is shocking how quickly it has popped out! "When you are Expectting Twins, Triplets..." says that the triplet uterus is 10-12 weeks ahead. That is TRUE for me! I am fully in maternity clothes now, at 10 weeks! That is definitely 10 weeks sooner than it was with A. Seriously, folks, I am going to be a whale in a few months. Watch out!

Monday, May 11, 2009

10 week ultrasound

We had a 10 week ultrasound today and the babies look wonderful! Their heartbeats were all strong between 150's-160's, and they measured between 10w1d and 10w4d.

Oh, are they cute! Their little arms and legs are formed and we could see them moving the entire time! Triplet A especially was grooving all over the place, and then B joined in. I think C was taking a nap, but her heartbeat was strong.


Today's pictures:

Here is A, you can see her little baby shape now! Note she is upside down, so head is at the bottom and you can see her little hands and feet.

Here are all three. C was hiding higher in my uterus and so A and B are much easier to see than C. Again, A is upside down, resting her head on B's bottom. C is to their left in both shots.

I am still feeling much less nauseous, and have been instructed to start protein shakes tonight, but I have gained a good five pounds now! That is a big deal for me, and I am trying to keep it up. I still am EXHAUSTED and headachy, but much less sick. The belly requires maternity pants now- or a belly band at least. They said a 10 week triplet uterus is like a 18 singleton one, which is how I look.

My doppler should be here soon, so I can listen to their heartbeats when I freak out (read: every day). It should work in the next week or so! :)

Friday, May 8, 2009

She's Back....


I am almost 10 weeks (9w5d) and am starting to get scared again. Yes, I see the same pattern: after 5-7 days have passed since my last ultrasound, I start to freak.out. The nausea has improved a bit, which scares me. I really like having lots of miserable symptoms to tell me my hormones continue to rage on in support of the pregnancy. I am still tired and headachy, but less pukey.

It is another 2 WEEKS from today until my NT scan at the MFM clinic when I will get to see our (hopefully) growing babies. I can't make it. I am like a junkie who cannot make it until the next fix, in this case, seeing that my babies are okay. I have been fooled by asymptomatic miscarriages before, so this time is particularly terrifying for me.

Ways in which I am behaving like a junkie:

1. I have Googled "risk of miscarriage after 9 weeks" more times than I care to admit. The results are all over the place, and with heartbeats seen, it is different. Don't waste your time there.

2. I have ordered a fetal heart doppler from Babybeat. All of my friends have said it helped them feel better. I know it might freak me out even more, but I am a glutton for punishment. Also My Friend over here got one and heard her baby's heartbeat. :)

3. I scheduled an ultrasound for Monday at 9:15 am with my RE. I tried to scam them into seeing me on the weekend, but she said, "No OB on the weekend unless it is urgent." Can't she see I am a basket case and it is urgent? No dice, Monday it is.

4. Pushing on my sore boobs to make sure they are still, in fact, sore. They are.

I think that most of the fear is irrational. I know that they told us it was less than a 5% chance that we'd lose them to early miscarriage now. I know that the chances of all of them having something chromosomally wrong is slim, also. It is knowing the unbearable pain of losing a baby, of starting over again and again, and getting through early pregnancy that scares me. I know I could if I had to, but I do not want to do it again. I want these three babies to be born into our family, and grow up healthy with their sister. I don't want their existences to end on ultrasound for us.

Please grow, babies. If you want to make me realllllly sick, that is okay too.

Wednesday, May 6, 2009

"You'll have to eat about every hour"

I met with the nutritionist at our MFM clinic this morning. I knew my weight was not increasing quickly enough, so I expected to be told firmly that I had to eat more. I am 9 1/2 weeks now, and have gained around 3 pounds. I know this is not enough, and that they'd encourage me to get the scale moving in the right direction.

We talked a bit about my weight before pregnancy and my eating habits. She said for someone like me, who was very "calorie conscious" and ate fewer than 2,000 calories a day, it would take a shift in thinking to be able to eat close to 4,000 required by a triplet pregnancy. I agree, but it also takes the cooperation of my stomach which feels full rather quickly and is easily turned off. I am supposed to gain somewhere between 58-70 pounds, but she said for my frame and size before pregnancy, 50 is a more reasonable goal. Each doctor and nurse have emphasized the need for early and adequate weight gain (as does Barbara Luke's book that I've mentioned) and shows that babies whose mothers gain more, earlier have better birth weights and fewer health problems at birth. This is a huge motivation!

We talked about some of the challenges I have right now:

1. I don't eat much meat, and no beef or pork at all. This makes it harder to get the recommended 200 grams of protein per day.

2. I feel extremely nauseous about half the time, and do not feel like eating then.

3. Many foods, cooking smells and scents make me sick. Cooking is not really an option right now.

So, she helped me devise a meal plan and I need to try to stick to it, even when I don't feel good. If I do feel extremely sick, all the more reason to eat extremely high calorie foods when I can, since I will eat less when nauseated. She said someone who started "a little behind" should really eat every hour (!!!) or so. She had many good tips:

1. No more water. Make every sip count, and have calories. Juice, milk, smoothies, or lemonade. Nothing diet.

2. Shoot for three meals with three snacks. A snack, however is not 1/2 an apple, but more like a mini-meal.

3. Eat fast food to get extra calories, and take out. She gave me the list of highest calorie restaurant entree's which she either gives to people who need to lose or gain. Example, a Starbucks blueberry muffin has 500 calories. That is A LOT and would help me meet my goal. A slice of Costco pizza has 800 calories. Can you believe that?

4. Must start drinking protein shakes at night and eating protein bars. The babies need some protein in there!

5. She told me to use to track my calorie intake. I started and with all my extra efforts today, I've only eaten 900 calories. GRRR. I had such a big lunch, I don't feel like eating at all until dinner.

6. Eat fat-dense foods like nuts, butter, avocado and cheese.

Had someone told me six months ago that I could eat whatever and whenever I wanted, I would've been thrilled, but once you start trying to do it... it loses its appeal rather quickly. I am sure once the nausea passes, it will be easier, but right now, it is a battle. I may have to start posting my weight gain so you all can encourage (read: harass) me into packing it on. It is like reverse Over Eaters Anonymous!

So there you have it. This seems like an impossible goal, but I want those babies to grow and be as heavy and healthy at birth. They said you can't really gain too much for a triplet pregnancy, and it will serve all of us very well. I know not every clinic advocates a plan like this one, but it makes sense to me, and there is a lot of research backing it up.

Listen up, A, B and C! Mommy is stuffing her face (out of lots of love) for you up here, so grow big and strong!

Monday, May 4, 2009

A Brand New Day

This morning's appointment at the Maternal Fetal Medicine (High Risk OB) clinic was wonderful. My hubby and I left there, hand in hand (actually, I was wolfing down a bagel) knowing this pregnancy will be hard, but that we want to do it, and we will have excellent medical care.

We had a quick ultrasound that showed three little beating hearts and babies measuring right on schedule. Some exciting news on the ultrasound front: I have graduated to abdominal ultrasounds! Woot woot! No more Wanda and taking off my pants for strangers!! Then we met Lisa, our nurse who was so warm, and kept saying "YAY!" for everything which I loved. She asked lots of questions of us about our history and we asked her many questions. I asked how many triplets Dr. P follows each year and she said, "Well, she has about six or seven sets right now!" which is great to hear! Obviously, this is the place for HOM (Higher Order Multiples).

Nurse L also told me there is a dedicated nurse line and they always call back the same day. She explained that she'd been in L & D for a long time and loved this hospital's NICU because the parents and babies get a PRIVATE room. I am serious! They get the same high-need medical care, but there are beds for mom and dad to sleep in so the babies are always with you as they heal. I love this concept! She also told me about the hospital bed rest floor where moms live (in private rooms, again!) and how there is Wi-Fi (must have) and lots of activities to keep us happy. A and my hubby could even sleep over and watch movies with me. As Dr. P pointed out, 1/2-1/3 of all triplet pregnancies have some hospital bed rest time, so it is good to know what the facility is like.

When Dr. P came in, she had a big smile on her face. She is around forty-ish and was wearing bright pink sandals with her doctor's coat. Loved it. She first started by congratulating us and asking what our questions were. She did not know what she was getting into! My first question was, "When you see a pregnancy like this in someone like me, do you think, 'It cannot be done safely?'" She said immediately, "Absolutely not!" Which really sealed the deal for me. Someone who sees very complicated pregnancies and many sets of HOMs felt that we have a good chance for a good outcome was amazing. She continued, "I think it will take a lot of monitoring, resting and eating, but we can do it." It was so reassuring. I asked a lot about Twin to Twin Transfusion (TTTS) and she and her partner are the only docs in several states who are true specialists in some of the more aggressive treatments of it. She said they will watch very closely for it, but that it only occurs seriously in 10% of identical twins. That was also reassuring. My husband asked if we might already see signs of it, and she said since the twins are measuring the same, that is a good sign that they are sharing resources well so far.

Some other things we learned: No chance for vaginal delivery, so scheduled C-section, it is. Most of the triplets she sees make it to 33 weeks or longer. She will measure my cervix routinely and if it shortens, do a cerlage to "keep it closed". Not including the rates of hospital bed rest, she said MOST triplet pregnancies will be on some form of bed rest after 20 weeks, sometimes sooner. They only see a small percentage of patients exclusively (usually they "consult" with an OB) but she will see me every two weeks, from here on out. I expressed my concern about my slow weight gain, so I will meet with their nutritionist on Wednesday to find out how to beef up. The doctor was very specific about the importance of early weight gain with HOM.

I cannot tell you how good it felt to be in a place that knew we could do it, thought it will be hard, and was so positive. We are so happy with them that we aren't going to try the other clinic- I love them. I am also a fan because I delivered A there and they are an amazing place to have a baby.

I was listening to this song today, and thought it was perfect. "A Brand New Day" by Van Morrison:

"When all the dark clouds roll away
And the sun begins to shine...
Well it shines so bright and it gives so much light
And it comes from the sky above
Makes me feel so free makes me feel like me
And lights my life with love

And it seems like and it feels like
And it seems like yes it feels like
A brand new day,
A brand new day."

Sunday, May 3, 2009

A, B and C, Accounted for, or Hanging out on the Fence

After my freak out due to the spotting last night (which has stopped), we went to the RE and were reassured that A, B, and C all have strong heartbeats and measure perfect for their 9 weeks!

Here are the little darlings:




We got to see one of my favorite docs, Dr. L who did my retrieval and my transfer. When he came in, he was happy to see us but seemed a little negative about the triplet thing. Honestly, it was wonderful to hear his thoughts, which were very candid and honest. He was so respectful but when my husband asked what Dr. L thought about triplets, he said, "It is going to be really hard. We won't know until you go into labor if you will deliver at 24 weeks or 36 weeks. We just don't know, and you have to decide what to do before we know." He said when people ask him what he'd do, that the choice is made for him as he is a Catholic, but that he respected all choices. We sort of stared at him, hoping to hear some advisement one way or the other, but ultimately we know it is up to us.

We told him we'd be seeing two Maternal Fetal Medicine (MFM) doctors this week at two great hospitals, and he said that is the best we can do: listen to their opinions and make our educated decision before 12 weeks. Dr. L spoke with a lot of truth when he said, "Reduction has got to be an emotional decision, too." I go back and forth, just hanging out on the fence, trying to decide what the "right" thing is. And as my husband pointed out this morning, there is no "right" thing.

On one hand, we could have a difficult triplet pregnancy with bed rest, preterm labor and the NICU, or it could be uneventful and easier. We could reduce to a singleton and have an easy pregnancy, or lose the whole thing. It is a game of risks and not knowing, and it is wearing me out.

So to the Maternal Fetal Medicine docs we go tomorrow and again on Thursday, to find out more of what we already know and hopefully some new things too. I have my list of questions ready, and hope to have them all answered. There is an amazing and comprehensive list of questions to ask a Maternal Fetal Medicine doctor on Stirrup Queens; check it out!

Big, giant thanks to Karen (Mom of triplets and knower of many things) of It's Not a Clown Car who has spend so much time counseling, supporting me and providing me with information, contacts and networking. She is my hero and I am so happy she found my blog! Thanks to everyone else for all your kind words, thoughts, support and understanding. I cannot believe how lucky I am.

Saturday, May 2, 2009

Up and Down

I have been a bad blogger, because I've been feeling oh so sick. The nausea (but never actally vomiting), aversion to any smell, headaches and fatigue have been truly knocking me down. I have little energy to stand upright, let alone cook dinner or write a coherent blog post.

The symptoms are totally reassuring. I have been very glad to have them, since we haven't seen the babies for a whole six days, and this is when my last miscarriage happened. This afternoon, laying on the couch, and watching "Marley and Me" I got nervous. (MOVIE SPOILER HERE!) I forgot after reading the book that she goes to get her first ultrasound and finds there is no heartbeat, which is not what I (or many of you!) need to see right now. I sneaked a peak and my panty liner and there is a dot of blood. That red spotting never ceases to terrify me. Even though I had it last week and all was fine, and I know of a small subchorionic hematoma, I did not have it with my daughter, the only pregnancy I've yet to carry to term.

The ups and downs never end. We went from being nervous about twins, to accepting it, to spotting last weekend which led to an ultrasound revealing a third baby (!) but three strong heartbeats, nonetheless. Somehow, we've been less worried about early miscarriage than what the health of the whole triplet pregnancy will be, and whether or not we'll be advised to reduce the pregnancy. Now, I am back to the basic but overwhelming need for all the babies to be okay, each of my little children. Keep beating, hearts.

I just called my RE as I have not yet seen any of the MFM clinics and I know my RE will be there tomorrow. I am already going to one of the MFM's on Monday and will have an ultrasound, but I do not think my sanity will hold until Monday. I need to know what is happening and that they are okay in there. I need them to be okay.

Now I am waiting for the RE's office to call back (hopefully someone with lots of compassion) to see what they suggest. I would love to go in for an ultrasound tomorrow, as it is probably too late today. The roller coaster of emotions never stops.

Update: Heading to the RE at 8:30 AM for a scan to make sure all is well. Hopefully it all is... update tomorrow. Thanks for the kind thoughts!