Sunday, August 30, 2009

Sharing the News

I did it. At 9w4d (8/26), I told my parents that we are expecting, and that I am pregnant with twins.

It was probably one of the most (if not the most) nerve-wracking conversations of my life. I started by asking my mom to put me on speaker phone so I could talk with her and my dad at the same time. Then I just came out with it: "I wanted to share some news with you... I'm pregnant!" There was silence, then my mom said "oh wow." I plowed right on: "and we are doubly blessed! it's twins!" More silence.

All of a sudden the floodgates opened and my mom started asking questions. The tone of her voice at the beginning was a mix of disgust and accusation. The very first thing she asked about was the donor. I don't remember how she asked, but the implication was that we'd gotten donated sperm from someone we knew nothing about. I calmly explained that actually, yes, we know a lot about the donor. We have personal profiles, medical information for everyone in each generation back to his grandparents, pictures of the donor as a child and as an adult...

Barely acknowledging my response, she went on to another question. Do I get maternity leave from work? (Yes, unpaid but I have saved enough vacation and sick leave time to cover me for the three months of FMLA, and have also saved a substantial amount of money to cover me if I need to be out of work for longer.) Do I plan to be a SAHM? (No, I will take the first three months off, then Sylvia will take the next three months off, and after that we have arranged our schedules so that we will only need a nanny or daycare 2 days a week. There's a great daycare at work, too...) Was I anticipating twins? (No, I had not ovulated on my own regularly for quite some time, so I did need assistance ovulating, and took Clomid. On the day of the IUI we had one mature follicle and one not-quite-mature follicle [okay, so I stretched that part a little bit; I actually don't know how big they were on IUI day, but they were probably both "mature"]...)

I forget how it came up, but at some point I started talking about the bleeding. All of a sudden I was overwhelmed, and I started crying. I told them about the subchorionic hematoma. How awful the bleeding was the night we went into the ER. The risks of these types of bleeds. I just kept talking, information and emotion pouring out of me. My mom's tone changed, then. Just slightly but it was a noticeable shift. Her voice softened and I started to hear bits of compassion in the questions and responses.

I didn't plan to cry-- and honestly once I started to cry I was a little annoyed with myself-- but I do think it humanized me and our situation and our babies to my parents. I was surprised to hear my dad say that I was welcome to call any time of the day or night. My mom echoed the sentiment, and even implied (albeit very indirectly) that she would fly up here to provide "moral support" if I needed her to. I was floored.

She asked again about the donor, and I shared more information about the process-- how we chose him, how long it took to settle on a donor, how careful we were when reviewing people's profiles. I tried to give her a sense of how seriously we took our responsibility to find a good genetic "other half" for our children. I stressed the similarities of our donor to my family, especially the longevity of his grandparent's generation... I did not tell them that our donor is black (I am white).

At one point my mom said "I know you've wanted to have kids for a long time..." It was nice for her to acknowledge that truth, and I am glad she remembered our many conversations about my desire for children. I have wanted children for as long as I can remember. These little babies growing inside me right now represent the fulfillment of a life-long dream. I am glad my mom can see and acknowledge that.

Another thing she said that made me happy was "there is no way that anyone can feel bad about babies." (She was saying this in reference to a comment I made about being initially worried that my brother and sister-in-law would feel that we were "stealing their thunder" [they just recently had twins]-- I wanted to cover all the bases/possible concerns my parents might have.) In any case, I was glad to hear her voice that sentiment. I trust that that will apply to her and my dad, too.

They closed the conversation saying that they would pray for me and the babies, and to please keep them updated. At long last, my dad said "congratulations" and my mom echoed "yes, congratulations."

All in all, I think The Telling of The Parents went well. My biggest concern was that they wouldn't engage me on the topic at all-- that they wouldn't ask questions or say anything other than the socially-expected "congratulations." The conversation was much more than that, and for that I am very grateful. It will be interesting to see where we go from here, but for now, I am feeling hopeful.

Tuesday, August 25, 2009

The Rest of That Week

Sunday morning (8/16, 8w1d) I woke up to another gush of red blood. It was greater in volume than the night before, but I was less scared because we'd gotten confirmation the night before that the babies were okay, and I knew what was causing the bleeding. Still, I called the only person I could think to call, the RE (we had not expected to be released from the RE so early, and didn't have an OB lined up). The on-call nurse called me back and I explained what was going on. She checked with Dr. P at home, and called me back. Bedrest, fluids, and orders to come in first thing Monday to be checked.

Sylvia and I spent the bulk of Sunday googling. Subchorionic hematomas (SCHs) have a range of outcomes, and for every positive story we read we also saw dire warnings. It was a scary day.

By Monday the bleeding had slowed, and the ultrasound at Dr. P's office showed the babies were okay. He put me on pelvic rest and ordered me to do no excercise until the bleeding completely resolved.

As soon as we got home from the RE's office, I started calling around to line up an OB for follow-up care. SCHs usually need to be watched, and at that point we had no information about how large it was (a key component to assessing the level of threat it was to the babies). One office I called, I found that the person who had been recommended to us was not taking new patients, but one of the other OBs in the practice could see me. Our choice was to come in immediately or wait another 8 days. We opted for the earlier appointment, and got right in the car.

The OB did an internal exam and asked the ER to fax over the ultrasound report. When it came in we discovered that it said very little about the SCH. Nothing about the size at all. But there at the bottom of the report was a much more ominous warning: "Probable septate or bicornuate uterus."

The OB explained that a septate or bicornuate uterus, while frequently manageable in a singleton pregnancy, would be essentially an insurmountable challenge for a twin pregnancy (depending on the degree, of course). He wrote orders for me to be evaluated by a Maternal-Fetal Medicine specialist (MFM).

After a sleepless night angsting about this new complication, we went in to see the MFMs on Tuesday (8/18, 8w3d). The MFM we saw was wonderful. Compassionate and kind and thorough in his exam. He pointed out to us what the ultrasound tech probably saw that led her to that dire suggestion. He measured the SCH and said it didn't look too bad for now. He let us hear our Little Babies' heartbeats (heaven!). They both measured right on track. We left that appointment greatly reassured that our LBs (pronounced "Elbees," our nickname for our Little Babies) would be okay.

Since that time we have essentially just been waiting for the bleeding to stop. Every trip to the bathroom has Sylvia and I both holding our breath. Every moment I'm not at work, I'm essentially on bedrest. I even ended up taking two days off from work at the end of that first week to try to encourage the bleeding to subside. It has slowly seemed to get better, and the red episodes have gotten less frequent.

Sylvia has been beyond wonderful. She does everything she can to keep me resting in bed, bringing me food and water and taking care of all the household chores. I am certainly blessed to have such a wonderful, wonderful wife.

Monday, August 17, 2009

Trip to the ER

So very much has happened since I last posted. It all started with a trip to the ER on 7/15. Even though I am writing this post on 7/30, I'll backdate it so it appears in its proper place.

Saturday, August 15th I finally got the nerve up to buy some maternity clothes. Maternity clothes had been off-limits for me to even think about, but we'd seen our precious babies' heartbeats several times by that point-- had even heard them via the ultrasound at our 7w5d appointment with the RE. We'd been released from the RE at that same appointment, and I felt confident that I had joined the ranks of regular pregnant women (albeit with twins, which are somewhat higher risk than a singleton).

So I was out shopping on Saturday. Found some jeans and a couple of work-worthy tops. Ran a few other errands and arrived home with takeout for dinner at about 9:30 pm. I stopped to go to the restroom and found I had spotted brown while I was out.

As much as I'd heard repeatedly that spotting is normal during early pregnancy, it was a very different thing to see it myself. Worried, I dove into the pregnancy books I have, looking for answers. I called my sister-in-law, herself recently pregnant with twins (my two adorable nephews who I have yet to meet in person), to ask if she'd experienced anything like this. We chatted for a while and I felt much relieved.

When I got up from where I had been laying while talking on the phone, I felt a gush of warmth. I tried to talk myself into the possibility that I had imagined it as I rushed to the bathroom.

And there it was-- bright, bright red blood. A lot of it. I sat on the toilet and sobbed.

Sylvia came around the corner and said "I'm taking you in." I didn't argue.

We got to the ER about half an hour later. We were checked in at the front desk and given a number. We went and sat numbly in the waiting room as I wished they didn't have the TVs tuned to bad news. War news on one and a movie about a woman trying to escape her abusive husband on the other. (Seriously? Is that really what you want to show a room full of anxious people in pain?)

After a few hours (which felt like an eternity), we were called back and given a room. They drew my blood (lots of it) and left us for two hours. The nurse reappeared to set an IV, so S slipped out of the room to go to the restroom. Right then, the ultrasound tech came in. As she was wheeling me out of the room, the nurse told her that my "friend" was with me. The tech barked "I don't allow anyone in the ultrasound room with me." I tried to clarify that it was my partner, not just some random friend, and she said "No one. No husbands, no boyfriends, no one."

As she wheeled me down the hall to the ultrasound room, I was filled with a mix of anger and frusteration at the tech and fear and anxiety for our babies. I kept envisioning S returning to an empty ER room, wondering where I'd been taken.

The tech started the ultrasound trans-abdominally. She didn't say a word as she pushed hard on my stomach. She kept clicking pictures, but said nothing and I couldn't read her face for the life of me. The screen was far out of my view. I finally asked: "Can you see heartbeats?" She gave me a dismissive look and said "I think so, but I don't know yet. Just wait."

After a while, she switched to the trans-vaginal ultrasound wand. Never in all the ultrasounds I'd had had anyone said either of the babies were hard to find, but she kept saying she couldn't find the second one, and she dug hard with the wand trying to get a good picture. It was the most painful ultrasound I've ever had.

Around this time, I heard Sylvia in the hall, calling my name. I called back "I'm in here, but they won't let you come in." She clearly didn't hear me because a minute later she called my name again. This time, the tech answered in a rude tone, indicating that I'd be out when we were done, but she couldn't come in. Not usually one to quiver in the face of medical professionals, I meekly tried to explain that Sylvia must not have heard me the first time. No response.

After another 20 minutes of poking and prodding (and a switch back to the trans-abdominal wand), she handed me some paper towels to clean myself off with. Still not having heard how our babies were doing, and fearing that no news meant bad news, I asked again: "Were you able to find the two heartbeats?" She said yes, and told me Baby A's heartrate (but not Baby B's). At that point I was just so happy to hear that there were two heartbeats and the babies were okay I didn't press her for more information. She wheeled me back to the holding room, barely glancing at S, who had been outside the door the whole time.

Eventually the ER doc came in and said that I had a subchorionic hematoma, and that that was what had caused the bleeding. He said I needed to get in to see my regular doctor on Monday, and in the meantime I should rest and keep my fluid intake up.

A few more tests and half a bag of IV fluids later, we were discharged. We arrived home at 5:30 AM and went straight to bed.

Sunday, August 9, 2009

Two Heartbeats

Despite our best attempts to be calm and patient about the two week wait between our first and second ultrasounds, Sylvia and I grew increasingly anxious as the days ticked by.

After some googling and hearing the ultrasound results of a good friend of ours who is just a few days behind us, Sylvia realized that many people see a distinct yolk sac at 5w5d. At our 5w5d ultrasound, Dr. P only mentioned seeing the gestational sacs. Did this mean there was no yolk sac in either? And if so, what did that mean? Fretting ensued.

For me, the question of "one or two?" ate at me constantly. Even in casual conversation between S and I, we were inconsistent about whether we referred to our babies as singular or plural. Sylvia's approach was to consider that there was one until proven otherwise. My approach was to not expect two (because really, the second sac was tiny), but to create a welcoming environment for the second one just in case a second one was in there. There's nothing I dislike more than my wife and I being on different pages.

Adding to both of our concerns was an episode of cramping on Saturday, just a few days after our first ultrasound.

On Wednesday evening (almost one week from our first ultrasound the Thursday before), we had a long talk and decided to call the RE's office to see if we could come in for an ultrasound while Dr. P was still on vacation. We called Thursday morning, and the incredibly kind and compassionate nurse found us an appointment for Friday mid-morning.

At our appointment on Friday (8/7/09, 6w6d), we saw the most miraculous thing. Two tiny babies, in their own sacs, hearts beating away!! Even though I held out the possibility that the second sac might develop, I honestly did not expect for him to find TWO babies! I was completely in shock. I actually asked the Dr if he was joking when he told us there were two babies and two heartbeats. He humored me and went back and forth between the two and pointed out the heartbeats to us. It was awe-inspiring, to say the least.

Before we left, he tried his best to get both of our little babies in view, and printed us a copy of the ultrasound image. Amazing!

Our two miracles. (6w6d)

Post-appointment, both of us greatly reassured, we went home to bask in the joy (and surprise!) of our two little babies.