28w3d - Good golly growing babies Batman!

Thank you all for checking on me.  I am out of my routine (with my babysitters hovering) and am trying to set aside time for writing and reading and commenting.  Also, I’ve been lying low for the last week or so.  Skulking around and just relaxing, trying to make it to 28 weeks and I did it.  I’m so happy about that.  Getting through the goals you set in your mind gives such a great sense of forward momentum, that you are doing something right (even if that thing is just laying on a bed, being a lame lazyass). 

My first goal was 12 weeks (I’m sure many have been there or are getting there).  It went by slowly then quickly.  Strange bursts of time that surprise you when viewing a calendar, then sometimes days that seem to go on forever.  The next goal was 16 weeks, just because it was another month down and I could get amnio and results to help set my mind at ease.  I was so fortunate to finally get good results and know that I’ve got two little grrl monsters baking away.  I made my next mental goal to be 20 weeks.  I had a tough and frightening time of that with the emergency cerclage, but in the end realized just how fortunate I was to have it caught just in the nick of time.  The next mental goal of 24 weeks was really tough and scary.  There were hospital visits and bleeding and so much time spent alone with my nightmarish thoughts.  That was the worse of it all, but I got through it.  It’s interesting because we all have that “24 weeks = viability” idea stuck in our heads. 

DrGav once told me at 23w while I was leaving the hospital, “Traci, we have a way to go, you need to rest, be a princess on the couch.  It’s against my DNA to deliver babies before 28 weeks.”  My ObDoc pretty much echoed the same thing.  28 weeks was their mental goal for a minimum time for babies, not 24.  I understood why they would know this so much better than me.  They’ve seen the difference.  I made 28 weeks my next firm goal.  We got my rotating shift of babysitters and I have kept very strict to my bedrest.  Last week I saw DrGav at 27w6d for an office visit, he came to my exam room dressed in scrubs, he seemed very concerned and a little grim.  He let me know that I was doing fine, the cerclage was holding and the babies were looking good, although their amniotic fluid was still a little high.  He told me what medicine to take to help and then he said, “OK Traci.  Congratulations on making it to 28 weeks.  You’re doing a great job, please keep up the good work.  I’ve got to go now, wish me luck.  I have to run off to deliver a baby that is only at 25 weeks.”  My heart dropped into an abyss for that woman.  I looked at DrGav and could tell he was genuinely sad and worried.  I gave him a hug and wished him luck.  He accepted the hug and squeezed my hands and he was off.

Hitting the 28 week mark has taken a great burden of despair and worry from my mind.  Also much of my physical pain and crampiness has been gone for a couple of weeks.  Finally another bit of encouraging news came today at my growth ultrasound.  The babies measured 3 lbs 5oz and 3 lbs 6 oz.  They are in the 90th percentile for growth and while some of this may be due to my gestational diabetes, a lot is also from sticking to the high protein twins diet the clinic has me on.  I am still a little underweight (at 28 weeks, I have only gained about 20 lbs) but DrGav said not to worry abou6t this because the high protein and the babies size is more important than just weight gain.  We also were able to see and measure the grrls practicing breathing.  Each one gets the hiccups from time to time.  These are all good indicators of their progress and pushes me to believe that soon this will be over and I’ll have a crazy time keeping up with crying and feeding and nappies and cuddles.

I have made my next goal 31 weeks (3 weeks away instead of 4), then 34w (DrGav’s next goal) and finally 37w (aka “full term”).  I’ll take any, but I hope for all.  Sending out much love to all of you watching clocks and calendars.  I love to cheer when we reach milestones.   WOOOOOOOOOT!

Checkups and Ultrasounds and Migrations

I went to my ObDoc appointment, the Grrl Monster’s heartbeats sounded good, the ginormous belly is measuring well, blood pressure staying steady.  The swab showed I have a minor infection starting, so I have been put on antibiotics, this was expected since I had been bleeding in the last week and both of my docs called blood “an excellent culture medium” for bacteria.  I have finally gained some weight.  WOOT!  I hadn’t gained anything in the past 5 weeks, despite eating good food pretty much all day long.  I am finally up 15 lbs (I don’t count the pre-pregnancy 2xIVF meds additional 10 lbs). Now, I’m not some frail petite little thing, so I have plenty of “maternal stores” if needed.  I did the gestational diabetes (GD) test where you drink the kool-aid stuff and then they draw your blood an hour later to see if you seem to have GD.  I haven’t received any results yet, but hope to find out more by the end of the week.  I’ve heard and read the whiney horror stories of people who do this test and you know what?  The kool-aid type extremely sugary beverage they make you drink is no big deal (I opted for “fruit punch” flavor).  Is it really sweet?  Yes.  Is it too sweet?  Yes.  Would you buy this as a favorite beverage in a convenience store?  No. Is it something worth making a big deal about?  Eh…no.  So if you have this test coming up, drink up, shudder a bit and say “Wow. That drink sucks.” and then move on with your day/life.  All I hope is that I don’t have GD and can skip having yet another “high risk” moniker on my chart thankyouverymuch.

After my ObDoc appointment, I went over the the MFM for my 24 week growth ultrasound.  I want to write more about this and post some pics, so the quick and short news is that everyone is OK.  I’m fine, the grrls are fine and growing really good 1lb 12 oz and 1lb 14 oz (in the 74th and 80th percentile).  Cerclage is holding really well, and now for the biggest news…

THE PLACENTA PREVIA HAS MOVED OFF THE CERVIX ENTIRELY!!!!

A lot of the achiness I have been feeling down low for several months has disappeared.  I had those last two big bleeding episodes and haven’t had anything but a bit of brown spotting since.  The ultrasound showed another blood clot above the internal cervical os, but hopefully once that is gone the bleeding episodes will be too.

I’m getting so excited for those who are so close to meeting their little ones.  Kate at Impatiently Waiting and Lisa at Meinsideout.  It’s so amazing to know that the end is in sight and they’ll meet their heart’s desire soon.  Wishing you both all the best for a safe and happy delivery.

Overwhelming Fear

I haven’t written much lately, although I have tried to keep up with reading and commenting on blogs.  I just can’t seem to wrap my head around the emotions I have swimming in my soul.  The truth is that I am all at once overjoyed and terrified.  My hopes soar and then they are dragged down by the weight of my fears.  I daydream of holding my sweet little girls next to my skin, kissing their heads and fingers and bellies and toes…then the worry and doubt, like nightmares, start to consume me. 

It has all become so much worse since sometime in week 20. I think it is because of a many reasons.  The main one is that I can feel my grrl monsters pushing and kicking and wiggling many times throughout the day.  Gone are the little flutters that I question are real.  MrBeep has even been able to feel them kick when his hand is on my belly.  Feeling these little beings gives me such great elation and hope.  They are so much more real to me now than they had ever been before.  Not just images on a screen or results of a test or fantasies of children to be.  Now I feel their presence, they are tangible in a new way that my heart cannot describe.  The thought of losing it all fills me with dread.

I know I should “just relax” and that most women will end up having healthy babies.  I know that my weekly checkups have been encouraging.  The babies are growing well, the stitch seems to be doing it’s job.  I begin to breathe.  I begin to let hope ease my worried mind.  Then I read from the LFCA, or other wonderful bloggers who ask for words of support and sympathy for others who lose their little ones.  All at once I crash back to the land of nightmares and I don’t know how to escape. I know many of you have/had these fears, how do/did you cope? 

Yesterday I think I overdid it a bit.  Sat in a chair for too long, did a few extra chores and by the evening I was feeling a new kind of achiness in my lower abdomen. Just before bedtime I had the smallest tinge of pink on the TP.  I was so afraid as I went to sleep that something was wrong and all would be lost.  I have now had a very full night’s sleep.  I have put myself back on strict bedrest, just laying on the couch or in bed with only bathroom breaks.  I have had no other achy feelings or pink since last night.  I have felt each little grrl monster wiggle and thrash and kick. My achiness could have just been ligament pains, it could have been from the previa moving (it has been moving and may clear completely).  I just don’t know. I actually feel fine…and sometimes that’s a problem too.  Every time I had complications, there was no warning.  Feeling fine and then all at once, the big bleed or the cervix almost fails.  My problems seem to come out of the blue and that deals a lot of anxiety that fuels these overwhelming fears…and I don’t know how to conquer them.  Only time can help, but it drags and lags and taunts me.

Today I am 22w1d.  At 22 weeks if something terrible goes wrong, my baby girls will not be saved.  It is too early for any hope.  Sometimes I wake in the middle of the night and lay in the dark.  I watch the clock, my mind racing.  I feel I am so close but so far away.  2 weeks to viability, 8 weeks to likely survival, 16 weeks to “full term” and these are indeed markers to celebrate.  The numbers as weeks look so small, but as hours in the dark of night they stretch to what feels like infinity – 312, 1,344, 2,688 hours.  I have been so fearful and sad today.  I have cried so much.  I feel defective.  I feel weak because of my worry.  MrBeep has been an incredible comfort, he soothes my soul.  I am lucky to know and love him.  I know that I will come out of this eventually, I will build myself back again…but in the meantime…my friends, can you help?  Any advice? 

UPDATE:  OK my friends, I have just read mekate’s post and am again overwhelmed.  I won’t give anything away, but please please go read and send her love.

A wholly different kind of nesting

First off, my first doctor’s visit after the cerclage update:  Everything looks good.  Cervix is stitched closed and this has created a measurement of about 2.8 cm.  DrGav thinks that it should stay that way given where he placed the stitch (good and high).  No new discomforts, no new bleeding, no new cramping.  In fact, I feel absolutely fine.  I let DrGav know that I was very good and stayed almost entirely prone on my back or on my side for the entire week.  He said that was excellent, he was pleased at how well my post-surgical recovery is going.  He recommended that I do the same thing for another week to continue to help in the healing process.  He hinted that after a few weeks of doing the same, I may be able to get off bed rest.

Each morning starts as I:

• Get out of bed
• Have a pee
• Brush my teeth
• Get dressed

Then I:

• Grab my ipod
• Laptop
• Current book(s) I am reading
• Puzzle book, pen and pencils

Afterwards I:

• Gently head downstairs (yes I’m allowed)
• Climb on the couch
• Arrange pillows and blankets on said couch for maximum comfort options
• MrBeep brings me breakfast, water, Tivo remote, cordless phone, cell phone
• He gives me a smootch once I am settled, then he is off to work for the day

My “couch nesting” day has begun.  I call the couch and it’s surroundings “My Nest” because that is what I have made it over the last week.  I am not a very good bed rest patient.  I hate being idle for hours and days at a time.  So I build up a nest of shiny bits, plenty of things to keep me busy and my mind active, but it’s not what I WANT to be doing right now.  I WANT to be cleaning out my pantry.  I WANT to be getting rid of the excess books in my library.  I WANT to be editing video on my big computer downstairs.  I WANT to be cleaning out my closets of excess junk.  However, if I am a very good girl, I may be lucky enough to only have to do this for a few more weeks and then I can get to a few of the other things in due time.  <sigh>  I shouldn’t whine or bitch or moan.  I am very lucky to be here, but I don’t even want to THINK about the idea of 16 more weeks of bed rest.  I’ll do it if I have to, but I would much rather be extra good now and hopefully be allowed to gently putter around the house later.

I don’t like regular TV that much.  It’s hard for me to kill much time watching the tube.  I especially hate talk shows, most reality shows, 85% of cooking/home improvement/fashion-sense shows, and sitcoms.  I can get into a few really good series.  My friend Tiff offered to bring by Sex and the City and the L-word.  She also mentioned Californication as a good show.  I told her that #1-she is a perv and #2-that I have already watched Sex in the City plus #3-I have been on strict orders for no sex (aka “pelvic rest”) since December and now with the cerclage going forward for the rest of the pregnancy.  Um yeah, don’t really want to watch any show that is a daily source of soft pr0n.  Frustrated enough for now.  Thankyouverymuch.

I did manage to stumble across this show called “Clean House” where a crew of people come in to clean up these places stuffed with a gajillion pounds of stuff/crap/junk.  A current member of my family’s house is like this, my grandfather who passed a few years ago was like this too.  When it gets really bad, it is truly an illness or a compulsion for hoarding and not merely a matter of organization.  Even though the cast make jokes from time to time, they generally treat the homeowners with compassion and respect.  I liked that, so I Tivo’d a few episodes…plus watching THOSE houses get cleaned up and organized somehow eases my need for nesting. :-)

Any good series YOU recommend I order from Netflix?

Emergency cerclage & bedrest

I went for my weekly cervix check with my peri, DrGav, on Tuesday.  I was a pretty happy and healthy little chick as I bebopped into the office. Things were great, I could feel the babies move here and there, a little tap, a slight jiggle when I didn’t expect it.  I had a walk in the sun the day before.  Life felt normal and good.  Got results back from karyotyping amnio test, but am still awaiting the final CGH microarray results.  So far no problems, but I want to save that post until all results are in.

As you may or may not recall, during my 16 week ultrasound, they noticed a blood clot right behind the top my cervix.  DrGav was concerned about this as it could cause irritation to the cervix and wanted me to see him for a cervical check every week until things looked fine.  A week later, I had a tiny bit of spotting and while the cervical check measured 3.5cm and closed, I was asked to come again in one week for another check.  On week later, two days ago, Tuesday came and I went in for my cervical check, which involves our good friend, dildocam, aka “Wanda”.  The babies were checked briefly, their heartbeats were fine and they seemed active.  Then the ultrasound tech started checking my cervix.  She looked both with the abdominal and vaginal transducer.  She had me move a bit and push to see how it was reacting.  She was very nice and didn’t give away too much, but at the end of the exam, told me to stay put and wait for DrGav as he may want to double check things himself.

He checked me out with Wanda and then started talking to me and the ultrasound tech.  He pointed out that the internal cervical os was completely open, that there was significant funneling (even I could see it with my untrained eye) and while my external os was currently closed, I had the beginnings of effacement.  The diagnosis:  Incompetent Cervix.  My cervix had gone in one week from 3.5cm and closed to .6cm with funneling.  I felt absolutely no cramping, no pain, no contractions and there was no spotting.  It’s very scary to know that it all could have been lost so easily.  The only thing keeping my babies from harm was my placenta previa.  The edge of the placenta of baby A was still stretched over the top of the cervix and acting as a bridge, keeping it from splitting wide open.  The previa was moving and getting near the edge of when it was going to break free.  A manual check of my cervix was also found to be very soft, which could allow for dilation starting at any time. 

DrGav and I discussed the situation.  We decided that this was all looking very dire.  His recommendation was to place a cervical cerclage.  He did an excellent job of answering all of my questions and describing the procedure, why he was choosing to do it, what type of stitch, etc.  He explained that he preferred the Shirodkar stitch technique. He also wanted to make sure the stitch was placed very high, closer to the internal os as he felt this has worked better for patients in the past.  I was actually very worried about having an incompetent cervix due to my prior uterine surgeries, so I had done many hours of reading on this subject.  I had no problem agreeing to the procedure.  Anything to keep them in here and safe was best.  Even with strict bedrest at 18 weeks, it was very unlikely that they would make it to viability, much less term.  DrGav checked his schedule and the OR at the hospital and we decided to do a cervical cerclage that same day in a few hours.  I went to the hospital, was put on intraveneous antibiotics and had the procedure with a general anesthetic four hours later.  MrBeep came to be with me after work and arrived a few minutes before I went to the OR.  He met with DrGav and discussed the procedure and asked questions.

According to DrGav (he talked to MrBeep after the surgery was complete) it went very smoothly.  I had no bleeding from the placenta, everything seemed to go very well and with no complications.  They checked the babies whose heartbeats were both doing fine. I awoke in recovery with little pain, was dispatched to a maternity ward room and rested for a couple of hours.  The contractions monitor they put on me showed no contractions after the procedure.  I had a tad bit of crampiness, like the day before AF arrives with a vengeance, but it was managed with medicine. I went home that night around 9pm.  I didn’t want to stay in the hospital and DrGav said I could go home if I felt fine.  I had a little bleeding just after the surgery and it’s fading to a smaller amount and today it is just a little bit of pink on the TP.

I am on modified bedrest until my next appointment with DrGav on Tuesday 2/2.  I have a friend who is unemployed right now over as my “official babysitter” for the next few days.  We are giving him a little $ to help him out.  He cooks my food, keeps me company and we needed to do some movie production work this week, so it really turned out well for us both.

Even though this all seems scary and nerve wracking, I am glad and so relieved that we caught it in time.  Many women who have an Incompetent Cervix don’t find out until they have had a pregnancy loss.  It is more common with twins and is most likely to happen between 18-22 weeks.  DrGav is hoping if the cerclage is holding well that I won’t have to be on bedrest for too long, but we’ll see.  I have my little countdown calendar on my browser.  I have 36 days to go until viability (24 weeks), my first goal.  Hoping that in the end it all works out and my monsters are with me for as long as possible.