Monday, October 26, 2015

36 Week Update

36 weeks

On Friday, two days after my weekly OB appointment I went back in to the clinic after work to be evaluated. I was having symptoms of another UTI and my doctor wanted me to have a culture taken before starting a round of antibiotics. When I arrived at the clinic my systolic blood pressure was in the 140s on the first reading. I texted my doctor as this was a bit concerning to me so she arranged to have the physician in the clinic give me another NST (non-stress test -- heart rate monitoring for babies) and decided to have me do a 24 hour urine collection. (Those are pretty fun, in case you haven't experienced it for yourself, especially when you have to use the restroom about every hour while pregnant!) They also checked my blood to rule out HELLP syndrome, a form of very dangerous pre-eclampsia that my twin sister developed in her first pregnancy. Things were looking pretty normal so I got to go home and the urine test the next day came back negative for protein.

What happened to my knees?
It looks like my calves belong to a different person than my thighs!
What a difference a few weeks can make! ~10 days post part

As the week progressed, I noticed my weight during this time had really jumped. I suddenly gained about 16 pounds in 10 or 12 days and 8 pounds in four days. This was concerning to me as I noticed I could no longer find my knees! My ankles and feet were getting much larger which has been unusual for me as long as I am wearing my compression stockings and I noticed my entire legs were looking much bigger. I went to work through Tuesday and asked them to not add on any additional patients for the day as I "was feeling it today." I felt a bit off and they were able to move most of my patients up so I could leave early. One of the nurses I work with checked my blood pressure throughout the day and it fluctuated from 120-140s. After seeing patients, I had to do a quick CPR session for some continuing education before leaving for home. I technically failed to perform adequate CPR for the last of the three cycles on the mannequin but the instructor could tell it had more to do with my large belly and lack of physical energy than any deficiencies in skill or training so she passed me. All of the people who witnessed me performing chest compressions seemed to think it was pretty funny.

After speaking to my doctor, we decided I should head in to clinic for another check so I drove straight from work. It felt like De'ja'vu being back there again just a few days later. They checked my urine again with a dip stick and found some protein and my BP was above 140 again. I was surprised how quickly things could change when I was just checked a few days prior for the same things. 

I was sent back up to Labor and Delivery for some additional monitoring. They did another longer NST and drew some more blood. My cervix was checked without significant changes from before, dilated to a 2 and effaced to 1 cm. My BP continued to fluctuate. While in clinic it was almost 150 systolic, lying in bed it was down to 102 or 104 in Labor and Delivery. I had a minor headache which wasn't fully relieved with pain medication and my swelling was pretty substantial. My doctor, who happened to be on call, diagnosed me with gestational hypertension and informed me that as such she would like to move my induction date up a week from October 21 at 38 weeks to October 14 at 37 weeks. I honestly was a little relieved to know the babies would be coming a little earlier and having a better idea when this would happen. 

I was released from Labor and Delivery that night and I was instructed to perform another 24 hour urine collection. This would help us know if I was actually having signs of pre-eclampsia which is diagnosed after signs of end organ damage (signs would be protein in the urine from kidney damage, elevated liver enzymes from liver damage, etc).

Shortly after arriving home I lost my mucous plug. I have been told this can be a sign of early labor but I also read it can sometimes happen weeks before delivery and figured it had to do with the cervical exam so I didn't think too much of it.

The next morning I had my scheduled 36 week ultrasound but the appointment with my doctor was cancelled as I had just seen her the night before. I was excited to see the babies one last time and see their weights. I figured they would be over 6 lbs this time. I was also starting to wrap my mind around seeing the babies in one more week. I was excited but suddenly realizing it would be here very quickly and wondering if I was quite ready.

I guess I was about to find out!

Week 36:
Weight: max weight on Oct 3 = 197.8 lb (our smart scale started identifying me as Abraham!). On Oct 6 weight = 191.1 lb.
Total Weight Gain: 49.1-55.8 lbs 

*Abe spoke with another twin mom about this time who told him that I would "Grow exponentially in the next few weeks." I didn't really believe that could be true but it turned out she was right. For the first time, I had a few strangers comment on my size --this still seemed to only happen at the hospital on my way in to appointments. One woman asked about my pregnancy as she slowly made her way down the hall with her walker, only to tell her friend on the phone something like,"Oh this poor little girl is hobbling in, pregnant with twins and about to pop!" Pretty bad when the sick elderly patient with the walker is taking pity on my lack of mobility! 

Less than *1 week* to go!

**New induction date at 37 weeks