33 Weeks!

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.

It was nice while it lasted...

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.

Reckless tag-pulling-off

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?)

"Don't smoke crack."

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!

Ask Carrie! (and cervical showing-off)

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!

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...

... 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. :)

26w1d: Holding my breath

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

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

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

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

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

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

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

The Triple Decker:


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

The 26 week belly:

25 weeks!

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

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

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

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

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

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

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

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

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

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

Notes from my hospital bed

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

Well, I've landed myself in the hospital.

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

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

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

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

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

Growing boys, Growing Cervix!!

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

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

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

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

= 4.5 lbs of baby inside of my belly!

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

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

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



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



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

Out on Parole*

*Cervical Parole, that is.

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

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

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

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

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

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

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

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

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

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

100th post: Good News and Bad News

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

Good news:

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

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

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

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

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

Bad news:

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

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

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

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

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

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

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

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

Not what we wanted to hear.

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

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

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

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

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

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

I asked her:

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

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

2. Will we get to 28 weeks?

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

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

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

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

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

Busy Boys

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?

It is really hard to type while laying down.

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.

Musings of a Couch Potato (more like Watermelon!)

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!

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

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.

More than you needed to know about my cervix

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

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

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

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

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

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