My Last and Final appt with Dr Veille was today. Thank goodness. I went in there really taking his opinion with a grain of salt. I cannot help but get skeptical when his ultrasound takes 15 min vs UCSF's 2 hr ultrasound that measures all the same things. I can see that he did not measure things he said were "fine." I asked if the DVP was good and he said yes but I never saw the sonographer measure it. I just luckily can see for myself that there is fluid in both babies sacs and that they have good looking size bladders. This tells me that they have fluid even without the Dr. measuring. However, I still think he should be more thorough. The office received a new ultrasound machine and the sonographer was having a difficult time trying to figure out how to use it. This made the ultrasound appt longer than usual. Half way through the appt I hear Dr. Veille say to the sonographer "the next pt is here" REALLY???? How unprofessional. She can friggin wait until my appt is complete. That really ticked me off. He also seemed genuinely concerned about my BP when I said it had been as high as 160/101. My shins are pretty swollen too. I had told him we were having a C- section this Friday. He said "well I am going to call Dr. Juhn about your BP." I informed him it was only that high once and it has since come down with the Nifedipene I am taking. He was still concerned and said "well I really think I need to call Dr. Juhn and you should be delivered this week. I said "well I told you about 10 minutes ago I have a C-section scheduled for THIS Friday." He replied "oh, OK good, you should be good till this friday then." I'm like seriously??? He is so confusing. He seemed like he wanted me to walk myself to L&D and deliver right now and then a second later he seemed like oh, you are fine. I am at a loss for words about that man. Another weird thing was when I was about to leave he said "If you are interested call the office after the girls are born next week because I am working on a project with my wife and I would like to take pictures of your girls for a photography project." ummm WEIRD. At first I thought he was going to come to the hospital and do it which I wouldn't be opposed to if it was for research but when he said his wife was involved and it was out of the office I thought it was a little weird. needless to say I don't think we will be doing that.
Sorry for the Debbie Downer I am when it comes to Dr. Veille. I really should just be happy that we got great news and that the girls are doing great. The Doppler's look good, bladders are good, fluid looks present as far as I can tell. HR looks and sounds good and is reaffirmed by my NST's. Also, we have some big babies for Twins which I am thrilled about. Baby A appears to be 7 lbs 2 oz and Baby B is 6 lbs 3 ozs. Which is almost 13 1/2 lbs of baby!!!!! HOLY MOLY. Cannot get much better than that. So, I just need to keep them in for a few more days. I am excited but nervous and apprehensive at the same time. I am ready to meet my miracle babes but they are still going to be 1 month early and I worry about their respiratory status. I pray they can breath on their own and will spend little to no NICU time. I am worried about how Cole will adjust so I had a sibling kit put together for him by my mom that is a gift from his sisters when he comes to visit in the hospital. It is a Thomas backpack with some coloring books, crayons, tractors, cars, etc. for some entertainment and so he feels special as well.
I am not sure I will be doing anything for my favorite Holiday tomorrow. I was going to try to sit in a chair and watch fireworks in my moms court but I may have to skip out and stay in bed to keep my BP down. I don't have a BP cuff to take my BP so I get nervous it may be high from all the piccolo petes I hate so much. lol. I really want to see Cole's face when all the fireworks are going off. That's what makes Holidays so much more fun when you have kids. Seeing it through their eyes makes it that much more special. Ill play it by ear and see how I am feeling.
One last NST on Thurday and my C- section is scheduled for Friday July 6, 2012 at 7:30 am. I have to be at the hospital at 5:30am. No eating or drinking after 11:30 pm. It cannot come soon enough. I am ready to get off this couch and start being able to be mom again.
Hope all is well with everyone and have a safe and sane 4th of July.....
Tuesday, July 3, 2012
Thursday, June 28, 2012
Our amateur maternity photo with I phone :)
this of Cole and thought we needed one of the girls as well.
The 34th Week events with L&D stay
It never fails that being pregnant with twins at 2 weeks before delivery that your doctor has to go out of the country for a week right?? And during that week what are the odds that something will make you need to be seen or visit L&D? 100% for this girl! I saw Dr. Juhn and things were ok but she informed me that she would be in Korea until this Friday June 29. She told me to be good and that I better be pregnant when she gets back. Ha!! I said I would do my best but the girls may have other plans.
It seems as though every time I go to an NST I plan for not coming home afterwards. My BP is always high and this results in a call to the on call doc. Dr. Juhn did warn me that any other physician will be concerned about me if I go in the week she is gone and my BP is high. Luckily my nurse who does my NST is usually always the same. We both know that my initial BP will be high and that if we wait a few minutes and I tilt to my left side that it will come down. So we just wait and then she can let the doc know it was initially high but it has come down and this is normal for me. Since I have had a few 24 hour urine tests and quite a bit of PIH bloodwork (pregnancy induced hypertension) that they seem to be okay with sending me home.
On Sunday night however, my contractions decided to pick up in intensity and frequency. I was having about 6-8 per hour and they were rather strong. Not painful but my medication didn't seem to be affecting my contractions anymore. I was taking it every 6 hours but I was told by my Dr. I could take it as often as every 4 hours. I started to do this and it was not working so we thought I should go in. Sure enough I was having more contractions than even I could feel. My BP was high (shocker I know) Dr. Scates who was on call came in and talked to me and said he wanted to check me because of how many contractions I was having. I was surprised to find out I was dilated to 2 already. Surprised because 3 days earlier on my US my cervix was long, thick, and closed. Needless to say I was admitted because they thought I was going into labor. They had the NICU team come and talk to me because if I was in labor the twins would have to go to NICU because they would be delivered prior to 35 weeks. All babies < 5lbs or <35 weeks gestation must go to NICU for observation at least. This of course scared the crap out of me as I was not anticipating delivery this day. In turn, my BP was High due to this event. They gave me more Nifedipene and kept me on a consistent every 4 hour regimen. They also gave me 3 liters of fluid which in turn made me swell up like a wood tick. It has been 4 days since I was discharged and I still am more swollen than when I arrived Sunday night. They actually did not want me to leave but really they were doing the same things I could do at home with the Nifedipene and monitoring my BP. I probably slept 3 hours that night and I was incredibly uncomfortable. So I thought if I went home and slept I would feel a lot better. My contractions had slowed considerably. I think the nurse talked the Dr. into letting me come home because she said I was pretty in tune to my body and she felt confident I would know when to return. She said most of their patients don't quite know when they should come in and be seen and this results in either Pts coming in too late or when they do not need to.
Since my Discharge I have had 1 NST and 1 Dr. appt. My NST was surprisingly uneventful and was super duper quick. I was in and out in 45 min. Record time for me. The girls stayed on the monitor and both had 2 accels in the 20 min period. My BP was initially high but we used our method I discussed before and it worked well. So I was off to home in no time at all.
I was supposed to see Dr. Scates on Wednesday as Dr. Juhn is out of the country. However, he was out (not surprisingly) delivering a baby when I showed up for my appt. He apparently tries to be at all his pts. deliveries even though it really inconveniences his pre natal pts. I was able to see Dr. Khwong and she was great. She actually has Mono -di twins herself so she was on the up n up. She also seems to have read my chart before she came into the room because she already knew about my stint in L&D. This made me happy and impressed. This appt ended up being long because my BP was (you guessed it ) high. So I had to sit for 3 repeat blood pressures every 10 minutes to be sure it came down. It did but not much. I finally told her assistant "Thats about as good as you are going to get" and she then told Dr. Khwong and she said I could go.
That brings us to today.....So far things are uneventful at home and my symptoms that would signal a trip to L&D have subsided or have not showed up yet. Im hoping we can make it another week. I am so amazed we have made it this far and I know we are in a good place if delivery is today but as they say...1 extra day inside of me is 3 days less in NICU if need be. So, 1 week of pregnancy could prevent 21 days in NICU potentially. I just sit and try to pass the time. I am trying to enjoy my last few days of peace and quiet but the anticipation is getting to me. We will see how my NST goes tomorrow. I have a pre-op appt on Monday for my C-section. I see the perinatologist on Tuesday as part of my last 2 week growth check. Wednesday is the 4th, Thursday is my last NST and Friday is BIRTHDAY!!!!!!!!
It seems as though every time I go to an NST I plan for not coming home afterwards. My BP is always high and this results in a call to the on call doc. Dr. Juhn did warn me that any other physician will be concerned about me if I go in the week she is gone and my BP is high. Luckily my nurse who does my NST is usually always the same. We both know that my initial BP will be high and that if we wait a few minutes and I tilt to my left side that it will come down. So we just wait and then she can let the doc know it was initially high but it has come down and this is normal for me. Since I have had a few 24 hour urine tests and quite a bit of PIH bloodwork (pregnancy induced hypertension) that they seem to be okay with sending me home.
On Sunday night however, my contractions decided to pick up in intensity and frequency. I was having about 6-8 per hour and they were rather strong. Not painful but my medication didn't seem to be affecting my contractions anymore. I was taking it every 6 hours but I was told by my Dr. I could take it as often as every 4 hours. I started to do this and it was not working so we thought I should go in. Sure enough I was having more contractions than even I could feel. My BP was high (shocker I know) Dr. Scates who was on call came in and talked to me and said he wanted to check me because of how many contractions I was having. I was surprised to find out I was dilated to 2 already. Surprised because 3 days earlier on my US my cervix was long, thick, and closed. Needless to say I was admitted because they thought I was going into labor. They had the NICU team come and talk to me because if I was in labor the twins would have to go to NICU because they would be delivered prior to 35 weeks. All babies < 5lbs or <35 weeks gestation must go to NICU for observation at least. This of course scared the crap out of me as I was not anticipating delivery this day. In turn, my BP was High due to this event. They gave me more Nifedipene and kept me on a consistent every 4 hour regimen. They also gave me 3 liters of fluid which in turn made me swell up like a wood tick. It has been 4 days since I was discharged and I still am more swollen than when I arrived Sunday night. They actually did not want me to leave but really they were doing the same things I could do at home with the Nifedipene and monitoring my BP. I probably slept 3 hours that night and I was incredibly uncomfortable. So I thought if I went home and slept I would feel a lot better. My contractions had slowed considerably. I think the nurse talked the Dr. into letting me come home because she said I was pretty in tune to my body and she felt confident I would know when to return. She said most of their patients don't quite know when they should come in and be seen and this results in either Pts coming in too late or when they do not need to.
Since my Discharge I have had 1 NST and 1 Dr. appt. My NST was surprisingly uneventful and was super duper quick. I was in and out in 45 min. Record time for me. The girls stayed on the monitor and both had 2 accels in the 20 min period. My BP was initially high but we used our method I discussed before and it worked well. So I was off to home in no time at all.
I was supposed to see Dr. Scates on Wednesday as Dr. Juhn is out of the country. However, he was out (not surprisingly) delivering a baby when I showed up for my appt. He apparently tries to be at all his pts. deliveries even though it really inconveniences his pre natal pts. I was able to see Dr. Khwong and she was great. She actually has Mono -di twins herself so she was on the up n up. She also seems to have read my chart before she came into the room because she already knew about my stint in L&D. This made me happy and impressed. This appt ended up being long because my BP was (you guessed it ) high. So I had to sit for 3 repeat blood pressures every 10 minutes to be sure it came down. It did but not much. I finally told her assistant "Thats about as good as you are going to get" and she then told Dr. Khwong and she said I could go.
That brings us to today.....So far things are uneventful at home and my symptoms that would signal a trip to L&D have subsided or have not showed up yet. Im hoping we can make it another week. I am so amazed we have made it this far and I know we are in a good place if delivery is today but as they say...1 extra day inside of me is 3 days less in NICU if need be. So, 1 week of pregnancy could prevent 21 days in NICU potentially. I just sit and try to pass the time. I am trying to enjoy my last few days of peace and quiet but the anticipation is getting to me. We will see how my NST goes tomorrow. I have a pre-op appt on Monday for my C-section. I see the perinatologist on Tuesday as part of my last 2 week growth check. Wednesday is the 4th, Thursday is my last NST and Friday is BIRTHDAY!!!!!!!!
33 weeks 6 days and our final UCSF trip
We made it through our last trip down to UCSF. It has gotten much more difficult to travel down there at this point in my pregnancy. I set myself up in the way back of our car with the seat in front of me folded down so that I can put my feet up and hopefully not swell too much. This tactic seemed to work well and I was pretty comfortable.
This was actually the first time out of our many visits to S.F. that we were late. We have always arrived with time to spare but today there was extra traffic in Sacramento because of a mattress that flew off someones car and caused 7 cars to crash. So, Scott decided to "take a short cut". Im sure you all know what that means? We got lost in a subdivision. I had to pull out the GPS and get us back to the freeway. I realized about 9:30 when we hadn't quite yet crossed the bay bridge that we were not going to make our 10 am appt. I called and they said no problem. Luckily, they were running behind and it was not an issue that we were late. We only ended up about 15-20 min late so not bad at all. I would have been pretty upset if they had to reschedule after traveling all the way down there. As always, they seem to come through.
Our girls were giving the sonographer a run for her money and making life a little difficult to get all the measurements. The sonographer even told us that she wanted to cry because she was having such a hard time getting the measurements. I felt really bad that she was having such a difficult time. At least she skipped the measurements she was unable to get instead of just "guessing" like our sacramento sonographer seems to do. She went and consulted with the radiologist and came back to try again. This time they were more cooperative but I think she earned her salary that morning.
We then needed to wait for Dr. Rand to arrive at 1:00 so we went to lunch and enjoyed a burrito at the taqueria near the fetal treatment center. They have yummy burritos!! We then met with the staff and Dr. Rand who basically told us everything looked great. Of course I was thrilled to hear this and I was thinking things were ok as well but I felt I needed to hear from them to really put my mind at ease. I actually feel a little selfish even asking them to see me because I know most of their patients are in much worst places than I am but I feel with how tumoltuous everything has been that I must get their blessing to move forward and lower my stress level. If it even helps keep my BP down for one more week it will have been worth it. I also think they like to have the "success" stories come through because I assume they deal with a lot of doom and gloom situations, so to see a family really graduate and have healthy babies makes what they do worth it. I am trying to figure out how to thank them for the immense emotional, physical, and psychological support they have been throughout this process. Im not sure what will be good enough to cover all that. A basket of fruit or cookies doesn't seem to do justice for what they have given me. They have wonderful baskets of wines as well but can you send wine to a hospital for doctors? I don't even know if they drink? Ill have to think a bit more and send them pics of the girls along with a special gift I have yet to determine.
So we left with a huge sigh of relief and a smile on my face. Scott even said how much happier I seem when we leave S.F vs. Sacramento perinatology. The babies are 6 pounds 2 ounces and 4 lbs 14 ounces as of Thursday June 21, 2012. So if we can make it to July 6 we may have 6 and 7 lb babies. woo hoo!!!! Im not sure if I can fit that with how little room I feel I have left but I welcome it for the girls health :)
So I continue my NST twice a week and seeing my Dr. once a week until the big day......
This was actually the first time out of our many visits to S.F. that we were late. We have always arrived with time to spare but today there was extra traffic in Sacramento because of a mattress that flew off someones car and caused 7 cars to crash. So, Scott decided to "take a short cut". Im sure you all know what that means? We got lost in a subdivision. I had to pull out the GPS and get us back to the freeway. I realized about 9:30 when we hadn't quite yet crossed the bay bridge that we were not going to make our 10 am appt. I called and they said no problem. Luckily, they were running behind and it was not an issue that we were late. We only ended up about 15-20 min late so not bad at all. I would have been pretty upset if they had to reschedule after traveling all the way down there. As always, they seem to come through.
Our girls were giving the sonographer a run for her money and making life a little difficult to get all the measurements. The sonographer even told us that she wanted to cry because she was having such a hard time getting the measurements. I felt really bad that she was having such a difficult time. At least she skipped the measurements she was unable to get instead of just "guessing" like our sacramento sonographer seems to do. She went and consulted with the radiologist and came back to try again. This time they were more cooperative but I think she earned her salary that morning.
We then needed to wait for Dr. Rand to arrive at 1:00 so we went to lunch and enjoyed a burrito at the taqueria near the fetal treatment center. They have yummy burritos!! We then met with the staff and Dr. Rand who basically told us everything looked great. Of course I was thrilled to hear this and I was thinking things were ok as well but I felt I needed to hear from them to really put my mind at ease. I actually feel a little selfish even asking them to see me because I know most of their patients are in much worst places than I am but I feel with how tumoltuous everything has been that I must get their blessing to move forward and lower my stress level. If it even helps keep my BP down for one more week it will have been worth it. I also think they like to have the "success" stories come through because I assume they deal with a lot of doom and gloom situations, so to see a family really graduate and have healthy babies makes what they do worth it. I am trying to figure out how to thank them for the immense emotional, physical, and psychological support they have been throughout this process. Im not sure what will be good enough to cover all that. A basket of fruit or cookies doesn't seem to do justice for what they have given me. They have wonderful baskets of wines as well but can you send wine to a hospital for doctors? I don't even know if they drink? Ill have to think a bit more and send them pics of the girls along with a special gift I have yet to determine.
So we left with a huge sigh of relief and a smile on my face. Scott even said how much happier I seem when we leave S.F vs. Sacramento perinatology. The babies are 6 pounds 2 ounces and 4 lbs 14 ounces as of Thursday June 21, 2012. So if we can make it to July 6 we may have 6 and 7 lb babies. woo hoo!!!! Im not sure if I can fit that with how little room I feel I have left but I welcome it for the girls health :)
So I continue my NST twice a week and seeing my Dr. once a week until the big day......
Wednesday, June 20, 2012
33 weeks 5 days
Just a quick update on my weekly check up from today. I received the c-section packet with my surgery scheduled for July 6,2012 @ 7:30 am with a 5:30 am check in time. CRAZY!! Seems so surreal. I can't believe it is almost here.
I also got the results of my bloodwork and 24 hr urine test which was done because my BP has been high. It seems I have mild pre-eclampsia. I have high protein but my liver enzymes and kidney function look great. So my doctor feels that if I really stick to bed rest I can push through 2 more weeks. My doctor is going out of the country next week and she really pushed the fact that I do strict bed rest because if I go to the doctor and my BP is high then another doctor may see that and want to admit me or deliver me. I don't want that. Every NST I go to I always have high BP the first time they take it and then after I relax and rest it always goes down to the normal range. So hopefully we can make it to my scheduled c-sec and my DR. will be here.
We talked to UCSF and decided for peace of mind that we will travel down there tomorrow. This will give us a little more accurate assessment of how the girls are doing growth wise because I know they will thoroughly and accurately measure them more precisely than the perinatal doctor we see. My regular OB gave me her pager number to give to UCSF so she can get an update on how to proceed since she leaves the country the next day. I'm glad she is concerned and wants to get my status evaluated to help take care of me rather than leaving me high n dry when she goes to Korea for a week. She's been really wonderful.
We are off to UCSF in the morning and I have an NST on Friday. Hopefully next week I can get through my 2 NST,s with no problems since my doc is out of town. I'll update after our appt tomorrow with UCSF.
Monday, June 18, 2012
33 weeks 3 days
I seriously want to punch my Dr. sometimes. I was really hoping to go to the perinatilogist today and get good news that made me feel confident that things were going well and then I could cancel my appt in S.F. and continue on the current path for the next 3 weeks until delivery.
It didn't exactly go that way. I am grateful however that things are going well and the girls appear to be doing fine. What bothers me is the nonchalant half assed assessment I get on ultrasound and the conflicting answers I get week to week from this particular Dr. I feel I have been around enough, learned enough, and researched enough to know when a Dr. is not being thorough on an ultrasound I have had almost weekly for 15 weeks. This first issue today was the sonographer finishing the ultrasound without doing any measurements of the babies. I said to her "umm, aren't we doing a growth check today?" She responds "not that Im aware of, I think this is just a follow up. We just did a growth check 2 weeks ago." to which I follow with "yes, we have been doing a growth check every 2 weeks for the last15 weeks." She states that she will "go find out." This makes me a bit irate because this is the second time they have done this to me and I have explained and discussed why we have been doing these check bi weekly and UCSF recommends this and they have agreed it is a good idea. So why now all of the sudden are we not doing it??? So, I wait and the Dr. walks in and he's all excited and says things are great the fluid looks good, bladders look good, and dopplers look good. All of which I am extremely happy to hear and this is great. My concern and anger of course is because of the growth check mainly because this is what is of extreme concern at this point especially for Baby B because she has such a small share of the placenta. We need to make sure she is growing to determine that life in utero should continue. This is what UCSF has told me and makes complete sense to me. Now maybe I am completely out of touch but Im obviously upset. So I explain to the Dr. that we are supposed to be doing growth checks every 2 weeks as UCSF has explained and we have discussed previously. He says, "Well we don't need to do a growth check every two week because it won't be accurate." "Its not like putting a baby on a scale and weighing them." "Its variable up to 10% both ways." Are you F'in kidding me????? So, why in world have we been doing it for 15 weeks then???? HMMMMM. So when we discussed this being a good idea months ago you were lying to me??? I didn't phrase my next question exactly this way but I said " So why exactly is it inaccurate if we have been doing it this way? Are the babies too big to get as accurate as in the past?" He says "ya"but Ill do it anyway." Meaning he do the growth check for me. With no other explanation or further explanation. I really just feel at this point he's making things up to appease me. I know I am not a Dr. or have near the expertise that he does but if you feel strongly we don't need a growth check EXPLAIN it to me so I understand because you have been telling me for months as does UCSF that we do indeed need it???
So, He does the growth check begrudgingly it seems and measures the babies heads and leg bones. He says that Baby A is 5lbs and Baby B is 4 lbs 13 ozs. So Now I get concerned because Baby A was 5 lbs 3 oz 2 weeks ago. So, does this mean she is not growing? Baby B on the other hand has grown 10 ozs which is good. The thing that upsets me about this is that in S.F. and at other growth checks here in Roseville you measure head, abdomen, leg, and arm to get an accurate measurement of size. He half -assed it and just did head and leg??? So, to me this seems not as accurate. Had he measured all maybe Baby A would be a bit bigger? Just a theory. I just feel completely brushed off and unimportant to this practice. Maybe I am overly worried or we are asking too much but if this is the case they are not explaining to me WHY my concerns are invalid. They just say "ok we we will just do it."I'm all for not needing unnecessary procedures and exams if you can give me a good reason for it. They just never seem to come up with a good reason.
So, at this point I am torn because although all things seem really good regardless of my concerns with the Dr.s lack of thoroughness I still am debating on traveling down to S.F. on Thursday to get a more accurate and thorough ultrasound. Obviously the girls are getting great blood flow on doppler, they have good size bladders, are moving around well, and Baby B seems to be growing. These I can all see for myself on the us. The other thing I am slightly worried about is that the fluid levels are 10cm for baby b and 8 cm for baby A. Although we have had worse and better fluid levels before I was worried that 10 CM was getting on the high side. We have had 12 cm on Baby A sack in the past and they were discussing amnio reduction and stating that she had polyhydramnios in the past. So 10cm is getting closer to that mark. The Dr. today explained to me that 10cm was perfect and that excessive fluid would be 20cm? 20? really? Not according to textbooks. Textbook is >8cm. So I just don't know what to do? Everything seems fine so going to S.F. is not necessary but it would put my mind more at ease.
Scott decided to call UCSF and see if they could take a look at my chart from today in Roseville and see how they feel about us coming down there. I would feel confident that if they read the findings from today and still felt I would do ok without traveling down there then I would feel better. I just want the experts who have been guiding me this whole time about how important growth checks were every 2 weeks to let me know Im doing ok. I would just really beat myself up if things don't go well and I didn't consult UCSF after everything I went through today.
It is very difficult to go from a point where we were monitored so closely for so long and were told that things did not look good and this would be a very difficult pregnancy etc. to now where we have made it this far to be told oh you are fine we will see you in a month. It just doesn't make sense to me or feel right in my heart.
We are waiting to hear back from S.F. to determine if we will travel down there on Thursday. If we do it will be our last appt in S.F. as we are planning to deliver July6, 2012 by C Section. I hope we don't have to go though.
I will continue my NST appointments 2x weekly and go see my regular OB weekly as well. Hopefully we can make it another 19 days with no issues. I am hoping to get these girls closer to 6 lbs in the next 3 weeks. My ob says if I can get them up to 5.5lbs that would be a great weight. I'd prefer bit chubbier but Healthy I will take no matter what the weight.
On a side note, Baby B who has been Breech for sometime now has flipped. So both girls are in the vertex (head down) position. Which by the way when she flipped I could tell and it was pretty painful. So I suppose they are getting prepared to enter this world and meet mom, dad, and their big brother Cole very soon. Cole will be excited to meet his sissies as he calls them.
It didn't exactly go that way. I am grateful however that things are going well and the girls appear to be doing fine. What bothers me is the nonchalant half assed assessment I get on ultrasound and the conflicting answers I get week to week from this particular Dr. I feel I have been around enough, learned enough, and researched enough to know when a Dr. is not being thorough on an ultrasound I have had almost weekly for 15 weeks. This first issue today was the sonographer finishing the ultrasound without doing any measurements of the babies. I said to her "umm, aren't we doing a growth check today?" She responds "not that Im aware of, I think this is just a follow up. We just did a growth check 2 weeks ago." to which I follow with "yes, we have been doing a growth check every 2 weeks for the last15 weeks." She states that she will "go find out." This makes me a bit irate because this is the second time they have done this to me and I have explained and discussed why we have been doing these check bi weekly and UCSF recommends this and they have agreed it is a good idea. So why now all of the sudden are we not doing it??? So, I wait and the Dr. walks in and he's all excited and says things are great the fluid looks good, bladders look good, and dopplers look good. All of which I am extremely happy to hear and this is great. My concern and anger of course is because of the growth check mainly because this is what is of extreme concern at this point especially for Baby B because she has such a small share of the placenta. We need to make sure she is growing to determine that life in utero should continue. This is what UCSF has told me and makes complete sense to me. Now maybe I am completely out of touch but Im obviously upset. So I explain to the Dr. that we are supposed to be doing growth checks every 2 weeks as UCSF has explained and we have discussed previously. He says, "Well we don't need to do a growth check every two week because it won't be accurate." "Its not like putting a baby on a scale and weighing them." "Its variable up to 10% both ways." Are you F'in kidding me????? So, why in world have we been doing it for 15 weeks then???? HMMMMM. So when we discussed this being a good idea months ago you were lying to me??? I didn't phrase my next question exactly this way but I said " So why exactly is it inaccurate if we have been doing it this way? Are the babies too big to get as accurate as in the past?" He says "ya"but Ill do it anyway." Meaning he do the growth check for me. With no other explanation or further explanation. I really just feel at this point he's making things up to appease me. I know I am not a Dr. or have near the expertise that he does but if you feel strongly we don't need a growth check EXPLAIN it to me so I understand because you have been telling me for months as does UCSF that we do indeed need it???
So, He does the growth check begrudgingly it seems and measures the babies heads and leg bones. He says that Baby A is 5lbs and Baby B is 4 lbs 13 ozs. So Now I get concerned because Baby A was 5 lbs 3 oz 2 weeks ago. So, does this mean she is not growing? Baby B on the other hand has grown 10 ozs which is good. The thing that upsets me about this is that in S.F. and at other growth checks here in Roseville you measure head, abdomen, leg, and arm to get an accurate measurement of size. He half -assed it and just did head and leg??? So, to me this seems not as accurate. Had he measured all maybe Baby A would be a bit bigger? Just a theory. I just feel completely brushed off and unimportant to this practice. Maybe I am overly worried or we are asking too much but if this is the case they are not explaining to me WHY my concerns are invalid. They just say "ok we we will just do it."I'm all for not needing unnecessary procedures and exams if you can give me a good reason for it. They just never seem to come up with a good reason.
So, at this point I am torn because although all things seem really good regardless of my concerns with the Dr.s lack of thoroughness I still am debating on traveling down to S.F. on Thursday to get a more accurate and thorough ultrasound. Obviously the girls are getting great blood flow on doppler, they have good size bladders, are moving around well, and Baby B seems to be growing. These I can all see for myself on the us. The other thing I am slightly worried about is that the fluid levels are 10cm for baby b and 8 cm for baby A. Although we have had worse and better fluid levels before I was worried that 10 CM was getting on the high side. We have had 12 cm on Baby A sack in the past and they were discussing amnio reduction and stating that she had polyhydramnios in the past. So 10cm is getting closer to that mark. The Dr. today explained to me that 10cm was perfect and that excessive fluid would be 20cm? 20? really? Not according to textbooks. Textbook is >8cm. So I just don't know what to do? Everything seems fine so going to S.F. is not necessary but it would put my mind more at ease.
Scott decided to call UCSF and see if they could take a look at my chart from today in Roseville and see how they feel about us coming down there. I would feel confident that if they read the findings from today and still felt I would do ok without traveling down there then I would feel better. I just want the experts who have been guiding me this whole time about how important growth checks were every 2 weeks to let me know Im doing ok. I would just really beat myself up if things don't go well and I didn't consult UCSF after everything I went through today.
It is very difficult to go from a point where we were monitored so closely for so long and were told that things did not look good and this would be a very difficult pregnancy etc. to now where we have made it this far to be told oh you are fine we will see you in a month. It just doesn't make sense to me or feel right in my heart.
We are waiting to hear back from S.F. to determine if we will travel down there on Thursday. If we do it will be our last appt in S.F. as we are planning to deliver July6, 2012 by C Section. I hope we don't have to go though.
I will continue my NST appointments 2x weekly and go see my regular OB weekly as well. Hopefully we can make it another 19 days with no issues. I am hoping to get these girls closer to 6 lbs in the next 3 weeks. My ob says if I can get them up to 5.5lbs that would be a great weight. I'd prefer bit chubbier but Healthy I will take no matter what the weight.
Sunday, June 17, 2012
33 weeks 2 days
19 days and counting until we meet the girls..... CRAZY!!! We have been doing our NST 2x weekly and going to the Dr. at least once a week as well. My last two NST ended up in L&D visits as well due to high BP and contractions. I am always prepared to stay for a few hours when I go for my NST's which take a mom with a singleton and no issues about 20 minutes to pass. My twins are a little sassy and never want to stay on the monitors. They are supposed to get 2 Accelerations in heart rate from resting hr 15 BPM(beats per min) for 15 Sec. Their resting HR is about 140 so they need 2 accels with a Hr of 155 for 15 sec simultaneously. So to get both babies to do this in a 20 min period is nearly impossible. And even after 2 hrs and the babies passing I always end up with several contractions and or high bp which turns into blood work and urine tests etc. I really need to learn to eat more before I go in because if I end up staying till 2pm like I do they won't let me eat. I am STARVING by the time I leave. I have to do the 24 hr urine test again. I had to do that 2 weeks or so ago and it was not fun and I am not looking forward to doing it again but I was spilling a little bit of protein in my urine last week when I was there so they want to make sure I am not getting pre eclamptic.
We have a appt tomorrow with the perinatologist to do a growth check and make sure the girls are growing. I hope they are getting big and able to join us healthy pretty soon. I can feel hiccups very often so that is good. I know they are practicing their breathing in there. I hope that after tomorrow I feel confident that the Dr. is being thorough because we have an appt in SF on Thursday that I would like to cancel if I feel we are getting good care here with the perinatologist. SF doesn't feel we need to be seen by them anymore but are more than willing if we feel we need it. I hope to be able to cancel it after our appt. tomorrow. Traveling to SF has not been a problem top until last time we were there and it was quite uncomfortable. I know I am not going to enjoy a 2 hr car ride at this point. I can't even sit in a restaurant booth for 1 hr to eat without being incredibly uncomfy.
After our appt tomorrow we have NST's Tues/Fri and an appt with my reg OB Wednesday. I am pretty much at the Dr. or hospital everyday next week. Which is totally ok with me because it gives me something to do and I get reassurance the girls are doing ok.
We have been really lucky lately for some wonderful moms for PC moms of multiples for bringing our family dinner recently. I want to thank Joy, Debbie, Lacey, and Jenni for the wonderful meals. Also, Michelle form SFD and Colleen from my mommy group with Cole who have all brought us yummy food. I feel so blessed and this has been a tremendous help for not only me but the stress Scott has been under as well. Thanks to all and Ill update next week after our appt.
nn
Thursday, June 7, 2012
31 weeks 6 days
I feel so blessed and lucky today. I feel this way most days but today has been a good day. After looking back and seeing where we have come from and the odds we were up against I am so thankful for what I have and for the people and friends in my life. This experience has opened my eyes to the extreme thoughtfulness of friends, family, and complete strangers. We have had so many offers for help, prayers, well wishes, etc. and I couldn't be more grateful. I got an email today form the Moms of multiples group I joined recently with the offer to bring meals a few times in the next 2 weeks. This is so sweet and generous seeing as how I have not even met most of them yet. I have not been able to attend any functions due to my modified bed rest and now strict bed rest. So, for them to be willing to help me out is awesome. I have also been blessed by my mommy group friends who have done so much to help me out as well. They planned a sprinkle for me and brought all the food, decorations, etc. and made a great day for me and my girls. They have been such a great support system and I appreciate all of it. My family has also been a wonderful help with Cole and taking care of him so I can rest and Daddy can catch a break. You all are the best and we love you!!
We went to our 2 week growth check today and got wonderful news. All is well and the girls have grown about 1 lb each in the last 2 weeks. YAY!!!! So exciting. Baby A is 5lbs 2 oz and Baby B is 4 lbs 1 oz. This is still about a 24% growth discordance but like I have said before is not of extreme concern because A is such an over achiever. Baby A is measuring about 34 weeks and Baby B is right on track at 32 weeks. This would be dis concerning if A was average for gestation and B was behind. I am not sure but I like to think all the extra protein I have been eating has helped put some weight on the girls. The fluid for each baby looks good as well. It even looks as if things may have shifted to where baby B has a little more fluid than A. This has been the opposite the entire pregnancy. Either way they both have abnormal amount at this point. Baby B has 7cm and Baby A has 6cm. The membrane is still intact and bladders look great. The girls are moving quite a bit still although with 9 lbs of baby I'm not sure how this is possible. LOL. 9 lbs of baby with 4 weeks to go. YIKES!!! I hope to continue the pattern of 1/2 lb per week and if we make it to 36 weeks that would make baby A 7 lbs and B 6 lbs. That would be so great!.
Now I continue with the NST's twice a week and hopefully my contractions mellow out on the nifedipene. I think it is helping some but I still feel contractions pretty regularly and I can tell when it is getting close to needing another dose of meds because the contractions do pick up.
Thanks to all who have been apart of this journey and continue to follow our blog. I am glad I have a place to keep everyone updated and to vent my feelings and emotions onto paper to have forever. Until next time.......
We went to our 2 week growth check today and got wonderful news. All is well and the girls have grown about 1 lb each in the last 2 weeks. YAY!!!! So exciting. Baby A is 5lbs 2 oz and Baby B is 4 lbs 1 oz. This is still about a 24% growth discordance but like I have said before is not of extreme concern because A is such an over achiever. Baby A is measuring about 34 weeks and Baby B is right on track at 32 weeks. This would be dis concerning if A was average for gestation and B was behind. I am not sure but I like to think all the extra protein I have been eating has helped put some weight on the girls. The fluid for each baby looks good as well. It even looks as if things may have shifted to where baby B has a little more fluid than A. This has been the opposite the entire pregnancy. Either way they both have abnormal amount at this point. Baby B has 7cm and Baby A has 6cm. The membrane is still intact and bladders look great. The girls are moving quite a bit still although with 9 lbs of baby I'm not sure how this is possible. LOL. 9 lbs of baby with 4 weeks to go. YIKES!!! I hope to continue the pattern of 1/2 lb per week and if we make it to 36 weeks that would make baby A 7 lbs and B 6 lbs. That would be so great!.
Now I continue with the NST's twice a week and hopefully my contractions mellow out on the nifedipene. I think it is helping some but I still feel contractions pretty regularly and I can tell when it is getting close to needing another dose of meds because the contractions do pick up.
Thanks to all who have been apart of this journey and continue to follow our blog. I am glad I have a place to keep everyone updated and to vent my feelings and emotions onto paper to have forever. Until next time.......
Wednesday, June 6, 2012
31 weeks NST and L&D visits
Im a little behind on my weekly update. A lot has been going on this week as far as being seen by the doctor and in L&D. I started my weekly Non stress tests to monitor the babies Heart rates and measure contractions 2x per week. These appts are Tues/Fri for me with a DR. appt in between usually on Thurs. These NST (non- stress tests) are to help determine how often I have contractions and what the babies HR does during this period. The babies have to be monitored contiuously for 20 minutes together and must have a couple of HR accelerations during movement (Each babies HR should increase during movement). This can be quite difficult to keep two babies on the monitor simultaneously. They like to move and come off the monitor. I feel like I cannot move a muscle in an attempt to get them to stay on together.
So, I started my first NST Tuesday morning at 8:45. I think I left L&D at 3:00pm. Not what I was expecting. Quite a day of continuous issues. Nothing too serious but my girls don't like to make things too easy for me. I passed the NST pretty early on in the morning but my BP (blood pressure) was borderline high and this concerned my Dr. She sent me from the ATU (antepartum testing unit) where the NST's are done to L&D down the hall to be monitored a little more and have blood work done to rule out signs of pre-eclampsia. I have been experiencing headaches but no swelling and or vision disturbances. During this monitoring session I started contracting about every 2 minutes. I did not feel all of them but I had been feeling the stronger ones. I had one really strong one that made my smaller twins HR have a deceleration. The Dr. was not too happy with this. This pretty much guaranteed me a c section when delivery comes because it shows that Baby B won't tolerate labor well at all. She told me that it would be a good idea to do the steroid injections to mature the lungs of the girls at this point. I am at a good gestation for the shots and she thinks I will probably deliver earlier than expected. The shots are betamethazone and they are given 2x in a 24 hr period. I got the first one Tuesday about noon. I was to come back the next day for the other shot. I was also given Nifedipene to slow and hopefully stop my contractions. This medication I will continually take every 6 hrs for the duration of my pregnancy. Lucky for Scott , the only pharmacy that carried the type I need was in Auburn. They called 14 pharmacies in town and none carried the 10 or 20 mg rapid release dose. The all only carried the 30mg slow dose. Nice huh??? I like to make it difficult! LOL.
The blood work all came back perfect. No protein in my urine, good platelets, not anemic, no uric acid, and liver and kidney enzymes were good as well. It is quite ironic that what I initially was being seen for (high BP) turned out normal but the contractions ended up being the issue. It was a good thing I went in. Also, since I was contracting so regularly the Dr. did a FFM (fibro fetal something or other). This tells the Dr. whether I will go into labor in the next 2 weeks. If the test comes out negative it is 98% accurate. If the test comes back positive it only has a 60% accuracy. So, mainly they are looking to see if the test is negative, which for me it did come back negative. This is great! So I probably won't go into labor in the next two weeks but the other issues need to be looked at as well.
Today I returned to L&D for my second steroid shot which bought me a ticket to another NST as well. They were never able to get both the girls on the monitor at the same time but were able to get good strips individually. This appeased the Dr. enough to discharge me. However, I did have a few high BP's again and now I get to do a 24 hr urine catch. Awesome right? I get to pee in a jar all day tomorrow and then refrigerate it. EWE!!! I had Scott run to Walmart to buy 2 gallon freezer bags so I don't contaminate the fridge. We will clean it, don't worry. Haha.
I go tomorrow to see the perinatal associates in Sacramento to check the growth, fluid, dopplers etc of the girls. This will tell us if they are growing still and getting the proper nutrients and oxygen from the placenta to continue life in the womb or if things might be easier on the outside.
Hopefully we can push this out another 4 weeks. Thats the goal. I'm not sure how realistic this is but I can be hopeful. I know the girls will do well at this gestation but I want some bonus days to reduce NICU time and all the risks of prematurity.
I may also end up on hospital bed rest in the near future as well. I think my Dr. hints about it regularly and with the difficulties of being on bed rest at home with a toddler it might be in my best interest to optimize rest and reduce stress on Mom and Dad.
I shall update after our appointment tomorrow and let you know how life in utero is going. I hope they have grown and the fluid looks good. There is such a nervousness prior to these appointments for me. I hope I can relax and get some good news.
31 weeks 3 days
Can you see the BIG contraction?
So, I started my first NST Tuesday morning at 8:45. I think I left L&D at 3:00pm. Not what I was expecting. Quite a day of continuous issues. Nothing too serious but my girls don't like to make things too easy for me. I passed the NST pretty early on in the morning but my BP (blood pressure) was borderline high and this concerned my Dr. She sent me from the ATU (antepartum testing unit) where the NST's are done to L&D down the hall to be monitored a little more and have blood work done to rule out signs of pre-eclampsia. I have been experiencing headaches but no swelling and or vision disturbances. During this monitoring session I started contracting about every 2 minutes. I did not feel all of them but I had been feeling the stronger ones. I had one really strong one that made my smaller twins HR have a deceleration. The Dr. was not too happy with this. This pretty much guaranteed me a c section when delivery comes because it shows that Baby B won't tolerate labor well at all. She told me that it would be a good idea to do the steroid injections to mature the lungs of the girls at this point. I am at a good gestation for the shots and she thinks I will probably deliver earlier than expected. The shots are betamethazone and they are given 2x in a 24 hr period. I got the first one Tuesday about noon. I was to come back the next day for the other shot. I was also given Nifedipene to slow and hopefully stop my contractions. This medication I will continually take every 6 hrs for the duration of my pregnancy. Lucky for Scott , the only pharmacy that carried the type I need was in Auburn. They called 14 pharmacies in town and none carried the 10 or 20 mg rapid release dose. The all only carried the 30mg slow dose. Nice huh??? I like to make it difficult! LOL.
The blood work all came back perfect. No protein in my urine, good platelets, not anemic, no uric acid, and liver and kidney enzymes were good as well. It is quite ironic that what I initially was being seen for (high BP) turned out normal but the contractions ended up being the issue. It was a good thing I went in. Also, since I was contracting so regularly the Dr. did a FFM (fibro fetal something or other). This tells the Dr. whether I will go into labor in the next 2 weeks. If the test comes out negative it is 98% accurate. If the test comes back positive it only has a 60% accuracy. So, mainly they are looking to see if the test is negative, which for me it did come back negative. This is great! So I probably won't go into labor in the next two weeks but the other issues need to be looked at as well.
Today I returned to L&D for my second steroid shot which bought me a ticket to another NST as well. They were never able to get both the girls on the monitor at the same time but were able to get good strips individually. This appeased the Dr. enough to discharge me. However, I did have a few high BP's again and now I get to do a 24 hr urine catch. Awesome right? I get to pee in a jar all day tomorrow and then refrigerate it. EWE!!! I had Scott run to Walmart to buy 2 gallon freezer bags so I don't contaminate the fridge. We will clean it, don't worry. Haha.
I go tomorrow to see the perinatal associates in Sacramento to check the growth, fluid, dopplers etc of the girls. This will tell us if they are growing still and getting the proper nutrients and oxygen from the placenta to continue life in the womb or if things might be easier on the outside.
Hopefully we can push this out another 4 weeks. Thats the goal. I'm not sure how realistic this is but I can be hopeful. I know the girls will do well at this gestation but I want some bonus days to reduce NICU time and all the risks of prematurity.
I may also end up on hospital bed rest in the near future as well. I think my Dr. hints about it regularly and with the difficulties of being on bed rest at home with a toddler it might be in my best interest to optimize rest and reduce stress on Mom and Dad.
I shall update after our appointment tomorrow and let you know how life in utero is going. I hope they have grown and the fluid looks good. There is such a nervousness prior to these appointments for me. I hope I can relax and get some good news.
Life In L&D with twins. One monitor for each baby and one for contractions......
Saturday, May 26, 2012
The Start of Something Special
I only add this to laugh at later as I am completely aware of how huge I am. Please avert your eyes if this offends you or small children who may be in the room with you.
I am 29 weeks 6 days pregnant
Friday, May 25, 2012
30 Weeks down and 6 to go!!!!
We hit the 30 week mark which is fan freakin tactic! We had our supposedly last appt yesterday at our safe haven UCSF with Dr. Rand. We had our ultrasound and then we hung around for a few hours at Burgermeister while we waited for Dr. Rand to arrive and review our case. We really wanted to talk to him so we could wrap up any lingering questions, get the placenta box, and decide our course for the next 6 weeks. Since we have been a little unhappy with our treatment in Sac we wantd to go over that with him and get his views and see what he could do to push our Sacramento office to get us the care we need. UCSF seems to be miracle workers and they make a call to Sacramento and amazingly things get done. Funny how that works. BTW, burgermeister on Carl St in S.F. is sooooo good and if you are ever in the area check it out.
For the results of our appt we are doing phenomenally well. My inner goddess is doing arabesques (haha if you are reading 50 shades of grey you will get that.) If not, it means Im over the moon sort of :) The bladders on both babes look great as do the kidneys, brain, gallbladders, stomachs, dopplers, cerebral blood flow, and fluid levels. I feel so blessed to be at this point. The fluids have normalized about 6 cm for baby A and 5 cm for baby B. The sonographer tried to get 3D images of the girls and the best we could do was a mouth and nose of baby B. The amount of room for twins at this point I think is running out and we may have missed the window for a good 3D pic. Luckily, we got one back at about 16 weeks that was really good of both girls faces. (see pics below). The weights for the babies are A a whole lotta nearly 4 lbs at 3lb 15oz, and baby B at nearly 3lbs at 2lbs 15ozs. So, they are 1 lb difference and that makes then still holding steady at 24-25% difference. It is good that this size discordance has not worsened. Like I have said before that even though 25% is a lot, in our case it isn't disconcerting because baby A is in the 90th percentile and baby B is right on track at 50th percentile. It would be more alarming if A was normal and B was behind her at the same difference in percentage (clear as mud.) Sorry if it is confusing but bottom line is things are good!
After a long discussion about how my treatment and the girls health should be monitored in the next six weeks we came to a few conclusion that I am happy with and they are as follows:
1. We need to have growth checks every 2 weeks from here until delivery. UCSF told me if I go to Sac in 2 weeks and I am still not confident in their assessment that I can come back to see them at the next 2 week appt. This works for me. They are also going to write up an extensive treatment plan to send to Sac telling them I need to be seen every 2 weeks and not 3 like Dr. Chyu had tried to do.
2. I originally thought weekly fluid checks were necessary as well but Dr. Rand feels that it is over the top and not necessary in my situation. I feel that coming from him I respect that and will abide by that recommendation.
3. I need to start having non-stress tests 2x per week starting at 32 weeks. This will help to determine if the babies are getting stressed in utero and might do better out than in. They will monitor HR at the hospital for a period of time 2x per week.
4. They do want to have my placenta and we will give Dr. Juhn the box and will get all kinds of data regarding inter-utero life for the girls. It will help for future people in this situation and give us insight as to why our pregnancy took the course it did. A win-win.
5. I will get steroid shots to help develop the girls lungs closer to the date when they think I will deliver if time permits. It takes I believe 48hrs for full effect and lasts 7 days so about a week before delivery I should get those but if i look like I might deliver early I may get them early and hopefully 48 hrs prior to delivery.
So lots of appts are in my near future which is relieving for me because I know we will be monitored closely because since we are at a good viability I don't want anything to be missed that we could have caught early. I feel much better having gone to UCSF and they will always have a special place in my heart and I appreciate everything they do!! They have it down over there.
The only thing that I am now on the fence about is C section vs. vaginal delivery. I had discussed this with my OB and we had decided that a c section would be best because Baby B has such a smaller share of the placenta that labor might be hard on her. I really don't want to vaginally deliver A and then have to have a c section for B. However, after talking to Dr. Rand he HIGHLY recommends that I give a vaginal delivery a try for a few reasons- it is safer for babies and mom, it will be better healing, and I won't really know if baby b will have a hard time with labor unless I try. He said if I were delivering at UCSF he would really push me to try to deliver vaginally if both babies are head down. At this point A is head down and B is breech. Things could change but he would deliver A and if b remained breech would do a breech extraction because the cervix has already opened enough for A that delivering B feet first is appropriate only in this type of situation. He also said this is something they do but not all regular Obs might be comfortable with this type of delivery. I don't think Dr. Juhn would be open to this and quite frankly it worries me. So, I may continue to think about this and if either baby is breech at delivery I think I will opt for the C section. If they are both head down I may try to deliver naturally. Time will tell. I want to do whatever will have an end result of 2 healthy babies and a healthy mom.
All in all we are trucking along and I am thrilled with how things are going. Im hoping Baby B will continue to gain weight and we can make it to 36 weeks. Happy Memorial Day Weekend!!
For the results of our appt we are doing phenomenally well. My inner goddess is doing arabesques (haha if you are reading 50 shades of grey you will get that.) If not, it means Im over the moon sort of :) The bladders on both babes look great as do the kidneys, brain, gallbladders, stomachs, dopplers, cerebral blood flow, and fluid levels. I feel so blessed to be at this point. The fluids have normalized about 6 cm for baby A and 5 cm for baby B. The sonographer tried to get 3D images of the girls and the best we could do was a mouth and nose of baby B. The amount of room for twins at this point I think is running out and we may have missed the window for a good 3D pic. Luckily, we got one back at about 16 weeks that was really good of both girls faces. (see pics below). The weights for the babies are A a whole lotta nearly 4 lbs at 3lb 15oz, and baby B at nearly 3lbs at 2lbs 15ozs. So, they are 1 lb difference and that makes then still holding steady at 24-25% difference. It is good that this size discordance has not worsened. Like I have said before that even though 25% is a lot, in our case it isn't disconcerting because baby A is in the 90th percentile and baby B is right on track at 50th percentile. It would be more alarming if A was normal and B was behind her at the same difference in percentage (clear as mud.) Sorry if it is confusing but bottom line is things are good!
After a long discussion about how my treatment and the girls health should be monitored in the next six weeks we came to a few conclusion that I am happy with and they are as follows:
1. We need to have growth checks every 2 weeks from here until delivery. UCSF told me if I go to Sac in 2 weeks and I am still not confident in their assessment that I can come back to see them at the next 2 week appt. This works for me. They are also going to write up an extensive treatment plan to send to Sac telling them I need to be seen every 2 weeks and not 3 like Dr. Chyu had tried to do.
2. I originally thought weekly fluid checks were necessary as well but Dr. Rand feels that it is over the top and not necessary in my situation. I feel that coming from him I respect that and will abide by that recommendation.
3. I need to start having non-stress tests 2x per week starting at 32 weeks. This will help to determine if the babies are getting stressed in utero and might do better out than in. They will monitor HR at the hospital for a period of time 2x per week.
4. They do want to have my placenta and we will give Dr. Juhn the box and will get all kinds of data regarding inter-utero life for the girls. It will help for future people in this situation and give us insight as to why our pregnancy took the course it did. A win-win.
5. I will get steroid shots to help develop the girls lungs closer to the date when they think I will deliver if time permits. It takes I believe 48hrs for full effect and lasts 7 days so about a week before delivery I should get those but if i look like I might deliver early I may get them early and hopefully 48 hrs prior to delivery.
So lots of appts are in my near future which is relieving for me because I know we will be monitored closely because since we are at a good viability I don't want anything to be missed that we could have caught early. I feel much better having gone to UCSF and they will always have a special place in my heart and I appreciate everything they do!! They have it down over there.
The only thing that I am now on the fence about is C section vs. vaginal delivery. I had discussed this with my OB and we had decided that a c section would be best because Baby B has such a smaller share of the placenta that labor might be hard on her. I really don't want to vaginally deliver A and then have to have a c section for B. However, after talking to Dr. Rand he HIGHLY recommends that I give a vaginal delivery a try for a few reasons- it is safer for babies and mom, it will be better healing, and I won't really know if baby b will have a hard time with labor unless I try. He said if I were delivering at UCSF he would really push me to try to deliver vaginally if both babies are head down. At this point A is head down and B is breech. Things could change but he would deliver A and if b remained breech would do a breech extraction because the cervix has already opened enough for A that delivering B feet first is appropriate only in this type of situation. He also said this is something they do but not all regular Obs might be comfortable with this type of delivery. I don't think Dr. Juhn would be open to this and quite frankly it worries me. So, I may continue to think about this and if either baby is breech at delivery I think I will opt for the C section. If they are both head down I may try to deliver naturally. Time will tell. I want to do whatever will have an end result of 2 healthy babies and a healthy mom.
All in all we are trucking along and I am thrilled with how things are going. Im hoping Baby B will continue to gain weight and we can make it to 36 weeks. Happy Memorial Day Weekend!!
Thursday, May 24, 2012
Top- Baby B nose and Mouth 3D Middle- Baby B profile Bottom-Baby A profile
Sunday, May 20, 2012
29 weeks 2 days/ 7 1/4 months/ 205 days/ 73.8%
Can you tell by my title for this post that Im a little crazy about counting the days that have passed? Each day that goes by is 3 less days in the NICU. So, Im a little anal about counting. Which in turn makes time go by pretty slowly. Haha!
I wanted to do a second update this week because we have had some news that may affect things in the near future but I hope not. I went and saw my regular OB on Friday to do our normal check up. Things with me are going well which is fantastic. I have been worried about my blood pressure since it got high with Cole around this time. It was not low but not high either. I passed my glucose test which was a big sigh of relief. Im not anemic and my platelet count looks great. Big thumbs up for me!
Scott and I discussed our concerns we have with how our appt went on Monday with Dr. Chyu and she agreed that our concerns were reasonable and that she would call Dr. Chyu and discuss trying to get growth checks every 2 weeks and fluid/bladder/ and dopplers every week. Especially since the fluid does look lower in the baby who had polyhydramnios it would be good to check it weekly. We felt a little rushed out of Dr. Chyus appt and we never really got a good answer as to why if UCSF suggests bi weekly growth checks why she wanted to to it every three weeks. This gets so convoluted because you have 3 different doctors, 3 different opinions, and 1 crazy mom who seems to never get the right answer in a timely fashion.
After our long winded discussion (good thing Dr. Juhn likes to talk) we had a quick ultrasound just to check heart beats with our reg ob. This is on a very low resolution portable ultrasound machine they typically use on non complicated pregnancies. Dr. Juhn was a little concerned that the fluid in Baby A's sac looks a little lower than what we got on Monday which was 5cm. She also thinks that our placenta is already in the beginning stages of calcifying which means it is starting to go kaput. It may be working at capacity to the point we might not make it to 36 weeks. However, since this is such a low resolution ultrasound and I like to think Dr. Juhn is very conservative. So I hope when we go to our next appt they will find that we are in better shape than it looks. I also, must prepare for the possibility that we might not make it to 36 weeks either. Kind of Scary. NICU time almost seems inevitable. Dr Juhn wanted to me to get in contact with UCSF and see if I could move my appt that is this Thursday up to Monday or Tuesday.
I left Dr Juhns office and called UCSF right away. They seem a bit skeptical about all the finding and asked me some questions I was able to answer but some I thought Dr. Juhn should answer herself. UCSF said they were all booked next week but that they would talk to my Dr. and figure something out. This was Friday at 2pm. I thought for sure I would not hear back by then end of the day. Much to my surprise I got a call form UCSF who always seems to come through. They said that they were unable to squeeze me in but talked to the MFM and want me to go in to the office in Sac Monday to re-check things to be sure they are stable enough to make it to my UCSF appt on Thursday. This puts me at ease a little because my concerns are legitimate and Im a little worried about my placenta because nobody has mentioned this to me before. The more appts I have I feel a little more at ease because I know we are more apt to catch something earlier than waiting 3 weeks. I just feel that at this point wouldn't it be smarter to check things more often because I am at a point where viability is so high? Meaning if something was going awry we could deliver rather than extend my appts to 3-4 weeks and miss something that could have been remedied by delivery that we missed because you all thought things were going to be ok. I may be totally over reacting and hope that everything will go ok. But if there is even a slight chance for acute TTTS or something similar I want to be checked weekly.
Ive also been having a lot of contractions lately as well and Dr. Juhn is threatening hospital Bed rest too. We will re-evaluate this after we go to UCSF and determine our status. Im really looking forward to going to UCSF and very nervous as well. When we get there we will not have had a growth check in 3 weeks and I'm on pins and needles to make sure they are both growing and getting plenty of blood flow through the umbilical doppler.
If all goes well we did discuss delivery at 36 weeks and are probably doing an elective C-section. I could do a vaginal delivery but my Dr. thinks that since Baby B is smaller and most likey has a thinner umbilical cord that she won't tolerate labor very well. So after Baby A is born (which she would come out first being closer to my cervix) that baby B will possibly turn and not be head down and show signs of distress and I would need a c section anyway. I DO NOT want to do both so Im electing to do a C section. July 5th looked like a good day so if all goes well we will have the girls On Thursday July 5th. I pray we get walk into the hospital on the 5th and deliver big beautiful healthy girls. :)
I wanted to do a second update this week because we have had some news that may affect things in the near future but I hope not. I went and saw my regular OB on Friday to do our normal check up. Things with me are going well which is fantastic. I have been worried about my blood pressure since it got high with Cole around this time. It was not low but not high either. I passed my glucose test which was a big sigh of relief. Im not anemic and my platelet count looks great. Big thumbs up for me!
Scott and I discussed our concerns we have with how our appt went on Monday with Dr. Chyu and she agreed that our concerns were reasonable and that she would call Dr. Chyu and discuss trying to get growth checks every 2 weeks and fluid/bladder/ and dopplers every week. Especially since the fluid does look lower in the baby who had polyhydramnios it would be good to check it weekly. We felt a little rushed out of Dr. Chyus appt and we never really got a good answer as to why if UCSF suggests bi weekly growth checks why she wanted to to it every three weeks. This gets so convoluted because you have 3 different doctors, 3 different opinions, and 1 crazy mom who seems to never get the right answer in a timely fashion.
After our long winded discussion (good thing Dr. Juhn likes to talk) we had a quick ultrasound just to check heart beats with our reg ob. This is on a very low resolution portable ultrasound machine they typically use on non complicated pregnancies. Dr. Juhn was a little concerned that the fluid in Baby A's sac looks a little lower than what we got on Monday which was 5cm. She also thinks that our placenta is already in the beginning stages of calcifying which means it is starting to go kaput. It may be working at capacity to the point we might not make it to 36 weeks. However, since this is such a low resolution ultrasound and I like to think Dr. Juhn is very conservative. So I hope when we go to our next appt they will find that we are in better shape than it looks. I also, must prepare for the possibility that we might not make it to 36 weeks either. Kind of Scary. NICU time almost seems inevitable. Dr Juhn wanted to me to get in contact with UCSF and see if I could move my appt that is this Thursday up to Monday or Tuesday.
I left Dr Juhns office and called UCSF right away. They seem a bit skeptical about all the finding and asked me some questions I was able to answer but some I thought Dr. Juhn should answer herself. UCSF said they were all booked next week but that they would talk to my Dr. and figure something out. This was Friday at 2pm. I thought for sure I would not hear back by then end of the day. Much to my surprise I got a call form UCSF who always seems to come through. They said that they were unable to squeeze me in but talked to the MFM and want me to go in to the office in Sac Monday to re-check things to be sure they are stable enough to make it to my UCSF appt on Thursday. This puts me at ease a little because my concerns are legitimate and Im a little worried about my placenta because nobody has mentioned this to me before. The more appts I have I feel a little more at ease because I know we are more apt to catch something earlier than waiting 3 weeks. I just feel that at this point wouldn't it be smarter to check things more often because I am at a point where viability is so high? Meaning if something was going awry we could deliver rather than extend my appts to 3-4 weeks and miss something that could have been remedied by delivery that we missed because you all thought things were going to be ok. I may be totally over reacting and hope that everything will go ok. But if there is even a slight chance for acute TTTS or something similar I want to be checked weekly.
Ive also been having a lot of contractions lately as well and Dr. Juhn is threatening hospital Bed rest too. We will re-evaluate this after we go to UCSF and determine our status. Im really looking forward to going to UCSF and very nervous as well. When we get there we will not have had a growth check in 3 weeks and I'm on pins and needles to make sure they are both growing and getting plenty of blood flow through the umbilical doppler.
If all goes well we did discuss delivery at 36 weeks and are probably doing an elective C-section. I could do a vaginal delivery but my Dr. thinks that since Baby B is smaller and most likey has a thinner umbilical cord that she won't tolerate labor very well. So after Baby A is born (which she would come out first being closer to my cervix) that baby B will possibly turn and not be head down and show signs of distress and I would need a c section anyway. I DO NOT want to do both so Im electing to do a C section. July 5th looked like a good day so if all goes well we will have the girls On Thursday July 5th. I pray we get walk into the hospital on the 5th and deliver big beautiful healthy girls. :)
Wednesday, May 16, 2012
28 weeks 5 Days
I had my weekly appt today with Dr. Chyu here is Sacramento. This was my appt where I thought they were going to do growth checks and dopplers since we have been doing them bi weekly since week 16. However, to my dismay she decided we would do this every 3 weeks instead of 2?????? Why? Not sure. I left my appt today with a lot of questions actually. Although I think Dr. Chyu is very knowledgeable I do feel rushed in her presence and feel she is in hurry and doesn't explain things as well as I would like. She is definitely more thorough than Dr Veille but I just can't help that nobody can compare to the care I get in San Francisco. They just seem to be so much more thorough on their ultrasounds, they sit and explain all findings in detail and let you ask a multitude of questions. They also seem soooo consistent when it comes to the values we have been getting every week. When I go to Sacramento or Roseville we get such drastically different values week to week that I am skeptical about the accuracy of the findings. I understand there can be error due to different sonographers and such but Baby A went from having 8 cm of fluid last week to about 5 this week. Now this was explained to us by Dr. Chyu that it can be normal and isn't cause for concern. She did however, see the drastic difference in numbers from a screen outside my room and came in to check for herself when she saw the numbers. So it must have shocked her to some degree to come in right after that measurement was taken to check for herself. In fact, she even said I couldn't believe what I saw so I wanted to check as well. They were able to re measure a pocket that was measured originally at 4 and got a little over 5. All of these numbers are normal but since it is so different than last week I was a little skeptical because the last 6 weeks we have been hovering around 10cm. Im just worried that if it can go from -10 in one week down to 4-5 the next week that it can be seriously lower next week?????? It is possible things are just improving and that is great but when they say "oh we don't need to see you for another month" Im like HELL NO. I may be over analytical and a debbie downer but I really need to feel that I am doing everything I can to ensure that weekly we check this. I know I am not a Dr. but sometimes I feel brushed off when this was so extremely dangerous and possibly life threatening such a short time ago and now I feel like they are assuming everything will be hunky dory. Good God I hope this is the case but one can never be to careful. Better safe than sorry right?
So, the babies look good and each have a DVP of about 5cm. This is fantastic and the bladders look great. But now I have to wait another week to check the growth to determine if Baby B is still growing well and thriving. I continue to be blessed and breath a little sigh of relief after hearing strong heartbeats and seeing fluid in the bladders.
Dr Chyu told us that the extra fluid that is now not there gets absorbed by me and by the baby. I asked if this was something we should be concerned with and she said no. I didn't think to ask until we left about where it gets absorbed and at what point it is a problem? I guess since she said it wasn't something to be worried about that I didn't think much else about it. But after I left I started to wonder if it could be a problem for the girls if absorbed in and cause pulmonary edema or CHF etc. Sometimes a medical background is not a blessing because you know just enough to stress yourself out but not enough to answer your own questions. Ignorance is bliss....
I did stew over the appointment while on the car ride home and decided it could not hurt to call Dr. Rand in San Francisco and discuss my concerns over the fluid differences and hear what he thought about it. They are so great and even though he was in with another pt. the nurse talked to him about my situation and got a instant response. He feels that it could be completely normal but that he would be skeptical at such a difference in one weeks time. There really is no course of treatment about such a difference since it is in the normal range but is glad that I have an appt down there next week to check for himself. Me Too!!!! The what ifs are just getting to me and I try so hard not to dwell on the well this could happen and that could happen but I can't help it. I know we are in a fantastic place and the girls are looking great. I NEED to focus on that and I tell myself all the time. This is just very stressful when you don't have a see through belly and I cannot do anything to help. The next 6 weeks will definitely go by so slow. I will do my best to enjoy the quiet and rest.
I think the babies are getting bigger just from the way they move and how they are now positioned. I feel punching and kicking very hard all the time and I am loving it. I know they are doing good if they are kicking me awake at night. :) They also have been next to each other throughout the pregnancy but today we learned the Baby A on the left has pushed Baby B up on top and breech transverse. So Baby Bs head is on the Left as well and her body comes across the top of my belly and down my right side. Hmmmm wonder if she will stay in this position or turn head down? We shall see.
Ive been feeling ok. Im having a hard time sleeping now and the fact that it is getting hot out does not help. I try to go organize the spare bedroom and I have about 20 minutes of standing and bending before I need a break. Its pretty crazy. My back just starts to ache and I start to have some contractions and I feel it best to throw in the towel and rest. I know the organizing can wait. It may wait until the twins are 5 but it will still be there. haha.
I see my regular OB on Friday and I had my glucose tolerance test last Monday. I assume I passed since it has been over a week with no phone call. Im so glad because I was worried about that as well.
Next week we go to S.F. and this may be our last appt down there. I am very grateful for the team down there and it is bittersweet to leave them. I must trust that the Docotrs here have my girls and my best interest at heart. I will keep fighting for them and I know they will keep fighting for me, Dad and big brother Cole. Cole was excited to see the "baby beds" up in the girls rooms and then he comes over and pats my belly and say "hi sissys" "bye sissy's" and kisses them. I look forward to him holding them and giving them love if even for 2 seconds before he smacks them with a toy. :)
So, the babies look good and each have a DVP of about 5cm. This is fantastic and the bladders look great. But now I have to wait another week to check the growth to determine if Baby B is still growing well and thriving. I continue to be blessed and breath a little sigh of relief after hearing strong heartbeats and seeing fluid in the bladders.
Dr Chyu told us that the extra fluid that is now not there gets absorbed by me and by the baby. I asked if this was something we should be concerned with and she said no. I didn't think to ask until we left about where it gets absorbed and at what point it is a problem? I guess since she said it wasn't something to be worried about that I didn't think much else about it. But after I left I started to wonder if it could be a problem for the girls if absorbed in and cause pulmonary edema or CHF etc. Sometimes a medical background is not a blessing because you know just enough to stress yourself out but not enough to answer your own questions. Ignorance is bliss....
I did stew over the appointment while on the car ride home and decided it could not hurt to call Dr. Rand in San Francisco and discuss my concerns over the fluid differences and hear what he thought about it. They are so great and even though he was in with another pt. the nurse talked to him about my situation and got a instant response. He feels that it could be completely normal but that he would be skeptical at such a difference in one weeks time. There really is no course of treatment about such a difference since it is in the normal range but is glad that I have an appt down there next week to check for himself. Me Too!!!! The what ifs are just getting to me and I try so hard not to dwell on the well this could happen and that could happen but I can't help it. I know we are in a fantastic place and the girls are looking great. I NEED to focus on that and I tell myself all the time. This is just very stressful when you don't have a see through belly and I cannot do anything to help. The next 6 weeks will definitely go by so slow. I will do my best to enjoy the quiet and rest.
I think the babies are getting bigger just from the way they move and how they are now positioned. I feel punching and kicking very hard all the time and I am loving it. I know they are doing good if they are kicking me awake at night. :) They also have been next to each other throughout the pregnancy but today we learned the Baby A on the left has pushed Baby B up on top and breech transverse. So Baby Bs head is on the Left as well and her body comes across the top of my belly and down my right side. Hmmmm wonder if she will stay in this position or turn head down? We shall see.
Ive been feeling ok. Im having a hard time sleeping now and the fact that it is getting hot out does not help. I try to go organize the spare bedroom and I have about 20 minutes of standing and bending before I need a break. Its pretty crazy. My back just starts to ache and I start to have some contractions and I feel it best to throw in the towel and rest. I know the organizing can wait. It may wait until the twins are 5 but it will still be there. haha.
I see my regular OB on Friday and I had my glucose tolerance test last Monday. I assume I passed since it has been over a week with no phone call. Im so glad because I was worried about that as well.
Next week we go to S.F. and this may be our last appt down there. I am very grateful for the team down there and it is bittersweet to leave them. I must trust that the Docotrs here have my girls and my best interest at heart. I will keep fighting for them and I know they will keep fighting for me, Dad and big brother Cole. Cole was excited to see the "baby beds" up in the girls rooms and then he comes over and pats my belly and say "hi sissys" "bye sissy's" and kisses them. I look forward to him holding them and giving them love if even for 2 seconds before he smacks them with a toy. :)
Saturday, May 5, 2012
27 weeks 1 day
The survival rate for babies born at this gestation is 85%!! That is pretty good odds. I would obviously like to push this out to 35 weeks but everyday that passes with healthy babies is better and better odds.
I went to my first doctor appt with High Risk Maternal Fetal medicine Dr. Chyu since about 9 weeks ago. I have been lucky enough to be seen with great care in San Francisco and have now graduated to be able to be seen in Sacramento. I also had my monthly appt with my regular OB yesterday as well. We got great news with respect to the girls. They are still about 25 % difference in size but both gaining weight steadily and are even above the curve for weight. Baby A was 2 lbs 11 ounces and Baby B was 2 lbs 1ounce. The fluid for each baby was pretty similar and even slightly better at about 8cm and 5cm respectively. These are great numbers. The dopplers "couldn't be better" according to Dr. Chyu. This is so relieving.
I obviously left this appt feeling optimistic and in good spirits. It also seems a little bittersweet because although I have been extremely blessed, I have been following and chatting with fellow women in somewhat similar situations who have not been so lucky. I have been corresponding with a mom in Canada who is the exact same gestation as myself with Mono/Di twin boys. She also had an ultrasound for her boys the day I had mine. She had been doing well and had some pretty good ultrasounds but at her appt was given the devastating news that her recipient twin no longer had a heartbeat. This crushed me. Mostly because I can understand a little bit what she must be feeling. I obviously cannot really understand but having followed her story and knowing the risks I just feel terrible for her. She has a great outlook and is staying strong for her survivor. Please say a little prayer for her angel and her survivor that they are able to get some peace and bring a healthy baby into the world soon.
These type of stories are so hard to hear about but definitely help me to advocate for my girls and to push my doctors to see me VERY often to hopefully prevent something like this from happening. Acute TTTS is always a possibility and something I want to avoid. Dr.Chyu at first said I did not need to come back for a month???? A MONTH??? Are you crazy? Im not going from weekly to monthly? I responded that UCSF recommended at least bi weekly for growth but that I would like to be seen weekly to check Fluid levels. I didn't think that was too much to ask and she agreed pretty easily that it was something i could do. Phew!!! Im usually not one to question the doctors too much but after hearing stories like the one above and others where healthy 5/6 lb twins didn't make it from acute TTTS I want to be on the safe side.
I think I have a few things on my side and the doctors feel optimistic that acute TTTS won't be something I will encounter. Mainly because I have never been in stage 1 TTTS or had an treatment. BUT, it doesn't mean it cannot happen. So, for my peace of mind I will be in there weekly to make sure I do all in my power to prevent it or get the girls delivered if things are not going well. If I have any abnormal dopplers I will be delivered right away so as far as I am concerned it is something to check weekly.
My regular OB is great and she is definitely open to my concerns and isn't too proud to take the advice of the experts when it comes to what needs to be done for me. She will deliver me at 35-36 weeks as UCSF recommends at the latest because the placenta is likely to deteriorate after this point and the girls are safer out than in. She also is going to start Non-stress tests weekly or twice weekly] at 32 weeks to make sure the girls are not in distress.
I feel the more I am at the Dr. the less stress I feel and the more at ease I am. Scott was pretty happy I said something about not waiting a month to be seen because he knows how much of a basket case I would be if I had to wait that long to make sure everything is ok.
I feel very blessed and thank god everyday that I am still in a good place and that I can feel two little girls growing and kicking everyday. I have never been happier to be this uncomfortable and I will do it as long as it takes. So, now I just continue to make appts and go to the Dr. It is weird to think I will have these girls in less than 2 months from now. I have one more appt in San Francisco mainly for my piece of mind and they have been gracious enough to let me come back even though they don't think it is necessary if all is going well here. But I think I need it for my sanity more than anything. Also, I need to pick up the placenta box so I can send it to them and get results as to what the share looked like between the girls.
That's pretty much how things have been going in the last week and I continue to try to rest and relax as much as possible. It is definitely hard for me to do more than about 1 errand a day which is fine because it gives me plenty to do during the week because I cannot get it all done in one day. Thanks to all for the continued prayers. Please say an extra prayer for those who are in worse situations that myself or are just starting this rough journey. One can never have too many positive thoughts and prayers. Have a Happy Mothers day next week. Spoil all those wonderful Moms who sacrifice everyday for the health and safety of their beautiful children.
I went to my first doctor appt with High Risk Maternal Fetal medicine Dr. Chyu since about 9 weeks ago. I have been lucky enough to be seen with great care in San Francisco and have now graduated to be able to be seen in Sacramento. I also had my monthly appt with my regular OB yesterday as well. We got great news with respect to the girls. They are still about 25 % difference in size but both gaining weight steadily and are even above the curve for weight. Baby A was 2 lbs 11 ounces and Baby B was 2 lbs 1ounce. The fluid for each baby was pretty similar and even slightly better at about 8cm and 5cm respectively. These are great numbers. The dopplers "couldn't be better" according to Dr. Chyu. This is so relieving.
I obviously left this appt feeling optimistic and in good spirits. It also seems a little bittersweet because although I have been extremely blessed, I have been following and chatting with fellow women in somewhat similar situations who have not been so lucky. I have been corresponding with a mom in Canada who is the exact same gestation as myself with Mono/Di twin boys. She also had an ultrasound for her boys the day I had mine. She had been doing well and had some pretty good ultrasounds but at her appt was given the devastating news that her recipient twin no longer had a heartbeat. This crushed me. Mostly because I can understand a little bit what she must be feeling. I obviously cannot really understand but having followed her story and knowing the risks I just feel terrible for her. She has a great outlook and is staying strong for her survivor. Please say a little prayer for her angel and her survivor that they are able to get some peace and bring a healthy baby into the world soon.
These type of stories are so hard to hear about but definitely help me to advocate for my girls and to push my doctors to see me VERY often to hopefully prevent something like this from happening. Acute TTTS is always a possibility and something I want to avoid. Dr.Chyu at first said I did not need to come back for a month???? A MONTH??? Are you crazy? Im not going from weekly to monthly? I responded that UCSF recommended at least bi weekly for growth but that I would like to be seen weekly to check Fluid levels. I didn't think that was too much to ask and she agreed pretty easily that it was something i could do. Phew!!! Im usually not one to question the doctors too much but after hearing stories like the one above and others where healthy 5/6 lb twins didn't make it from acute TTTS I want to be on the safe side.
I think I have a few things on my side and the doctors feel optimistic that acute TTTS won't be something I will encounter. Mainly because I have never been in stage 1 TTTS or had an treatment. BUT, it doesn't mean it cannot happen. So, for my peace of mind I will be in there weekly to make sure I do all in my power to prevent it or get the girls delivered if things are not going well. If I have any abnormal dopplers I will be delivered right away so as far as I am concerned it is something to check weekly.
My regular OB is great and she is definitely open to my concerns and isn't too proud to take the advice of the experts when it comes to what needs to be done for me. She will deliver me at 35-36 weeks as UCSF recommends at the latest because the placenta is likely to deteriorate after this point and the girls are safer out than in. She also is going to start Non-stress tests weekly or twice weekly] at 32 weeks to make sure the girls are not in distress.
I feel the more I am at the Dr. the less stress I feel and the more at ease I am. Scott was pretty happy I said something about not waiting a month to be seen because he knows how much of a basket case I would be if I had to wait that long to make sure everything is ok.
I feel very blessed and thank god everyday that I am still in a good place and that I can feel two little girls growing and kicking everyday. I have never been happier to be this uncomfortable and I will do it as long as it takes. So, now I just continue to make appts and go to the Dr. It is weird to think I will have these girls in less than 2 months from now. I have one more appt in San Francisco mainly for my piece of mind and they have been gracious enough to let me come back even though they don't think it is necessary if all is going well here. But I think I need it for my sanity more than anything. Also, I need to pick up the placenta box so I can send it to them and get results as to what the share looked like between the girls.
That's pretty much how things have been going in the last week and I continue to try to rest and relax as much as possible. It is definitely hard for me to do more than about 1 errand a day which is fine because it gives me plenty to do during the week because I cannot get it all done in one day. Thanks to all for the continued prayers. Please say an extra prayer for those who are in worse situations that myself or are just starting this rough journey. One can never have too many positive thoughts and prayers. Have a Happy Mothers day next week. Spoil all those wonderful Moms who sacrifice everyday for the health and safety of their beautiful children.
Thursday, April 26, 2012
26 Weeks 0 Days
Today we "graduated"!!!!!! YIPEEEE! We have surpassed the surgery mark as we are 26 weeks tomorrow. We continue on the stable path and we couldn't be happier.
We arrived for our appt and unlike last week we waited an extra 30 min to be seen. So I guess we made up for getting in early last week. Our appt actually went pretty quickly. Our ultrasound technician was pretty quick and she was new to us. We figure she was not as thorough as our other techs. Usually we get 3 measurements of each item and they take the best two. This sonographer just took one. This was dis concerning to me but I knew if the radiologist didn't like the pictures she would come and do some herself. She seemed pleased with the pictures and did not even need to meet with us.
We also had our medical student who's name escapes me join us again for our ultrasound. She showed up half way through and said she would escort us to Dr. Rand after our appt. It seems so weird because Im pretty sure we don't need an escort after being there for the last 10 weeks. know I have pregnant brain but I haven't gotten lost at UCSF since day 1. Maybe she just feels like she is helping us out so we go along with it pretty easily.
When we arrived in Dr Rands office we had to wait a few minutes as he had not arrived yet. We were sitting in the waiting room with another couple who didn't seem to be quite as far along as myself. Im not sure what they were being seen for since the fetal treatment center treats all fetal complications but the mom seemed to be awfully upset. The scheduling coordinator came out to let them know they were just waiting on the surgeon. The mom seemed to have been crying. I felt so bad for her. I wanted to give her a big hug. I had been there only a short time ago with the whole crying thing and I know how horrible the feeling is. As much as I wanted to jump for joy about our situation and how far we have come I felt horrible for them. I hope they get some comfort and healing for whatever it is that they are going through.
We met with Dr.Rand and he confirmed what we had seen in the ultrasound. Our Babies Fluid/bladders/kidneys/dopplers all look great and seem to be slightly improving for both girls!!! Such good news! Baby A's (DVP) deep vertical pocket was 10.10cm and baby B's was 5.18cm. All seems to be on the right track. Although anything can happen and I still need to be seen weekly/bi weekly here in Sacramento I feel good and hopeful for a positive outcome for our girls! We are very Blessed and couldn't ask for anything more than 3 healthy beautiful children. There is nothing I need or want more than that.
So, the near future starts with appointments back at Sacramento perinatology with Dr. Chyu. She has been working very closely with UCSF and they know her well. This makes me at ease because we have had some trust and promptness issues with Dr. Veille our previous perinatologist. UCSF has been such a safe haven for me that leaving them scares me. They were so awesome and told me to call anytime and if I felt that I needed to be seen by them I am welcome. They will make me an appt. anytime I feel I need one. I do have an appt to be seen by them in one month to check up on things but told me if everything is going well here that I could cancel. Also, on the flip side if Dr. Chyu feels uneasy or worried about any findings I can be referred back to UCSF momentarily.
Each week is small but huge progress for the development of the girls. I really want to get out the 20's and into the 30's. this will make me even more at ease. If I make it to 35-36 weeks will be huge for monochorionic twins Dr. rand tells us. They usually deliver about 34 weeks if the stars line up. So I will continue to rest as much as I can and fatten them up as best as I can.
Scott returns to work tomorrow and this leaves me with a little more work getting Cole ready but I know I can manage and I am lucky to be able to rest most of the day. I am starting to really feel big and some days I feel like my pelvis may rip in two and my belly button might split. Small potatoes compared to what we have been through so i cannot complain. Well, Scott hears me complain enough. LOL. I am not looking forward to the heat. The last weekend we had in the 90's was over the top. Probably because we went from the 50's to 90's. No easing into it or anything. Sheesh!! I think it may be a hot summer since our last tow were pretty mild. BUT I WILL get through it.
We arrived for our appt and unlike last week we waited an extra 30 min to be seen. So I guess we made up for getting in early last week. Our appt actually went pretty quickly. Our ultrasound technician was pretty quick and she was new to us. We figure she was not as thorough as our other techs. Usually we get 3 measurements of each item and they take the best two. This sonographer just took one. This was dis concerning to me but I knew if the radiologist didn't like the pictures she would come and do some herself. She seemed pleased with the pictures and did not even need to meet with us.
We also had our medical student who's name escapes me join us again for our ultrasound. She showed up half way through and said she would escort us to Dr. Rand after our appt. It seems so weird because Im pretty sure we don't need an escort after being there for the last 10 weeks. know I have pregnant brain but I haven't gotten lost at UCSF since day 1. Maybe she just feels like she is helping us out so we go along with it pretty easily.
When we arrived in Dr Rands office we had to wait a few minutes as he had not arrived yet. We were sitting in the waiting room with another couple who didn't seem to be quite as far along as myself. Im not sure what they were being seen for since the fetal treatment center treats all fetal complications but the mom seemed to be awfully upset. The scheduling coordinator came out to let them know they were just waiting on the surgeon. The mom seemed to have been crying. I felt so bad for her. I wanted to give her a big hug. I had been there only a short time ago with the whole crying thing and I know how horrible the feeling is. As much as I wanted to jump for joy about our situation and how far we have come I felt horrible for them. I hope they get some comfort and healing for whatever it is that they are going through.
We met with Dr.Rand and he confirmed what we had seen in the ultrasound. Our Babies Fluid/bladders/kidneys/dopplers all look great and seem to be slightly improving for both girls!!! Such good news! Baby A's (DVP) deep vertical pocket was 10.10cm and baby B's was 5.18cm. All seems to be on the right track. Although anything can happen and I still need to be seen weekly/bi weekly here in Sacramento I feel good and hopeful for a positive outcome for our girls! We are very Blessed and couldn't ask for anything more than 3 healthy beautiful children. There is nothing I need or want more than that.
So, the near future starts with appointments back at Sacramento perinatology with Dr. Chyu. She has been working very closely with UCSF and they know her well. This makes me at ease because we have had some trust and promptness issues with Dr. Veille our previous perinatologist. UCSF has been such a safe haven for me that leaving them scares me. They were so awesome and told me to call anytime and if I felt that I needed to be seen by them I am welcome. They will make me an appt. anytime I feel I need one. I do have an appt to be seen by them in one month to check up on things but told me if everything is going well here that I could cancel. Also, on the flip side if Dr. Chyu feels uneasy or worried about any findings I can be referred back to UCSF momentarily.
Each week is small but huge progress for the development of the girls. I really want to get out the 20's and into the 30's. this will make me even more at ease. If I make it to 35-36 weeks will be huge for monochorionic twins Dr. rand tells us. They usually deliver about 34 weeks if the stars line up. So I will continue to rest as much as I can and fatten them up as best as I can.
Scott returns to work tomorrow and this leaves me with a little more work getting Cole ready but I know I can manage and I am lucky to be able to rest most of the day. I am starting to really feel big and some days I feel like my pelvis may rip in two and my belly button might split. Small potatoes compared to what we have been through so i cannot complain. Well, Scott hears me complain enough. LOL. I am not looking forward to the heat. The last weekend we had in the 90's was over the top. Probably because we went from the 50's to 90's. No easing into it or anything. Sheesh!! I think it may be a hot summer since our last tow were pretty mild. BUT I WILL get through it.
Friday, April 20, 2012
25 Weeks 0 days
We were able to squeeze another week of S.F. into about 3 hrs. We had our appt. at 10 am but we arrived about 9am. We were called back at 9:30!!! Yay!! After our ultrasound which is getting shorter every week it seems like since they know us so well, we went to the fetal treatment center to go over our results with Dr. Rand and his team. We had a fourth year medical student join us for our ultrasound and she walked us down to the FTC.
Scott and I were able to determine a few things in our ultrasound before Dr. Rand even started to explain to us our current situation. Being "experts" in sonography we saw that the DVP or amniotic fluid levels we have been watching closely have remained similar at 10.8 for A and 4.8 for B. Still too much for A but not concerning at this point. B is slightly improving over the last few weeks as we have slowly gained from around 2.8 to almost 5. This is great. We had nice bladders, stomachs, kidney function. We also had great dopplers and blood flow through the umbilical cord for each baby which is good. I think our AA (arterial anastomoses) is doing its job. They were clearly able to see that this week. YAY!!
The growth discordance is still hovering at around 24%. Last week it was 28%. So this is a good sign. Like I said last week, although >20% is abnormal we have two little girls who are overachievers. Baby A is 70th percentile for singleton babies and B is 38th percentile for singleton babies. B has also gained about 150 grams since last week. Im soooo proud!!LOL. Baby A weighs in at a whopping 2lbs 0ounces and B weighs in slightly behind at 1lb 8ozs.
We still need to get to a safer gestational age as the next few weeks are critical in terms of gaining weight, lung development etc. I think making it to 29 weeks will be a bigger sigh of relief for me. Although Im feeling optimistic making it to 25 weeks I would feel much better at the 30 week mark or even further of course. It was hard to imagine that 2 months ago I was hoping to make it this far. Im reaching for the stars now. We still continue to go to UCSF next week and then depending on our numbers we may "graduate" to biweekly appts at UCSF. Since surgery after next week is not a possibility and I have been stable they feel it would be ok to go to bi-weekly. This makes me very nervous yet happy at the same time. Im feeling uneasy about leaving my safety net at UCSF. I feel they are wonderful and know me better than anyone. I feel they have all the resources to take phenomenal care of my girls. Sutter is great don't get me wrong but they have not been following my care other than monthly since UCSF took over my weekly appts. Sutter has the resources to care for preemies but Im scared that they may miss something that UCSF would pick up on being experts in this particular condition.
I have voiced my concern over the perinatologist that I was seeing before S.F took over my care and Dr. Rand was able to call Sutter and get me an appt in May with the doctor he and I both prefer. I am willing to drive to Sacramento to see her. Easy peasy compared to driving to S.F. right?
I was told by Dr. Rand yesterday that this pregnancy will not be allowed to continue past 35 weeks. So, I am guaranteed to be delivered on or around June 30 if everything goes smoothly. Yikes!! Seems so early compared to 41 weeks with Cole. But making it to 35 weeks will be awesome considering a few months ago I nearly had TTTS. Baby B still has a smaller share of the placenta and most likely will at some point require more than it is willing go give her. We must watch this closely to determine the point where nourishment and oxygen in the NICU will outweigh the amount my placenta is giving her. Since Placentas are fixed and don't grow with the baby, she will demand more and more as she grows. Hopefully the AA we found will help to remedy her needs for more but this is not a guarantee. So, we watch and see...... more waiting.....more waiting.....ugh.. but no news is good news!!
So from here on out I am off work and trying to rest as much as I can to fatten the girls up because 1 day inside of me equals 3 less days in the NICU. Keep the prayers and wishes coming as they are working!!
Scott and I were able to determine a few things in our ultrasound before Dr. Rand even started to explain to us our current situation. Being "experts" in sonography we saw that the DVP or amniotic fluid levels we have been watching closely have remained similar at 10.8 for A and 4.8 for B. Still too much for A but not concerning at this point. B is slightly improving over the last few weeks as we have slowly gained from around 2.8 to almost 5. This is great. We had nice bladders, stomachs, kidney function. We also had great dopplers and blood flow through the umbilical cord for each baby which is good. I think our AA (arterial anastomoses) is doing its job. They were clearly able to see that this week. YAY!!
The growth discordance is still hovering at around 24%. Last week it was 28%. So this is a good sign. Like I said last week, although >20% is abnormal we have two little girls who are overachievers. Baby A is 70th percentile for singleton babies and B is 38th percentile for singleton babies. B has also gained about 150 grams since last week. Im soooo proud!!LOL. Baby A weighs in at a whopping 2lbs 0ounces and B weighs in slightly behind at 1lb 8ozs.
We still need to get to a safer gestational age as the next few weeks are critical in terms of gaining weight, lung development etc. I think making it to 29 weeks will be a bigger sigh of relief for me. Although Im feeling optimistic making it to 25 weeks I would feel much better at the 30 week mark or even further of course. It was hard to imagine that 2 months ago I was hoping to make it this far. Im reaching for the stars now. We still continue to go to UCSF next week and then depending on our numbers we may "graduate" to biweekly appts at UCSF. Since surgery after next week is not a possibility and I have been stable they feel it would be ok to go to bi-weekly. This makes me very nervous yet happy at the same time. Im feeling uneasy about leaving my safety net at UCSF. I feel they are wonderful and know me better than anyone. I feel they have all the resources to take phenomenal care of my girls. Sutter is great don't get me wrong but they have not been following my care other than monthly since UCSF took over my weekly appts. Sutter has the resources to care for preemies but Im scared that they may miss something that UCSF would pick up on being experts in this particular condition.
I have voiced my concern over the perinatologist that I was seeing before S.F took over my care and Dr. Rand was able to call Sutter and get me an appt in May with the doctor he and I both prefer. I am willing to drive to Sacramento to see her. Easy peasy compared to driving to S.F. right?
I was told by Dr. Rand yesterday that this pregnancy will not be allowed to continue past 35 weeks. So, I am guaranteed to be delivered on or around June 30 if everything goes smoothly. Yikes!! Seems so early compared to 41 weeks with Cole. But making it to 35 weeks will be awesome considering a few months ago I nearly had TTTS. Baby B still has a smaller share of the placenta and most likely will at some point require more than it is willing go give her. We must watch this closely to determine the point where nourishment and oxygen in the NICU will outweigh the amount my placenta is giving her. Since Placentas are fixed and don't grow with the baby, she will demand more and more as she grows. Hopefully the AA we found will help to remedy her needs for more but this is not a guarantee. So, we watch and see...... more waiting.....more waiting.....ugh.. but no news is good news!!
So from here on out I am off work and trying to rest as much as I can to fatten the girls up because 1 day inside of me equals 3 less days in the NICU. Keep the prayers and wishes coming as they are working!!
Thursday, April 12, 2012
23 weeks 6 Days
Tomorrow is our 24 weeks NO 'Birthday' day. Whoop whoop!! We are still pregnant and still able to say that things are going well. I normally wouldn't use the word well but I feel like today was a good day and I am feeling optimistic. I have spent a lot of weeks leaving S.F. feeling disappointed and scared. This was the first time I feel things may hopefully continue on a path of stability for us.
We made it to S.F. in the rain with 1 hr to spare. We also pulled across the bay bridge to some sunshine. We decided to head to the beach to hang out for a few minutes to enjoy the fresh air and warm sun. We saw lots of families running around on the beach and chasing after their dogs. It was nice to see.
We then headed to our appt and made it with about 15 min to spare. We were called early and were seen by the same sonographer we have seen the last 3 times we have gone. This was very convenient because she seems to know us well and seems to need less time to figure out where things are. She is pretty familiar with who is who and what is what. I also felt a little more relaxed and really tried to tell myself that "it will be ok, I have done everything I can, things are out of my hands, etc. etc. to keep me from getting so nervous and crying during the ultrasound. It seemed to work and I actually didn't get dizzy or lightheaded lying on my back the entire ultrasound. Scott and I being the experts we have become in sonography saw that Baby A's fluid (bigger baby) was 10.89 and Baby B (smaller baby) was 4.8. This is fantastic news. We still have polyhydramnios (excessive fluid) in A baby but B had slightly improved from last week. Even though Baby A has polyhydramnios it is not excessive enough at this point to need any intervention. Also, Baby B holding steady at 4.8 keeps us from needing laser surgery again this week. We did not do any measurements this week since that was done Fri. We will revisit this next week.
We talked to Dr. Kim today as our normal Dr. was out. She seemed very knowledgeable about our case as well. All the doctors meet every tuesday to go over all patients ultrasounds. She seemed very optimistic about how things are going for us and how she anticipates them continuing. She expects that when we return next week that we will continue to be stable and may even "graduate" out of coming every week and coming every 2 weeks. This is awesome but also a little scary because there is some comfort in going every week. Usually if TTTS is going to rear its ugly head it will by the 26 week mark. We will be at the 25 week mark when we go next week. We found out that surgery is not done after 26weeks because this is the point when babies eyes become unfused in utero and they have the ability to blink. The laser used in surgery can damage the eyes if used after the 26 week mark. Obviously anything can happen but we may have some things on our side at this point I like to think.
I am still concerned with the unequal placental share between the girls and the fact that Baby B is 28% smaller than her sister. According to Dr. Kim that although >20% difference is significant, the girls fit the growth chart at 64% and 32 % respectively. This is also in terms of singleton births. So what this means is that Baby A is bigger than 64/100 singleton babies and Baby B is bigger than 34/100 singleton babies. This is really good for twins as she puts it. She also says it is good in terms of A being an "overachiever" because she is above the 50th percentile for singletons. Since she is an overachiever it makes sense that Baby B is 28% smaller. Thats my girl!!!
So all in all I left feeling better than I did when I arrived for the first time. I hope this continues! We still have a ways to go to get to a safer gestation but I am hopeful and thank god that we have been this blessed because after talking to a lot of moms in similar situations we have been pretty lucky thus far. We have yet to need any intervention and this helps to decrease possible complications or preterm delivery. Yay!! We still have two healthy little girls that I need to fatten up in the weeks to come. In the next four weeks they should double their weight.
I also went to the Sutter Memorial NICU yesterday for a tour just in case we deliver before 30 weeks to see what it was all about to ease some of my fears. I was able to see 2 babies that were born at 500 grams and 23 weeks gestation. The other was born at 27 weeks and weighed 800 grams. Although they were super tiny they looked good and the Nurse said they were doing well. Although this was hard to see and I hope we never even see the NICU, it was reassuring that they were doing well at such a young gestation and had the best care possible.
After going to L&D on Tuesday night and experiencing the symptoms I had I have decided to re-evaluate the amount of work I am doing and to really adjust my schedule to possibly stay home or work very part time. I have mulled this over in my head for awhile now and I think this may be for the best.
I want to thank Scott and my parents for their continued help as I become more and more couch/homebound. Scott has really been working hard to make sure Cole and I have all we need and I really appreciate it. I also want to thank everyone who has offered to help us out. We have great friends and family and it is times like this that make that even more apparent. :)
We made it to S.F. in the rain with 1 hr to spare. We also pulled across the bay bridge to some sunshine. We decided to head to the beach to hang out for a few minutes to enjoy the fresh air and warm sun. We saw lots of families running around on the beach and chasing after their dogs. It was nice to see.
We then headed to our appt and made it with about 15 min to spare. We were called early and were seen by the same sonographer we have seen the last 3 times we have gone. This was very convenient because she seems to know us well and seems to need less time to figure out where things are. She is pretty familiar with who is who and what is what. I also felt a little more relaxed and really tried to tell myself that "it will be ok, I have done everything I can, things are out of my hands, etc. etc. to keep me from getting so nervous and crying during the ultrasound. It seemed to work and I actually didn't get dizzy or lightheaded lying on my back the entire ultrasound. Scott and I being the experts we have become in sonography saw that Baby A's fluid (bigger baby) was 10.89 and Baby B (smaller baby) was 4.8. This is fantastic news. We still have polyhydramnios (excessive fluid) in A baby but B had slightly improved from last week. Even though Baby A has polyhydramnios it is not excessive enough at this point to need any intervention. Also, Baby B holding steady at 4.8 keeps us from needing laser surgery again this week. We did not do any measurements this week since that was done Fri. We will revisit this next week.
We talked to Dr. Kim today as our normal Dr. was out. She seemed very knowledgeable about our case as well. All the doctors meet every tuesday to go over all patients ultrasounds. She seemed very optimistic about how things are going for us and how she anticipates them continuing. She expects that when we return next week that we will continue to be stable and may even "graduate" out of coming every week and coming every 2 weeks. This is awesome but also a little scary because there is some comfort in going every week. Usually if TTTS is going to rear its ugly head it will by the 26 week mark. We will be at the 25 week mark when we go next week. We found out that surgery is not done after 26weeks because this is the point when babies eyes become unfused in utero and they have the ability to blink. The laser used in surgery can damage the eyes if used after the 26 week mark. Obviously anything can happen but we may have some things on our side at this point I like to think.
I am still concerned with the unequal placental share between the girls and the fact that Baby B is 28% smaller than her sister. According to Dr. Kim that although >20% difference is significant, the girls fit the growth chart at 64% and 32 % respectively. This is also in terms of singleton births. So what this means is that Baby A is bigger than 64/100 singleton babies and Baby B is bigger than 34/100 singleton babies. This is really good for twins as she puts it. She also says it is good in terms of A being an "overachiever" because she is above the 50th percentile for singletons. Since she is an overachiever it makes sense that Baby B is 28% smaller. Thats my girl!!!
So all in all I left feeling better than I did when I arrived for the first time. I hope this continues! We still have a ways to go to get to a safer gestation but I am hopeful and thank god that we have been this blessed because after talking to a lot of moms in similar situations we have been pretty lucky thus far. We have yet to need any intervention and this helps to decrease possible complications or preterm delivery. Yay!! We still have two healthy little girls that I need to fatten up in the weeks to come. In the next four weeks they should double their weight.
I also went to the Sutter Memorial NICU yesterday for a tour just in case we deliver before 30 weeks to see what it was all about to ease some of my fears. I was able to see 2 babies that were born at 500 grams and 23 weeks gestation. The other was born at 27 weeks and weighed 800 grams. Although they were super tiny they looked good and the Nurse said they were doing well. Although this was hard to see and I hope we never even see the NICU, it was reassuring that they were doing well at such a young gestation and had the best care possible.
After going to L&D on Tuesday night and experiencing the symptoms I had I have decided to re-evaluate the amount of work I am doing and to really adjust my schedule to possibly stay home or work very part time. I have mulled this over in my head for awhile now and I think this may be for the best.
I want to thank Scott and my parents for their continued help as I become more and more couch/homebound. Scott has really been working hard to make sure Cole and I have all we need and I really appreciate it. I also want to thank everyone who has offered to help us out. We have great friends and family and it is times like this that make that even more apparent. :)
Wednesday, April 11, 2012
Hospital Visit 23 Weeks 4 Days
We enjoyed a view of Room 13 last night at Sutter L&D from about 4pm to 10 pm. I was sent to L&D by my primary OB for some testing as I was having some dis concerning symptoms. On Monday night I began to feel some contractions and some shortness of breath that I thought was not normal. I am pregnant with twins and getting bigger everyday as I am sure some shortness of breath is common. Same with Braxton Hicks contractions. The issue was that I was short of breath just having a normal conversation. I felt like my 2 year old was sitting on my chest and I needed to take a deep breath every few sentences and all I was doing was talking. Also, combined with the contractions I was worried about the girls and specifically Baby A and her polyhydramnios ( excessive fluid). I was worried that it may have gotten worse and this was causing contractions and pushing on my lungs. I wanted to get checked out just to make sure everything was okay.
I called my regular OB the morning after the incident. She was not available in the morning as she usually has her scheduled C sections at this time. her assistant told me I could come in at 2:45 or if I was having contractions I should just go to L&D. I was no longer feeling any of the contractions so I thought going to L&D was unnecessary. I also was not at work because I though i would need to get in first thing in the am. So, I decided to just tell her assistant to have her call me and we could discuss it over the phone. I went to work and figured things were ok. I was talking with a co-worker and he was noticing that I was short of breath. He was like "sarah, you need to call your doctor." I said I did and was waiting to hear back. After some prodding from co-workers I decided to call UCSF and let them know what was going on. I figured if they thought it was serious enough they (being the experts) would tell me what I should do. They told me to be seen for sure either by my high risk perinatologist or my primary OB. I took the advice and called Dr. Veille who is my high risk Dr. here on Roseville. I informed the front desk person of my symptoms and she went to tell the Dr. and put me on hold. She then returned to tell me that Dr. Veille said if I was having shortness of breath that I needed to go to the ER. The ER, Really??? Come on now!! For those of you who know me well would know I will not do that . Plus if you are over 20weeks pregnant the ER looks at you like a leper and sends you to L&D first chance they get. I decided to call Dr. Juhn (primary OB) back and ask for the 2:45 appt I was offered this morning. I was able to get it and was much more inclined to do that than go to the ER where they know nothing about me and my situation.
Needless to say after talking to all my Dr.s who apparently don't talk to each other and I constantly play middle man. I end up in L&D anyway. My primary OB was concerned about my shortness of breath while at rest and the contractions. I was sent to L&D for a 12 Lead EKG, Doppler ultrasound on my legs to determine if I had a blood clot (which can cause shortness of breath), and to monitor contractions, HR, and movement of the girls. After 6hrs in L&D and all my test were complete I was told I could go home and we had no answers to my symptoms. It is possible that it is stress and anxiety related. maybe I push myself a little too much or just everything that has been going on is getting to me and my body is saying "whoa" time to slow down and take it easy.
After battling with the bed rest vs. non bed rest issue for a week I think this incident was the icing on the cake. I don't think I need to strap myself to a bed but Im thinking at home rest might be a better option. The health of my girls is top priority. I am going to S.F tomorrow and after I talk more with them and get this weeks ultrasound results I will have a more clear picture of what I need to do I think. Hopefully we will continue on the path we have been on for the last 6 weeks. These next few weeks seem so crucial. Being born at 25 weeks vs. 29 weeks seems to have a huge impact statistically on survivability and health. Im hoping and praying the next 6 weeks pass quickly and uneventfully. I know with twins visits to L&D like the one last night are more common but I would like to avoid that if possible.
Hope everyone had a good Easter. We enjoyed a lovely Brunch and egg hunt at Michelle and Jeremy Lawson's house. Cole got lots of goodies and was spoiled with love and treats.
I will let you know how our appt goes tomorrow. keep those Prayers coming. We sure appreciate the love and support!
I called my regular OB the morning after the incident. She was not available in the morning as she usually has her scheduled C sections at this time. her assistant told me I could come in at 2:45 or if I was having contractions I should just go to L&D. I was no longer feeling any of the contractions so I thought going to L&D was unnecessary. I also was not at work because I though i would need to get in first thing in the am. So, I decided to just tell her assistant to have her call me and we could discuss it over the phone. I went to work and figured things were ok. I was talking with a co-worker and he was noticing that I was short of breath. He was like "sarah, you need to call your doctor." I said I did and was waiting to hear back. After some prodding from co-workers I decided to call UCSF and let them know what was going on. I figured if they thought it was serious enough they (being the experts) would tell me what I should do. They told me to be seen for sure either by my high risk perinatologist or my primary OB. I took the advice and called Dr. Veille who is my high risk Dr. here on Roseville. I informed the front desk person of my symptoms and she went to tell the Dr. and put me on hold. She then returned to tell me that Dr. Veille said if I was having shortness of breath that I needed to go to the ER. The ER, Really??? Come on now!! For those of you who know me well would know I will not do that . Plus if you are over 20weeks pregnant the ER looks at you like a leper and sends you to L&D first chance they get. I decided to call Dr. Juhn (primary OB) back and ask for the 2:45 appt I was offered this morning. I was able to get it and was much more inclined to do that than go to the ER where they know nothing about me and my situation.
Needless to say after talking to all my Dr.s who apparently don't talk to each other and I constantly play middle man. I end up in L&D anyway. My primary OB was concerned about my shortness of breath while at rest and the contractions. I was sent to L&D for a 12 Lead EKG, Doppler ultrasound on my legs to determine if I had a blood clot (which can cause shortness of breath), and to monitor contractions, HR, and movement of the girls. After 6hrs in L&D and all my test were complete I was told I could go home and we had no answers to my symptoms. It is possible that it is stress and anxiety related. maybe I push myself a little too much or just everything that has been going on is getting to me and my body is saying "whoa" time to slow down and take it easy.
After battling with the bed rest vs. non bed rest issue for a week I think this incident was the icing on the cake. I don't think I need to strap myself to a bed but Im thinking at home rest might be a better option. The health of my girls is top priority. I am going to S.F tomorrow and after I talk more with them and get this weeks ultrasound results I will have a more clear picture of what I need to do I think. Hopefully we will continue on the path we have been on for the last 6 weeks. These next few weeks seem so crucial. Being born at 25 weeks vs. 29 weeks seems to have a huge impact statistically on survivability and health. Im hoping and praying the next 6 weeks pass quickly and uneventfully. I know with twins visits to L&D like the one last night are more common but I would like to avoid that if possible.
Hope everyone had a good Easter. We enjoyed a lovely Brunch and egg hunt at Michelle and Jeremy Lawson's house. Cole got lots of goodies and was spoiled with love and treats.
I will let you know how our appt goes tomorrow. keep those Prayers coming. We sure appreciate the love and support!
Saturday, April 7, 2012
23 weeks 0days
Well that was an exhausting day. We left for S.F. at 5:15am and got home about 8pm. Ugh!! No time to even enjoy the city. We did get to have a small excursion to Crepevine which was pretty nice. It is a crepe restaurant that was recommended. The owner and her twin sons run it. So funny huh? The owner was over the moon when she found out we were having twins. It was cute.
So, long story short we are still blessed and in the "stable" zone. We had our first appt for an ultrasound at 8:45 am. Since it was a Friday and a holiday weekend I was not able to eat since the night before. They wanted the surgical team on standby in case I needed surgery. This way they could get it done before everyone went on the holiday weekend because if I needed it (worst case) I wouldn't be able to wait the weekend for it. Normally, I go on a Wednesday or Thursday and if I need surgery it can be done on the next day. This week was different because they like for me to see a specific sonographer who is the best. She also is getting to know us quite well as you can imagine. This is helpful because she is very familiar with all my previous appts. She was only working Friday this week. The perinatologists have Fridays off from seeing patients. So, our Dr. would be called in from home if need be. Luckily for us and him we all got to go have the weekend to enjoy with the knowledge that things are ok for now.
As soon as I had my ultrasound the Dr. told me I could eat. Thank goodness. I slammed a nutra grain bar I had on standby because this momma and her babies were starving by 10:30am. I was then able to go to the fetal treatment center to go over the results with my perinatologist Dr. Larry Rand by conference call since he was at home. The "stand by" surgeons were called off and Im sure they were happy too.
This week we had the full ultrasound with measurements of each baby to determine growth between the two. We also has a 2 hour echocardiogram ultrasound at 1pm to make sure heart anatomy and function continue to be healthy. We learned that the DVP (deep vertical pocket) or fluid level for Baby A (bigger baby) is still polyhydramnios or excessive at 10.8 and Baby B (smaller baby) DVP is holding steady at 3.8cm. Both babies have bladders and they are normal. This is fantastic. If they could not find a bladder on Baby B we would have had to have the surgery. PHEW!!!! The polyhydrmanios is not an issue as I stated in my last post for Baby A but we need to keep an eye on it for preterm labor and or difficulty breathing for me. So far, my cervix is nice and thick (TMI I know) but this is good.
As far as growth is concerned they have moved slightly up from 25% 2 weeks ago to 28% this week. Although this seems disconcerning the doctors assure me that it is no cause for concern at this point because both babies are still growing. Baby A is 1lb 9oz and baby B is 1lb 2oz. 2 weeks ago baby B was 12 oz so a growth of 6 oz in 2 weeks. This is good. We must continue to see them both grow and when Baby B stops growing and or decreases in size she must be delivered. This is where she reaches the point that the placenta is no longer nourishing her. Our hope is this is later rather than sooner. GROW baby GROW!!! Im hoping I am doing my part.
I went to a nutrition class last week for pregnant moms with multiples and they say I should eat about 3700 calories a day. HOLYCRAP!! thats a lot. Im sure I'll manage!! LOL. They say you should gain 24 lbs by 24 weeks. WOW. Thats next friday and I have not hit that mark yet. Ill work on it this weekend. hehe.
Our Echos went well other than I wanted to shoot our sonographer. He was horrible. I told him before we started that I will pass out lying flat on my back for to long. So could I please move to my side unless he needs me on my back for certain measurements. He kept me on my back for about 30 min and I finally said Look, I need to lay on my side for awhile. I was sweaty, hot, nauseated and near syncopal!! He was pushing soooo freakin
Since it was Good Friday we got lucky enough to get stuck in the Holiday traffic heading out of the city. That was not fun. But we managed to make it home in time to snuggle with Cole before he fell asleep. My favorite part of any day.
So that is where we are now. I also saw my regular OB on Thursday and She and UCSF have very differing opinions on bed rest. My OB really wants me on strict bed rest and feels that if I cannot stick to it at home that she can admit me to the hospital and this way I have no choice. UCSF is very against this opinion and after long discussions on pros and cons I have decided that modified bed rest is what I will do for now. I am going to try not to take Cole to to many party's or functions as this wipes me out all by myself chasing after him. I will let some household duties go or Scott will be nice enough to help more than he already does, which is quite a lot. I just feel that the experts in field win out in their argument against bed rest. There may come a time when UCSF decides it would be beneficial but at this point they feel it will not help and could be detrimental in terms of blood clots/atrophy, and mentally and physically hard on me. My OB feels that although there are no studies that suggest it helps that it may. Since I am not in pre term labor there is no indication for it. I am obviously torn because I want what is best for the girls but I feel stuck between an rock and hard place. These opinions are not even close to similar. One says admit me and strap me down and the other says daily activity is fine??? What do you do? Well I'm just going to meet them in the middle and do hardly anything at all. Then we will hopefully keep trucking along to a safer and safer gestational age for the girls to be born healthy with little to no NICU time.
Next week we hit the 24 week mark which is termed "Viability." This is awesome to hear that if they are born they have a chance. Obviously 24 weeks is not ideal and each week increases our girls chances for a healthy birth. Weird when I think about where I was at 24 weeks pregnant with Cole. It was November and he was born in March!! Seems drastically different. Hopefully we can make it into weeks 30 and beyond. Hard to wish your baby can be born at 30 weeks but I'll be excited to see June come and still be pregnant. Thanks to all for the well wishes and for following our journey. This blog has been quite cathartic for me and it helps to keep all those who care in the loop. Hope everyone has a Happy Easter!!! Enjoy Spring break.
-Sarah
So, long story short we are still blessed and in the "stable" zone. We had our first appt for an ultrasound at 8:45 am. Since it was a Friday and a holiday weekend I was not able to eat since the night before. They wanted the surgical team on standby in case I needed surgery. This way they could get it done before everyone went on the holiday weekend because if I needed it (worst case) I wouldn't be able to wait the weekend for it. Normally, I go on a Wednesday or Thursday and if I need surgery it can be done on the next day. This week was different because they like for me to see a specific sonographer who is the best. She also is getting to know us quite well as you can imagine. This is helpful because she is very familiar with all my previous appts. She was only working Friday this week. The perinatologists have Fridays off from seeing patients. So, our Dr. would be called in from home if need be. Luckily for us and him we all got to go have the weekend to enjoy with the knowledge that things are ok for now.
As soon as I had my ultrasound the Dr. told me I could eat. Thank goodness. I slammed a nutra grain bar I had on standby because this momma and her babies were starving by 10:30am. I was then able to go to the fetal treatment center to go over the results with my perinatologist Dr. Larry Rand by conference call since he was at home. The "stand by" surgeons were called off and Im sure they were happy too.
This week we had the full ultrasound with measurements of each baby to determine growth between the two. We also has a 2 hour echocardiogram ultrasound at 1pm to make sure heart anatomy and function continue to be healthy. We learned that the DVP (deep vertical pocket) or fluid level for Baby A (bigger baby) is still polyhydramnios or excessive at 10.8 and Baby B (smaller baby) DVP is holding steady at 3.8cm. Both babies have bladders and they are normal. This is fantastic. If they could not find a bladder on Baby B we would have had to have the surgery. PHEW!!!! The polyhydrmanios is not an issue as I stated in my last post for Baby A but we need to keep an eye on it for preterm labor and or difficulty breathing for me. So far, my cervix is nice and thick (TMI I know) but this is good.
As far as growth is concerned they have moved slightly up from 25% 2 weeks ago to 28% this week. Although this seems disconcerning the doctors assure me that it is no cause for concern at this point because both babies are still growing. Baby A is 1lb 9oz and baby B is 1lb 2oz. 2 weeks ago baby B was 12 oz so a growth of 6 oz in 2 weeks. This is good. We must continue to see them both grow and when Baby B stops growing and or decreases in size she must be delivered. This is where she reaches the point that the placenta is no longer nourishing her. Our hope is this is later rather than sooner. GROW baby GROW!!! Im hoping I am doing my part.
I went to a nutrition class last week for pregnant moms with multiples and they say I should eat about 3700 calories a day. HOLYCRAP!! thats a lot. Im sure I'll manage!! LOL. They say you should gain 24 lbs by 24 weeks. WOW. Thats next friday and I have not hit that mark yet. Ill work on it this weekend. hehe.
Our Echos went well other than I wanted to shoot our sonographer. He was horrible. I told him before we started that I will pass out lying flat on my back for to long. So could I please move to my side unless he needs me on my back for certain measurements. He kept me on my back for about 30 min and I finally said Look, I need to lay on my side for awhile. I was sweaty, hot, nauseated and near syncopal!! He was pushing soooo freakin
Since it was Good Friday we got lucky enough to get stuck in the Holiday traffic heading out of the city. That was not fun. But we managed to make it home in time to snuggle with Cole before he fell asleep. My favorite part of any day.
So that is where we are now. I also saw my regular OB on Thursday and She and UCSF have very differing opinions on bed rest. My OB really wants me on strict bed rest and feels that if I cannot stick to it at home that she can admit me to the hospital and this way I have no choice. UCSF is very against this opinion and after long discussions on pros and cons I have decided that modified bed rest is what I will do for now. I am going to try not to take Cole to to many party's or functions as this wipes me out all by myself chasing after him. I will let some household duties go or Scott will be nice enough to help more than he already does, which is quite a lot. I just feel that the experts in field win out in their argument against bed rest. There may come a time when UCSF decides it would be beneficial but at this point they feel it will not help and could be detrimental in terms of blood clots/atrophy, and mentally and physically hard on me. My OB feels that although there are no studies that suggest it helps that it may. Since I am not in pre term labor there is no indication for it. I am obviously torn because I want what is best for the girls but I feel stuck between an rock and hard place. These opinions are not even close to similar. One says admit me and strap me down and the other says daily activity is fine??? What do you do? Well I'm just going to meet them in the middle and do hardly anything at all. Then we will hopefully keep trucking along to a safer and safer gestational age for the girls to be born healthy with little to no NICU time.
Next week we hit the 24 week mark which is termed "Viability." This is awesome to hear that if they are born they have a chance. Obviously 24 weeks is not ideal and each week increases our girls chances for a healthy birth. Weird when I think about where I was at 24 weeks pregnant with Cole. It was November and he was born in March!! Seems drastically different. Hopefully we can make it into weeks 30 and beyond. Hard to wish your baby can be born at 30 weeks but I'll be excited to see June come and still be pregnant. Thanks to all for the well wishes and for following our journey. This blog has been quite cathartic for me and it helps to keep all those who care in the loop. Hope everyone has a Happy Easter!!! Enjoy Spring break.
-Sarah
Subscribe to:
Posts (Atom)