It's A ... And Only One!

Week 22 

During the study that got me pregnant we did an ultrasound to confirm ovulation. It showed that I had ovulated...three times! Somehow, perhaps miraculously, we are only pregnant with one baby. I chided my doctor for almost getting me pregnant with triplets again and I could tell he felt a little sheepish.

It was confirmed on both of our more recent ultrasounds that in fact, it was just ONE baby. Phew. Part of me would love to have twins again, but I am relieved and hoping this ONE will be a comparative breeze.

* * *

Before we became pregnant, I felt we would have three children, one girl and two boys. I think this was the idea that maybe our son's identical twin would get a second chance to join our family. However, as I continued to experience morning sickness beyond what I remember or had documented in my previous pregnancy, I started to wonder more and more if this baby was a girl. "I was much sicker with my girl," seemed to be the common consensus expressed to me by friends. I even had a dream that we were having another daughter. So I was a little uncertain what our 20 week ultrasound would show.

Unlike last pregnancy where we had ultrasounds sometimes every week, this time we were excited to catch another rare glimpse of our baby. Luckily, baby seemed to have all the parts and pieces they look for on an ultrasound and even gave us an open fisted wave with both hands. Baby bopped around and was quite active, but showed us everything except for the pertinent anatomy! The Ultrasound Technician started packing up shop and wiping the gel from my belly when I said, "So do we not get to find out the gender today?"

Unlike many of our family members and some friends, we are not the wait and see until the baby is born type! We  want to know ahead of time, as soon as the technician knows and as early as possible. So I kind of had to laugh to myself that maybe we'd get a surprise gender reveal, after all. 

The technician quickly said, "Oh yes!" as baby had been pretty shy and cross-legged (very Sheffield-esque) during the scan. She had me lie on my side and right away we could see that baby was a girl! I had been thinking she was in fact probably a girl, but we were still a little surprised. My biggest thought to that point was that Mister would probably have another little mother to gang up on him with his bossy big Sister. Abe was worried by the fact we'd have to choose another girl's name, which was difficult for us last time.

But, we are happy and excited by the turn of events, despite the difficult naming task ahead. Abe made one of his delicious and rare cakes with pink frosting to share the news with family. 

Do you think little sister looks like her siblings? I see some resemblance, especially to her big sister.

Baby A -- Big Sister

Little Sister

Baby B -- Brother

At about 11 weeks I thought I was beginning to feel better. I luckily have had very little vomiting episodes (mostly just from gagging while brushing my teeth!), but have had quite a bit of nausea. The nausea become more intermittent but seemed to worsen. Finally about the time of my 20 week US the nausea had subsided. I told the doctor I was suspecting a girl because of the nausea and wondered if it was an old wives' tale. She said "No, it's true!" I'm still a little puzzled why I would be more sick this time than I was with a girl AND a boy...but okay. My horrible body (but not face?!?) acne thankfully also subsided about a month ago as well. Phew.

I'm feeling big but not nearly as uncomfortable as last time -- by 18-19 weeks with the twins I remember thinking I had already breezed by my second trimester and into my third. I am still sleeping with only one pillow. My rings are still on my fingers (although they did get resized up one full size after my delivery). I haven't had carpal tunnel (hallelujah!). It is a little strange being pregnant in the winter instead of the summer. Instead of trying to squeeze my swollen feet into sandals I am trying to zip coats over my belly.

My doctor warned me that after last time I would feel a lot smaller but would still feel huge because my uterus is all stretched out. After seeing these pictures I am wondering/scared I am as big as last time. Or bigger? Maybe black is slimming? (My belly shape is a little different.) Luckily after just checking today, I have gained 10 lbs less than last time so far (18.4 vs. 28.5 lb). Still a little more than I'd like at this point but I'm not sweating it yet. Hopefully in another week or two I'll have all of the eggnog and Christmas cookies behind me and can slow down a bit.

22 weeks with twins

Almost 22 weeks!

We evidently love pink around here!

About 22 weeks with twins -- funny we are also color coordinated for boy/girl twins!

Singleton Pregnancy Symptoms Week 22:

tiredness, low motivation

insomnia (thank you Unisom!)

some discomfort with sitting at times

feeling movement, mostly about 9 pm

round ligament pain

Twin Pregnancy Symptoms Weeks 22-23:

evening tiredness 

arm/hand numbness -- worse this week

hand and foot swelling -- thank you compression stockings!

discomfort -- it's getting hard to move!

insomnia

mild acne flare up

no leg hair! I've gone weeks without shaving

feeling movement

left TMJ popping -- I guess all those joints are loosening up!

Study Time

Before the twins and my IVF journey to get them, I did months of oral medications to try to induce ovulation. With a diagnosis of PCOS, that is my problem: I have eggs! I just can't get to them.

When my twin sister had success on clomid I thought for sure I'd follow in her path within a few short months. I suffered through the side effects, which I remember including hot flashes and some mood swings (including an embarrassing emotional outburst at work). At one point I suffered with almost continuous nausea and frequent vomiting which I attributed to the clomid so was switched to its sister, letrazole (turns out it was actually the metformin I was also taking that caused the nausea), and I think eventually ended up back on clomid.

Between these two medications, I was on the roller coaster ride of hormones for about 9 months (much longer than most people try) without ever a sign of ovulation. Never. Not once.

After my failed IVF attempt this spring I felt I just couldn't bring myself to do more IVF. When the office calls to give the bad news they also want to know the plan moving forward. I think the nurse was surprised by the finality of my answer. "I think I'm done."

I mentioned I would consider maybe trying on my own for awhile, maybe with clomid again if that made any sense at all. I assured her I did not have any unreasonable hopes that this would work, but it would be something I would possibly consider.

Shortly after, I received a call from the head of Reproductive Endocrinology. He kindly apologized for the sad news. He mentioned a study he was heading on the use of clomid and letrazole used together. Content with the idea that I was done and might as well get used to the idea, I agreed "all in the name of science." I figured who better could they learn from than me, one who continued to puzzle them with my lack of unexplained success.

Taking the medication was a little FLASH from the past, or should I say, HOT FLASH from the past. Phew. Luckily I was on a relaxing trip to Vail, CO while Abe was at a conference because I didn't sleep a wink before 5:00 am four out of the five nights we were there. I also about had an emotional breakdown, which I realize now, was probably related. HORMONES!

During a follow up ultrasound we discovered I had indeed ovulated, the first time ever documented. Surprise! However, when I took the pregnancy test at the end of the one-month study, it was negative.

As I said before, I didn't have high (or probably any real) hopes for the study. After all, the success rates at our hospital for two rounds of IVF is close to 80%. To offer more perspective, the odds of pregnancy the good ole' fashioned way is only about 25%, even if you are Fertile Myrtle and whatever you would call her virile partner. And as I mentioned before, I was an experienced clomid and letrazole user with zero history of response. You could say I am the anti-poster child for these medications.

But, I had a suspicion. And instead of writing off my normally absent/irregular cycle as just that, about 10 days later I woke Abe at 3 am with this:

I have no previous experience with this but I think that's a positive

It truly is another miracle. I'm not sure which is bigger, the twins or this new rainbow baby, but I guess miracles don't need to be ranked or quantified. The fact this time was physically easier (and cheaper) doesn't discount the miraculous nature for me.

Yesterday Once More

May 22, 2017

Today was my blood test, the end of the infamous "two week wait."

Abe's mom came over early this morning and she helped me get Mister and Sister ready for a walk. We took our stroller to the hospital for a quick lab draw, met up with Daddy for a short time, and came home. On our walk Abe called with the results.

It was a familiar conversation.

Abe: "It came back negative."
Me: "Oh, okay.
(Abe: silence)
Me: "Well, not surprising I guess. Hmmm. (Awkward pause)"
Abe: "I guess I should go get ready for my next case."
Me: "Okay, I love you."

We have had this conversation 5 times now with only slight variations in the script. Maybe that is what made it easier to hear.

So how am I feeling now? I didn't have much emotion at first. I left the twins with my MIL to feed them breakfast while I took some quiet time to process. The tears didn't come until I told a few family members the news. I am so used to disappointment in this way that I feel pretty okay with not being pregnant right now. But the finality of it is something to mourn and for which I shed a few tears. I had kind of expected before the news at the transfer (that the embryo hadn't done well in the thaw) that this would work, that this cycle would work now that my body "knew what it was doing," and that we had a third baby ready to come join our family -- the baby we lost in the womb coming for another chance at a healthy body.

Taken by my MIL as I cried in my room

However, I also feel like God has been reminding me the past few weeks how lucky I am. I have two miracle babies who are wonderful and sweet and make me smile every day. I love how they sing "Twinkle Twinkle" wih a variety of lyrics, from singing about stars, ABC's, BAA BAA BAA's, EI-EI-O's, or even Ma MA MA's, and give each others sweet hugs and kisses. I think He has been telling me, "You have enough. You don't have to keep doing this anymore. You are already so lucky."

So I choose to have faith in disappointment. I would love to have another baby. Just one. (I don't need to get greedy!) Crazy as I feel saying it even to myself, I would love to experience pregnancy again (I guess with the hope it would be easier this time!). I am disappointed I will probably never get that amazing birth experience, meeting and holding my baby in the delivery room without the many negative emotions I experienced last time. I was hoping to successfully nurse without all of the frustrations of before. I am sad thinking I wont get another chance to savor the smell of my new baby or the amazing feeling of cuddling him as he sleeps.

I'm not sure where we go from here. There is a common mentality that I will probably just get pregnant on my own. I'm not counting on that (although I do personally know other IVF mamas where that has been the case). In many ways, it feels easier to decide that I am done. To cut my losses and exit the roller coast of emotions permanently. Or at least for now. If I decide I want to ride that wild ride again, I can always purchase another ticket. Right now I am already dizzy and nauseated and will probably feel like I am still spinning at home in bed for awhile.

Either way, I'm not sure I am ready to throw out all of my baby stuff just yet. Whether that is me holding out a glimmer of hope or for sentimentality's sake, I'm not sure.

Our Hail Mary

May 11, 2017

Our embryo transfer was today. 

At 9:45 am I was picking up Abe from work and I received a call from my doctor. He told me our embryo had split after the thaw and that it "wasn't looking too great." He wanted to give me a "heads up." In the meantime, we would see how it looked in a few hours.

My appointment was at 11:15. My favorite doctor and his fellow (the same one who got me pregnant before -- a good sign?) came in before I changed for the procedure. He sat on the bed (a bad sign, I thought -- a technique taught to doctors to build rapport or to be more personable when giving bad news). They showed us pictures and explained that sometimes embryos don't do well after thawing (we had been lucky up to this point to have all of them survive the thaw). We now had two embryos after the one split. I was hoping he would say they looked good and now we had the chance for twins, which I would gladly do again. (Also has me wondering if we could implant them at separate times and have identical twins with different ages. Weird! -- I don't know that they could re-freeze it.) However, they felt that one looked like it was degenerating and the other looked questionable. It didn't seem to be growing like they expected it would.

#1 shows the split embryos

#2 shows the questionable transferred embryo

#3 shows the non-transferred, non-viable embryo

They offered us to "cut our losses" and we could go home, or we could proceed with the transfer knowing it had a low chance of working.

We decided to try. The biggest negative was continuing with the shots. I reminded them I was an old pro and they laughed in a knowing and apologetic way. Abe said, "Well, we will give God something to work with!"

They gave us 5% odds.

I started to process the idea of a failure for the first time. When we got back in the procedure room I felt infertile. Again. I had forgotten those feelings for about 2 years. I felt bad I couldn't give Abe his big family. I felt sad that I felt like we "didn't even have a chance" this time. I felt broken. And I remembered the many times in this room full of excitement and the disappointments that followed so many times over.

I also felt more modest this time. Out of practice I guess. The procedure took less than a minute -- much easier to get the catheter that delivers the embryo in place than ever before. My uterus must have changed because they always commented before on the difficulty. My bladder wasn't as full as the other times so the five minute wait after the transfer wasn't unbearable as before.

After we quietly walked back to my room in my socks to change, we kept our tradition of going to an Indian Buffet for lunch. (I mention the socks because somehow that feels important. There is a vulnerability of being in a public building without shoes, but also a coziness and warmth of only wearing socks. Is that weird?)

I had the romantic notion of not telling anyone until I was pregnant and starting to show. After the procedure, we decided it was such a long shot we could use the prayers so we decided to tell our families. I think everyone is trying to be optimistic/hopeful/supportive so we got a lot of "exciting"-s and "congrats"-s. In the moment I felt this should be more like condolences since this was my last (perceived?) chance of growing our family but I understand their thought process.

As I have spent more time in the day I have thought of that little baby I assumed we would get. As hard as it was, I want to experience pregnancy one more time. I want to savor one more little baby and all of the precious moments that went so fast before. I want to have a normal delivery and feel the magic of meeting my baby without the fear and separation anxiety of the NICU. I want one more round, less rushed and frantic than two often was (although I understand maybe a mom of three never get that!).


But...

I felt at peace. I felt like an answer to prayer to see and experience the immense joy and wonderful personalities I already have at home, today more than other days. Their laughs and smiles at simple silly things like the name of dinner and their sweet and purposeful kisses today as if they knew I really needed them were like messages from God.




They are miraculous. And enough. If I don't get another baby we still have a perfect family.

Abe and I are putting it in God's hands, one more time.

T-1 to Transfer Day

May 10, 2017

Do I really want to do THIS again???
I was HUGE and that was HARD.

We were at Costco last night and I picked up a bottle of pre-natal vitamins. The checker asked if we were having another baby. I wondered how he was on to me and didn't know how to respond (he was a stranger so I could probably be honest, but then again, what???) I realized I must look pregnant (something I have commonly been told/asked in the past), especially with my recent weight gain. Then I realized it was just the pills. Ha!

* * *

Tomorrow is the big day, my round #6 of IVF, FET (frozen embryo transfer) #5.

I still don't know what time I need to be there...I better double check this afternoon.

Honestly, I haven't thought about it much. I've been doing my progesterone shots since May 6. I dread them every night although they honestly haven't been bad and easier than before. (Tip: the cold of an alcohol swab on the adjacent skin is a nice distraction.) But besides my TID (three times per day) estradiol pills and the nightly shots I kinda forgot about it. Abe even mentioned something about "Thursday" and I literally said, "Oh yeah, Thursday!"

Am I blocking it from my mind in some subconscious defense mechanism? Am I such an "old pro" at this IVF thing it just doesn't phase me any more? Or maybe life as a working mother of twins is enough to keep my mind busy I haven't had time to ruminate on it all?

I don't know the answer but it is strange to think tomorrow I may be pregnant. And if I find out in a few weeks that I am not, then I am probably never going to be pregnant again. I don't know how I will respond when I actually process that.

So prayers that things go as they should tomorrow, whether that means God has another baby for us or not. And prayers I will be able to gracefully accept whatever that answer is, because right now either answer is a little scary.

Needle Phobic People Beware

Injection target area for PIO 

April 23, 2017

After that initial day of feeling off, I seem to be doing fine. Phew! It seems like it is a really long build-up this time. I don't remember being on the estradiol this long before starting the injections. It must have been the same protocol before but it sure feels like a long time until May 1 when I increase the frequency of the estradiol and a LONG time before I start the progesterone shots on May 5 or 6. Luckily, I'm not super anxious about that!








May 6, 2017

More needles!

I started my PIO (progesterone in oil) injections tonight. Back at it! The huge bag of needles
brought back the realization of how long I will be doing this again if it works (10 weeks!). I tried calculating out in my head how much of my life I have spent injecting a thick oil filled with hormones into a target on my butt (sorry, hip) and it comes out to about 5 months.

I feel less dread and emotion than I expected and it really wasn't painful like I remembered. But it did have that familiar strange and tight soreness that only injecting a mL of hormone impregnated oil can bring.

The medication is so thick it can be difficult to draw up.

The target areas are so different every time depending on which nurse you have.
I think these were the best so far... much less painful than any other cycle.

I can inject myself but I prefer the emotional support of having Abe do it for me.

I am on the estradiol pill TID (three times per day) now. You really should take all of the medications at the same time per day with a window of a few hours.  It can be hard to remember so I have to set my alarm, especially for my afternoon dose on days that I work. During the times I am in treatment it isn't uncommon for me to wake up night in a panic "realizing" I have forgotten to take a medication (usually for the entire cycle) and I must have lost the baby. Luckily, I haven't missed any doses yet in my conscious state.

I had my ultrasound appointment a couple of days ago. This is to observe the uterine lining and its response to the medications. It needs to be a certain thickness before proceeding with the actual transfer. They also checked my ovaries to make sure I haven't been shooting eggs out on my own (which could mean an unexpected multiple pregnancy if they transfer an embryo as well).

Fat chance of that, as who knows if I EVER ovulate. 

Things were looking good (my lining was thick and my ovaries were "quiet" as they say), so we are good to go ahead next week. I also met with the nurse who reminded me of the instructions (funny how it seems so fuzzy now).

I also turned in my "thaw consent." This has to be signed in the clinic with one of the staff acting as a witness, or it has to be previously notorized. I guess they have to take this eriously -- no creating offspring behind someone's back! This time was easy, "Thaw one embryo." No further instructions or decisions to make on that.

As for the hormones, I find myself very tired and unmotivated. And I am up about 5 lb --suspiciously similar to the amount of weight I gained last time! I look pretty bloated.  Maybe like I am pregnant already...?

Strangely, most of my IVF friends are pregnant now and another friend is doing her last few attempts at IUI (intrauterine insemination). Most of them conceived well before me in our journeys, so I am hoping we can all be pregnant together this time.


*I made some videos of the injections if anyone would like to see them. I have had some friends who feel pretty intimidated with how to draw up the medications, etc, so please contact me if you need help. I guess if you have a morbid curiosity, that works too.

Hormone-ee-e-es: Wow, just wow!

April 18, 2017

The medication schedule for IVF is so strict and complicated you get a calendar to stay on track!

24 hours after taking my first pills and I feel out of whack. Cranky and sad. Incredibly cranky and sad.

Nothing is wrong but it feels like the world is falling down.

It always makes you wonder if this is ME or just the hormones talking. If it is the hormones I'm in for a wilder ride than I remember!

Mum is the word

April 17, 2017

I already said this time feels different.

This time I am keeping quiet about it. This time I want it to feel like a "normal" pregnancy where I get to start showing and have people wonder if I am pregnant or just putting on the pounds. That I can simmer on my emotions by myself for awhile. That it can be my happy surprise to share or my disappointment to decide what to do with.

But I find myself a little nervous about not sharing. Last time I feel the prayers of many were on my side and I believe in the power of that. I feel like this last little embryo has to fight against the world for his spot in humanity and I have some worry without the legions of prayers he won't have as much of a chance. But I also trust that faith and prayers are strong and that God has a will. So the prayers of a longing mother and father I think have power as well and hopefully that will be enough.

I do find myself almost accidentally spilling the beans already, after just a few days, about to make comments about how I have an appointment or need to go take my medication, etc. We will see how far I can go. The transfer is scheduled for May 11. I may not have to keep this secret longer than that if we get negative results.

I am choosing to be optimistic that that won't be the case. However, it is a tricky thing to be hopeful and excited enough to have the courage to go forward with something as significant and life changing as a child. Plus, facing all of the unpleasant interventions to make it happen while trying to tell yourself to "not get your hopes up" or be "too disappointed" if it isn't in the cards, --or as I prefer to think, "God's will."

"God, grant me the serenity to accept the things I cannot change"

The Final Round

Here's a peak into my journals for those of you wondering what I have been up to.


April 17, 2017

On a whim I decided maybe it was time to try for embryo baby #3 -- or actually, technically, #6. 

Who does that? 

Makes a major life decision like the possibility of having three babies two years and under -- without days, weeks, or months of thought and preparation?

Add to it the part about having to be pregnant. (Man that was hard!)

Why didn't anyone tell my I was this big?!

Oh yeah, and then there is the whole IVF part: 

The shots. 

The pills. 

The frequent appointments. 

And most of all, the chance for major and in this case FINAL disappointment --because if this works it will in all likelihood be my last pregnancy and my last baby; and if it doesn't work, well...yeah. It WOULD have in all likelihood been my last pregnancy. 

I guess that is why I didn't want to think about it much and to take the plunge thoughtlessly. (And now my mind is making IVF needle puns about syringes with plungers...)

So without much mental energy or emotion really, I called the IVF clinic last week to matter-of-factly find out what the protocol would be for a FET (Frozen Embryo Transfer). I figured it would be a bunch of appointments and weeks or months before they would be ready. Nope. We could get started right away and why not in just a few weeks? "Start by going off your birth control pill today."

Before I knew it, I was getting my first of many upcoming needle sticks with a blood draw for my thyroid levels. 

Nurse: "We need to get your blood drawn? When can you come?" 

Me: "How about now I guess?"

Things are already different this round as my TSH (thyroid stimulating hormone) was normal this time, which means one less hormone to add into the mix than I had last round. And so far, no news of starting any metformin, a medication usually taken to regulate diabetes. 

And then last night I started 2 mg of Estradiol (an estrogen hormone to help support the uterine lining for pregnancy) and again this morning. I was careful to set my alarm for morning and night so I wouldn't forget any of these important doses.

And then I came into my room and plopped onto the bed as it started to hit me what I had just done. Abe hugged me and we prayed, as I realized the seriousness of this newfound plan. Round 6. I have done this so. many. times before. I should be an old pro. This should be old hat. I can't help but wonder if that will make it easier? Or if it will make it harder? 

I felt the dread after swallowing the small blue pills. I wish I could remember with accuracy what these hormones were about to do to my body. To my mood. To my weight. I am amazed by what I can't remember after spending almost a year constantly putting myself through this regimen before Mister and Sister's arrival. And also what I remember is slowly flooding back -- the pain and the disappointment and the dread and most of all the waiting. 

Amazingly I didn't cry. But I questioned if I was strong enough and brave enough to do this all again. 

This time feels different. This time there is an endpoint in the near future. Before, I had the hope of six embryos securely in the freezer and a large family coming from them. Now I know how hard it was to get the two blessings I have. I know that the odds are more likely than not that I will not get pregnant -- it took 5 embryos to get where I am now, why will one lone survivor suddenly stick this time? It doesn't seem like the way to start the "trying" process -- without much hope.

Mister and Sister's first baby picture

So we will see what happens. Despite it all, I have hope there is a little brother or sister there waiting to join us. I also have the joy of knowing we already have an amazing family. 

There is some relief in the finality even though it is also scary. Some of the worst parts of the whole process before was wondering and having to ask God, "How much do I have to do this before I give up? Before I know it won't work?" This time I know we have one more shot. (Again with the puns, actually 2-12 weeks of shots... but one chance at a pregnancy.)

I am anxious to finally know if I can give away my baby gear. I am also terrified to think I may have to. 

So here's to my Hail Mary. Crossing my fingers it will work. And if it doesn't, that I will be okay with God's answer. 

We are breaking up...

Dear Medela,

I'm breaking up with you. It has been a long almost 11 months. I know it seems almost silly to break things off now --we always said we would go the distance! To one year, or heck, maybe even farther! But you know, I just can't take it any more. You are sucking it all out of me.

Then again, you aren't --and that's the problem.

You think you own me and frankly, are a bit controlling.
You dictate what I wear. No dresses unless they have stretchy necklines or buttons! Nothing too fancy!
You leave your messes behind you--in my car, the couch, my kitchen.
You won't let me see friends when I am with you.
You set my schedule, no matter the occasion or time. And you want me, all to yourself! Alone in a dark room, a car, even a quick special hotel room meet up at special events.

It's true, we have been through our ups and downs together. Your monotonous hum always lurking there in the background, in videos and phone calls, people always asking about you, "what's that?" The quiet companion always there--In the winter and the hot summer. With babies crawling over us and in the lonely wee hours of the night. Through work meetings and long commutes, weddings and shopping trips and family parties. Awkward sittings in the nursing lounge when our non-traditional relationship becomes obvious with the other nursing couples who are surely wondering about us. You've always been so mechanical! I know there are others like us, but they tend to remain in the closet!

You have always been there, nagging at me every 3-4 hours and on my mind almost every minute. "Come back to me, it's been too long. You need me. Only I can help you." And even, "You should be pumping. You are 'nursing' twins!"

But alas, I am giving way more than you are. I tried my best but unlike many of the other moms I know with over-flowing milk and their freezers full of storage bags, the few drops you are giving me just aren't worth the hassle. So I need to make a clean break. You have about a week to take the last of your milk before it is all gone.

No please, just go. Don't watch me cry! Sure, I'd love to stay friends, just another pump or two more. But then you really have to go. Before I change my mind.

Believe me, it's me, not you. I just can't make it work any more. And actually, there is someone else. It's my life. She called and she wants me back.

I know it hurts. I'm crying as I write this. But it has to happen. Maybe in a few years we can try again. I can't say that I will miss you but it will be an adjustment.

Sure, I may be willing to take you back. But you've made promises before to change your ways. More quality time together, power pumping sessions, wining and dining (well not really wining). But I just can't see it working. It's never lasted before. Why would I believe you now?

Sincerely,
Erin

Oh! And, I just learned that Janet down the street may be in the market. I think you will be just what she is looking for. You guys could be great!

Twin Skin and Tiger Stripes

Photo credit: Sarah Siler Photography

Before my struggle with infertility, I had a lot of anxiety about becoming pregnant, including some concerns about what it would do to my body. I wrote about some of those worries in my Blueberry Girl post. Knowing how hard I am on myself, I was worried that changes I could not control may wreak havoc on my body, which would cause a lot of personal dissatisfaction. Silly or not, these were some real concerns and although I was called out by some commenters for being selfish or vain to worry about such things, I still was quite worried.

Looking back I was bigger than I remember!

I mentioned before that my first body awareness after having the babies was noticing my immediately deflated belly as I lay on the operating room table. I felt a little unnerved seeing my once taut belly all soft and saggy. I started to wonder about the damage of what some call "twin skin."

Again, bigger than I realized!

I was stuck in bed and unable to move well enough to do much for days after the delivery. The first time I took a bath and saw myself in the mirror I was shocked. I couldn't believe how huge my hips looked. I figured it was because the size my lower body had grown was now grossly out of proportion without the large belly to match (I did gain at least 7" on my hips when I measured part way through my pregnancy). I managed to make it through my pregnancy with no stretch marks on my belly and a few small ones on my hips. Now, I have tiger stripes all along my outer hips and love handles that I attribute to the swelling from the IV fluids given to me in the hospital, partly to combat anemia after losing significant blood during the procedure, and realize now the large "hippy" appearance was also due partly to swelling.

Induction day edema

What happened to my knees?

Home post partum a few days later!

I don't know what I weighed in the hospital (close to 200 lbs) but I lost about 20 lb. by the time I got home 5 days later. One month later I had lost 47 lb! I attribute the bulk of this to water weight as I lost most once my knees and ankles were back to normal. I currently bounce about a pound below and a few pounds above my pre-baby weight, and about 5-10 pounds above my pre-IVF weight.

Induction day

13 days after delivery

13 days after delivery -- not hard to feel skinny after as big as I was!

Halloween, about 3 weeks after delivery

I have gone up a size or so in most of my clothes. I resized my wedding ring when it wouldn't come close to fitting over my knuckle. My feet seem to have mostly gone back to normal.

I didn't expect "The Mom" look to come so fast.
Maybe with two babies at once you accelerate along the path to Mom Bod that much faster.

I feel like I went over 30 years without looking like a mom. I had hoped to avoid looking like a mom. I wanted to always look young and hip, with flat, hard abs. (Not that that was true before kids!) Instead, I feel I look tired. I look older. I don't seem to know or understand many of the current fashion trends (leggings as pants, still an utter mystery to me!) and find myself continuing to wear my maternity clothes (baggy is in, right?). And my abs? Well, while they have never been flat, I somehow managed to avoid diastasis recti (separation of the abdominal muscles) but I still have a little extra sag. And as I mentioned before, the stretch marks.

But I couldn't be happier.

Okay that's an exaggeration. I could be more pleased if I looked like Heidi Klum after all her babies. It would be nice to fit into all of my clothes again. To have beautifully taut belly skin and supple unstretched hips. But...I still don't think I would be happier. So maybe I was right...

I couldn't be happier.

Because really, the way I look at my body has completely transformed. No longer do I look at my body as an ornament to dress and adorn. No longer is it an object to perfect or to use to seek admiration. It isn't something to be sexualized or even demonized.

It is a tool. It is an instrument. And an amazing one that has done amazing things. It has survived years of infertility. It has overcome hundred of shots and ravages on its system with synthetic hormones and mad scientist happenings. It has carried and delivered two healthy babies. It has provided much of their needed nutrition. All of this automatically, miraculously, without any input or feedback from me consciously.


***This is another post from my archives of works in progress. I wish I had finished it completely as I wonder exactly where I was going with it at the time, as it ends a bit abruptly. I contemplated adding another ending today but just didn't have the words. And it felt a bit fraudulent not to just ride the moment of the feelings I had then. 

I wish I could say that I have held on to this new found confidence completely since those early months post partum, but I think it is quite normal to have days where I begrudge my stretch marks! I haven't lost any more weight (although I am back in my old clothes), I continue to battle hormonal imbalances while nursing that cause skin issues, and I have more than my fair share of bad hair days but I find almost a year later I still place less scrutiny on the appearance of my body than before where every flaw and imperfection was something to improve, fuss over, or loathe. My main goal these days is to try to get healthy and back in shape. After exercise restrictions during my fertility treatments, a difficult pregnancy, and an overwhelmingly busy schedule with infant twins, exercise hasn't been much of a reality for over two years. As an athlete growing up, it is crazy to think I could ever go that long but I suppose life happens. 

Every day is a new day! I feel so lucky to have this wonderful body to live it with. ***

Birth Story

Our first selfie!

When I awoke Wednesday October 7, 2015 I noticed my underwear seemed wet with clear fluid. It was 5:50 am. I immediately suspected my water had broken. The instructions I had received from the hospital told me to come in within 2 hours if that were to happen but I figured I had my already scheduled ultrasound at 8 am so I would wait until then.

The ultrasound was pretty quick. There isn't much to see with two big babies cramped into such a small space at 36 weeks. Baby A remained head down and Baby B remained breech, slightly transverse. Baby A measured 6 lb 7 oz and Baby B measured 6 lb even. I was a little surprised our Baby Boy was measuring smaller than his sister but I was happy with their good size and curious to see if the sizes would be similar when they were born. Abe was able to sneak down between patients in the resident of the day clinic to see them, too. At first I felt bad how big I had become in my pregnancy, even compared to another twin pregnancy I knew, but now I was relieved they were so big when I knew they would be coming before their 38 week due date.

Finally looking pregnant with twins! Induction at 36 weeks

I told the ultrasound tech I was concerned my water may have broke that morning and asked if I could talk to a doctor. They found a nurse to speak to me, one who had helped me multiple times the past week when I had been evaluated before. She was kind and friendly but I got the feeling she was thinking, "Oh no, you again!" when she saw my face. She did a quick hallway consult and tried to explain  to me the difference between mucous (from the mucous plug) and other fluid (something I think I have a good grasp on after years of working in the mouth). Because I didn't have the stereotypical "gush" of fluid she seemed skeptical and stated it would keep leaking if it had broken. I told her it had only been a short while so I wasn't sure that was a good way to rule it out. She offered to have me stay to have it checked but I sensed she wasn't convinced. I guess I was getting a little sick of being there hours and hours and this time maybe "for nothing" so I decided to go home and call if it continued.

Of course walking to the car I wondered if I was leaking and should have stayed but went home to lie down and see if more fluid would accumulate when I stood up. It was a little hard to tell but it seemed to stop (whatever little may have been there) by about 11 or noon. I knew my doctor had been on call the night before and had had a busy night so I tried to reach her but wasn't too concerned when she didn't answer-- probably sleeping. I felt pretty certain that my water had broke that morning because I didn't know what else the fluid could have been, but I started questioning now as it was later in the day without any additional fluid. My doctor called me back mid afternoon and I gave her the update. We decided that I would go in to be checked when I dropped off my urine sample to Labor and Delivery that evening.

I also was trying to make the decision of whether or not I should go to work the next two days. I decided I wasn't feeling great so had them cancel my patients. I guess that ended up being a good idea!

36 weeks

Last bump pictures

My mother-in-law Kristin stopped by and offered to drive me in at 6 pm to be seen. Luckily, she had helped me finish packing my hospital bag shortly before (procrastination, even after my previous pre-term labor scare!). I didn't feel like driving and parking myself so I happily accepted the ride even though it felt lazy to do so. She kindly stayed with me while we waited. I got checked in (again) at the triage and changed into a gown. They did another NST while we waited. It seemed like a long time before they finally did the cervical swab (partly because they wanted me to lie down long enough for fluid to have chance to pool). I think it was close to 9 pm when they finally did and noticed some fluid had actually accumulated. The resident wouldn't tell me the preliminary result so we kept waiting and wondering. Finally, a nurse came in and we asked. She told me I was "ruptured." We weren't really sure what that meant for the plan and we asked if that meant my MIL should start texting updates that we were having the babies. The nurse said that was up to me and we were both confused what she meant until we realized she was saying, "Yes, you will be having the babies and it is between you two whether she gives you permission to tell anyone."

Abe was on call that night and in an emergency surgery case, draining an infection with the oral surgery team. I had the nurse page him so I could tell him the news that they were going to induce me and we were about to have our babies. I didn't want him to be the last to know so I was glad to catch him before he was scrubbed in and unavailable. We knew he would have plenty of time so I encouraged him to finish the surgery.

Monitoring the babies while being induced

The unit was very busy but finally a real room opened up and I was transferred into it for the night. Abe's mom and sister Jessica kept me company and bought me dinner while we waited for Abe to finish his surgical case. We joked that black bean soup was probably a bad choice right before labor. We took some last pictures of my bump, got hooked up to the IV to start the pitocin, and I was strapped to the monitors and stuck in bed for the rest of the night (except for annoying and frequent trips to the bathroom). I started feeling contractions right away with the initial dosing of the pitocin but they seemed to slow or ease up after the initial feeling. They continued to ramp up the dosage and we tried to get some sleep. This was difficult and I don't think I got any sleep. By the early morning my contractions were getting worse. I was starting to feel paranoid about how dilated I was. They were trying not to check too frequently (I think since my water had broken so long before) so I had no idea how I was progressing. I felt a little torn between going as long as I could and not being caught off guard and having to rush the epidural when we needed it. About 5 am I asked for the epidural. I figured I might as well be ready and also take advantage of the relief if I was going to get it, anyway (something my doctor insisted upon for my delivery). Funny how I felt a little like I was copping out not waiting until it was unbearable.

I had no idea I was this big!

The resident did a great job with the placement of the epidural. I was surprised how comfortable I finally was, not realizing how much pain I was actually having. The restlessness in my legs and the discomfort of being stuck in bed for hours without being able to move much (to avoid disturbing the baby monitors) was gone (which I think almost worse than the contractions themselves). It unfortunately was replaced with itching, but I finally relaxed and got a few hours of interrupted sleep.

Getting ready to go to the OR for delivery

Later that morning the OB team finally came to check me. I was dilated to I think an 8. I was surprised and happy to know I had progressed that far. They gave me more time and by about 11 am I was at a 10. My doctor wanted to give me a little longer before taking me in to the OR for the delivery. It seemed to take a long time (and longer than they had said) to get me back in the room. The epidural was still working great as I was able to move my legs but avoid the pain.

I was happy to see a friendly face as the anesthesia staff, Matt. We had spent a lot of time together on my anesthesia rotation in residency and it was nice to have someone there I felt I could joke and speak comfortably with. Between him and my friend Erin, my OB, I felt pretty calm considering the circumstances.

It's time! 

When everything was set they informed me I should start pushing. I had a hard time understanding what they wanted me to do and an even harder time telling if I was doing it. Pushing came much harder than I had ever imagined. I felt like all of the pushing was happening in my head. I could feel the veins pulsating and I literally worried I may stroke out, detach my retinas, or maybe even just shoot my eyeballs out their sockets. I had thoughts running through my mind about how I was going to die, leaving my poor husband to take care of two babies and without ever getting to meet my children; or secretly hoping I didn't have an undiscovered aneurysm that was about to blow. I felt really frustrated, emotional, and discouraged like I was doing something wrong even though the doctors were all very encouraging and trying to tell me I was doing okay. I didn't believe them as they told me I was doing "perfect" or to keep going. It had been about an hour of pushing and I really felt like giving up as I felt a little frantic I was failing. They tried to assure me that some people have to push for 3 hours and an hour was pretty great. (Ha!) I finally felt like I started to make a little headway (oops, sorry for the pun!) and was able to direct the pressure away from my developing brain aneurysm to my pelvis.

Baby Girl

My doctor finally asked me to stop pushing and told Abe to get suited up. He gowned up, came around, and I could see him guiding our baby out, first the head and then each shoulder as he caught her. I remember noticing how cone headed she looked! They called for the pediatricians to take the baby away to be evaluated. I knew there were a bunch of people in the OR (the anesthesia team, the OB team, and two pediatric teams) but I didn't really notice. Abe came back to my side and I was very relieved that I wasn't going to have to push out Baby B.

Now on to the breech extraction. Phew!

The resident reached up inside my uterus. I was surprised and relieved (very grateful for the epidural and my doctor's sound advice to receive it) to note that this was not unpleasant or uncomfortable. I couldn't help but think of the James Harriet veterinary tales I read as a kid. She felt around trying to locate him. My doctor asked her a few times if she had him and she kept saying she had just one foot. I started to get a little nervous but shortly after she had a grip on him.

Soon I could see his little legs and body. The doctors started trying to turn him but he didn't seem to come. An older doctor at the same time was applying pressure to my abdomen. They continued to turn him as I could see his blue body flailing. I could hear them saying they were trying to turn him but his head wasn't moving with his body. My doctor asked the doctor applying pressure on my belly to come around and put on some gloves. At first she said no, "Don't you want me here? You want me here, don't you?" My doctor became more firm in her request that she move down to my pelvis. I started to sense there was a problem. Abe kept telling me calmly that everything was going to be okay. My doctor was also calmly telling me that everything was going to be okay even though I could sense an urgency in her voice and actions. But I started to worry and feel panicked. The other doctor finally came around, evidently without gloves (per Abe) and the two staff doctors started trying to turn the baby, "Come on baby, come on baby, come on baby, come on baby." He still didn't seem to want to budge one way or the other.

To her credit, my doctor has an amazing bedside manner. She ever so sweetly and calmly told me, "Ok Erin, just so you know we may have to break his arm to get him out." I started to panic and cry. I tried to tell myself that that would be okay, a broken arm would be okay, but I was actually worried he was going to die. And if he didn't, would he have long term problems from a broken arm? I was praying very hard that the angels would be there with my little baby to get him out safely. Abe told me it was going to be okay and coming from him, I believed him...mostly. I wondered if this meant I would be getting a c-section after all and if I had enough anesthesia for that to be okay or how they would even get him out the other direction when he seemed so stuck.

Baby Boy

Finally, after the longest 6 minutes of my life, our little baby boy was delivered. They whisked away his blue limp body to the pediatricians and Abe told me again he was going to be okay. We finally heard his cry and I was told he was fine.

They brought baby girl around to my head to show her to me. I got to touch her little hand before she was taken to the NICU step down unit to be evaluated. The doctors continued to work on me. I remember thinking it was disconcerting to see my suddenly deflated belly! I found myself wanting my familiar tight abdomen back instead of the soft and foreign one left behind.

I was told I was bleeding and they started applying heavy pressure and pushing on my belly. The pain was excruciating as they continued to push and knead on my abdomen around my belly button. I kept telling them that I have a sensitive belly button so that really hurt. I didn't realize at the time that what they were doing likely would have hurt anyone. The anesthesiologist finally gave me 100 mcg of fentanyl and I remember saying, "Oh, so that's what it feels like when I give it to my patient's." I felt much more relaxed but the pain was still present and severe.

Baby B, boy

They continued to work to stop the bleeding. They placed a bakri balloon (a saline filled balloon) to put pressure on my uterus to help with the bleeding and a gauze packing. I was given some medications to put in my cheek and they started stitching me up. I continued to think about how I was probably going to die without ever getting to really hold or see my babies and what a sad joke that would be (not sure why I was so fixated on my own demise). In the meantime, or maybe once I realized I might live, I joked around with the anesthesia staff until they finally finished and wheeled me back to my room.

Settled back in bed. We did it! 

I remember being so relaxed and tired from the fentanyl I was excited to get back to my room. I was sad I didn't get to hold my babies but maybe a little relieved because I felt so miserable. By the time I was settled in my room, unfortunately the euphoria of the fentanyl had worn off and I didn't think I could sleep any more. My body was shaking uncontrollably in large shivers, a side effect of the medication I was given to help stop the bleeding, so I was told. I was parched and drank about 3-4 liters of water, popsickles, and juice. I was uncomfortable in bed and really wanted to get up to walk around and use the bathroom but the nurse wouldn't let me. I was tired of being stuck in bed since about 6 pm the night before, I was bleeding, and in a lot of pain. I was told I could see my babies later when I was able to get out of bed but now my nurse was saying she didn't think it was a good idea for me to get up. I figured I may not see my babies at all that day as I would be stuck in bed the rest of the night on Labor and Delivery.

 

Daddy and Baby Boy

Abe went up to see the babies in the NICU. I started to feel very down and depressed. I had just gone through a horrific and scary experience on what was supposed to be one of the happiest and most exciting days of my life. After a few hours, I felt very upset. I was all alone. I was in horrible pain. I was not allowed to get out of bed. I felt like I had lost my dignity as nurses helped me with the most intimate tasks. And I felt lonely. I wondered about my babies, if I even really had babies or cared that I had babies or would even love my babies. I was glad Abe was able to be with them but I felt very alone. I couldn't even reach my call light or the remote control to turn on the TV. So I cried.

So thirsty afterward

About the time I was feeling really bad Abe came back to the room. He was excited about the babies and showed me their pictures and gave me updates. Baby girl was doing well and would probably join us that day. Baby boy was also doing well but was on a CPAP (positive pressure breathing tube) for breathing support. Luckily, despite some bruising he was doing fine and his arm was not broken (although my doctor later informed me that she had indeed tried to break it).

Feeling emotional meeting a baby for the first time

Baby Girl

 

About 8:00 pm they brought Baby Girl in to meet me. I didn't know what to think and worried how I would feel finally getting to see her. I almost felt mad or resentful like I wasn't sure I even wanted to see her anymore. Holding her made a big difference and my spirits improved significantly. They even told me I could get out of bed and go to the NICU if I wanted by wheelchair to see our baby boy.

Meeting Baby Boy in the NICU

Getting out of bed was horribly painful. My lower body was horribly swollen, more so than at any point in my pregnancy and I have the stretch marks on my hips and thighs to prove it (much more and much deeper than any I had at my induction the night before) and even sitting up to get out of bed was awfully painful. I wished I could jump from lying down to standing and had to have a donut to even sit. About 10 pm Abe took me to meet our little guy in the NICU. It was sad to see him all alone in that little bed with a tube in his nose but I was very happy to hold him. I felt guilty that after only a short time, maybe 10 minutes, I asked to go back to our room as I was so tired and not feeling well. Luckily when we got back to the room they had decided to transfer me to the much more comfortable Mother Baby Unit. Yay!

 

In the end, it was a pretty traumatic day. The nurse helping me right after my recovery told me that in her 20 years she had "never seen anything like [my delivery]." In the beginning I felt like it was going pretty well. My sister-in-law talks about how she loves labor and the magic of having that little baby. After my epidural and my initial labor I thought how things had been going so smoothly and maybe I could understand where she was coming from. Unfortunately, my experience shifted far from that and it was one of the hardest, scariest, and loneliest days of my life. I didn't experience that incredible urge to push, the magic of holding your baby in your arms right after the delivery, getting to look them over lovingly to count fingers and toes or enjoy that skin to skin contact.

But I am so glad they are here, any way it had to happen, and I have no regrets. I guess it was a fitting end to their miraculous beginning -- it was hard getting them in and it was hard getting them out!

A few days ago I cried when I coincidentally came upon this scripture:

"And God shall wipe away all tears from their eyes; and there shall be no more death, neither sorrow, nor crying, neither shall there be any more pain: for the former things are passed away."
Revelations 21:4

I thank God that all of that heartache and pain, the years of infertility, the weeks of discomfort, the hours of pain, and the minutes of fear have passed away and have been replaced with these two miraculous blessings.

* * *

By the next morning Baby Boy was off all the tubes and finally brought to our room late the next day where he met up with his sister again for the first time since birth.

Reunited for the first time out of the womb the next day

First family photo

Birth Stats:

Baby A Girl:
October 8, 2015 1:13 pm
6 lb 8 oz
19 "

Baby B Boy:
October 8, 2015 1:21 pm
6 lb
19"