All cultures came back negative, so they have started to wean me off of the antibiotics a bit. Apparently it is quite common for them to not get a positive culture with a uterine infection and who knows what else I have. Today was a much better day, although I'm starting to make more frequent bathroom trips again tonight. I think this is just going to take awhile to run its course, which totally sucks. If I don't have a fever through the night and into tomorrow and I'm still relatively good, they will discharge me tomorrow and switch me over from massive IV antibiotics to massive amounts of oral antibiotics. Then I have a follow up appointment with the infectious disease doc on Friday morning. Hopefully that will be the end of it. Oh, did I ever mention that the hospital is requiring anyone who enters my room to wear a hospital gown over their clothing? It is humiliating. The infectious disease doctor said it was their protocol because he never wrote a containment order.
I'm a bit nervous about going home even thought I CAN'T WAIT to get home. I just know myself and it is going to be hard to take things slowly when I feel so guilty about all the extra work B and my parents have put in already. It is going to be hard to tell the difference between normal "new mommy" exhaustion and recovering from massive infection exhaustion. And I worry about B and my parents. Everyone has been running on all cylinders for too long now and I can see the exhaustion in all of them.
Both babies saw the pediatrician again today. Apple's bilirubin went from 17 on Saturday down to 9 something today, so we are back where we started when we left the hospital on Thursday. She is no longer on the bili table and has to go back in tomorrow for another heel stick to get checked again. Banana has been a little congested, but the pediatrician thinks it is still leftover fluid from the womb and birth and isn't a cold or anything like that. Apple is up to a chunky 4 pounds, 13 ounces and Banana is up to 4 pounds 10 ounces, so they are both already above their birth weights. Considering we were told they should be back at birth weight by 10 to 14 days, they are quite a bit ahead of schedule. I've been pumping in the hospital and they've been eating pretty good by bottle taking both my milk and formula. At times, they will each take 60 cc's per feeding, which is really good. I just hope I'm able to get both of them back on the boob a bit when I get home. I'm not ready to give up on breast feeding.
Banana also saw a pediatric orthopedist today. This doctor repeated everything all of the other pediatricians said about the bone just needing time to heal and that it should heal pretty quickly. They took new x-rays and the bone ends had shifted quite a bit since the initial x-rays on Tuesday, but the doc said this is normal. I'm almost glad I wasn't at the appointment because B said there was a bulge in his upper arm where you could tell the bone had shifted. The doc reset the arm straight and wrapped it really gently in some gauzy stuff. It looks like a cast, but isn't hard like one. We are supposed to keep his sleeve pinned across his chest to keep it stable and he will go back to the doc in 3 weeks. They gave us some copies of the x-rays from both today and Tuesday and they are a little hard to look at. But all in all, he is doing just fine.
After the doctor's appointments today, B and my dad brought the babies by the hospital to visit. It was so incredibly great to see all of them. My dad and B looked pretty tired. The babies were a bit sleepy. I held my baby boy for awhile until he woke up a bit. He looks incredibly sad, but incredibly cute and tough at the same time in his pseudo cast. I just can't wait until we can handle him without being careful about the arm and we can see his arm along with the rest of him. At least with the new cast we can see his little hand wiggle around whereas it was covered before. I fed Banana some milk while my dad fed Apple and then we watched them sleep for awhile. I held my baby girl close on my chest while she slept and it was perfect.
I sent my mom to the house tonight with all of them so that B could get some rest and my dad wouldn't be alone with both babies all night. So I'm alone at the hospital tonight, but hopefully it is just for one night. I can't wait to get the hell outta dodge.
Rather than bore you with disgusting details of my hospital stay while my body tries to fight off multiple infections, I thought I'd take this opportunity in between potty breaks to write this up.
This post is made easier (and shorter) by the posts that B and my Mom wrote on the 22nd and 23rd. I think you probably got the basic picture of how the induction process went. We were frustrated that things moved so slowly and it seemed that the nurses were being overly conservative on increasing the pito.cin. Regardless, none of that seems important now other than one thought I keep having. The slower the induction, the more cervical checks they do after the water is broken, the greater the chance for uterine infection. I'm trying not to dwell on this as the infection could have been introduced during the actual delivery as well.
If I remember right (I should just have titled this post with these 4 words as it is all a bit blurry), most of my pain during labor was in my lower back. I was pretty uncomfortable once they broke my water (well, Apple's water) and they put an internal heart rate monitor on her head and an internal pressure monitor in my uterus to better track contractions.
I can't remember exactly when I requested the epidural (maybe at 4cm?), but I did so knowing it could take awhile to track down the anesthesiologist and to get it in place. The anesthesiologist showed up pretty quickly and ensured me it took longer to set up the epidural (20 minutes) than it did to actually administer it. I'm not sure if that turned out to be the case. It seemed to take forever. He had trouble getting the catheter in and kept saying that I have "small spaces." Some of that was blamed on me being short, but he seemed to think I had overly small spaces. I kept trying to lengthen my back, while rounding it at the same time. Not all that easy to do when you are contracting. I remember thinking during this process that I might have to resign myself to having no epidural and I was NOT going to be happy with that.
Regardless, he got the epidural in and everything was good for a bit. At some point I began feeling a lot of pressure. The only way I could describe it was that it felt like I really had to poop. Bad. I kept asking the nurses to do cervical checks because it felt like something was going to pop out at any moment (either a baby's head or poop!). They were hesitant to do too many once my water broke because of the risk of infection. I honestly didn't care about that at the time, I could only focus on the present. I was disappointed each time they did a check and it didn't result in confirmation of massive progress. At some point the doctor came in to check and decided I was completed dilated on one side, but still 8-9cm on the other. There was a "lip" of cervix on one side that just didn't want to go away.
Side note: we did have the Bears game on the whole time and, lucky, it ended before I was ready to push. I was even able to focus on it a bit towards the end after I had the epidural.
The doctor decided to let me start pushing even though she could still feel cervix on one side. I think she felt a little bad for me, but also maybe that pushing would get it past that last point. I think her thought was that me pushing might be more effective than relying on the contractions at that point. I pushed for about 50 minutes in the L&D room before they decided to move me to the operating room. The doctor, nurse, B and our doula all coached me through this. It was pretty tiring, but felt good to finally be "there." They were all very encouraging. They all told me I was a "really good pusher." Not really sure what that means as I didn't know what I was doing, but I guess I should give credit to the hundreds of birth shows I watched on tv on bed rest! One thing I found really difficult was pushing for a whole ten count. We usually did three pushes in a row counting to 10 and by the third push, there was no way I could make it to 10. Just never felt like I had enough air for that.
After 50 minutes, we moved to the OR. This was the plan all along. Because of the higher risk of c-sections with twin deliveries, they prefer to deliver in an operating room so that everything is ready if needed. Same theory on the epidural. If you already have an epidural in, they shouldn't need to knock you out if you do need a c-section. They put me on the operating table, added some oxygen and not sure what else they did to get ready. Felt like I was hooked up to a million tubes. The operating room table was VERY narrow and it felt like if I leaned a little too far to one side I would just topple over. I don't remember if it started in the L&D room or in the OR, but I remember my hamstrings kept cramping up and I kept having B and the doula stretch my legs out in between contractions. This was pretty annoying because it was really difficult to relax in between contractions. After about 20 minutes of exhausting pushing in the OR, Apple was born. Wow, that sentence makes it sound so easy! It wasn't. I know that she was pretty small at 4 pounds 11 ounces and I just can't imagine what this process is like with a big baby! Her tiny little head felt like a watermelon! They took her over to the side and started cleaning her off while I listened to her beautiful screaming.
This is where things get a bit blurry for me. The had an extra doctor in the room to help if things got dicey and for us that meant trying to get Banana to turn head down. They had an ultrasound machine out and were trying to guide his head down. From what I understand, he was actually piked so that at one point both his head and feet were down, with his butt up in my belly. I just remember excruciating pain and wishing he would come out and that they could work faster (the extra doses of epidural at this point were doing nothing) and I think I was being pretty vocal about it. My main doc had most of her arm up trying to grab him while the other doc was manipulating from the outside. I remember wondering if I was supposed to be pushing at that point and I'm not sure why I didn't ask. I think I finally just decided to (or did someone tell me to?), and with that push, Banana's feet popped out. That is what decided the breech factor once and for all. So the doc grabbed his feet and started pulling him out.
The details of the rest of the delivery are a little unclear as we heard more details from the nurses in postpardum than we heard from the doctor at the time. All we were told when Banana came out was that he might have a broken arm or separated shoulder as they had heard a pop pulling him out. All of this happened in only 8 minutes time so he was born 8 minutes after his big sister. Each shift of nurses we had in postpardum commented on the difficult delivery and a somewhat benign "broken arm" turned into the fact that the doctor had broken his arm to save his life. I can't remember now who told us this (doctor, nurse?), but it seems my cervix started to clamp down once they got his feet out and they had to act quickly so that it didn't clamp down on his neck or head. I do remember hearing that his arms were above his head when they pulled his body out and they had to reach in and pull his arms down before they could get his head out. This is when his right upper arm bone popped.
At the time, I didn't think twice of any of it. I was just happy to hear him cry once they got him out and of course I was crying the whole time they were cleaning him off. They brought each baby to me one by one and put them on my chest. I told B he had to hold them on me because I was shaking so bad I was afraid I would drop one of them. B got to cut both cords and went with the babies when they took them to the nursery to weigh and measure them and check them out. They did tell me that both babies got 9's with both APGAR's, but we found out later that this was only true for Apple, Banana got a 7 and an 8, so still pretty good. While B was in the nursery with the babies, he went back and forth from one warmer to the other like a ping pong ball. Then they sent Banana up to get x-rays of his arm. It seemed to take forever and we were told one of the elevator banks was down.
They got me cleaned and stitched up. I did have a small episiotomy once the doctor thought I was starting to tear internally and B thought they did it when they were having trouble getting Banana out. From his perspective, he thought he heard them talking quietly about doing a c-section for Banana and that it did sound like there were some tense moments and were extremely close to doing the c-section. He also watched them do the episiotomy and thought it was cool (ewww). From what the doctors have told me, breech extractions are not very common these days and when the baby has its arms above its head and kind of wrapped behind (nuchal arms or something like that), it is quite common to have a broken clavicle and not quite as common for a broken humerus, but it does happen. The OB that I saw this morning (who is my regular OB) said that there was some drama in the OR and that the OB who delivered was not likely to forget the delivery. And she is the one with the most experience in the practice. We were lucky that they got Banana out without more damage, but it is scary to think of what could have happened.
I'm finally at the point where I can think about it and write about it without sobbing and hopefully soon I'll be able to talk about it without crying at all. I just can't believe how close we came to disaster after everything we've been through. But both babies are healthy and managed to escape without any NICU time whatsoever.
Aside from my little side trip back to the hospital, Banana's arm and Apple's jaundice, things are pretty damn good and we are counting our blessings. Thank you so much for everyone's support this week. It has been such a help to us. From simple good wishes to making meals for us, every little gesture has helped. (and thanks to our neighbors for feeding B while I'm in the hospital!)
Last night after dinner I started feeling crappy. Fast forward a couple of hours and I was in the ER being evaluated for vomiting, diarrhea, abdominal pain and fever. Really fun symptoms to deal with when you have given birth 4 days earlier and are still very sore (vomiting requires using abdominal and pelvic muscles that I was not prepared to use). It took about 4 hours for the ER to evaluate me including blood work, a CT scan and a pelvic exam. Again, never expected a pelvic exam 4 days after giving birth. They found a slightly elevated white blood cell count indicating possible infection. They also found elevated liver function indicating who knows what. The only thing indicated by the CT scan was constipation. How do you have constipation and diarrhea at the same time? The scan also confirmed the gall stones that I've known about for awhile, but have had no symptoms of a gall stone attack.
By the time they admitted me back to the mother and child unit, they suspected a uterine infection and/or the flu. Apparently uterine infections don't generally present with the exact symptoms I had and for awhile there they were concerned about toxic shock syndrome, which is quite rare post pardum. After seeing an infectious disease doctor this morning, he confirmed the most likely culprit was uterine infection and possibly a touch of the flu on top of it. So I'm back in the hospital and they are giving me a broad course of IV antibiotics along with fluids. If all goes well, I should be released on Monday.
In the meantime, B is home with the babies, taking care of them like a single daddy. My dad is helping him while my mom is here with me in the hospital. What would we do without our parents here?
B and my dad took the babies to the pediatrician today. Apple's bilirubin did go up to 17, so they now want her to use a bili blanket to help her get past the jaundice. Banana is fine. They both weigh about what they did when we were discharged Thursday, so it looks like maybe they've stopped loosing weight. The pediatrician is trying to set up an appointment for Banana for Monday with a pediatric orthopedist to look at his arm. The pediatrician seems happy with our feeding schedule. Although this hospital stay has caused a bit of a bump in the road. I'm not sure either baby will take the boob again after being bottle fed for three days. I am pumping in the hospital and we got confirmation from both my OB and the pediatrician that the medications they have me on shouldn't cause an issue with giving them my milk. At least I can still feed them some breast milk and we'll just have to wait and see if I'm able to introduce nursing to them again when I get home.
So that's where we are. Not the best place to be, but it could be worse. We were prepared for the possibility that we might have to go home without the babies for awhile. We never thought they would be home without me. Just another situation that took us completely off guard. Emotionally, I'm dealing. I'm doing what I need to do and I know getting myself healthy is the best thing for the babies. But it is difficult to be here without them. It almost feels like I never gave birth to them in the first place. B and my dad brought them by the hospital to visit today, so at least I got to see them. I was still too nervous to hold them as I'm still sick and when I have to go, I have no control over it. Part of me keeps repeating infantile phrases to myself like "why me, why did this happen" and "it just isn't fair." But there's nothing I can do about it other than what I'm doing.
Just wanted to let everyone know that we are all home safe and sound, and together. Everything we were hoping for. It took us a bit longer than expected. We started getting ready to leave the hospital at 3-ish and ended up leaving around 5:15pm. I hope to update sometime tomorrow if I can find the time!
Just thought I'd pop in for a quick update. We are all doing fine and we are schedule to be discharged tomorrow (Christmas morning). I'm healing slowly, but surely. I'm quite sore, but I've been told that I'll feel pretty good after about a week. We did manage to accomplish a fully vaginal delivery, although getting Banana out was a bit more difficult than planned and he was pulled out feet first. I do plan on giving you all some more details about the birth, but that can wait until we get home and I have a chance to collect my thoughts a bit. It was a lot to process and I'm still processing. We will also post a picture or two of the babies once we get home.
Speaking of the babies, they are doing just fine. Banana's arm (his right humerus) was broken during his breech extraction, but he really doesn't seem to mind it. I think I'm more upset about it than he is. He is a very calm baby (so far) and makes the funniest faces. He has had a hard time nursing, but is taking a bottle like a pro. We've really only gotten one good latch from him so far, but the nurses have encouraged us to keep trying and that he is completely normal for his weight/gestational age.
Apple is extremely strong and has also been pretty calm. Although she is a voracious eater and she has had more successful nursing sections than Banana, she seems to prefer the bottle lately. I think nursing is going to be an uphill battle with both of them, but we'll see. Apple is definitely a hungry girl. She starts sticking her tongue out to let us know she is hungry and usually a bit before we are scheduled for her next feed. She has the most beautiful skin, but she seems to be getting a little jaundiced now, so we're hoping this doesn't delay her homecoming.
As you all probably guessed, B was awesome during the whole labor and delivery and he has been demonstrating his natural ability as a daddy. He has been taking the best care of all three of us and he even had the foresight to buy me a "push" gift to bring with to the hospital. He gave me a beautiful diamond band Tuesday morning after the delivery that has three stones, one for us and one for each baby. I cried, of course. I cry A LOT these days. But for good reason.
We are anxious to get home and get settled, but for now we are just in awe of our two little miracles.
Thanks to everyone for your comments. B read me all of your comments during labor and it was so cool knowing that all of you were thinking of us and encouraging us with so much positive energy.
I will update when I can. Until then, Merry Christmas and Happy Hanukkah!
Sorry this is so late in the making. The babies were born at 1:21 and 1:29 am on 12/23. Baby A is now officially xxxxx xxxxxxxx and Baby B is now yyyyyy yyyyy.
Apple weighed in at 4 lbs 11 oz and Banana was 4 lbs 8 ozs. Everyone is doing fine but extremely exhausted. Banana ended up breach and they has some trouble getting him out. they think they may have separated his shoulder and they have taken some x-rays to determine for sure. it sounds a lot worse than it is. both babies are fine and just finished their first feeding. Grandma and Grandpa got to help feed and hold the babies. We have tons of pictures and I will leave it up to denise on what she wants to post.
We will post more information in the morning (which is actually now). Thanks again to all and sorry for the delayed finale.
Well the BEARS pulled off a big win tonight. As soon as the game was over the doctor (who is also a big BEARS fan) came in and checked Denise. She is just about 9cm dilated. That means we are getting very close. Shouldn't be long before we start to get ready to go into the Operating Room.
We all joked that the kids were just waiting for the game to end.
This is it folks. I think we are getting real close. Hopefully we aren't keeping to many of you up so late. If you need a note to your boss in the morning because you had to sleep in, just let me know and I will write one for you.
I think the next update you all will get will be from Denise's mom. She will let you all know when we were on our way to the operating room. After that, we will try to post the specifics after the birth.
We still have a little while but I think we are getting very close.
Hi, its Denise's Mom again. Apple and Banana are making progress! Yippee! Denise's cervix is now dialated to about 6 to 7 cms and 95% effaced. The babies have come down and Apple's head is at zero station. Pit.ocin is now at 12. And, Mom and babies are all doing great. Stay tuned. M
The only problem is, is that there is not much news to update everyone on. They have upped the pitocin. to 10ml but other than that things are still moving along slowly.
The good news is is that Denise is still doing well. She is relatively comfortable after the epidyrl and still seems to be in good spirits. The nurses keep telling us they need to see accelerations in baby "B" before they will increase the pitocin. more and the doctor tells us that the babies are fine. Unfortunately the nurses have their "protocol" before they can increase the pitocin. The doctor did say she will override the nurses "protocol" at some point and just start to move forward with increasing the pitocin.
It's all just a little frustrating. The good thing is that mom and babies are doing well. They babies just don't seem to want to come out into this world right now. Maybe it is because the Bears are losing to the Packers at halftime.
Again, we will try to keep everyone updated as to what is going on.
This is Denise's Mom (also known as M) posting for Denise and Brian. The news at this point is that the contractions began to come more frequently and to hurt. So, as the Chicago Bears were getting ready to start their game, Denise got started with an epidural. She had one of the normal side effects-- a big drop in blood pressure. But the doc and nurses got that under control in no time. So, her bottom half is now very nicely numb. I will try to post again when there is more news. M
They did a quick check and Denise is now dilated 4cm. Still 80% effaced (spelling???) They upped her pitocin. to 7. Denise's parents are now here and we are all just relaxing (except for Denise) and talking.
Denise has been eating jello, Sprite, juice, basically anything with sugar the get those babies moving.
The doctor is supposed to be back in around 6:00 pm (MST) to check on us so hopefully she will have a plan of attack to speed things up.
Nothing much to update on. Things are moving along, but slowly. Upped the pitocin. to 6ml but other than that everything else is status quo.
Will post when I have more relevant information. She did just go to the bathroom and getting there was a huge event, All types of cords and wires dangling from places they have no right being.
Maybe I can take this downtime to let everyone know that we appreciate their kind thoughts and wishes. I am normally not this nice of a guy but the whole being a new dad thing has softened me a bit. I am sure once the kids are born that I will turn back into my normal bad-ass self (in case you can't tell, I am being facetious).
Thanks again. I believe she is due to be checked again in about 20 minutes (4:00 MST) so hopefully I will have something better to offer at that time.
Doctor came in to check on things. They ended up breaking Baby "A's" bag-o-water. They inserted an internal monitor on Apples's head and also an internal contraction monitor. Now they only need to externally monitor for Banana. They also upped the pitocin. to a whopping 4ml.
We are moving along but obviously we thought we would be farther along. I think Denise is starting to get a bit frustrated but overall she is still in a good mood.
We are now monitoring the contractions internally which can give us an idea of how strong they are. With the external monitor they only measure frequency.
Again, Denise wanted to make sure that everyone knows she is doing well and I have been reading her all comments and that has given her a boost so keep them coming.
I will try to keep up with this but I have also been busy phoning family and friends.
They have upped the pitocin. to 3ml. Nothing else new to update on. Denise is still doing well and is in good spirits.
I will add as a side note, that Denise and I have been to Europe a few times and I don't think we ever took as much luggage on those trips as we did today for our trip to the hospital.
On top of all the luggage we also have a mini Best Buy store here. 2 computers, 2 blackberies, 2 cell phones, digital camera, 2 sets of headphones (1 noise cancelling 1 regular) and digital camcorder.
After checking in and being admitted I went back to the car to get our luggage. I needed a bell-hop. As I walked up to the labor and delivery floor all the "dads to be" just gave me that "man-nod" as if to say, been there done that.
Doctor came in for a quick check. Baby B is now sideways but natural birth is still viable. We will just have to play it by ear. They upped her pitocin. to 2 ml (she was on 1 ml). They did a quick ultrasound to check to see positioning but that was about it.
The doctor did promise to try and have the babies delivered before the Bears/Packers monday night football game. Before I get a thousand "negative" responses on this, I did NOT bring this up the doctor did. Her family are huge Bears fans and we found out we have this in common.
Denise is in good spirits and has not started yelling obscene phrases at me yet.
Denise has asked me (me being her husband B) to provide periodic updates. Let me start off by saying that I am not a medical professional and I am notorious for completely translating this type of information incorrectly. Remember the game you used to play as a kid when one person would whisper something in your ear and then you would have to go around the room and the last kid would have to say what he "thinks" the original word was? Well that is what is going to happen here. I am the "last kid" and I don't always listen attentively.
They currently have Denise on oxygen to try and get the babies to wake up a bit as they seem a bit sleepy this morning. They have also started her on the pitocin. to get the party started. They will gradually increase the dosage every half hour or so to speed things up when they see fit. She is currently listening to some classical music while reading one of those trashy grocery store magazines. Seems a bit of an oxymoron but who am I to judge. I have come to learn that a happy momma is a happy me.
That's about all for now. Nurse just walked in as they are having trouble keeping the babies monitored (which always seem to be the case so this is nothing to worry about).
Until later - Dad to be.
Sorry but after my editor (Denise) read my post she has asked me to tell everyone that she is 2cm dialated and 80% effaced (told you that I don't always get this stuff correct)
We're all checked in. IV is hooked up and monitors too. They are giving me a bolus of fluid to try to get the kids to wake up as they are looking a little sleepy. Nurse just went to call the doc to see if she will be by anytime soon. They need to check my cervix and will then start the pi.tocin/break my water.
Just thought I would take the opportunity tonight while things are still quiet to post some last belly shots. These were taken yesterday before we left for the party. I managed to stay at the party for 4 hours and it felt so good to be in a social situation again.
Had to take a rear shot since I haven't done any of those yet and I don't appear to really look pregnant from behind. Kind of strange to just have a huge belly and not really gain anywhere else. Not that I'm complaining! I did manage to add an extra chin these last couple of weeks.
I also just wanted to put out a blanket "thank you" to all of you for your support throughout our IF treatment and this pregnancy. We are truly lucky to have such supportive family and friends and to have stumbled upon this online community of friends in the computer. This would have been a much longer, harder, lonelier journey without all of you!
There are so many thoughts swirling around my head these days. I am still having trouble picturing how this is going to work. What will labor be like? Will I be able to push BOTH babies out without needing a c-section? How are the dogs going to react to the babies? What will our lives be like next week? I'm still having trouble believing that we are really here. If you had asked me 7 weeks ago, I never would have believed we'd make it past 36 weeks.
The labor part has been on my mind the most the past couple of days. I've had ample opportunity to watch all of the birthing shows on Disc.overy Health and TLC and not ONE of them has shown a vaginal twin birth. What's up with that? I know they happen. It isn't THAT rare. I have to keep reminding myself every time I watch one of those shows, that I'll have to do the pushing part twice and then worry about two babies when they come out, not one. I know once Apple comes out, it should be easier to get Banana out, but this may not necessarily be the case. The cervix can actually close up. And since Banana is likely bigger, there would still be potential for more pain and tearing, etc.
The time in between the babies' births is actually the most dangerous part for Banana. He can easily go into distress because of the drastic change of pressure in the uterus or he could flip around into some other position that would require a c-section. After. A. Vaginal. Birth. This would be a bad scenario. Not one I want to even contemplate. And I can't even picture what it will be like once Apple is out and I'm focused on her, but still have to push Banana out. Uggh. I know there's no point in worrying about it now. I have no control over it and I know my doctor will do everything she can to get us all through this healthy and happy.
It is also bothering me that we will have to deliver in a sterile, uncomfortable operating room on a table instead of an L&D bed. With about 10 people in the room. I knew this would be the case pretty early on, but I'm just now starting to think about it and I guess I shouldn't. I know it is for the safety of me and the babies, but it just isn't the ideal environment for a "comfortable" birth.
I'm also annoyed that I still have this stupid rash. I'm sure once I'm in labor I'll forget about it, but part of me can't help wondering if I'll just be focused on both pain and itching. Is that possible? Again, something I'm worried about that I have no control over. Sensing a theme here? Then, there's the breast feeding question. Will I be able to nurse two babies and actually manage to not starve them? I am resigned to supplementing with formula, but I hope I'll be able to at least experience nursing and give the babies as much benefit as I can from breast milk.
Other than my mind racing with all of these thoughts, we are pretty much ready. The nursery is set up, for the most part. B hooked up our fancy video monitor with 2 cameras this morning so we can see both cribs. The car seat bases were installed and checked by our local fire department. We have take home outfits for the babies, although we have no idea if they will fit. My hospital bag is packed along with our "media" bag that holds the camera, video camera, and a laptop. My ipod is loaded with tons of music and the headphones just need one last charge. Our doula is on notice.
All that is left is for B to pack a change of clothes and some snacks for himself and a bag for the dogs. The dogs are now going to the kennel on Monday since we will be home tomorrow night. I would like to try to shave my legs tomorrow, but let's face it, that really isn't the most important thing. Oh, and we still have a couple of last minute holiday gifts to take care of before chaos hits.
We are actually going to try to go to a little holiday party with some friends tonight if I feel up to it. We've done this with this same group of friends for a number of years now and I would hate to miss it. Hopefully I'll have enough energy to go-even if it is only for half an hour. Our last hurrah as a childless couple.
Now if only I could wrap my brain around Monday and what will come after!
There is not a simple answer to the poll I had up earlier, so I can't tell you who won (and really I didn't have any sort of reward available anyway). At my check today, the doc said that the "outside" of the cervix is open, but the "inside" isn't. I asked her to clarify and the way my brain works, it means that the bottom of the cervix is open, but the middle is closed. She did not give me a number and I didn't ask. I don't know why I didn't ask. I guess my brain was too busy trying to picture it. Because, if you recall, the last cervical check they did by ultrasound showed my cervix funneling, meaning it was opening at the top. So, this is how I'm now picturing my cervix:
While the doc was looking through my file today, she mentioned that the doc on Monday had written "fingertip" in my chart, but I didn't ask her to clarify. From what I've read, this can mean either 0 or 1 cm. Some sites I've read say that this means 1 cm, but others say that true dilation means the cervix is open all the way through, in which case, I'm still 0 cm. She also didn't say how effaced I am today. I didn't ask this either. Not sure where my head is today. Oh well. So much for answers.
My cervix is very soft or "ripe." Because of this, the doc today didn't think it made sense to start with the medicine that goes behind the cervix because this generally just helps it soften. So, we are officially reporting to the hospital at 7:30am on Monday morning to start with pito.cin. We have no idea how long labor will take. Usually a first labor takes a long time, but twin labors tend to go quicker because of the extra weight/pressure. I'm hoping it goes quick (of course).
Apple and Banana both passed the BPP today. Apple's heart rate was 138 and Banana's was 148. Although it is a total and complete guesstimate at this point, we asked for estimated weights out of curiosity. The measurements put both babies at 5 pounds 3 ounces, although she had a really difficult time getting a good measurement of Banana's head. We'll see how accurate that is on Monday. Oh, and my belly is now measuring almost 43 cm!
I replaced the poll to the right with a similar one for Monday morning. It refers to how dilated I will be Monday morning when we get to the hospital (before they start the induction).
We do plan on bringing a laptop with to the hospital Monday and I will try to post updates as much as possible. But of course I can't make any promises. Not sure how long I'll be able to "live blog" through labor!
I just read through my post from yesterday and it struck me that at the end, I found it necessary to hedge my bet and say that "most likely" we will be a family of 4 next week. It was completely unintentional that I worded it that way. It seems I still can't convince my subconscious self that we will have our happy ending. I guess it will hit home on Monday when Apple and Banana are finally in our arms.
In case you were wondering, my cold is worse today and so is the rash. Good times.
We are officially on the schedule to be induced Sunday night/Monday morning. As of today, I am 70% effaced and my cervix is very soft, but I'm not yet dilated at all. If I'm still not dilated at my appointment on Thursday, then we report to the hospital at 7:30pm Sunday night to start the induction. If I have started to dilate by Thursday, then we will go in Monday morning. The theory is that if I'm not dilating on my own, they start with a medication that goes right behind the cervix (can't remember the name of it). They put the medication in every 4 hours and it should take awhile to cause my cervix to dilate. By Monday morning, I should be somewhat dilated and they would break my water and start me on pit.ocin. If I'm already dilating on my own, they will start by breaking my water and giving me the pito.cin, so we skip the first step. This is why they would have me go in Monday morning instead of Sunday night. Everyone confused yet?
The bottom line is that Apple and Banana should be born Monday, December 22nd! We will have two little miracle Hanukkah babies! That is, if I don't go into labor on my own before then. The dogs are scheduled to go to the kennel Saturday and we will keep them there until next Friday (the 26th). This should give us time to get home (hopefully with the babies) and settle in a little before we turn the dogs' world upside down.
The NST was pretty standard today. Apple very reactive, Banana not so much. They both passed the BPP, but Apple took her time about it, while Banana was quick. They tend to take turns like that. The doctor did an internal exam today to check my cervix and it was pretty uncomfortable. Now I'm really sore. Just wait until Monday, right? Both babies are still head down, so we are on to try for a vaginal birth. Yay! They also did another culture for group B strep as apparently the one I had done in the hospital was too long ago and it could have changed. My blood pressure was normal, but a bit higher than it usually is (120/74). Total weight gain is somewhere around 33 or 34 pounds.
My throat was killing me last night and this morning, but it feels a bit better now. I really expected to wake up to a full fledged head cold this morning, but it hasn't fully hit yet. Maybe I can dodge the bullet and just deal with the sore throat for a bit. I've been stuffed up pretty much for the entire second half of my pregnancy, but it isn't completely congested, so hopefully I can avoid that.
Oh, and Monday night is also the Bears/Packers game. And the doctor on call on Monday (in case you wonder Jen, it is Dr. Abm) is a big Bears fan-we bonded over it while I was in the hospital and we were able to get her some Bears gear from our connection (thanks Staley!). I'm actually happy that we were in the hospital for those 11 days as it allowed me to get comfortable with all of the doctors in the practice (there are 6 of them).
That's all for now. Sorry, this post is kind of rambling. My head is all over the place. Can you believe we will most likely be a family of four this time next week?
I can't believe we've made it to 35 weeks. With the exception of the last week or so (since the rash appeared), my 6 weeks on bed rest has gone by pretty quickly. Although I bet B and my parents feel differently. The three of them have traded off waiting on me like a queen for this entire time.
I took my last dose of proc.ardia at 6am this morning and so far I haven't noticed any difference. I have absolutely no gut feeling as to whether something will happen in the next week or not. I know it is probably better for the babies to stay in until 36 weeks, but I wouldn't mind one bit if it happened sooner. I obviously have selfish reasons for feeling this way, but I also just would rather go into labor on my own rather than being induced.
I've posted some belly pix below. I figured I needed to get off my ass (literally) and take some more pictures before it is too late. If you dare, you can click on the picture to see a bigger version and you can see the rash within my stretch marks on my lower abdomen in addition to on my side. But it doesn't really do it justice. I would have to take a picture of my thighs to give you the full effect and I just didn't want to. I don't even like looking at it as it seems to make me itch more!
We had our last appointment with the perinatologist today. It went well, the babies looked fine. They measured Apple at 4 pounds 6 ounces and Banana at 5 pounds 1 ounce, so pretty close to what the OB's sonographer got on Monday. Fluid looked okay too. Apple is coming in at the 17th percentile (was 19% two weeks ago) and Banana at the 27th (was 40% two weeks ago). So Banana slipped down the curve a bit. But the peri said the growth curves are based on singleton averages and that it is common for twins to be behind the curve, so not concerning enough to do anything about it.
Because of where the babies are now (head down, stable and at a late enough gestational age) and because of this hellacious rash I have all over my body, her recommendation is to take me off the pro.cardia tomorrow (contractions be damned) and schedule an induction at 36 weeks (in about a week) if I don't go into labor first. She didn't bother with a cervical check today because it really doesn't matter at this point-if I go into labor, they will let me.
I have mixed feelings about induction, but I really think that my days as a stellar incubator are past. I'm not getting any decent sleep (maybe an average of 2 hours a night) and when I do sleep, I'm scratching myself in my sleep. My appetite is starting to wane. And frankly, I'm starting to lose my sanity. I'm usually in tears at some point every night because I just want the itch to stop. The rash keeps spreading and absolutely nothing is helping. I'm also appalled at the sight of it. I played around with the idea of taking some pictures to post, but I'm afraid I might lose all of you, my dear readers, for posting something so incredibly offensive. I guess one good point is that the itch pretty much takes my mind off of the pelvic pain and makes it less intense.
I can definitely tell that the babies are low now. Lots of pressure going on down there. It will be really interesting to see if anything happens spontaneously after stopping the medication tomorrow. It has been a long 6 weeks since I first went to the hospital and I'm proud of us for making it this far. My goal all along was to get each baby to 5 pounds and to go to 38 weeks. Those goals tend to slip as things start going wrong along the way. I am just relieve to be past the major developmental milestones for the babies and will just hope for the best at this point. I'm trying to get excited that we are so close to the end now, but to be honest, all I feel right now is relief. The itching will stop. It is all I can think about right now.
Today's NST went fairly well considering we were able to get both babies on the monitor for a long enough period of time. Apple looked great, but this time Banana's strip was a bit flat. Met with the doctor next and everything is normal with me. She looked at my rash (this is a different doc than the one who looked last week) and said she thought the rash on my abdomen is PUPPP, but that she wasn't sure what the rest of it is. She did say it looks pregnancy-related to her and that it should go away after the babies are born. In the meantime, I just have to keep doing what I'm doing and suffer through. This is going to be a long (x) days.
Next was the BPP and both babies passed. It took awhile for Banana to pass this time, but he did eventually. Today Apple measured 4 pounds, 5 ounce and Banana measured an even 5 pounds. The sonographer mentioned that we shouldn't get too caught up in the numbers because the margin of error this far along is up to a pound. But based on these measurements, their growth is different by 14%, so not too bad. Banana still has more fluid than Apple, but she appears to have a good amount of fluid, so I no longer need to keep doing the baths for her fluid. However, the doc said I could take baths if I wanted to and try the A.veeno oatmeal bath treatment to see if it was soothing for the rash.
Both babies are still head down and the sonographer noted that Banana is much lower now than he was last week. I had a sneaking suspicion that he was lower as I've been feeling a bit more pressure. The other notable change is that my cervix has shortened to 2.3cm and has started to funnel. This means that the top portion of the cervix (closest to the uterus and the babies) has started opening. Normally this would be a sign of pre-term labor, but since average gestation for twin pregnancies is 35 weeks and I'll be 35 weeks on Thursday, this isn't a cause for concern at this point. It just means that we are getting close and starting to see some action.
That's about all for now. I can't type for long (or concentrate on anything for long) as the itching just drives me batty. The prescription lotion and the cream don't really seem to help at all, but I'm still using them. The only relief seems to be from using ice packs (thanks Rebecca!), but it is hard to know where to put them since I itch all over. Gotta try out that oatmeal bath tonight and see if it helps.
The rash continues to spread. There are more bumps on my fingers than there were yesterday and it is now showing up on my arms, legs, shoulders and back. I pulled out the leaflet in the steroid cream today just to take a look and noticed that the drug is listed as a Pregnancy Category C drug. From what I understand, this means that the drug has been shown to have adverse effects to a fetus in animal studies, but has not been adequately tested on humans. However, the FDA recommendations state that the potential benefits may still warrant use of the drug despite the risks.
Although I'm sure the PA yesterday knew what he was talking about when he stated it is perfectly safe to use in pregnancy, I started to get nervous. I mean after all we've been through, I just don't want to risk harming Apple and Banana and I had never met this guy before, nor seen anyone in the practice. I know plenty of medications are used in pregnancy, but between my morning sickness, pre-term labor scare and now this, I've just taken way more drugs than I ever imagined or wanted to during pregnancy.
So I called the answering service for my OB's office today and had the doctor on call paged. I might have said this before, but one of the positives that came out of my hospital stay is that I have now met each of the 6 doctor's in my OB's practice more than once and I'm very comfortable with almost all of them. The OB that called me back today confirmed what the PA said and she was happy that he had prescribed the steroid cream. She said they use it for PUPPPs patients all the time. She also suggested we put the immersion therapy on hold for the weekend, so no more baths for me at least until my next appointment on Monday. This is a relief. Last night and this morning I would sit in the bath just wondering if I was making the stupid rash worse. But I didn't want to stop them if the OB thought it was still necessary to help Apple keep her fluid up.
What I love about my OB's practice is that I never feel rushed when talking to them. I feel like they take the time to listen and provide as much information as they can. The PA at the dermatologist's office was not like that at all. He was short with our conversation and seemed in a hurry to be done with me. I don't like this treatment at all, especially in a medical setting. The OB that I spoke with today reassured me that even though the rash is still spreading, it will run its course and will likely clear up as suddenly as it appeared. She also said that unlike PUPPPs, which you are stuck with until delivery, this will likely clear up before then. Of course who knows when delivery will be, but at least I can stop worrying that I now have a skin condition that I'll have to live with the rest of my life since it isn't pregnancy-related.
So now I just need to concentrate on NOT SCRATCHING as much as possible. This is SO much easier said than done.
Someone must come up with a better word for what I'm feeling. Itchy just doesn't cut it. I want to jump out of my skin. Got in to see a PA at the dermatologist today and he didn't think I have any of the pregnancy specific rashes. Simple dermatitis. Dry, inflamed skin aggravated by two 30 minute baths and a shower each day for 6 weeks now. He glanced at my hands and my belly for all of two seconds, announced his conclusion and sent me on my way with a script for some fancy lotion and instructions to use cet.aphil cream. He said it could be gone in a week and if so, continue with the script for another week so it doesn't recur.
Tonight has been the worst night yet. Not sure why, but I just don't feel all that confident that this is going to work.
Yes! We've made it to 34 weeks. The doctor on Monday said they wouldn't let me go past either 36 or 37 weeks, so only 2-3 weeks left max! Scary thought. But at the same time, I am SO ready. What has started pushing me over the edge is the itchy skin I've had for awhile that has now turned into a rash (or multiple rashes). It is ridiculous. I had an appointment for an NST today, so I asked to see one of the doctors. The rash could be one of two things that are related to pregnancy, or it could be some other type of rash unrelated to pregnancy. The itching started on my abdomen a week or two ago, but the doctor at the time thought it was just dry skin related to the stretching. Now, I've developed red bumps both on my lower abdomen and sides, and on both hands.
One of the most common pregnancy-related rashes is PUPPP. The doctor thought it was possible that I have this, but she didn't seem to think it likely because PUPPP doesn't usually show up on the hands. And the bumps are usually smaller than what I have on my abdomen. There is no definitive way to diagnose PUPPP and they usually just do it by visual exam of the rash. Unfortunately, there isn't much they can do to treat PUPPP.
Another possibility is Cholestasis of Pregnancy. This one involves the liver and usually involves the hands. I asked the doctor if it could harm the babies because I had done some reading ahead of time. She said she thought it was a very low risk. It is possible, but she has never seen it affect the babies and really is just an annoyance (which I think is an understatement). She did say if this is the culprit, it is treatable, although she didn't mention what the treatment would be and I didn't think to ask. They took blood today to check for cholestasis, but results won't be back for a week.
The doctor also suggested I make an appointment with a dermatologist because I could have a rash that is unrelated to pregnancy or not caused by pregnancy, but is being aggravated by it. I will be putting in a call or two tomorrow to beg for a quick appointment. In the meantime, I'm supposed to use hydrocortisone cream twice a day and 50mg of ben.adryl every 6 hours. I've been on the hydrocortisone for a couple of days now and it doesn't seem to be helping. So I'm adding the bena.dryl and hoping for the best.
The good news is that the rash shouldn't affect the babies, but it is driving their mother MAD. The rash on my hands is on the outside of the hand and runs from the last knuckle of the pinky down to the wrist bone. It is also starting to show up between the fingers and my palms itch too. This morning in the shower I was using an exfoliant for my face and I ended up sitting there for a minute or two rubbing it between my hands because it felt so good. The rash on my abdomen just looks gross along with the stretch marks. One of the nurses commented today that my skin looks like it's been through the wringer. Yeah, that's how it feels.
The NST was fine today-for one of the babies at least (we think Banana). We couldn't get the other baby on at all (likely Apple). So it was a big waste of time again and they ended up relying on ultrasound to check fetal well-being. The ultrasound was pretty miserable for me today. It took forever because both babies were pretty sleepy and weren't moving around enough to pass the BPP quickly. Both ended up passing, but I think it took almost the full hour. I was really uncomfortable lying on the table for so long and I'm quite sore tonight. The sonographer did note that both babies now have hair on their heads. Yea! She also noted that Apple emptied her bladder. At the beginning of the scan, it was full and then when she checked back later, it was empty.
We didn't get any good pictures today because the babies were facing each other with both heads facing out. They are now lying like mirror images. Can you tell what is different now from Monday based on this statement? Banana seems to have turned Vertex (head down)! I had a sneaking suspicion that this was the case because Tuesday night there was so much violent movement that it was painful and I actually yelped involuntarily a couple of times. So I think I was feeling Banana struggle to flip himself head down. What a good boy! I'm hoping that at this point there is not enough room left for him to flip back to breech, but you never know. If he does, I'm sure I will feel it. They did not do measurements today, so no estimates for weight.
Next appointment is on Monday. I have to go put some icepacks on my abdomen and hands now or I'm going to claw my skin off the bones.
The more monitoring these kids get, the more convinced I am that the tests are really inconclusive or quite possibly, inaccurate. I was originally scheduled only for an NST and a cervical check U/S today, so we didn't expect to see the babies. However, Apple's heart rate looked flat on the strip today. She wasn't having decelerations or anything bad like that, but she wasn't showing accelerations either. Banana had a bunch of accelerations where his heart rate would jump up for short periods of time. This is a sign that he is healthy and happy in my ute.
Because Apple wasn't quite as reactive, the doctor decided we'd better do a BPP (biophysical profile) to check her out. And while we were in there, the sonographer did one for Banana as well. Here's what it showed:
Moving around great
Heart rate fine
Fluid looked pretty good (one pocket at 5cm)
Blood flow through cord okay from what I gathered (although they didn't really say)
Weighs about 4 pounds 7 ounces, at the 18th percentile on the growth chart
Heart rate fine
Fluid looked good (I think I saw a 6cm measurement on the screen when she was measuring a pocket)
Blood flow through cord okay (again, they didn't say otherwise)
Weighs about 4 pounds 9 ounces, at the 25th percentile on growth chart
His testicles have descended! (yes, Daddy is proud)
So if today's measurements AND last Wednesday's measurements are to be believed, Apple grew a whole pound in 5 days and Banana didn't grow at all. Not likely. The doctor said it is possible that Apple could have had a growth spurt and grew about half a pound in that time, but not really a whole pound. It could be that the measurements on Wednesday were a little stingy while today's where on the generous side. They were done by different people using different U/S machines, so it is really difficult to truly know what has happened. It is also possible that Banana didn't grow much as they can grow in spurts and then have short periods where they don't grow much at all. Last Wednesday the babies had a growth difference of 24% and today they are considered to not really have any difference. So who knows what to make of any of it? This is why they don't generally do growth scans any closer than two weeks apart.
Because Apple's BPP looked good, they aren't concerned about her non-reactive NST. They generally look for accelerations on the NST to show that the baby's heart rate increases with activity, so it is an indication that the baby is moving around. Healthy babies move a lot. However, some babies move around a lot, but their heart rate stays steady and doesn't increase. This is just fine too, but when seen only on an NST, there is no reassurance that the baby is active enough. You can't rely on kick counts with twins because it is often difficult to tell which twin is moving. So the BPP is a better indication. We have another NST scheduled for Thursday and if we run into the same problem, they will do another BPP. If that does happen, we might skip the NST's altogether and just do BPP's twice a week. I would much rather have ultrasounds anyway instead of the NST's where I'm hooked up to the monitors.
So what does all of this mean? As of today, they didn't see anything concerning, but who knows how accurate the measurements are. At least they are both moving around a lot and have better fluid levels. The OB did say if the peri wanted to delivery early based on what they are seeing now, she would question the suggestion and argue against it. This is my main concern-that we will be pushed to make a decision based on misinformation. It is just difficult to tell which information is good and which is not. As of today, we are keeping everything the same unless something with me changes (less fetal movement or worse contractions). At the next appointment on Thursday, I'll be 34 weeks, which is another milestone.
The OB said today that they may not want me to go past 36 weeks (or maybe 37) with the fluid and discordant growth issues. December 18 is 36 weeks, so place your bets now!
As far as mom goes (meaning me, of course), everything is going well. Blood pressure is still low and I'm not showing any signs of pre-eclampsia. My weight gain has continued slow and steady (up about 31 or 32 pounds now). My belly now measures 40cm. And I haven't had much swelling. I do have a bit of swelling in my lower abdomen which the OB said was normal. She also commented on how little I complain, which my mom and I both thought was funny. I told the OB she is lucky she isn't at home with me!
My stretch marks continue to itch like mad. I've tried lotion, cocoa butter, medicated lotion and bio oil, none of which seems to do anything for the itch. The OB told me to try hydracortisone cream or bena.dryl cream (or even oral be.nadryl), so we'll see if that does anything. I have my doubts. Here's my take on the scientific equation: Skin stretching to ridiculous dimensions in short period of time + dry climate + winter + little limbs constantly poking out = many loud exclamations of "someonemakethisitchgoawayfortheloveofgod!!!!"
I also have some new pains that have popped up in the last couple of days. The nail on my big right toe somehow seems to be bruised, although I don't remember stubbing it or hitting it on anything (which in no way means that I didn't actually stub it or hit it and just can't recall). The more annoying pain is in a couple of fingers on my left hand. Any type of movement that requires the fingers to bend is painful. The OB said it is likely fluid retention in the joints and that even a tiny amount of fluid can produce pain and stiffness. She said she would assume it is pregnancy related unless it doesn't go away after the pregnancy. If it continues to get worse, I might have to start dictating my posts B or my mom! (just add it to the hundreds of other things they do for me every day). Other than that, I'm just as uncomfortable as ever and getting antsy every so often. Still having trouble getting comfortable on the couch or in bed and still having some lovely pelvic pain every time I move. Nothing new there.
I'm definitely carrying lower now. Baby B was lower on the ultrasound today and one of the nurses commented on how low the babies are. This really isn't any indication of when I'll go into labor, so it doesn't really matter. Although I'm trying not to sit up too much because my belly rests on my thighs which is a really uncomfortable feeling. Weird. I'm not supposed to be sitting up anyway, but sometimes a girl's gotta cheat.
In other household news, B bought a ceiling fan/light fixture for the nursery this week and it will be installed sometime next week. Good thing as there currently isn't a light in the room. We continue to get other little odds and ends done for baby stuff. The christmukah tree is officially up and decorated (with the help of my parents and B, while I sat on the couch and put hooks into ornaments). We got a good 8 inches or so of snow over the weekend, so it really started to feel like winter. Although it is 50 degrees today and melting quickly. We also got a cabinet guy out last weekend to give us an estimate for doing a built in for the tv niche in the family room. We've been wanting to do this for 2 years now (since we moved into this house), and it feels great to have that finally in the works. It should be ready for installation the week of December 15th though, so we might need to postpone a bit depending on what these babies decide to do.
That's all for now. We did get two U/S pictures from today, so I'll post later once we get them scanned.
Forgot to mention, my cervix measured 2.7cm today. On Wed. the peri got two different measurements at 2.5 and 3.0, but she documented the 3.0 in my chart. So, on paper, it has shortened a tad since Wednesday.