Monday, August 29, 2011

the plan (and then a change to the plan)

Dan and I went to see Dr. P on Friday. Prior to the appt, I needed to get an ultrasound, which turned out to be the most detailed (and painful) u/s I've ever had. We walked in and the asked what time the appt was with Dr. P. When I told her she said "you'll be late." Huh? These appts usually take 15 minutes. Apparently, he had ordered a bio-physical u/s, which I had never heard of. It requires observing each baby do 2 gross motor movements, 1 fine motor movement and have an episode of "practice" breathing. All this, on top of the usual cervical check and fetal growth check.

We had Sophie with us, so Dan left to take her to day care, knowing she would NOT last for an hour, nor would he, lol. I didn't like the tech, so that didn't help, but I was SO extremely uncomfortable. She didn't seem too sympathetic to my cause, talking under her breath about why Dr P didn't have his own tech do this. Lovely. I finally had to almost faint to get her to let me move into another position.

Long story short, babies both looked good, although B did not do the practice breathing while being observed. Dr. P was not worried in the least. In his office, they did an NST scan, where they measure the babies heartbeats and my contractions. That all looked good too!

So, we started talking delivery:) He was much less optimistic about Baby A (still breech) turning than he was two weeks ago. He also mentioned that hours of labor, after this much time on bedrest would really affect my body post delivery. Bottom line: it would be a bitch. I told him my recovery with Sophie was not good at all, and that I didn't feel like myself until 5 weeks post partum. He said a twin c-section would probably leave me feeling the same way.

He confirmed that I am to stop all meds this Sunday. He suggested that that appt be the last appt with him. Basically, he thinks I'll deliver before I had a chance to see him again. I talked him into one more appt, just for my own mental health, and that will be on Spet 7, two days after stopping meds.

I called Dr. S's office to check on c-section date, since no one had called. They didn't have one, so I called back today and was given a date that is equivilant to 38w 1d. I was beyond upset. I found out the reasoning is the Chief of OBGYN at the hospital will not approve a twin c-section before this time. Grrrrrrrr. Honestly, I don't think it will get to that point, but the idea of waiting 28 more days is just more than I can take.

I'm DONE being pregnant. DONE. I.am.miserable. I haven't picked up Sophie in almost 2 months. I can't do anything around the house. Lying in bed just HURTS at this point. My sides ache all night long, b/c they are taking all the pressure since I can't sleep on belly or back. Most of my pants don't fit anymore. I'm hardly ever hungry b/c there is no room, but when I DO eat, I get nasty reflux. I can't sit up straight in the car, I have to lie back gangsta style, lol. My pelvic bone feels like it's going to split in two. I sneezed the other day and I swear my skin was going to tear. I could go on, and on.

And really, I HATE to complain about this. If I were reading this 2 years ago I would be pissed at myself, complaining like this. I worked so hard to get to this point and now all I can do is bitch.

So what did I do? I took a shower and had a good cry. And then I put on my big girl panties (and trust me, pun intended!), and tried to put on a better attitude.

But, I am miserable.

Monday, August 22, 2011

Updates and plans

I meant to post last Tues night, after my appt with Dr. P...but you know how that goes. At that appt, and at today's appt with Dr. S, we started making plans. Not necessarily the plans I want, but plans none the less.
1) Per Dr. P (I'd just really like to call him the Wizard of Oz!!), I will stop the Indocin this Wednesday. We're at the point where it's more of a risk to babies than a benefit.

2) While Wed is my last day of that, it's my first day of oral Turbutaline. This one scares me a bit. So far, I've had it via IV and via sub-q injection. The latter was much more managable; the IV administration left my heart feeling like it was going to jump out of my chest. Dr. P assured me this was normal, and I should have even less side effects with pills than with the sub-q. Let's hope so. I have to check my pulse prior to taking it, and if it's 110 or higher, I have to wait 30 minutes to take it. I will start out on Wed at 3 times a day, and then starting Thursday, I'll be taking it 6 times a day, in conjuction with the Niphedine.

3) Dr. P was really thrilled that I made it to 32 weeks. Apparently this was a big hurdle to accomplish, and I did it. He mentioned some stats that neurologically, at 1, 3, 5 years of age, a 32 weeker looks no different than a 36 weeker. I hate to say it, but once I heard that, I thought "ok, let's just get this show on the road." Thankfully, the docs won't let me be selfish.

4) As of last Tues I was measuring 40 weeks. He told me, SERIOUSLY, that he'd like to see me measure 50 weeks. FIFTY. Really? My stomach is so tight right now it's ridiculous, it seriously feels like a rock. Dr. P says it's my abdominal wall.

5) Baby A is STILL breach, although she's moved from her little ball. Now, both of their heads are in my ribs, and their feet are hanging out below belly button. The u/s tech got a shot of their little heads so close together...looked like they were conspiring already;)

6) Weights were ok last week, but this week took a huge leap. Baby A is 4 pounds 11 oz, and B is 5 pounds 4 oz. Seems impossible there is 10 pounds of baby in there, not to mention the weight of placenta, fluid, etc. No wonder I'm exhausted!!

5) The big news of the appt was that he gave the suggestion/decision that we would schedule induction or c-section for 37 weeks. He confirmed he wouldn't make me go any further:)

I saw Dr. S today who was also extremely pleased with the progress. It was the shortest appt we've had in awhile, lol! She also mentioned scheduling c-section at 37 weeks. No mention of induction. I've known there might be an "induction struggle" since the beginning. Should Baby A turn and be born vaginally, she does not want to risk any issues with Baby B. Further, she doesn't want me to have a double recovery, which I *do* get. But you better bet I'll stand my ground if Baby A does turn.

I'm really trying to come to terms with a c-section, I am, but I'm not happy. I'm not scared, or worried. It's not that. I think women that ask for an elective c-section are no more crazy than I am, wanting a vaginal delivery. I think maybe it's that I know this will be the last time I will be pregnant. This is it, and I wanted to experience labor again. Yes, I realize I'm a masochist, lol:) I wanted the anticipation of not being fully aware of how it will go. I don't want to be told "arrive at 9 am and we'll take you to the OR by 10 am." I don't want to know ahead of time that these babies will be born at 10:15. Plus, I have the irrational and probably unsubstantiated idea that if I have a c-section, it will be harder for the weight to come off, and more importantly, harder to breastfeed. I feel like if I don't have a vaginal delivery, my body won't know that it's time to start producing milk.

Or maybe by now I am just genuinely crazy. Who knows. All I know is if Dan mentions "we're going to have a c-section" one more time, I'm going to slap him. Hard. In the face. First of all, really? They're going to take a knife to HIS abdomen, and then pull out HIS insides to get the babies out? I think not. Secondly, ever since Dr. S put the thought in our mind that it could very well be a c-section, he has grabbed on to that idea and won't let it go. I'm so TIRED of arguing with him about it. He thinks it's because I'm scared. Again, that's not it, but he's never stopped to ask why, and quite honestly (as a man), would most likely not understand anyway. That's why I haven't wasted too much breath on it.

I'm really just glad there is an end in sight. I've wondered all along how long they would let me go, but our conversations never got that far b/c of all the difficulties I've had. It's nice to be able to say "no more than 4 weeks left," but at the same time I'd really like to go into labor on my own. With all the crazy anti-contraction meds i'll be on though, I don't know how that is even possible. Maybe my water will break??

Sunday, August 14, 2011

32 weeks

I honestly can't believe we made it this far!!! Each day, I feel better and better about babies coming early, if indeed that will happen. We almost went to L & D on Friday night. Dr. P's "rule" is 4-6 contrax per hour, for 2 hours in a row=L & D. Well, hour 1 I had 6. Hour 2, I had 2 and then fell asleep. I couild have had more while sleeping, but I woke up feeling ok.

And because a few people have had qusetions about this...the contrax don't necessarily hurt...so it IS possible to have them while sleeping and not be woken. In my case, it is more of a tightening as far as feeling goes, but it will register on the machine as a contrax. That's just the way my body works I guess. The contrax are what causes the cervix to shorten, so I'm more than a bit concerned about my Dr. P appt on Tues.

How far along: 32 weeks

Total weight gain/loss: 30 pounds, and that's if I'm wearing heavy clothes. I've lost weight the past few weeks.

Maternity clothes: Um, duh! I am mostly in size L. I can still do medium tops, but the pants pretty much have to be large.

Stretch marks: Knocking on wood as I type this, but NO. And yes, I still analyize the belly each morning.

Sleep: As good as it can be for now. I have to stay up until 11 to take my meds. Then, I set my alarm for 3 am, and then again for 7 am. Luckily, I can usually fall back to sleep very easily after the 3 am meds.

Best moment last week: Getting sent home from triage:)

Movement: Baby B is a mover and shaker. He is ALL over the place, seriously. Baby A is more "chill". I feel her move, but not nearly as much as her brother.

Food cravings: No major cravings right now. If anything, I'd have to say sweets.

Gender: Boy and Girl!!

Labor Signs: None

Belly Button in or out: Still an innie. How that is possible, I don't know. It is *this* close to popping out.

Other random yuckiness: Being hydrated means I pee all.the.time. Sometimes every 15 minutes or so. Not yucky really, but not fun.

What I miss: Being able to pick up/carry Sophie:(

What I am looking forward to: each day that the babies are inside.

Taken today at 32 weeks:)

Thursday, August 11, 2011

Good follow-up:)

I was so nervous for today's appt. It was scheduled for 11, but at 9:30 they called to tell me that Dr. S wouldn't be in and was it ok to see the nurse practitioner. My immediate response was yes, but then I thought about it and wondered what an NP was going to do for me. So, I called back and asked if Dr. R, the OB that took care of me while Dr. S was on vacation(and I was in in hospital) was available. Turns our, Dr. S WAS able to come in in the afternoon, so they just moved me to her schedule thankfully.

We decided to go out to lunch prior to appt. On the way, I was just SO depressed, miserable. I just felt so defeated, and wondered how I was going to keep on dealing with this. Not a great mood to be in as I headed to the dr.

AFter weighing me, they took me straight back to be monitored for contrax. I was SO freaking nervous. I am officially petrified of that machine, which seems to tell me all the things going on that I can't feel. BUT, after 30 minutes of monitoring things looked good. Not one contrax, and the uterine irritabilty was almost non-existent.

Dr. S came in and told me she was proud of me, so I knew it was good news after that. She asked how the increase in meds were making me feel. I had a feeling it was a loaded question...which it was. My first comment was that the contrax had significantly decreased since the doubling and increase in frequency of Niphedipine had been ordered. Then, I also told her they were making me loopy and very sleepy, and that I was now spending most of my time in bed, whereas a week ago I would at least alternate between bed, couch, chair. Now, I have no motivation to get up. She just smiled and said "yes, it does that too." I think in her mind this increase was also confirmation to her that I really am slowing down.

The Q and A of the appt.
1) Do I need to keep taking meds round the clock (i.e. every four hours)? It was an adamant yes. She went on to say that my body is just one that needs the constant meds. She said usually this only happens in first pregnancies, and the only reason she can think that it's happening to me is because of my small frame. Basically, my body is done, and the great weights of the babies are only validating that thought.

2) Is hospital bedrest inevitable? Her answer was no, but that I should expect a few short stays between now and "the end."

3) What is the goal? I asked this, b/c on Tues she mentioned 36 weeks, but prior to that she talked about 34 week, as did Dr. P. Her response was 36 weeks, and when I brought up the fact that Dr. P had suggested taking me off meds at 34 weeks, she explained that only one of the meds (Indocin) would be stopped at that time. This is the one that tends to reduce amniotic fluid. I will stay on Niphedine, which stops the contrax, until 36 weeks, should I make it that far.

I think there were more questions, but these were the biggies.

So, next appt next Tues with Dr. P. Hoping for a very uneventful 5 days between now and then.

Wednesday, August 10, 2011


Time for a little update.

Dan and I went to OB appt on Tuesday. I felt great, have been doing well, so assumed there would be no major drama. WRONG.

As usual, we started out with an ultrasound, that started really well. Baby A is measuring 3 pounds 14 oz and B is 3 pounds 15 oz. Great weights, and it's great that they are sticking so closely together, weight wise.

Baby A is still breach, and Baby B is currently head down with his head on my left side and feet in my ribs. A's heartrate continues to be in the 130's and B's in the 150's.

Sidenote: I'm really thinking that (at least in utero) A has my personality and B has Dan's. A has been curled in up in her little ball, just chilling for the last several weeks. She moves around a bit, but NOTHING like B, lol. He is ALL over the place, and his butt is is usually sticking out of my belly:) He is MUCH more active than A.

The u/s started going downhill when she checked my cervical length. Last week, it was a 43 and this week it is down to a 26 DESPITE all the meds Im taking. Dr. S checked me and I'm still dilated to 1, so no progress there thankfully. She asked me if I was having contrax and I said no. She had me get on a monitor anyway, which showed one contrax in about 20 minutes, but lots of uterine irritability.

So, she sent us "upstairs" to try some meds to calm down my uterus. We went to triage, where they gave me an IV to help hydrate me, as well as a shot of terbutiline to help relax my ute. After a few hours, it was back to normal so luckily I got to go home.

I have an follow-up with Dr. S tomorrow. I'm not really sure what she's going to do though? No u/s scheduled, and I doubt she will check for dilation again. Maybe another FFN test? I'm pretty clueless, unless it is to "talk" more about bedrest, blah, blah.

I do have several questions for her that I didnt get to ask on Tues, so we'll see I guess. Fingers crossed that I will be sleeping in my own bed tomorrow night!

Tuesday, August 2, 2011

specialist appt today

Today, I had an ultrasound, and then my first out-patient visit with Dr. P. Both Dan and I assumed I'd be admitted. Since meeting Dr. P two weeks ago, we've talked with several of his previous patients and they have ALL had some sort of hospital bedrest, ordered by him.

However, the u/s was great. Babies look good. Baby A is STILL way low and still breech, hanging out in what feels like my hip area. Obviously she can't be that low, but that is what it feels like. Her heartrate was 138. Baby B is ALL over my upper right quadrant, Head in my ribs, butt on my left side and feet up by my lungs. How is that even possible??? Heart rate was about 150.

The GREAT news is that my cervix was measuring 43. So, a slight change from last week, but still very normal. Slight funneling still, but he wasn't worried. Dr. P thinks I'll have no problem making it to 34 weeks.

Things we learned today.
1) Indocin, one of the main meds I'm taking to stop contrax will most likely be stopped at about 34 weeks. At that point, the risk to babies outweighs the benefits, all having to do with lowering the amniotic fluid.

2) 50% of women go into labor in the 34 hours after they stop their meds.

3) Babies born at 35 weeks have a 50% chance of going home with parents.

So, the important topic for our next visit, which will be at 32w2days is when to stop the meds. As of today, he thinks all can be stopped at 34 weeks and we'll see what happens.

The important topic for my next visit with OB is delivery method, and if my OB is comfortable attempting a vaginal delivery if Baby B is breech at the time of delivery. Obviously, if Baby A is breach at delivery time we HAVE to do a C Section. I'm not thrilled with this at all, and just hope there is enough time for her to get in the right position. Dr. P was NOT a proponent of Baby A vaginal and Baby B c-section. I said "yeah, that seems like a double whammy as far as recovery" and he said "it's much more than a double whammy" but didn't really expand, and I was not ready to have that conversation.

So, here I am at 30w2d, measuring 38 weeks (yikes). I've lost about 4 pounds, which I'm assuming is probably just lost muscle from the bedrest. STILL no stretch marks (fingers crossed)! I can lighten up the bedrest a bit, but he said a trip to Target was "too ambitious":(

hospitalized (Sophie, not me)...

We have an official diagnosis of asthma, for Sophie:(

Friday late morning she developed a cough and a runny nose. Runny is actually an understatement. I could not keep it wiped, and when she sneezed, well it was everywhere. I assumed she was getting sick. Makes sense, right?

It got worse as the day progressed, and Fri night was torture trying to get her to sleep. In the back of my mind, I was thinking about the night before her first hospital admission, and how I'd stayed up with her all night. It did occur to me this could be another episode of "whatever that was" but because there was SO much congestion in her nose, I ruled it out. She was coughing, but not much.

Saturday morning we woke up around 8 (Sophie in bed with us), and discovered that she has started the belly breathing and had some retrations in her neck area. Dan made the call to give her Albuteral, but we couldn't find her Asthma Action Plan they had given us when we were discharged the first time. I assumed it was in a box that we had yet unpacked, just a single piece of paper. Dan dug and dug and found it, thankfully.

At that point, she was somewhere in the middle of the yellow and red zones. According to that plan, we were able to give her 4 puffs of Albuteral in an hour. So we gave her a 2nd dose, and then waited 30 minutes. No improvement (but no worse), so we gave her a 3rd and 4th dose. We both decided on the ER at pretty much the same time, but neither of us really felt it was all that urgent. She was lethargic yes, but her breathing wasn't horrible. Honestly, I don't know what the hell we were waiting on...she needed to go.

I got in the shower, knowing that an ER trip would most likely last all day. I'm uncomfortable enough as it is, so at least wanted to be clean, lol. As soon as I turned the water off, Dan is yelling "we need to go to the ER NOW." I walked into our bedroom, where she is lying on the bed, breathing very clearly worse than when I got in the shower.

Long story short...They did a 5 minute Albuteral treatment (via nebulizer) as soon as we got there. It helped, but her respirations were still high and it was clear she was having trouble breathing. They did a chest X ray to rule out pneumonia (negative) and did the nasal swab to test for viruses (normal). She got a dose of prednisone also. Finally, the did a 20 minute Albuteral treatment, and decided to admit her. The treatment improved things, but she was still having trouble. And, the ER docs were definately playing it safe after her quick downward spiral last time, that landed her in the PICU.

She got started on Albuteral treatments every 2 hours, then weaned to every 3, and then every 4. Their protocol is that she has to respond well to two every 4 hour treatments to be a candidate for discharge. Luckily, she got there quite quickly, and we were sent home Sunday afternoon.

Our pedi's partner came to visit on Sunday morning. I asked if it was asthma, and she said yes. She said it's almost impossible to dx asthma after one occurance, but now that we've had two, and she presented very similarly both times (and responded to the same treatment both times), then yes it was asthma. She asked if there'd been any triggers lately and neither of us could think of any. That's the scary part.

We were sent home with 3 days of prednisone (let me tell you how fun THAT is!), albuteral via inhaler every 4 hours for 7 days, and she's back on the Flovent that she had previously been weaned from, 2 puffs in the AM and PM.

Luckily, despite all the stress...I was able to stay with her, and got almost complete bedrest while we were there.