Seargant Cooter of the Mole Control Regiment, reporting for duty! *heel click*
Cooter not only caught a mole and brought it home (as a present?) he also carried it up on to the work bench and buried it in the food bowl. I get the connection, however odd it might be to have dead prey in the kibble.
Do twins run in your family? (every time, without fail)
Proper answer: Identical twins aren't genetic.
Tempting answer: They do now.
You're huge!
Proper answer: Everybody's healthy and doing great!
Tempting answer: I have two babies inside me. I'm supposed to look like this.
You're starting to get that pregnancy waddle.
Proper answer: Yeah, things sure are changing.
Tempting answer: What's your excuse?
Was twins part of the plan?
Proper answer: Nope, nature just took it's course.
Tempting answer: Yeah, right after we found out.
Twins, huh. How are you going to do it?
Proper answer: We'll find our way, I'm sure.
Tempting answer: I'm scheduling you for Wednesday afternoons and every Sunday.
So, how are the twins? What? Why are you being hospitalized?
Proper answer: (Retell the whole story about the girls being monoamniotic)
Tempting answer: Seriously? We told you this when we told you they were twins.
When are you due?
Proper answer: Full term would be late July, but we'll end up having a C-section in early June.
Tempting answer: Any day now. Whoa, I hope those shoes were waterproof.....
Will you breastfeed?
Proper answer: We'll have to see how things go.
Tempting answer: Probably not, I have inverted nipples. In fact this one, (lifting shirt) has never seemed to work, while this one works only when carefully manipulated. Here, give me your hand and try it....Oh, was that too personal?
How will you tell them apart?
Proper answer: Probably with nail polish at first, then we'll get to know them well enough.
Tempting answer: Tattoos.
We've accumulated quite a collection of glamour shots by now, some good, some eh. The UWMC ultrasound tech did several that we liked a lot, so here they are!
Yesterday we had our visit with the OB/GYN and another ultrasound at Group Health at Bellevue. The OB/GYN reiterated much of what we already knew and continued to emphasize how critical it was that we plan on being hospitalized for monitoring. He said that of the two places the perinatologist had privileges, Overlake didn't take patients who would possibly deliver before 28 weeks and Evergreen didn't have a contract with Group Health so the care there wouldn't be covered. So his recommendation was to move forward with a perinatologist and care at University of Washington Medical Center (UWMC).
Side note: That sucks for Sean. When we were thinking it was Evergreen, that would have been right down the road from our house and been a pretty easy commute for him to make back and forth. But UWMC is a trek and a half and will suck up a lot of his time. Plus the parking garage is expensive, so he'll have to find street parking and hope he gets something nearby when he can.
The OB/GYN had to leave pretty quickly to go deliver a baby, but he promised to get moving on setting us up at UWMC and to be in touch. At around 6 pm, a perinatologist from UWMC personally called us and said she had spoken with our OB/GYN and told us she had arranged for an ultrasound at 8 am today and an appointment later in the afternoon with another perinatologist. We were pretty surprised to hear from her that quickly and to be set up for care that quickly!
So we woke up bright and early (Sean called in to work so he could be at the appointments) and headed down to UWMC. This was our 4th ultrasound in 3 weeks, so we're becoming pretty familiar with what we're looking at and why it's important - I think Sean could probably perform them on his own at this point. The babies looked perfectly healthy, no abnormalities in any way, and are measuring just about equally and about a week behind. They look great! We even got a few 3D pictures, but because there are so many limbs flailing around in there that they get in each other's way for a clear shot.
The perinatologist was great. She asked us what we knew already and then treated us like we were smart people when she talked to us. She re-re-re-confirmed what we expected to hear about the course of care with momo twins. She usually leans toward hospitalization around 26-28 weeks (we're currently 22 weeks 1 day) but based on our known risks and outcomes, we felt more comfortable toward 25 weeks, so we're splitting the difference and planning on me being admitted on Monday, April 20th. (Sean calls it my "incarceration".) We'll have an appointment the Thursday before for a Non-stress test (NST - which is monitoring the heart rates and movements for about 20 minutes) and another ultrasound.
Once I'm in the hospital, I'll be monitored several times a day for heart rates and movement and get ultrasounds and other monitoring throughout each week. I'll be able to wear my regular clothing and leave my room when I want. And since I'll be there for so long, it will become my home away from home and I'll probably accumulate a lot of gear. We checked out a few of the rooms and they're pretty small, but it helps me to visualize what I'll need and what I'll have room for.
Most of all it gives us a game plan for all of this. That makes me feel a measure of relief because planning gives me some semblance of control and ability to anticipate what's to come.
I buckled down last night and did some serious research. The end result: ordered bedding for the girls which wasn't completely pink and frilly yet still looked like it was for a girl, and picked out the crib set which is convertible to a daybed and then head/footboard as they get older. Both were great prices. Check and check.
We are 22 weeks pregnant, which makes us "in" our 23rd week.
I've been having Braxton Hicks contractions since about 16 weeks, but in the last week or so they've become more frequent - every hour or two for a minute or so. It's just the uterus contracting, kind of like a practice session, or in response to being so much more stretched than it's used to, and is completely normal. It doesn't hurt, it's just a little uncomfortable and odd feeling.
The baby books and sites say that the uterus should be just above my navel by now...ha!! It's about two fingers away from my rib cage! Those who haven't seen me since the gender unveiling have been surprised at how much I've grown in that short time. Hopefully it means the girls are taking off like the weeds in my sorely neglected yard.
Right now they're supposed to be about a foot long, which could be either a spaghetti squash or a package of Oreos, depending on your point of reference, and around a pound each. They have eyelashes, eyebrows and fingernails. ("Your baby has a beating heart… it can feel pain… and it has fingernails!" Well, not until week 22 or so, Su-Chin.) The nerves in their fingers are advanced enough that they're testing out their hands by touching their faces, umbilical cords and, probably, each other!
Baby growth is a bit of a concern in the back of my mind because I still haven't put on any weight since getting pregnant. I fit in the obese category (which I hate about the whole BMI system) because I have a lot of muscle, which weighs more. According to the experts "Women who are in the obese category should gain approximately 15 pounds. Women carrying twins should plan to gain about 35 - 44 pounds." I have gained... zero as of the 5 month mark.
I blame it on a combination of:
1) Losing 8 pounds from morning sickness, which I just barely have gained back;
2) Losing muscle tone from stopping my weight training classes. Once we found out that they were momo, the perinatologist and midwife both said that with cord compression possibly already in progress, its more important than ever to have the maximum amount of blood flow to the placenta and weight training steals that blood and directs it to the extremities; and,
3) Never feeling hungry and always filling up too quickly. The girls have been up against my stomach for some time now and don't leave me a lot of room to eat anything. I've been trying really hard though, I swear.
It kind of feels like the end of Thanksgiving dinner when you're positive you couldn't possibly have another bite to eat and then someone insists on filling your plate again. You take a deep breath and power through even if it's not the least bit desirable. Eating used to be fun. Now it's a chore. I never thought I'd feel that way! Sean picked me up a case of Ensure and a case of protein drinks because taking in fluids is a lot easier than a meal, so that helps. And I've been planning a lot of foods that are quick and easy here at work, like an apple with a side of peanut butter or a Ziploc of fresh pineapple. But still, it takes a ton of effort.
Tomorrow we have another ultrasound and an appointment with our OB/GYN, whom we haven't met yet. We had been seeing the midwives, and then got our referral to the perinatologist right away, but the OB/GYN is the one who has to decide to turn over our care to the perinatologist and he won't make that call until he's actually met with us. I asked his nurse if he could just review our case file because it feels like a waste of time to be meeting with yet another doctor, but she said he wants to meet with us. It's frustrating (yet again) because we can't plan any timelines (again) until he makes this decision. I can't get a letter stating my ability to work on a laptop while I'm in the hospital, can't establish a definitive date to plan around for leaving work or my home, etc. We're playing the waiting game. And then our follow-up appointment with the perinatologist is this Friday, when we'll have another ultrasound and do this all over again. Not that I'm all that eager to go to the hospital, mind you, but I would like to have a game plan more than a week in advance.
The girls have gotten big enough that I'm now feeling their little taps throughout the day, even when I'm sitting or standing, so that's fun. Every once in awhile one of them will do a giant movement of some sort that takes me off guard and even makes me a little sea-sick. Sean has felt it once, but they're not yet often or reliable enough for him to sit there with his hand on my belly waiting around for more.
This weekend I went out and about with 2 specific goals: find a bra that fits and will be comfortable in the hospital, and get some baby bedding so I can move forward with the color scheme for decorating. I was brutally disappointed on both counts.
I'll start with the bedding. Although they have a decent selection online, both Target and JCPenney were practically bare when I arrived. Is there a sudden baby boom of girls coming? Should I set up dates for our daughters now in anticipation of a shortage of eligible males at some point? Babies 'R' Us was a little better, but you can't buy separate items, just the whole kit. Due to safety, the quilt would go on the wall anyway, and the bumper would only be used at the very beginning and once they're toddlers. But you can't buy a bedskirt or cute sheets all by themselves. I left empty handed and more stressed about getting this done in time.
I'm a unique size bra, and I need one without underwire if I'm going to be wearing it at the hospital, so I headed for Nordstrom and the maternity store. Maternity didn't have my size at all. Nordstrom had one (ONE) and it was black with white polka dots. Seriously, what kind of clothes am I supposed to be wearing where that wouldn't show through like I'm under a black light? I know women want to feel pretty during pregnancy, but whatever happened to simple nude? Who decides these things and how can I get their address? When she told me she couldn't fit me, I teared up a little. What am I supposed to do now? Invest in ACE wraps?
Ok, so maybe my patience for problems is inversely proportional to my waist size. As one grows, the other gets infinitely smaller. In a future post I'll address the ways that the twins and hospitalization have a brighter side and hopefully that will help compensate for all of my whining.
We had our follow-up consult with the perinatologist on Friday and she confirmed that our girls are momo and the recommended course of action is hospitalization between 24-27 weeks for constant monitoring. (We are currently 20 weeks 5 days). It's our choice when to be admitted - I was kind of hoping the doctor would just tell us what to do - based on our preferences.
She said that pretty much all they could do if the babies went into distress is to either deliver them or let it run it's course. If the choice is to let it run it's course, then there is no point to being hospitalized. If the choice is to deliver, we have to consider whether their prematurity at that point is within our comfort range. Tough choices. At 24 weeks (5.5 months) the survival rate if delivered is 50%, at 25 weeks the rate is 75%, and it gets progressively better from there. And the earlier they are delivered, the greater the chances of long-term health issues, including being what she called "special needs" children. It's hard to know the right choice, or how that choice will impact the girls.
I think we're leaning toward being admitted at late 25 weeks or so, which is the week of April 14th, depending on how their growth looks. It's so soon. And they typically won't let the pregnancy go beyond 32 weeks, which is the first week of June.
Sarah and Kristina asked about a baby shower, but because the timeline is getting so tight (and they have their own obligations at the moment, including K delivering little Evey!) I thought it might be best to delay until after the girls are delivered and then schedule a shower for about 3 weeks after that date. They'll still be in the NICU in all likelihood at that point, so we won't need to have everything set up just yet.
I feel a pending urgency to get things situated here at the house before I leave, but between work and daily life, I'm not sure how much I'll realistically get done. I need some more time to think things out and map out a game plan.
Once I'm in the hospital, I won't have any limitations - no staying in bed, no laying in a certain position, etc. - I'll just have to be in the room so that I can wear the heart rate belts for the babies and have ultrasounds a few times a week. It's going to be dull dull dull and I just found out my employer won't let me work via laptop while I'm there because they consider hospitalization to be "disability" regardless of medical condition. I'm so incredibly frustrated by that, not only because I'll be bored and need productive ways to spend my time, but also because any paid time I use up before the girls are born means less paid time after they arrive. In all likelihood, by the time they get to come home, I'll have to go back to work and won't get my own precious time with them. It breaks my heart to think about that even now.
The perinatologist also provided us with a DVD of the ultrasound (we're working on uploading the more interesting parts) , said that they look healthy and still about week behind, which is fine considering the margin of error on an ultrasound. The clinic usually only sees about 1 of these cases a year and we happen to be the second this year! Our next visit is in another 2 weeks and we'll find out more about whether our OB/GYN or the perinatologist will take over our case.
Anyone know someone who is in the market for some furniture? http://seattle.craigslist.org/sno/fuo/1067946801.html
We're trying to sell our couch and chair set, but this is probably bad timing to sell anything for cash. : ( So far I've only gotten e-mails from people who are "out of state" and want to send me a cashiers check so they can send a delivery person to pick "the item" up. Oh, and the check will be for more than the amount so I should give the balance to the delivery person in cash. Ri-ight.
Today is officially the gestational half-way point! According to my sources, the babies are now 10.5" long head to toe or 7.5" head to rump, and about 12 oz (our girls were both smaller than that at last week's ultrasound). I haven't been able to find out if they should be at exactly the same milestones as singletons yet, or if slightly smaller is to be expected. They can hear our voices, although probably muffled, and it's not as though there's a shortage of talking in this house.
On Saturday a switch got flipped and I suddenly began to feel movement in both places the ultrasound showed a baby. It's just a light tap from the inside here and there but it's unmistakable. And thrilling! It's so nice to get more confirmation that all is going along swimmingly (pun intended) in there. I feel it throughout the day, mostly when I'm laying down, and I'm hoping Sean will be able to feel it for himself soon. There's not a whole lot for a guy to be jealous of when it comes to the ins and outs of pregnancy, but actually feeling your baby is definitely something to envy. I'll try to remember that around my third visit to the bathroom in the middle of the night.
I got frustrated with the idea of waiting so long to find out more about our course of care, or whether they are monoamniotic with complete certainty, so I e-mailed the midwives and voiced my concerns about the lack of urgency. One of them got back to me and said she had been thinking the same thing and was glad I let her know because she agreed. So, she set us up with an urgent referral to Eastside Maternal Services and our appointment is Friday. (Here's to my assertiveness paying off!) It was a huge relief to know that we'd be able to get some questions answered and care started in a much shorter period of time. I felt like I could really breathe for the rest of the day. We'll have a more advanced ultrasound and a consult with a perinatologist who will walk us through everything to come. There is still the possibility that a thin chorion (a second layer within the amniotic sac that separates the two babies) will be visible on the advanced ultrasound, and that would take us back to a normal twin pregnancy...keep your fingers crossed!
I also got hooked up with Eastside Moms of Multiples (www.emoms.org), a group that gets together monthly to share information, hear from speakers, etc., and it turns out that the co-chair also had Momo twins and was also treated by Eastside Maternal Services! She was at Overlake for 2.5 months and gave birth at 34 weeks, which is outstanding. It was helpful to hear a nearby success story! She offered to be a resource for us and we're going to try to get together and find out more from her. EMOMs also hosts a twice annual sale of twin stuff from the families, but the Spring sale was canceled because of the recent legislation on testing toys for harmful substances before they're sold. Too bad. We're still in the market for, well, everything. Registering is just gonna have to wait until we know more.
So we're sitting with the ultrasound tech at the start of our appointment and she begins to point out what we're looking at. "That's your cervix. And that's your right ovary. That's your left ovary." And then she moved the wand over and this popped on the screen:
The first thing I thought was: "Those look too big to be organs. How weird." And then I asked, "What are those two things?" at the same time that the very thought was running through Sean's mind. The u/s tech, Marina, got quiet for a few moments and then finally said, very softly, "It's twins." (This picture is looking down at the tops of their heads as they face each other.)
I laughed nervously. "No really." Silence. My smile fades. "You're kidding, right? Shut up!" Silence and my slow realization. "Wait. Are you serious? Is that twins? Are you joking?" She replied, quietly, "We don't joke about that."
She said, "I'm going to step out for a moment and just let the girls know that we'll be taking a little longer for this ultrasound than we thought." Apparently this was the first time in her career that she had been the one to tell someone they were having twins. Normally people know a lot sooner than 18 weeks, 6 days because they can hear two heartbeats or the bloodwork comes back wonky, but not us! In those brief moments until she returned, Sean and I tried, unsccessfully, to process this. "Wow. This changes everything." "Oh, my God. We're having twins." "Holy cow."
As the tiny detail about suddenly having two children was being absorbed, we got another piece of news. The babies are sharing the same amniotic sac. In a normal twin pregnancy, there is a placenta that connects to a different sac for each baby, so they're kept separate from each other but within the same womb. To put it in perspective, 1 in 250 pregnancies results in twins. Of those, less than 1% are what are called "monoamniotic". We are that very rare occurrence. Our babies are in the same sac and have arms and legs all intertwining with each other. (More on that in another post.) And, since we know they are monoamniotic, it is 100% certain that they are identical.
The babies kept shifting position and getting in the way of the right angle for some of the shots, so we have a few of Baby A and only one of Baby B at this point. We saw WAY more than this during our 2 hours of scanning, but these are the shots she printed out:
