Well, this weeks update is...

...no progress!   And in fact, things seem to be moving backwards.  WTF?!? The doctor of the week (we see many since its a large perinatal specialist group) did a check and I appear to be less dilated and effaced, the cervix is posterior (far back) and baby A is "high".   As opposed to "right there" last week.  Not sure how much of this is due to different doctors interpretations, or if things have really changed, but I think its possible that once she moved back up everything closed back up again.  That would explain the considerable decrease in contractions and feelings of labor.

Ah well.  This really is good news, though of course we are anxious to meet them.  I will be 36 weeks tomorrow, which is the average delivery time for twins, but they would still be premature and could easily have feeding issues and NICU time for that.  Another week or two would significantly increase the chance that breastfeeding will go successfully, I have to keep reminding myself.  And hoo, boy, we can use all the good mojo we can get in that realm.

Meanwhile, I am trying to get off my butt and move around a little more, both to get back some of my strength and t o encourage the babies to "drop".  Supposedly lying reclined (as I have been doing, a whole lot) can encourage the  babies to be 'sunny side up" (facing my stomach, not my back) which leads to extremely challenging "back labor".  I think I may have had some of that with Emma, in fact, which might have been why things got beyond my coping abilities then.  But when you have a stomach the size of a beach ball, one is rather limited to the positions one can hang out in for long, so we'll see....

At yesterdays appointment we had the usual non-stress test, and the babies heartbeats were good and responsive.  No more ultrasounds scheduled for the rest of the pregnancy!  Weird, after having them every 2 weeks since 16 weeks!  I didn't ask why but have a feeling its because a)they've been looking so good all along, and b)the weight estimates become less and less accurate near the end.  I know tons of folks who've had estimates up to 2 pounds more or less than what their babies came out as, so you really really don't want to base any birth decisions on those estimates (which is another good reason not to think these babies are "ready", since they could be 4lbs something instead of 6 lbs something, and that would mean a lot more trouble for them).  But, in the same vein, that means, especially by the end, they could both be 9 lbs something, OMG.  My doctor said this is not a problem, though they would watch me carefully after delivery for bleeding issues due to the uterus being so distended. 

Our specific doctors are pretty adament about inducing at 38 weeks (2 weeks from now), to avoid risks of stillbirth that have been shown to increase after that time.  I know a lot of natural leaning folks adamently disagree with this, but I will take the induction, thanks (even knowing 50% or so of inductions end in a C-section).  Hopefully we won't get to that  point -- if we get to 37 weeks I might try acupuncture or some of the other things we tried last time.   Seems funny to be thinking about all this considering all that was happening a few weeks ago! 

This is pretty inspiring.....

No babies yet!  There have been many times over the past few days where I was pretty sure they were coming soon, and then, alas, nothing.  I have been having periods of lots of somewhat painful and regular contractions, then they die down and just come every once in a while (still 4 or so an hour, but they need to be 6+ to be considered anything, really).  They feel different and I think they must be doing something, just not enough, yet.

Meanwhile, I feel HUUUUUUGE.  I don't want to complain, as I know its best to get as far along as we can here (currently 35 weeks 2 days) but AHHHHH (see, I am going to anyway)!  My stomach is stretched so far, the skin hurts constantly where the stretchmarks are continually growing, yet its also basically numb, too.  I have zero clothes that will even cover my stomach, nada, nothing.  Even though I am off bedrest, I can't really do much because my belly is just too huge, and hurts because it hangs down with the wieght.  I can't even sit upright in a chair, because there is no room for the belly!  Still super itchy due to what I think is a PUPPPS rash -- I just CANNOT stop scratching even though I know it makes it worse.  It has spread up my back and on my arms.  Boo. 

At night, I can sleep for about an hour at a time without having to use the bathroom, which is fine, since I am at least getting some sleep!  But in fabulous news Emma has slept through the night TWO NIGHTS IN A ROW!!!!  This is a major development that I really hope sticks (but won't count on it, as its pretty common for all sorts of regressions when new babies come on the scene).  

Next appointment is Weds (or Thursday? I forget) and I have to admit we are hoping not to make it that far.  Though its probably good if we did, I know, I know.....

So, the ramping up of contractions was enough to get us to finally pack the hospital bag (last night) and write up a birth plan (this morning).  Today, we had three appointments:

ultrasound:  all looked great.  baby A (lefty) estimated at 6lbs 2oz, baby B (righty) at 6lbs 7oz.  Both head down, normal amounts of fluid, good blood flow in the cords, etc.  

Non-stress test -- both babies heartrates were reacting well, and they were picking up my contractions that ranged from every 4-8 min or so.  Lefty was so low it was really hard to get her heartbeat, and then she was not moving/reacting so the nurse had to jab at her a little and buzz her with a noise machine.  Good times. 

Dr. Appointment:  She checked my cervix and it was 3 cm dilated, 75% effaced, and very soft.  She felt the head of Lefty right there, as well.  She gave us the okay to stop the meds as of today or tomorrow, and gave us a 50/50 chance of making it to next week (I am guessing it won't be that long, but who knows, I did walk around at 3-4 cm for 2 or so weeks last time).  

As of Saturday, the babies will be 35 weeks.  The doctor said that at this point, the meds won't do much to stop labor anyway, which is why we are stopping them.  While it would be ideal, perhaps, to have them stay in a bit longer, the doctors all seem to think they will do pretty well once they are out.  We are getting excited to meet them!  Lonnie actually assembled the crib today, so they will now have a place to sleep once they are home (assuming they will actually sleep in it, unlike Emma). 

Haven't gotten to that birth plan, yet.
No hospital bag packed (though I at least wrote out a list for it, does that count?)
Haven't settled on names, at all (possibly making progress, however)

A fair bit more contractions and crampiness, though, hmmm....

Procrastination, much?  Or second-time-around laziness? 
Lots of tests & appointments scheduled for tomorrow, in any case.  So we'll see what turns up...

Still here, no babies yet!  Woot! 

Had an appointment today that included a non stress test to check out the babies heart rates and my contractions, and all looked well.  They picked up a couple of contractions (which I feel throughout the day) but they are not frequent enough to be of concern (I get them a lot more, though, if I am up and moving around).  Still have the "irritable uterus" (well, duh, there are two BIG babies crammed in there, I would be a bit irritable too) but that's not too worrisome at this point, either. 

Also had an appointment with the doctor and she did a check and all seems fine on the cervix front.  No more progressing, which is what we want.  I asked about how long I have to stay on the meds I'm on, since they affect my blood pressure (lowering it when its not high to begin with) and therefore make me really really tired when I stand up and walk around (not that I am doing lots of that anyway) and she said somewhere in the 34-35 week range.  Same with easing up on the bedrest. 

I will be 34 weeks this coming Saturday, so I think we will be attempting to lay low for another week and a half and if we are still here then we will stop the current efforts and see what happens.  It could still be awhile after that, or it could be right away, we don't really know.  I'd love to be off the meds for a bit before labor actually happens so that I feel stronger and have more stamina.  I get out of breath just walking to the bathroom now, and I can't imagine going through labor the way I want feeling how I do now!

Oh, sadly I had a nice long post that I spent half of yesterday writing, but (stupidly!) forgot to save and then had a mishap with the laptop touchpad (oh, how many times a day I curse thee, oversensitive laptop touchpad).

But anyway, here is version 2.0.  

1) House:  Thanks to our great friends and family, we are moved!  We had lots of help last Saturday, with packing, moving, unpacking, cleaning, and now we are feeling pretty settled.  Still lots to do (including unloading the Pod) but nothing that is critical.  We LOVE the new house and it is working really well for us.  Hooray!

 
2) Baby Drama:  Tuesday and Wednesday after the move brought a bit of an adventure as well.  I started getting contractions (no more painful than the usual ones, but much more frequent) that just were not going away with the normal treatment (lying down, chilling out, hydrating, etc).  I was also suddenly feeling nauseaus a la the first tri and really tired.  Eventually I called the after hours nurse hotline and was told to try Ibuprofin, which relaxes the uterus.  That seemed to work overnight, but it was all back again Weds AM.

I then called in to the clinic and was offered to either wait until my Thurs appt, or come in early.  I went in that morning, and they did some monitoring and checked my cervix.  I think they were pretty surprised, due to my past history, to find I was 50% effaced, and 2 cm dilated!  I was not, really.  They immediately brought me more Ibuprofin, then wheeled me over to the antepartum unit in the hospital (a wing dedicated to folks with preterm issues) and checked me in. 

They then started me on stronger meds (a high blood pressure med, actually) and monitored me throughout the day.  It took awhile, but finally the ute calmed down and the contractions mostly went away.  Babies were doing fine throughout this -- clearly they are fine and its my body trying to press eject a bit early.  After a day and a half of monitoring, I was released home, on full bedrest.  Whee!

We also had an ultrasound in the hospital, and both babies are estimated at 5 pounds each!  This is fantastic for two reasons -- first, that they are measuring the same, and have even decreased the small weight gap that they had a few weeks ago, and second, that they are so big already!  Thats 10 pounds of baby in there, oof!   

So all in all, things could be much worse.  At 33 weeks today, and 5 pounds each, the babies should be in pretty good shape if they did come soonish.  However, 34 or 36 weeks would be even better (38ish is considered full term for singletons and I went to 41 with Emma, but twins most often come earlier), and with each day/week, the risk of preemie problems goes down.  So, for now we lay low (well, I do) and try to keep them cooking a bit longer.  And maybe try to tie up any loose ends around here to make sure we are ready!  

Through all of this, Emma has been a trooper, first dealing with her stomach bug (which she finally kicked mid week) and then with a lot of changes with the new house, and mama being gone.  Luckily, Grandma Waitt was still in town when I was checked in to the hospital, so she stayed longer and will be back again next week.  Whew!  Not sure how we would manage without her!   

We'll keep you posted!  I guess we are officially on baby(ies?) watch now, and it could be any time.  Eeeps!

Yesterday was the 20 week mark!  Which is generally the halfway point, though for us we are perhaps a bit into the second half with probable early deliveries and all.  Eeeps!  Probably something like 15 weeks to go, OMG!  My constant thought, which I think is somewhat normal for a rapidly getting more pregnant person is where the heck are we going to be living?  Its kind of hard to imagine it all when you don't have a background on which to set your imaginings.  

On Thursday we had another ultrasound and doctors appointment.  We had our now Very Favorite Tech for the u/s, and she was so great at reassuring us that everything looks fab. We are on a two week schedule these days, with every other appointment being a shorter fluid check (measuring the fluid levels in each of the girls sacs, and a few other general measurements and anatomy checks) or a longer anatomy scan (and hour and a half of measuring every organ/limb possible, it seems).  This week we was the shorter one, and the fluid levels were both within normal.  With each good ultrasound we get a little less worried.  

When we met with the doctor after that she confirmed what I had read somewhere, too -- that having carried a baby to term (and then some) previously drops me into the lowest risk catagory for preterm labor with twins.    I don't think that takes into account an early delivery if something like twin to twin transfusion syndrome, or some other health issue affecting the babies appears, but it does mean that the risk of my body pressing the eject button too early (often an issue with twins) is less.  Hooray!

I am sorry to have left you hanging without updating about our last two appointments! Times have been busy!  

Last week we had another ultrasound appointment, mostly to look at the fluid levels in the sacs, and all looked good.  Both twins had sac sizes within the range of normal (as it was the week before) but there was still a discrepancy between the two in terms of how much fluid was measured (which is the reason for worry, since with TTTS the discrepancies become more and more noticable). 

Yesterday, we had another long anatomy scan ultrasound, where they measured all sorts of body parts and organs and such, tracked blood flow and looked at all the chambers and valves in the heart, etc.  Everything looked great, they are both measuring on track (18 weeks) and very similar to each other.  The fluid levels were still within normal and slightly less different, too.  Whew!  This one really made us feel good.  

I am feeling better, too --  today in particular I felt like I had so much more energy and felt less out of breath and achy and such.  What a relief!  I am not sure if this is because it was just a quiet day inside, because I have had two good nights of sleep in a row, because we are finally weaned (!! -- more on this soon!) or because I am just finally getting past the tired stage for a bit here.....probably a combo of everything.   I'll take it! 

And, um, I am starting to look Very Pregnant.  Like way more than 18 weeks.  Will try to get some photos up soon (that would require taking them, however....)

So, first off....

We are having girls!!!  OMG!  So we will have three girls within two years of each other.  Eeeeps! 

The other good news is that both babies looked good, had good heartbeats and all the organs and various limbs and seemed to be there, and in working order.  They did what was equivalent to the 20 week anatomy scan, so lots of time with each baby getting pictures and measurements, which means we got to seem them both for quite awhile.  The left twin was moving around a ton, which was really neat.   My cervix also looked great and was long and closed.  The ultrasound tech who did the procedure seemed really experienced and was very positive about everything. 

However.

The  not so great news is that they are starting to see early signs of possible twin to twin transfusion syndrome, or TTTS.  Icko.  This can be bad, bad bad.  This is a vascular issue having to do with the shared placenta, where one twin gets more blood than the other, leading to unequal growth.   I guess at the nuchal scan (measuring of the neck folds -- a common screening ultrasound)  a few weeks ago the two babies had a discrepancy that should not be there since they are identical, and the one with a smaller measurement (right twin) also appeared to be slightly less amniotic fluid yesterday.  This is a key indicator that things can be going wrong, so they want to keep a close eye on that twins fluid levels and size, and to make sure her bladder continues to be visible (a sign that she is not getting dehydrated). 

So for the time being (and perhaps for the rest of the pregnancy?) we will be having weekly ultrasounds to keep an eye on this.  The doctor tried to tell us not to worry at this point (ha ha), and that in approximately half of the cases he's seen (though he was careful not to say any actual stats) this resolves on its own and is fine.  But, how can you not worry when it is bad enough to need weekly ultrasounds starting at 16 weeks!!!  And half of the time, it does become a problem!   

I have been following this blog, of a couple here in Seattle who also had identical twins with TTTS.  Their story is, I have to say, very scary and overwhelming to me right now.  I wish them the very very best, and hope that their babies get stronger by the day.  And I know that what happened to them may not happen to us (nor is their story a worst case scenario -- their babies have made it thus far and are doing well, considering all that they are facing).  But, um, yes, very scary.   Hopefully the ultrasounds in the next few weeks will give us good news! 

Okay, okay, I have been meaning to post more for ages.  Sorry! 

This Tuesday we had our first appointment with our new doctors, along with the rescheduled NT scan ultrasound (at a separate office).  All looked good in the ultrasound!  Both babies were doing well, with good heartbeats, and all the appropriate arms and legs and such.  The doctor mentioned how "thin" the membrane between the twins are, which freaks me out a bit (I think she said it means there is a greater chance of one stealing from the other, though I forgot to ask our main doctor about it at our later appointment).

After a bit of research, we decided to go to the big hospital that seems most equipped for multiple births and possible preemie issues (the same one that Emma was born at).  There are things I don't like about that hospital (having to do with medicalizing birth and non-necessary procedures post birth), but in the end my concerns for having the best care if we have problems trump those smaller issues.  

The doctor practice we are going to are Perinatal specialists, so high risk pregnancy doctors.  Definitely a far cry from the midwife experience I was hoping for, though I did get quite a few recommendations for them, even from folks in the birth community that generally lean more "crunchy".  The theory that I have heard is that because these folks are the experts in high risk situations, they tend to jump to unnecessary interventions less often than a regular OB might.  

In any case, we met one of the docs for a "consultation" Tuesday, and had a good experience.   He was good about bringing up all the added risks we have without freaking us out too much, and was pretty funny taboot.  He was reassuring about my concerns about my low weight gain (I have been reading a rather alarmist book about how important early weight gain is in multiple pregnancies -- he called it the "how to scare the crap out of people pregnant with multiples book" - ha!).  And, he was cool with the fact that Emma is still in the process of weaning (more on that later).   We have another appointment next week, a HUGE 4 plus hour one later in later December (this includes a 2 hour (!) ultrasound), and then one every two weeks here on out.  Egads, I guess we will be getting pretty familiar with the place!

So, other than that, the big news in my world is that I finally  got my hands on some Zofran, a harder core prescription anti-nausea med that is helping in that arena quite a bit.  Last Tues, the day before we were headed down to my parents in Vancouver for Thanksgiving, I was really  at rock bottom and feeling like  crawling into a hole for good.  Seriously, bad times!  It is just so hard to be too sick to get what needs to be done done (like making lunch, or picking up the  meds that might make you feel better, or getting the family packed for the trip).  I think some of that had to do with being pretty  anemic, too, since I couldn't get off the couch without being totally out of breath.  Luckily, once I was on these meds (and after having a week in Vancouver to seriously chill and eat) I was able to start keeping food and my supplements down enough to replenish my system somewhat.  Feeling so much better now! Woo hoo! 

In Emma news, the sleep is better, though definitely still room for improvement!  More posts on this coming, I am sure!  We started weaning in earnest once we got the twin news, and are down to about 3 nursings a day, all related to sleep -- bedtime, 4 AM (buying me another 1-2 of sleep most days), and nap.  She can go to sleep in the car and with others (my mom or Lonnie, currently) but I have fewer tricks in my stash and the nursing/sleep association is still so strong for her when its just me.  My goal is to be done by Christmas, though.  Wish us luck!  It  is so bittersweet, especially after all our early struggles.

So, um, yeah.  Given our past history, this new development is rather shocking.  Is this really happening?

The ultrasound was yesterday, and it was supposed to be the NT scan.  This is is usually scheduled for 11-13 weeks, which we were too early for (as I had guessed -- my midwife was basing things of my official dates but I thought I had ovulated about two weeks later than that -- and was right!).

But, despite that, we we did get some very interesting info, nonetheless.  TWO babies!  TWO heartbeats!  Holy %*&#!  We are shocked, excited, freaking out, happy.  And overwhelmed!

They are diamniotic / monochorionic twins, which means they have their own amniotic sac (which is good!) but share a placenta (not the best).  This means they are identical!  The shared placenta means there is a risk for twin to twin transfusion syndrome, where where the twins do not share the blood and resources equally.  We will be monitored very closely with lots of ultrasounds to keep tabs on the babies growth, and to watch for this.

Unfortunately, I now need to find a new midwife and/or an OB! Which means I have to decide (again) what hospital we want to deliver in.  Which means I have to do at least a little research on NICUs, twin birth policies/stats, or at least get some recommendations from people who know more than me!  Eeeps!  I have a higher chance being allowed to at least be considered for a vaginal birth (depending on circumstances, of course) at certain hospitals, like the one I was planning to go to.  BUT, since that one is smaller, it is not equipped for births under 32 weeks.  Which I really hope we don't have, but its something to consider. 

I feel like overnight I have been given a new identity: Twin Mama.  OMG.  That is weird!  I know I will get used to it, but I'm not there yet....

Still here, still mostly horizontal!  I have been hesitant to post because most of what I can think of to post about is whiny and unpleasant.  While of course I am very thankful to be here, I am also, for the most part, so not a good pregnant person.  Much too focused on my own self and comfort (only child syndrome, anyone?) than the world around me.  I fear I am going to end up being that old lady who goes into the sordid details of her current health issues to every stranger she meets on the street.  (And now, I will go on and do just that!)

So far the worst of it was a few wickedly bad few days last weekend, which promped calls to the midwife, warnings of IV fluids (I was not to that point yet, despite much puking, but supposedly pregnant folks can start having seizures after only 36 hours of not keeping anything down) and a new routine of Unisom and vitamin B6.  Yes, the sleeping pill, which makes it very hard to do much when you take it during the day!   I think that combo is what helped me get a handle on things again, though -- it helps with the nausea, allows you to get some food down, and mostly, MAKES you sleep, which I desperately, desparately needed, I think (Lonnie still thinks I had some sort of food poisoning or stomach virus, but I am not of that opinion).  I was freaking out, though, about what I was going to do once Lonnie went back to work on Monday (definitely can't take the Unisom when you are the only parent on duty!).  The only thing that made sense was for me to move down to Vancouver for a bit, so my mom could look after Emma, and that remains the backup plan if I lose it again, especially mid week. 

But so far, that has not happened -- this past week was actually much much better, and I was even up for a few outings, shopping and errands, and trick or treating on Wednesday night (pics soon, I promise)!!!  It is just so great to have almost whole days at a time where food actually sounds good, and I do not have to obsessively weigh what food sounds palatable with exactly how much effort is involved in actually getting that food into my mouth.   And to not have a constant pit deep in the stomach that yearns, (and threatens), to come up at any moment.  Unfortunately, I started feeling less good Friday and today, eh, sort of feels back to "normal", though obviously not bad enough to be totally couch bound (hence this post!).  I am pretty sure that this is all sleep related -- I slowly build up a sleep debt during the week, then crash near the end of the week and sleep as much as I can all weekend.  Maybe if I try to balance things a bit more I will keep a more even keel.

In other news, I did have an appointment with the midwife on Mon, and all seemed well -- she said I was measuring (just by manual exam, not ultrasound) about 10 weeks, so 11ish now, which is about what I thought and a week behind what they thought based on dates.  I was able to skip the glucose screening, because with my current state it was doubtful whether I could keep that sickly sweet drink down for the hour required.  Ha!   My next appointment will be in another month, so we will try for that then.  This coming Friday, however, is our Long Awaited first ultrasound, across town at Fancy Ultrasound Place, and I am looking forward to it.  I really hope all is well in there, and it will be nice if we can confirm there is actually a viable human in there, instead of a tumor or an alien or some other puke-inducing parasite.  Fingers crossed for viable human!!! 

Okay, will do my best to get some photos up of the Halloween fun soon, today or tomorrow.  Emma was a cute puppy dog and definitely enjoyed her first M&Ms!   

So on the day I found out I was pregnant, I told Lonnie something to the effect that "in 2-3 weeks, the shit is going to hit the fan".  Well, I was correct.  Oooooh, boy, is morning sickness not fun the second time around!  And its definitely worse! 

Last week was really pretty miserable, and I actually came to a realization that I needed to come up with some child care help for the next few (well six-ish) weeks.  I was pretty much having to be horizontal at all times, and standing up for more than 5 minutes was horrible and made me gag and want to throw up (though I rarely actually do, and I am not sure if thats a blessing or a curse).  I was constantly hungry, but sick, knowing I needed to eat to help ease the nausea, but having only a very limited amount of foods seem even somewhat tolerable.  Gah.  The past few days have definitely been a bit better, due to a variety of things, I think (including Grandma Waitt being in town, woohoo!).

Luckily, Emma is a great sport and is generally a pretty good independent player, so we do manage okay.  But she really needs more physical activity, and to get outside and do things!  She loves seeing other kids, going for walks, going to the playground and all that, and I can't find the energy (or stomach) to even set foot out of the house.  So I sent out an SOS to my local mama friends and got a few childcare leads and some great offers to help, as well.  Hooray!  I think we are going to be able to cobble something together that will work well and allow me to get some time to rest and go to appointments (like acupuncture, which seems to be helping a bit) and Emma some social interaction as well.  It would still be nice to find some kind of local, drop-in type care for her, for last minute things or times when other folks are busy, but that is definitely hard to find.  

I think a lot of how I am feeling has to do with being tired, as I remember how much of a link I found the first time to getting enough sleep and being able to manage the nausea.  This time, its just impossible to get it, though, as I deal with Emma's crappy sleep (still plugging away and nightweaning and dealing with molars, etc) along with some very annoying pregnancy insomnia.  Her lack of napping is definitely a challenge, but even when I get a chance to nap (like right now!  I have the house to myself for the first time in 17 months!!!) I can't actually fall asleep.  Ah, well.  My new goal is to try to go to sleep each night with Emma, at 8pm.  Lame, I know, but its my only chance to catch up, I think! 

More, very soon.  I did also want to give a shout out to my dear internet friend Kim, who has welcomed her new son into her home this past week.  Hooray, hooray!  Welcome to the world, baby Bryce!