Wednesday, December 19, 2012

Week 32: A Milestone in Carrying a Multiples Pregnancy



          Week 32 has been tumultuous at best. I have been continuing to have regular contractions, low back ache, menstrual like cramps, and pelvic pressure/pain. On Tuesday I saw my OB’s Nurse Practitioner and mentioned all of these things to her (again). This woman is not unkind by any means, but she makes me feel incredibly rushed. She did not seem to think much about my symptoms and tried to dismiss me. When she finally remembered to take my blood pressure (her nurse was out sick) she found that it was high but told me to just have my perinatologist look into the next day. I had to ask her to check my cervix because she wasn’t volunteering and I was worried because of all the contractions I had been having. So she manually checked it, they can’t measure it there, and found that it was closed but starting to soften (and I am not 100% sure what that means, effacement maybe?)
          So on Wednesday I did have an appointment with my perinatologist for my now once weekly biophysical profile of each baby. The appointment went great; I actually got a great sonographer this time! Their heartbeats, lungs, stomachs, brains, kidneys, amniotic fluid, cord blood flow, etc. all seem to be in perfect condition! And I love to see their little diaphragms practice breathing! When she used the wand to check my cervical length we even got to see our little girls head and it was covered in hair! I couldn’t believe you could see the hair! The details of this appointment are that the babies look great! My cervical length is still 2.8cm, down from 4.3cm, but they are okay with this length until I get to 2.5cm. They never say if I am dilated or effaced, so I assume that I am not. 
Twin B


          My blood pressure was normal at this appointment, however, when I told this doctor about my headaches, upper abdominal pain, and high blood work Tuesday, he was concerned. He told me that if I still felt this pain on Thursday, I had to go in for a pre-eclampsia work up. Thursday morning I was still in pain so I had a pharmacist take my BP, and it was still high. She sent me home with a cuff to check it myself and throughout the day it was still high. I finally gave in and called the doctor and they insisted that I go to the hospital where I will deliver to get pre-eclampsia blood work done, which is an hour away. I had to cancel our weekly Thursday night Bible study and I waited for my husband who was 2 hours away at a staff conference. So he drove 2 hours to the conference, 2 hours back, and then an hour to and from the hospital. We got to the hospital and they hooked me up for monitoring, took my blood, took a urine sample, and repeatedly checked my blood pressure. After 2 hours, my blood pressure was normal every time and we got the lab results back. My only abnormal results were that my blood platelet levels had dropped to 180 and my uric acid level was elevated to 5.8 (which are indicative of low kidney function/failure).
          The nurse said that pre-eclampsia causes these results but that I was not being diagnosed with pre-eclampsia because my blood pressure was remaining normal. We agreed on pre pre-eclampsia. When she called my doctor with my results the decision was made to give me the intramuscular steroid shot, betamethasone, to help speed up the baby’s lung development in case they are born early due to these lab results. High uric acid levels and low platelets can lead them to induce labor early because of danger to mother and babies. This shot is a 2 part, so I was instructed to come back in 24hours for the second shot and repeat blood work to see if my labs worsened. I admit I was a little excited because they only give the steroid shot when they think labor is impending; all I could think was “I may deliver babies tomorrow!”
          Did I mention that my husband in in school for his MBA and this particular Thursday was the day before his last day of class this semester so he had work to turn in that night? Thankfully we made it home by 9pm-ish that night. This brings me to the next day, Friday. I am not sure there could have been a busier day! At 9 am my husband took our 2 dogs to the vet to update their shots; easy peasy right? Nope. Our smallest dog had a severe allergic reaction to the distemperment shot and it turned into an emergency situation and they had to keep her there (thank goodness I wasn’t there, I may have gone into labor, I love that little dog so much!) So when he got home from that appointment we had to take my car into the dealership for a quick service (a fix for something they had already supposedly fixed earlier in the week); this appointment was an hour away of course. We had another appointment that afternoon that we had to rush to after this service visit. Well, after waiting in the customer lounge for an hour, the service manager finally told us to take a dealer car to our next appointment and then come back. They gave us this really old ford Taurus that almost stalled at a red light and made horrible sounds! I didn’t think it would get us anywhere!!! While in route to the appointment the dealer called us and said the problem was with our airbag (in a 2012 car) and that they couldn’t fix it today so just take the Taurus home. That was not an option. 1) It was a death trap, and 2) our car seats and stroller couldn’t fit into it. My husband informed them of my pending labor and the need for a larger car; they said they would have to look into it.
          So we pull into the parking lot of our next appointment 10 minutes early, only to receive an email (thank goodness for smartphones) telling us that they were not ready for us and could not see us. WHAT? Who cancels an appointment 10 minutes before its start time? Do they think we live down the road?  My husband told them that if they couldn’t see us by 3:00 that day then we couldn’t see them at all; they agreed. So we drove back to the dealership but of course they didn’t have ONE vehicle that would fit our stuff so they rented us a ford escape from Enterprise. Then we had to wait for Enterprise to pick us up, drive us back to Enterprise, fill out all the paperwork, find out the gas tank is empty and have to get it filled, and then drive back to the dealership to load all of our baby gear into this rental car.
 Are you starting to get a picture of how this day is going?
          I think that it is important to interject here that Thursday morning the orthodontist put “chains” on my teeth to close the gaps my newly straightening teeth were causing. I am pretty sure they used small bike chain! So this meant that from that appointment on I was/am in total pain from the top of my head down to my shoulders. These chains make me feel like I have the flu. I recently read a few articles that said Tylenol leads to increased asthma in children if taken during pregnancy and I have taken my fair share with these braces, so I decided to just suck it up and not take anything for pain because I don’t want to harm my babies.
          So back to the scene, we have now been out and about for 4 hours; I am in excruciating pain, starving because I can’t chew anything, exhausted and swollen. Remember, I am supposed to be on bed rest. After the ordeal at the dealership is finished we make it to our now 3pm appointment, to which the other party is still running late. We finish that appointment only to have to drive another hour to another state for a 4:30pm appointment. (I am very thankful that our 3:00 appointment had snacks in their office, I may have started hallucinating if not!) We made it to our 4:30 a little late and that one took 2 hours, so of course food was the only thing on my mind. However, we still had to drive another 1.5 hours to another state for my repeat lab work and 2nd shot, oh yeah, and we had to stop at home to let our dog out (the one who didn’t get kept at the vet. P.S the vet called while we were on the road and told us to come pick up our dog…yeah, that wasn’t going to happen.)
          We left that appointment, grabbed a quick meal that I could chew, and took off for our next appointment. Remember that this is Friday, my husband’s last day of his current school semester and he had work due by midnight. This meant that he had to grab our laptop from home so that he could complete his school work at the hospital because we wouldn’t get back home until 11:30pm, with his work due at midnight. Phew! We arrived at the hospital around 8:30pm and they hooked me up the same as before and ran all the same tests. My blood pressure was still normal, my platelet levels were the same ( I think) but my uric acid levels had climbed higher from 5.8 to 6.1 in just 24 hours; how much more would they rise over a weekend? They gave me my 2nd steroid shot and instructed me to follow up with my OB Monday. I have an appointment scheduled for Tuesday at their office that is closer, and part of me wonders what good it would do to move my appointment up by one day. On the other hand, if my uric acid levels rose that much in 24 hours, how much more could it rise over 3 days? I guess I will call Monday and see what my OB’s office says.
          So no babies were delivered that night, I was sent home on bed rest and diagnosed with “symptoms of pre-term labor and pre-eclampsia.” My husband finished his school work and submitted it from the hospital room, and we were out of there by 10:30pm. We finally arrived home around 11:30pm and crashed…until the next morning when he had to run out and pick up our poor little dog from the vet. And so concludes the longest day in the history of time! We were out running the gamut for 12.5 hours. At the end of the day my feet and legs looked like an elephant’s! It was such a brutal, long day. So here I am this weekend, trying to rest and recuperate and get my feet to stop looking like Barney Rubble’s!
          I am thrilled that I made it past 32 weeks carrying twins. I read a lot of women’s stories about giving birth around 32 weeks so I wouldn’t have been surprised if I had gone into labor. I am now at the beginning of my 33 week, and my guess is that I will give birth sometime in my 34-34 ½ week. 34 ½ weeks would give us Christmas babies! My OB would like me to hit 35 weeks and I agree, that would mean New Year’s Eve babies : ) 
          Oh and P.S. at this past week’s appointment Baby A had returned to a head down position! Yay! I am praying that she stays in this position so that we can attempt a vaginal birth. So my prayers are that Baby A will stay in this position, and that in the end run our birth scenario will be whatever is best for mine and the babies health.

Friday, December 7, 2012

Week 31: Yep, I am Carrying Adopted Embryos



I guess most of the medical field has decided that being pregnant with adopted frozen embryos should be considered IVF. While I guess that technically the process of transferring frozen adopted embryos into my womb meets the criteria of IVF, it just doesn’t sit right with me. When we see rotating doctors and sonographers the first thing they say to us is, “So, you guys used IVF?” Why does this bother me? Perhaps it is because in my head I don’t think the definitions line up, or perhaps it is simply that I think our journey and the process of embryo adoption is so much more special and rare that simply taking my eggs and my husband’s sperm and implanting them; (I mean no offense to any of you who may have used IVF) it is as if the term IVF minimizes what we have gone through because they through the term around so frivolously, as if it is no big deal.
          Most of the time I then feel the need to explain to the medical professional at hand exactly what we did and what embryo adoption is. Even then, many of them cannot grasp what I am saying; they think we used a frozen donor egg, or something of the like. This tells me that awareness about the option of embryo adoption needs to be shouted from the rooftops to the general masses, but also to the medical world. If doctors don’t even know about embryo adoption, how can we expect the general population to?
          Okay, so enough of that rant! It dawned on me the other day that I am walking around 31 weeks pregnant with the genetic material of another couple; and when I thought this I was once again floored by the magnificence of our God and this miracle, and that I was being allowed to honor of carrying these babies. You would think that by now I would be used to this miracle…but some days it catches me by surprise. Like on days when I feel a really strong kick or a lot of activity; I am reminded that the life within me was not supposed to be according to doctors. Every moment of discomfort due to pregnancy was not supposed to be, yet here I am, waddling around with strange pains, little sleep, and a huge belly…all which I am grateful for. So yeah, sometimes I just stop in my tracks and think, “yep, I’m carrying adopted frozen embryos. What a miracle.”
          So at 31 weeks my fundal height is measuring in at 38 weeks, which is why I am having all these contractions. My uterus is saying, nay, screaming, “I’m done! You are full term; deliver these babies.” I am politely trying to convince my uterus that although it seems that way, the reality is that I need at least 4 ½ more weeks of work out of her. We just had the babies measured yesterday and Baby A (girl) is a petite 3lbs 4 oz, and Baby B (boy) is a whopping 3lbs 10oz. This means that there is almost 7 pounds of baby in my uterus, which is also signaling my body that it is time to deliver. I mean, a 7 pound baby is a pretty decent size, and they are only going to keep growing! My OB would like me to make it to 38 weeks but he feels that by 35 weeks they probably wouldn’t have to spend much time in the hospital. Everyone thinks their weight gain is good, although Baby A is a little small, and that makes me hopeful because I hope that by 32 ½ or 33 weeks they are both 4 pounds or more.

Elli will not let us see her beautiful face anymore, this was the best "profile" shot of the whole visit.

          Baby girls heart rate has dropped into the 130’s which they say is normal and Baby boys heart rate is at 168; big difference I thought but they say it is normal. Everything else with them looks good; size, heart, lung functioning, amniotic fluid, etc. *Warning, small rant ahead* At this latest perinatologist appointment we had a sonographer that we have never had before and she was rushing and talking the whole time about nonsense and we really didn’t get to see much. When it came time to do my cervical exam she had to measure 3 times and got 3 different numbers each time. Normally, the examiner asks me to bear down at the end to get a cervical length when my cervix is “under pressure” however; she did not ask me to do this. So I asked her if she wanted me to bear down for a measurement and she said no. Okay, so maybe it was unnecessary?
 The first measurements were in the 30’s and the last measurement was 28mm (they worry if you are 25mm or less). SO THEN, the doctor comes in and says everything looks fine because my cervical length is 33mm (last week it was 43mm) so although it has shortened it is still okay. I had to interrupt him and mention that my last measurement was 28mm, not 33mm and he said, “oh she didn’t note that.” Grrr! Okay, as if that wasn’t bad enough, I asked him for the report of that visit and it stated that my cervical length “under stress” was 28mm. Now remember, he said the tech didn’t tell him that number AND the tech never did an “under stress” measurement. So what the heck? That is just frustrating. *End of rant*
          On Tuesday night, the night before this exam, I had 12 contractions in an hour and 20 minutes. That is a lot. I have a feeling that that high number is what shortened my cervix from 43mm to 28mm(or 33mm depending on who you ask, ha-ha ), thus I really am trying to rest. On top of the contractions I have been having a lot of back pain and menstrual like cramps. Yesterday night and today I have been feeling a sense of pressure low in my abdomen and when I have contractions I feel a need to bear down, (TMI, as in a bowel movement but I don’t actually need to go). Thankfully I see my OB Tuesday and my Peri Wednesday so if something is going on they should see it, thus I will not spend my weekend worrying!
          We are currently rushing around, trying to prepare everything we can for the babies just in case they come, say…tomorrow! We just never know and we don’t want to be caught with a million things to still do. And good heavens, I have never done so much laundry in my life! I felt the need to wash and or/wipe down everything for the babies and I still am not done. So wish us luck as we try to finish up the nursery this weekend and figure out what to pack for the hospital!