Pregnancy

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Continuing the tradition of putting every little detail of my life on this blog, here’s my latest plan: When I reach my weight-loss goal, I’ll reward myself with liposuction. It seems like a strange reward, but I think the only way I’m going to be motivated to lose any weight in the first place is to know that if I get most of the way there, I’ll have help for the hardest part.

After my final miscarriage fourteen months ago, Adam and I decided two things: we would make the trip to Italy, and I would get liposuction. We did the first, but I put off the second because I realized if there was any chance that I’d be pregnant again, it would be a waste. Well, now I’m done with pregnancy, and I’m putting that goal back on the agenda. Re-reading the post that discusses that decision makes me realize how far we’ve come in the past year. We went through so much, but now we’re here. I’m watching the babies on the video monitor right now. We had our most excellent honeymoon in Italy. And we’re no longer in limbo; the world is open once again to the pursuit of new values.

Anyway, I see the weight-loss as the final chapter in the struggle against the negatives of the past two-and-a-half years of my life. I only gained 47 pounds during the pregnancy itself (yes, with twins, 47 can be called “only”), but there were also the 12 that I had gained during the miscarriages. And then, there were the 10 that I never lost after my pregnancy with Sam. Add all that up on top of the 128 I was at originally and I was at a maximum of 197 pounds! I don’t think I’ll ever get back down to 128 (or the 115 that was ideal in my twenties); I think 130 is a reasonable weight at my age. So, I’m shooting to get myself down to 140 before I’ll get the lipo.

I lost about 27 pounds after the twins were born without any effort, leaving me at 170. I hovered there for weeks, and that’s when I knew I was going to have to put some serious effort into this project. There is no way I’m going to allow myself to remain at this weight!

I’ve never really lost weight before on purpose. One time I lost a few pounds by cutting out snacks after dinner and all sugary beverages for a couple of months. But that is the extent of my dieting experience. Since I had success with that method, I’m using it again and I’ve lost about 3 pounds. But it’s slow going because I’ve been eating tons of sweets lately. Besides the Halloween candy, I’ve also had dessert almost every night because my neighbors have been bringing us dinners. I mean, I’m not complaining: I haven’t had to cook for a month because of the generosity of my neighbors (and before that I had other gifts of food and my mom was in town). But most of them have brought these huge desserts – cakes, cookies, fudge, etc. And it’s hard to resist when it’s in the house and my lactating body is just screaming out for calories of any kind.

That is all coming to an end now, so hopefully I’ll see some improvement in my efforts. I’ll be cooking my own meals and not buying any sweets to tempt me. Exercise is also on the agenda, but honestly, I’m not sure I can fit that in yet. I don’t have a goal date in mind – I’ll be happy if I can just see a continuous improvement. But May or June would be good. Then it’s mommy-makeover for me. Hopefully there will be enough money left over to buy yet another new wardrobe.

My Birth Story

This is the story of Leo and Zoe’s birth. But it’s really my story. I’ll tell you more about them some other time.

My water broke at 5:30am on Saturday morning. My first thought: “Noooooo!” It was too early. And I don’t mean the hour of the day. I was only 34 weeks and 3 days. They were supposed to stay in there for 3 more weeks! I was in a bit of denial at first. Maybe the leaking would stop. Maybe it was a false alarm. It took me about 10-15 minutes to accept the inevitable. They were coming. Then, I started getting a little bit excited.

I wasn’t feeling any contractions, but we knew we still had to get to the hospital asap. My labor with Sam was only 4.5 hours and we dawdled and barely made it to the birth center in time. This time, we would do better! We needed to call the doctor, find someone to take care of Sammy, eat, shower, and pack up a few last items. The eating and showering might seem optional, but I knew I wouldn’t get another chance for either for at least the rest of the day, if not longer, so they really were absolutely necessary, and I’m glad I took the time.

My OB, Dr. K.,  wasn’t on-call that weekend, which was a huge disappointment. I was told that a Dr. A. would be handling my delivery. Great, some woman I’ve never met, who has no access to my records. I chose a sole practitioner knowing this might happen, but it still just made me sad.

Our next-door-neighbor ended up being available to take Sammy. This was really the perfect situation – Sam got to spend the day with her best friend, and they had our house key and could come to take care of the animals as well. They even let the contractor in so he could put the finishing touches on that goddamn bathroom. (I’m not convinced that the bathroom project had nothing to do with me going in to labor so early. It was a source of stress for 5 straight weeks.)

We got it all done and got out of the house within an hour without any panic or even a big rush. That was nice. But the most precious moment of the whole morning was when Sammy woke up. She heard me in the shower and came out rubbing her eyes. We told her that the twins were coming. She said, “But mommy, my clock isn’t green yet. We can’t get up yet.” (Her clock turns green at 7:30am each day and that is how she knows it is morning.) We told her that the twins don’t know what time it is – that they come whenever they are ready, and they were ready now. It took her a few minutes to process all of this, but at one point I saw her comprehend what was going on. She finally realized, Zoe and Leo are coming TODAY. Her face lit up with joy and excitement, and I wish, oh how I wish, that I had that on video. It was one of my favorite moments with her, ever.

We had no problems getting to the hospital or checking in. I still couldn’t feel any contractions. We were brought to the triage room which is just a bunch of beds separated by curtains. They hooked me up to the monitors: one heart rate monitor for each baby plus a monitor for contractions. These are just belts strapped around my waist with sensors in the appropriate places. But none of the nurses could get those sensors positioned properly – I guess Zoe and Leo were moving around too much – and I was continually poked and prodded for the next 4 hours as they tried to get them working consistently. It was frustrating because they could not accept that everything was fine from the readings they did get. They have a rulebook that requires continuous monitoring, and no matter how that interferes with the rest of the process, they have to keep trying. I also got an IV (evil, evil IV) and they took my blood and did a couple of other tests. The monitor told us that I was indeed having contractions. They were mild and irregular. I only felt a few of them for the next 4 hours.

Besides the medical stuff, the staff had to do tons of paperwork while I was in triage. The most extensive form was the one where I acknowledged that “falls happen” and that it is not the hospital’s fault if I fall. Ugh, liability bureaucracy. We found out that Labor and Delivery was extremely busy that morning and that they didn’t have a room ready for me yet. The plan was to move me to an L&D room for my epidural and the labor process, then to an OR for delivery. But nobody was in any rush because they didn’t think I was in active labor yet. After a couple of hours, though, nobody had checked my cervix and I was starting to get nervous. Everything in the hospital was moving so slowly, and I knew that I could go from nothing to pushing in a very short time.

In the middle of all of this, I noticed my nurse’s name tag. Her last name was the same as my OB’s. Then I remembered that someone had told me that his wife worked in the hospital. Click! I asked her and it was true! She was Mrs. Dr. K.! (For some reason I didn’t understand, she didn’t want to tell us, but she didn’t mind that we figured it out.) I don’t know why, but this made me so happy. I didn’t feel so alone. My nurse had a special connection to me. Dr. K. would get a firsthand report of at least part of my labor. And I just felt like he was there for me, through his wife. We chatted a lot with her and we liked her as much as we like Dr. K. It was a wonderful surprise.

Around 11:15am, I started feeling the contractions, and the monitor confirmed that they were becoming stronger and more regular. The first few were no big deal, but then they started getting intense and coming very quickly. I demanded that someone check my cervix, but I was only 2cm. The nurses continued to assume that I had a long wait ahead of me and nobody was making any moves to get me to an L&D room. I still had not seen any doctor, which is pretty normal, but at this point I demanded to see the doctor and for them to get me to a room for the epidural. When the doctor finally came, I think around 11:30, she agreed to get me a room, but her attitude was that I needed the epidural and pitocin, to “speed things along” since my water had broken but I wasn’t progressing much. My blood pressure was also high, but since she didn’t have my records, she didn’t realize that it was actually pretty normal for me. She was concerned about it spiking. I didn’t really care about her reasoning, as long as she was willing to get me out of triage for the epidural. I wasn’t dying of pain, I just knew that things would move very fast, and I didn’t want to get into an emergency situation, or not be able to get the epidural and end up having a C-section under general anesthesia. So I didn’t argue about the pitocin, even though I think that trying to induce or speed up labor with drugs is almost always a mistake. Adam got upset because he knew that I didn’t want pitocin. But I told him that the doctor’s stance was reasonable, given that she didn’t know about my blood pressure history. But more importantly, I told him, “Don’t worry – by the time they get me the epidural, I’ll have made so much progress they won’t need the pitocin.”

So, they got me a room and I got the epidural pretty quickly. I only had to endure about a dozen strong contractions (mixed with another dozen weaker ones) before I got it. And it was wonderful. I didn’t mind laboring with Sam when I could move around and be left alone to deal with my contractions. But in the hospital, when you are forced to lie in bed on your back, and when you have people constantly talking to you and have to tell them to shut up when a contraction comes along, it was really, really painful. The hospital environment simply does not allow you to relax and focus. I recommend that anyone who is giving birth in a hospital should have the epidural. It’s insane to try to deal with contractions in that environment. If you want a natural birth, have it outside the hospital, or at least hire a doula to make everyone leave you alone, and don’t allow them to limit your movement. Continuous monitoring is the first problem in the chain of interventions leading to C-sections.

After I had been in the L&D room for a bit, Mrs. Dr. K. arrived. She had either ditched her post in the triage room, or had finished her shift and come to me on her own account. She stayed with us through the rest of the delivery. Even though my primary nurse, Ann, was excellent, I was so grateful to have that connection again.

Dr. A.’s orders were to start pitocin at this point, and the nurse could have just put the bag on the IV, but I told her about my fast labor with Sam and how I knew by the strength of the contractions that I was progressing quickly. I asked if she could check me first and she agreed, even though I’d been checked so recently. As she was checking she said, “I’d say…I’d say…[long pause]…I’d say you’re complete!” My response: “Ha! I knew it!” Thank god I knew my body and was an advocate for myself. I have no idea what would have happened if they hadn’t gotten me that room and the epidural, or if they had given me pitocin when I was already fully dilated. The whole situation reinforced my belief that hospitals do not handle childbirth well at all. I’m grateful for so many aspects of modern medicine: the drugs, the skills of the doctors and nurses, the blood banks, the NICU, and so much more. And I needed that for this situation. But I’ve done it both ways and I know that hospitals could do much better. Maybe if the “natural birth” advocates weren’t so anti-medicine, they would stop promoting birth centers and midwives and try to make changes within the excellent medical system that we already have. I’ll have to add that to my long-range to-do list. (Otherwise known as my wishful thinking list.)

Anyway, I was feeling great. I was in no pain and I was ready to be moved to the OR. I still didn’t know if I would end up with a C-section or not. Leo was head-down, but Zoe could go either way. The plan was for me to push Leo out and hope that she turned head-down as well. But if she went into a breech position and if the doctor recommended it, I was going to take the surgery and not try to force the issue. They wheeled me into the OR. Adam had to wait outside while they set up the room. I had enough feeling to slide myself onto the table. I felt pretty powerful and in control. But then I spent the next 30 minutes watching as the doctors and nurses fumbled around trying to get things set up. A couple of them had never participated in a vaginal delivery in the OR before, and nobody seemed to know how to get things set up properly. They practically had to pull out the user’s manual to get the stirrups hooked up to the OR table. They had machines that were not normally in the room and they couldn’t figure out how to plug them in, so there was some crawling around on the floor, stringing wires and cables under my bed to the other side of the room. It was comical!

As this was going on, a steady stream of people were entering the room. There were three or four people for each baby, my anesthesiologist, his assistant, my doctor, my two nurses, another assistant, and probably more that I’m forgetting. My doctors had blue gowns, and the baby doctors had yellow gowns. The yellow gowns were all behind me, so I knew that Leo and Zoe would end up there, where I couldn’t see them. I suppose they do that in case something goes horribly wrong. But I wasn’t too concerned about the babies’ health at this point. I knew that they would go to the NICU for sure, which made me sad, but didn’t freak me out. I was mostly focused on the time elapsing – hoping the staff could get their act together in time. With the epidural, I couldn’t tell where Leo was, and I wanted Adam in the room. I kept reminding everybody, “Don’t forget my husband!” Finally, they let him in and the pushing began.

Leo was easy. I pushed a few times and he was out. I’ll never forget looking down past my still-huge belly and seeing him being lifted up towards me. I’d been here before – with Sam. I didn’t think a second child could be as shocking and awe-inspiring. But he was. I said, “Oh my god. He’s real!” There is no other way to describe it. No matter what you experience when they are on the inside, you can’t be prepared for the reality of an actual human being coming into this world. They let me hold him for a moment before they whisked him off behind me to check him out. He looked great – pink and full of energy. But his cry started out pretty weak and I worried a bit until it grew stronger. Then I knew he’d be okay. He was four pounds and seven ounces.

Zoe didn’t suddenly make a break for it. She just stayed put. That ended up being the best thing, because the doctor was able to guide her to come down head-first as I pushed. I wasn’t going to need surgery – hurray! I still had to push her all the way down, so it was a lot more work than it was for Leo, who had been right there at the door. Zoe did end up head-down, but in a posterior position – face up. This means a slightly more difficult birth, but since she was so small, it wasn’t a real problem. Still, despite her smaller head, I noticed how much more difficult it was to get her out than it was Leo. I feel for mothers of full-term babies who are born this way! Anyway, after all that pushing (it really wasn’t that long – about 10 minutes), it felt like a real accomplishment when I finally got her head out and I cried, “Yes!” like I had just aced a serve at Wimbledon.

Zoe’s appearance didn’t have quite the impact that Leo’s did since I was a bit more prepared for her reality. But still, there was the mindblowing realization that this was a unique human being who had just arrived. She looked different than Leo. She was smaller. Her face was more delicate. She moved differently. Leo and Zoe are not a “set.” They happen to be twins, but that doesn’t mean much more than that they are siblings. I knew all of that in the abstract, but seeing Zoe for the first time made it concretely real.

Despite her smaller size, Zoe’s cry was strong from the moment she let it loose. I knew she would be okay, too. She was three pounds and fourteen ounces.

I didn’t get to see either of my babies much after the first few moments. I didn’t fall in love with them right away. I was stunned from the whole experience, and I ended up having some problems delivering the placentas, which required that I be drugged up even more than I already was. By that time, Adam and Leo and Zoe, along with all the yellow gowns, were gone to the NICU.

Eventually, I was brought back to the L&D room and I dozed off for a while. It seemed that hours had passed before Adam finally came back. He gave me a report on Leo and Zoe which is a complete jumble in my memory now, but which boiled down to “they look good.”  I wanted two things: I wanted food and I wanted to see my babies. I felt like they had been stolen from me. It just seemed so wrong that everyone could see them except me. Still, my hunger was even stronger than my desire to see them. I kept begging for food, but I didn’t get it until many hours later. They made me drink juice and eat a few crackers first (crackers don’t count as food). They are so scared that people might vomit. The whole thing is just so wrong. They should have a feast waiting for you after you give birth and trust you to eat according to your needs!

The hospital was still busy. The next step was for me to be moved to a “Family Centered Care” room, and there was a room available, but there were 13 women ahead of me in line just waiting for someone to physically move them. Apparently, the move process requires more paperwork and specially skilled “transfer personnel” in order to accomplish the daunting feat of wheeling the bed into an elevator, pushing the right button, and then wheeling the bed into a room. But my nurse, Anna, decided I was special and she wheeled me there herself. I know this is something she normally doesn’t do because when we arrived in the FCC area, she said hello to a lot of the staff saying things like, “It’s nice to finally meet you in person.” “We’ve spoken on the phone so many times but I’ve never seen you before.” I’m not sure why we got such excellent treatment, but I was so grateful for it because it meant that I’d get a meal that much sooner.

Zoe was born at 3pm. I arrived in the FCC room somewhere around 5pm. We quickly found out that the NICU doesn’t allow visitors between 6:30pm and 7:30pm because that is when they do their shift-change. I didn’t want to wait until 7:30 to see Leo and Zoe. I told everyone that I was going to make the trip (four floors down and maybe 40 yards of walking), so they should help me get ready. I had to use the bathroom and they had to give me some lectures about this and that. I ordered food from the cafeteria so it would be there when I got back. Suddenly, it was 6pm. I told them I was going now. They tried to get me to go in a wheelchair, but they were so slow about everything I was afraid that I’d lose my chance if I waited. So Adam and I walked, wheeling my IV cart along.

I don’t even remember much of my first visit to the NICU. It was overwhelming. I just wanted to see their faces, and once I did, I felt better. First I saw Leo, and noted what a big nose he had. Then I saw Zoe, and noted how tiny she really was – more tiny than I had realized in the delivery room. As I was finishing up with Zoe, I felt something dripping down my back. My epidural injection site was leaking. Someone found me a wheelchair and we went back to the FCC room. It turned out to be nothing. Then I ate.

That’s the end of the story. But there’s a postscript. About two weeks later, while I was visiting Zoe (Leo was home by that point), one of the NICU nurses came up to me and said, “I just had to come over and say hello. You probably don’t remember me, but I was there when you came to visit Zoe that first time. I’ll never forget how determined you were to see your babies. I couldn’t believe you had just delivered them three hours ago. You were amazing.”

Yes, I was.

 

 

Announcing the arrival of two brand new human beings!

Leonidas Jeffrey Mossoff (Leo), born August 20, 2011 at 2:42pm, 4 pounds 7 ounces:

Zoe Alleyne Mossoff, born August 20, 2011 at 3:00pm, 3 pounds 14 ounces:

These are the very first photos of them. I like them better than the ones where they’re all cleaned up and bundled.

They are both in the NICU but doing great. They won’t have any health issues – they just need to grow a bit more before they come home, which could be anytime between this weekend and another three weeks. I was hoping to cook them myself for a while longer, but I went into labor early Saturday morning and no matter how much I tried to hold them in, they were determined to come out. The whole birth experience was magical. Leo and Zoe are magical. I can hardly believe they are real. But they are. They’re here. It took 27 months, 4 losses, and the magic of science, but we made these two babies. It was definitely worth it.

34 Weeks

I’m over the hump! My pre-eclampsia symptoms have not progressed and everything seems stable. And at 34 weeks, Zoe and Leo are going to be fine, even if I go into labor tonight. This is the magic time where everybody breaths a sigh of relief.

And speaking of that, I was afraid last night might have been the night for a while. I was having all kinds of pain and strange goings-on, but it turned out to be nothing.  I did get a little taste of the imminence of the big event though, when I thought I might be going in to labor. At first I was scared, but then I accepted that it might happen and I actually started looking forward to seeing my two babies. I really, really want to keep them cooking for a while longer, but it wouldn’t be devastating if they came now. And going in to labor on my own is preferable to being induced for some problem like hypertension. I figure that if I go into labor, there is probably some reason for it that makes it the best thing for me and/or the babies – not a mystical reason, like “everything happens for a reason,” but a real causal reason that we just can’t see because we don’t really know what the heck triggers labor to begin with.

I had an OB appointment this afternoon and I was really nervous. I had gotten used to going in every day and it had been a whole six days since I had had any kind of checkup. But my blood pressure is stable and nothing new has cropped up. The kids are growing and responding to stimuli. Today, my doc got fed up with waiting for Zoe to have a heart acceleration on the non-stress test so he poked my belly with a cattle prod. Well, I guess it was more like a vibrator, but it felt like he had electrocuted me and Zoe went nuts, as she was supposed to. It was hilarious.

So things are good right now. Once again I’m feeling like my body is good at this pregnancy thing. I’m starting to trust my body again. I had such an easy time with Sam, so it’s been kind of a let down to have had all these problems this time. But then again, what I’ve had aren’t full-fledged problems. They’ve all been Almosts and Maybes. The gestational diabetes thing was a joke from the start. (Today I told my doc some of my numbers and he wouldn’t even listen to any more and told me to forget the whole thing. Ha! I was right!) And I’m not sure if I have even been officially diagnosed with pre-eclampsia, or even pregnancy induced hypertension. We were just watching very closely for a while there. I know my doctor is no longer seriously concerned because he told me I can go another week before my next checkup. So, my body really is doing okay. I don’t even have stretch marks on my belly. Not bad for a 41 year old.

Steroids!

My 24 hour urine test came back showing some protein in it, but we had expected that. It wasn’t any higher than we would have guessed, based on my other symptoms and what they’ve seen in the regular urine samples I leave at each trip to the OB. But my doc still decided that he would recommend that I have the steroid injections to speed up development of the babies’ lungs. (He said he hemmed and hawed about this for quite a bit before calling me. It’s totally borderline.) It’s a standard procedure when an early delivery is likely, and there is a lot of evidence that it does indeed help them with breathing when they are born. Side effects for both me and them are not a big concern. The only thing is that it is not clear whether or not the positive effects last beyond a week or so, so we might not get any benefit out of them if I keep chuggin’ along for a few weeks.

The doc still insists that he doesn’t think I’m going to have any sudden problems. But it is possible that things could go wrong very quickly, and the shots wouldn’t have time to be effective if we had to do an emergency delivery. I agreed. So I had a shot on Thursday and a shot on Friday, bringing my total doctor appointments to nine in fifteen days.

Those steroids have made me feel like a million bucks! What a miracle drug! Every pregnant woman should get steroids. I have more energy, my gastrointestinal issues have disappeared, I can roll over in bed without it feeling like I had to carry a piano up the stairs, and I even got through the night with only two trips to the bathroom last night. Best of all, I can feel my fingers again. I’ve been living with this carpel tunnel for so long, I had forgotten what it is like to feel normal. I didn’t even wear the wrist braces last night, which made me feel so free! I still have a tiny bit of numbness just in the fingertips, but it doesn’t hurt and it’s not nearly as irritating as what I’ve been used to for the past few months. It makes me realize how far from normal I’ve been feeling, and now I’m looking forward eagerly to feeling normal again.

I tried to pin my doctor down on his best guess for when I’ll deliver. He told me that at 36 weeks, he’s just looking for reasons to deliver. A bad headache (pre-eclampsia symptom) would be enough at that point, since the benefits of keeping the babies in longer are marginal. 36 weeks is August 31. It’s going to be a photo finish for me to meet my goal of two more September babies!

33 Weeks

Whew! Seven doctor appointments in two weeks, including one trip to the hospital.

The bottom line is that my doctor was monitoring me very closely because of the signs of possible pre-eclampsia. The trip to the hospital was just to run bloodwork, which I found ridiculous, but wasn’t going to argue with. It was a Friday and if they had drawn my blood at the office and sent it to the lab we wouldn’t have had the results until Monday, whereas we got results within an hour at the hospital. That bloodwork, along with all my other tests, was fairly normal. And since then, everything has pretty much stabilized. My blood pressure is elevated but not rising. I’ve actually lost some weight and we know the babies are growing normally, so we know that it was fluid retention that has lessened. As my doctor says, rest is the key. As long as I lie down for much of the day, I can see just by the swelling in my feet that I’m doing okay. If I’m active, I balloon up and my pressure rises.

The other crazy thing I had to do last week was collect my urine for a full 24 hours. They gave me a gigantic jug and I almost filled it. It was a horrible, horrible experience. I had to keep the jug in the fridge, so every trip to the bathroom (there must have been about 20 of them) meant getting the jug, peeing into a smaller cup, pouring it into the jug, repeating as necessary, returning the jug to the fridge and throwing away the cup, and washing my hands. The worst part was the four trips downstairs to do this process in the middle of the night. I swear, I wonder how many women trip and fall down the stairs when forced to do this damn test. We haven’t gotten the results from this test yet – it’s just to look for protein in the urine. It’s my last test before we can relax a bit and say that I’m not in imminent danger of needing to deliver the babies. Also, I get to go back to weekly appointments instead of the insanity of going in two or three times a week.

So, I’m not on bed rest, but I’m continuing my own campaign to rest as much as possible. I try to stay horizontal at least 15 hours a day. It is much easier now that I have my wonderful babysitter to help each day, and because the bathrooms are finally finished. (I hope to get some photos up soon – the master bath is spectacular!) My stress level has gone way down. We’ve started making preparations for the arrival of Leo and Zoe – finally! A good friend came over on Sunday and helped clean all the toys and junk out of the nursery. We also cleaned out the eating area next to the kitchen which has served as Sammy’s playroom for the past couple of years. We moved all of her stuff down to the basement (which is no longer filled with junk!) and now I have a nice big space for Leo and Zoe to hang out. Eventually, we plan to put up gates and make that their safe space to play without much supervision. Sammy has a new “big girl” playroom, where, I tell her, she can keep her toys safe from the babies. Things are coming together. If I had to bring babies home tomorrow, it would not be a disaster. (Of course if they came tomorrow, they’d be in the hospital for a while anyway.)

Leo and Zoe are just over four pounds each now. If they were born now, they’d probably still need help breathing, and they’d have trouble eating and lose some weight, but every week, I can relax more about the possibility of severe problems due to premature delivery.

All other signs of health are positive. My doctor tells me every visit, “These are two very healthy babies.” Yesterday we did a little 4-D ultrasound, just for fun, and I got a decent view of Zoe’s face for the first time. (If you’ve never seen a 4-D ultrasound, the lumpy things are remnants of movement. You have to be like Michelangelo and imagine the perfect form underneath.) Unfortunately, Leo’s head is too low and squished into a small space to get a good picture. Here is little-Zoe and big-Me, and a bonus picture of medium-Sammy since I’ve been neglecting sharing her with you lately:

 

32 Weeks

I’ve done so many updates on the pregnancy you’d think I’d have nothing left to say for my weekly update, but I skipped most of the fun parts.

Leo and Zoe are basically head-down right now, and they are getting less and less likely to flip. Zoe is still questionable, but even if she ends up breech, this doesn’t rule out a vaginal delivery. I’m doing some research now on how to convince my doctor to allow that even if Zoe is breech. Of course, I could end up with a C-section tomorrow for other complications.

Speaking of tomorrow, I have another doctor’s appointment. That will be three in one week. They are monitoring me very closely because of the blood pressure, but still, no diagnosis of pre-eclampsia. Since making a concerted effort to spend more time lying down, I lost two pounds in four days. That’s all water-weight, obviously, and that is a very, very good thing. I’m definitely helping myself and the kids by taking it easy.

I think I mentioned that my doctor agrees with me about the gestational diabetes bullshit. He said I can quit all the fuss, eat my own way, and just monitor my blood glucose every other day. And he only wants that done because it still is possible that my hormones could kick up my insulin resistance at any point. See, he wasn’t such a bad doctor after all.

I had my first-ever non-stress test on Tuesday. L&Z did their job and had some accelerations in their heartbeats. Everything that relates directly to them and their health continues to be absolutely perfect. They are getting close to being about four pounds each now.

Our “nanny” is working out great. She’s taking Sammy to the water park this afternoon. She keeps Sammy occupied for at least two hours a day, which is enough time for me to get some really good rest. She is also helping with dishes and laundry and opening the zillions of Amazon.com boxes that seem to arrive every day. Yes, I’ve started ordering supplies for the babies – finally!

The master bathroom is supposed to be done today! (That means it will be done by the end of the day tomorrow.) We can finally move on with our lives. I’m already finding that my stress level has gone way down. On Saturday, a friend is coming over to help me get started on sorting out the baby clothes and toys from Sam’s current things. We still have a lot of other projects, but they are not as “do-or-die” as the bathrooms were. Hopefully I’ll have some photos to share early next week. I must say, it is going to be absolutely fabulous!

And now that things are calming down, I’m able to start daydreaming about my babies again. I barely gave them any thought for the past month. I think I’m starting to get excited now. Only eight weeks until my due date, which is really quite irrelevant. Only six weeks until my scheduled C-section, which is probably the latest they will be born. Only five weeks until I am officially “term” with twins  - the average (or is it mean?) delivery time. And Sam came two weeks early, so only three weeks until I would anticipate the possibility of going into labor for completely normal and healthy reasons.

But I’m still holding out for two more September babies. Anyone want to make guesses as to their birth date? My guess is September 4 – one month from today.

Mental Set

I have this mental set I can’t seem to get rid of. It is:

“I am poor.”

Adam and I were “poor” for so long. I’m sure everyone has different ideas of what “poor” means. What I mean is that we had to watch every dollar (although not every penny), and we had to live without a lot of things that would have made our lives so much easier. We shared one car for many years, which was not easy. We never bought a new appliance. We spent almost no money on clothing or jewelry. Things like a pedicure or a massage were completely out of the question. The only luxuries we permitted ourselves were travel and dining out, and we only did those in the most limited ways. But, we were never in danger of running out of money for food, or being late with our mortgage, or anything like that. However, we were one disaster away from that, since we had virtually no savings (excluding retirement funds). We were definitely living from paycheck to paycheck for a decade.

Only recently we came out of this state, due to a number of factors. Now, we have a little nest egg for emergencies, and we don’t have to freak out if the dishwasher breaks and we need to spend a few hundred dollars to replace it. We can take those things in stride, as normal expenses. (And that’s a good thing, since everything in this house seems to be breaking down.) We’re definitely not rich or even well-off. We are simply “secure.” It’s a wonderful feeling.

But I’m having a really hard time getting used to spending money on certain things. I have it in my head that we can’t afford babysitting, let alone any kind of child-care. So when I realized that we would have two toddlers right at the time when I’d be starting to homeschool Sammy, my mind was open to spending money on private school, but the idea of hiring a nanny for the twins (which will be much less expensive) never occurred to me until someone suggested it right here on my blog!

And now, when I’m facing the possibility of bed rest, my first thought was to call on all my friends, but it didn’t occur to me at first that I could actually hire someone to help me. At least this time, it only took me about 24 hours to get past my block and think of it myself – I didn’t need someone to suggest it.

So, I’ve hired the college girl who lives across the street to come and help me take care of Sam and the house for the next month or so – probably about 15 hours a week. (I had already hired her to be my mommy’s helper when Leo and Zoe arrive and I still had a hard time realizing that I could do this.) I’m not sure exactly how it will work out, and I don’t yet know if I’ll be put on real bed rest or not, but no matter what, I need more help. I’ll probably still need some help from friends if I end up on bed rest (I certainly can’t afford to hire someone full-time), but I much prefer to be paying someone instead of taking “charity.” I know my friends would actually love to help, but beggars can’t be choosers, and when I’m paying someone I can rely on her coming at certain times, and to do certain things. That gives me so much more peace of mind. She starts tomorrow.

Here I am at 31 weeks pregnant. My belly measures like a 37 week pregnancy with one baby, and Leo and Zoe together already weigh more than Sam did at birth. No matter how difficult this pregnancy becomes, I still love that huge belly!

Things are happening fast. The gestational diabetes is a non-issue (my ob even agrees with me about not following the meal plan), but now it looks like I might be on the road to pre-eclampsia. My blood pressure has been rising and fluctuating. At my ob appointment today, they took two readings. The first was something like 143 over 69 and the second was 125 over 70. I tend to have low blood pressure, so these are definitely high for me.

The doc did a blood test for pre-eclampsia again today (the last one was negative) and he wants me to come back on Tuesday – just four days from now – for another check. I told him that I had purchased a home blood pressure monitoring kit and he agreed that it would be a good idea to test at home here and there. If I get a reading of over 130 systolic or 80 diastolic (did I get those right? I always get the names mixed up), I need to call him immediately, and if it’s on the weekend, I’ll be sent to the hospital.

I’m not worried about pre-eclampsia, so much as I’m pretty sure I’m going to end up with it – it’s just a matter of when. To me, all the signs are there: the incredible swelling, the rising blood pressure, and the clear signals I’m getting from my body, telling me, “you must lie down immediately!” And, just in the past week or so, I’ve been getting nauseated in the middle of the night, which I took as a need for more food, but which can also be a sign of pre-eclampsia.

If I am diagnosed with mild pre-eclampsia, I’ll be put on bed rest. If it is severe, I’ll be on bed rest in the hospital.

The good news is that the problem can always be solved by delivering the babies (and the placentas). So when the condition gets to a certain point, they just do a C-section. I am 31 weeks along now. If I can just get a couple more weeks in, we’re past the really bad premature delivery issues. But I still have a goal of making it until September, and hopefully until September 16. (Did I tell you that my “just in case” C-section date was changed from the 15th to the 16th?) So, I now have the excuse that I need to slow down. I mean, I really, really have to slow down. It’s going to be very difficult. I don’t really know how to do it. What do I do with all the things that need to get done? Sam’s last day of camp is today. What will I do with her all day after this? It might be time to start calling on that list of friends who have offered to help. And I have to sit down with Adam and figure out a plan to deal with this. Asking for help is hard, but I’m going to do it.

Well, the gestational diabetes class wasn’t as stupid as I thought it would be. The dietary advice was much better than things I had read on the internet for diabetics, and they did a personalized meal plan for me (based on my weight gain, the fact that I have twins, etc.) which is very close to how I actually eat. The only real difference is that I pay much more attention to timing and balance (and my body’s own signals), whereas the meal plan I was given was basically just a way of controlling overall carb intake. They do spread it out over the day (in three meals and three snacks) but there is no recommendation to also take in any certain amount of protein or fat, so there are suggestions like having a snack of fruit and a slice of bread. That would be a problem for me. Another suggestion would be to eat for breakfast, one egg, two slices of toast with butter, and a glass of milk. That much carb with that little protein would be a problem for me. Give me three eggs and I could handle two slices of toast if I really must eat them. But why must I eat them?

I was pleased to see that they didn’t make any distinction between complex and simple carbs. I suppose they would do so before putting someone on insulin, but by default, we were all allowed to eat white bread and rice and even have fruit juice, if that’s how we want to spend our carb allotments. They also didn’t ban candy or ice cream, just told us we had to count the carbs. Again, that works for me, as long as I have protein and fat in my system, too.

I did get a free blood glucose monitoring kit. (Well, I guess my insurance is paying for it – nice how I have absolutely no idea about medical costs, huh?) I’m supposed to test each morning and two hours after each of my three main meals. I’m also supposed to test my urine each morning for ketones, which will supposedly tell me if I’m drawing on my body’s stored fat. (I need to do more research on that. I don’t understand the relationship between ketones and low blood sugar, and I don’t understand exactly what the problem is, and whether it’s only a problem in pregnancy.) And I’m supposed to follow the meal plan and write down everything I eat and at what time.

But here is what I’m going to do. I’m going to do all the testing. And I might test more often as well. (I’m suspicious that my blood sugar is dropping in the middle of the night.) I’m going to record everything I eat. But I’m not going to follow the meal plan. I’m going to eat like I always do and see what happens. If I never have an elevated blood glucose level on my own diet, then why change it? During the class, we did a finger prick just to make sure we all knew how to do it. It happened to be exactly two hours after I had eaten lunch, which is the time I will be testing going forward. My blood glucose level should be less than 120. It was…ready? 67. And my level two hours after dinner? 76.

I go back in a week for the nutritionist to analyze my data. Maybe I’ll get more insight into hypoglycemia and how I can even better manage my condition after pregnancy. That would be wonderful. I also look forward to showing her how worthless and stupid that glucose tolerance test was in my case.

Well, that’s assuming I’m right and my levels stay low. But I’m pretty sure I’m right.

31 Weeks

Okay, I’m really hurting now. But the heat wave is over, and we got a window a/c unit for our bedroom, so I’m not nearly as swollen as I was last week. Sam and I did go to a hotel for two days and it was a fabulous getaway, even though the hotel a/c couldn’t quite get the room cool enough for me. Yes, the heat was that intense here!

I don’t think I’ve mentioned it here, but my biggest problem symptom of this pregnancy is the carpal tunnel syndrome in both my hands. It stared about two months ago and it’s bad enough that I can’t hold a pen or a razor or a hair dryer without my fingers going completely numb. I’m also awakened in the middle of the night with excruciating pain occasionally, although the wrist braces that I wear at night help a lot. Luckily, it doesn’t seem to be progressive. It started out bad and it’s still bad, but no worse, and it should disappear after I deliver. The cause is all the extra fluid in my body compressing that nerve.

What is causing me to hurt more now is the fatigue. It is so hard to carry around these babies. They’re heavy! They wear me out! Getting in and out of the car is a challenge, and as I’ve mentioned, I try to avoid stairs at all costs. But I have good days and bad days. Two days ago I had a great day. Yesterday I struggled all day. Today seems somewhere in between. But as long as I can keep cool and get a lot of horizontal time each day, I think I’ll be okay.

I’m going to the gestational diabetes class tomorrow. What a waste of time. But I think they’re going to give me a prick kit as part of the program. I look forward to testing my glucose levels and proving the stupid test wrong.

The bathroom remodel continues. We can’t do anything about preparing the nursery or even buying supplies for the babies until it’s done. But I made a list, and I think we should be able to get everything done by the end of August. I’m figuring that there is no way, even if I deliver before the end of August, that the babies will come home any sooner than September 1.  So that is my drop-dead date to get everything prepared.

We still haven’t decided on the exact names for our babies. We know we’ll call them Leo and Zoe, but we haven’t yet decided if they’ll have middle names, and if so, what they would be. Adam and I don’t have middle names, but we gave one to Sam. (Miriam, after Adam’s mom who died a long time ago.) And we have to decide if Leo’s name will actually be Leonidas, or just Leo. Leonidas is the inspiration for the name, but we don’t intend to ever call him that. Still, it’s a pretty damn cool name. Of course Zoe is just Zoe, unless we want to give her the middle name Alleyne, which might be cool since that is the inspiration for her name. I just thought of that. I’ll have to talk to Adam about it. Our two warriors.

We have decided that we’re not circumcising Leo. Maybe I’ll write more about why we made this decision in a future post, but the short explanation is that we think that circumcision is a relic of religion and nothing more. Any arguments you hear about the medical benefits of circumcision appear to us to be complete rationalizations for a barbaric practice. It actually seems to be such an obvious decision that it’s hard for me to get motivated to write any further about it. But someday I’ll probably get angry about it and go on a rant, so you have that to look forward to.

Well, I finally have an official “problem” with this pregnancy. The test says that I have gestational diabetes. But unless someone can convince me that the standard interpretation of the test trumps my history, experience, and other aspects of the test, I don’t accept the diagnosis.

I’ve had a problem with hypoglycemia all my life – that’s low blood sugar, due to my body’s overreaction and overproduction of insulin after I consume sugars. At least, that’s how I’ve diagnosed myself, since no doctor seems interested in testing me. I know I have a problem with sugar because if I eat too much sugar (or simple carbohydrate) without protein and fat, I crash about two hours later. And when I crash, it’s very, very bad. All my symptoms are in-line with those of low blood-sugar. It’s still a serious problem that has to be managed, but it’s not due to pregnancy, and it’s not diabetes. The glucose tolerance test just seemed to confirm my self-diagnosis.

So here’s how it works. You fast for eight hours. Then you have a blood draw. Then you drink a huge, super-sugary drink. Then you have your blood drawn at one, two, and three hours after consuming the glucose. If two or more of your blood-sugar levels are above a certain threshold, then you are diagnosed with gestational diabetes.

My levels were:

  • fasting: 68 (normal is less than 100)
  • one hour: 193 (normal is less than 180)
  • two hour: 175 (normal is less than 155)
  • three hours: 50 (normal is less than 140)

Did you catch that last level? 50! That is why I would never, ever, eat pancakes for breakfast, or even fruit and toast, or even cereal with whole milk, or even a bagel with cream cheese. Even those smaller amounts of sugar without enough protein and fat will cause me to crash. I’m better off not eating. A blood glucose of 60 or less is considered hypoglycemic, and at 50, I was technically in insulin shock, which can be very dangerous. Not one person I’ve spoken with yet seems to care about that last level, which makes me crazy. This is the first time I’ve been unhappy with my ob-gyn for just following the rules. But apparently, the way it works is that he just orders the test and, based on the black and white results, refers me to a diabetes center.

Now, I didn’t expect my earlier readings to be so high as to fail the test, and that might be a part of what I call my existing hypoglycemia, or it might be due to pregnancy. I did have one bad experience about a month ago – I ate a McFlurry, which is more sugar than I’d normally consume at once. But I had just eaten a huge hamburger and felt like I could handle it. I never did crash, but I had a different reaction: I got the sweats and a rapid heartbeat. Adam told me that it sounded like too much sugar. I don’t know – I’ve never had that feeling before. So indeed, I might be having more trouble getting the insulin process started during pregnancy, and maybe I do have gestational diabetes on top of my existing condition. I’d like to find out more once my body is back to normal. There is also something called “occult diabetes,” where the body is extremely slow to react to blood sugar, and then overreacts. That sounds like me, but the crash is not supposed to happen until about five hours after consumption of the sugar to be a candidate for that condition. I’ve noticed that, during this pregnancy, my crash is taking longer than usual. I would have expected the low level at two hours, not three, but three is still early for occult diabetes. Still, I might have some variation of that. And the fluctuation in my levels is not a good thing, one way or another.

But the point of all this is that I already know how to manage my condition. My dad has the exact same problem and he taught me how to avoid sugars without protein, especially in the morning. I’ve experimented with this for years. I’ve found that I do need some carbs in the morning – just a small amount, and always with protein. I’ve found that nuts don’t balance out the carbs as well as meat, so a peanut butter and jelly sandwich can be a risky meal unless I’ve eaten a lot of good protein earlier in the day. I’ve found that there is almost no difference in effects on me between simple and complex carbohydrates so I rarely distinguish between them. I also need to eat more often than most people, and when I feel a certain kind of urgent hunger, I know I have to eat immediately, and I know that I have to eat a certain kind of thing, to avoid the crash. But I also know that I can eat desserts at night, as long as I’ve eaten well during the day. I know a lot of things. I know what works for me. And I’m not going to go on some standard diabetic diet (which probably contains more carbs than I eat anyway because complex carbs are supposed to be good!) unless someone can give me a compelling reason to do so. I’m not giving up my occasional ice cream after dinner in exchange for disgusting whole grain bread for breakfast which I know will make me sick.

So now I have to go to some kind of educational class, which I dread. If it is some standard thing about gestational diabetes, it will probably be a complete waste of my time, but maybe there will be someone with a brain who will actually talk to me about my particular case. And I’m going to have to monitor my glucose levels. That I won’t mind doing. After I failed the one-hour test earlier this month, my father-in-law lent me a finger-prick kit to use for a week and I tested every m0rning, and after a few meals. It was fun to actually know my levels. (I was always in the 70′s or 80′s in the morning, and under 110 after meals. No signs of elevated levels at all, because, dammit, I was eating properly, not drinking sugar-water!)

And I’m not clear on what the risks of gestational diabetes are for me or my babies, except that it might cause them to be bigger. If that’s the only downside, then maybe I should just start eating more chocolate anyway.

30 Weeks

I’m 30 weeks along. A singleton pregnancy is usually 40 weeks. For twins, the average is 37 weeks. Sammy came 2 weeks early. I have no idea when to expect these two little babies, but I’m starting to look forward to the end.

Just a few weeks ago, I was stressed out that it was all going too fast, and that I had so much more I needed to get done, and I wanted to just take some time to enjoy the pregnancy. Well, now I can finally relate to all those women who talk about how, by the end, they were just desperate to get it over with. I used to think they were wimps, or just couldn’t appreciate the awesomeness of the experience. I knew they might have been more uncomfortable than I had been with Sam, but I still harbored that feeling that they must have some kind of bad attitude, or they would be able to ignore all of that and just enjoy the good parts.

Well, I’m one of them now. Well, not completely. I’m still enjoying aspects of the pregnancy, but I am in such pain and discomfort that it’s hard to just get through a day. I am seriously grumpy. This insane heat wave is not helping. My air conditioner can’t keep up and the bedroom is usually about 75 degrees by the time I go to sleep, despite the thermostat being set at 69. 75 degrees is simply too hot. In fact, it’s unbearable. I slept a good part of the night on the sofa in the living room last night, because it was cooler there. If I get five hours of sleep in a night, I’m doing well.

And then there is the chaos of the bathroom remodeling. We’re having the master bath done now, and the work is going well, but the chaos in the house is unbelievable. A lot of my energy is going into things like keeping the cat from slipping into the space between the joists and the ceiling below. I also have to coordinate all laundry and dishes and showering with the workers’ schedules, which change hourly.  We’ve had power to one circuit off for two days now which means, in the one bathroom that is not being worked on, we have no light. I’d just use it with the door open, except that there are strange men all over my house and I really need a bathroom where I can lock the door. I have to pee at least once an hour, and each time, I have to give serious consideration to where I might be able to go this time, and a lot of times it means going up and down stairs, which, in my condition, is another major challenge. (One time, I walked up two flights and had to lie down for five minutes before I recovered my breath.)

I can’t take a nap. My bed is covered with a tarp all day. I certainly can’t cook or even pick up all the crap that is all over the house. I just don’t have any energy left for those things. Adam has been doing most of that stuff for me when he gets home in the evenings. But today and tomorrow he is working late. I’m seriously considering moving to a hotel with Sam for the next two nights.

So that’s all the bad news. And I’m refraining from telling you all the gory details about my pregnancy symptoms. It’s not fun.

But still, I’m fundamentally healthy, and so are Zoe and Leo. I did the dreaded glucose tolerance test yesterday. I had to go to the lab at 8am with no food or coffee, drink the horrible sweet drink, and sit there for three hours while they drew blood every hour, my blood sugar dropping so low that I had the shakes and felt like I was going to pass out by the end. It ended up being the best part of my week. It was freezing cold in the lab waiting room, and it was mostly quiet. I propped up my feet on a chair and slept the entire three hours, waking up only for the blood draws. It was heaven.

Yes, I think I’ll do the hotel. But first I have to figure out how I can find Sam some clean underwear.

I happened to be wearing the same shirt for my photo tonight that I wore for the last photo. Check out the difference 5 weeks makes:

 

 

 

 

 

 

 

 

 

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