Monday, August 31, 2009

26w1d: Holding my breath

12 days until I let out a big sigh of relief. Holding my breath is starting to hurt.

After a sleepless night of anticipating my appointment today (and I do have to pee every 45 minutes), I waddled into my MFM's office for a cervical check. Good news: STABLE! It is still holding around 2 cm, and since my contractions are much less, I am allowed to be at home. Dr. P said her threshold for admitting me is higher now since I've been treated with corticosteroids. Hopefully we'll have another negative fFN on Friday and I'll be allowed to be at home for my baby shower.

A note about the baby shower: I am ridiculously excited for it. I have been dreaming of getting to the point that I could have another baby shower for years. I love to host them for friends; love the planning, invitations, cake and favors that come with these wonderful celebrations. Lately I have attended many, often with a little lump in my throat, wondering if I'd ever carry a pregnancy this far. Now we are nearing the safer zone (if their is such a thing) and I get to open gifts from loved ones, each a little window into our babies' futures in our home, in our lives.

I am sort of afraid that it will not happen, that I might deliver the babies before then and they could not survive. For some reason, this seems to be yet another mental milestone for me or perhaps, a mental roadblock. Once the house is full of baby swings and tiny blue clothes, will they really get come into this family safely? Can the celebration make it real?

Many things have happened recently that feel more... permanent. I have not told you this yet, Internet, but amazing mother who we affectionately call "Gramma" has resigned from her job, sold her condo and has moved in with us to help raise the children! When she first offered, I said, "You don't have to do this!" and her response was always, "What could be more satisfying than being with my grandchildren all day?" She is one of the most selfless people I know, and I am eternally, completely grateful.

I did not want her to give notice until 24 weeks, and when it came and she did resign, I was a little alarmed; I was scared that still, the babies could come too soon and she'd no longer have a career. Her last day will be around 27 weeks, and while that seemed relatively safe a while ago, I am surprised at how anxious I still am now, almost to our first goal of 28 weeks. So I am wondering: when will I feel safe?

As we counted the days until 24 weeks, I had planned to order the cribs, stroller and other big items as a celebration when we hit the milestone. I balked. At 25, my husband was encouraging me to get them, knowing I wanted to buy them, but was scared. I had long ago decided on the stroller I wanted, the Triple Decker and while I knew they could take many weeks to ship, I continued to be hesitant to order one. Yesterday, while searching Craig's List, I found one, with the three car seats and bases for about 1/3 of what it would cost new. I could not ignore the great deal, and felt it was somewhat of a good sign that someone who lived 10 miles from us had put theirs up for sale just the day before. My husband and daughter picked it up, and met the family with their darling 15-month-old triplets. My mom also nudged me into ordering the cribs yesterday.

The Triple Decker:

While I admit to be an anxious person (sliiiiight understatement) I am a bit surprised at myself for not feeling more comfortable. My awesome nanny is expecting and I have been handing down my too-small maternity tops to her (read: all of my shirts). I realized today that another batch now stop at my belly button and need to get sent along, but I immediately thought: what if I have to do this again? What if my boys don't survive and I have to do IVF again and go through another pregnancy? I totally see these thoughts are not rooted in reality, but in fear. I know there are no guarantees with any pregnancy, but ours is a high-risk one, and I am used to waiting for the other shoe to drop. Will I ever stop doing that? Once I am holding my boys, God willing, I hope to let out the loudest sigh of relief the world has heard.

The 26 week belly:

Friday, August 28, 2009

The view from my own bedroom...

How sweet it is to be at home!

Thursday morning looked bleak: I had not slept much at all and had dreamed that Baby C had died while inside me- I woke up crying, sweating and was even more homesick than ever. I knew Dr. P was maybe going to let me out on Friday and so I knew Thursday would be spent obsessing about whether or not my cervix would be okay, and if we would receive the great news of another negative fFN.

During morning rounds, Dr. P came in and asked how I was. I told her I needed to be broken out of this hospital if it was still safe for the boys. She looked at the blood shot eyes and heard my weepy voice, and decided to do the fFN and scan Thursday instead of Friday. (Insert angel chorus of "Hallelujah" here.) I almost burst into tears for the twelfth time that morning, this time with relief.

First piece of good news: the fFN was negative! For those of you who are not keeping track of each day of this gestation, that gets us to 27w4d- ALMOST 28 WEEKS!! Again, a negative fFN shows less than a 1% chance of going into labor in the next two weeks.

Then, I waited for my scan. Waited for about three hours, heart racing, silently imploring anyone listening to please let my cervix be the same. The sonographer who finally came to get me was, how do I say this nicely, inexperienced. When the wand went in, I thought it looked bad, but she measured it at 1.9-2.4. Monday it measured 2.1-2.4. It really seemed to me she was measuring it short, and she said, "No. That is right." I was sure any other sonographer would've had more length. She scanned the perfect boys and their pretty even fluid and called Dr. P to see if we needed anything else. Dr. P said, "Tell her she can go home and I will be over to discharge her." For the second time in a day, I almost cried with joy!


Dr. P: "You get to go home now! Sometimes it takes a few (or six, but who was counting) days in the hospital for people to really know what we mean by bed rest. Now you get it and you'll be good, right?"

Me: (Nodding repeatedly.) Yes, Ma'am.

Dr. P: I am very hopeful that you'll continue to be stable. The fFN is always so encouraging and your cervix was the same. That sonographer could've gotten you a few more millimeters, easy!

Me: (No shit!) I thought so too! What is the trend you see in cases like this? Will it just keep getting worse?

Dr. P: It usually sort of stair steps. Stable for a week, shortens, we try something else, stable.

Me: So you think we can get even farther now? 32-34 weeks?

Dr. P: I am hopeful, yes. Sometimes we have to take them due to IUGR (Intrauterine Growth Restriction, AKA: they run out of room to grow) earlier than that.

Me: Right. (Did she just suggest that they might have to be taken, not because of imminent labor? SQUEEE!)

Dr. P: I need to see you every Monday and Friday. Enjoy being at home... for now. (Insert diabolical laugh and rubbing of hands together.)

Actually, she was pretty darn sunny, and is a wonderfully competent doctor. I feel unbelievably lucky to have her, but while I was in there I think she seemed like a prison guard. I know if I have to go back it will be because things have become more risky, and it will be the right place for the boys, but for now, I am thrilled to be home. I read stories to my daughter before bed from the couch, slept next to my husband and am looking out the window at the woods behind our house while the boys wiggle inside of me, safe for a while longer. Life is wonderful.

Tuesday, August 25, 2009

No, I am not Bi-Polar

Here we are, 25 weeks and 2 days! 18 days until the 28 week mark! Thanks to everyone for the kind comments and encouragement after my meltdown yesterday. I wish I could say it was a good day, but I cried a good part of the day and felt more and more like I needed to have a better talk with Dr. P. My husband and I talked about the options and he came to lay in my bed with me last night to talk (after working all day and taking care of our daughter).

What I realized while talking to him, my mom and friends is that I want more than anything for these boys to be safe and sound and sound and born at a healthy, 30+ week gestation, and I also want to be with my family. I felt like I had to choose between these two things yesterday, and obviously am being as cautious as can be with the boys. My husband and I both decided I'd have to stay put unless Dr. P suggested that there was no need for it at this point.

I was so excited to talk to her this morning, but she ended up doing rounds late this afternoon instead. When she came in I was ready to communicate clearly with her, and get her opinion. It went something like this:

Me: Okay, I really want to be cautious and make sure they stay in as long as I can, but am I any safer here?

Dr. P: Not right now. Your contractions have been SO few the last couple days, and your cervix is stable. In fact (takes me off toco monitor) you don't need to be monitored anymore unless you feel a lot of contractions.

Me: So is it reasonable to measure my cervix again on Friday and do an fFN and if all looks the same I can go on strict bed rest at home?

Dr. P: Yes. If it is the same, and the fFN is negative, I will discharge you. You will have to be on more strict rest- no trips up and down the stairs, no walking around. Having you here is being extra cautious, which is fine, but it is not really necessary right now. I will check your cervix twice/week and if it shortens at all, you'll be readmitted.

Me: (Trying to be as explicit as I can) If all is okay on Friday and I head home, I am not in anymore danger of delivering early if I follow the rules and take my meds?

Dr. P: (Looking at me like I am kind of slow) That is right. I will schedule your U/S and fFN for Friday. We'll talk then. You should get to have your baby shower at home now!

Me: (Sniff, sniff.) THANK YOU! We should talk like this more often! (Not really, but that is what I was thinking.)

Who has a big grin on their face? ME! It was awesome to be reassured by her that I was not risking anyone's life by sleeping in a different bed. I will be taking the same meds and resting as much. I asked about home monitoring for contractions and she said since I've demonstrated that I know when I am having them, it is better to just call and be seen.

I feel so much better today! Now I know that if I have to stay (due to more contracting or a shorter cervix on Friday) that it will be necessary and if all is the same, I can rest at home, hopefully preserving a shred of my sanity.

The boys and I at 25 weeks. They have grown!

The physical therapist just came in and talked with me about the wonderful affects of losing muscle mass while bed resting and how to do some simple exercises. She also told me Kegel exercises can help strengthen the cervix and prevent shortening! True or not, I will be doing mine religiously now.

Monday, August 24, 2009

25 weeks!

(And one day, seven hours and fifty minutes.)

(And a meltdown! You knew it was coming after all of that positivity.)

This morning, I had an ultrasound and saw the growing boys. They looked perfect- their Dopplers were great (no signs of TTTS) and all three had nice strong heartbeats, even fluid and were practicing breathing! Both Dr. P and the sonographer said it is a great sign to see breathing movements already and they don't expect to see it until closer to 28 weeks. Good job, boys!

My cervix was 2.1 - 2.4 which is pretty close to what it was when I was admitted. The lower number has not changed and Dr. P was very happy with that. She said the new meds and increased rest seem to be keeping me stable here and she thought my cervix would make 28 weeks.

We talked about how long I'll be here most likely:

Me: So I am in for a while?
Dr. P: I thought I'd have to fight to keep you here!
Me: Well, I know how important the next twenty days are to get us to 28 weeks, and I really want to be safe.
Dr. P: That sounds very reasonable. Let's check in about it every week after we see your cervix and make decisions as we go. You contract less here, and you rest more than you would at home, so it makes sense.

Now, to the normal person, this conversation would seem to go great, right? Not for me: as soon as she walked out of the room I burst into tears. I called my husband who was in a meeting and dear friend to hash it out. What I figured out is that I wanted her to tell me I HAD to stay for the babies; that it was the best thing and I was doing a good job. I wanted her to remind me that although I was away from my daughter every day, I NEEDED to be here for the boys. Instead, I felt like I should've fought her, wanted to go home to be with my family, and damn, I am kind of a selfish woman. (Cool-ish bedside manner and hormonal lady don't communicate well...)

The thing is, I have children in two places and I want to be with all of them. Despite her frequent visits, Skype sessions and phone calls, I miss my daughter painfully, and I miss my husband. I hate being away from the place where their lives happen each day. On the other hand, A seems to be doing really well with all the change, and might even be happier than when I was at home but couldn't do anything for or with her. I think it was extremely confusing for me to be home, but not involved much. When she comes here, she can catch up with me, snuggle, eat and play here, and seems to have no confusion about why I do not come home with her. I am so proud of her.

I feel in my heart that this is the right place for the boys and me to remain until they are past that magical week. By then, my cervix may be down to not much or it could be the same, but either way, I want to know that I am doing every single thing I can to buy them these next three weeks. Hopefully, they will come quickly and I might be home again with my family at 30 weeks or more, knowing that the most important time of growth happened here.

Preview for tomorrow: the technology that gets me through the days and the techie to whom I am married.

Saturday, August 22, 2009

First Impressions

Now that I have officially been an inpatient of The Hospital, a few notes and happenings:

My room is NICE! Nicer than many motels and hotels I stayed in as a young traveler, in fact. I have lots of light from two big windows, a fridge, a (teeny, tiny) television and DVD player, a table and chairs for guests and a day bed for someone to sleep on. The last item, however, my husband describes as less comfortable than a hard wood floor. When I offered to switch places with him, he quieted down. Honestly, he was awesome yesterday. He spent the whole time, from check-in to bed time with me, which was infinitely comforting. I see why some of my fellow hospital-bed-resters cry when family leave. It was so sad to know he was going home to our house, bed and family and I'd been here. They also brought in an art table and chairs, paints, paper and crayons for A. She left me several masterpieces on my bulletin board.

The awesome Dr. L, one of the neonatologists here, come to speak with us. Let me just say: I ADORED him. My mom, husband and A were all here getting ready for dinner, so our talk was cut a bit short, but he was amazing. He said, "I love to see when they bring people in at risk of preterm labor but NOT in labor as we can buy those babies more time." I reminded him about a thousand times of my negative fFN so we just focused on what the babies would face if born two weeks from now and beyond. He was so unbelievably positive and gave us SO much hope.

Because I asked about some of the scarier statistics, he said triplets born at 24 weeks usually have about a 46% chance of survival. Not at all what we want for the babies, of course. Between 24-28 weeks with triplets in particular, we go from about a 46% - 95% chance of survival! These next weeks are critical: each day buys them so much! While we continue to shoot for 34 weeks, it is awesome to have an idea of what to expect should things take a turn. He reiterated that he would come speak with us anytime, and answer any question we had. I kind of wanted to hug him, but I would've tripped over the toco monitor and probably given myself a concussion.

He said what we expect from babies born 27-28 weeks is that they will need some immediate respiratory assistance (intubabion, CPAP, etc) and temperature control. Those are first addressed in the delivery room and they are QUICKLY taken to the NICU. Then, they are checking blood gas levels and administering meds through and umbilical line.

We talked briefly about some of the more major problems: PDA's (problem with the heart valve), intestinal issues and feeding issues. He said all babies, up until 33-35 weeks are fed through a tube and they can start colostrum right away if they can tolerate feeds. I told him I am a huge breast feeding advocate and nursed A forEVER... he said it is the most important thing we can do for them, provide Mommy's milk. I will be the best pumper ever. :) He asked me twice if I was a nurse or physician since I was familiar with the terms and what to expect, and I said, "I am just on bed rest and read compulsively."

Today the doctor on call, Dr. W, came and chatted with me. He felt very confident we'd get past 27-28 weeks when viability is good since I have "so much cervix left" and a negative fFN. This kind of news really makes my day and the more docs who say it, the better. :) We do not want our babies born anytime soon, but very reassuring stuff to hear about 28 weekers. Again: October or BUST!

Friday, August 21, 2009

Notes from my hospital bed

First of all, please excuse typos- am blogging from my iPhone.

Well, I've landed myself in the hospital.

After a week of more cramping, contractions and drugs, my cervix shortened. It was 2.1-3 cm which is still "not terrible" according to Dr. P, but we need to monitor me to figure out how to slow the contractions. So I am being monitored constantly and we've upped my Nifedipine and still using Terb as needed. I need to lay on my side all day but am allowed one shower and one wheelchair ride per day... thank goodness!

Best news of today: a negative fFN!!!! So that means despite the scary shortening and contracting, we are very reassured that I will NOT go into labor in the next two weeks! That gets us to about 27 weeks and we all know that 28 is our most important milestone.

The boys look awesome! Still no signs of TTTS, another huge blessing.

I am actually feeling pretty calm, like this is where we need to be. The hardest part was leaving A today. I kept kissing her face, smelling her head, and left while trying to hide my big tears. I cannot wait to see her later today! My awesome mom and hubby are making me feel very taken care of by filling the fridge and thinking of things I might like. Hubby is staying with me all day which helps ease the transition and my mom is bringing A up for dinner. I miss her so much already.

Thanks for all the encouragement. October or bust is still our mantra!

Monday, August 17, 2009

Growing boys, Growing Cervix!!

Today was one of those remarkable appointments where there was good news all around! They usually measure my cervix last, after the growth scan of the boys, but I begged them to do it first today since it would determine whether or not I would be admitted to the hospital. So they did it first and it was measuring 2.6 - 2.9! It has grown a whole 2-3 mm since Friday. Hooray for another week (or more) at home!

Dr. P reminded me that it can change quickly, so bring my bag again on Friday. I will be seen twice a week from now on which is awesome for a Wemberly like me. I kept asking her, "Do you think they'll survive?" to which she said, "Well, they aren't going to be born this week probably." I have never been able to get her to say, "YES! They are going to make it!" which my husband and mom remind me she could get sued for saying, but STILL. I would love some kind of firm reassurance from her, but she seems to take it a week at a time. I said, "I did get a negative fFN (which gets us to 26 weeks) on Friday, and we know 26 weeks is better than 24..." waiting for her to say, "You'll get past 26!" but she just said, "That is true." She is such an amazing doctor, and I truly love her conservative approach, except when it comes to my constant need for reassurance.

The boys look great. Their fluid remains even and adequate and there are still no signs of TTTS! Their weights were all very close to each other and are all in the 50th - 60th percentiles.

Baby A: 1 lb, 9 oz
Baby B: 1 lb, 7 oz
Baby C: 1 lb, 8 oz

= 4.5 lbs of baby inside of my belly!

The sonographer was the most efficient one I've seen! She was not only quick at getting all the required measurements, but stopped whenever we saw something cute to print pictures. She also did 4D on A and C (B was hiding his face behind A) which was amazing. They are filling out already!

I know these can be hard to distinguish, but here they are:

A with his arm curled up and hand by his face- it looks like he is flexing!

Here is C's little nose and mouth (no hole in his head, it is just the way 4D looks):

Very grateful for our healthy boys and slightly more cooperative cervix!

Sunday, August 16, 2009

Happy Viability!

Dear Boys,

Happy Viability Day, my sweet sons! Today, we have reached the much anticipated milestone of 24 weeks which means that if you were born today, you would have a chance at life outside Mommy. That said, please try to stay inside as long as you can, for another eight or ten weeks. Every day you stay inside, you grow stronger and more ready for the world, more ready to meet your family. If you can make it just another four weeks, we are almost guaranteed that you'll be healthy and here to stay. So listen to Mommy, since I know what is best in this case, and stay inside. I am doing everything I can to make sure my body keeps you safe.

Enjoy the days of swimming in a warm and safe place, of feeling your brothers right next to you and hearing our muffled voices. We can hardly wait to see your faces, kiss your heads and hold your little hands. We have been waiting so very long for you to make our family complete, and we can wait a little longer while your bodies grow bigger and stronger.

I love you!

Here is a song for you, boys. Coldplay's "A Message". When I was trying to conceive your sister, and then you, I felt like this song sang to you, my future children whom I wanted so badly. Now sometimes I listen to it and imagine you singing it to me. Here are the lyrics. (Give it a listen, but don't watch the silly homemade Youtube video.)

The boys, in alphabetical order:

And the (ginormous) belly in which they reside:

Tomorrow I have a full growth ultrasound to see how big the boys are, and a cervical measurement. Hopefully it is unchanged or has grown, but it is not so likely. I will bring my hospital bag and be prepared for admittance (which as Miss MVK suggested may jinx me into getting to come home) for a while. Thank you again for all the cheers, support and celebration!

Friday, August 14, 2009

Out on Parole*

*Cervical Parole, that is.

This morning showed my cervix has, in fact, shortened again to about 2.4 - 2.6. We seem to be losing around 3 mm per week right now which is NOT good. We want that cervix to be stable for another 10 weeks and at this rate, I will run out before then. The good news is that the babies' fluid is even more consistent and they all have a perfectly normal level. I will get their full growth measurements on Monday.

When Dr. P came in, she said, "Well, it shortened." My husband and I stared at her for any indication as to if she would admit me then, but she said, "I think you can be at home this weekend, but if there is no change or if it shortens again, we will admit you on Monday. Keep in mind, you might not be here for the duration, but we'll want to keep a close eye on you and maybe start steroids (to help the babies' lungs mature)."

We also did and fFN today which was NEGATIVE! Again, this indicates that I have a very, very low chance of going into real labor in the next 2 weeks. That gets us to almost 26 weeks.

I still seem to be in denial because I am contracting but it is controlled with the medications, so I was hoping the cervix wasn't affected. I probably should not be surprised since I do have to take more and stronger medication to get them to quiet down, but I was hopeful. The Terutaline I am taking makes me feel pretty awful: my heart races around 110 beats per minute and my hands shake as though I've had too much coffee. I am so grateful that it stops the contracting effectively, though! Now it is the uterine activity as well as the weight of the babies pushing on the cervix causing the change. That is something we cannot control, but we can treat any contractions more aggressively in the hospital if need be. It isn't that I am worried about being admitted now; it is that I am afraid it will not help.

Today I am feeling disappointed and worried. We are so close to viability, but at this rate of shortening, we might be seriously looking at babies born before 30 weeks, which as we all know means more NICU time and more potential for complications. I am so very hopeful we will get to 30 weeks, but I am starting to think we may not, and am preparing myself for that. It is certainly possible for the cervical length to stay the same for some weeks, and that is what we are hoping for.

Sunday, which marks 24 weeks, and the beginning of viability, will still be a party at our house! I am so excited the boys are healthy and have made it this far. I had planned to order the boys' cribs, wash some of their clothes, make some more real plans and now I am afraid. I hate the wondering... but I do wonder: will all my boys come home one day? Will they stay inside long enough to be healthy and well? I feel like I am in some kind of fog that I cannot see my way out of- I don't know which way to go.

Apparent to my close friends and family is the fact that I have become WEEPY. Really, overly emotional and weepy. I blame hormones (why not?) and also my sense of insecurity about the future: where I will be and when the boys will come. It is so hard to let go and relinquish control. If you have not figured this out: I am a control junkie.

Some of the things I have cried about this week (happy and sad tears):

- Reading "The Kissing Hand" to my daughter
- Listening to a play list Baby Smiling sent me and making one for her
- My cervix
- Watching my daughter dance to "Super Trouper" using my iPhone as her radio
- Feeling the babies move
- Probably not taking my daughter to her first day of preschool
- A trailer for "The Time Traveler's Wife"
- My cervix
- Everyone's sweet words and encouragement

I realize that I sound like a HUGE WEENIE after writing all this, but I am more scared than I remember being in some time. (Insert weepiness here.)

Monday, August 10, 2009

100th post: Good News and Bad News

23 weeks and 1 day... 6 days until viability! Good news and bad news today. How about good news first?

Good news:

- This is my 100th post! I cannot believe how quickly it came! :)

- After an extra visit to the MFM last week due to intense contractions, my meds were changed to a different form of Nifedipine and we added Terbutaline as needed. The Terb has (as I was told) some very icky side effects: shaking hands and a jittery feeling but nothing too terrible. Until today, the contractions seem to be less. This afternoon I have had more and had to take extra meds.

- The fluid levels on the babies have normalized! No signs of TTTS whatsoever. The twins had very good Dopplers today as well as more even levels of fluid. YAY!

- Drum roll please... I had a negative fFN on Thursday! WOOT WOOT! That means I have less than 1% chance of going into serious labor in the next two weeks (that gets me to 24w4d). We will repeat it again on Monday, but big sigh of relief for now.

- Their movements are so strong! I love to feel little feet kicking and rolling around- I can even see little feet sometimes. The boys are getting so big and strong, and remind me of how much I love them already.

Bad news:

- Today my cervix was shorter again. On Monday of last week it was over 3.1, Thursday was more like 2.9 - 3.1 and today was about 2.6 - 2.8. I could tell as soon as the scan was on the screen that it was shorter and immediately felt disappointed. I was so sure the meds were working that I did not expect it to have shortened at all.

- Dr. P came in and her first words were, "You are going to get yourself admitted here soon!" I had a feeling it was coming after seeing the scan, but she confirmed it. She said her best estimate is that I will be in the hospital on bed rest in the next two weeks, or as soon as my cervix shortens further or I get a positive fFn (hopefully not for a long time).

- These could be my last days or weeks at home. I am going to have a cervical measurement on Friday and she told me she may admit me then. If admitted, they would start steroids for babies' lungs at 24 weeks and monitor me closely.

- Obviously, increased anxiety (read: uncontrollable terror) at the boys coming WAY too soon. I know it will be after 24 weeks and I hope with all hope it will be after 28. Will my body hang on?

I suppose I should feel lucky that I made it this far without hospitalization, but the thought of being without my daughter's little voice and face each day shred my heart. I know so many of you mommies have to be away from your older kids while on bed rest, and I think it must be the hardest part. I am already frustrated that I can't put her to bed, give her a bath or go for a walk with her; but spending a whole day away from morning until night without seeing her little face, feeling her hands or kissing her forehead seems terribly painful.

Unfortunately, there is nothing I can do aside from resting and taking my meds like a good patient. I went over my activity with her and she said it seemed fine, but to try to go up the stairs less. She said it probably won't make that much of a difference, so not to stress out about it too much.

So the best case scenario has changed: now we hope that my cervix stays the same and I get to be home with my family for as long as possible. I want to be here with them so much, but I may not get to be for long. We hope my body holds on past 28 weeks, and the boys grow bigger and stay healthy. This is the most amazing and hardest thing I think I have done yet.

I will post a darling little Baby B's face and profile later as well as the LARGE 23 week belly shot. Thanks for all the support and cheers. I cherish every one of your comments.

Thursday, August 6, 2009

Show and Tell: Miscellany

For today's Show and Tell I have a little bit of everything. As most of you know, I am on strict-ish bed rest with the triplets and am counting the days until viability begins (24 weeks) and today is ten days to go! I installed a really useful Ap on my iPhone that counts down for me, so the exact time remaining is 9 days, 13 hours and 17 minutes. Not that I am excited or anxious.

The good news is that the higher dose of Niphedipine seems to be helping with the contractions, but I am still having them. They have told me more than once that four an hour is fine as long as it is not ALWAYS four in an hour, but if it is six in an hour that I need to be seen. Hoping that they stay under that and I can coast into my Monday appointment with a long and strong cervix. (Please, please, please.)

First of all, my dear friend B, who I have known since we were twelve sent me the most amazing card. She has always been a very creative card-maker and an avid cheerleader of her friends. I almost cried when I saw this in the mail, and have read and re-read the card all morning. I do think the envelope is the best part:

If you can't tell, the sentiments on it include: "Is it time for a protein shake?", "October or bust!", "Rest, rest, rest" and "You can do it BOYS!"

Secondly, Deb from Waiting on Life Part 2 gave me an award! As she pointed out in her post, some of the recipients did not even know she read their blogs at all (me included) so it was a great surprise! I am supposed to tag 15 people, but I don't know who has received it already. So if you feel so inclined, consider yourself awarded! I read all of your blogs and love their variety!

I will leave you with my 22 week belly picture. The boys are growing so big, and it is evident here! I tend to bump into things with the tummy now since it grows so fast that I don't have time to adjust.

Once again, a big, triplet-belly-sized thank you for all of the encouragement. The comments, links to other blogs and prayers are like gifts to me. When I read comments, I savor each one like a treasure and re-read them when I am feeling low. Thank you!

Go see what everyone else is showing today at Mel's Show and Tell!

Monday, August 3, 2009

Not what we wanted to hear.

Today I am 22w1d (13 days until viability) and my weekly appointment was... not great.

I am gaining weight well, my uterus measures at 32 weeks (!) and my blood pressure is nice and low. They did my glucose screening and CBC to check for anemia, and I will get results tomorrow.

The scan of the babies showed them healthy and active, but with some fluid issues. Baby A has plenty of fluid, but Baby B and Baby C are both low. While this is most likely caused by the fact that I have been taking Advil for contractions (hence the reason you should not take it without the doctor's approval) we are still a bit worried about TTTS. We don't ever want to see a difference in A's and B's fluid. Dr. P was confident that once I have been off of the Advil for a few days, their fluid should increase, but we will be watching closely to ensure no other signs of TTTS emerge.

I asked her what we'd do if they developed it this early and she said I'd have Selective Photocoagulation surgery (or Laser Ablation) to treat the condition. This is an amazing procedure only offered at a few hospitals around the country (one of the reasons I chose the practice we are in) but they literally shoot a laser through the abdomen and uterus into the placenta. SCARY, but very effective. If they develop it later, after 28 weeks, they would do serial amniocentesis to draw of excess fluid from the recipient twin. More info on TTTS here. Dr. P seems very confident that the discrepancy in fluid is due to the Advil, not TTTS, but we'll be paying more attention to their fluid.

As if that was not already enough to cause me to enter high-anxiety mode, my cervix shortened. Just a little, but STILL. It was about 3.5 last week and this week it was down to 3.1, 2.7 with pressure. Again, not an incompetent cervix but it is reacting to increased contractions. I have noticed and reported many more contractions this week, so my Niphedipine was doubled in an attempt to stop their effect on my cervix.

Also, my bed rest is now much stricter. Not yet "strict" which means bed pan and being horizontal all day, but much more limited. I am only allowed to stand up to use the bathroom, shower and get meals, but should remain reclined the rest of the day. No more outings, puttering around the house or walking much to the car. My activity has slowly increased lately, without me meaning to, and I need to stay down all day now. Hey, at least I got to scoot around Target a couple times.

I asked her:

1. When will we do an fFN (a test on the cervical mucus to determine if labor is imminent in the next two weeks)?

Starting at 24 weeks. If we ever get a positive test, then I will be admitted to the hospital for the rest of the pregnancy and given steroid shots.

2. Will we get to 28 weeks?

Yes! Prepare that you may be in the hospital and will certainly be resting much more.

3. Why else would you put me in the hospital?

If your cervix shortens again, if you have four contractions in an hour consistently or if the twins develop TTTS.

The good news is the Nifedipine has worked for me in the past, and we assume the higher dose will help. Also, the twins have NO OTHER signs of TTTS and we hope the fluid thing will normalize next week... yes, I have to wait a whole week! These are the positive things to which I am clinging.

Feeling pretty anxious on the couch over here, and wishing there was a way to know for certain that all will be well. I cannot imagine losing these boys now, and hope with my whole heart that the rest and medications will help my body hold on for another 10 weeks or so. Thanks for reading this extremely long post, and for all of your support. Hopefully next week will bring us news of normalized fluid levels and a longer cervix.