Wednesday, September 30, 2015

35 Week Update

It was almost impossible to capture pictures of the Lunar Eclipse with my iphone

We really enjoyed watching the Super Moon this past Sunday. It was a perfect clear night in Iowa for sitting out to experience it. Hopefully it was a good omen for these babies! We were thinking how strange it was that the next time we will have that opportunity will be when the twins are almost ready to graduate from high school.

35 weeks!
It feels like the last week went by really quickly! Which is great as the end of the second and into the third trimester really seemed to be dragging. These babies really could come at any time and it is hard to imagine that they will be here in less than three weeks.

I made it back to work on Monday and Tuesday. The drive seemed longer than usual but we kept the days a little bit shorter and I seemed to do well. In some ways I seem to have found my second wind, feeling better than I did before going in to the hospital. I feel more mobile and less uncomfortable. I have had more energy. But I also can tell a difference after a few days of working. My swelling seems to be coming back (Hello cankles! And I gained about 8 pounds this week! -- I'm attributing it to fluid), I feel a little more stiff, and tired in the evenings.

My non-stress tests have been going well. Since they have a hard time monitoring twins with the standard doppler, they check heart rate with a non-stress test which for me is now a weekly occurrence. My babies are very cooperative! (So well behaved!) The nurses and doctors really seem to rave every time about how "good" they are. They are usually able to find the heart rates within seconds without needing to search for them again part way through. I am always happy to see them doing so well as I can't always feel my Baby B very well. It was a wonderful surprise that Abe got to pop in and say hello today while I was at the appointment.

I did have a contraction during the test today and I have noted a few at night occasionally during the week which I had attributed to Braxton Hicks. Except for that I went a week without any noticeable contractions. I guess we will see if they continue. It is difficult to really tell what is a contraction as my belly always feels tight! The nurse assured me this was normal with twins since they are taking up so much room and that I'm not clueless or dumb when I can't tell.

My belly seems to be popping out further and further. I am having a harder time finding clothes to fit. My pants don't seem to want to stay up and my shirts either wont go on or are often not quite covering the bottom of my belly. I may have to switch to some of my bigger flowy dresses if I go much further. (Ok I just noticed the picture below...Ha ha! Maybe portions like this have something to do with it!)

Jethro's BBQ in Des Moines -- enough to feed all 4 of us! (Abe, me, and babies)

Abe and I made a trip to Des Moines this weekend to buy some more items off our registry at Buy Buy Baby. Having twins is expensive! It seemed like we bought a lot of stuff and the clerks at the store seemed to agree (longest receipt ever?). I think we are mostly ready with what we need in the beginning. Now, I just need to get it put away and the house cleaned up. It's been a constant process as we keep bringing in more gear which means reorganizing and packing things away and a constant barrage of boxes and packing materials to be disposed of. I have been working to get our basement more organized as well as a place for family to stay after the babies come.

So it is pretty hard to believe we made it here, to 35 weeks. The babies will be here in no longer than three weeks, which when I really think about it, doesn't seem like very long at all (although my body argues differently). I feel grateful I am feeling less miserable and more up for the challenge. And really, whenever they decide to come now I feel confident things will be okay. Although at least another week will be better for them and hopefully give me a little more time to get things in order for their arrival. (I still need to pack my hospital bag, for one. Talk about procrastination!)

Oh, and still working on names. We are having a really hard time with Baby Girl's name.

Week 35:
Weight: 188.9 lbs (up about 8 lbs from last week!)
Total Weight Gain: 46.9 lbs 
BP: 132/84

*some really big baby movements from Baby A; Baby B is sometimes hard to find when he crowds to the right (he must like to cuddle his sister)
*arm/hand numbness mild
*hand and foot swelling increasing again, especially in ankles
*discomfort/immobility -- not bothering me as much
*poor sleep -- some nights horrible insomnia
*frequent bathroom breaks -- increasing again
*knee pain -- coming back after my first day back at work
*itchiness with foot swelling --slightly increased again
*very tired
*smaller appetite
*round ligament/pelvic discomfort
*Braxton Hicks or contractions?

Less than 3 weeks to go!

Thursday, September 24, 2015

34 Week Update

34 weeks!
Last week I set 3 progressive goals for myself: 
1. Hold off labor until I received two steroid injections
2. Hold off labor until my SIL had her baby (due this week)
3. Hold off labor until 34 weeks.

I am happy to say I have met all three goals! What a relief, as babies born after 34 weeks have a very good prognosis. Hopefully lung and feeding reflexes are getting closer and closer to normal development and we are getting farther and farther away from a NICU stay when the babies decide it is time to come.

I had my 34 week appointment yesterday and things were looking very good. We had another Non Stress Test (heart rate monitoring for babies). Every time we have done this the nurses and doctors rant and rave about how great the babies are doing. Their heart beats are pretty easy to find and they evidently have great rates. I sometimes get a little nervous that I can't feel Baby B very well so I am always glad to see him trucking along on these tests, just like his busy body sister who I feel very distinctly. And my cervix has been relatively stable since I was checked in the hospital.

I lost about 5-6 pounds this week! My doctor checked amniotic fluid levels on ultrasound yesterday just to be sure and things looked good. I think it is fluid as I perceive I am much less puffy than I was before.

My contractions have eased up and I haven't had any of that crampy back pain for a few days. I have been trying to do a little more around the house to test how I am doing and while I get very tired, I seem to be doing well! This is good because my nesting instinct is kicking in strong and I really want to have the house cleaned up and organized before the babies come. My pregnancy insomnia was really flaring up last night and I found myself doing dishes and cleaning out cupboards at 2 am. Yawn! Too bad I feel so tired this morning I haven't got anything else done today. It seems like I can't quite get caught up  as I keep getting more boxes full of baby gear arriving at my door. Who knew babies needed so much stuff!

The babies dropped on Sunday. Suddenly I noticed I had space between my chest and my belly and I can feel the babies kicking much lower in my pelvis. And suddenly I feel like I can breathe!

I plan to ease back into work next week with a shorter schedule. Honestly, I think we are all a little nervous about getting caught that far away from the hospital if I go into labor. We will give it a try and if I have a problem it is nice to know I am just a few minutes away from the Labor and Delivery Unit there. I am also hoping I will feel well and not too exhausted or sore. 

Week 34:
Weight: 181.2 lbs
Total Weight Gain: 39.2 lbs 
*I went from my highest weight gain of 45.3 lbs to 39.2 lbs this week. The last time I weighed close to this was Aug 26 when I was 180.5 lb.

*some really big baby movements from Baby A; Baby B is sometimes hard to find when he crowds to the right (he must like to cuddle his sister)
*arm/hand numbness mild
*hand and foot swelling decreased
*discomfort/immobility -- not bothering me as much
*poor sleep -- some nights horrible insomnia
*frequent bathroom breaks -- less than before
*knee pain -- haven't noticed much
*itchiness with foot swelling -- not bad this week
*very tired
*smaller appetite
*round ligament/pelvic discomfort

Less than 4 weeks to go!

Sunday, September 20, 2015

Since I've Been Home (33 week update)

33 week home from the hospital glamour shots!
I keep having that Kelly Clarkson song running through my head, except with the words "Since I've been ho-ome!"

It has been one week since I was admitted to the hospital. It feels like time has flown by and I am grateful the babies got a whole 7 more days (hopefully more) in before coming to meet us. I have heard people say "Every day in the womb is 3 days out of the NICU." I doubt that has any scientific basis, but it makes me feel pretty good about every day we get to share this space.

Today I am 33 weeks 4 days pregnant. The doctors all seem optimistic we could go weeks more like this and may still need to be induced on October 21 (which crazy enough is only a month away!) so I am very curious to see what happens. I find myself wishing I had a crystal ball to know when they will come, but my own twin ESP isn't kicking in, even with the amplification of three of us twins together.

Which reminds me: Abe came to the realization that he would be the only non-twin in our family. Isn't that weird and kind of funny?

Everyone seems to want to know the plan so I guess I'm not the only one. I have been off work this week and plan to be at least until my next OB appointment on Wednesday (which will be the 34 week mark!). After that I don't know if I will be back at work or not. It really depends on how I am feeling and what my doctor finds/says at my appointment. I would like to be back at work if possible if we are going to continue pregnant for weeks, but we need to do what is smart and best for me and the babies. It is hard to turn off the mentality that gets drilled into you in residency that work comes first, pushing through illness, etc, so a reasonable discussion with my doctor will really help with this decision.

Also, I am not on "bedrest." There are other problems that can come with bedrest so I've been told to "take it easy," and to be a "couch potato," instead of being on bedrest. I have only been sleeping about every other night so I have been enjoying this more than I would have thought. I have only left the house a few times since getting home: to get a much needed pedicure (Holy long toenails Batman!), to go to my baby shower yesterday, dinner at my in-laws, and an hour of church today. I have wondered as I see and hear about other pregnant women out and about if I am being dramatic by lying on the couch almost all day, but after a few of these outings I have learned that I am doing the right thing. Who knew sitting for an hour at church would be so unpleasant? Or that a few hours at my baby shower would wipe me out for the rest of the day?

Still can't wear my rings but my hands are almost back to normal! 

As for how I am feeling, I continue to get waves of discomfort in my back. This seems usually worse at bedtime and very early morning. I had one day of what seemed like more typical abdominal contractions that came every 25 minutes for about 1.5 hours and then subsided but I haven't felt that since. And when I am up and about more I tend to get more of the crampy back pain that landed me in the hospital.

I have had some really kind friends bring dinners and help clean. The missionaries from our church even helped assemble some new furniture for me! I had some lovely friends and my MIL throw me my baby shower yesterday morning which was super sweet and nice. It was great to see so many friends from different groups and times during my life in Iowa and I feel blessed by their generousity and kindness.

We finally got a couch to fit in our basement!
Strangely enough, many of my typical pregnancy symptoms haven't been bothering me as much. I figure I am focusing more on the more acute discomfort of these back/contraction pains that I am not noticing the other stuff as much. I feel strangely less hugely pregnant and more mobile (being stuck in a hospital bed on monitors for hours really makes you feel like you can't move). My hands have shrunk down quite a bit and feel better than they have in months, I'm using the bathroom less despite drinking more fluids, and my feet are less puffy and itchy.

And we finally ordered our car seats and bought a few more of the essentials to prepare for the babies to come. I will feel relieved knowing we have this done so we can bring the babies home from the hospital now when they decide to come.

Week 33:
Weight: 186.5.
Total Weight Gain: 44.5 lbs 
Week 33 day 1: 185.5
Total Weight Gain: 43.5 lbs
*My weight this month has been bouncing. I got up to 187.3 on 9/12 but have bounced back down to 185.5, which is essentially the same I weighed on 9/2 at 185.7 lbs.

*some really big baby movements from Baby A; Baby B is sometimes hard to find when he crowds to the right (he must like to cuddle his sister)
*arm/hand numbness mild
*hand and foot swelling decreased
*discomfort/immobility -- not bothering me as much
*poor sleep -- some nights horrible insomnia
*frequent bathroom breaks -- less than before
*knee pain -- haven't noticed much
*itchiness with foot swelling -- not bad this week
*very tired
*smaller appetite
*nesting--this instinct finally came back with the babies threatening to come! Too bad I can't do much of anything right now.
*left sided back cramps

Less than 4.5 weeks to go!

Saturday, September 19, 2015

False Alarm at 32 weeks 4 days

If only all hospital beds were as nice as on the Mother Baby Unit!
We had a bit of a scare this week! Saturday I was in our church temple when I noted some uncomfortable left sided crampy back pain. It was uncomfortable enough I found myself wishing the two hour session I was sitting through would be over instead of really savoring any kind of spiritual experience I was hoping to have. I felt a bit better throughout the rest of the day until the evening when the discomfort came back. We decided to ride it out and call the doctor if I wasn't feeling better by morning. I took a bath and felt quite a bit better as we watched the BYU football victory on TV.

The next morning I woke to use the bathroom. I got back in bed and noticed the pain in my back had returned. Abe was already gone for a church meeting but he encouraged me to contact my doctor. She happened to be out of town on vacation but texted me back to tell me it was probably nothing but worth checking out. I threw on some comfy clothes, texted Abe, and drove to the hospital after calling Labor and Delivery.

Walking in I realized I felt worse than I thought. It seemed like a long walk from the car. Still, I checked in to Labor and Delivery thinking it was nothing and they would send me home in time for church. I emphasized my sister's issues with HELLP syndrome and how this was caught late so requested they keep that on their radar. They did a cervical exam and noted that my cervix had thinned to about 1.5 cm (our last early on had been 4 cm) and I was dilated to 1cm. They said this wasn't normal but could have been going on for weeks so they wanted to keep me for observation to see if it was actively changing. They checked my blood to rule out HELLP (everything was great and I wasn't even anemic), a urinalysis, and a non-stress test of the babies. They had some concerns about a possible UTI, which can trigger labor. The babies looked great, baby A was still head down and baby B still breech and heart rates very good.

I got settled into a room on the Labor and Delivery Unit. Abe made it home from his meeting not realizing at first I was actually already at the hospital and not waiting for him to take me there. Most importantly, they gave me my first dose of steroid (by an injection in the hip) to accelerate the babies' development. As an old IVF veteran this didn't bother me much. They started an IV (my hand vein has been so huge they didn't even use a tourniquet) to give me precautionary penicillin (not knowing my group B strep results) and nifedipine to help slow down/stop possible contractions. It seemed the back cramping was coming more frequently at this point. They monitored my blood pressure and pulse as they gave me a loading dose of the nifedipine every 15 minutes. I couldn't take the last dose because of nausea, dizziness, and low blood pressure. Abe went back to church for an hour while I waited things out. They resumed the nifedipine every 6 hours which seemed to slow the frequency of the pain.

In the meantime, they checked my cervix two hours after my admission, which they thought had thinned to 1 cm.  So yes, I was in labor. They also had the NICU team come and introduce themselves and answer any questions I had. That made it feel a little more real! I had been feeling pretty calm but even though intellectually I knew that what they were telling me about prognosis rates for 32 weekers was a good thing, I felt a little nervous.

Abe made it back and I continued to rest in bed with monitors on my belly for the babies and contractions. Everyone kept asking me about contractions but they were hard to identify -- again, mostly just left sided low back pain that would last for a long time (20-60 minutes? or longer?). I never felt any abdominal discomfort and it wasn't like what I had heard about timing so I felt unsure what was happening or how I was feeling. I felt hungry and a little nauseated. I hadn't eaten anything except 6 oz of applesauce on my way to the hospital, and it was hard to move with the monitors and the discomfort but the time went by amazingly fast.

Emotionally, I felt surprisingly calm. But I had a few moments of fear. I wasn't ready for the babies yet, we thought we still had weeks. I didn't even pack a hospital bag or bring anything with me, thinking I would have time to still change and make it to church after being checked that morning. I started feeling pangs of guilt and inadequacy for potentially not being able to keep the babies in longer to keep them safe and healthy, for not going in to the hospital early, and even for having a potential UTI (which I think was probably accurate as after I received antibiotics my required trips to the bathroom cut down by 1/2 or more!). I also felt torn because as time went by I was uncomfortable enough and unsure how long this would all take to play out that I was kind of wishing they would "just come" so I could be out of pain and just be excited about the babies. But then that brought more guilt because I knew keeping the babies in place was really the best thing!

By the evening, I had a number of visitors which was nice. The babies and I seemed to be stable so they let me off the monitors for the night and I took a bath in the giant whirlpool tub, I finally got some food, and then we went to bed. I didn't sleep at all until the nurse gave me an ambien at 2:30 am. I woke up at 3:30 am to a clenching pain in my back. I was wimpering in pain and really wanted to get up to use the bathroom but couldn't move. I was hoping Abe would wake up but it took a few minutes and I wasn't in the right state of mind to speak louder or wake him beyond my panting in pain. He finally heard me and he and the nurse helped me get more comfortable. The pain subsided after about 5 minutes and I tried to sleep again. This happened again 3 times about every 45 minutes.

At this point I thought the babies were coming. They increased my nifedipine dose and gave me some morphine (thank you!). I knew the team was getting nervous when they came in with my second steroid shot (this time it was quite painful) for the babies at 7:30 am instead of 11 am like we had initially planned (they like to space it out 24 hours) and we started talking about delivery plans. I thought for sure they must be on their way, but luckily the medication seemed to start working more and the severe contractions I had had calmed down. I was able to get comfortable with tylenol and a warm heating pad. I got off the monitors and took another bath and had a quiet rest of the day. By the evening, I was back off the monitors and they transferred me to the much more comfortable Mother Baby Unit. They switched my nifedipine to as needed and stopped my every four hour dose of penicillin (thank goodness because the horrible burning that caused in my IV was about as bad as the worst of the contractions I had).

I got a wonderful night of sleep and woke up Tuesday feeling pretty good. The doctors seemed happy things held off long enough for the babies to get their two doses of steroids in and that I was mostly feeling better. We did some more monitoring of the babies, I took another bath, and then we got to go home about 3 pm. I dreaded going home to my house which was in a state of disarray but my MIL wonderfully helped clean up and get things ready for us. It was wonderful that Abe was able to take me home and get me settled before heading back to work. I had been lucky that his department had been so flexible with him during my hospital stay! He was off on Sunday, they unassigned him from scheduled patient duties on Monday, and he was pretty available to pop in and out on Tuesday.
Tired after days of pain and poor sleep!

Thank you to all of the wonderful and accommodating staff at the hospital and all the friends and family saying prayers, checking in, bringing meals, and helping me around the house. We are lucky to have such a good support system and a lot of love for these babies already!

A little pampering!  
This picture cracks me up. I have a big smile on my face as I break into my food after not eating for hours!
I'm not sure if that is why I'm smiling or not but it makes me laugh looking at it!

Wednesday, September 9, 2015

Week 31/32 Update

31 weeks
The big question I keep getting lately is, are you still working? Somehow the answer continues to be yes! The past few weeks I am feeling much more uncomfortable and very tired. But, I tend to feel probably my best at work. This probably has to do with me staying more mobile and distracted from my many aches/pains/discomforts. My patients are starting to get a little belly button to the face or shoulder and maybe even a few baby love taps, and I find myself positioning myself closer and closer to the patient chair to improve my reach. My belly button area is a little sensitive so I do mostly fine unless it starts getting too close to the patient or chair. By the afternoon I am pretty wiped out! I plan to continue working as long as possible and am crossing my fingers I continue on, although it may mean shorter hours with how exhausted I feel.

The three of us (babies and I) attended a breastfeeding class (which I thought was great and alleviated a lot of my anxiety about feeding twins) and daddy joined us for a birthing class. I dreaded the breathing exercises and getting hammered about natural birth (my OB has taken this off the table for me) but I thought it was very helpful and didn't focus too much on either of those topics. In all of my healthcare and physiological training over the years, I have never learned about the birthing process so it was really educational to learn what will happen to me and the babies. We did SOME breathing exercises but didn't dwell on that too much and I even got a nap in while doing some relaxation techniques (if only I could fall asleep like that at night or when I try to nap at home). Abe got to wear the "empathy belly" and complained about shortness of breath when tying his shoe and having pressure on his bladder so it must have worked at least a little! Despite how good the class was, it was difficult and exhausting to sit through about 8 hours of class in my third trimester, harder than a full day at work.

32 weeks. Tired!
I feel like you can see how my stomach is a little lopsided to the right where both babies like to hang out!
Best of all, Abe moved home! After 9 weeks in Des Moines on a rotation for work, he finally got to move back in. It has been so nice to have him home. He has been a wonderful support -- helping with dishes and laundry (as usual), feeding me, helping me get up from the couch or bed, and making sure I am doing and feeling okay as much as possible. In the end, despite my serious misgivings about having to share a bed with someone else again (and not just my pillows), it has been a worthy trade-off, and just in the nick of time as I feel even minor chores like heating up food (not even cooking it!) are becoming daunting feats!

I have been talking about getting pictures taken of us for years. We haven't had "family pictures" since our wedding. So it good timing to get this done. I found myself wishing we had taken care of it about 28 weeks instead of 30 as I was feeling puffy and large that day, but I'm expecting good things of our photographer, Sarah Siler. I'm excited to see how they turned out. (I think I did get some chigger bites while rolling around in the grass which made my already itchy legs that much itchier, so I really hope they turned out!)

Our teaser image from our shoot
I recently bought some more maternity clothes because I had to upgrade a size or two as I entered my third trimester. I bought this denim dress and found it again in a bigger size on sale for only a few bucks. I decided to send the smaller one to my twin sister Amber who is also pregnant and thought it would make for a good chance to get a twin picture. She is about 10 weeks behind me in her pregnancy with a little boy. She always tells me she thinks she is bigger than me, but we can clearly see that even in a baggier version of the dress, I look much more pregnant! I don't think we look super identical in these pictures but it is still fun to compare.

Twins! I think I am about 30.5 weeks here and she is about 22 or 23.
As we get closer to my due date I find myself feeling a little more nervous. My belly has episodes of feeling very tight and uncomfortable. I question whether this sensation is labor or Braxton Hicks (so far I think it is just babies hanging out under my ribs). I have been paranoid about swelling and blood pressure and wondering if my face and nose are looking swollen, knowing my twin sister had complications with HELLP syndrome which can be a deadly form of pre-eclampsia. So far things are checking out and my blood pressure has been better than it was before. I will start weekly checks from now on with the doctor which makes me feel more confident hopefully we will find any symptoms early on.

So, just hanging in there! In a lot of ways I feel optimistic and happy how things are going. I am still working, avoiding complications, and the babies are becoming bigger and healthier each day. But I also feel immobile and sore, tired, itchy, and more and more ready to deliver these babies...oh, and then enjoy them! I think God was wise in making pregnancy, especially the end, pretty uncomfortable so women will be ready to have the baby any way necessary ("I don't care, just get it out!"). Unfortunately for me, I feel like I have been "full term" for about a month now, with over a month still to go.

Week 31:
Weight: 185.7 lbs (Whoah, I gained over 5 lbs in what seemed overnight!)
Total Weight Gain: 43.7 lbs
Week 32:
Weight: 184.1 (down 1.6 lbs from last week)
Total Weight Gain: 42.2 lbs
BP: 120/78 Pulse: 83
Baby A profile (with Baby B booty in her face!)
Baby A: 
Weight: 4 lbs 7 oz (70 percentile)
FHR: 132 bpm
Position: head down
Another uncooperative spine pic of Baby B
Baby B:
Weight: 4 lbs 9 oz (75%)
FHR: 155 bpm
Position: breech (he flipped!)
*I feel like those are some big babies! We may be on track for 7-8 pounders!
*baby kicks -- big movements from Baby A, Baby B is harder to feel. They both tend to move to the right side (Baby B under my belly button). I guess they like to cuddle? I kind of wish they would stay on their own side though!
*arm/hand numbness
*joint popping
*hand and foot swelling 
*discomfort/immobility -- YUP! 
*poor sleep
*frequent bathroom breaks, especially at night (hourly)
*nee pain -- ouch!
*itchiness with foot swelling -- so uncomfortable! And more white splotches on my lower legs (they are starting to look like constellations of the sky) and extending up my legs
*reflux (more controlled)
*very tired
*occasional dizziness and mild headaches
*smaller appetite
*I've implemented my own form of "modified bed rest" -- doing nothing when I am home! I'm doing pretty well staving off guilt for lazy days and evenings when I am not working because I really just don't have it in me
*getting more excited for babies!

6 weeks to go!