Tubeless in Seattle: Triplets and a Big Sister (Life After IVF)

(Barely) Controlled Chaos

2011-11-19T21:23:00.001-08:00

HI! I am going to pretend like I haven't been away for far too long and just say this: HOLY HELL. Triplet toddlers are trouble.

I cannot believe the things they think of! They moved their table over to the oven after I had to hide their chairs- quite resourceful!

They like to jump off of things. They even like to build things just to climb onto something taller to jump off.

There are moments of cooperation, but these are few compared with the battling over toys...

There is a major interest in being inside of toys. They always exclaim they are going to "Costco for popsicles!"

And my little guys are TWO! They are an all-at-once roving horde of destruction, full of snuggling (still nursing) gang of boys with whom I am totally in love! Each day is different, but always a challenge for me. Mommy is growing gray hair.

This was our thank-you card photo after their birthday- lollipops got them to at least look our way.

I won't promise more posts, since I am notoriously bad at following through, but I will try! Interesting identical twin connection versus our fraternal guy... also, pondering preschool for next year. SO much to think about!

Happy, happy season of gratitude and Thanksgiving to everyone. I am so very grateful for the amazing communities of mommies around the world, outside my door, and online too.

18 months already?

2011-04-21T20:00:00.001-07:00

How did my sweet, four-pound preemies become such big toddlers?

As a result of excitedly over-volunteering, I find myself with only a few minutes for this post, but as I stated last week, brief and frequent is the goal.

What are we up to, you ask?

Still nursing, and loving it! (Except when they beat on each other or me in order to get a latch position...)

Egg Decorating

O-Bear

Egg Hunting

Four SERIOUSLY handsome boys

This is how we roll; the comments about the stroller are truly endless.

Happy half birthday, sweet boys! I adore each of you!

Coming posts: "Why I Want to Have Another Baby OR My Husband Thinks I Am Nuts-o" and "What the Boys are up to These Days: the Chaos Files".

Roadblocks to Blogging

2011-04-14T11:23:00.001-07:00

HELLLLOOOOO!!!

Somehow, I knew life with three toddlers (nearly 1 and 1/2 now) and an almost-kindergartener would be busy, but really, I had no flipping idea of how busy it would get once mobility set in. Insanity! Chaos! Overwhelming Activity! These are the headlines that fly through my mind while I try to figure out how to adequately catch you up.

I have come to the conclusion that since I am not going to write a retrospective summary of what life has been like, we should just jump right into it. I am hoping to be able to blog more regularly as the boys become more manageable, but in order to do that, I should address some of the Blogging Roadblocks I have identified that get in the way:

1. TIME. Could I please have three extra hours in each day? I need the children to either be sleeping or playing independently though. Thanks! Seriously, between child-caring-for, preschool shuttling, cooking, cleaning, organizing, meal-planning and shopping, I am left with about an hour of truly "free time". And this is with the help of an amazing nanny and my mom. My free time is frequently spent running or at the gym, volunteering for A's school, or maybe grabbing tea with a friend. I will add blogging (reading AND writing) to that list again!

2. PICTURES. Okay, I have tried to keep my kids faces off my blog. I have, so far, done a good job of it. However, I find that some of my very favorite blogs are the opposite of anonymous. We are invited into someone's life, see what their days are like, and reflect with them on what it all means. It is hard, but not impossible, of course, to do this without photographs, but I find myself wanting to share more. I have almost blogged a thousand moments, but felt without a picture of what the kids all look like covered in ice cream from their first sundae, or a video of A pushing her brother in his red toy car, something would be lacking. I am hoping that this will help me document those small moments, and take more pictures!

3. QUANTITY. I have so much to say, and so little time to do it. This space will be for those moments in life that make us laugh, give pause, or connect with others in our amazing world. I want the kids to feel that we are all honoring that first soccer practice or scraped knee, taking time to say that despite the fact that I have four kids, each child's experience is important. Brevity but frequency may be the key to my blogging success.

What are your Blogging Roadblocks? How do you get around (or over!) them?

Let's start the photo-fun now...

Cheeks, O-Bear, Ace

October 2010, 2 weeks old

O-Bear, Cheeks, Ace

April 2010, 6 months old

Ace, O-Bear, Cheeks

October 2010, 12 months old

And my first born, my always-full-of-life daughter! I am in a bit of denial that she is almost five and off to kindergarten next year. WHAT?

I have some very cutie-pants pictures that are recent, but I need my techie husband to help me figure out how to connect to our AppleTV which has a Dropbox folder on it, containing the aforementioned cutie-pants pictures, from which I have somehow been denied access. (I only pretend to know what I am doing, technologically speaking.)

I do suppose that this might serve as a teaser for some of you to come back and check in with us? Recent pictures, and a video or two of the chaos that is our daily life are assured in the next post! If you are here, and reading, leave me a comment, so I can build up my Google Reader again. I would love to catch up with you and yours!

Mobility Anxiety! And the Blonde Baker!

2010-07-10T20:36:00.001-07:00

I am excited to share my new blog with you! This whole parenting-triplets-thing requires serious baked good consumption, so I decided to channel all the time I spend baking, reading cookbooks and sharing treats with friends into a blog all it's own. Please come check it out- and try a recipe or two. (I also heard a rumor there is a picture of me on the About page. Just sayin'.) I am The Blonde Baker!

Back to our (semi-)regularly scheduled programming.

We are entering new territory here, folks. MOBILITY. Although the babies have yet to sit up without some major assistance, they are figuring out how to move. Quickly. Usually toward a sharp object or one of their sister's choking-hazardesque toys. We are entering an uncharted territory of "busy".

It is usually my mom and I (thank heavens for her!) all day with the trips and A, so we usually rotate who rushes upstairs to get ready or shower in the mornings. We take our iPhones and text if help is needed. Usually, things go fine, although I may end up holding two while pacing if they are fussy, or she could have to hold Cheeks while feeding Ace his breakfast. It's just the usual "double-arming-it" that we do daily.

Ace and O-Bear

Increasingly, the babies have been more and more content playing on the floor with lots of toys and one of us sitting with them. I usually have to adjust baby limbs so they don't conk each other in the face, sing songs with hand movements or pick up a fussier boy pretty much constantly. A few days ago, early in the morning, I was sitting on the floor drinking decaf, while A watched "Sesame Street" and the boys played. Pretty soon Cheeks became fussy and needed to be held, so I picked him up and sat him in my lap. Then A needed help in the bathroom, so Cheeks and I went to help her. By the time I got back, O-Bear had army crawled all the way to the ottoman and was half way stuck underneath it and Ace had rolled about 20 feet to the hardwood floor and bonked his head in the process. My mom rushed down to see what the hysteria was about, and all I could do was stand there, holding two crying babies, with a look of terror a glimpse of what was to come on my face: MOBILITY.

I believe the thought, "We are SCREWED!" ran through my head in stereo.

The new challenges now are not that they refuse to be set down, but that when they do, off they go in THREE directions! I knew this stage was coming, but I did not expect it yet! They cannot even sit up- what do they think they are doing, rolling/crawling/getting stuck already! We live in a three story home with hardwoods throughout the main floor and many a dangerous staircase entrance. The stairs need to be gated, the hard edges padded, and the choking hazards removed from the family room (by the way, all four-year-old girl toys are choking hazards).

Let the baby-herding begin!

Cheeks in the bath! Seriously, have you ever seen any cuter ones?

I almost just Googled, "Creative Blog Post Title"

2010-06-20T20:40:00.000-07:00

Pathetic. Anyhoo...

Right next to the button I just pushed that says, "New Post" is the information that I have not posted since March 27! WHAT? (A very sheepish blush has overcome my cheeks...)

Needless to say, I am a bit on the busy side with eight month old triplets and our nearly four year old, but how can I continue to neglect anyone who still reads this crazy blog? This year has certainly been different from last. On Father's Day last year, we had a fun family brunch and relaxed all day. I was 16 weeks pregnant with my three perfect boys, and thanking my husband for being such an amazing Daddy to our daughter and daddy-to-be to our little guys. This year, we both had the luxury of a shower, made it through the day with three teething babies, a tyrannical almost-four-year-old and are currently trying to decide if we can stay up until 9 pm to watch "True Blood". Interestingly enough, I talked about that (most awesome of awesome) show last year. It seems some things never change.

Everything else does!

Some pictures and highlights to catch you up...

- We have three teeth among the boys, spread out over two babies! Cheeks and O-Bear, true to their identical twin-ness cut their first tooth within a week of each other, and now Cheeks has number two!

- Ace (always the rockstar nurser) has also become the rockstar eater! He eats three solid meals a day- homemade veggies or fruit and Yobaby, his fave. The other day, we were trying to entice O-Bear to just TRY some yogurt (It is sweet! And creamy!) while Ace ate some of his favorite pear-banana-peach blend that I whipped up. He saw us giving his brother yogurt and cried so hard and whacked his tiny, ineffectual fists on the tray until we shared the cultured wealth.

- Cheeks and O-Bear mostly make faces like you are trying to poison them when you attempt to spoon some goodness in. They really just want to nurse (ALL the time, which is fine by me) but are beginning to dabble in vanilla Yobaby. Only vanilla.

- They are all rolling everywhere, which scares and delights me, but are not sitting up. I really am excited for this so they can have a new view that does not include our ceiling and perhaps they'll be a bit more entertained when my mom and I try to pee/make dinner/take care of their sister.

- I have become obsessed with the only hobby that I can do at home: baking! I bake something (usually some delish cookie with chocolate in it) at least once a day, and have been on a cake kick lately. I am thinking of starting a baking blog, complete with fantastic (ha!) looking pictures of my creations and lots of recipes. It would be a fun thing to do from home, while babes sleep, and that is unrelated to parenting, nursing or multiples. As soon as I have my blog looking good and sweet, I'll share the url. Hopefully it will be a well-nurtured blog! (The best cookie I made this week: chocolate marbled oatmeal cookies. HEAVEN.)

Some happenings:

A, "nursing" her doll

O-Bear, who insists he is on his tummy at all times

We happen to be on the other side of the state with the kids (and my awesome mother, and my little cousin) in search of the sun, as it appears it will never shine again in Seattle. One of my assignments for the week: more blog-friendly pictures and another post. I promise one by Friday. Dang, I am getting ambitious around here...

I have a more serious and reflective post in the works, one that makes me all teary and sweaty, about the guilt I feel to not be the mom I was to my daughter, about how hard it is to see two crying babies and sometimes have to choose which one to hold, about how I still want to have a clean house and make dinner, which means sometimes I choose to do housework while my mom hangs with babies. It is all a recipe for guilt and anxiety for me lately, and I am working on being more forgiving and also trying to have quality time with all four of my children, each day. Even if it is only for one chorus of "The Wheels on the Bus".

I am catching up in my Google Reader while on vacation. Expect to see me in your comments!

Shameless distraction!

2010-03-27T21:07:00.000-07:00

5 month-old bottoms!

I am hoping that helped you forget the fact that I have not blogged in over a month. A funny thing happens when I stopped pumping (!) and was able to nurse instead- no more laptop time. While this was my ultimate goal, I miss reading blogs from a screen larger than my iPhone, and really miss blogging regularly. Mid-year resolution: short and sweet updates.

The boys are five months old! The nursing continues to go well- we have not used a bottle in weeks and are not looking back. I am so proud of them! They love to nurse now, and I usually have at least one baby attached to me for the better part of the day. I think they each nurse around 10 times a day- maybe more. They demand feed at night, too, which is getting out of hand (since they wake up to nurse and promptly fall asleep after latching on) but for now, it works for us.

Everyone is growing- our Cheeks is still the largest at a whopping 13 pounds! He is on the chart for his weight without adjusting for prematurity. Clearly, his nickname still fits. He has become extremely vocal about everything. He coos loudly at himself in the mirror, grunts while I get ready to nurse him, and is the first to exhibit stranger anxiety with heart-wrenching wails. Luckily, he is never with any strangers for long, but even out in the community, he can be sensitive. He has a ginormous head that we are hoping rounds out a bit soon, but at least we know his brain is a-growing.

O-Bear is also getting so big! He is definitely our snuggler. Wherever he is, he reaches for his brothers and hooks arms with them. He will settle for just gripping their sleeve or hand if necessary, but he likes to be really linked in to his brothers. Lately, he has been bucking while laying on his back, with just his head and feet on the floor and boy, can he move! He basically refuses to roll from front to back (something his brothers love to do) and settles for sucking on his hand. Our O usually has a few fingers in his mouth and drool on his shirt.

Ace lives up to that nickname! He rolled over first and is working on back to front. While his Nanna was here, he laughed out loud many times for her and will now for us, if we kiss his neck noisily. He is sort of a boob hog and will cry when he sees his brothers eating until his turn. Ace continues to be super social and loves to be worn facing out in the Bjorn, so he can see the world. He flirts with everyone, with a wide-open grin and loves new people. He reaches for and holds toys, as do his brothers, and he has showed them how to mostly get toys to their target: the mouth!

So much to write about- more coming on nursing, "leftover" embryos, multiple parenting and other adventures! For those who still read- thank you! Better posts follow... but now, I must sleep for an hour before someone wakes up to eat.

Happiest Mommy EVER

2010-02-24T20:51:00.000-08:00

I have so much to write about our adventures in breastfeeding over the last month. For now, I just have to share with you this:

The boys are all breastfeeding on demand, without any bottles all day!

You may be wondering how they got to being able to get all they need every three hours from nursing. The answer: they didn't! I gave up on that unnatural schedule and am feeding them when they are hungry, two at a time, for hours on end sometimes. They are simply not ready to nurse every 3 hours, so I am following their lead. Today I think I nursed each about 9 or 10 times ... but sometimes it was in tandem. I do not need to pump as often, and I am having the wonderful experience spending more time with my children and less time with my pump.

There is so much less crying (by them AND me) and much more bonding time. They nurse happy, smiling and cooing. I feel the same way.

I will write a detailed post about how we came to this awesome place despite our major setbacks and roadblocks. I feel so lucky to have all the support of nursing friends, experts and other triplet moms. I have learned more about the way the body makes milk, keeps a supply and the way babies, especially preemies, nurse since the boys were born. I am one of the lucky few who can, with effort, make enough milk for all my babies.

I have not felt this good in MONTHS. It feels so frustrating to know where you want to be but not be able to get there, and that is what the last weeks have been full of. Little progress, frustration by all and lots of crying on my part. What it took ultimately, was time, persistence
(bull headedness?) and support. We are here!

Details to come if there is interest!

The boys' other favorite new pastime is touching hands.

A Year of Tubeless, Volume 1

2010-02-19T20:03:00.000-08:00

The next six months Tubeless in Seattle's first year will come later in the week. Thanks for reminiscing with me!

It has been one year since I began writing here!

When I decided to start the blog, it was from reading others, and appreciating so much that people could share their pregnancy loss, infertility and treatment stories and experiences so authentically. Hoping that it would be cathartic to me, and perhaps provide a tiny bit of insight to another person going through the pain of miscarriage and fertility treatments motivated me to start writing.

A great decision, it turns out! I have made so many friends and found such an amazing community that supports its members and is unbelievably welcoming to neophytes. I've read both joyful and heartbreaking stories of birth and loss, life and death. I have found myself less quick to assume I understand someone else's experience of fertility, pregnancy or birth after seeing into so many people's worlds.

When I started out writing, I was the mother of a two year-old girl who'd experienced the pain of three miscarriages, two after seeing beautiful heartbeats which eventually stopped beating. My OB had put me on Clomid after months of unsuccessful conception but did not monitor me at all. After nothing happened, we sought help at a big Seattle RE, moved to IUI's but then discovered my tubes were severely damaged (from a previous Pelvic Inflammatory Disease) and had to be removed. I was made "Tubeless" in December 2008. Of course, without tubes, IVF was the only option, so in February of 2009, I was waiting impatiently for an ovarian cyst to resolve so I could begin stimulation drugs for my first IVF cycle. I was in waiting-to-start and birth control purgatory and was so desperately hoping for a shot at another pregnancy, another child in our family of three...

Here is a bit of what each month over the first half of last year held for me:

February 2009: Crazy Infertile Lady's behaviors are revealed while I wait for an ovarian cyst that is delaying my IVF cycle to GO AWAY. Also, I share an Affirmation after Miscarriage.

March 2009: Eventful! I get to start my cycle, Retrieval goes well, as does the Fertilization Report. I develop Ovarian Hyperstimualtion Syndrome (OHSS) which almost causes our cycle to be cancelled and embabies frozen, but we still get to transfer and put back two blasts. The OHSS gets worse and I have paracentesis done to remove fluid in my abdomen. Oh: I also find out I am PREGNANT!

April 2009: We find out I am pregnant with twins! I lament how previous miscarriages can ruin pregnancies. I start spotting (which is the way two miscarriages began...) and find out in the ER that I am carrying triplets. PANIC and WONDER.

May 2009: We discuss the idea of reduction for about a second, and are extremely reassured by our amazing MFM (high risk OB, called a Maternal Fetal Medicine doctor). The first panicked call to said doctor occurs, and the fear of pregnancy loss and preterm labor commences.

June 2009: I whine about trying to be an energetic mommy while preggo with triplets and we are thrilled to discover that my belly holds three boys!

July 2009: I am put on strict-ish bed rest when my cervix starts to shorten, I count the days until viability, and post this priceless picture.

I am so thankful to have thoughtful, supportive readers, some of whom have become close friends. Thank you for reading and coming along for the ride through infertility, multiple pregnancy and triplet parenthood. Your supportive comments have lifted me up many a day.

Check back this week for the next six months which are full of worry, waist expansion and the birth of our boys!

Babywearing is not just for babies

2010-02-15T13:51:00.000-08:00

As I have mentioned before, our daughter has had a hard time with the triplets' homecoming. OBVIOUSLY. We knew bringing three high-need preemie infants home to a three-year-old who is usually the center of everyone's attention would be terribly hard for A.

She went through many weeks of hitting, having accidents, not sleeping and generally regressing in every way she could, and attempting to get attention however possible. Even if that meant throwing a shoe at me while I was nursing Ace, or throwing a full cup of milk at Gramma who was changing a diaper. The list goes on, but the point is, things are better. She has become more accepting of the fact that we are often busy and we've become more creative at finding things for her to do, and times that are just for me and her, Daddy or Gramma and her, or other fun outings.

I have realized lately that she is really missing the amount of physical touch I used to give her. I am snuggly, cuddly and full of affection and right now I have a baby attached to my body several hours a day and a pump the rest of the time. I've noticed that I am craving that snuggle time with her, and am determined to get more. We have started going into a different room from the babies and reading together, or just laying on the couch and talking.

We wear the babies on our bodies in Bjorns, Moby's, or slings, as we did with A. She is a tiny three-year-old, so a month ago, I asked her if she wanted to ride in the Ergo carrier on my back, since she was feeling jealous that O-Bear was in the Bjorn, next to me. She climbed in and I wore her on my back while I made cookies. She laid her sweet blonde head onto my back and said, "Ahhh. Isn't it nice to be stuck together like glue again, Mommy?" MELT.

Again this week, she was wanting to be nearer to me, so my friend suggested some Ergo time. It is amazing what that does for her! We went on a family walk yesterday and I wore her on my back and O-Bear on my front, and this is what it looked like:

It was a gorgeous day, and empowering to feel I could meet her needs too. What a wonderful reminder that she is still very young and needs just as much touch, physical closeness and interaction that the babies do. I just have to be creative in finding that time!

3 1/2 Months!

2010-02-13T11:03:00.001-08:00

If I show you a super-cutie-pants picture will you forgive me for not blogging in WEEKS?

Baby A, Baby B, Baby C (Scroll down for updated nicknames)

I hope that worked! As usual, our days are so full of feedings, pumpings, changings and snuggles, but that is no excuse for an extended bloggy absence. Or for my lack of commenting, but friends, I promise I am reading and will quit it with the quiet lurker behavior.

Updates, in list form:

- I must change the babies' silly and unfitting nicknames which I assigned (after surgery and with three newborns) in the NICU. The babies will now be known by nicknames that mean something and use their first initials:

"Cheeks" is Baby A. He is CHUBBY! Possibly our most high-need baby, requiring a lot of help to settle, sleep and eat. He also has the most gorgeous grin and coos loudly, especially at his big sister. He is not a fan of being in the car and has almost required me to run red lights to avoid stopping. Did I mention the cheeks? SQUEEZABLE and chunky. His twin is O-Bear.

"O-Bear" is our Baby B. I have always called him O-Bear. He is our little fighter who had NEC in the hospital and who has recovered his weight difference to pass Baby C and almost pass Cheeks! We have a harder and harder time telling them apart as he gains so well. He eats the most and is quite dramatic. If he coughs, or coos to much, he chokes on his saliva and lots of dramatic gagging ensues. He is flirty and bats his long and curled eyelashes at everyone while tuning his head to the side and saying "ah-goooooooo".

"Ace" is Baby C. He is not a twin, but knows he is a triplet. He is patient, calm and collected. He rarely cries and smiles all day long. He has dark hair and olive skin, while the twins are fair and blonde like me and my daughter. Wait for the best part: he nurses WITHOUT a supplement after, about every 3 hours during the day. Oh, and he nurses all night, laying next to mommy. :) He also has more strength and just seems older. He doesn't have some of the other preemie behaviors that the twins have, like over extension of their bodies and weak sucks. (See more on that below...)

- We are BIG! The babies are all 11 - 11.5 pounds and growing so well!

- STILL working on breastfeeding but these boys are getting no formula! I am pumping 'round the clock to ensure the twins have milk for their supplemental bottles after nursing and at night. Hate my pump sometimes, but it has enabled me to provide for them!

- The twins were seen by a Speech Language Pathologist (SLP) and both have weak jaws/tongues and are just not ABLE to get all they need from the breast... YET! I keep up with nursing each one at each feeding, and give them my milk in a bottle if we need to. I want them so badly to be able to do it, but they are not there yet.

- I have some amazing LLL friends who are keeping me sane, and one even brings me her own expressed milk on occassion. I call them crying, frustrated and they bring me back to the fact that I am nursing TRIPLETS and that is a wonderful thing. I am the luckiest mommy ever.

- I am coming up on my Blogoversary! A year-in-review post will be coming.

The Post About Breastfeeding

2010-01-14T08:01:00.000-08:00

Breastfeeding! I never knew what a struggle it could be to get there with these boys. I nursed my daughter until 15 months when I weaned her to try to get pregnant (insert hysterical laughter here) as I was not ovulating or having periods while nursing. So I consider myself a pretty seasoned breastfeeder and can troubleshoot a lot of latch, supply or other problems. Nursing triplets, on the other hand, was something with which I had no experience. Preemie triplets? Uncharted waters.

The knowledge and experience about nursing I had before having the boys has served me well. I know that breastfeeding is a supply and demand operation. In theory, the more you tell your body to make (through nursing and pumping), the more milk it will produce. This, unfortunately, is not the case for everyone, despite best efforts, pumping and drugs to stimulate production. I am so far, lucky enough to be able to keep up, but that could always change. For now, I drink ridiculous amounts of water to ensure I am hydrated, and take 14 Fenugreek capsules a day. This is an herb that stimulates milk supply and can be found online or at any health food store. I get mine from Amazon or the grocery store.

We are still working to get the boys all nursing from the breast their "full" feeds, which for them is about 90 cc's, or just over 3 ounces per feed, seven times per day. If they are unable to nurse the feed, we supplement with a bottle of EBM (expressed breast milk). How do we know if they got their full feed? I am CRAZY like a fox and have a rental scale. Actually, it provides us with an amazing amount of information about their nursing habits. We simply weigh them before and after nursing, and each gram they gain translates into a cc. So if they gained 60 grams during feeding, they ate about 60 cc's or 2 ounces, which is 2/3 or their feeding. Of course, sometimes they are not as hungry, and sometimes more often, and we always have a bottle ready if they are hungry.

This way of feeding, scheduling a breastfed baby to eat seven times a day, sucks (no pun intended) in so many ways. Newborns should be breastfed on demand, and usually between 10-12 times per day. Our guys are 12 weeks old, almost 6 adjusted, and really should be eating about 10 times a day still. If they did that, they'd only need to eat around 2 ounces or so at each feeding, so that is probably what is developmentally appropriate. Because there are THREE mouths to nurse, and I still have to pump 7 times per day, they cannot be demand fed most of the time. In the evenings I cue feed them whenever they are hungry since we have an extra adult home and I don't have to pump one time then. Ideally, they'd all be put to the breast all the time, all day long, but there are literally not enough hours in the day for me to do that and pump. The other problem with it is I would pump my breasts empty and then be trying to feed a hungry baby who is not the most efficient nurser, as it is.

So a schedule it is. Right now, so they get the most practice, I nurse everyone at each feeding, and anyone who is still hungry will get a bottle of EBM. When we get to where they are all nursing well, I may only nurse two at each feeding while one has a bottle in the interest of time. We've chosen to start doing "AC/PC" or before and after nursing weights with our rental scale to get an idea of how they are doing. We'd like them to nurse 70-90 cc's or 2+ to 3+ ounces at each feeding.

While my little Elephant, our non-twin Baby C is doing an amazing job, usually getting 60-90 at each feeding and often going a whole day without a supplemental bottle, the twins have plateaued. They have made very little gain on the amount they can nurse in the last couple weeks, which is so frustrating! I really hoped they'd be off of supplements by now. So each feeding we weight Baby A, nurse Baby A, weigh Baby A and then possibly give a supplement. Then we repeat that three times. After that, I pump and we begin again shortly after. This process is obviously tedious but keeping logs of AC/PC weights, how much milk we use and how much I pump is really helping us see patterns, or in the case of the twins, a plateau. Part of the frustration is the lack of consistency: sometimes our Lion will take 50 and sometimes 15- it does not seem to have anything to do with time of day, nursing order or position. Their suck is not as strong, they are not as patient to wait for my milk to let down, and they seem to be easily frustrated. To have them push away from me and then latch on easily to a bottle feels hurtful sometimes, though I know it should not.

I've had my friend and lactation consultant out, and she thinks they just need to "grow up" a bit more until they can do it. Other multiple moms have said they need to be a bit older to truly have the ability to take full feeds. Other people have suggested that the twins could have tongue tie or another sucking problem and not be able to get more. This could require occupational therapy simply a few tweaks in bottle type to help them learn to suck better. I am getting referrals from our pediatrician today to be seen at Pediatric OT units at two Seattle hospitals. They evaluate baby's abilty to suck/swallow efficiently and their overall muscle tone which plays a part in nursing. I recently discovered I know a Pediatric OT and Speech Language Pathologist (SLP) who works with preemies who are learning to breastfeed. I have a phone call set up with her this weekend and cannot wait to hear her point of view, which may be different from a lactation consultant.

That is where we are at right now- sort of in a holding pattern. I am so grateful that my babies will latch on at all, and enjoy each second of nursing them. I am truly determined to make this work, but I had not expected we'd need to persevere this long. Were it not for my completely amazing mother, who helps me with each feeding, does the dishes and laundry and bottle washing, I would not be able to do this. If it weren't for my husband who encourages me, distracts our three-year-old when I am focused on a nursing baby and doesn't mind the pump and scale rental costs, I would not be able to do this. I am lucky to even have the chance! I have also met an amazing triplet momma who is nursing her trio and she has fielded long emails from me with so much support and kindness. I have an awesome LLL leader friend, one who is on her way and totally unwavering and a great LC to consult with. This is taking a village.

You, bloggy friends, are part of the village! Please let me know if you have any ideas, thoughts or questions about this major undertaking. :)

I think it is important to add our successes over the past couple weeks:

- No one needs a nipple shield to latch on!
- Two of the babies can nurse, laying down in bed with me. Most precious feeling ever.
- They don't cry before they even start as they used to scream and flail while trying to latch them.
- Baby C PREFERS to nurse :)

Part of the problem is a complete lack of info about nursing triplets. It is different from nursing twins or a singleton, and throwing the preemie factor in there makes it even more of a unique situation. I have had limited success in gathering resources about nursing triplets, but a good (and really the only) book about nursing more than twins is Mothering Multiples by Karen Gromada. For those of you expecting babies who are interested,some of my favorite resources about breastfeeding are KellyMom, a great general breastfeeding guide; La Leche League's site which has a good tool to finding local help; and The Nursing Mother's Companion by Kathleen Huggins.

Breaking my own rule

2010-01-12T21:40:00.000-08:00

You know, the one about no pictures? I had to show off- my babies are getting big on my milk and I am so proud! How big? 9 1/2 to 10 pounds each!

A very long, overly-detailed and obsessive post about breastfeeding is forthcoming. These babies are amazing, and I am hoping I might be able to drop a pumping session or two soon as they take more from my breast and less from a bottle. Are you on the edge of your seat or what? I am sure you'd rather be watching "American Idol" auditions than read about nursing, but STILL. It occupies my mind, breasts and time 'round the clock, so what better to write about?

A Different Mother

2010-01-03T11:13:00.000-08:00

I have been reflecting on the kind of mother I have become since the birth of the boys: decidedly different. The number of children born into our family 10 weeks ago has necessitated a busier, more multi-tasking, less present mother than I ever was with my daughter. These thoughts were not coming together in prose; a style departure is in order.

The day you emerged from me, you were pulled away.
Your tiny bodies were not laid on my breast.

I mothered you through thick plastic and
Hated the leaving of you in a place not your home.

Your three new lives broke me open into four pieces,
Each piece regenerating and growing stronger.
I am one mother moving in many directions, all at once.

I am less able to hold each of you, but able to hold more of you each day.
You hear my voice singing to you less, but hear me soothing your brothers constantly.
Does that soothe you too?

I am spread too thinly now, but wider, longer too.
Like spilled milk, vast and white, smoothing out the rough edges.

You, my three glorious boys have but one mother to nourish and nurture you
Whose body makes your milk yet cannot feed all of you at once.

I hope when your tiny hands touch, you draw comfort from each other and
You understand that I wish I could always hold you, always feed you, just us.

I learn from you each day how to make each moment, each interaction
Thick and warm and sustaining.

I am different this time, not ideal, but perfect for us, I hope.
You three are perfect for me.

Are you a different mother than you'd imagined? Are you still trying to become a parent? What is your ideal role? Do you have peace about your mothering?

I have not lost all brain cells yet...

2009-12-26T20:11:00.000-08:00

As a result of having triplets and a preschooler and therefore little time to blog, I will give you a bullet-point update while pumping.

- The Refluxers seem to be doing better with their Prevacid! A Christmas miracle!

- I am in serious need of a diet overhaul. Apparently, sleep deprivation makes me want CARBS and nothing else, and the weight loss has stopped, leaving me with 8-ish pounds that I would like to be free of. The extra skin? We'll have to see if that ever goes away.

- As a result of above epiphany, I am going try to watch what I shove in my mouth as I walk by the kitchen while holding a baby, and get out for more walks up hill. Although I love to run, the size, sensitivity and weight of the ginormous breasts will prohibit it for a while. I am trying to squeeze in (A pun! Am not totally brain dead!) lunges and squats while holding babies. A frequently tries to imitate my lunging and only then do I realize how silly I must look to her.

- A wonderful Christmas we had! My mom and I, frequently called Martha Stewart-types, learned a hard lesson: we cannot do everything for the holidays that we usually do. I forgot to help A put out cookies for Santa, we were all wrapping gifts at midnight on Christmas eve, and I did not get to watch "Love Actually" which is a huge tragedy. What we learned? We have to let go. My house is no longer spotless and well-decorated (unless you count piles of burp-rags and pacifiers on the tables as decor) and it does NOT matter. What matters is happy and content children- four of them, not whether or not we made the marinara for the lasagna from scratch.

- The nursing/pumping adventures continue! I am working hard to keep up with my little eaters... and am constantly amazed at how much milk my body can make, and how variable my pumping output is. Frustrated post about the pump and its quirks to follow. The babies are all latching on better and taking more at each "session" but still need a bit more after sometimes. The times where they nurse themselves milk-drunk and are content are more frequent, which is awesome. I am also nursing two in a row (tandem is a three ring circus still) and having some success with that. I cannot believe how hard this is, the nursing followed by pumping followed by bottling. It sucks (Another pun!) all the time I'd have with them and their sister, but is so necessary to get where we want to be. Listening to their contented nursing sounds while they snuggle next to my skin is the most wonderful sound.

- Lastly, we are a spectacle! And neighborhood celebrities. It is rather amusing to watch cars slow down and stare at this (not liking the way my behind is looking these days! Must resist cookies.):

Four Stockings

2009-12-24T14:35:00.000-08:00

Last Christmas, all I wanted was another stocking hanging over our fireplace, another child in our family. Never in my wildest dreams did I imagine there would be three new little stockings gracing our mantle. I am so full of love and gratitude that I tear up whenever I see these stockings. They represent a desire fulfilled after years of heartbreak.

This year was full! Full of delayed cycles, surgery, OHSS, bed rest and high protein intake, more surgery, hospital stays for me and the boys and finally, a home full of healthy children. I cannot believe how much our family has changed this year:

- I became infertile without IVF after my fallopian tubes were removed
- I carried triplets and became a mother of four
- My amazing mom moved in, making our home even more loving

What changed for you this year, the good or the bad?

Wishing each of you many more wonderful changes in 2010, and promising more posts. :)

Happy Holidays!

It should be called "Ass-id Reflux"

2009-12-16T17:09:00.001-08:00

... because Gastroesophageal Refulx (GER) is an asshole and it makes my babies scream. Two of them, anyway.

About ten days ago, we noticed that Seal and Elephant (Babies A and C) were having a very hard time eating. At first, we thought it was just when they were nursing, but then we realized it was nursing or bottle feeding. It has never shown up in our Lion, baby B, who had NEC in the NICU, who was the "sick" one. He slurps down bottles, nurses like a champ and falls promptly back to sleep.

For the two experiencing the pain of reflux, it goes something like this:

Baby acts HUNGRY and roots around, opening mouth for a nipple of some sort. Is placed at the breast or given a bottle of breast milk, and latches on happily. Then, after a few swallows, Baby's eyes open wide and they begin to cry. Then, they make the saddest face ever and scream at the top of their lungs while arching their backs stiffly. Often, they are inconsolable, and we pace the house, holding them upright while they try to root around on our arm for some food. When we try the bottle or breast again, the whole thing usually starts over, but sometimes they've had enough of a break that they can keep eating. Sometimes, they exhaust themselves crying and fall asleep in our arms, only to wake up hungry again in an hour or so.

I talked with our pediatrician last week and she saw the babies to ensure there was not something else going on and put them on Zantac, the first line of defense of babies with reflux. (I should add that preemies are at a high risk for it, and that it often does not show up until the sixth week of life or so.) She said we'd give it a week and if it was not dramatically improved, talk about other options. Well, it got worse. The poor guys spent at least every other feeding crying so hard, while we did all the things we could to comfort them: feed them upright, give them little bits and breaks in between, hold them up after eating for about 30 minutes or more. Please keep in mind that it is usually two adults trying to manage this along with another baby and a three-year-old who would like some attention, thank you very much.

Our daughter, A, has already had a really hard time since the babies life-altering arrival (sibling post forthcoming), and she does not tolerate their crying well. Honestly, it is LOUD and stressful, and frustrating for adults, so I can only imagine how it makes her feel. When it first started, she used to ignore it, since it was for short periods, but now it can go on for an hour or more, and she often lets out the most highly pitched screams ever heard. Just in case we forgot about her, which we did not. Let's just say she is watching a lot of "Super Why" and "Sesame Street" right about now.

Yesterday, we decided to move on to Prevacid, the "big guns" in baby reflux, and hope it makes a difference. Their first dose was this morning, so we shall see if it helps. The pharmacist said we could see results in as little as a day. Their pain is so obvious, and I know that caring for one baby with reflux is challenging, without any other children or multiples in the house. I have cried with them many times.

Yet another reason why reflux is an asshole is it makes them unable to nurse when they are having a hard feeding. I have held them up in some crazy positions, which can help sometimes, but usually, I end up pacing the house with my breast hanging out, "shooshing" and trying to get them to latch on to me, a bottle, anything. The contrast between the two Reflux-y ones and Lion is that he never cries when he eats, nurses like a professional nurser, and is soothed by food. The other two are made worse by eating, which is the ultimate comfort and nourishment one gives a baby.

It is emotionally tiring to see our sweet boys suffering, and I am hoping with all hope they get some relief soon. All I want for Christmas is Reflux-Free Babies.*

*And three extra hours in each day, and exclusive nursers, and my body back. Just in case anyone has Santa's ear...

Look Who's Blogging

2009-12-07T21:35:00.001-08:00

Hi! Remember me? I used to have endless hours laying on the couch with no one but my Bloggy friends and Wi-Fi to keep me company, and nothing to do but update my blog with frequent worries and musings. Not so with three precious newborns and a darling yet wildly jealous preschooler; the times, they are a-changing.

What do I do all day, you ask? Aside from the bit of sleeping, snacking and trying to spend some time with our daughter, I am doing two things:

... nursing (here is my view)

... and pumping.

This amazing contraption has given my babies an abundance of breast milk and allows me to pump in less time than if I didn't have a hospital grade model. I LOVE IT but sometimes, I wish the babies could take all they need without the seven times daily pumping sessions.

Without the unwavering support of my mom and husband, I would NOT be able to nurse and pump as much as I am. As of now, I make more than enough milk for the babies and have to freeze some each day, which is an awesome feeling. It takes about 30-45 minutes to work with one of the babies at each feeding and pumping is usually a 20-30 minute operation. Without my mom who does ALL the laundry and bottle washing and fixing, this would not be doable. Without my husband's commitment to breastfeeding, this would not be possible and I am very thankful to both of them. If I was alone all day or even most of the day, I would have thrown in the towel, I think. So the wonderful thing is I pump often and make a lot of milk for my boys.

The whiny, grass-is-greener thing: I wish they were ready to nurse exclusively, eat until they were full whenever they were hungry, and be able to tandem nurse. This is an unrealistic goal for many triplets at this age because despite their birth date being 6 weeks ago, they are 1 day old, adjusted, and have about the maturity of a baby born YESTERDAY. It is hard to not to rush the process and to trust that one day they will all be more efficient nursers.

I met with an amazing nurse lactation consultant from our NICU and she was incredibly encouraging. She gave me some wonderful tips on how to soothe the frantic baby who won't latch on, how to ensure they all get enough practice, but mostly, she cheered me on for the efforts and time invested and reassured me that in a few months, we should be where we want. Not only is it easier for me, but it should allow me to nurse two at once while one is given a bottle of breast milk, making it easier on the other adult here and certainly easier on my daughter. Also, less bottles to fill and wash and prepare, and less pumping for me! One of the most frustrating things is I have to go off to pump after a feeding, which is when the babies are most likely to be awake and extra cute.

As for my recovery, I was given the "green light" to exercise and the other things they "ok" at your six week visit today. I am thrilled that I can start Pilates and cardio (although these boobs preclude running!) because this body is flabby. Although I've only got 8-ish pounds to lose, the abs are stretched, the behind is saggy and I can't wait to feel some sore muscles after a good workout again. The effects of triplet pregnancy and months of bed rest need to be counteracted ASAP. I know the extra skin that is residing in my midsection needs a bit of time, but those transverse abdominal muscles better watch out- I am determined to flatten something out, and goodness knows, it will not be my breasts anytime soon.

My daughter and I brought a big box of homemade cookies and nuts that my mom and I have been working on to the nurses and doctors at our MFM clinic. We were met with lots of hugs and showed off pictures of the little guys. I spent so many weeks there, getting to know the sonographers and nurses, Dr. P and a few others, and it was bittersweet to say goodbye to them. We were all a bit teary, and we promised to bring the boys in when it is not 20 degrees in Seattle.

I remember feeling the same sadness about the graduation visit from the fertility clinic, but even more intensely because I know I will never be pregnant again. Just typing that makes me pause and swallow a lump in my throat. One would think that after a pregnancy like that, I'd be thrilled, and I am, mostly, but the feeling of my children moving inside me is one of the most magical and I will mourn the fact that I won't feel it again. Four children makes our family perfectly complete, but it is strange to know with certainty that we are finished having children since we have spent the last two years trying to bring one into the world safely. To switch from the trying-to-get pregnant mindset and the trying-to-stay-pregnant mindset to the no-more-children one is a shock to my heart, and requires some adjustment.

The boys! My love for each of them separately and the three of them together is more than I could have imagined. Their personalities are so fun to observe and without one of them, something would truly be missing. I am so thankful they are all safely here, growing and thriving.

As of last night (yes, I rented a scale):

Seal: 7 pounds, 6 ounces (CHUNK!)
Lion: 6 pounds, 7 ounces (my daughter's birth weight)
Elephant: 7 pounds, 3 ounces

Their growth is amazing everyone- all those cookies I am still eating are going to good use, I suppose. (That is what I tell myself at night when I have another biscotti.)

I promise another post within the week. What should I write about next? My mind is mush and I need prompting and direction!

1. The hardest part: my daughter with her broken heart and demon-like behavior
2. The boys' personalities and quirks
3. What our days and nights are like

I am getting good at typing/scrolling/reading while pumping, so I will try VERY hard!

Flying by the seat of my yoga pants

2009-11-16T21:07:00.001-08:00

I cannot believe it has been so long since I've posted, but seriously... I am sort of busy around here. Life is wonderful and amazing with four children in our home! All of our boys are so very healthy and happy, and our three-year old is adjusting to the new life. My husband, mom and I are all getting used to sleep deprivation and wander around like cheerful zombies.

People have asked questions about life since our triplets' birth and I thought it might make a nice and organized blog post, since my mind is a bit mushy lately. A thoughtful narrative post will follow, most likely some time around the new year.

How is the Lion?

Our little Lion! He is an amazing boy whose body is healed, who astounded his doctor's with "the mildest case of NEC" they've seen. He managed to quickly recover, thanks to the highly skilled staff at the NICU. His seven days "NPO" (without anything by mouth) were brutal. Although he was getting IV nutrition, he cried often and his tummy was audibly rumbly. My mom, husband, mother-in-law or I always stayed the night with him while he healed. We never wanted him to feel empty and hungry and not have one of us there. While the Seal and Elephant were home (4 days before Lion), life was crazy! We only had two adults to do all the newborn preemie care and feedings and care for our daughter, while one of us was at the hospital. Thankfully, Lion was only a bit behind his brothers and after he was allowed to eat, he caught up so very quickly to them! Since he's been home, he eats like a champ with his brothers and is getting much better at nursing. He usually latches on and falls asleep, though, and requires foot-tickling and such to stay awake.

I know I will always watch him more carefully, paying special attention to his cries and behavior. I examine each diaper for traces of blood- I have no doubt this habit will go on for months. I promised him when he was in the hospital that he'd always have dessert first- he earned it during his days of being hungry. We could not be more grateful knowing that many babies are not so lucky and have major ramifications from this awful disease whose cause we know little about. Our Lion was a lucky boy, and we are so glad his body fought the infection with so much strength.

How big are the boys?

Lion is about 4 pounds, 14 ounces, Seal is 5 pounds, and Elephant is living up to his name at 5 pounds, one ounce! They've all had their first "well child" visit and their pediatrician is very pleased with each of their growth.

What is your day like?

Pull up a chair and grab a latte- this may exhaust you.

5 AM: Feed babies! My mom and I usually do this one together while my husband sleeps. It is a "super bottle" feeding where the breast milk is fortified with a preemie powder for lots of extra calories.

6 AM: Pump. I always have to wash one of my two sets of pumping parts after this. Our daughter usually wakes up in this hour, too.

7 AM: Make bottles for the day, do some sort of household chores. My mom is always on top of this, too.

8 AM: Feed babies! This time, we add vitamins and iron to a bottle of breast milk and I nurse one of the three. Depending on who is nursing, we have to give them a bit more breast milk in a bottle.

9 AM: Pump. Play with our daughter if she is not at school.

11 AM: Feed babies! A super bottle again, and I nurse one.

12 PM: Pump. Household stuff or play with A.

2 PM: Lunch for the people in the house over a month old, if we are lucky. Usually a handful of trail mix or veggies and hummus. (In fact, I just found a cashew in my bra.) We tend to graze when we feel like we might pass out.

5 PM: Feed babies! Again, a fortified bottle for two and I nurse one.

6 PM: Pump.

6:30 PM: Dinner. If we have time. We always feed A, though, so don't worry.

8 PM: Feed babies! More vitamins and iron and I nurse one.

9 PM: Pump.

10 PM: Go to bed.

11 PM: My husband and my mom do this one while I sleep unless A wakes up (as she has been) or I am needed.

2 AM: Feed babies!

3 AM: Pump.

5 AM: Return to beginning and repeat!

This is infinitely easier when we have an extra adult (besides my mom and I) so when my husband is home, it is much better, and my wonderful mother-in-law was here for a week, but for the most part, we will be on our own. My sister-in-law will be here for five days later in the week and that is the end of our "planned" helpers. Then we will be at the mercy of our friends and family who will come help feed, hold a baby, play with A or fold laundry.

How goes breastfeeding?

It is a wonderful joy to feed my babies from my body. When A was an infant, I struggled to get her to latch on, and used a nipple shield for a couple months, then nursed her for 15 months. I loved every nursing session with her and do not think I ever felt closer to her. The initial frustration of trying to get her to latch on, stay awake and eat enough so that she was not hungry again 90 minutes later felt like it would never get better. Slowly, her latch improved and she was able to eat more quickly with less fuss.

In the hospital, I was able to nurse the boys for a maximum of 3o minutes, and they were weighed before and after each feeding. Sometimes they got their whole feed, sometimes only a few CC's. Through all of it, I have pumped every three hours, around the clock, telling my body to make enough milk for three. So far, I am able to keep up with what they need, as long as I drink insane amounts of water and take Fenugreek to boost the supply a bit. It is not my favorite pastime, pumping, but I am figuring out the tricks and am usually able to pump 5-6 ounces per session, for about 40-50 ounces per day.

Trying to give each boy a good chance to nurse and help them "learn" to latch on, stay awake and take in enough are similar problems to how my daughter's nursing began. However, then I had ONE baby to teach and work with and I would put her to the breast about every 2 hours during the day. She had many more chances in 24 hours than her brothers do. I try to nurse one baby at almost each feeding (the nights I don't) and then sometimes they need a bottle of breast milk to finish. Seal could just nurse, I am convinced. He latches on without the shield and does a great job of getting my milk to let down. Lion, who does not latch well, is the most efficient eater and is usually done very quickly. Little Elephant has the hardest time latching on and gets frustrated. I just keep working with him until he is latched, but he is often wiped out after all the efforts and doesn't get much milk since he passes out quickly.

Ultimately, my goal is to nurse two at once at each feeding while the third one gets breast milk in a bottle (or formula if necessary) and right now that feels so very far away. I know it's ambitious to expect a preemie to "get it" so quickly, so I try to take heart in what both my pediatrician and lactation consultant said: That (a) they will be much stronger nursers by their due date and (b) the most important thing is to give each practice while maintaining my pumping schedule. I just expected it to come more quickly and for it to be easier to get them off of so many bottles. A very small concern compared to what can happen with preterm triplets, but it is something that is a very important goal for me. The always-wise Dr. Sears says in his “Premature Baby” book that to teach preemies to breastfeed, you need the two P's: Patience and Perseverance. I think he is right once again.

Here are a couple of pictures of our trio, settling in at home.

Snuggled in their Boppies; second favorite only to being held.

Thirty toes!

10 second update

2009-11-11T10:49:00.000-08:00

Our Lion is healed.

Our three beautiful boys are at home with their family.

I cannot tell you how much each comment and thought meant to us as we got through the most wondrous and terrifying week.

I will post tonight, though it may not be coherent.

My heart is swollen with love and gratitude.

Our Sweet Lion

2009-10-30T18:51:00.001-07:00

We've finally come up with appropriate nicknames for our trio as we won't be posting names here.

Baby A is our little Seal- he smiles in his sleep all the time, makes little barking sounds when he is rooting around for food and his sister thought the seal sticker was the perfect one for his isolette.

Baby B has some seriously spiky hair, quite like a lion. So he will be The Lion, one of the twins. His nickname suits him even more with what he has gone through over the last two days.

Baby C is an amazing eater. He sucks breast milk down through his bottle and nurses like a professional. He can almost take a full feeding (36 cc's, or about an ounce) at the breast. For his isolette sign, we picked the Elephant.

Now I understand why having your babies in the NICU can be called a "Roller Coaster". I can easily say that yesterday was one of the worst and also one of the best days of my life.

But I am getting ahead of myself. Let me begin at the beginning ...

Yesterday morning, on the boys' sixth day in the world, my mom and I came in for the morning feedings. When we arrived the nurse told us that all three of the babies would have their phototherapy lights off as their billirubin levels had normalized. This means they could be held much more again and got to take off the masks they so loathed. Great news! Also, since the twins were taking their maximum feeds, their IV's could be removed. Another step closer to coming home. (Elephant is just a day behind on feeds and had his IV removed last night.) I felt like a child on Christmas morning! So many wonderful things happening.

After I nursed the Seal, we removed his IV and put him into his isolette for a nap. I was excited to nurse Lion as he'd been too sleepy at 8 pm the night before and I had not held him. T, our amazing nurse, and I went to our Lion so I could help her change him and she mentioned he'd had a hard night, fussy and seemed to be hungry, but after he was fed, he was fussier. They were watching him closely and he seemed peaceful when we arrived. As soon as we opened his diaper, we saw blood. T immediately called the neonatologist who ran into our room. I looked at her and said, "Is it NEC?" She said, "It could be. We need to run some tests, but bloody stools are never a good thing." I asked if she'd ever seen this kind of stool and it was not NEC and she said, "Maybe... once." And I burst into tears, watching the room's energy change as the doctor ordered an x-ray, blood work and a discontinuation of all oral feeds. His IV was staying in, and they were going to start antibiotics.

I have read extensively about NEC or Necrotizing Enterocolitis as it can become very serious, very quickly in premature babies and multiples are at a higher risk. It is a disease that begins after babies start feeding, and the cause is not well understood. The baby often presents with fussiness, distended abdomen, vomiting or bloody stools. An x-ray is needed to diagnose the disease. It looks for air in the liver caused by pockets or areas of necrotic (dying) tissue in the bowel. It can also cause apnea episodes, drops in the heartrate and desaturation of oxygen, all of which can call for intubation. They cannot be put on CPAP as it pushes air into the body and we do not want any air in his tummy, so it would be straight to a ventilator. The babies are started on antibiotics, their feeds are discontinued for 7-10 days and a suction tube is put into their nose to pull out any stomach contents and examine it. It some cases, it can require immediate surgery which tries to cut out the infected tissue in the bowel and sometimes bring the intestines to the surface of the abdomen. Of course, surgery on a premature infant is terrifying and must be performed by specialized nurses, surgeons and anesthesiologists. Most NICU families know what NEC is and are terrified of it.

The x-ray was performed in his isolette and we waited while the doctor obtained and read the films. It was the longest 20 minutes of my life until Dr. C walked in and said, "He has NEC." I was nursing Elephant when he came in, and could not even speak. I just looked at the baby at my breast and let my tears fall onto him while he contentedly ate. Dr. C said that he felt we'd caught it early, but we do not know how NEC will progress until we have at least a few x-ray images to compare to one another.

I kept saying, "Can he survive? Will it get worse?" and he said, "I hope this is a very mild case. Stay tuned is all I can say for now. If he is going to get sicker, we will see it quickly. He will start to look different, his vitals will become unstable, and he will change his behavior. I will let you know more when I know more. I called a surgeon from another hospital who does NEC surgeries all the time, and he's coming to read the next x-ray. We may need to transfer him to Children's or another hospital. I will come back soon. I am so sorry this happened."

My mom and I were left with our babies, sobbing, with our most caring nurse, T, who filled in the blanks on any questions we had. She reassured us that the best thing he had going for him was he looked healthy, and had stable vitals. If he had not had the bloody stool, she said, no one would know he is sick. We waited and my husband arrived, who'd been dropping A off at preschool, and I had the unbelievably hard task of telling him the news. We stared at each other and he walked to Lion, telling him how strong he is, and how much we love him. The next few hours while we waited for the next x-ray were torturous. We watched Lion like hawks, staring at his monitors, and were reassured that his vitals did not crash and he did not seem to be in pain.

The surgeon, Dr. H, arrived. He is a man of maybe 70 years, who was the chief of surgery at Children's for many years. He explained what he is looking for, and that the next x-ray would tell us a lot. He said, "We do not want to see anymore air in the liver, and certainly no air in the free space of the abdomen. That would require immediate surgery as it would indicate a bowel perforation." He assured us that if he thought it was necessary, he would have him transferred but he hoped he could stay with his brothers. He promised to visit him each day and consult with our neonatologists for updates frequently.

The x-ray began while he was here and it was a digital x-ray which allowed us to read it immediately. They had to position him on his side and hold his arms over his head, which made him scream, but we had to just stand back and soothe him with our voices as best we could. After it was over and Dr. H was able to see the images, he smiled. He looked at us and said, "These look quite normal! With NEC, we usually see a rapid progression and this is very reassuring. I think we should be cautiously optimistic." He told us to call him for anything, but he did not think our son would need surgery, just antibiotics and an empty tummy for 7 days. We thanked him over and over, crying, and sat down next to our sick baby, urging him to keep healing.

The rest of the day we clung to our babies we were allowed to hold, sat next to our little fighter and sang to him, touched his face, rubbed his soft, fuzzy head. I cursed the disease that was inside his body, wishing I could take all of his discomfort away, wishing he would keep healing. We were so encouraged by the doctors' comments and examinations, but we know how NEC can be, and kept ourselves cautious. He had an x-ray scheduled for 10 pm that would provide us with a little more info.

I went home after softly begging my son to heal, to keep his fighter spirit. I needed to spend some time with our daughter who has been missing us terribly. My amazing husband has not left the hospital in two days and sleeps with our boys each night. We do not feel that we can leave them alone right now, and so one of us is always hereI came back three hours later for the 8 pm feedings and to be with Lion. He had another x-ray that evening and we wanted to talk to the neonatologist after he read it. I tracked him after 11 pm and he came in to tell us the best news we'd heard all day: his x-ray was normal and his blood work looked great! He said if we did not know he had NEC from his previous symptoms and x-ray, he would not be able to tell. He felt hopeful he would continue to improve. Tears of relief came to us, and while we knew this disease can be so sudden, he seemed to be fighting hard to heal.

This morning I came in and his first x-ray also looked "stone cold normal" according to the surgeon, Dr. H. He decided to just check in on him this weekend but he feels great about his progress! We are overjoyed! After his last x-ray this evening and blood work, Dr. C came in and said he feels Lion is "out of the woods"! Again, things can change so quickly, but his body seems to be going in the right direction. Leaving his digestive system empty while administering strong antibiotics is working to reverse the damage. Had it not been caught so quickly by the excellent nurses here, and had the doctors not responded with knowledge and care, things could be very different right now.

Now, the plan stays the same: he will be "NPO", which means nothing by mouth, so no breast milk at all for seven days from the onset of the disease (Thursday) and strong antibiotics. All of the nurses and doctors have repeatedly told us that they were thrilled he was on breast milk only; babies on formula have a much higher risk of NEC, so when his feedings do start again, we can feel good. He will start very slowly, receiving only a few CC's (1/10 of an ounce) while we see how his bowels react to the restarting of milk feedings. In the meantime, he is on IV nutrition called TPN which delivers his calories and lipids. Unfortunately, since yesterday evening, he has started to be truly hungry, rooting for a nipple when it is time to eat, needing to suck more on his paci to feel calm, and crying very hard when we hold him and cannot feed him. It is so unbelievably difficult to want to nurse him, make him feel satiated when I know that would be the worst possible thing to do. All my maternal instincts are wrong in this case, and I've taken to singing to him through his hunger. He seems to like Coldplay.

For now, we are feeling like things might be all right, but are still watching him extra vigilantly, keeping eyes on the babies' monitors and watching for signs of NEC in his brothers. So far, they both are doing extremely well, still nursing often and taking one ounce of breast milk 8 times a day. I am so happy to say I have about 80 ounces of milk in the freezer, waiting for when Lion is ready to eat again. I cannot wait to nourish him when his body is ready.

This was one of the best moments of the day:

Seal and Elephant are dressed! They seem to have shown they maintain a normal temperature quite well and are probably moving to an open crib to co-bed tomorrow. Of course, Lion will be in his isolette while he heals and has an IV, and we know we will be aching for him to join his brothers. They haven't seen each other since birth and they were in quite tight quarters for 7 1/2 months!

Please keep our Lion in your thoughts and help us urge his body to keep fighting, keep healing and that he will feel comforted.

Madly in Love!

2009-10-28T22:22:00.000-07:00

Thank you so much to my husband for being the guest blogger to let everyone know that the babies have arrived! He claims that those posts had the most comments because of his superior blogging skills, but I pointed out it could've been the news he shared: our sons are here, and they are doing marvelously!

The short version of how our boys came a few days before their "scheduled" day is that I had gone to see Dr. P for my last ultrasound and was miserable. I had woken up that day in so much pain, and had not slept in a week. The contractions were harder to control at home and I just felt off. Thank goodness my husband decided to drive me to this appointment. When Dr. P saw me she said, "Something is different!" I told her how I'd been feeling, and the boys took a while to pass their BPP's so I was worried about them. She found that I was starting to have protein in my urine and sent me over to triage for an NST.

The contractions showed up right away, and I took a hefty dose of Nifedipine after Terbutaline. They slowed for about 10 minutes and picked right back up, stronger than ever. My body was in real labor that did not want to stop, and Dr. P felt there was no need to put us all through even heavier meds, monitoring and possibly an emergency C-section, so we decided that since I hadn't eaten much, she would deliver them that night. While I was "prepped" I had regular and painful contractions and was surprised to have to recall my labor breathing from our daughter's birth. We were thrilled! And terrified!

A mad dash ensued to find a way for my mom to attend the birth while our dear friend and my brother cared for our three year old daughter. My mom arrived with many bags of things I spouted off between contractions and we all prepared to meet our sons. I looked at my husband and asked if he remembered the feeling of falling completely in love when we'd met our daughter. He said, "Of course! And we get to do it again ... " I wished I had kissed our daughter before I left the house, held her tighter for a minute because I did not know it was the last time I would see her as my only child.

All the preparations were in place and I walked into the operating room, was numbed and in seconds, it seemed, Baby A was out and screaming. I heard myself say, "OH! You are here!" and cried while his brothers emerged shortly after. I watched them all be examined, and have wonderful reports shouted from the NICU nurses and Dr. C, the neonatologist. He kept saying, "They are so healthy and beautiful!" and they all hit the four pound mark. They were taken to NICU with my husband and I was wheeled to recovery with my mom, and we stopped to see our beautiful boys being checked out further. Someone told me they all got APGARs of 9/10, and needed no help breathing. I was put into my room and after a couple of hours of begging to be let up, off my IV's and meds, they let me be wheeled in to see our little men.

They were in radiant warmers, not isolettes yet, and I was able to touch each of them, smell their intoxicating baby smell and tell them how long we'd been waiting to meet them. I started getting pretty sick from the Morphine and had to go back to my room for the night. I pumped three times that night and had the nurses deliver the colostrum to the babies even though their feeds did not start until the second day. I was very proud of having something for them already. My husband stayed mainly with our sons and my mom was in and out before she went home to see our daughter, the big sister to three.

The next day they were put into their isolettes, received IV nutrition and monitored closely. No one has needed any help or interventions- no episodes of apnea or bradycardia, no need for medications or extra tests. After that they moved to feedings through their NG tubes, and the next day from the breast! They all practiced nursing while a nurse would squirt their bit of colostrum into the corner of their mouths. Now they all are able to take a bottle or nurse a bit, though we still put their feeds down their tubes to help conserve energy. Breastfeeding uses more calories and energy than bottle feeding or getting a feed through their NG tube (a tube that runs into their tummies) so we are only allowed three feeds a day at the breast right now. It is more than I had hoped for and I am thrilled to nurse them and say they are only getting breast milk. I have been pumping about every 3 hours and am producing 30+ ounces of milk a day for them. WOO HOO!

They are currently under phototherapy lights for jaundice but their levels are down already and they'll be out tomorrow. When they are under the lights, the time they spend "out" being held or nursed is strictly limited, so no extended cuddling sessions, which we hate. We cannot wait to have them be able to look around again, without their masks (protect their eyes from the lights) and able to be kangarooed for long stretches. Their IV's should come out tomorrow also since they take all their feeds orally or through their tubes. Next steps: maintain their temperatures and get into an open crib together and take all feeds orally.

We know everyone wants to hear when they'll be home. The answer: we wish we knew! They will most likely come home in about 2 weeks or so, but it could be sooner. It could be together or staggered, they might have something come up that delays them, or they could jump ahead. We just do not know, and that is the hardest part.

The recovery from the C-section is no fun at all, but I am amazed at how much better I feel each day. I was eager to get up and walking, and managed to get myself discharged early so I could be with the babies more. The nurses could never find me since I was always in the NICU anyway, so they had the doctor discharge me. The biggest hurdles are the lack of abdominal strength and just being swollen and tired. The incision does not hurt much at all.

The side effect of producing lots of breast milk for my sons is engorgement, sore nipples and general breast pain. I kind of look like Dolly Parton, with the added ability of shooting milk across a room. I am so lucky to have a good supply, but I am sort of chained to my pumps (one at home and one in the boys' room) and it is not nearly as appealing as snuggling a little baby.

My schedule is tough, but do-able and SO worth the exhaustion. I cannot wait to see them each day but miss their sister so very much when I am away. My husband and mom spend so much time with our daughter and are both very present in the boys' care. I can't stress this enough: without "Gramma", we could not do this well!

6 am: Pump and shower
7:15 am: Leave for the hospital
8 am: Nurse the boys, snuggle for a minute, help do their "cares"
9:30 am: Pump, pack up to go home
10:30 am: Hang out at home with A
12: 30 pm: Pump, eat lunch
1:15 pm: Leave for the hospital
2 pm: Nurse the boys, snuggle for a minute, help do their "cares"
3:30 pm: Pump, pack up to go home
4:30 pm: Do something with A, help at home
6:30 pm: Pump
7:15 pm: Leave for the hospital
8 pm: Nurse the boys, snuggle for a minute, help do their "cares"
9: 30 pm: Pump and go home for the night. Discuss the plan for the evening with the nurses before leaving.
11:00: Go to bed
12:30 am: Pump
3:30 am: Pump
6:00 am: Start again!

(I may need to print this so I know where I am supposed to be!)

And now ... I must go sleep a bit. I will leave you with this cutie pie picture of our little guy getting phototherapy. I cannot wait until their masks come off and we can see their gorgeous eyes again! I will try to update more frequently, and I am sure when I buy a hands-free pumping bra that I will have much more time with my lap top. I cannot wait to share about each of their personalities and the sweet things they do as well as how AMAZINGLY their big sister is doing. (She told us she'd like an isolette from Santa for her baby dolls for Christmas.) I could also write a ten page post on the range of emotions I am feeling right now, from downright euphoria to hysteria and anxiety. Ahh, the postpartum period.

Thank you for all of the congratulations and well wishes. We are so very, very blessed and we know it. Falling in love with three precious boys is just as amazing as it sounds.

Boys and Mom are doing great

2009-10-26T07:39:00.000-07:00

This is a guest post by Carrie's husband.

Carrie asked that I give everyone a quick update until she can write a longer post about birth and the first two days. She has been amazing and spends all her time breast feeding, pumping, holding and helping care for our three beautiful sons.

The boys were born around 8:30 on Friday night. All the boys are doing great. They are all breathing room air without assistance, breast feeding and growing stronger every day. We both feel extremely blessed that are boys are healthy and doing amazingly well.

Baby A
Weight: 4 lbs 1 oz
Length: 17.3 inches
Apgar score: 9

Baby B
Weight: 4 lbs 0 oz
Length: 16.7 inches
Apgar score: 9

Baby C
Weight: 4 lbs 1 oz
Length: 17.1 inches
Apgar score: 9

Tonight is the night

2009-10-23T18:45:00.000-07:00

This is a guest post by Carrie's husband.

I took Carrie to her final appointment this afternoon. Carrie has been having more frequent contractions for the last few days and generally not feeling well. Today, she also has a headache and the contractions continue to get more painful.

The babies looked great during the ultrasound but contractions continued. After the ultrasound, the doctor decided to send her over to Triage for NST monitoring. The contractions only got stronger throughout the day. After a few hours of monitoring and an extra dose of nifedipine, the contractions are still getting stronger. Dr P. has been checking in every few hours and decided to go ahead and schedule the delivery tonight. The babies will be born in about 2 hours. Carrie will post more tomorrow.

Stillllllllll pregnant at 33 weeks and 4 days

2009-10-22T20:59:00.000-07:00

87 hours and 14 minutes until my C-section. 12:15 on Monday. Are we really almost there?

A long and reflective post is working in my mind, but I have a feeling this body of mine will not allow me to post it until after the boys' birth. I could give a laundry list of the aches and pains accompanying these last few weeks, along with all the interesting things my body is doing, but mostly, I am grateful. I am so grateful to be here, and so hopeful that the boys will make it until Monday and thrive after they come into this world.

Their breathtaking movements are so encouraging, and their NST's have been wonderful. But. There is always the small chance that something could happen, and I need to hold them in my arms, hear their voices, touch their skin to know they are truly well and here to stay.

Several people have asked the excellent question of why the babies will be born at 34 weeks if I am not in labor. Why not wait until 35 or 36? GREAT QUESTION! And I have a great answer. :)

In every pregnancy, the placenta supplies oxygen and nutrients to the fetus(es) and eventually becomes less efficient at this job. Studies show that multiple babies' lungs and bodies mature faster, but their growth slows considerably after week 30-32 because the placenta(s) have done their job and cease delivering enough nutrients to the babies. In our case, we have seen the rate of growth on all of the boys slow because of both the space limitations and the placental deterioration.

Our doctor's office will NOT deliver triplets after 34-35 weeks. If the rate of growth stays good, they will go closer to 35 but not after. This book, called "Triplet Pregnancies and their Consequences" asserts that the fetal death rate for triplets is the LOWEST when they are born between weeks 35 and 35. While getting to 34 is great because of the increased lung development and eating abilities, going past 35 puts the babies at other risks, and they generally (according to my doctors, and what I've read) do better outside the womb.

In the case of our boys, their weight has gone from being in the 40th percentile to less than the 20th in two weeks. The Doppler studies which examine the quality of blood flow from the placenta into the babies' cords, bellies and hearts has become elevated- they are having to work harder to get as much nutrition. When Dr. P told me this on Tuesday, of course I asked if we should deliver NOW? Was this dangerous? She said, "No, not dangerous. It just gives us the information that they are going to be ready to come at 34, and that their placenta is aging." She said it is not a bad sign, it is just indicative of what is happening. Because their fluid, NST's and BPP's continue to be wonderful, she (and I) feel good about getting to 34 weeks, which is THREE DAYS AWAY!!

Again, this is only my understanding from our doctors and nurses, as well as the neonatologist we spoke with. I know some who have 6 pound, 36 week triplets, but it is not going to be us, and that is okay.

I seem to have "Come Monday" by Jimmy Buffet stuck in my head, once again.

"Come Monday, it'll be all right.
Come Monday, I'll be holding you tight..."

If you need to give it a listen, here you go.

33 Weeks!

2009-10-19T08:21:00.000-07:00

Saturday night my husband and I were going to go out to dinner since the days of date nights are numbered, but around 4 pm, my uterus began to thwart our plans.

I started having contractions about every 3 minutes, and then they started to hurt. Not a lot, but enough that I didn't want to talk while I was having one. I took some Terbutaline which slowed them, but didn't stop them. Realizing this could be true labor, I called our MFM's number which automatically transfers to the answering service on the weekend. Usually. I tried it no less than 10 times and it disconnected me each time. I gave up and tried calling our hospital directly, and was also disconnected! Eventually we found a number that was not in their main network and someone transferred us to Labor and Delivery. After about 45 minutes of trying! Of course, they said to come in, but I had hoped to talk to Dr. P first.

When we arrived, they hooked me up to the monitor and only saw about 8 contractions and hour, and the babies looked wonderful! They were having good accelerations and great baseline heart rates. After the oral terb started to wear off, the contractions picked up again, this time more painful and longer. My awesome nurse checked my cervix and announced I was dilated to 2.5 cm and about 80% effaced. Not a huge deal, since I have had a child before, but we wanted to make sure it stayed that way. The nurse went off to call Dr. P and said, "Do you want to have them now? Sometimes doctors just decide your "done" and deliver." After we picked our jaws up off of the floor, we said, "We want to get to 34 weeks, and we are sure Dr. P will too."

When Dr. P came in she asked why we didn't call her and I explained the answering service didn't ANSWER! The nurse told us the entire hospital's switchboard had been down and that affected the service. Dr. P was a bit horrified and said, "Yikes! I hope it was not down too long..."

She agreed with us, of course, that she wanted to try to get to 34 weeks, and I received a shot of Terbutaline which stopped the contractions right away. They kept me overnight to make sure the contractions stayed away after the Terb wore off, which they did, and monitored the babies again in the morning. Dr. P used words I have not heard spoken by her: "gorgeous monitoring session for the babies" and "they look beautiful!" were phrases that set my mind at ease.

We left the hospital, happily, the next afternoon and I will go back tomorrow for a quickie ultrasound and NST. Then back for my LAST appointment on Friday and then three short days later, my sons will be born! There are just about seven days remaining until the big C-section. What's that? You want to know how many hours? Okay, 166 hours and two minutes. And you can figure we sleep 8 hours per day, so that is about 110 waking hours left!

So I am alternating between states of excitement, overwhelming gratitude, fear and organization. Really, you should see the closets around here. Tidy and labeled! In fact, I have been labeling everything. EVERYTHING. My daughter's toy bins, the boys' drawers, art supplies. (I am aware of the psychological implications here and that by creating order in my drawers and closets, I feel some control over the outcome of this pregnancy, but ANYWAY...)

Cases in point:

I become very annoyed when I cannot get things into a label-able category, as is often the case with my techie husband's gadgets, cords, chargers and nameless pieces of electronics. In this case I found something that fit:

Seriously, I should be a professional organizer, but I am willing to admit that I am only this good when pregnant.

47 weeks, 12 pounds, 10 days

2009-10-15T19:11:00.000-07:00

47 weeks is how big my fundal height measures. That is seven weeks past full-term.

12 pounds is the weight of the baby goodness in said uterus. Well, two ounces shy of it.

10 days until I get to meet my sons.

Longer post forthcoming, but I get in trouble when I do not update after visits with Dr. P.

Hoping the next ten days FLY!

32 Weeks!

2009-10-12T19:33:00.000-07:00

Well, actually, 32 weeks and 1 day.

I am so grateful to be here and hope to make it another 13 days, 16 hours and some minutes to our scheduled C-section. 34 weeks has always been our ultimate goal and I want to get there!

Today I had a cervical measurement, and it is still around 1 centimeter, but not changing. Hard to believe a third of an inch is keeping A's head inside my body! The boys' fluid was even and plentiful and we will have our last full growth along with Dopplers on Thursday to ensure the placentas are still doing their jobs. I also had an NST which the boys aced. Baby A was asleep and we need him to be moving to show us his accelerations, so the nurse brought over something called an acoustic stimulator. It looks like a lighter or something but makes a loud buzzing sound to wake up the baby. She put it on my skin and it buzzed loudly- then I felt some swift kicks. Baby A was not happy to be awoken but we saw that his heart rate accelerated and normalized appropriately when he was moving.

Dr. P was all sunshiny again since I am past 32 weeks. We discussed how if I do go into labor, we'll still try to stop it until 34 weeks, and if my membranes rupture, I will be hospitalized but we'll still try to hold off labor. These next two weeks inside of me mean FOUR LESS WEEKS for the babies in the NICU. They are very important, so we'll keep trying to get there.

She also said I do not need to have anymore cervical measurements or fFN's, to which I replied, "No more transvaginal ultrasounds!" She laughed and said, "Not exactly. A's head is so low that a transvaginal is the only way we will be able to measure his head on Thursday for growth." So that should be interesting. I cannot wait to see how big they've grown, however we measure it! It would be a huge deal to have them around or over 4 pounds now.

Not much else to report. I still have low blood pressure and feel pretty good. I know that I will be eating my words in a week or so, but right now, although I am huge and uncomfortable, I want these boys to keep growing inside. I feel so very grateful that this pregnancy is going well for now. I know things can change so quickly, but for today, I am thrilled that we are in a safer place for our sons. I hope, hope, hope we get to bring home three healthy boys sometime soon.

I will say that the discomforts are multiplying (no pun intended). Last night, I counted six bathroom trips, almost on the hour for a while there. I cannot bend over to tie my shoes, and the days of flip flops are gone in Seattle, so I wear my cozy boots everywhere. My back really hurts, right between the shoulder blades, and my pelvis feels like someone is pushing down on it, very hard. (Oh, Wait! Three someones are!) I am sitting on the couch typing and my belly keeps getting in the way of my arms, so the laptop is elevated on pillows. The whole thing is quite a sight!

Here is the 32 week belly. I cannot believe how big it is! Can it really keep expanding? We will see...

And here is one of me and my husband whose waistline is not expanding, much to my dismay. I am happy to report I do not think I will weigh as much as him during this pregnancy.

Oh, and we are buying a minivan. We tried to resist, but as you know, it can be futile. We already have a ginormous SUV but the third row will not accommodate the rear-facing infant seats, and sliding door would be extremely handy with four little ones. That means we'll have to trade in my non-green SUV, which I love, and get a Soccer Mom Mobile. I always made fun of my friends who had them, and this is what I get. :)

I saw an awesome bumper sticker the other day on a van that said, "I may drive a minivan, but at least I still put out." I need one of these, until A starts reading and I have to explain it...

Small Rant (About an NYT Article on Twins)

2009-10-11T09:16:00.001-07:00

I read the New York Times online for my news most days. I think their Health articles are especially good and send them to friends often (a habit I am sure they do not enjoy always). Last night an article called "21st Century Babies: The Gift of Life, and its Price" by Stephanie Saul caught my eye. I called my husband over to my laptop and we read it voraciously, both of us indignant at the tone of the article and incredulous over the claims it makes.

The article focuses on twins. More specifically, how IVF can result in twins and how multiple pregnancies are infinitely more risky, and often result in preterm birth. While briefly acknowledging that most twins are completely healthy, there are still risks associated with prematurity. It begins with this:

"Scary. Like aliens. That is how Kerry Mastera remembers her twins, Max and Wes, in the traumatic days after they were born nine weeks early. Machines forced air into the infants’ lungs, pushing their tiny chests up and down in artificial heaves. Tubes delivered nourishment. They were so small her husband’s wedding band fit around an entire baby foot."

After I read that, all I could be was angry. I am quite sure that this woman who had gone through a fertility treatments and a difficult pregnancy did not just think her newborns looked like aliens. I would be she thought they were also the most perfect, desired and loved beings she'd ever seen. And I bet she was extremely grateful for fertility treatments allowing her to become pregnant.

It discusses the irresponsibility of Reproductive Endocrinology and how the "Fertility Doctors" transfer too many embryos to inflate their birth rates and "lure" more customers. It discusses the promising research on Single Embryo Transfers (SET) which are more successful as they are better able to grow embryos to blastocyst stage.

Another major focus is the cost to "society" of preterm infants and how insurers should not have to pay for babies' care conceived via fertility drugs or IVF. It alluded to a national health crisis caused by the cost of caring for babies in the NICU. The article allows for comments, and I read over 100t this morning. Most people wrote something along the lines of "Outrageous! Irresponsible and dangerous industry" or "Just adopt!" as though one could just run out and adopt a child, and not spend many years and many thousands of dollars trying to do just that. Many people wrote horror stories of higher- order multiples, selective reduction and severely disabled twins. A few were more level-headed, and acknowledged the risk of twins but also pointed out that people who underwent fertility treatments were also extremely cautious and well-cared for prenatal patients.

In response to some of these idiotic or ignorant comments, a woman wrote this, and I cheered:

" ... if you, personally, deem care of babies produced via fertility processes just too expensive to pay for, then heck, I guess I'll just deem the exceptoinal costs associated with treating cigarette addicts, overweight diabetics, and any manner of self-inflicted sicknesses out of bounds.

Really, how selfish to continue with your unhealthy and costly habits when you could just adopt an apple."

Go give this article a read, and leave the editors a comment letting them know what you think. Apparently, this article is first in a series and I really hope the Times has something better in store for the remainder.

The Uncomfortable Place

2009-10-10T09:32:00.000-07:00

Apologies for my brief absence. I am still pregnant with three busy boys, and have reached the Uncomfortable Place. My back, hips, legs are truly feeling the effects of the extra weight and the curvature of my spine while this body tries to support 11-ish pounds of baby. I am extremely grateful to be carrying these boys around, so I will gladly reside in the Uncomfortable Place for another 15 days. That is right, just 15 days (unless the boys conspire to exit the cozy womb earlier)!

I was fairly convinced that Dr. P would be admitting me to the hospital for the duration on Thursday, after Monday showed a shorter cervix and positive fFN. That cervix never fails to astound me. It grew again. Just a touch, but there is no further shortening or funneling. The babies did amazingly well on an NST (my first one ever) and had appropriate accelerations and no decelerations (in their heart rates) which is a good indicator of placental function and their handling of stress. They also rocked their BPP's! Baby B was sleeping and did not want to show off his breathing during the scan so I had to roll onto my right side to smoosh him to wake him up. After that he was annoyed enough to start breathing for us.

Dr. P said she thinks maybe the positive fFN was a result of my increased activity, and does not think I will go into labor until my C-section on the 26th of October! Which I would like to point out again is a mere 15 days or just less than 400 hours away. She said to stop worrying about being admitted: if I was in unstoppable labor now, she thinks our babies would still be quite healthy!

On Monday I will have another NST and a quick ultrasound, followed by a full-growth on Thursday to see how big our boys have grown. Then the following week, I have another NST on Monday and Dopplers on Friday. Then it is just the weekend, and the boys' birthday! Again, if they change their mind and want to come earlier, being past 32 weeks (which I am tomorrow) is a good place for triplets to be. I had a repeat dose of steroids for their lungs, one administered by my mom. Add another talent to Grammma's list of gifts: excellent intramuscular injection giver! I am not as worried as I once was about complications related to prematurity after seeing how well 32+ weekers usually do, so if they come sooner, it won't be as scary as it would've been a couple weeks ago.

I would, however, love to be sedated or heavily drugged until their arrival date. The worry I feel is also part of the Uncomfortable Place. Wemberly has been working overtime about all the "what if's" that could happen in the next 15 days. What if I make it this far with healthy boys and still, I do not get to keep them? What if I have to go through fertility treatments and a scary pregnancy again? I know this seems irrational to most of you, but after wanting something SO much for SO long, the end is quite terrifying.

I am already a parent and know I will continue to worry once they are born, but this is a different feeling entirely. I need to know they are here, they are alive and healthy before I can truly relax. I love to feel their movements and kicks and hiccups for now, but holding them, studying their noses and staring into their eyes is what we've been waiting for. To this Infertile, seeing is truly believing.

It was nice while it lasted...

2009-10-05T16:35:00.000-07:00

Back to the couch with me. Do not pass the nursery, do not fold clothes. Bed rest is in effect again.

The boys looked fantastic today! They were all swimming in lots of fluid, wiggling around with strong heart beats and showing us their breathing. Go boys! I asked what the results of my fFN from last week were and they realized that instead of running the culture, they discarded it. Some doctors only run it if the cervical measurement is alarming, but my Dr. P always runs one per week. They repeated it today - more people seeing me without pants.

Then, the cervical ultrasound. Not. So. Good. It is measuring just about 1 cm. Still stable under pressure, though, so Dr. P was not too concerned. She told me to take it "easier" and stay off of my feet more, but that she wouldn't admit me until it was less than one centimeter this week. After 32 weeks, she would not. We made appointments for me to get steroid injections next week for the babies' lungs and scheduled my last (!) growth scan for next week.

I came home and waited for the "Your fFN was negative!" call that I usually get about 3 hours after arriving home. After not hearing from the nurses, I left them a message and had a feeling that they were not calling me back this time because it was positive and they had to Dr. P before calling me.

I hate being right all the time. Positive fFN.

You may recall that a negative fFN indicates a less than five percent chance of delivering in the next two weeks. A positive fFN is less clear. It means one is at an increased risk of delivering in the next two weeks due to cervical changes, but only 20-30% of women actually deliver in that window. I have heard doctors say they hate positive fFN's because they are compelled to be more aggressive with tocolytics like Terbutaline but the majority of women do not deliver within two weeks.

It does cause alarm when it is coupled with a shortened cervix (like mine) after several negative fFN's. Dr. P wants me to come in tomorrow to treat me with Betamethasone, a steroid which speeds fetal lung maturity. I was treated with this at 24 weeks, but it is not uncommon for docs to do it again around this time. Then I will inject myself again on Wednesday, and go back to their office on Thursday to have my cervix measured and Dopplers on the babies.

When I was talking to the nurse, she reminded me to go to L & D if my contractions are more than six per hour or are not controlled by Terbutaline and to report any leaking or change in discharge immediately. Because I am about 30 minutes from the hospital, she said just to leave for L & D and call on the way and they would page my MFM for me. Then she said, "But your cervix is okay right?" I said, "It was around 1 cm. To which she said, "Oooooooooh" in a not thrilled way.

If I had a shortening cervix, but negative a fFN, I am certain Dr. P would not admit me. That was always my argument if she threatened to admit me: "Shortening cervices are to be expected at this stage with triplets and I have a negative fFN!" - not anymore. Hopefully Thursday will show it has not changed, but if it is losing any length, into the hospital I will go and I have a feeling there will not be parole this time.

I am a little scared. I don't want to go back to the hospital, but even more than that, I don't want the babies to come too early. Hang in there boys! Mommy promises to put her feet up.

Another great reason to be born in October

2009-10-04T08:33:00.000-07:00

Today's Multiples and More Question of the Week about our favorite cookie recipes. Why, you ask?

It is National Cookie Month! In my previous life, before I was a bed-resting, triplet-gestating lady, I baked! My daughter and I baked something nearly every day, especially in the fall and winter. Since the fabulous Dr. P has given me a bit more freedom, I am going to try to bake some cookies with my three-year old today.

Our favorite fall cookies are Auntie H's Pumpkin Cookies. Unfortunately, the national pumpkin shortage means there is NO canned pumpkin in Seattle. Seriously. Go read this if you don't believe me. We have combed the shelves of our local stores, but it seems to be a national problem. Libby's, the supplier of 90% of our national canned pumpkin supply apparently had a bad harvest last year, but thankfully, more is on the way. When you can find yourself a can or if you feel like roasting a sugar pumpkin, make these. They are AMAZING.

Auntie H's Pumpkin Cookies

1 C sugar
1/2 C butter
1 C canned or roasted, pureed pumpkin
1 egg
1 tsp baking soda
1 tsp baking powder
1 tsp vanilla
1 tsp cinnamon
1/2 tsp salt
2 C flour

Preheat oven to 350.

1. Cream butter and sugar until light and fluffy. Add egg, vanilla and pumpkin. Mix well.

2. Meanwhile, whisk together flour, soda, powder, cinnamon and salt in a medium bowl.

3. Add in batches the dry ingredients to the wet and mix until incorporated.

4. Drop desired size amounts of dough (I use a 1/2" ice cream scoop) on Silpat-lined cookie sheets (or use parchment paper) 2 - 3 inches apart.

5. Bake at 350 for 10 - 12 minutes until cookies are firm. Cool on racks before frosting.

Frosting

3 Tbsp butter
1/2 C brown sugar
1/4 C milk

Boil these ingredients for three minutes. Then whisk in powdered sugar to "icing" consistency, about 2 cups. If it gets too thick, you can add back more milk and whisk it until smooth. Frost cookies with a bit, or drizzle over in a waffle pattern when cookies are completely cool.

These are a huge favorite around here. I cannot wait until we can get a can of pumpkin, but we might just have to make our own pumpkin puree.

Happy 31 weeks to the boys! Quick ultrasound tomorrow morning. Can't wait to "see" where they are- I feel like Baby C has flipped over again since there seems to be a head in my ribs. :)

Show and Tell: She's Baaaaack.

2009-10-02T10:08:00.000-07:00

You know who she is. Wemberly is back.

For those of you unfamiliar, Wemberly is a little white mouse in an awesome children's book written by Kevin Henkes called "Wemberly Worried." I knew the book when I was in education but was reintroduced to it by my friend at Just Another Infertile. We are both Wemberlies. What do Wemberlies do? We worry. All the time. About all sorts of things, but in this case, pregnancy. Pregnancy, miscarriages, still birth, TTTS. You name it. If it can go wrong in a pregnancy, Wemberly reminds me of it.

Today I am 30 weeks and 5 days pregnant with our three boys. 23 days away from my scheduled C-section. We are in the home stretch, on the last leg, the finish line is in sight. (Choose your sports metaphor.) And although the likelihood of TTTS is teeny tiny now, and if the babies were born today, they would most likely be just fine, I am worried. What could I possibly be worried about? I am glad you asked! Today, I am worried about sudden and unforeseeable fetal death and Tetanus (I dropped a kitchen knife on my foot yesterday). Let me explain.

After crossing the threshold of Week 30, I began to relax. I pulled tags from clothes previously untouched and unwashed. I put art up in the nursery. I let myself get excited. Then suddenly, She was back. Wemberly is back, and has taken up residence in my subconscious. She keeps reminding me that anything can happen. People lose babies at the end of pregnancy. Abruptions are more common with multiples. She seems to implore me: "YOU CANNOT STOP WORRYING YET!" And while I admit to always having been a worrier in the extreme, even as a child, it has become worse. And I have a theory about that. Infertility conjured Wemberly.

My pregnancy with my daughter was a breeze: easily conceived, carried and born. Easy as pie! Pregnancy is so EASY! What I was meant to do! Then we started trying for number two. After a few months of wacky cycles, we managed to get pregnant again. At our ten week ultrasound, we found there was no heartbeat- and no baby at all- it had been a blighted ovum. Deeply painful, but we felt many couples had one miscarriage and it was not indicative of a bigger problem. Then we got pregnant again! The next month! Meant to be. We saw our daughter's heartbeat three times before the day when I laid on the table and was told the baby was "quiet." She had Trisomy 18, we later discovered. Then on to Clomid. No luck. Then IUI's with Clomid. On IUI #2, a BFP! Beta came back at 5, however. A chemical pregnancy. Then fallopian tubes removed. IVF is our only option.

It was during this time that the cute white mouse Wemberly began to chatter in my ear. The worries began to overtake the hope. Moving through IVF was a true test in my ability to work through each worry, one at a time. Then the discovery of triplets brought many new worries to life, each with their own statistics, likelihood and outcomes stamped on my brain. For me, knowing more is better, and I have become a master of navigating clinical studies and Perinatology journals. I know the survival rates for triplets born at each week of gestation.

Since the milestone of 30 weeks passed, and the survival rates went up, I am not so worried about them being born too early. Now I am worried that something will happen before they are born. When I don't feel each baby moving, I become nervous. I can tell who is moving accurately most of the time, so I will occasionally have to wake a baby up, just to calm myself down. As soon as an ultrasound begins, I hold my breath while the sonographer searches for heart tones on everyone. I am terrified to ever hear the words, "the baby is quiet" again. I have wanted to be pregnant for so very long, and love looking at my belly, full of babies. Although I know this will be my last pregnancy unless the unthinkable happens, I want it to speed up. I want to hold my sons, and watch them breathe, and know they are HERE. They are alive and ours.

Unfortunately, the statistics on "unforeseeable and sudden fetal death" are sparse. I am aware of how extremely rare it is, but know too well, in life and in the ALI community, that it does happen. I discussed this concern yesterday with Dr. P who said, "While it does happen, the risk is low for you. We see the babies twice a week and monitor them closely." I know this should be comforting. I should be comfortable with this answer. Babies are not always born to be brought home, though. I desperately want ours to come home with us, breathing in and out, crying and giggling and making our family complete.
-------------------------------------------------------------------

I cannot wait to meet this little boy and his perfect brothers. (Nose, lips and eyes, with his arm over his face.)

Yesterday, all of the boys looked wonderful. Their little hearts were a-beating and they showed us they were breathing. Babies A and B (the twins) were both 3 pounds, 6 ounces, and Baby C was 3 pounds, 8 ounces! Big for triplets and growing at a wonderful rate. All passed their BPP's with flying colors! I know I "should" stop worrying, but until these boys are nestled in our arms, I will continue to be a Wemberly.

Go see what the rest of the class is showing today at Mel's Show and Tell!

Nursery and Shower Pictures

2009-09-30T11:53:00.001-07:00

As promised several weeks ago. Bad blogger.

Great appointment yesterday, however! Dr. P is very happy with my cervix (still the same and stable under pressure) and the babies are looking great. I cannot wait to see how big they are on Thursday! They will have full growth and Biophysical Profiles as well. We hope to see them continuing to practice their breathing. We are hoping for around or over 3 lbs, 5 ounces (1500 grams). That is a big milestone for preemies and it would be wonderful to know they were past that should they decide to arrive early.

I have been promising pictures... so here are a few from baby showers and some nursery ones. I will post another set when it is finished.

The cute diaper cake my awesome neighbors made for me:

The cookie favor from my Mom's Group friends:

The cake from my friends and family shower:

My anniversary present! A new diaper bag (that has back pack straps... very important)!

A few nursery shots. Right now, we have two cribs in the only partially finished nursery, and one in our room. They will be able to co-sleep for a long time, but I know how often they'll be sleeping with us too!

We are putting up their art today, so updated pictures soon! As for the belly shot, it is coming... it might not fit on the screen.

Reckless tag-pulling-off

2009-09-25T14:55:00.000-07:00

29 weeks and 5 days today. Only 30 days until our C-section unless things change dramatically and then it could be even sooner!

Something big is happening in my house today. Tags are being ripped off of clothing, baby blankets are being washed, diapers put away. I am getting ready for our boys, our sweet boys to come home. Until now, the fear of loss has been too strong. The memory of our miscarriages, of the promise of life and babies taken away has stolen from us the excitement and joy that comes with most pregnancies. I was terrified to purchase anything baby related this pregnancy until 28 weeks, with a few exceptions. I imagined the pain of putting something into a box and hiding it in the garage should the worst happen, and our boys don't survive. Hope seems to be popping up around here, as we near the big milestone of 30 weeks. The fear seems to be getting pushed over a little bit.

Today I had a great appointment. I half expected her to say, "Just kidding! Into the hospital with you!" but remarkably, Dr. P is thrilled with me and our trio. My cervix is the same. THE SAME! It has not changed since 24 weeks, which is remarkable. After the ultrasound, she remarked, "Your cervical length is actually normal now. It was not normal at 24 weeks, but it has not changed at all, and anyone carrying triplets at nearly 30 weeks should have a cervix like yours." If my husband was not there to witness, I might think I hallucinated the whole thing.

The boys are looking busy and active, all getting 8 out of 8 points on their Biophyscial Profiles. This means basically, that they are practicing breathing, showing movement and muscle tone, and have normal fluid levels. Our guys are only eligible for 8 instead of 10 because I do not have to have an NST to go with it, thank goodness. Still no signs of TTTS.

My husband, sweetie that he is, asked Dr. P if I would be allowed out to dinner for our four year anniversary this weekend. She said yes, and we discussed our favorite local restaurants. We talked about where would be a good place for me to be dropped off and picked up, but then she said, "You can increase your activity a little bit, to your comfort level and assuming your contractions don't pick up. Still rest most of the time, but you can get up a little more now." I told her that I didn't want to do much, since I contract a lot when I am up, and get tired easily, but her giving me a bit of freedom was AWESOME! I think it will make all the difference in my sanity and hopefully will make no difference in my cervix.

Don't worry, Readers: I am always very good and lay down most of the day, more so if contractions pick up. I am not heading out to run a marathon (or even walk to the mailbox) but I have been cleared for Target Scooter Rides. I have not been in any store in about 8 weeks, and this is exciting! I have not been able to peruse baby clothes or gear unless online (thank goodness for the Internet) so this tiny bit of freedom is thrilling. I am so thankful to still be pregnant, a fact I never take for granted. This just feels like a bonus.

Something about being almost 30 weeks (Oh, and did I mention the negative fFN today?) and likely getting to 32 or beyond makes me feel a bit reckless. Watch out for bouncy seat assembly and major laundering of clothing at our house. All the while, I hope that I will bring three boys home later this fall, that we will be some of the lucky ones. Fear is still so present in most of my actions and my thoughts about the boys, but slowly, excitement is creeping in. Excitement and hope.

(I did not just jinx myself, right?)

Non-Substantive Belly Picture Post

2009-09-20T19:44:00.000-07:00

Just for comparison ... and just because I like to see how small my butt once was.

11 Weeks

29 Weeks

35 days until our babies are born! (See that? That is reckless optimism, and I will probably pay for it, but I like to pretend like I am in control sometimes.)

"Don't smoke crack."

2009-09-18T16:47:00.000-07:00

That title drew you right in, did it not? I saw the wonderful Dr. W today, and his ability to soothe me and also mock me a little is a surprising combination. Picture a British forty-something in a dress shirt and slacks who would definitely rather be wearing shorts (what he usually sports).

After he declared that all was well with me, my cervix and the babies, I told him I was worried about placental abruption. Why am I worried about this relatively rare condition in which the placenta detaches from the wall of the uterus, leading to bleeding, premature labor and possibly fetal death, you ask? Since the risk of major complications and death from prematurity is low as we are past 28 weeks (woo hoo!) and we have a less than 1% chance of developing TTTS at this stage, I need something to worry about! Don't I? C'mon! Worrying is for me what stamp collecting is to others: a comforting pastime.

Me: How common is placental abruption? I am very concerned about it since it is more common in multiples.

Dr. W: We rarely see it. It is usually associated with high blood pressure, and your blood pressure is low.

Me: Hmm. But it is more common with multiples, right?

Dr. W: About 1% of pregnancies have an abruption.

Me: Ohh. And it usually presents with bleeding?

Dr. W: Yes. Most are minor and do not result in fetal death, just an earlier delivery which should not concern us too much as you are nearly in the 30's.

Me: Okay. (Furrows brow.)

Dr. W: You can do something that reduces your risk tremendously, actually.

Me: (Practically jumps off the paper-covered table to grab his arm.) YES! What is it?

Dr. W: Don't smoke any crack cocaine this weekend. That is the biggest cause. Ha, ha!

Me: I was going to have some crack with my popcorn for movie night, but I shall refrain.

Dr. W: (Laughing his English ass off...) Great! See you next week!

I have to say, he is good at making me feel like everything is okay while reminding me not to worry about things not worth worrying about.

28 weeks and 5 days baby stats!

Baby A: 2 lbs, 13 oz
Baby B: 2 lbs, 12 oz
Baby C: 2 lbs, 12 oz

Their weights are all within the normal growth curve for a singleton- about the 40th percentile. The sonographer commented on how long the boys' arms and legs are, indicating they will be fairly tall. I was able to see their cutie pie faces and watched them breathing and swallowing. And kicking each other in the head. Since Baby C is breech, his little feet hover right around Baby A's nose. Occasionally he gives his unsuspecting brother a little poke with his heel just to remind the twins that he is in there too.

My cervix is still over 2 cm! I am very pleased knowing they consider it to be quite stable. Dr. P said she would only hospitalize me if it was hovering closer to 1 cm (which, unfortunately, can happen quickly) and I still might have a couple weeks of cervix left to keep me at home. I am hoping with all my might that I will be among the lucky few who manage to stay out of the hospital until right before their C-section, or even drive to the hospital on the boys' birthday which we hope is Monday, October 26th!

Privacy, Protection and Publicity

2009-09-16T09:18:00.000-07:00

Pregnancy update: My cervix is stable! I had a negative fFN! And the boys are all looking great, practicing breathing and I have a growth scan on Friday.

A few months ago, I read an especially appropriate post by Cassandra at Baby Smiling in Back Seat about using images and identifying information of oneself and one's children on a blog or other Internet-based forum. The question she posed to us: Do you/will you post images of your children on your blog? Facebook? Why or Why not?

At the time, I was at a loss. I have read many infertility-followed-by-healthy-baby blogs and always pictured myself following the progression of many of these. The entries sometimes begin with the IVF protocol (or the pregnancy), move to ultrasound and nursery images, belly shots and then when the miracle of the birth occurs: baby pictures! Sometimes pictures of tiny ones hooked up to wires in isolettes and sometimes bigger babies sleeping on a parent's warm chest.

Because I am 28-ish weeks pregnant with triplets, I seem to be especially excited to see photos of these threesomes when they come out on others' blogs. It is helpful to me to see what babies born at 29 weeks versus 34 look like so I can prepare for the birth of our own boys. (Aside from that, it is insanely cute to see triplets snuggled together in their crib.) Perhaps I am looking to see that they can really be born and come home into our family, which I still struggle to believe. At any rate, I look forward to these photos, and I somehow assumed I would post photos to share with my readers.

Cassandra's post, however, caused me to reevaluate this assumption. As you all know, I have a three-year-old daughter whose name or image has never been revealed on the blog. I have posted a picture or two of her back, but have protected her face, just as I choose to post headless belly pictures of myself. I made a conscious decision to never show the face of any of my family members. I do not refer to my husband or daughter by name, either, and never plan to.* Yet I somehow had imagined announcing the birth weight and name under a perfect picture of each of our babies.

Why the contradiction? Why did I assume that I would share photos of the babies, while protecting the likeness of everyone else in our family? Do I think it is some kind of reward for readers who have followed our journey, and support me immensely? Perhaps I felt that people would not want to follow our lives anymore if there was not photographic documentation along with my words. What I have come to realize is, once these boys (God willing) make their entrance into the world, I will be as fiercely protective of their faces as I am of my daughter's and I will not post pictures of our sons.

While I will want to shout from the rooftops and the Internet, "I had real babies! They survived! You want proof: here they are!!" if the boys do arrive safely, my desire to protect these innocent faces will override my desire to share pictures. I understand completely why parents would choose to share these images, also. Our friends and families read my blog, checking it for updates on the pregnancy, and it would be a very simple way to share pictures of the boys, and how they are changing. I personally love to see the adorable images of babies as they grow, and blogs are wonderfully easy to access (usually) and anyone you direct to your blog can see them.

What frightens me is what can happen to the images once they are online. I know how easy it is to "right-click" on an image and save it to my hard drive, allowing me to do with it what I wish. I never want anyone to have a picture of my child's face whom I do not know and trust, and the only way to avoid that is to not put them on my blog in the first place.

Many have suggested alternatives: use Facebook or another social networking site. Create a new blog and make it invitation only. I think for now, we will plan to share images of six little feet in snuggly socks, or a tiny hand curled around a grown-up finger, but not the identifiable faces attached to them. Unfortunately, this means the people whom I do trust and know, many of you, will not get to see their little faces.

This leads me to the next conundrum I am pondering: what will happen to this blog if the babies arrive safely? It could remain my home, and morph into a parenting-after-infertility blog, one that tells the story of our family as a novel with the many chapters of miscarriage, infertility, treatment, pregnancy and (hopefully) parenting multiples. I could also write somewhere else but leave this blog intact as a resource for anyone who many find it useful. Obviously, these musings warrant another post on another day.

What are your thoughts on the changing nature of an infertility blog? Should bloggers continue to tell their story, wherever it leads, from their original URL, children and all? Does a blog need a label like "Infertility" or "Parenting Multiples"? Should they set up shop somewhere else to spin a new narrative? What have you done? What would you do?

*I have realized how awkward it is to refer to my daughter as "A" and my husband as "My Husband", so I will be coming up with more appropriate pseudonyms for each of them. The babies will also be given some nicknames which will only emerge after I have the pleasure of getting to know them outside the womb a bit. Mel at Stirrup Queens has maintained nicknames for her children and it works seamlessly as it allows her to share stories and updates without revealing identifying information. Much to consider.

28 Weeks! And Carrie Answers.

2009-09-13T14:47:00.000-07:00

Today marks a day I have been looking forward to for months: we are 28 weeks pregnant today, meaning the boys have over a 90% chance of survival if born now, and a low risk of long term disabilities. WOOT!

My inspiring friend Michele, who has endured much loss, gave birth to her twins, Bobby and Maya a few days ago at 27 weeks and 5 days. They are doing remarkably well, and are beautiful to boot. Congratulations Michele and Peter!

You asked, I answer.

Q: Jill asks:

Will your house will be large enough to accommodate the increase in children from one to four?

A: We moved into a larger house last August, thank goodness! Had we lived in our old house, which was about half the size, we'd have been looking for a new one. Our current house has four bedrooms: One for my husband and I, one for Gramma, one for A, leaving one for the boys. Luckily, the bedroom is quite large and will be able to eventually hold three cribs. For now, two cribs are in the nursery and one is next to our bed, since I am sure I will be up with them at night for many months. Had the triplets been of both genders, it would be harder to imagine them sharing a room for a long time to come. As far as living space, I am sure that once they are home and the swings, bouncy seats, and other baby gear begin to multiply it will seem crowded, but it a good way!

Q: Nishkanu asks:

How you will handle the care of three newborns?

A: Copious amounts of coffee. Because we've parented a newborn before, we are aware of the crushing exhaustion and zombie-like state we will be in for many months. We can only imagine that times three! We realized quickly that we'd need a live in nanny or someone here most of the day at least. While we were not crazy about this idea, I have only two hands and two breasts, and an older child to care for, so we prepared for it. Then my awesome mother offered to quit working, sell her home and move it with us! To have "Gramma" helping raise the kids is a huge blessing. So the short answer is: Gramma (and copious amounts of coffee).

Q: Kendra, who is fifteen weeks pregnant with triplets (congratulations!) asks:

Is there was anything you have done to get this far in a triplet pregnancy?

A: Paranoia! In all honesty, and as all of my readers know, I spend most of the time in a state of mild to severe panic, sure that something is about to go wrong. If I could counsel you to do just one thing, it would be to educate yourself. Read as much about triplet pregnancies as you can. Learn the warning signs of preterm labor and whenever you are concerned, call your doctor, even if it is 4 in the morning.

You are the only advocate your babies have, so if there is something happening that feels wrong, or if your doctors are not completely answering your questions and concerns, persist. The nurses at my MFM clinic surely think I am a complete whack job and the doctors call me "The Worrier" but truly, I never want to regret not asking for another test or further explanation about what was happening. I would tell you to try to relax, but who the heck would I be kidding?

Q: Not the Path I Chose asks:

Did you do anything to help make your IVF cycle successful and how did you stay sane?

A: Well, I wouldn't really say I stayed sane. Infertility alone is stressful, and when expensive treatments and injectable hormones are thrown in, you have a recipe for insanity. As far as the chance-upping, the only thing I did that was not literally printed out for me on the protocol calendar was acupuncture. I do not know if it worked, though studies suggest it does, but it did me good in the sanity department. I tried to take it one step at a time: First, get through suppression, then get through stims to retrieval, then to transfer and finally to beta. It helped me to break it up into chunks so I could focus my anxiety and not melt down (as often).

I also listened to a wonderful series called "Health Journeys: Guided Meditations Help with Infertility" and loved it. I brought it with me to acupuncture, loaded it on my iPod and even played it while I did laundry. The visualization was very soothing for me.

Q: What If? asks:

What does a contraction feel like to you? How long do they last?

A: Interesting question, and one I am asked often! I would describe my contractions as a tightening around my abdomen that is forceful enough for me to notice. It could also be described as a squeezing sensation, and my uterus feels as hard as bone. Their length varies, but I would say they average about 45 seconds. I get more if I have a full bladder, if I have just stood up or am walking around or if I am dehydrated.

Q: Anonymous asks:

Was anything "special" done for your IVF cycle since you've had multiple miscarriages tubal issues?

A: After my HSG showed damaged and possibly blocked tubes, my doctor suggested we remove the fallopian tubes altogether to increase our chance of success. To this suggestion, I burst into tears and asked if it was the only way, knowing once the tubes were gone, I would be unable to have children without IVF. He felt very strongly that our chances of successful pregnancy would be increased exponentially if we proceeded with the surgery and delayed our IVF cycle. After he consulted with his other partners who agreed, we decided to schedule the surgery. The tubes were badly scarred and had pockets of fluid adhering to them. I would have been able to start stims 30 days later if not for the giant cyst that took up residence on my ovary.

We decided not to do PGD even thought we'd had miscarriages because the current method can decrease pregnancy rates and lower the number of embryos to choose from. After our cycle, they were especially conscientious to do extra HCG tests and ultrasounds knowing that we'd experienced pregnancy losses. Being vocal about my worry was a good thing- it revealed the triplets early on!

Hopefully you enjoyed the first edition of Ask Carrie! I go back to the doctor tomorrow afternoon and am hoping I have not jinxed myself with all of the cervical bragging.

Ask Carrie! (and cervical showing-off)

2009-09-11T12:11:00.000-07:00

At the risk of sounding like a complete braggart, my cervix grew again. Today it measured at 2.8 cm - 3.2 cm. Again, the cervix is a dynamic muscle which changes over time and will likely shorten as time goes on, and we expect it to as the triplets' birth draws nearer. I can hardly believe it actually grew. (I was a bit afraid to blog about it but I knew there would be an email onslaught if I did not update.) Today showed stability which translates into more time at home with the family.

Today the babies (except B, who was being a bit lazy actually) showed off their breathing, even fluid, and good Doppler measurements. Dr. W insisted I get a flu shot and reminded me how bad it would be for me to get the flu while caring for three preemies or for them to get it at all. I did, and took comfort knowing that it grants the preemie babies some immunity from the flu after birth. I am sure I do not need to tell you how immature preemie babies' immune systems are, and how protection for them is critical.

Here is Cutie Pants Baby C:

As promised, I bring you the first ever edition of Ask Carrie! I get many questions in the comments section from anonymous readers and some of you who I know well. I thought I'd give you a chance to ask questions- really about anything. No need to make them fertility-related or about pregnancy unless you choose.

As a reminder, I will not reveal doctors' or hospital names, our fertility clinic or any other info like that on the blog. If I know you, I will be happy to talk with you on email, so leave me a way to contact you if you'd like.

Looking forward to reading and answering them! I am still writing my post about privacy, pictures and identifying information about our children. Cassandra, in her usual pesky, thought-provoking form gave me even more to consider so it will be delayed a bit.

Oh, did I mention: 2 DAYS UNTIL 28 WEEKS? No? Well it is less than 48 hours now!

We've got cervix, yes we do!

2009-09-08T15:22:00.000-07:00

It is a miracle I didn't have a heart attack during this ultrasound. The sonographer who was doing my cervical measurements announced that with no pressure my cervix was 3.2 cm, a marked increase! Then she applied pressure and said, "Ohhhhh. Look at the funneling! Now I get about 1.5 cm." She measured more in the 2.0's while I watched. Heart racing, I asked if she was sure and she said, "Actually, no. I am having a hard time being able to tell what this is... let me go show the doctor." So I laid there, half naked and thinking of being hospitalized.

Back in she comes, thankfully after only a minute, to tell me he said that was just cervical mucus and a shadow- the measurements were 2.2 - 3.2 cm. So yeah, my cervix ... grew. I wanted to cheer and get really excited but I was a little afraid a piano might fall on my head, like in the cartoons when the cat is walking along the sidewalk on a sunny day and BAM! Piano on head. (But I cheered inside.)

The boys look beautiful, with no signs of TTTS, plenty of fluid and practicing their breathing for us. Baby B had a wicked case of the hiccups which made his Doppler measurements challenging, but I loved it. All the little boys are still head down, which causes a great deal of rib-kicking, which I also love. Everyone's heart rates were nice and even, and their boy parts apparent (for those who still wonder if there is a girl in there). Dr. W, who is the stand-in for Dr. P breezed in for about two minutes and said, "Your cervix is great, the babies look wonderful. Go home; you live to fight another day."

I am so grateful! Home again with my family, spared the hospital this week. We are 27w2d, just five days until the biggest hurdle is cleared: 28 weeks. It seems like we might all make it through this but I am scared to say it out loud. Will I get to bring my boys home, to have a baby survive a pregnancy inside my body, and grow into a child of mine? I hope, hope, hope so.

Me and the boys at 27 weeks

Forthcoming posts:
1. The baby showers
2. Will we or won't we: posting pictures of our children and privacy issues
3. Carrie answers your questions (I have nothing but time on my hands!)
Are you excited or what? ;)

Reporting live from...

2009-09-05T13:32:00.001-07:00

... my living room! I am a very grateful and happy woman, surrounded by gifts from shower number one, watching my daughter run around, with the boys safe and sound.

(Contented Sighhhhh.)

A longer post is forthcoming, but for now, here is the update after my ultrasound.

Cervix: 1.8-2.2. Still almost exactly the same as it was at the last check, and less funneling this time. Keep up the good work, Cervix!

Babies:

Baby A: 2 pounds, 4 ounces (!)
Baby B: 2 pounds, 1 ounce
Baby C: 2 pounds, 1 ounce

Yay babies! Their weights are all in the 30th - 50th percentiles for singletons, which is truly wonderful for triplets. I have not gained any weight in the last couple weeks, so it was very reassuring to see the boys are getting exactly what they need.

Dr. P was thrilled, which is not a word I would use to describe her very often, and said the boys look awesome, no signs of TTTS, and my cervix is stable. "Everything is in the green zone," she said. WOOT WOOT! Words I do not often hear that make me very happy. Dr. P is presenting at a Fetal Therapy conference out of the country next week, so I will be seeing two of her partners, Dr. W and Dr. K, both of whom I adore. Dr. K is quite the hugger/hand-holder which is obviously good for me. I told Dr. P I will not be in the hospital when she gets back and she said, "Maybe you'll walk right into your scheduled C-section." A girl can dream!

All of us know how quickly things can change, but for today, everything is good. I am at home, the boys are big and healthy, my contractions are not too intense and tomorrow marks 27 weeks, one week shy of our most important goal. Then onto 30 weeks (I still have a hard time imagining the "thirties") and then our scheduled C-section date of October 27th. Sounds like a great day to be born.

Your suggestions for stress-relief were all awesome! Thanks for the continued support and good thoughts. At the risk of tempting fate, I think they might be working. :)

Under Pressure*

2009-09-03T16:57:00.000-07:00

No news to report yet. I have been chastised by my faithful readers for not updating more frequently, so I thought I'd better check in. I am feeling stressed out on the couch, and need some cheer from you all! (See below...)

Tomorrow I go back to see Dr. P and I am seriously considering "forgetting" the appointment. Okay, well not really, but I have been enjoying my week at home and am a little fearful (read: terrified) that my cervix will do that shortening thing it does occasionally and I will be back in the hospital. Of course, if the situation is serious or there is a real need for me to be there, I will go willingly, but if it is just to rest somewhere else, I would rather rest at home.

The next 10 days have some pretty important happenings and I want to be here for them (insert the god's laughter here):

1. Not one, but TWO baby showers this weekend! My amazing neighbors are throwing an impromptu one on Saturday followed by a friends and family shower on Sunday.

2. My three-year-old who still very much seems like a baby to me starts preschool next week. The first time she has EVER been left anywhere like a school or playgroup without me, Daddy or Gramma. I want to be here when she departs for her first day and Dr. P said I can even ride along to pick her up.

3. The 28 week celebration! I want to be in my house, rejoicing with my family that we've crossed possibly the most important milestone in prematurity.

So yeah, there is a bit of a mental buildup to tomorrow afternoon's cervix check, fFN test and growth scan. My doctor is a reasonable, although conservative, woman and I am pretty sure I could eek out a few more days at home even if I was on the "border". Not that I will do anything to endanger any baby boys, just that in triplet pregnancies, hospitalization can be mostly a precaution. I would love to stay home right up until my scheduled C-section at 34.5 weeks, but I will settle for another couple weeks here. Yes, I hear myself bargaining... I am practicing for my conversation with Dr. P tomorrow.

I have about 20-ish hours until I see how the ol' cervix is holding up, and since I don't sleep much, I will be awake for most of them. I'd rather not give myself a stroke before I even arrive, so...

Here is my question for you: when you are stressed, nervous, distracted about something out of your control, how do you deal? Make yourself laugh? Listen to music? Please remember, there will be no mind-clearing walks or jogs around the 'hood; bed rest means the stress relief must be sedentary.

This poster has kept me laughing for about a week. My brother sent it to me during my hospital confinement... and it still makes me laugh until tears stream down my face. Cat lovers, forgive me, but I am pretty sure every cat I've ever met wanted to chew my face off. Here is proof: "Is your cat trying to kill you?" Really, really funny stuff... go read it. :)

What helps you mitigate stress?

*Get it? Because the cervix is measured two ways, neutrally and "under pressure"! I have such a way with words sometimes.

26w1d: Holding my breath

2009-08-31T19:36:00.000-07:00

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:

The view from my own bedroom...

2009-08-28T10:22:00.000-07:00

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!

Later:

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.

No, I am not Bi-Polar

2009-08-25T14:20:00.000-07:00

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.

25 weeks!

2009-08-24T07:49:00.001-07:00

(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.

First Impressions

2009-08-22T07:55:00.001-07:00

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!

Notes from my hospital bed

2009-08-21T14:23:00.000-07:00

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!

Growing boys, Growing Cervix!!

2009-08-17T11:12:00.000-07:00

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!

Happy Viability!

2009-08-16T10:23:00.001-07:00

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!
Mommy

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!

Out on Parole*

2009-08-14T13:52:00.001-07:00

*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.)

100th post: Good News and Bad News

2009-08-10T14:08:00.000-07:00

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.

Show and Tell: Miscellany

2009-08-06T10:31:00.000-07:00

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!

Not what we wanted to hear.

2009-08-03T14:27:00.000-07:00

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.

The Dog Days

2009-07-30T13:39:00.000-07:00

You have probably heard at least one person you know who lives in the Pacific Northwest complain about the record-setting heat and humidity. It is currently about 90 where I live and we are nowhere near the daily high. We were made for weeks of rain and flooding, gray skies and North Face jackets and few of us have air conditioning. Seattleites are sweaty and cranky.

While I am worshiping my air conditioning, I still feel a bit hazy, out of focus. I am not sleeping much and my feet look like they are wearing foot-sized fat suits. Here are some of the happenings from the dog days of summer, straight from the couch.

- We all know I am counting the days until 24 weeks (17 more!) which is August 16th. Today I discovered that the BEST SHOW ON TV, or "Mad Men" is making its long awaited, third season premiere on... you guessed it! August 16th! This must be a good sign, right? RIGHT?

- From the mouth of my three-year old (emphasis is hers):

"I have twins named Scratch and Lucy and they were too small for bottles so they had to drink out of my breasts and they stayed at the hospital for two weeks but now they came home with me and you!""

"My tummy is big and I have to be on bed rest. Actually it is couch rest because I am really tired and it holds the babies in. That is what my doctor told me and I don't like it. It's no fun bed restin'."

"I am having so many contractions today!" (Said while clutching her tiny tummy.)

"Mommy, are your nipples getting bigger?" (She also asked the nanny that the other day.)

-And last, but not least, for your enjoyment, a picture of me (snapped by my mom's iPhone) scooting my way through Target. I get many strange looks, some annoying questions and knock over displays occasionally. Those little seat backs are not made for someone lugging around extra boob-age and babies in their body. I was so uncomfortable that I stuffed a package of (super cute, boyish) onesies behind my back for added support. This may have been the cause of some of the staring.

Busy Boys

2009-07-27T18:45:00.000-07:00

I would like to dedicate this post to Air Conditioning, without which I would not be able to function in the humid, 95 degree Seattle weather. Even with it I am still too hot and cannot sleep at night, but I am so thankful we have it at all.

Okay, back to your regularly scheduled programing.

I saw the boys today, and they look great! Still no signs of TTTS, and my cervix is... wait for it... still over 3.5! This is wonderful news. Dr. P has returned from abroad, and she had no idea I'd be waiting with an itemized list of questions for her. That'll teach her to take a family vacation! (I am really kidding and eternally grateful to her for all her excellent care). Here are some of the highlights:

- I got in trouble for losing a pound. Must drink more protein shakes.

- She is thrilled with my "competent" cervix and said it is doing a nice job... let's hope it continues to do so!

- She said, in a triplet pregnancy at 21 weeks, this is the best case scenario. My bed rest and meds are controlling the contractions and she said I could stay like this (modified bed rest) until the end as long as all continues the same.

- She told me that we need to pick a day for my C-section. I almost fainted! Is this really happening? She said to choose a day the week of Halloween and we will make it our goal. I keep thinking of how our daughter could visit me in her costume and then go trick-or-treating with Daddy. Makes me smile from ear to ear. If I go into labor before then and we cannot stop it, they will do an emergency C-section, but we will aim for our C-section date.

- I felt SO much movement out of B last night! It felt like he was kicking constantly for an hour and at one point, I felt his feet sticking out. At the appointment, we saw that he has flipped himself completely back to head down position. That takes some effort given the space considerations.

Everything (aside from the enormous growth every day) has stayed the same which is JUST how we want it. I am feeling more hopeful, hoping my boys make it, hoping they will come home with me in a few short months.

Me and the boys at 21 weeks:

In this picture, it looks like A (on the right) is whispering to B, or maybe giving him a little kiss. Regardless, this picture makes me smile- to see them snuggling together is hopefully, a glimpse of what is to come.

Here is Little C, oblivious to A and B's shenanigans. Could his nose BE any cuter?

Paper Charts

2009-07-25T21:22:00.000-07:00

In my last post, I wrote about the mental milestones for my higher risk pregnancy. The period of viability begins at 24 weeks and by 28 weeks, babies almost always survive with lots of medical help to begin. These dates are burned into my mind: August 16th and September 13th, respectively. I certainly hope they do not make their entrance until Halloween or so.

Gone are the days of keeping busy to distract myself, although I do have many wonderful visitors to break the monotony, and my family is always around, which is a huge blessing. My daughter and I made a "Countdown until 24 Weeks" calendar. I cannot wait to wake up tomorrow morning and see there are only three weeks, or 21 days left until our first milestone.

She loved the idea and made one for the next time her 13-year-old friend and "mother's helper" comes to play in three days. Her 3-year-old spirit wants to tear all the sheets off in one day, and while I tried to explain why we can only do one page for each day, I completely understood her wanting something that cannot come sooner to happen likerightnow. I want to be in the safer zone, to know that if something happens suddenly, there will be a chance for our babies.

For now, seeing the days pass and torn away to reveal a new day is comforting.

It is really hard to type while laying down.

2009-07-22T10:25:00.000-07:00

My marathon appointment (3 hours plus!) yesterday went very well. My sweet little boys are growing so well and are actually bigger than most singletons at this stage- great news for babies who will definitely be born before 40 weeks. The average 20 weeker is about 10 ounces; A and B were both exactly 13 ounces and C was 12 ounces. Almost three pounds of baby inside of me! It is reassuring to see the twins the same size and their fluid even (no signs of TTTS there) and know they are growing well.

My cervix was a nice 3.7 cm! Even with pressure it never went below 3.2 which is great news. Something we are doing, or more specifically, the combination of what we are doing is still working to slow and weaken my contractions and lengthen my cervix. WOOT WOOT! The protocol stays the same, although we will decrease the Advil a bit as it can affect the babies' heart development.

Dr. K, who I've been seeing in Dr. P's absence was truly thrilled and said this is what we wanted to happen. She reminded me again, I do not have an incompetent cervix, and that contractions are easier to treat. We need those boys to stay in a long time and grow big for the big world. All the good news lifts my spirits and helps me to be hopeful until the next appointment. I keep telling myself, three appointments from now and I will be 24 weeks! Please let me get there.

When I was a little girl and was counting down to something like Christmas, vacation or a relative's arrival, I would make a countdown chart with the number of days left on sheets of paper, and tear one off each day. Somehow it seemed to get me closer to the date and I felt that each day was an accomplishment. That is how I feel now. In my mind, I check off a day closer to 24 weeks, then 28 but I am thinking I might just have to make another chart of paper. I know my daughter would love the project, would adorn the numbers with bug stickers and crayon swirls and colored glue. It would feel so good to tear off a day each morning and know the babies are getting closer, minute by minute.

Last post, I told you of Stacey who had her twin boys at 27 weeks after a long bed rest. Devastatingly her and her husband lost their son, Connor. The doctors are hopeful his brother, Colby, will continue to fight as he's been, but they need all of our support and prayers.

20 weeks!

2009-07-20T13:26:00.000-07:00

Okay, this is getting a little insane. I am officially bigger than I was when I had my daughter, and the boys and I are only 20 weeks! I have a feeling stretch marks are imminent.

Bed rest is turning my usually steel-trap-like mind into mush, but here are a few things happening:

- We are 4 weeks from some viability, 8 weeks until the MAJOR milestone of almost 100% survival without problems. Please keep cheering for us as we get there!

- There is some kind of party happening in my uterus and I was not prepared. They move so much and are already so strong. I love feeling their kicks, rolls and occasional foot, knowing they are thriving inside, and stretching out. Space must be getting tight!

- Tomorrow (Tuesday) I have a full growth ultrasound in the afternoon along with the usual Doppler studies (checking for TTTS) and a (gulp) cervical measurement. They told me to plan for 3 hours, and bring snacks. Sort of like seeing "Harry Potter". (Which I was allowed to do yesterday and loved it, but movie seats suck.)

- Bed rest is not so fun, but I do it happily knowing the boys need me to rest. I cry easily and generally worry and fret more since I cannot distract myself with doing anything. A motorized cart trip to Target may be in order.

I will update tomorrow after the appointment. I cannot say it enough: thank you for each comment, cheer and prayer. They mean the world to me and the boys!

Also, Stacey had her babies yesterday at just over 27 weeks and all are doing remarkably well for their gestational age! Go say congrats!

Musings of a Couch Potato (more like Watermelon!)

2009-07-18T10:22:00.000-07:00

Here I sit/lay, with not much to do but think and worry, rinse and repeat.

I am feeling so many fewer contractions since my new regimen started. The Nifedipine, Advil and rest combination have certainly slowed my contractions to almost nothing, and yesterday at my appointment, we saw my cervix is now 3.3-3.9 cm! This is great news. Someone commented to me that they had not realized the cervix could go both ways; indeed it can, and it does. With more activity and less meds, it would probably lose some length and we hope it grows even more or stays the same for the rest of the pregnancy now. I have spoken with several friends who were on the same meds and rest combination who all carried their babies well past 28 weeks. Both of them have noted the marked decrease in contractions with the Nifedipine in particular.

Dr. K was extremely pleased and said this is what we want to see: the cervix responded to the relaxation of the uterus and lengthened as a result. Of course that means my bed rest will continue until the boys come (hopefully around 14-16 weeks from now). She gave me more guidelines which really help me know how much is too much activity, and what I can still do. Dr. K reminded me that she is more liberal with bed rest than many at our practice, so enjoy it while I can. :) I trust these doctors so much, and will follow their instructions to the letter.

For now, I need to remain mostly on the couch, sitting or laying on my side, with a little walking around my house. I am not supposed to pick up my daughter, take too many trips up or down the stairs or do any housework or carrying. I asked if I could go places (besides doctor's appointments) and she said she encouraged it for mental health, but I need to go somewhere and sit, not go somewhere and walk around. For example, I can be dropped off at the door of a friend's home or a restaurant, and sit the whole time, or even go to a movie. I cannot, however, walk through the parking lot of a store and shop. She is going to get me a handicapped parking sticker to use for appointments to minimize even that walking. She reminded me that I can ride in a wheelchair through the mall, or use a motorized scooter at Target. I laugh when I picture this, but in about a week, I am going to be ready to go ANYWHERE that isn't my house!

I have been a bit crampy this morning, and get worried so easily. I will call the doctors (who may think I am a little nutty, but oh well) if I don't feel better soon. I know things can change quickly, and I am afraid that despite my doctor's efforts and my compliance, my body will not hold on. Please, body, continue to carry these boys as you should... they need a while longer inside of me. Dr. K said yesterday she would be very surprised if I delivered before 28 weeks, and has much higher hopes for me. Music to my ears! You hear that, body, we are going to 34 weeks at least!

Here are some pretty cute boy pictures for your enjoyment. I really think A and B look so alike and C is his own little person. It will be interesting to see if the identical twins look noticeably different from their brother.

Baby A

Baby B

Baby C

Also, there is a rumor going around that I gained 4 pounds from Tuesday to Friday, but I cannot confirm or deny it. ;) YIKES!

My Cervix heard YOU!

2009-07-16T08:10:00.000-07:00

I am overwhelmed by your support, Readers. I was moved to tears more than once, and laughed out loud often when I read your commands and musings to my cervix. Yes, I am referring to it as "my cervix" again since it is shaping up and doing a better job. Thank you, thank you, thank you for your support. How do I know this? Glad you asked...

Yesterday afternoon I had more contractions than normal and pretty soon also had tremendous rectal/vaginal pressure which reminded me of labor with my daughter and freaked me out. I called my MFM and they told me to go to Labor and Delivery since their office was closing. My mom, the saint she is, came right over and took care of our daughter while we raced out. Dr. G, a wonderful man who I've spoken with on the phone before would meet me there. The ride there was long due to rush hour, and I was shaking with anxiety. What would they find when I got there? Would my cervix be shorter with all of the contractions? I tried not to panic, but inside, I was terrified.

When we got there, I was met by Dr. G and he did a scan of my cervix, showing it at 3 cm +!! I was quite relieved, but it had still gone from 4 to 3 or lower in a week. I asked him about cerclage and he said, "I love cerclage. I use it ALL the time and think it is an amazing tool for some women. You, however, do not have an incompetent cervix, you have preterm labor contractions, and your cervix is trying to hold strong, but it cannot hold on if you continue having contractions that affect it. The bottom line: we need to treat your contractions and cramping, not your cervix."

What a relief to me! Pre-term labor is real and scary, but much easier to treat than a cervix that cannot hang on at all. When he explained it that way, I was still nervous about the contractions, but much less so than with a renegade cervix. It looks like my one day of resting had already improved its length. Which leads me to... my treatment plan.

1. More resting. He feels "half time" bed rest is not enough. I need to be resting almost all of the time with my feet up.

2. Antibiotics. Apparently, any time he sees preterm contractions, he prescribes two strong antibiotics to ensure there is no infection or bacteria in the vagina or cervix. Either of these issues could weaken the cervix and irritate the uterus, causing contractions.

3. Nifedipine. This is a blood pressure medicine that is commonly used to reduce contractions. It can cause dizziness, fainting and headache. I already feel the headache. Dr. G feels this will be the "mainstay of my therapy" and we can increase the dosage. If this isn't effective, we are on to Terbutaline with all its ugly side effects.

4. Continue Ibuprofen. Also relaxes smooth muscles (like the uterus) and can control contractions. I am supposed to stagger this with the Nifedipine for the best effect.

5. More Folic Acid. The March of Dimes did a huge study last year that shows 4 mg of Folic Acid (I was taking 3) reduce preterm labor by 70%. You cannot OD on it, so whatever your body doesn't need, it doesn't absorb.

6. Magical Pills. This is a sleeping pill that has the effect of, you guessed it, relaxing the smooth muscles while you sleep. It made me sleep like a DREAM last night, and before I passed out, I laughed hysterically about some not-that-funny game my mom and I were playing. My husband Googled it to see what its side effects were, and "reduces anxiety" was one. Perfect!

Overall, I felt great about my treatment. It really feels like we have a lot more options to treat the contractions than to treat the cervix. Of course, it could continue to shorten, but we hope it does not. It is awesome to not have to think about cerclage yet (and hopefully not at all) since my cervix does seem to be responding to a contracting uterus. If we can get that under control, we hope the cervix will hang in there, long and strong for at least 9 more weeks.

Again, thank you so much for all the words of support, encouragement and humor. I particularly like Miss MVK's Billy Joel song dedicated to my cervix! All of your experience and kind words are appreciated beyond measure.

The Disappointing, Shrinking Cervix

2009-07-14T18:38:00.000-07:00

The cervix is no longer "nice and long". I don't really even want to call it "my cervix" since clearly it is not doing what I want it to do. I need it to hang on for another 9 weeks and then I might disown it.

Last week's measurement: 4.0 cm.
This week's measurement: 2.7 cm.

NOT GOOD.

While this is not an alarmingly short measurement, the change is what is cause for concern. I was extremely upset by this, of course, and Dr. K (who I completely misjudged) hugged me for a good few minutes while I sobbed into her shoulder. I am still pretty upset and terrified, so a bullet list it will be.

- We discussed a cerclage (okay, I begged for one). At this point, the risk of rupturing A/B's sac is greater than my risk of delivering too soon. If it shortens again, we will do a cerclage (probably this or next week) but if it hangs in at 2.7, we will not do one. You pretty much cannot do one after 24 weeks, so the sooner we do it if we have to, the better. I will be measured again on Friday.

- I am now on Ibuprofen until I deliver. Every 6 hours, I take 600mg. This drug is extremely efficient and relaxing the uterus, which should cause less contractions which change the cervix.

- She did a pelvic and said it "feels better than it looks" and was hard, although shorter.

- I told her that I am a worrier, and am terrified. She said, "I am too! I think we'll see you twice a week. Would that make you feel better?" Would it ever!

- Modified bed rest it is. I am restricted from much activity at all. She told me to get more childcare NOW so my amazing mom and mother-in-law as well as a great nanny are all coming to help. I should not be lifting my daughter, chasing her around, carrying her up and down the stairs which I usually do. Dr. K told me the calmer the body is, the calmer the uterus is, and that is why bed rest helps with any kind of preterm contractions.

- Although it can stay this way for the rest of the pregnancy (and we HOPE it does!) the next steps would be cerclage, other drugs like Terbutaline, more strict bed rest or hospitalization.

- I asked her if she thinks we can get these babies to 28 weeks, and she said, "Absolutely!" which did so much to make me feel more calm. I hope and pray she is right. I want my boys to stay in as long as they can, where it is safe for them.

I am pretty much drained, and oh so frightened. Every twinge is making me think I just lost more length on the cervix... I am trying to find solace in the fact that I do have excellent care and they know what they are doing.

The beautiful boys, however, look perfect. No signs of TTTS, great heart beats and very active. I am so happy they are healthy, now my body has to do its job, and keep them inside for a long time. Next Tuesday I have a full growth ultrasound, so we will get weight estimates and more detailed anatomy on each of my sweet hearts.

When I came home, I was talking to my mom, crying, and my daughter touched my tears and said, "Why are you crying?". I told her that Mommy would have to rest all the time to help the boys grow big and strong and I was a little sad about it. She snuggled me and said, "Honey! It is going to be okay. You don't have to cry." My little angel, I hope she can understand when I cannot take her outside to play or tuck her into bed at night for a while.

Please, faithful readers, feel free to try to talk to the cervix. It is not listening to me.

19 Weeks

2009-07-12T20:16:00.000-07:00

...and only FIVE weeks until the V-DAY! For those of you who think I am crazy for counting down until Valentine's Day in August, I am actually referring to Viability Day. Babies begin to have a CHANCE at surviving if born at 24 weeks, and since multiples can come earlier than most, it is more of a milestone. Although their chance of survival is about 50/50 then, it shoots up to almost 100% by 28 weeks. Of course we hope to be having big 35 weekers, to know that they could survive outside my body in a couple months (with lots of medical help) is amazing to me. Stay inside a long, long time Boys and stay closed and long, Cervix! (Yes, I frequently converse in my mind and out loud with my cervix.)

My husband and I took a "Life with Multiples" class at our hospital. It was so fun to be around other pregnant-with-multiples parents, although we were the only ones who already had a child. At one point, we had several couples sitting around us, taking notes about the newborn experience, car seats and breast pumps. The second half of the class was mostly about what to expect from the NICU and how to begin breastfeeding preemies. I learned much about how parents can be involved with NICU care, and what the reasonable expectations for them are depending on when they are born.

Out of 11 couples in the class, 9 had twins, and 2 (including us) had triplets. The other BBB triplet mom there was in "bed rest" chair which reclined, and she looked much more comfortable than I. Those chairs were BRUTAL and I am thinking at the next class in about 3 weeks, I need one of those, too. She is almost 28 weeks and looks miserable. She looked at me and said, "This is going to be you in 8 weeks. Get ready for it." She also sees Dr. K at our MFM and was put on bed rest 4 weeks ago when her cervix went from 3 to 2 cm in a week. She has held strong there and they are hopeful there won't be anymore changes to it. It frightens me how much it can change in such a short time. Frequent readers must know that every twinge or cramp makes me worry about mine.

And, the 19 week belly. Wow, is it growing. I am surprised at how much harder it is already to bend over, get up off of the couch or roll over in bed. My body is changing rapidly making yoga pants my favorite thing and it necessary for a new bra, STAT. The one I am currently in (already up from my normal size) leaves large indentations all over me. I am loving feeling the boys move more now, and laugh at how active Baby B is compared to his brothers. Baby C likes to snooze, and A is more of a sporadic mover, but B seems to move almost constantly some days. I have a feeling A is still kicking him in the head, poor guy.

My next appointment isn't until Tuesday (how DARE they make me wait 8 days? Don't they know about the neuroses in my head?) afternoon, so I will update then. Hoping to have more good news, with the twins sharing their placenta evenly, and my cervix still over 4 cm. I also need to talk to the substitute doctor about activity and bed rest since she is less concerned about it than my own doctor. I might start calling her the too-relaxed-for-my-taste-doctor but it takes a long time to type. Oh, how I miss my conservative Dr. P. I think she returns from Europe next week, thank goodness. She is not the hugging type, but I might just have to tackle her when she gets back.

Off to watch "True Blood". Nothing to take one's mind off preterm labor like sexy vampires and the Deep South!

18 Weeks and CUTENESS!

2009-07-06T13:49:00.000-07:00

All right, I admit it. I have been a bad blogger. Weekly updates are all I am managing right now, and it is usually because whenever my daughter is napping, so am I. Also, my laptop has been heading down hill. Right now, for example, I have to hit the "k" key about 5 times before it will produce a letter. Makes for slow blogging. Today I have some cute pictures to share of my boys, and a quick update from the doctor (the in-a-hurry-substitute doctor since mine is in Europe).

First of all, here is the 18 week belly in all its glory. Today, they measured my uterus and it is measuring at 28 weeks. Holy Hell!

This morning I had a long ultrasound which again showed no signs of TTTS and a long cervix... now let's hope it stays that way for another 18 weeks! The boys are so very active in there, especially Baby B. He head down, along my right side, lowest. Baby A is the long way across my belly button, and Baby C is at the top on the left side, usually taking a big old nap, since no one is kicking him in the head.

I had a scary incident at 5 am on Saturday when I had severe cramps that I would NOT go away. I called the on-call doc who was had me take 600 mg of Advil and call if it had not gone away in an hour. It did go away, and he checked in with me later that morning to tell me to continue the Advil until I saw Dr. K today, and to call if it came back. I was terrified, having visions of my water breaking, of losing the boys, but it really didn't come back at all. When I saw the stand-in doc today, she said it was most likely growing pains (since my cervix remains unchanged) as this is a rapid growth period for the babies, but if it returned, she'd want me back in this week. Stand-in freaked me out a little- she kept saying, "With triplets, the cervix can change rapidly, but I think you;ll be okay..." which I already know, but seriously! Don't remind me of my biggest fear!

She also said that unlike Dr. P, she does not automatically put people on modified bed rest at 20 weeks unless there is a reason. She kept saying, "I am more liberal than her" and we'd wait and see. Honestly, I don't know what to think! I will continue taking it easy, but I guess I might have a few more weeks of freedom before the serious resting starts.

The awesome sonographer asked if I'd like to see my babies in 4-D... UM YES!!! Here are my little boys, looking so beautiful to their mommy. I could not help but cry when I saw their faces.

Baby A:

Baby B:

Baby C:

I know they are a little blob-like but I see their Daddy and their sister already. I cannot wait to meet you, boys, but keep on growing inside for 18 more weeks!

2009-06-29T16:33:00.000-07:00

I saw my precious boys today, and they are looking perfect! Sort of like the floating babies above. The twins are still sharing the placenta well (no signs of TTTS) and my cervix is 4 cm, 3.8 under pressure. Yes, they apply pressure while Wanda is doing her thing, and measure what your cervix does then. Not exactly comfortable, but a very accurate measurement. Looks like mine is holding long and strong for now! Thank you to EVERYONE for your comments, thoughts and positive thinking. I can truly feel all of it and appreciate it so much. I feel so lucky to have so many people thinking healthy baby thoughts for us.

I almost fell of the scale (literally, no balance) when it showed I have gained 20 pounds! This is very good news with multiples, so they were impressed. Dr. P kept saying, "I don't know where you put it... okay, maybe in your bra..." and I told her to look at my thighs! Growing, also!

I won't see her for a few weeks while she is out of the country, so I will see her partner, Dr. K. I made sure to ask her if Dr. K was as much of an expert in TTTS and all, and she said, not to worry (HA!). I met a woman at the park who happens to see Dr. K regularly and said she was quite warm and reassuring, which is good for me! I asked her if we would just discuss the aforementioned modified bed rest at 20 weeks, or if that was for sure, and she said it was already decided.

Three more weeks of walking around, running errands, having my daughter's third birthday party, then I will be on the couch/bed/chaise lounge with my feet up. I am glad they do this preemptively, as it reduces pressure on the cervix, increases blood flow to the uterus and helps the babies to grow, grow, grow! Since it is "modified" I will be able to sit for meals, use the bathroom and do a bit of walking around the house. I am working out the details of childcare (in a panicked moment today I may have begged my nanny to leave the family she works with on Tuesday and Thursday, to no avail) but needless to say, one cannot prepare meals or take a child to the potty while on bed rest.

That leads me to my question for you, my faithful readers. I am trying to plan some entertainment (that sounds like a mean a stripper, but I don't) to keep me occupied. I am thinking TV series on DVD, learning to knit, writing boring blog posts and spending LOTS of money online. I might have to re-read the Harry Potter Series or finally get to Anna Karenina. Any suggestions for activities, shows, movies, novels that are your favorites? I would love to hear them!

17 weeks and a Growth Spurt

2009-06-28T19:13:00.000-07:00

Those babies, they are a-growing! My talented husband made this to show the triplets' progress over the last four weeks:

Some other highlights:

- I can feel Baby B moving around! Sometimes I can feel A and C, but B is low, and protests with a little jab when I bend forward. I love feeling them.

- I am worried (no sh*t!). More nightmares- and I have some mental block about these upcoming weeks. In some tragic cases, the cervix cannot handle the next weeks, so I am on super high alert. Can't we invent some home cervical monitoring device? Anybody?

- My daughter said to me, "The babies are going to be okay Mommy! Worry, worry!" which tells me I need to stop it already (easier said than done) or at least spare my darling daughter Mommy's neuroses. You all get to read about them instead!

- It is "True Blood" night, and a new series called "Hung", about a gentleman in the oldest profession in the world premieres tonight on HBO ... looks quite entertaining.

Hopefully all will be well with the twins and all three tomorrow. Update then!

Show and Tell: Hope. Courage. Always.

2009-06-24T16:13:00.001-07:00

(Pregnancy mentioned)

I am a sentimental person who tears up at greeting cards and commercials, occasionally. Throughout the battle with infertility and miscarriage, I have sought to find a "mantra" or affirmation that would guide me through. Some words I may repeat to myself as we waited on each test, dealt with unimaginable news or tried again. I had a wonderful CD of affirmations as I went through my IVF cycle. It relaxed me and reminded me that no amount of stress will actually impregnate me. I listened to it at acupuncture and after giving myself injections.

Now, I am a lucky person whose cycle was successful. VERY successful. After transferring two lovely embryos, we find ourselves 16 weeks pregnant with TRIPLETS. Yep, one split. This pregnancy has truly been fraught with wonder, excitement, terror and worry, all wrapped into one hormonal ball of emotion, and again, I find myself in need of an affirmation, some words to soothe my heart.

I purchased these stones when I was on Clomid, after two miscarriages, and held them in my hand frequently. I especially stared at the stone reading "Hope". Such a simple word, with so many emotions tied to it. Hope became my mantra, and my three- year- old even carries her own hope stone in her pocket sometimes. We talk about what hope is, how it is the thing that keeps you going, helps you keep trying to get something you need or want. I haven't looked at it lately, and recently I glanced over at the dish in my kitchen where my stones are, and found immediately what my mantra is: Hope. Courage. Always.

As the pregnancy progresses, I am finding that the worrying and risk of a triplet pregnancy are wearing on me, but I never stop hoping. So far, everything is going extremely well, and the baby boys are looking perfect. Still, I worry about babies born too soon, pre-term labor, twin to twin transfusion. I think what I am looking for right now is the courage. I need the courage to be brave, to smile and be happy in my pregnancy despite the risks and unknowns. My daughter needs a courageous mommy, and so do my boys. I need to be quietly courageous, and face whatever comes to us. The "Always" stone reminds me that these are things I will never give up on. I will Always have Hope and Courage, for myself and for my family, present and future.

Go see what the other courageous women are showing at the Stirrup Queen's Show and Tell. :)

16 Week Appointment

2009-06-23T12:52:00.000-07:00

We had our 16 week appointment yesterday which was almost three hours! The scan alone was about 90 minutes. I had an early anatomy scan to check brains, hearts, limbs and organs, as well as a growth estimate. Everyone has two arms, two legs and all the organs in place! They also checked my cervix, which is long and strong, despite my more frequent contractions.

Here are the highlights (list form will have to suffice today):

- The boys are growing right on schedule. Everyone is around 6 ounces, so there is more than a pound of baby in there already! It is so obvious how quickly they are growing. I truly think I added two inches to my expanding waist in the last 36 hours.

- I have gained 17 pounds. WOO HOO!!!! They'd like me to gain 25 by 20 weeks so I have eight to gain in four weeks. They made sure to tell me my protein intake is not good enough. Protein has amino acids, the building blocks of tissue and muscle, and those babies need more. Protein shakes it is. I am actually amazed at how much I've gained already. With my daughter, I gained 18 the whole time, so this is wonderful. Dr. P says more weight gain for multiples = bigger babies.

- I am continuing to have Braxton-Hicks (practice) contractions. Before, they were a few a day, now I have about one an hour, sometimes more. Dr. P said that that does not worry her too much, but that since it is likely they will increase each week, I will be on modified bed rest at 20 weeks. IN FOUR WEEKS. Modified means to "be a couch potato" but do no lifting, extensive walking or standing for periods. This is causing a mad dash to find enough child care as well as housekeeping. I am glad I have some notice, though. Of course, I will do absolutely whatever they tell me to do to avoid preterm labor.

- We had planned to fly to Dallas to visit relatives, but the doctor decided she is revoking her blessing of it. She said since it is a long-ish flight, and I would be almost 20 weeks when we go, it is better to stay here for the summer. I am so sad to miss our relatives and for A to see her cousins, but I am going to be a good patient. Dr. P is traveling out of the country for three weeks in July (how dare she?) so I will be seeing her partners, none of whom I have met. I've spoken with two on the phone (I like to call at night...) and they were exceptionally kind and responsive. I am sure I will be in good hands, but I. don't. like. change.

- I signed my husband and I up for classes that our hospital offers: "Multiple Pregnancy" as well as "Life with Multiples" about how to adjust to caring for multiples, nursing them and transitioning from the hospital. There is also a NICU tour which I am sure will terrify me and comfort me at the same time.

- I did not great pictures this week, but I did get three "male anatomy" pictures since I kept asking if they are SURE about three boys. The proof is in the ultrasound, I suppose!

- Many nightmares abound. I dream of babies born far too soon, too small for the world... and wake up sobbing. My subconscious reminds me of what I fear the most at night. I am hoping our great medical care and monitoring will be able to spot any trouble a mile away, and those babies will grow for another 20 weeks!

16 Weeks (!) Belly

2009-06-21T20:02:00.000-07:00

Wow, have I grown! My entire family and my friends are sort of shocked each time they see me. I feel like I am growing inches every day! Someone recently said, "This is starting to seem like a horror movie" (in a nice way) and I do feel like my abdomen is on the fast track with three in there!

The stretching thing has been much better this week. I attribute it to having wonderful family around to help with A so I could lay and nap, and drinking obscene amounts of liquid every day. That nurse was right about the irritable uterus!

Long ultrasound day tomorrow! Have I mentioned how much I love going to my MFM every week? Well, I LOVE IT! I cannot wait to see them again, and feel reassured that the cervix is holding strong and the twins are sharing their placenta well.

Happy Father's Day to my most amazing husband. The way he speaks to our daughter with such kindness and love and the enthusiasm with which he discovers the world with her are more than I hoped for. For all the hand-holding during pregnancy loss, the injections, the appointments, the many times he has answered the question, "Do you think the babies are going to make it?", and his unfailing belief that all will be okay, I thank him for being an amazing father to these boys before they are born.

Pictures and updates tomorrow. Off to watch "True Blood"-- the only show for which I could stay awake.

15 Week Check Up and Gender Reveal

2009-06-15T14:44:00.000-07:00

Today's appointment was surprising. I didn't know they were going to scan the babies (I thought just my cervix) so when they lifted up my shirt I was so excited!

Everyone is still looking wonderful. No signs of TTTS, fluid levels even, all good heart rates and still ADORABLE. I was alone as this appointment was impromptu, so my husband didn't get to see their cuteness this time. I will be seen weekly from now on, which makes me feel so much better. I feel like a lot can change in the cervix or with the babies in a two week period, but weekly check ups make me feel much better.

As expected, the doctor told me to rest as much as possible, hire a housekeeper and prepare for bed rest in the next couple months. I shared with her some of my more irrational fears and she was very comforting, reminding me that almost all the time, a problem is seen coming and they can take steps to correct or slow it down. I said, "I am kind of a worrier" and she said, "Yeah, I can tell." I should bring her a copy of "Wemberly".

The best surprise was the sonographer was able to determine all of the babies' genders with certainty! Allow me to introduce:

Baby A, our SON!

Which means Baby B, must also be our SON!

And... last but not least, Baby C, our SON!

We are overjoyed to be having three boys! I will be dispersing all of my many totes full of darling girl clothes to my deserving friend with a baby girl.... and rapidly learning everything I can about Thomas the Train and Bob the Builder. :)

15 Week Belly and Vampires

2009-06-14T17:32:00.000-07:00

Thanks to everyone who was so encouraging about my last post. I got so many calls and emails from friends and family wanting to help, and the comments were very appreciated. One of my friends reminded me that just because I experienced infertility and losses does not mean I cannot complain when I am feeling tired or in pain, because pregnancy is wonderful and AMAZING but sometimes tough.

Here is the large-and-in-charge belly picture for 15 weeks! I cannot believe we are already here! Now we need the babies to stay inside for another 20 or so, and they will be great. The strangest thing happened with my pregnancy with A, and is already happening now. From right under my bra line to my mid-abdomen, I am completely numb. It sometimes tingles like a foot that is asleep, but mostly I cannot feel anything! Apparently it is the uterus pushing on nerves, but feels so strange. Amazing how much earlier everything is happening. Last night I dreamed that I had sextuplets, and they just missed three of them this whole time. I must be feeling big for a crazy dream like that!

I have literally been counting the days (and today, the hours) until the BEST show on television, aside from "Mad Men" comes back on. Tonight, my friends, is the premiere of "True Blood," a sexy, bloody, funny and intelligent show about a culture where vampires are "out of the closet" and living among us humans. If you haven't seen it and get HBO, I highly recommend it. You can download the first season on iTunes, too.

Doctor's appointment tomorrow... will report!

Whine, whine, whine

2009-06-12T13:33:00.000-07:00

Yesterday was not a good day. Nothing catastrophic happened, the babies are all fine in there, but their mommy is getting a bit worn out. From about 6 am yesterday until I went to bed at 10 pm last night, I was in pain. I am not talking about screaming and unbearable pain, bur a constant aching and tightness in the pelvis and back. This is the same feeling I had about 10 days ago that sent me freaking out to my MFM to have my cervix measured (which was a nice long 4 cm). At that time she reminded me that this pregnancy would hurt more, and to try to remember how much further my uterus is than in a singleton pregnancy. So I knew that nothing terrible was happening, most likely, and that I had to deal with it.

*Insert whining and self-pity*

It is really hard to be an energetic food-fixing, park-going, nap-giving mommy to an almost three year old with this level of energy. Quite emotionally difficult is it to have to change your parenting, tell your daughter you are too tired to do something or feel less than patient. I was so worried all day, even thought I know things were fine on Monday, that I was nervous every time I carried our little girl up and down the stairs in our three-story home. As soon as she napped, I did too for 2 1/2 hours! I called my husband and he came home earlier at five to help, but the day was exhausting. I laid on the couch or in the bath for the rest of the evening, feeling sorry for myself.

This triplet- growing business is serious stuff, ladies and gentlemen. I know, I know. We chose to transfer TWO EMBRYOS. Yes, that is right, TWO! We were hoping for a healthy singleton or fraternal twins, but instead, we ended up with identical twins and their fraternal triplet. Do not get me wrong, I am so in love with them, all three of them, and cannot wait to meet them. I don't think I truly understood "hard pregnancy" until I lived it. And this is only the beginning. I think the hardest is the worry. Will I go into labor at 20 weeks or 35? Will my cervix continue to hold up? What if something else goes wrong? Will the twins get TTTS? Parenthood and pregnancy are both fraught with worry, and honestly, I do think I am three times as worried as I was with our daughter. I laid on our bed last night, crying, wishing I knew the babies will be healthy, that they will live.

*End of wallowing*

I called my MFM this morning to make an appointment for next week. At this point, she usually sees people every other week, but at my last visit she said she was happy to see me each week if it was more reassuring. I was trying to be tough, and said I was fine with every other week. I WAS LYING. I spoke with L, an amazing nurse who said a few things:

1. I should cut my activity down. Have a nanny or family member come so I can lay down more often.

2. She is switching me to weekly visits so that we can monitor the rapid growth and ensure my cervix is holding strong.

3. Most of the triplet mommies they see, she said, they see every week, so I should do that too. It made me feel better to know that I am not the only one! :)

I am going on Monday afternoon and arranged for an extra morning a week of help (right now I have an awesome nanny 4 hours/week) so that I can rest enough. I never imagined at almost 15 weeks, I'd be slowed down this much. I am naturally energetic, on-the-go, and like to have a hundred things going. It looks like those days are coming to a screeching halt, and it is going to be a long summer of me, my laptop and some good books. Of course, I will do anything to have three healthy babies in the fall, and am a good patient, I just wanted to still be the same Mommy I have always been to my daughter.

Great Appointment, Happy Pregnant Lady

2009-06-09T16:10:00.000-07:00

Yesterday's appointment was wonderful! My mom also got to go with me and see her grandchildren. They never did locate the source of the obnoxious and minor spotting, but Dr. P said, "I don't get gray hairs over brown spotting." Words to live by, Ladies!

The ultrasound went really well. I thought it was a long one (45 minutes) but they said it was a short one, and in two weeks I'd have a long one. They are so very thorough there, and I feel in excellent care. Next appointment they will measure the babies' exact sizes, look at their organs, try to determine gender and do the Doppler studies again.

Some take-away's:

- Cervix grew to at 4 cm. Dr. P said it would as the bottom of the uterus developed.

- No signs of TTTS! They did a very LONG Doppler flow study on the twins' cords, insertion to the placenta, brain and stomach. Size of babies and fluid levels are equal, and both babies have similar activity levels. WOOT WOOT!

- My weight gain is good: 11 lbs at 14 weeks! They really want me to have gained 25 or so by 20 weeks, but I am not sure I will make it. Considering I gained less than 20 the whole time with my daughter, this is good.

- The sonographer is quite sure that the identical pair are BOYS (a change from before) but we couldn't tell what Baby C was as he/she kept snuggled tight in a ball. A and B are always rocking out in their respective sacs and C is generally sleeping.

- I asked about the average time for bed rest in triplet pregnancies, and they said usually people are on at some form by 22 weeks, and definitely in the weeks after. 22 weeks for me will be the beginning of August, so we shall see how my body is doing then. I certainly am more tired, rather than less, as the weeks progress... but my body is BUSY.

I only got one good picture since they were mostly focusing on Doppler studies, but I will post it later. A darling little hand waving at me. :)

14 Week Belly and Nerves

2009-06-07T20:56:00.000-07:00

Today, after an exhausting morning (actually, all we did was go to a coffee shop and a three-year old's party, but that wears me out) I came home and laid on the couch. My wonderful husband and daughter brought me a sandwich and I took a nice, long nap!

When I woke up and headed for the bathroom, I discovered some brown spotting. Which is the most terrifying thing that can happen to me. It was a relatively small amount, but more than I had at 9 weeks. I (very calmly) paged the doctor on call and she got back to me in a few minutes. She asked about the color (brown is better than red) and if I had cramps or contractions (no). Because the spotting was the only "symptom" and I am going to see my Dr. P tomorrow anyway, she said to just try to relax, and that she wasn't worried. I asked if it could be my cervix changing, and she said VERY unlikely since that is usually bright red blood and accompanied by other "feelings" around the cervix or uterus. Since my cervix will get measured tomorrow, she felt fine about it.

I am nervous too, but you know what you saved my sanity today? You guessed it: my Doppler! If I was a cartoonist, I would draw my Doppler in a cape that saved the day. Maybe my talented friend Brenna will do it for me? ;) It truly makes my heart slow down and allow me to feel calm when I hear their beating hearts, and know that for this moment they are all right. I have a list of questions as usual for my MFM tomorrow:

1. Are the random contractions normal? I felt them much later in my first pregnancy.

2. When will I go to weekly ultrasounds to measure my cervix and check for signs of TTTS?

3. When do you anticipate I will be on partial/full/hospital bed rest? What is the average for this kind of pregnancy?

4. What is up with the spotting?

Here is the 14 week belly, in all its glory. I compared it to my pictures with my daughter, and I look about 6 months with her! I know it was my first pregnancy, but the rate at which my uterus is growing is CRAZY. It is so fun to be changing so quickly, but there are some growing pains in my back, pelvis and hips.

I will report tomorrow after my ultrasound. Thanks for all the good wishes and please keep thinking good thoughts for our check up tomorrow!

'Twas the Night Before the Second Trimester

2009-06-06T21:00:00.000-07:00

...and over on the couch lay Carrie, she was starting to slouch.

We have almost made it to the second trimester, which begins at the stroke of midnight (I will probably be up to pee around then...) a feat I was unable to accomplish in any of my three most recent pregnancies. WOO HOO! We are celebrating over here with a protein shake, old episodes of "True Blood" and hopefully, a foot rub. I am so very grateful to be in the lower-risk time of pregnancy, and while I acknowledge the risk of preterm labor/birth with multiples, I am so happy we have made it this far! It has been a long, tiring, nerve-wracking first trimester, and I expect the same from the second. Nonetheless, it feels great to be moving into a new stage of pregnancy! I hope that we are as blessed in the next 14 weeks as we've been in the first. Each comment and cheer from you all have been such an important web of support for me. Thank you. And please don't go anywhere.

The. belly. is. huge. I truly cannot believe the growth spurt the babies and my uterus have had in the last few days. Everyone who sees me is sort of in awe at how quickly I have grown. I had to take off some usually comfortable maternity jeans today because they were too tight in the lower pelvis. The babies must be really growing in there! I haven't seen them in a couple weeks but I get to see them on Monday. Dr. P will be checking, as always, to ensure my cervix is remaining long, that the babies are not developing twin to twin transfusion and that everyone is growing appropriately. Hopefully, we'll get another opinion on gender, too.

Belly picture to come tomorrow, Monday I will have ultrasound pictures, too. This is how big the babies are now. 3 1/2 inches, crown to rump and 1 1/2 ounces at 14 weeks. You know what they say; "When life gives you three lemons..."

Bon Voyage, First Trimester! While I did not enjoy the nausea, smell-sensitivity and utter exhaustion, I certainly do appreciate all the organ-forming and healthy baby growing. Here's to two more great trimesters!

The Crazies

2009-06-04T09:01:00.000-07:00

As promised, here is the post quoting some of the most outrageous and offensive things I've been asked or told when people find out we are carrying triplets. *Important disclaimer: Even if I had to hear this hogwash every minute until our babies are born, it would be totally worth it. Just annoying.*

My favorite conversation came when my mom and I were at Gap Maternity buying some much needed warm-weather clothes that fit me. It has been in the 80's and 90's in our suburb of Seattle and pregnant lady is hot. After trying on lots of darling tops, my mom and I stood in the long line and finally were able to check out. The girl (I do mean girl) helping us was somewhere around twenty, and VERY chatty. Normally, I like chatty.

Chatty Cathy (CC): Look at all these clothes. You must have a baby in your tummy!

Me: (Answer stupidly) Actually there are three!

CC: Really? Wow! You are going to be huge! Was that a surprise or did you DO something to get them?

Me: Um, well, it was sort of a surprise...

CC: WOW! You are going to have your hands full. (To my mom) You are going to have to help out a lot!

Me: Anyway...

CC: Okay, well have a good day. I just have to say this is so amazing. Your babies are so much more special than someone like Octomom because they are NATURAL! KTHANKSBYE!

Me: Grrrr. (Mom leads me out of the store while I try not to cry.)

Clearly, an ignorant young'n, but still, hurtful words. Are IVF triplets unnatural? I think they are 100% baby, actually, you crazy wench. However, I completely asked for it by telling her about the triplets, and lesson learned. Don't share with strangers unless I am willing to answer questions and listen to sometimes-ridiculous comments.

Some other choice reactions:

-What are you going to do with all of them?? I get this one almost every day.

-Did you do fertility treatments? IT IS NONE OF YOUR BUSINESS.

-Hey, Octomom! I don't have to explain why this is obnoxious, do I?

-I love "Jon & Kate Plus 8!" So did I.

These comments are always strange, but again, I will take them for three healthy babies! Basically, I only tell people whose reactions I can predict, who know about my many miscarriages or our struggle with infertility. I am so grateful to have had so many people literally burst into tears with joy for us. It is amazing how much others have wanted this for us, and I didn't even know.

I am accepting any witty answers my faithful readers have for me! My triplet-mommmy-blogger friends all tell me it will only get worse when they are born, so I have got to prepare now!

13 Week Picture

2009-06-01T20:52:00.000-07:00

Well folks, not a lot to report around here. I suppose the three main things: I am tired; I am hot; I am growing (and so are the babies)!

I am happy to be almost officially out of the first trimester and that everything seems to be moving along as it should. I am continuing to get really tight and sore in the pelvis and uterus, and I called the sweet nurses at my MFM clinic and was told it is most likely dehydration. They were right! When I keep up with an insane, nauseating amount of water, I feel much better. The heat makes it even harder, but we had some air conditioning guys come today and it will be installed next week. WOO HOO! Hot pregnant lady needs her air conditioning.

Quite like most of my pregnant bloggy friends, I am so very tired, and not being a good blogger. I promise my post about all the WACKY things people say to me tomorrow or ... soon. :)

More than you needed to know about my cervix

2009-05-28T13:12:00.000-07:00

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...)

12 Week Triplet Belly Picture

2009-05-25T21:13:00.000-07:00

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

2009-05-25T08:02:00.000-07:00

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!

Nuchal Transulcency Scan Results...

2009-05-22T13:26:00.000-07:00

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!

NT Scan Jitters

2009-05-21T13:47:00.000-07:00

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.

11 Week Triplet Belly Picture

2009-05-18T06:51:00.000-07:00

...as 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.

Window Shopping

2009-05-14T16:16:00.000-07:00

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!

I Heart My Doppler

2009-05-12T21:10:00.000-07:00

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!

10 week ultrasound

2009-05-11T12:15:00.000-07:00

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.

(INSERT HUGE SIGH OF RELIEF.)

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! :)

She's Back....

2009-05-08T13:02:00.000-07:00

Wemberly.

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.

"You'll have to eat about every hour"

2009-05-06T12:44:00.000-07:00

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 www.fitday.com 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!

A Brand New Day

2009-05-04T15:16:00.000-07:00

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."

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

2009-05-03T11:25:00.000-07:00

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:

A:

B:

C:

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.

Up and Down

2009-05-02T13:45:00.001-07:00

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!

Hope, creeping in

2009-04-28T18:39:00.000-07:00

*Thanks to each and every one of you who commented on our last post and gave us so much support. I loved reading all of those comments, and keep looking them over again. Whoever put it up on LFCA, a special thank you!*

Since we learned on Saturday night that we are not carrying twins, as we'd thought for four weeks, but triplets, it has been a cycle of disbelief, shock, excitement and acceptance. I felt comfortable with the slightly increased risk of fraternal twins, but now we are dealing with identical twins with a fraternal triplet, which comes with many more risks.

The identical twins can have a unique problem (since they most likely share a placenta) called Twin to Twin Transfusion Syndrome, where one twin "donates" its blood to the other through the placenta, making both ill. One or both twins can die from this condition which affects 10-20% of identical twin pregnancies. I have done quite a bit of reading about it and in the last ten years, many new treatments have shown promise, such as a laser ablation surgery that operates on the placenta while the babies are in utero. There are other therapies that can help, and if worst comes to worst, they will sometimes tie the cord of the sickest twin, sacrificing it and saving the healthier twin. This sounds terrible and it is, but it is does not occur with every pregnancy. The MFM clinic I will be going to starting on Monday (woo hoo!) is the only clinic in six states to perform the laser surgery.

Also the risk of preterm labor and low birth weight is higher with triplets. They are happy if triplets get to 32 weeks. Bed rest, medications, and cerclage are a few treatments that can help delay labor, but they are no guarantee.

Now that I have laid out the biggest risks, and my biggest worries, let me say: we are getting used to the idea. At first, we started talking about reduction which has its own risk of miscarriage. But I've read a lot and talked to some helpful nurses and doctors, and I am starting to wonder: can we do this? My husband very much worries about the time after they are born which would be INSANE, even with help, but I worry mostly about the pregnancy, clearly. I worry that I'd be on bed rest for a long time and my daughter would hate it.

Despite all these worries, we are starting to feel that we do not want to reduce. I have no religious convictions about it whatsoever, and am completely pro-choice, but I am not sure if I can do it. After seeing the tiny gummy bear-like shapes floating around inside of me, and the strong flickering of all three of their hearts, I don't know if I have it in my heart to stop it. We adore them already. That said, if our MFM doctors advise us that we really should or must, we will reconsider.

For now, I am trying to make myself eat because suddenly, the nausea is much worse, and cannot sleep. I get so overheated at night, that I open our window and stand in front of it while the cool air comes in. The only time I sleep well is from about 4 am on, and my daughter gets up at 6. After the scary bleeding, I am so happy to have symptoms to reassure me! I am reading triplet blogs, with good and sad endings, and learning more about identical twins. I am being hopeful, and am secretly chanting in my mind: "We can do this." I hope I am right.

"Once you choose hope, anything is possible." -Christopher Reeve