Tuesday, March 24, 2015

Thinking about twins+

Twins + -- I don't have any triplet pictures!

7 weeks 6 days!

I think my belly started showing, just a bit, yesterday! And so the expansion of my soon-to-be huge belly begins!

This week has been pretty good so far. I stopped my huge metformin pills (yay) and replaced it with unisom and B6 for nausea. This seems to be helping. I think. I was feeling pretty great compared to before for about five days but feeling a little more blah again the past few days.

Other medication update: I am on the countdown on my shots, less than a month to go! This is great because my hips are starting to feel pretty sore throughout the day. It seems like other cycles I got used to the shots. This time it seems to hurt. every. time.

My tiredness has really hit me the past few days but I am taking a no-guilt approach to this pregnancy. If working a full day at work and sitting on the couch all night is all I do, so be it! But I do try to make dinner when I can as I can't help but feel guilty making hubby cook after he gets home late (and I can't wait that long for dinner, anyway!). So thank you Costco frozen section, as you are feeding all five of us right now!

I've tried to take walks most days, even when tired. It has been harder to get out when it has been cold and rainy as of late. I could really do for some of that "Spring" weather that is supposed to happening during this season.

Emotionally I am feeling good. Honestly, I have been surprised by all of the excited responses we have received. I guess I was wondering if triplets was something most people would see as a blessing or a huge trial. I know most people wouldn't wish it on themselves. There are certainly a lot of challenges and risks with triplets. So I guess I expected people to respond accordingly. But thank you everyone for acting excited and positive. It has helped me focus on the blessing instead of the question marks.

It is a little hard to be in limbo, wondering just how many babies we need to prepare for. At first I felt like I should write off little Baby C as the doctors seem to expect him (I'm not sure why it is hard to visualize him as a her) to go away (-- or are they just preparing us?). Certainly that would make life easier, pregnancy easier, delivery easier, for me and the babies and for Abe and the future in general. But I kind of feel for little "C" who I have been calling "Danny" or "Devito" (Reference to the movie Twins where Arnold Schwarzenegger and Danny Devito are twins). I find myself rooting for the little guy who seems to have the odds against him.

For now, I feel calm. I am excited for our next ultrasound. I am looking forward to being able to start figuring this all out. Will we need a new car? A new house? Will I be able to keep working? Will I be delivering closer to 30 or 40 weeks? How many names do I need to choose? Will we be getting a nanny? And just HOW BIG can/will I get (because oh my! have you seen a woman pregnant with triplets before!)?

Once I know a number I will be able to wrap my head around this all a little better.

In the meantime, I guess the uncertainty gives me a chance to calmly consider both options. If I knew it was triplets for sure I think I would have been freaking out from the beginning. I have had some more time to get used to the idea. I realize in all of this that it is truly in God's hands. Worrying isn't going to change anything. It isn't going to help anything, either. I keep thinking, "The Lord giveth and the Lord taketh away." We are all blessed for the time we get with each other, no matter how fleeting. So if He gives us three babies, I am ready to figure that out. And if He takes one or more away, I am grateful to have had them for even a short while. Or so I am telling myself.

Until then I will keep reading forums and blogs and poorly reputable internet sources for more info on vanishing twins/triplets and wondering just what is going on in there with those little guys.

I hope you are doing okay in there little guys. And whatever happens, little Danny, we will love you if you stay or have to go.


Sunday, March 22, 2015

My Favorite Post Ever: His Response





I've mentioned before that my husband has been the silent observer as I have publicly lived our lives online. Despite the fact that infertility hurts both partners, fertility often feels like a "woman's issue." We don't hear often from the men struggling with the heartache and disappointment that comes with this struggle. On top of that, my husband is a pretty even tempered and private person. This means even I don't always get to know the inner workings of his mind as I seem to express enough for the both of us. I guess that is why I am so excited he took the time to write his version of this journey. It is a bit long (as he has a lot of catching up to do) but this will be to this point and probably forever my favorite post!


* * *


I’m not good at keeping a regular journal or Blog like my wife. But I think it’s important to record life’s important events and experiences. I’ve appreciated how Erin has been able to be so open with our experience with infertility. I’m a very private person by nature and I initially wasn’t all too excited about Erin’s openness. I figured, however, that if writing and talking about it was therapeutic for her then a bit of lost privacy was a small price for me to pay. I enjoyed reading her posts. As time went on I noticed that her sharing our story was not only benefitting her, it seemed to be benefitting other people, including me. Friends and acquaintances started opening up to Erin about their own struggles with fertility. Erin’s openness gave other people the courage to be more open, or at least to share their personal experience with Erin. My eyes were opened to fact that infertility is actually very common. It was just a fact; one of the many challenges that life throws our way; not something to be embarrassed about or ashamed of. When people asked me when we were going to have kids, instead of sort of shrugging and mumbling something about how we hope to someday have kids but the time’s not right yet, I started telling people that we’ve really been wanting children but we’ve been having trouble getting pregnant and so we’re doing in vitro fertilization (IVF) but that hasn’t worked for us yet, either. Erin’s openness has been a blessing for me.

As a husband on the IVF journey, I have felt more like a spectator than a participant. It’s my wife who has to have all of the medical exams, be on multiple medications, have daily hormone injections, have the side effects that come with the medications, take the blood tests to see if she’s pregnant, and
receive the phone calls telling her the results of the pregnancy tests, and then having the emotions of
wondering why it all wasn’t working. I think that was the hardest thing for me—watching her go through all of these hard things and wishing there was more that I could do to help carry some of the weight. Other than be emotionally supportive, give her injections (I hate causing my wife pain), and try to help more around the house, there really wasn’t more that I could do. About 10 days after each embryo implantation, my wife would go to the hospital for her pregnancy test, a blood draw to test her HCG level. As a doctor at the hospital (and with her permission), I had access to the lab results as soon as they were posted. Her blood draw was usually at 7:00am and at ~8:00am I would get onto the computer and check the HCG result. The results of the first three embryo transfers looked like this:



I would always try not to get too hopeful in order to not feel too let down if it was negative. I felt like I had my emotions pretty well in check, but each time it was negative I remember being surprised by how hard it was for me. Partly, I was sad for Erin because it meant having to go through the process again, but I was also sad for us because it underscored what we felt was missing from our otherwise very happy and contented life together. I would call Erin on the phone while she was still driving to work and let her know that the test had been negative. I would try to say a few encouraging words and prayed that she wasn’t too upset. She said that she was always glad to hear the news from me rather than wait for the nurse to call several hours later.

After failing three rounds of IVF, we had 3 frozen embryos remaining. The doctors, who almost always recommend only implanting a single embryo, recommended that we try implanting two at once. We had followed their advice in the past and decided to follow their advice again. Besides, maybe God wanted to send two babies to us at once and was just waiting for us to use two embryos. So on February 16, 2015 (President’s Day was fortunately a holiday at the VA hospital where I was working) we went through a similar routine to what we’d done three previous times: check-in, change (Erin into a hospital gown, me into scrubs), go into the IVF procedure suite, talk briefly with the doctors who show us a picture of our microscopic embryos and tell us they look good (of course!), watch the embryos be transferred under ultrasound-guidance, confirm that the embryo is no longer in the catheter, thank the doctors, wait 10 minutes before Erin can get up (during which time we would take some pictures and I would send text messages to my family that things had gone well), change, and then go to an Indian Buffet for lunch (I’m not sure exactly how we started that tradition, but we’ve gone with it).


I was optimistic about this time. For some reason, I felt more confident that it would work. I don’t know exactly why. Maybe it was that I felt we were getting close to the end of the line and I wasn’t sure how I’d react or what we’d do if it didn’t work. Even with the infertility, I have never really felt like we wouldn’t eventually have kids. I wondered why it wasn’t happening when we wanted it to happen, but I felt like it would happen eventually. So it must work soon, right? I remember trying to think about what we would do if it didn’t work: probably try one more time, using our last frozen embryo, and then maybe take a break for awhile, regroup. In the weeks preceding this, we had talked to my mom about how to start pursuing adoption. We weren’t sure we were ready at this point to fully commit ourselves to the adoption process, but we knew through the experiences of my parents and other relatives that there is a lot of work to do before adoption can become a reality and we thought that it would probably be a good idea to at least start looking in that direction. Maybe I felt more confident this time because statistically we were due for an IVF cycle to work (how many times in a row are we going to keep flipping “tails”?). Maybe the confidence came from the hope in the back of my mind that perhaps God was simply waiting for us to implant two embryos. I’m sure that most of my confidence was because I knew how many people were praying for us. One of the great benefits of Erin sharing our experience was the great outpouring of support from our friends and even from strangers. I know that our families were fasting and praying for us. I also know that people across the country, from a variety of faith backgrounds, were sending prayers to Heaven on our behalf. My cousin told me that she had said special prayers for our implanted embryos—“Maybe a bit unconventional so early,” she said, “but I felt no one is too young or tiny for God to notice.” Erin and I appreciated the special blessing she had been given the day before the implantation by our two faithful hometeachers (people from our church who are called to visit us in our home each month to offer support and share a gospel message with us). And I had the experience a few days before the implantation of hearing Erin pray one of the most heartfelt prayers I have ever heard, asking God to bless us and help us to become pregnant. These things gave me confidence. They made me hopeful. I still wasn’t 100% sure what was in store or what God had planned for us, and I’m sure that my faith wasn’t as strong as I would have wanted it to be, but I at least felt like we were sufficiently placing the matter in God’s hands. This provided some confidence and peace.


Then we waited. 10 days. It went by pretty fast. Erin commented several times that she felt peace. I was nervous when I thought about it, but it surprisingly didn’t occupy my mind constantly. The date of the pregnancy test was February 26, 2015. Unfortunately, I was scheduled for a full day of cases in the OR on this day and the first case would start at ~7:30am. This meant that I likely would not be able to check the results as I had done in the past. Erin had the whole day off work. She went in at ~7:00am for the blood draw. She texted me, “Now that the test is in, I feel surprisingly calm.” I told her to text me when she got the results, although I didn’t make clear whether I really wanted her to tell me the actual results via text message (“They’re just now bringing the patient into the room. I may have time to check, but probably not. I can call you after first case or I’m ok with text message.”). I tried checking the results on the computer at 7:45 am, right before scrubbing in for the first case. Unfortunately, the results were not up yet. I would have to wait.

The first case took about 90 minutes. Towards the very end of the case I felt my cell phone vibrate,
indicating a text message. It must be Erin with the results. After we had cleaned the patient and I had
taken off my surgical gown, I quickly checked my phone. It was from Erin at 9:15am: “I just got off the phone with the nurse. Call me when you are available.” My first thought was, “Oh no. She didn’t tell me the results. It’s probably because she doesn’t want to give me bad news via text message.” But then I immediately corrected my pessimism and thought, “Maybe she doesn’t want to give you GOOD new via text message!” Then I just didn’t know what to think and I was really anxious to call her. We first had to transport the patient to the recovery room and then I went to talk to the patient’s family about the surgery. Then I had a moment to call Erin. I was in a hallway next to a waiting room that had quite a few people in it. I saw an open and empty exam room and went inside for some privacy. I called Erin and she said, with tears in her voice, “It’s positive!” I was shocked and relieved and happy and excited! I said, “I didn’t think you’d be crying if it was positive.” I can’t really remember more of the conversation. I was kind of speechless. I remember feeling my eyes get a little misty. I didn’t have much time—I had to go and get the next patient ready for surgery. I hope that I was able to express a little bit of my enthusiasm; I mostly probably just came across as being stunned. This was the result when I looked it up later (very positive!):









The rest of the day was very busy. I remember just wishing I could leave work and go home and
celebrate. I wished that I could spend the day with Erin. I wished that I could call all of my family
members and tell them. I wished that I had time to read all the text messages that my phone was
getting. But it was a very busy day at work and I really just didn’t have time to process it all. But I was excited and happy. It was nice to finally get home in the evening and celebrate with Erin.

With the implantation of two (good-looking) embryos, the next question was whether we were
pregnant with twins. The high HCG level at the initial pregnancy test was suggestive of multiple embryos (we looked up a paper about it). I think we both felt that twins made sense: Erin is a twin (so it runs in the family, right?), we put in two embryos, high HCG. They tested Erin’s HCG again 4 days later and the result was really high:








There was the recent story of the couple in Utah who implanted two embryos with IVF and ended up
with quadruplets. We joked about triplets or quadruplets, but realized the likelihood was very small. It would be twins. I remember also thinking multiple times, “We shouldn’t assume it’s twins because I don’t want us to feel any disappointment if there’s one baby. One baby would be blessing enough!” So it was with the question of whether it would be one baby or twins that I accompanied Erin on the morning of Thursday, March 19, 2015 to her first ultrasound appointment after being pregnant. I was excited to find out but knew that I’d be happy with either outcome. The ultrasound started and they quickly found the fetus. Even at this early stage, I was amazed that it was already taking shape and the heartbeat was easy to see. They looked around for another fetus and I wasn’t seeing anything initially so I started thinking there was just one there. I thought, “One will be good.” Then they found another. That was really exciting. “Great! Twins!” The second looked similar to the first. They labeled them “Baby A” and “Baby B” and took measurements and recorded the heart rates. Then the ultrasound tech focused in on a small little thing near Baby B. I saw her and the doctor look at each other and whisper something about “a third?” I thought I saw what they were seeing, but wanted to wait and hear what they said. They focused in on it more. It was smaller than the other two, but it’s shape and heartbeat were clear. Baby A and Baby B were the embryos that had been implanted. Baby B and little Baby C were identical twins (the embryo had split after implantation). They took measurements of Baby C. They initially forgot to get the heart rate and so Erin had to come back from changing so they could get the heart rate. Then they sent us to a clinic room to wait to meet with the doctor. Once again, I was speechless. I think Erin was too. I think we were both shocked. We had gone from wondering if we’d ever get pregnant, to now being told that Erin was pregnant with triplets! How do you process that? I was wondering about the size of Baby C. The doctor addressed that when she came in. She told us that Baby C is lagging ~1 week behind the other two and that there is a good chance that it will resorb and that we will end up with twins. However, there is also a chance that it will survive and we’ll continue to be pregnant with triplets. They want to do another ultrasound in ~10 days to see how things are progressing and hopefully we’ll know by then what Baby C is going to do.


I’m looking forward to the ultrasound because I’m curious what the future holds. I still don’t know how to process the idea of triplets. Actually, I don’t really even know how to process the idea of twins or even of being a parent at all. It’s too early to have sunk in. Maybe it doesn’t sink in until after you hold your baby/babies in your arms. Maybe it doesn’t even sink in at that point. I’ll have to wait and see. After we found out that there are three babies, I remember wondering to myself, “What should I pray for now? Should I pray for Baby C to continue to grow, knowing that that makes for a riskier pregnancy both for Erin and the other two babies?” Then I realized that my prayers should be prayers of gratitude and that whatever is best will happen. It is in God’s hands now. In my education and profession, I have the privilege of seeing the miracles of modern science and medicine. It is very powerful. Erin would not be pregnant now without it. However, the struggles that we’ve had getting pregnant even while using modern medicine and then the presence of triplet when only two embryos were implanted (“1+1=3” says Erin) have been reminders to me that, ultimately, it is God who is still in charge. If He wants us to have triplets, we will; if He wants us to have twins, we will. And, either way, I will be grateful for the miracle of it all and excited for the adventures ahead.

Friday, March 20, 2015

A Little Favor



Thank you everyone for all of the kind words and support with our newest news. Life has been full of a lot of news, changes, and excitement for sure! It helps so much to know how many lovely people are rooting for us and the offers to help with the craziness of multiple babies.

I have never done a sponsorship or a giveaway on my blog or even tried winning a give away before. But I recently signed up to try Stitch Fix when I heard they have a new maternity line and they just happen to be doing a give away for $5000! This includes money for maternity clothes and also for baby gear. We know I will definitely be needing a LARGE wardrobe and a load of stuff for these three babes!

So please take a second to vote for me and share with your friends!

It just takes a second. Click on the link and then the red vote button. You can vote on all of your devices every 24 hours until March 29.


Vote Here!

The contest is based partially on votes and partially on my blurb. I'm far behind the first few contestants but only a few votes away from the top 10.

Winning would be such a blessing!


Thursday, March 19, 2015

April Fools Came Early, And The Joke Is On Me!

At the end of last week, I received the glorious news that I passed the first stage of my Oral Maxillofacial Surgery boards. I literally laughed and cried for over an hour, tears of such relief. I have never been so nervous about a test. What a blessing! I couldn't help but think "GOD IS GOOD!"

Today we got even bigger news! Our 7 week ultrasound was this morning. And today I remembered why I haven't always liked math. Sometimes it just gets confusing.

Like when simple equations don't seem to add up.

For example, sometimes

1 + 1


equals 3!



When we saw the first baby I was very relieved. I slept horribly last night, having bad dreams and anxiety about the ultrasound, including finding a completely empty uterus. (I was upset and disappointed and also mad to have been feeling sick for nothing!) Seeing I was actually pregnant took away that nervousness. 

Then they found Baby B. Di/Di twins (fraternal) -- "the best kind" (at least for decreased risk) the doctor said. I told her she better be careful what she says as I am an identical twin and then asked jokingly, "And only twins, right?" 

"Well, we'll keep looking just in case," The tech and doc said sweetly.

They kept looking and measuring things which felt like a long time, checking heart beats and ovary size and yolk sac dimensions. 

As I thought we were finishing up they said something quietly that sounded like the word "triplet." 

Next thing I knew, they were measuring Baby C, Baby B's identical twin!

After finishing the ultrasound I had my weight and vital signs checked, I noticed I was shaking the whole way! We waited nervously until the doctors came in to go over the results and answer our many questions.

Baby A and Baby B are likely the two embryos we placed, fraternal twins. Baby C is the small identical twin of Baby B. He is measuring small, about a week behind. There is a good chance Baby C will be resorbed and this will turn in to a normal twin pregnancy. This would be the lowest risk for the other two babies and for me. I'm not quite sure how I feel about either of those options! 

It's in God's hands now!

I am also so glad Abe was allowed to be there by his kind and understanding senior resident. Can you imagine me trying to get ahold of him in between OR cases to tell him that?!


Today's stats:
Week 7 day 1
145.5 lbs (143.8 lbs at home, up from 141.9 6 days ago)
Blood pressure 154/78 (about 50 points higher than usual!)

Symptoms:
fatigue
nausea
headache
constipation

And other good news, I get to stop two pills per day, my metformin!












Monday, March 9, 2015

Hello Morning Sickness


I made it into my second month, technically week 5 day 5. (Time goes fast when they add on extra bonus days at the beginning!)

The morning sickness has been teasing me the past few days. Nothing horrible but it is definitely becoming ever more present. It was bad enough today that my office manager and nurse at work today both noticed something was up. I found a pile of treats on my desk to keep the queasiness down. I do feel better if I eat frequently, even just a few bites. In light of all this frequent eating, I've been worried my weight would go up way too much for being so early (my weight has been hard to keep stable since being on my hormone therapies the past 9 months) but I luckily haven't really gained anything yet.

I have been feeling quite tired, but not the extreme exhaustion from the first few days after finding out. And the smells. That part of pregnancy is real! It hasn't lead to nausea yet but I am feeling much more sensitive to smells, especially the multiple forms of bad breath -- from decay or infection, smoking, and even just the smell of blood. I'm hoping that doesn't get much worse!

The progesterone shots are still quite painful. The injection sites are bruised and sore. 

I am continuing with all of my medications. I feel like I own stock in a pharmacy right now -- at least for a healthy person it seems like I take a of medication. I am excited to discontinue some of these as time goes by! It will be so nice to not have to take so many medications soon.

My morning pills consist of one or two thyroid pills, estrogen, and colace. 
Not too bad!
The afternoon is easy except for remembering!
Another estrogen
Then break out the pharmacy at bedtime! Another estrogen, 2 metformin ER, prenatal vitamin, and colace.

Bring out the big boys!
Moving in to week 6! Ultrasound next week!







Thursday, March 5, 2015

My Response

I've been struggling for days to put down my thoughts after our good news. I keep writing and rewriting and can't seem to say it how I want to say it. But I thought I needed to ask the question again, at least one more time (who knows, maybe I'll keep pulling it out!), even if my response isn't just right.

So how am I feeling now?

Finding out I was actually pregnant after two years of trying, one and a half years of fertility treatments, eight to nine months of in vitro fertilization, one embryo harvest, four frozen embryo transfers, and five embryos -- I was in shock!

Now that I have had time for it to sink in the emotion I feel the most is an amazing calm. My whole adult life pregnancy has terrified me (You can read about that here). Body changes, potential complications, labor, and the life changes that come with becoming a parent all made me extremely nervous to take the plunge into parenthood. I used to joke that I should have had all my babies when I was "young and dumb" (not saying all people are dumb when they are young, but I think I was in a lot of ways) because now I know way too much about the bad things that can happen (working in a hospital has not helped with this phobia!). This worry has only been exacerbated by the potential complications that can occur with IVF.

After a lot of thought and talking to friends with multiples, I decided I did not want twins because of worries over pregnancy complications. In fact, we kept choosing to implant only one embryo to avoid this very problem round after round, until the last time when it felt like we were running out of hope and the doctors actually recommended we implant two embryos.

So I can say I am completely surprised by the amazing calm and lack of anxiety I feel now that I am actually pregnant. AND knowing that there is a good chance I may be having twins! The only understanding I have of this change in thinking is that after so much disappointment and waiting I have come to realize that God is really the one in control.

I think most IVF moms go about their pregnancy worried about every twinge or symptom. (No wonder, after all that has gone into an IVF pregnancy.) But I want to just try to "enjoy" this pregnancy (it might be my only one!), without worry or anxiety as much as possible. Whatever happens, I feel we will be blessed for any experience or time we have with these little babies (assuming there are two).

I also feel so happy.

You might think that is a "duh" response, but I actually worried how I would react to being pregnant. Weird, I know --after trying for so long it makes sense to be happy, right?

But I wasn't quite sure: I have been telling myself for so long why it is a good thing to NOT be pregnant (defense mechanism!) that I started to wonder if I believed it. Things like "We are happy just the two of us," and "We are so lucky we can do whatever we want without finding a babysitter," or "We can travel so much easier." I was worried the fear or anxiety would override the joy. But it has not. I feel overwhelmingly joyful.

And grateful. So so grateful. I know not everyone gets this chance.

Tuesday, March 3, 2015

Still REALLY Pregnant

Unrelated happy picture!

Yesterday was my follow up blood test to ensure I am still pregnant and my hormone levels are progressing normally. I quickly stopped by the lab for another poke on my way to work. I realized there was a possibility the test could show bad news, but I felt pretty confident. Later that morning I noted some light spotting. Not until then did I get a little nervous. I've heard this can be normal but it did put a glimmer of doubt in my mind while waiting for the result to come back.

Abe texted me mid-morning to let me know that the test was 4042! I had read that the test should double every 48-72 hours so this seemed crazy high from 662. I was a little worried what this might mean. "How many are in there?!?" (My staff keeps teasing me about triplets.) But I was also relieved I am still pregnant.

I called the nurse to report the spotting and she didn't seem concerned unless I have increased bleeding or single sided abdominal pain. (Nope.) She reported the blood test results to me and stated that the target at four days is 1900. 

So I figure I am REALLY pregnant, not just kind of pregnant. And maybe being about double the target makes sense for two babies?

I think we are both happy and excited after more good news. It is hard to believe we are on our way to that baby bump!