Day 40: T-12

Monday, August 31, 2009

29 comments
Wow. Day 40. For some reason, that number is hitting me right now.

We were taken to perinatal testing to see the cardiologist, Dr. Bott, at 3pm. The echo was done just like an abdominal ultrasound, they just used additional features. It took over an hour. Maya's heart looked perfectly normal and sounded just find. Bobby's heart looked structurally normal, which is great news. His heartbeat was still arythmic and the signs of SVT were still there. (In fact, the monitoring from last night and this morning both sucked because the arythmia was so present and the SVT was back). The monitoring was fairly quiet, but at the end, the doctor said that he thinks Bobby will be fine. That the SVT is not severe enough to put him into heart failure at this point. That he has seen babies have the arythmia that Bobby currently has go 10+ weeks with no issues. He cannot tell us why this is happening. There are no external signs as to why. He cant see any internal reasons as to why. So, at this point, they seem to think that it will continue throughout the next 10 weeks and will resolve upon birth. And if it doesnt, fixing a heart issue in a full term baby is much better than in a 26w one. But he was very optimistic.

Dr Bailey just came in and said that he spoke to Dr Bott, who wants to continue my current dosage of medications and have be ultrasounded every few days to check for hydrops (fluid on the heart/lungs). Dr B said that he is still hopeful that we are going home in 12 days but that he wont make that official until we see how Bobby progresses and watch his heart ultrasounds for the hydrops. The problem is that he doesnt want me to have to come to the hospital twice a week and put extra pressure on my cerclage by traveling and sitting. But he said that these are all things to discuss in 10 days or so. That he'd rather see what is going on and have some basis for how to proceed versus dealing in hypotheticals right now.

He also said that he is amazed that I've been here so long and havent complained once. As sad as I am to be here and not home... As much as I want to go home... I cant complain- my babies are still alive and inside of me. I know the alternative. I cant complain about that. I may break down to Peter and I may vent here, but ultimately, I'm just thankful for one more day.

I was talking to Sarah today and we were both commenting that we cant believe tomorrow is September 1st. September... Fall is soon going to be here... The babies are going to be here in a little over 2 months... Wow...

September 1st... 19 months since my first son was born...

September 1st... 41 days in the hospital.

I am tired. Emotionally and physically. My body hurts. My back, hips, and bum ache. My fingers are starting to bruise. My arms are black and blue. My heart is fearful. My mind is struggling to process everything and I just feel so tired. I am so very grateful- please dont get me wrong. Each day is such a blessing. As I lay here, feeling them engaging in a circus in my belly, I feel such joy that they are okay and playing together. I look in awe at my growing belly and the stretchmarks that go on forever. I am so thankful to have them inside and, it seems, safe. But I am so tired. I cant concentrate when people call me on the phone and I dont want to talk. Most folks dont get that. It isnt them; it is me. It is just too hard to focus. There are exceptions, like my mom and Sarah, but is because I dont have to focus. I can be a lump and they are okay with that if that is what I am at the time. My body is starting to feel the lack of movement and my muscles are starting to hurt as they become weaker and weaker. My mind tells me that, even though I am only 68 days from the full term, 36 weeks we are hoping to get and that seems so short, it feels so long. I am trying to keep my eyes on the prizes that I am lucky to carry... To stay positive... But now, adding in the concern of not going home to my bed... I want to cry. This was what I was holding out for and the fear that it wont happen... It is hard. We will do whatever is safe for the babies but this was a rainbow in the distance.

Dr B says to hold out and we will make a decision later on. To try not to worry. We will cross this bridge in 10 days. So, that is what I will hold out for. Not worrying. And Peter says that if the ultrasounding is all we need, perhaps we can go to a local hospital outpatient and have them send the reports over. We will see if that is an option. I will look into it.

Please continue your prayers for our little ones, especially that the arythmia calms itself down and disappears. This is a priority right now. Even if it doesnt disappears but calms down considerably.

All in all, we are relieved that Dr Bott basically confirmed Dr C's diagnosis and didnt find something worse. It seems that this low level SVT can continue for 10w and be okay for his heart, so that is what we are hoping.

Day 39: T-13

Sunday, August 30, 2009

11 comments
Good days have to have bad days. I understand that, but I dont have to like it.

I ate pizza last night and my blood sugar was crazy high before bed: 252. :( But I'm not sorry. Dr B said that I could cheat once a week and, dammit, I wanted that Papa John's like nobodies business. So I cheated. And it was good. And now, I will be good. So, this morning, my fasting continued to drop, this time to 114. And after breakfast, I was 118. And before lunch just now, I was 89. That is perfect. After a meal: 120 or less; before a meal: 90 or less. We will see how my post-lunch is, but I am actually happy with my readings for today. At some point, this will be figured out.

And, of course, the bad news. Bobby's heartbeat. Part of me doesnt know how bad this is and how much was a circumstance. I'm still doing the research. Part of me is pissed off because, while my nurse is nice personally, I dont feel like she is listening to me.

So, I got put on the monitor this morning and the nurse said that she was following the written orders to a T: 15m of Bobby by himself w/ 30m of both of them. Now, most nurses, since he's been behaving, have been putting them both on and, as long as 15m of Bobby charts, they are happy. The doctor only wanted the 15m alone because he wasnt charting. And even the nurses who do him alone, then add Maya in for 15m. So, total, about 30m of charting. And, since I am on my back, this works well, since I get contractions on my back. Usually, during half an hour, I get 2-3 mild contractions. Nothing major. Once that 30m becomes greater, however, the contractions actually hurt and come on top of each other. They are irregular, but they are there and they suck.

So... Today... Bobby and Maya are put on together. The arythmia is still there and was actually more present than yesterday which bummed me out, but his HB was between 120s-160s, which is within normal ranges, so I was happy with that. Maya continued to be 140s-160s. They both would hop off with movement (and he was more than happy to move a lot today), so it was a pain to keep them on. They were so active last night and early this morning that I didnt sleep well, so Peter held them on so that I could take a quick nap, once they began to behave. So, the thirty minutes ends and, having been told that I had to keep him on for 15 more minutes, we begin that. And the contractions start. And his heartrate starts to become very arythmic. Loud, off kilter, and surging. Up to the 190s. For a beat or two, into the 200s. The average is now 160s-180s. So, the nurse says that she is getting the doctor. (Mind you, the half hour before, he is as he has been for the last few days, just with the arythmia very present.) At this point, my back is in a lot of pain and the contractions are one after another, so Peter tells me to roll over on my side, that Bobby's additional 15m was completed and that, if they want more, they will have to figure it out on my side. (Peter gets very frustrated when medical personnel dont listen or when he sees me in pain that can be easily fixed.) So, I roll onto my right side (since Bobby is to my right and I didnt want to lose him), and hold the monitor in place. And his heartbeat drops back to the 130s-150s, with the arythmia present, although not severely. We did this for 15 more minutes. The nurse came back and said that the Resident was watching with her on their monitor and, since he had calmed down, she felt that all they could really do is wait and see, and wait for tomorrow's visit with Dr Bott, the fetal-pediatric cardiologist. As the nurse is removing me from the monitor, I say that, perhaps his heartbeat increase was in response to the contractions I was having, since they were hard and painful. Her response: "Well, I didnt see anything pick up on the contraction monitor." That's great. Since the monitor is NEVER placed anywhere near my belly button anymore and is just slung wherever, I'm not surprised. And, on top of that, the TOCOs dont always pick up contractions. I contracted with Alexander the night before he was born and the TOCO didnt pick it up. They told me I wasnt having contractions! So, since I have an idea of what a contraction is and since we all know that I get them on my back (which isnt uncommon) and every medical site I've seen says that laying on your back decreases fetal oxygen and can lead to the baby's heartbeat either falling or rising... Could you give me a break and say, hmmm... Since his heartbeat went back to his current "normal" as soon as you rolled off your back, maybe, just maybe, this played a roll? Especially since he was quasi-okay before??? (Sorry... I dont sound bitchy at all, I'm sure...)

So, bad news because it is a setback, but I dont know how bad it is. Is it really just status quo but because of how this nurse monitored, it came back "bad"? I know that, really, all we can do is wait until tomorrow's echo. The monitoring right now is to make sure nothing gets worse. The babies are very active and healthy, and that, according to one of my nurses, is a better sign than any monitor can give. The ultrasound on Friday was good. Things can change in a split second, but it "seems" like everything is still okay. Tomorrow, we will know more, and we are praying, just praying, for good news... Please.

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On a fun note, Peter and I decided that, for my MIL's shower, we wanted to design and purchase the cake. So, we've settled on a design. (Please forgive me... Art is not my strong suit and I created this in Paint, so, of course, it is ROUGH.)
The cake with be 1/2 chocolate, 1/2 white with a strawberry filling. The buttercream icing will be a light green with a brown border (this matches the colors of the nursery). The text will be the same brown. There will be a blue elephant on one side and a pink elephant on the other. And, because as so many of you pointed out, this shower isn't just for these children, it is for ALL of them, Peter had the beautiful idea to include three angels on the cake, so at the bottom, we will have a blue angel, then a pink angel, then another blue angel, to signify Nicholas, Sophia, and Alexander. We struggled with what to "say" on the cake, but came up with "Celebrating Bobby and Maya" because, even we realize, they are the focus. A supermarket near our house did the cakes that we used at the two memorial services and they were remarkably good, in both taste and in keeping with the designs we asked for, so, we've opted to use them again. Creating this was a nice distraction...

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Remembering Ezra Malik today... Please remember with me. And celebrating Gregory's little sister, Gwen's arrival home... Please celebrate with me.

26w (Day 38: T-14)

Saturday, August 29, 2009

17 comments

GOAL!!!! We are officially 26 weeks pregnant! My 5 pounds of babies are happily playing and I am so happy to tell you all that Bobby was monitored- without assistance- for the half hour! He popped off here and there (but Maya does too... They like to move.) His heartbeat was mostly steady and sounded normal for the most part. There were bits and pieces of arythmia but what we heard on Tuesday is not there. What we heard on Wednesday with the labored beats was gone. I can count on one hand the number of times his numbers surged, and even the surge was only to the 160s. He was happy beating away in the 130s moving into the 140s and 150s at times, and then, settling back into the crook of my leg and whoohaa with his 130s. The nurse put him on and backed away and he stayed. She watched for a bit then left and he stayed. When she returned and put Maya on the monitor, he stayed. And then, together, they were on the monitor and the lines were (mostly) consistent. He'd move here or there, she'd move here or there. But it was almost like last week. I could not ask for more right now (well, except the whole "full term" thing). It's all I can do not to burst into tears. Thank you all for the prayers that are getting us another day and bringing health to the babies. Whether you are lighting a candle in church or sitting under the moon with your hands raised... Regardless of the name you call the Divine by or even if you call That Which Is by no name at all, we are grateful.

It's been a pretty relaxed day. We now are on what may be our last hospital countdown. 14 days. 2 weeks. Not just the BIG 28w goal but also the going home goal... the baby "un"shower... so many things.

It's hard to think about baby showers, honestly. When we initially discussed them, the days were so far away. There was today, when we were going to leave for TN to have a shower next Saturday... And then the "un"shower for some friends on the 12th... And then the one Peter's mom is throwing on the 26th... While my mom's shower has been postponed until the spring, the other two are still on. What was so long ago are now 2w and 4w away, respectively. People are RSVPed for 2w from now... Peter's mom is mailing out invitations this weekend for her shower... 28w... 30w... Wow... We have somehow gotten to the point that this is around the corner. And I am both thrilled and wordless...

I have tried to look towards these things will excitement and joy (even though I am not the "shower" type... It's why I chose to not have a bridal shower). And I do. The idea of a day where people are just thrilled for the babies and where that is the focus- what parent doesnt love that idea! But then there is the hurt. There was the planned TN shower for Nicholas and Sophia- a month after I first went into labor. I remember Peter calling to cancel my plane ticket and my mother calling people to tell them her first grandchildren had been born and has so soon after died. With Alexander, there was some sort of discussion that we would "plan" a shower after 24w. We never even looked at invitations or anything else. I mean, why tempt fate? Although, fate didnt need the tempting... And now... Bobby and Maya.... Invitations that were made.
(forgive me... I used Paint to take off my MIL's contact cell and email for the RSVP since I didnt feel right leaving it visible...)
Items purchased off a registry... And it all seems like one part of this journey that is normal.

As much as normal is what I've wanted from the start, part of me is afraid to enjoy this. Does that make sense? Everything has been so different... How can I let a regular baby shower in? How can I pretend to all the people who come that things are fine? With the un-shower, thrown by Sarah and attended by a small group of friends that have hung out together for a while, it's different. They know that this is all different. This is a party with baby undertones. It's not a baby shower. But for my MIL's shower... It's the real thing. With baby favors and lots of people and gifts and food and cake... And, dont tell, but I am afraid. I am afraid that it wont be me. That there will be a person who smiles and laughs and plays everything off as fine, who inside is breaking apart because this is what was meant to be almost 2 years ago... Something that was lost. And suddenly, is found.

Please dont misunderstand me. I am thrilled that people are celebrating with us and are happy for us. I am thankful that people are helping us provide for the twins in this way. And I am touched that so many people are actively engaged in helping plan and prepare the baby shower (from what I hear, it is a huge deal among the church ladies :) ) But there is a part of me that aches from this and I wanted to share that. Because, sadly, I know that I am not alone in that. And, if you are reading and in a similar place and are fearful, you are not alone.

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As I close, I ask that you say a prayer for another special family. Sarah and David welcomed their beautiful Ezra a year ago, after finding out that their precious son had passed away in his womb home. He is now watching over Sunflower, the baby brother that is currently growing inside his Mommy. Please remember their family and, most of all, Ezra, on his special day today and his birthday tomorrow.

Day 37: T-1

Friday, August 28, 2009

29 comments
There are bad days, like Tuesday. And there are days when you have to take the good with the bad. And then, there are good days. Like today. Today has been a very good day.

This morning, the kids went on the heartbeat monitor. The instant Bobby went on, I could hear a marked difference. The arythmia is still present, however, he stayed within 130s-150s. But he sounded less like a train rumbling along the tracks (that lumbering sound) and closer to a regular heartbeat with a skipped beat or an added beat along the way. Even the nurse commented that he sounded better this morning than on Monday when she monitored me before. She was able to keep on the monitor for several seconds at a time, but he was moving also, which, with the arythmia, isnt fun for the monitor. But we heard him and he sounded so much better. Even after his 15 minutes of solo monitoring, he would stay on the monitor by himself for seconds at a time. Maya was fine once she was hooked up. It was such a nice way to start the day. They were both very active and just hearing a more normal sound was great.

So, Peter's mom came around lunchtime and, while she was here, Dr. Bailey came. He was really happy with Bobby's monitoring and with how the meds are working to bring his HB back into normal ranges. He congratulated us on reaching 26w tomorrow. He's just as happy as we are! While we were discussing things, I said that I had my baby shower scheduled for the 30w mark and, how would he feel about me leaving the hospital for a few hours on Sept 26th for that. To which he replied, "You'll be home by then!" I asked if we were still looking at the Sept 12th discharge and he said YES!!! That they dont keep mothers for a baby's arythmia unless the SVT is present and that I will need to be monitored for that, but that, assuming my cervix holds, the 12th is good! I cant believe it! I thought I was going to cry! So, as we were discussing what the 26w mark holds, he said that the hospital has a 90% success rate with 26w babies. While we are chatting, a flower delivery comes. I am surprised because, you'd think, if someone was going to send flowers, they would have done it earlier. So, he takes the card out the bag as my MIL asks who sent them. I look over the tag and cant tell (dont you love the new "cards" that arent really cards at all...), so he looks at it and says "Oh, it's here". I look at the card and it reads: "Congratulations on 28 weeks. Love, Dr. Bailey and staff".

I burst into tears. It is a beautiful arrangement of summer flowers in a basket.
I stood up and we embraced and kissed on the cheek. As I said "Thank you so much, I dont know what I would do without you," he replied with "Carol, I love you and these kids. And the kiddos are going to be absolutely fine. Dont you worry." I told him that we loved him as well and were just so grateful for his help. He joked that I'd better get back in bed so I didnt "mess up his stitch", and we finished discussing 26w and this milestone, and how the next 2w bring us even closer to everything being perfect.

As if that wasn't enough for today, I also had an ultrasound. Not only did my cervix measure 1.6, the same as last week, but they didnt see any fluid around Bobby's lungs or heart. And the babies are weighing about 2w ahead still! Bobby is 2lb 3oz and Maya is 2lb 4oz. The MFM doctor, Dr G, who was supervising the scan said, "Don't your babies know they are twins and are usually under 2 pounds for at least another week or two? They must think they are singles!" I laughed and said that we hadn't told them that yet. The tech, prior to the doctor arriving, did get me pictures, which Peter will scan in early next week (he will be here Sat-Mon, so no scanning...) They looked so wonderful. Bobby was sucking on his thumb and Maya was posing for the camera. I couldnt wipe the smile from my face.

So, I may be bruised from IV sticks and battered from not being able to stretch out comfortably in the hospital bed, but I am far from broken... And today, this good news, this is enough to last. The only thing that could have made today better would have been for the fetal cardiologist to suddenly appear and tell me Bobby's heart is perfect. But, I'll save that piece of good news for Monday. :)

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In introspective news... 10w ago, gestationally, Nicholas was born... And tomorrow, 9w and 8w, respectivelly, Alexander and Sophia were born. Each week, it hits me, these milestones we've made, but the big ones... Those are the ones that I ponder. If only... If...

Peter and I watched a Discovery Health program on a set of quintuplets born at 24w3d. I didnt want to watch but I felt compelled to. I needed to see the NICU and what they went through. And it was horrible. Inside, I kept praying "God, please dont let our babies need the NICU. Please let them be born full term, healthy, and safe." But yet, we need to see that too. We need to see and prepare for the "just in case" even as we pray for 10 more weeks.

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My blood sugar is still out of sorts. They keep raising my insulin to try and combat it. The endocrinologist came today and said that she thinks it will take at least another 7-10 days to regulate me. Until then, it's sticks and needles for me! But no complaints. Not a single one.

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Your prayers are working. :) Thank you. We feel so blessed.

Day 36: T-2

Thursday, August 27, 2009

26 comments
Thank you a million times over for the support and prayers. I feel so blessed by your compassion and your love for our family. Thank you.

Your prayers are working. Last night, during monitoring, Bobby's heartbeat went between 120s-190s. This morning, his HB was 130s-160s, with the majority 130s-150s. The arythmia is still very present; it is hard to hear the happy sound of Maya's normal heartbeat and then the irregular sounds of Bobby's. He sounds so labored. It just breaks my heart. But we are so grateful for the "normal" numbers. The SVT hasn't presented since Dr P did the u/s and monitoring. We are relieved that his heartbeat has not been over 200 in 2 days. We are praying that it never gets that high again. The nurses keep trying to reassure us that arythmias happen all the time and never lead anywhere, that it could totally fix itself before birth, that the medication can bring his HB back to regular beats... I dont think we will feel any sort of peace with the issue until Dr B, the Dupont fetal cardiologist, arrives on Monday and does the echo. If he says "Your son's heart looks perfect", I will be able to take a deep breath and believe that the arythmia isn't going to lead to his death in-utero and that this will either fix itself sometime between now and when he's born. But at this point, when a 28w delivery is still on the table, it is terrifying. I think that if his report is good, then we can look back at the 32-36w delivery. I am so hopeful for a good report. Please continue to pray that this is the case: that our little Maya continues to be safe and healthy and that our sweet boy has a perfect heart that is simply going through a growth spurt of some sort.

Peter and his scientific background have been a godsend right now. (For those who may not know, Peter's background is in biology and chemistry; he is a biochemist for a pharmaceutical company doing research. He will finish his Master's next spring (he's been going part time) in molecular biology.) As part of his coursework, he took a class on embryology, in which the fetal heart was discussed. He is handling the arythmia better than I am because of this, I think, and he helps to explain what the doctors are thinking to me, sometimes with visuals or just by using real world examples. I'm not a science person at all. I consider myself reasonably intelligent but I dont know how I would stay off the ledge if he werent here to talk me down. He was here on Tuesday (he basically got to work, I called, and he turned around and came back) and he stayed yesterday to talk to the doctors. He's taking Monday off so that he can be here for the echo and to interact with the doctors. I am so thankful. He has always put our family first and we are lucky that his company has always given him the leave to do that without any issue. When I read about people struggling with employment and insurance, it makes me all the more grateful that we are taken care of in this regard.

My blood sugar is all over the place. And I mean ALL over the place. For a few days (pre-propanolol), the diet worked to keep my blood sugar lower. But now... I am eating exactly the same thing and getting numbers everywhere, well over happy. I saw an endocrinologist yesterday and today, and I loved her. Just loved her! Dr Lee had always recommended that we see a "regular" endocrinologist in addition to her, to help manage the PCOS, and after a long consult with Dr Patel yesterday, she is our girl. Peter liked her too. So, post pregnancy, I will pick her up as part of my medical team. We discussed how she managed PCOS and I really liked her ideas. But, that is for the future... She came in to discuss the gestational diabetes. My A1C came back at 5.6, which she said is great. It shows that the diabetes is a recent issue and not something that was unchecked. That was great to hear. After yesterday and today's testings, the current plan is that I will get a slow moving dose of insulin before bed (after a blood sugar check). Then, in the morning, I will get a slow moving dose of insulin after my fasting blood sugar. Before breakfast, lunch, and dinner, I will get a blood sugar check, then a dose of emergency insulin (to counteract my food), then eat as soon after the injection as I can shove the first bite of food in. An hour after meals, another blood sugar check. So... if you count blood sugar sticks, that is 8 finger sticks. Every day. Yeah. It sucks. When they check on the side of the fingers, it doesnt hurt at all and my fingers dont bruise. The nurses who missed that memo and do the sticks on the inner part of the finger... those suck. My finger will hurt for an hour or so and then it feels sore. But, on a positive note, my fingers feel better than my arms and hands. Those IV sticks stay with you for days!

As much as I'm not thrilled about the constant blood letting, I dont want the babies to have ill effects from my blood sugar. And if it is the drugs that are bringing Bobby's heart rate into check, then getting 8 sticks a day for the next 10 weeks... I can do this. And I will do it gladly.

And speaking of... 10w to a full term delivery! I can barely believe that, starting Saturday, at 26w, we will begin a single digit week countdown! 9w6d... 9w5d... Wow... It's been such a long journey just to get here. To think about getting closer and closer, it brings tears to my eyes. Of course, we are still looking at our small goals.
2 days until 26w....
then 2w/14 days until 28w...
then our big jump: 4w/28 days until 32w!
and our final goal: 4w/28 days until 36w!
We will soon move from 4 goals down to 3 goals. Wow... Of course, each day is a goal and blessing but still... Just seeing it laid out this way when we've had so many goals set for us, is a great feeling.

And, as I am closing, some more news. My favorite Resident, Dr P, just came to see me... His rotation here is over... I am so sad! He will be in OB on nights for the month of September, but his next rotation is Oncology. I am just crushed that he is no longer in L&D. He said that he will be checking in on me regularly and that, if I feel concerned about anything, to let the nurses know and they will page him. What a sweet guy. I hugged him and thanked him for everything he has done for us. It was all I could do not to cry (damn pregnancy hormones...) as I wished him well. He is an outstanding doctor; I know that he will continue to grow in his work and become a great doctor outside of his residency. The compassion that he has shown me for the last 7 weeks... He will do very well in oncology, where those patients need a gentle hand, too. But how I will miss him... I will miss him so much.

On another note: it's been a year since this blog began, back on, August 25, 2008. A year, hundres of posts, and so many new friends. I wondered if I would make use of this space when I started. Now, I'm not sure what I would do without it. Or without you.

Day 35: T-3

Wednesday, August 26, 2009

56 comments
Yesterday was not a good day, hence no update. I wasnt even in my room.

At yesterday morning's 9am HB monitoring, Bobby's HB was 212. He is normally 130s-140s. A second nurse confirmed then the Resident, Dr N, was called. (Dr P was at a different hospital after visiting me for rounds in the morning- funny stories about him, actually...) She used 2 different u/s machines to confirm the HB. It was a blur of activity as they tried to get an IV and give me oxygen. Suddenly, I was told that I was being moved to Delivery and that Dr B had been called to discuss an emergency c-section. I called Peter and tried not to cry.

They moved me from Antepartum to Delivery and continued trying to get an IV while also trying to get the babies on the monitor. 6 sticks later, I had an IV in my arm (and my other arm is now just one bruise), oxygen, and a nurse monitoring Bobby and Maya. Maya was fine, but Bobby's heartbeat stayed in the 200s then would momentarily drop to the 150s then back to the 200s. It was terrifying as they were concerned he was in distress. Dr B called Dr C, the MFM doctor that we've been seeing, and they consulted. The wanted to avoid delivery if at all possible, so Dr C came and did an ultrasound on the high resolution equipment. By this point, Peter had arrived.

As we waited for Dr C. the u/s tech pulled the babies up and the first thing he said was "There's no fluid around the heart or lungs." This was great news. This means that Bobby's heart has not started going into failure. Once Dr C arrived, it was quiet for most of the scan. But he also had some better news. Bobby was not in distress. The upper part of the heart, the atria, are not beating regularly. In a normal heartbeat, you get atria-ventricle-pause-atria-ventricle-pause, etc. The atria contracts, then the ventricle contracts and relaxes, preparing for the next round. Hence the lub-dub sound you hear on a stethoscope. Bobby's atria is contracting twice. atria-ventricle-atria. atria-ventricle-atria. The ventricle is getting the sign to contract but it cant be cause it is relaxing and by the time it contracts again, the atria has contracted a second time. This is causing the arythmia and pushed his heart into overdrive. The overdrive is called SupraVentricular Tachycardia, or SVT. The concern is that SVT leads to heart failure if not treated. Since they cannot give Bobby treatment directly, the discussion became what to give me to try and help him while not hurting Maya (whose heartbeat is stable and regular). At first, the discussion was Digoxin, a cardiac medicine that would possibly lower his heartrate but also would require cardiac monitoring for me since my heart is normal and would be impacted by the medication. This is a common first line of defense because it is an older drug that, although a class C medication, has been used enough in pregnant women that no adverse effects have been shown (there just havent been studies conducted). Dr C decided to call Dr B, a pediatric and fetal cardiologist from Dupont in DE, to consult on what he had seen and heard from the monitors. Dr B will be arriving on Monday to do a echo on Bobby's heart and, in the meantime, suggested they start me on Propranolol, a beta blocker and also class C, since it would have the greatest impact only on my blood pressure and not my heart, and he feels might lower Bobby's heartrate. The idea is to lower his heartrate and then try to figure out what is causing the arythmia. Is it a heart defect that was missed on the MFM ultrasounds (although Dr C still couldnt see a problem even yesterday) or is it an unknown arythmia that will fix itself either in utero or upon birth, which can happen. Either way, their hope is that, even if the drugs dont work (and they have a plan to add drugs if that is the case, including adding the Digoxin to the Propanolol), they can buy us time to 28w and deliver then, versus delivering now. Not that we want a 28w delivery but we will take it if that means both of them are okay. The worry is that if they cant get Bobby's hearbeat to settle back down to normal and it does go into failure, that drugs wont work. And since we arent willing to let something happen to him for the sake of going longer into pregnancy, we've already made the choice that, at whatever time they see distress, we are opting to deliver both babies.

So, last night, we were in Delivery with the idea that we would be transferred back to APU, but they decided they'd do my monitoring, etc, over there and bring us back later. That monitoring showed that he was still in tachycardia (high HB), but that in addition to going back to normal ranges, he was droppping into subnormal (80s-100s) and then back up. The residents were called and they did an ultrasound in the room. He was still moving and happy but you could see his heart going fast then normalizing and then, it appeared, taking pauses in between beats (the low beats). They felt that there was really nothing they could do except watch and wait and hopef or the best, since he was normal or high much more than he was low. Of course, I had a good cry when it was just Peter and I, terrified that Bobby's heart was stopping and that he was trying to tell us something that we just couldnt understand. "Is he saying, "Mommy, help me," and I'm not?" I sobbed. Peter just held me and rocked me and, with every little cook of our baby boy's foot, told me to take heart that our son was okay.

We got back to our room around 10pm and were so tired. I woke a few times in the night (for the bathroom, to have my BP measured, to take my new med) and each time, I prayed and willed the babies to move, just to let me know they were okay. Maya was more than happy to oblidge when I rolled onto her side and she didnt like it, but Bobby was fairly quiet. I was terrified and ended up falling back into a restless sleep with my hand glued to his side of my belly.

This morning, as we were laying in bed, Peter told me he wasnt going to work today, that he wanted to make sure that things were stable before he even thought of leaving the hospital. I am so glad that he stayed. Bobby was more than happy to make me aware of his presence with kicks and rolls, along with Maya, and I felt better about his safety, and I actually took a peaceful nap. Dr B came in during this time and talked to Peter, and then my nurse came in to do monitoring. I explained about the irregular heartbeat and SVT, but she was nervous listening to his HB because she said that what she was seeing on the monitor wasnt matching what she heard. So, she called in the Nurse Practitioner, who did an ultrasound and confirmed that his heartbeat was stable with drop offs (but not surging). Still, she was concerned and called the Resident, Dr P. Dr P had seen me this morning on rounds and told me that, while he knew I was scared, he has seen fetal arythmias a lot and they usually resolve themselves... that Dr B from DE is an expert and will find any abnormalities but that he thinks things will be just fine... To try not to worry... (and, funny story, I dont know how he found out that I had been moved from APU yesterday but apparently he called Dr N and drilled her on what happened. Last night, she laughed and told us "I had to keep telling him that you were fine.") So, Dr P came in and listened and repeated the u/s. He was able to confirm that Bobby's HB was within normal ranges and dropping off with periodic highs (190s) that only lasted seconds. So this is actually better than last night. His heartbeat is still very irregular (i.e. arythmia) but the tachycardia aspect is diminishing. This could be because of a quick response to the medication (which has lowered my blood pressure to the point that my morning dose was skipped and I felt a little off kilter) or it could be that this was just a fluke thing. I'm hoping the latter and that the arythmia as well will clear up on its own. The CRNP wanted to move me from APU to L&D; Dr P doesnt. (He wouldnt be my Resident over there... Such a nice guy.) He also told the CRNP that if he could sit and get Bobby's HB on a solid strip for 15m (meaning they can see all the highs and lows and not just points blipping up on the print out), then the nurses can do. The CRNP argued with him for a bit but after a while said "You've proved your point." He also wants them to monitor the babies seperately since they know that Maya's heart is fine right now and that way there isnt dual lines on the print out. So, a nurse will sit with me for 15m of my monitoring to get a solid, 15m strip of Bobby's HB, highs, lows, and everything inbetween.

Emotionally, I am drained and am a nervous wreck. It's bad enough to not know "why" this happened; it's worse to feel like it is a wait and see. Hopefully, come Monday, we will have some answers when the pediatric/fetal cardiologist comes, but it is the waiting until Monday that is killing me. Will Bobby be okay until then? Everyone seems to say yes, but then there is the mini-freakout when they monitor him and the nurses see/hear the arythmia. I just want to know that he is safe and okay. I dont want them to go for monitoring one day and not find him. That is my huge fear right now. I realize that delivery at this point isn't a good thing and we are desperate to get to 28w... I just want to know that he is okay until then. When he moves, I am reassured; but when he doesn't, I panic.

A note about my blood sugar... Yesterday, after breakfast and lunch, my BS came back at 120 and 127 respectively. I was really pleased. After dinner (and my first dose of the pro...), it was 166. Even though I ate the same as I had for lunch. The meds screw with your blood sugar. This morning's fast: 135. So... even though diet actually DID help, I will have to go on insulin therapy to moderate my BS as a result of the meds to help Bobby's heart. I'm a walking pharmacy!

Prayers are much appreciated. I am hoping that I will have better news to report within the next week. I'm also having a MFM u/s on Friday, which I hope will give us some peace of mind as well. Right now, both babies are kicking and I am relieved to say that we are doing okay.

Day 33: T-5

Monday, August 24, 2009

28 comments
Well, it has been 2 days of ups and downs. The babies are great. :) That is the biggest up, always.

Yesterday, I didn't feel much like posting, except to share Alexander's 9m birthday. I've been battling some "bedrest depression" the last few days. Very much a personal pity session that falls along the lines of "why cant I just be normal". My entire life has been spent outside of the curve and I've often had moments of wishing I could be "just like everyone else". As I've grown older and accepted things about myself, I've accepted the skin I'm in. But infertility and then mourning my children has left me with a longing to be "normal". To be someone who gets pregnant whenever they try... To have uneventful, happy pregnancies where their children are born full term and healthy...

For most of my pregnancy, I have shoved my feelings aside; the feelings of gratefulness at each day have kept those feelings at bay. But as my body starts to ache from the months of being in bed and I hear the stories of people near me and in my own family who dont get a rat's ass about their pregnancies complaining and wishing for a premature baby just to "get it over with" and giving birth to healthy babies in spite of their bad behavior, it has gotten harder and harder to wash over the things I've missed. In a way, I feel like I am having to mourn the pregnancies of our dreams because they are things I cant accomplish. Other pregnant women are wearing cute maternity outfits; my wardrobe consists of pajama pants and stretchy tank tops. While couples are out at the movies or dinner with their bumps in game, Peter is wheeling my bedside table over so that I can eat or refill my endless water cup. Our normalcy revolves around twice daily monitoring, weekly ultrasounds, and bloodwork. Is it so bad to want to be normal? To be able to enjoy childbirth classes or light exercise or a walk around the block? To be able to attend church or take an active role in planning a baby shower?

So, yesterday, this all came to a head. Perhaps it was meant to do so or perhaps it was my talk with my mom about my brother's girlfriend (due in 4 weeks). I dont know. But it spiraled and I cried quite a bit. Peter doesnt really understand, I dont think, just how much it hurts to not havea "perfect" pregnancy when you've tried so long... I know that he walks my infertility journey with me, but I think that he is so happy to be pregnantt and doing whatever we can to get full term that the idea of "mourning" a lost ideal doesnt connect with him. And I do get that. Which is why I am just so happy to be pregnant every single day and I do know how lucky I am to be given the chance to continue a pregnancy be it via bedrest, or whatever. But it still hurts that I have fallen short of my own expectations. And, for whatever reason, it took me 25w to get to the point where I feel like I need to mourn that so that I can let it go and move on.

I talked to Dr B today. There were good points and then a really bad point. On the good side, my discharge date is being tentatively set for 28w even: Sept 12th. (Yes, this is the day of the unshower so, as Peter said, it will be a "welcome home" party, too.) Discharge is usually around 11am. This could change, of course, if my cervix misbehaves, I start having contractions, etc. But this gives us an idea and a date to aim for, and it allows Peter to make some work plans, since he wants to take some time off to get the house cleaned and ready for our return. Also, instead of weekly appointments, Dr B said that he thinks it would be best to see me in the office every 2 weeks so that I am not in the car for almost an hour each way plus sitting up in the waitnig room for an hour plus, etc, every week. The appointments will be in his office. At the sign of any changes, I'm back in the hospital. During our "off" weeks, he said that we could do a phone consult to discuss any issues that have arisen, and that, of course, I am welcome to call him anytime if we have any concerns. He stressed that, any changes, and he will yank me back into the hospital for the remainder of the pregnancy so to not get too comfy at home. He hopes that I wont have any issues and will be able to stay home until the cerclage comes out, but he also said that he's not willing to take any risks if it looks like the hospital is safer. He'd rather us be back in the hospital until the cerclage comes out than risk something at home, even if the change looks minor. Which we completely agree with. We are grateful for the opportunity to go home and have as "normal" a pregnancy as we can, but if that does cause even a minor change, we'd rather come back to the hospital and wait out whatever weeks we have remaining. Another good thing: my blood pressure. Since it has been really low, he said that he is fine with the nurses using parameters as to when to give it to me and that, if it looks like we can, he's considered dropping my meds all together and using them on an "as needed" basis. He said that he isnt ready to make that decision yet because my top number is still coming in around 140 at times but that he takes heart that my BP has been low for the most part (usually under 120/80 by several points). I've also been given permission to sit up to eat. Tonight, I will be having dinner sitting in the chair. :) I really am excited about this, since I get heartburn after I eat. He said that no hanging out in a sitting position, but for the short time of eating, he is okay with trying it out.

And now, for the really bad news. My blood sugar. So, I was incorrect in my previous post about 120 being the end of normal. It is the end of normal AFTER a meal, not fasting. A normal fasting is under 90. Dr B said that he expected me to be slightly elevated because of the bedrest and twins and was prepared to let a small elevation go. When he saw my 117 from the other day, he said that he assumed I had possibly eaten something small or that the test had been done within several hours of eating. He had not distinctly ordered the fasting test; the CRNP had after she asked if I had fasted. I confirmed today that I had NOT eaten within 8h of the test. So, this morning, I had a finger stick test (think the whole diabetic daily stick test type thing) and my result, after fasting for almost 11h: 128. That's right. Nearly 40 points above normal. (And, actually, most labs consider 110 to be the cut off, which would make me, as Dr B called me, an "overacheiver". Nice...) He decided that doing the 1 hr is pointless since I am guaranteed to fail at this point (since it should be less than 120 after the drink), which also makes the 3h still moot. Not that I'm complaining; the nasty sugar drink was not at the top of my list of fun things to do. A nutritional counselor is coming in along with a diabetic counselor to discuss food options, etc, that impact blood sugar and how to try and manager my blood sugar with diet. I will get a finger prick every morning prior to eating and then one 2h after eating for the next several days. If, even with a diet modification, my levels are way above normal, he wants to discuss insulin injections.

I spoke with my favorite nurse, who came to do my 2h post lunch reading. (199... yeah... that is really bad...) She knew I was upset and said that it happens and to try not to worry. She said that, as far as impact to the babies, the biggest issue is that they may continue to grow bigger, which is in their favor as twins. She said that, post birth, they will have to have heel pricks every 3h for 24h to make sure their blood sugar is normal but that if they were born preemies, this would happen anyway and to try not to worry. For me, she said the biggest issue is that I will need to stick to a 2200 cal diet (which she thinks I am already doing, since she sees my meals that come in; she said that I am one of the healthiest eaters in pregnancies that she has seen in recent days and that she thinks my "diet modification" wont really be much of a modification at all). Since my weight gain is well under what the norm is, she said that is also not a concern. She reiterated what Dr B had said: that most likely this is a result of 2 placentas plus a lack of walking/mobility combined with a predisposition to insulin resistance due to PCOS. It sucks, but, in the grand scheme of things, I could be much worse and be eating poorly, gaining a lot of weight, etc., and that, while the situation isnt ideal, I am healthy and that makes a huge difference. (I love this nurse.) She explained that after discharge, I will still have to prick myself at home and submit the results to Dr B.

I cant lie. I am still saddened by this. I really hoped I'd just be marginally over the line and not "bad". I'm also pissed off. I feel like this is just one more slap in the face of my "planned" pregnancies.

But, it is a blessing that we are finding out now versus a few more weeks. If diet can get this under control (although everyone seems doubtful since I have a good diet now, but we shall see...) then great. If not and it takes insulin injections, as long as it keeps the babies healthy, then I'm there. No problem. After all, it's just another needle and, thanks to infertility, I'm used to those... Even if I hate them...

On a cute note, I took belly measurements. When I met Peter, I was 29" and I loved it... A decade of marriage, PCOS, Hashimoto's, and our pregnancies brought that measurement to 37" at the date of conception of Bobby and Maya. Right now... It is 48". Quite the belly... My fundal measurement is 38cm, which puts me on par with a 36w singleton... So 11w ahead. Fun times!

While I'm still having a rough day because of the diabetic thing, but my mood was just improved by a visit from our pastor, Fr P. We had such a nice, laid back visit, full of smiles and laughter, as well as church news. It really did help. It took my mind off the "bad news" of the day and brought some joy into the day.

Happy 9m Birthday, Alexander

Sunday, August 23, 2009

11 comments
9 months ago today, at 3:45am, I was in this hospital, in a room down the hall, giving birth to you, my sweet baby boy. You were kicking me up until you were on the outside, where you continued to kick! You actually got your foot caught, my breech little one, and your daddy helped your bent leg so that you could finish your birth. You kicked and punched as you entered this world, just as you had in your womb world. I cant not smile when I remember feeling that as you were born. And then looking over my still rounded tummy to watch those little shoulders of yours going back and forth. You were so active, my cuddlebug.

9 months ago... So short... A lifetime... And I feel so nostalgic for that time, perhaps because I am here.

Your daddy and I were awake at 3:45am. Did you wake us so that we could share that special time? I'm glad- we are glad- that you did.

Your (paternal) grandmother visited today with two large mugs "I love Mom", "I love Dad", and a tupperware of your favorite: tomato soup. And, let's not forget, a bag of tuna fish sandwiches, using your great-grandpa's recipe. A recipe that your daddy perfected when I craved them so much with you... I know that Grandpa is with you now, holding you on his knee, telling you all about the sandwiches he used to make your daddy and Uncle Robert and, later, me...

We love you so much, my sweet Alexander. Happy Birthday, baby boy. A very happy 9m birthday.

25w (Day 31: T-7)

Saturday, August 22, 2009

15 comments
Here we are! Another week into pregnancy! The big 25! One week until our next big goal of 26w.

As I type this, Peter is in the chair in the corner, feeling like crap. He was fine earlier, but after lunch, he took a nap and then woke up not feeling great. Poor guy tried to throw up and failed. He's thinking the samosas he ate were bad. :( Poor guy. I want to take care of him and there is nothing I can do for him.

I saw Dr B yesterday afternoon and this morning. We are rerunning the fasting blood work on Monday morning, followed by my 1 hour glucose test. Fun times. He said that, if I fail, he isnt running the 3 hour, because he thinks my failure will be due mostly to bedrest and multiples. Unless my levels are in the true diabetic range, I will have the required "nutritional counseling" and be about my business. If something shows up funky, we will re-evaluate, but he said that a low level fail wont mean too much at this point.

On a not-so-happy note, I think Dr M got to him... (She wants me here until 32w.) He said that he doesnt think I need to be here that long, but that he thinks, instead of 26w and talking about discharge, he'd like to wait until 27-28w to do it. So, it looks like 2.5 more weeks in the hospital instead of 1.5 more weeks... If it is safer for the babies, so be it... But I have to tell you. What I do here is what I did at home, sans the twice daily monitoring and the weekly ultrasounds down the hall. But, I should be grateful. The initial talk was about being here until 36w. I am just a tad homesick and was so excited about possibly getting back to my own bed in the near future. But no complaints... I'd also rather know that my cervix is behaving and my babies wont just live they will thrive. The less chance of months in the NICU, the better. I realize I may not get away with zero days but that is a goal that I'm not willing to give up because I'd rather be in my Sleep Number bed than the hospital one. And Peter agrees. He also said that it would suck if I got my hopes up at 26w and then Dr B said "let's wait another week or two". Which he's right about.

Bad girl that I am today, I sat up for about 15 minutes. I came back from the bathroom and just wanted to sit down. So I did. My poor abs and back didnt know what to do with themselves. I will ask Dr B tomorrow how he would feel about me sitting for meals. My poor back and legs could use the break, even if it is only a few short bursts (and my post-meal heartburn would love it, too...) Never fear, I am back in bed! It was only a few short minutes to try and relax my back and bottom!

Peter ordered our cell phone upgrades and brought them last night. All of my stuff has been transferred from my Razr to my LG Dare (which I love!). Using the Dare's camera, he got this picture of my mother's ring, which is much nicer than the other one I posted. You can clearly see the claddagh and you can even make out the stones on the side.

Our cell phone package hasnt been changed yet, but I am sure he will get around to it. It's not exactly a priority right now...

All in all, it's a good day. I'm having a round of bedrest homesickness but that really cant be helped. (And let's not forget the "Why cant I just be a normal pregnant woman" bedrest depression, but hey... it's taken weeks for that to really hit so I should count myself lucky!) Bobby and Maya are keeping my spirits up with their playing and kicking. Who couldnt be thrilled to be in bed if their days consisted of playing with two, beautiful, belly babies? I'm counting my blessings. It's 25w and I am thankful beyond measure.

11 more weeks and these babies will be full term! That's less than a third of a pregnancy. I am still blown away that I am here. And just so very grateful. In that way, I know that Nicholas, Sophia, and Alexander, along with their miscarried siblings, have taught me so much about cherishing each and every moment and never taking anything for granted.

And, before I go, let me share with you my favorite moment from yesterday. Dear friends of ours have a little boy, D, who is in first grade and reading at a 3rd grade level (he and his sister are homeschooled and are so very well rounded and bright!). We spoke on the phone for about an hour last night and he read to me, then we talked, then he read to me some more. It was such an enjoyable time! I know I'm partial to kids reading because of the whole librarian thing, but I have got to tell you, little more has brought cheer to my day like hearing D read. I know the whole thing was so that he could get more out of reading by having someone to read to, but I gained more than I can say. Ever thought of letting a child read to you? I recommend it. There is nothing else like it.

Day 30: T-8

Friday, August 21, 2009

14 comments
Here we are... A new decade of numbers.

I ate a very delicious vegan brownie last night. It was wonderful. Thank you Whole Foods. Dark choc over peanut butter. Does dessert get any better than that?

This morning, a nurse (not my regular nurse) came in to do my BP and proceeded to turn all the lights on. Really? People are sleeping here. I know it's an amazing concept at times but... (Sorry... Can someone say "grumpy"?) She came back around 6:30-7am to take blood. I asked why and she said that my BP has been high? Huh? I thought she had the wrong person! I told her that my BP has been low and she's like, yes, well, we're taking blood to run another preeclampsia panel. Okay. Whatever. But as I was grumpy, I gave her the lowdown on my veins. She told me she was going to stick my hand and I was like, "No. You can have this vein, right here." I just kept repeating myself until she stuck the vein I pointed to (and nothing else) and got it on the first time. I just wasnt up for another screwed up pricking session. Not that early. Peter joked that there are going to be nurses that are like "I dont like that b!tch in 511" and then the others who will say "Are you nuts? She's the best patient on the floor!"

The babies got monitored and were all happy for a while until Maya decided she didnt like where she was and fell off the monitor. So, instead of my favorite weekday nurse coming in to adjust it, it was "THE" nurse (the one who made the "not all pregnancies are meant to last" comment). I hope that my shudder wasnt visible. So, she adjusts the monitor and finds her and then tells me that my fasting glucose was high at 118 (120 is the cutoff for normal) and she is recommending that Dr B check me out RIGHT AWAY. Now, Dr B and I just chatted about this and whether we do the test this week or next, I know his feelings on it, so I wasnt that concerned. But I hate the "we need to medicate you" attitude, which is how she came across.

When my real nurse came in to do my weight (same as last- nothing gained all week), she asked if everything was okay and I told her that the other woman got under my skin with my "high" result and she just chuckled and said that she wouldnt worry. That my diet is fine and that my late night brownie probably had a lot to do with it since my digestion has slowed down, not to mention the bedrest and the twin gestation. That she thinks it is very normal and to just not worry. I felt better. I know that she would be honest. She and I have similar personalities and she's never been one to withhold her thoughts. So, I felt a lot better after that.

On another not-so-groovy note, the Resident who I still hold partly responsible for Alexander's earlier than it had to be birth came in this morning. It was all I could do to tell her to not touch me. She listened to my chest and then touched my belly and legs (to check for swelling). I was curt with my answers to her and couldnt help it. Just having her touch me made my skin crawl. I guess I'm not over those feelings as much as I'd like to think... Thankfully, I think she came in because she was leaving, because Dr P, the Resident I really like, came in for his rounds and it was perfect, as usual. But ugh... That woman... her voice grates on me like nails on a chalkboard and her face is etched in my memory. I really hoped that, since I hadnt seen her, she wasnt here anymore. But perhaps this will be the only experience I have with her.

Overall, another good day. Babies are happy and active and we are soon to be about a week about from our next goal! 26w (and possibly my own bed!) here we come!!!

Day 29: T-9

Thursday, August 20, 2009

11 comments
My last day in the 20s... Tomorrow is day 30 in the hospital. Really? Wow... Today marks the change into the 5th week of my life in the hospital. Fun times! (Although, since I am now counting down to a possible discharge home, that does make all the days a little easier! Will I hit day 40 here?)

My favorite day nurse is back from vacation... She was only gone a few days, but I missed her! She is a real sweetheart. We have similar personalities and I like her a lot. My favorite weekend nurse was subbing last night, so I got to see her extra, so hey! Good news all around on the nurse front. (And, as if it couldnt be better, this week, my favorite Resident was back from his vacation to Vegas. So I really cant complain.)

I'm starting to get used to the added pubic pressure now that Maya has turned. It took a few days to realize that no, no one is coming "out", it is just perceived that way because of their lowness. Thank the nurses and Dr B for promising me that I will "KNOW" when they decide they arent hanging out anymore and that low babies are normal and can hang out for a long time. That helped with the mental screwiness of it all.

I've decided that little miss likes to put her feet against my spine because she knows that I will sucker her daddy into rubbing my back, which means she gets a footrub out of the deal! This child is more like me than I dared to realize... (Of course, she already has him wrapped around those adorable fingers of her... It's not like I am surprised.) :) And her brother too!

For your viewing pleasure...

This is what I look like for 60-120 minutes each day (depending on if the floor is busy and they leave me on the monitor for an hour each time). The beige thing is the belly band (this was last night, so I'm in a blue nightgown). There are three monitors. The one of the upper left is the TOCO (contraction monitor), the other two are the HB monitors. Bobby is the lowest and Maya is almost next to the TOCO. They add rolls of tape in between the monitor and band to give slight pressure to keep the sounds flowing.

***
My IRL friend, BS, asked me a question about the special dinners I talk about on Nicholas, Sophia, and Alexander's special days. She asked if I'd ever blogged about them and I honestly couldnt remember. But I thought I'd post a bit from my email response to her, in case you are wondering why certain things were selected, or in case you've ever thought of memorial dinners as well.

"Peter and I were vegetarians for about... 6 years. No meat at all. When I got pregnant, I fully intended to continue that. But then I had these massive cravings. The major one was pork chops, rice and beans, plantains, and cornbread. It was a "staple" Puerto Rican meal in Peter's home growing up and in our early marriage. So, we decided to give in since we felt that cravings were the body's way of getting nutrition in some way. And I ate it ALL THE TIME. We must have had twice a week and he'd make extra so that I could have it during the week, too! It was bad. I've never eaten so many pork chops per week in all my life. The night Nick was born, I was cooking that meal. After he was born, the entire idea repulsed me. Instead, constantly for those 2w, I craved polish sausage (which I have never cared for), pierogi, broccoli, and garlic english muffins. So, once again, I was eating this constantly. After Sophia was born, nada. So, we decided that, even though they shared the womb, they didnt share taste buds! So, on the 1st of each month (when Nicholas was born) we had "his" dinner and on the 16th, hers. It just felt like the right thing to do. When I got pregnant with Alexander, I craved Peter's grandfather's tuna fish sandwiches and Campbell's tomato soup (no homemade would do!). So Peter would try to recreate the sandwiches. Now because of mercury, I couldnt/wouldnt eat the sandwiches as much as I wanted them, but that actually worked out because I also had a hankering for turkey sandwiches around lunch time! So I could alternate somewhat (which is funny, since Alexander was born near Thanksgiving!). So tuna fish sandwiches and tomato soup are our dinner on the 23rd of each month.

"I had other small cravings too during the pregnancies for other meals. Breakfast before Nick was born had to be Peter's breakfast sandwiches (egg, soy sausage on eng muffin with OJ) and afterwards cream of wheat and milk. Then with Alex, fruit loops with apple or cranberry juice (funny, I know!). Lunches were roast beef sandwiches with the twins and PB&J or Turkey with Alex. They were just such needs and so independent of my own personal tastes. I cant stand milk but with Sophia I just had to have it. All the time. (And with these babies too!)"

These babies have pretty different tastes, as my cravings only go for a week or two and then switch to something else. I've had weeks of wanting nothing but lasagna (and not even good stuff, I mean like buy it in the freezer section of the supermarket lasagna) and now I'm ending a week of wanting daily cheesesteaks (can I just say how repulsed I am by that???). Earlier in the week, it was fried (and it has to be fried!) calamari, another thing I dont eat. So, it's a fun time. But I treasure the cravings, I really do. It's them talking to me. :)

On my brother-in-law's birthday and the anniversary of when he died, our family also celebrates his life with his favorite meal: chicken parm. When he was sick, he didnt really want anything else and my MIL would get up whenever he was hungry, which was sometimes wee morning hours, to make it for him and eat with him. The chemo made him so sick that he couldnt always eat a lot or hold down what he did eat, but when she tells me stories about him and how his eyes lit up when she would start cooking, I know that I would have done the same thing, every day, just for that look and that smile. One day, I will have to scan a pic of Peter and Robert as children and post it. They are two of the most handsome boys (excluding my own "most handsome boys" of course!) I've ever seen, and their love is palatable from the picture...

Well, I'd better go for now. Speaking of my MIL, she is on her way for a visit (and sweetie that she is, she's bringing the kids their much wanted calamari, even though she thinks it is gross too!) and dear "Aunt Sarah" is going to stretch her patience and try to teach me to knit again... If she succeeds, her niece and nephew will get something out of it... Maybe a trapazoid blanket? ;) We shall see...

Day 28: T-10

Wednesday, August 19, 2009

12 comments
A week and a half to our next goal! Even Dr B is counting down with us. He dropped by this morning, all smiles. I was on the HB and TOCO monitors and he seemed just as entranced by the constant pitter patter of heartbeats as I was. We talked a little about Maya turning and my good cervical measurement. He said that he will be thrilled when we cross the 26w mark and then 28w. He also said that, of his high risk patients, 90% of the ones who delivered at 28w and beyond had not only babies that survived but that survived healthy. That was nice to hear. Less than a month to that beautiful place. (Even though, it is only one of many goals!) We joked about me being "in prision" and having a calendar hidden on the wall where I marked off days. It was a good chat. He seems so optimistic, which is really nice to see. I do feel better, even though I'm still scared. Feeling both babies very pubic is nerve wracking. They are so low. I am trying to just tell myself that their lowness is not indicative of labor. That many babies hang out low for months. Bobby and Maya will too. But that is pretty scary. I think, too, because they are so low, I have a lot of fear about "going" to the bathroom. I have no issues, thank goodness, but just the feeling of being there and waiting is scary. (TMI- sorry).

But we are doing well. :) Really. We are.

Peter brought me my notecards that arrived! (Thanks again, Debby, for the giftcard!) I'm going to spend the afternoon writing some good, old fashioned (if not messy!) notes! And a woman from the Parents Advisory Network, which supports families on bedrest and in the NICU, came by with a goody bag. And I mean goody bag. I havent even sorted through everything yet! It was such an unexpected visit and so sweet! She was really kind and gave me her phone number (she did bedrest from 12w+ with 3 pregnancies) and said that, whatever I needed or wanted, she would do her best to bring in. Very nice. They do so much here to try and make bedrest as easy as possible.

Well, lunch is here! Time to move the laptop off my little table!

Day 27: T-11

Tuesday, August 18, 2009

19 comments
Yesterday afternoon, a neonatologist came up and talked to me about the outcomes for babies born 24-28w and boy was that a grim talk. Coming on the pantslegs of Dr B, it was quite the flip side. We discussed lungs being damaged by medical intervention, brain bleeds, heart valves that dont close, blood transfusions, infections, you name it. She didnt pull any punches. Which I appreciated. I've read up on preemies and the issues, so none of it caught me off guard, but it is still very black and white and very gray... No one wants to deliver early but this info just made me feel all the more determined to do whatever I can possibly do (stand on my head???) to please, please, please, make it to 36w. Please. I dont want to think of my babies in the situations she discussed. I dont want to think about having to make the decision to end life support. I know none of us do, and sadly many of us have been there. And it sucks. And I dont want to be there. In that place. She told me that I was doing well and that she hoped she wouldnt see me or my babies for 12w at least, and that even then, it was because she was just double checking they were okay and not because they were ill. You and me both, sister. (And, she also offered to consult if we had any questions and to come back after 28w to discuss the 29w-32w period, either here if I am still admitted or readmitted or via the phone, as well as to talk to Peter via the phone if he had questions.)

In happy news, my mother in law came and she gushed about my baby shower, scheduled for Sept 26 (30w) since it now seems like I will be out of the hospital. Ah... rooms full of people and me in pajamas... How sexy. Sarah is throwing an "unshower" at 28w, which she thought of moving to the hospital (just a small group of mutual buddies) and she's pretty pleased I should be home. Again, can we say sexy PJs? But these are my contemporaries and I dont mind them seeing me at my worst (okay, so I do, but...) Family... Not so sure about that. I might have to have dear sweet hubs find me some better looking loungewear for my rapidly expanding tummy. I dont know if my bedding wear is appropriate for the priests (and yes, MIL is inviting the priests and a slew of folks from church, as well as children, so I want to be "covered" in all the places that count.)

I am legitimately excited. It makes things seem so... real. Like this is a big step. I mean, the happy ending has nothing to do with a baby shower, but... Normal people have showers. I will get to be a "normal pregnant woman", even if for only a little while.

My mom is throwing a post-baby shower, probably in the spring. We are hoping that, assuming the world continues to spin in the right direction, that we will take the kids to TN in March, which is really nice there, even though it is still chilly here. She already has the invitations and everything, so we will just set a date in January or so, and go from there.

And, into today... Well, first off, I know hospital food is supposed to be gross, but they just moved to a new restaraunt style meal thing and it is actually quite good! (Not that I dont miss home cooking but this is better than what I've expected and experienced from meal service). I just ate and I was hungry- can you tell???

Babies stayed on the monitor for an hour today! The nurses got busy and came back much later than expected, but the papooses had cooperated for 55 minutes. I was so proud of them. And I didnt have one single contraction while on my back! Success! But it gets better... I got called for my ultrasound around noon. The tech was waiting when I got there. She did an ab one and we saw both babies. The last 2 days, I have had some back pain, which at first I thought was my back deciding to rebel against bedrest but then I had the distinct feeling of a certain little girl burrowing into my spine. So... my suspicions were confirmed- Maya has turned and is now vertex! So the pitter patter of little feet against my spine and upper uterus can now be attributed to both sets of feet! They looked great and were playing (which meant the tech couldnt get clear shots of them, so no pics).

We waited for about 20 minutes and the MFM doctor didn't arrive, so the tech went to page him. She came back and said that he had been called to an emergency in the OR (which just made my stomach fall) but offered to do the scan anyway. While she cant interupt the results, she said that he would review the images and, if he wanted a live show, they would come back and do another scan at some point. I said that would be fine (after all, I'm already there and I want to see!). She was nice enough to write her notes outloud. :) So, my cervix measured 1.6-1.7 which was wonderful. I even peed before my jaunt to the u/s room, so I was worried it might have shortened because of the movement but nope! And she said that Mr. Big Head (whom I love dearly) was pushing down in such a way that she could barely see the funneling (and couldnt see enough of it to measure!). We got a great image of the cervix, which looked like a rainbow in shape. So, it is closed and tight and everything looked wonderful (to my untrained eyes). I am still reeling from all this news. First the "you might go home" and now the "good cervix". Not to mention that both babies head down is a relief when you are considered a natural birth. She said that it is still possible for them to move but that most of the babies she sees head down by 24w tend to stay that way and that you typically see babies that are older and not head down move into that position. So, we shall see. They still have room to play, so they may decide to go all over the place.

When I came back, I had mail! You guys- your support... There aren't words. Each week, someone I've never met ends up in my hospital room in the form of a card or letter or something. The letters usually begin with "You dont know me..." But I feel like I do. I feel like I know each of you who drops by and reads and says a silent prayer, each of you who comments, each of you who walks the road of an infertile or an orphaned parent... Your cards and letters touch me. We hang them on the wall and I can see them every time I look up. They are what help keep me upbeat and happy. The pictures your children draw: they are on the wall next to the bed. These things... I just dont know how I would survive a bleak room feeling alone. I feel so terribly blessed in ways I cant count. I have IRL friends who email, call, or come by often (and send not only prayers and good thoughts, but bring crafts and laughs and positive vibes (and chocolate- thanks AB!!!!)). I have blog friends who email and send cards and notes and little things to say hi and make the time pass with a smile instead of ever present fear. And my family and friends in TN who always email daily or send letters weekly, just to say hi and check in. I am truly blessed by this outpouring. You guys give me faith in not just the human race, but the human family. And, from today's mail pile, thank you to little LV for her beautiful fractur (it's a PA thing... Google can explain) of our children's names. And to EH for her goody bag (I will start the book as soon as I finish the one I'm on- which will be today- THANK YOU!). And to PJ, who has been a penpal of mine since I moved away from home (and a mentor to me well before that). We've regularly wrote for years but seeing her familiar script always brings me a smile from home.
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So, another good day everyone! Those prayers are working! And we have less than 11 days to our next goal of 26w!!!

Day 26: T-12

Monday, August 17, 2009

20 comments
I've got my handy dandy flip chart that Carrie and her daughter made me next to the bed, and am looking at a beautiful "12" right now. Because 12 isn't just the number to 26w. It is the number to when I might be going HOME!

Dr B came in this morning with a big smile on his face (now, I'm sure some of that smile is the post-vacation relaxation). He said that I was the first patient he was coming to see and that he was over the moon with our progress. He's reviewed my ultrasounds and said that they looked great. That we knew my cervix was going to misbehave but the stitch and bedrest are keeping it at bay. He was pleased with my most recent measurements. He even gave me full potty priviledges! I can use the bathroom 100%! It felt so good to get up and go. It's a small walk but my legs appreciated the stretch too versus just going from bed to one step to the pottychair. So, as we discussed "where do we go from here", he said (and I didnt even bring it up), "I think that we can look at you going home in the coming weeks". He wants us here for at least 2 more weeks. He said that viability and health at 26w is a huge jump from 24w, as it relates to twins, and that 28w is even better. Assuming I am stable for the next 2w and my u/s results continue to show more of the same, he said that he would look at sending me home between 26w-28w, still on bedrest, but with bathroom and shower priv's. He still wouldnt want me going to church every week or making any meals for myself. But we can all live with that! He'd want me back weekly for monitoring, which I expected.

Right now, our primary delivery goal has been shifted from 36w to 32w. He still wants 36w. But he said that his concern isn't really cervical since the stitch hasnt torn at all and hasnt let my cervix change below 1cm. His concern is that my water will break. If PROM occurs, they will not try to stop labor at this point, since the cerclage would need to be removed (for risk of infection) and since I have the steroids. (We didnt discuss a rescue dose in the early 30s at this point, although I'm sure it will come up again.) He said that, since the babies are measuring quite a bit ahead in weight and size, he feels that they may trigger labor around 32w. Which wouldnt be horrible and to try not to worry. That 36w is still our big goal and when the stitch would voluntarily come out, but that if we hit 32w, he will consider that a huge success. And, once we hit 28w, he feels 32w will come quickly. And, even better, once 32w comes, it is a 28d countdown until the perfect result. (So, I'm not the only one counting down!)

I am overwhelmed with the good news. And I needed it, a lot, after last night.

During my monitoring, Peter went to get water, etc. and to prepare for the evening. It was late because of how the night worked out, later than normal, and when he came back, he had this look on his face. I assumed that he was thinking about Sophia or Nick and Alex... But, when the nurse left, he said "I think the couple at the end of the hall lost their baby." I asked what he meant, and he said that, since it was way passed visiting hours (it was almost 11pm) and he saw people with suits going in and out, he was concerned and asked the nurse. She said that they were having a rough time. Obviously, they cant tell you personal info and he wasnt shocked by that. Well, I just broke down and cried. I couldnt stop. Just knowing... Oh God... It just hurt so much. Finally, I was able to breathe and he said that he was going to tell the nurses that, if indeed that was the case, and they needed or wanted to talk to another couple who understood, to pass our personal info along. She said that she would give our information if that was the case and, based on Peter's perception, that is, sadly, indeed the case. When he returned, I was a mess again. I just couldnt control myself. I bawled. He just held me and rocked me, and eventually, I feel asleep, but even now, I cant think about this couple whom I've never met, who are grieving and wondering "why" and feeling alone. This couple whom I am too intimately aquainted with because we've been there. It hurts. So much. Even in my happiness over our recent prognosis, I am in agony over theirs. And I cant even walk down the hall to tell them. I cant hug her and tell her that her baby will live forever in her heart. That one day, she will take a breath and, even though it will hurt forever, she will find a way to live so that her child can live on inside of her. To tell him that it is okay to grieve, that he doesnt have to be strong, that crying with her will help them both because they will both realize they arent alone in this. And that hurts too.

I dont know how I would have handled someone coming to me after. After Nicholas, I was in shock and we were just so focused on saving Sophia that we couldnt grieve the way we needed to. I think I wouldnt have called anyone then. After Sophia, I was lost. We both were. And we grieved our twins together, but still felt alone. Because I couldnt handle the idea of verbal communication with anyone really, the blogosphere saved me. The first blog I found, the blog for whom Maya is being named after, was my salvation. She saved me. Her grief, her longing, her honesty... They were what pulled me through and helped me tell Peter we werent alone. That other people, different people with different circumstances from all over the world, they understood. And then, through her blog, I found others. And others. And others found me. And there was help. I think that, at that point, I would have been receptive to another parent contacting me. After Alexander, I think that we were very much together in our pain and there was the already built support blog system, along with our very dear IRL friends who shared the grief and the joys of our children. I would have been open to talking to them, but I think it would have been more to connect and not as a salvation of any sorts. I already knew we werent alone.

Yesterday afternoon, Sarah brought over Sophia's dinner, homemade with love from the depths of her soul. I treasure this woman. She is a sister to me, in every way except genetics (and we all know how little I think of those!). She brought homemade pierogi, made from her grandmother's church in NY, and they were wonderful. But most of all, even though the food was great, it was that she thought to do it, wanted to do it, volunteered to do it, and that it wasnt odd to her in the least to do it. She was happy when she unpacked the goodies and shared them with us. She sang "happy birthday" with us, as we watched a candle flicker over the brownie that Peter had picked up for Sophia's special dessert. She talked about our daughter (and her two brothers). She still grieves them, too, and I am grateful that she remembers. That she always will. That she loves them, too, and never shys away from bringing them up in conversation or letting their names flow from her lips or telling me "I saw/heard X and thought of Y today." I know she reads this sometimes, and if she catches this post, then I want her to know how much all that means to me. And to Peter too.

Sometimes people can only talk about how great the pregnancy is and they dont mention the children we have. I understand that they dont always fit into whatever conversations we are having. But, both in real life and in the virtual world, we are blessed by people who remember. There are too many to name, but I do think of you and thank each one of you for remembering with us.


Happy 18m birthday, Sophia!

Sunday, August 16, 2009

10 comments
Today, my sweet girl, is 18 months since you were born into this world, although I held you in my womb and my heart for so much longer. You are my firstborn daughter and I love you so very much. It takes my breath away that you have been with us and away from us for this long...

Tonight, your Aunt Sarah is bringing over your birthday meal and your Daddy is getting your special dessert. We all love you so much. I love you so much.

Happy Birthday, Sophia, my sweet baby girl. My forever baby girl.

Day 25: T-13

9 comments
I really thought about making it T-27 instead and just shifting to 28w as the next goal (since it is the bigger of the two), but mentally, I cant... Not yet. And 26w is a big goal. The survival rate of twins born at 24w is 30% (and of that 30%, 70% will have a medical concern or hardship due to their prematuity). At 26%, the survival of both twins is 50% (with a 50% chance of hardship). At 28w, the survival rate is listed as 85% of both twins (with a 15% of hardship) and each day beyond that brings better and better results. So, 28w really is a super place to be. But, 26w is nothing to bat the eyes at either... So, T-13 it is.

We (well, Peter) spent the morning straightening our room, changing linens, etc. It's something he's done since the beginning. The nurses think he is not only a sweetie but, especially on days like today when they are understaffed, he is a gift to them. (It's been a rough day for my favorite weekend day nurse...)

Why do some people just not listen??? The nurses I see all the time are GREAT. Just wonderful. But some of the subs they send from other areas when they are understaffed... They are nice and mean well but they arent used to antepartum. Today, my nurse is being assisted and, while nice, the spare nurse isn't a regular...

For example, yesterday the resident said that the babies needed to be monitored for an hour 3 times a day (non stress test or NST). At 24w, most babies arent reactive (which is the result you are looking for in a NST) so it is pointless. Now, that being said, ours are (yay!) but still, they are small and have room to play, which means a solid hour is a nightmare. It takes 2 just to get 60 fairly consecutive HB tones. Not fun, for the nurses or me. We discussed this with Dr M on rounds and expressed that there is no reason, when the babies are this small and this active, to do an hour 3x day. She agreed. We compromised on 30m twice a day, which is a huge help. So, it took our regular nurse an hour and a half for that 30m because they were just everywhere. They had to strap me in so tight that my belly was sore all day and I thought I was going to vomit all afternoon. I had a breakdown yesterday, the first "I dont know if I can do this" because I was just so frustrated. It passed quickly, but still. I was not looking forward to the evening.

Our evening nurse was the nurse who came after Alex was born and baptized him, so we have a history. She is very sweet and she always comes in even when she is not my nurse to check on us. She asked how I was feeling and I was honest about the earlier nightmare monitoring (even with a nurse I love) and she said, not to worry. She had an idea. So she took out what they call a belly band (which looks like the belly bands you buy almost, sort of like a tight tube top). She helped me slide into it and it fit like a second skin. Then, instantly, she found the heartbeats and the second skin (along with a roll of tape between the monitors and band for a tiny bit of pressure) kept them in place. She slid the TOCO in as well and, even though I was on my back, I only had 2 very mild contractions, only one of which picked up. The 30 minute monitoring took 35 minutes- and that's because of getting them on the monitor and me getting comfy on my back! It was wonderful. Just wonderful. I wanted to cry. I wasnt frustrated or in pain and the babies were happy that stuff wasnt pressing against them and trying to constrict their movement. Because they were free to move, they relaxed. It was great. (And then, this morning, she gave me my steroid shot and I didnt even feel the thing she was so fast. Now, afterwards... but the heat did it's job in 10 minutes. So yay.)

So, this morning... New nurse... And it is the sub. She comes in, does my BP and temp, and all is well... Until the monitoring. Now, I tell her about the belly band and she's cool with that. But let's just say she hasnt used a HB monitor in a while. She squirts the gel on my belly instead of the unit which, as you can assume, meant the units werent picking up the HBs as well. And I was a mess. In my last (quasi) clean clothes before Peter picks up stuff tomorrow night before coming back to the hospital. Yeah. Great. So, she tries and tries for almost 40 minutes and rarely gets a good tone on them. I kept telling her where they were and where they never are (which she insisted on trying anyway- hello? I live with these babies 24h a day, every day... I know where each of them is at any given time even when they are sleeping, and I know for a fact that neither of them has ever, ever been on my sides!!!). So, it was a nightmare and after the clean up I was frustrated and couldnt even pee in spite of a full bladder. She gave up and said that my real nurse would be in to do it later. By the time she came in, I had calmed down a little and asked about the gel on the belly. She said that no, they dont do that, and that I was right. Poor girl... She has to have this "help" all day. (Dont get me wrong; the subbing nurse is really nice, but since I've been here so long and know the other nurses, it is hard to let nice take the cake sometimes.) So, in 5 minutes, both babies have been found and the belly band is doing it's job. Half an hour later, we are done and everyone was happy. I realize that my standard nurses know the babies by now and know where they are, but the babies are active and the standards are the ones that dont go looking for someone who isnt lost. They may move around slightly, but they stay in the one place and the babies come back. If Maya is flipping over, moving isnt going to get her heartbeat; hanging around will. The nurses who take care of us regularly know this. I guess I just expect that everyone will. (I know... Me and my expectations...)

But, overall, it has been a good day... A day of breathing a little easier because we are in the third trimester and the babies have a real chance. Every day is a blessing... A day closer... I love feeling them inside and being pregnant with them (even though pregnancy is nothing like I planned or ever thought it would be and brings with is immense fear and terror). But I wouldnt take it back. Not once. It's the mommytime with them. I do wish for the next 11w5d to go quickly so that I can "know" they have more than a fighting chance. But, as any orphaned parent knows, the womb time is only the beginning. I think of the moms and dads who lost babies full term or through SIDS (or an unexplained post-birth infant stage)... There is no safety in laboring a full term baby for them. They know the side that I dont. They know that a live baby moments before birth or months after birth doesnt gurantee a happy ending. But nothing does. I look at my brother-in-law, who was a happy seven year old, who died of neuroblastoma. I'm sure that once labor and delivery were over, everyone thought things would be great. We just dont know... So everyday is truly a blessing. For all of us. I dont want my pregnancy to end but I also want it to end. I dont wish the days away but I am glad when they go quickly. But it is just another aspect of having had the day. And being so very grateful for that.

And, on a very happy note, please pop over to my friend, Carrie's, blog. She is carrying triplets and today is her 24w milestone!!!