Where to start with the first two months

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Life with newborn twins and a toddler is busy — life with newborn twins and a toddler when one of the newborns has medical issues is insane.  Our daughter, M, has problems with aspiration and reflux.  At 3 weeks old we took her for two swallow studies where they determined that she was unable to safely swallow regular liquids or thickened liquids without aspirating into her lungs.  At 4 weeks we had an NG (nasal) feeding tube placed.  Tomorrow she will have a g-tube (abdominal feeding tube) placed.  The NG tube has made her already significant reflux worse and can cause oral aversions and significantly increase the gag reflex so it was always only a short-term solution.  The good news is that once we put the NG tube in and she was able to get enough calories and grow she has been able to safely swallow.  We are working with a feeding therapist to increase her oral intake, but it will be a while before we can get rid of the tube completely (optimistically a few months and everyone tells us that almost all kids are tube-free by 2 years).  We don’t know why she has swallowing issues – every doctor (pediatrician, ENT and GI) has a different theory.  We are having her esophagus and trachea scoped tomorrow while she is under anesthesia and hope to get some more answers.

To say that this has been stressful is a massive understatement.  In addition to everything that surrounds simply feeding her, she still cries a fair amount from discomfort (before the NG tube she screamed for hours and hours a day from pain and hunger).  Its meant that caring for all three kids on your own for any extended period of time is impossible.  We’ve enrolled L in daycare three days a week and are relying on help from friends and family the other two days a week.  My mom has been a LIFESAVER and flies in every-other week to help out.  She has booked trips through the first week of June to help us.

I realize that no one plans to have a kid with medical issues, but good lord this is not at all what I imagined.

And then my heart exploded

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The twins were born last Monday, January 14th, via scheduled c-section at 38w2d. W, our son, was 7lbs2oz and 19.25″ long.  M, our daughter, was 9lb11oz and 21″ long (no, that is not a typo).  When they pulled out W (Baby A), several people in the room remarked “that’s a big twin!” and we laughed and said “that’s the little one!”  The big twins were the talk of the nursery and several nurses said that M was the largest twin they could remember in recent history.  Both were extremely healthy and came out crying.  M in particular was giving all the OR and nursery staff the what for after delivery, she is a sassy one.

The plan had always been to try and deliver naturally but my body refused to get with the program and despite two weeks of prodromal labor I was less than 2cm dilated and unfavorable for induction.  In the 2 weeks before our scheduled delivery, both babies flipped vertex to breech and back again.  M flipped just 5 days before delivery.  How either of them had the room to do that is beyond anyone’s imagination.  Between being unfavorable for induction, my history of postpartum hemorrhage and the large size discrepancy, with baby B being the larger of the two (she was estimated at 9lb5oz via ultrasound 4 days before delivery), it was decided that a c-section was the safest delivery route.  I was disappointed and the first week of recovery KICKED MY ASS STOMACH but I am feeling pretty good now.  I am still very weak and physically tired, but I think that has as much to do with being all but immobile for the past two months as the delivery itself.

I couldn’t really imagine it before they arrived, but my heart is now three times the size.

We have been home since Thursday evening and my mom is here helping us out until Saturday (she arrived before the c-section to watch L).  The day after she leaves, my sister arrives for 5 days and the day after she leaves my mom is flying back to stay for one more week.  We are lucky to have essentially 4 weeks of live-in help and I can’t even imagine how this is going to go when we are “on our own.”  We are keeping our heads above water with three adults though. TFO is going to take 2 days a week off from work for the next 3 months or so and we will still get help from his mom and aunts as well.  I am just trying not to think about it too much and remind myself that so much will change with the babies in the first few weeks that I just need to try and roll with it as things come.  Its hard not to worry about it though, especially when L is still PISSED at TFO and I for up-ending his life with these babies and refuses to even acknowledge their existence.  I can’t imagine it being just me with all three of them down the line.

I’m going to go snuggle a baby and try not to think about it…

Knock, knock

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Not sure if anyone is even still following this thing, but I figured I would pop in for an update.

Still pregnant at 33.5 weeks!

Two weeks ago I ended up in labor and delivery with pre-term contractions.  It took two shots of terbutaline to knock them down, but my cervix was long and closed.  The week before that they had measured my cervix at 6cm.  I’m a little concerned that these two don’t even know where the exit is (though A is head down and has been that way for 10+ weeks now).  I was put on modified bedrest after that though.  I’m not supposed to walk or stand more than necessary (which is fairly loosely defined, but I start to feel like crap VERY quickly when I’m on my feet anyway) and I’m not supposed to take care of L by myself any more than necessary.  TFO’s family has been a huge help with that.  Between his parents and two of his aunts, I have help every morning from 9-12 and 4 out of 5 afternoons a week after nap until TFO gets home (and TFO’s mom still takes him to her house for one full day a week).  Fortunately, L has also been in to coloring and stickers, so when I’m on my own with him we sit at the table a lot working with those and, yes, watch a lot of TV as well.

My OB’s first goal was to get me to 34 weeks (this Friday!). The second goal is 36 weeks and after that I can do whatever I want (no bedrest restrictions — which is kind of hilarious because I don’t have any energy to anything anyway).  I’ll be induced at 38 weeks (starting the night of January 13) if we make it that far.  One way or another, these babies will be here in a month (so close…and yet so far when you are physically miserable).

As of last Wednesday they were measuring 5lb and 6lb and 1.5-2.5 weeks ahead of schedule (and bucking the norm, Baby B — our girl, is the bigger of the two). I’m also measuring 17 weeks ahead of schedule.  My fundal height was 50cm, its out of control.

Overdue Update

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So I was going to try and post last week when we cross the 24-week line into “viability” but life and exhaustion got the best of me.  And then on Thursday I got sick and it has been SUPER FUN since then.  I do not recommend a hacking cough while pregnant.  I’ve managed to pull a couple of muscles in my abdomen and I suspect I gave myself an abdominal hernia as well.  I have to sit down to cough or blow my nose because I can’t support my aching belly well enough when standing or lying down.  It’s pretty attractive.  Saturday I had to get TFO to take me in to urgent care because I couldn’t breathe very well [I had croup a lot as a kid and to this day bad viruses will settle in my voice box, which swells up and blocks off my airway].  Good times.

Oh, and did I mention that Friday was our 10th wedding anniversary?  And TFO spent all weekend trying not to get to close to me (totally legit, btw).  Not so awesome.  We are hoping for a do-over on our aborted celebratory plans in the next couple of weekends.

The whole thing also earned me a BPP appointment today because the babies have been quieter than normal (but still moving, so I wasn’t freaking out) and my blood pressure was elevated at urgent care.  My BP was fine today and the babies were moving and shaking.  I also learned that Baby Girl shifted position (still transverse, but lower), so that explains why I thought I wasn’t feeling her as much.  I thought it was her brother punching me in the bladder, but apparently it’s her kicking me.  Thanks, dear.

The babies are measuring ~1.5 weeks ahead and weigh over 2 lbs each.  That’s 4.5 lbs of baby in there — L was 5lb3oz when he was born.  I was also just looking at another blogger’s 38 week belly shot photos and thinking about how I am already looking bigger than that.  At my 22 week appointment I was measuring 37 weeks.  That was when Baby Girl was up under my ribs though, so I think that was distorting things a little bit.

Aside from the cold things are trucking along.  We got the nursery painted and eventually we will get the crib set up in there again (and even more eventually get another crib).  My grandparents bought us our 2nd car seat, so now we’re technically ready to bring two babies home (not any time soon, please).  I have a shower scheduled for the first weekend in November.  I am oh-so-slowly working on asking for help.  To that end, we’ve hired a house cleaner to come every-other week and she starts a week from tomorrow.  This weekend has been a good reminder of just how hard strict bedrest would be on me, both mentally and physically.  It’s a good motivator to accept the help that is offered and try to avoid over-doing things and sending myself into avoidable complications (not to be confused with the unavoidable ones that may crop up).

One of each

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Whoa.  So in the past month — really in the past two weeks — we went under contract on our old house, closed on our new house, moved, bought a second car and found out that we are expecting a boy and a girl!  To say that life has been moving at a frantic pace is really understating the situation.

We moved last Wednesday and had a lot of help from family, especially my mom who flew in to be here for a week!  Thank goodness we did as I also ended up bed rest over Labor Day weekend for cramping and contractions.  My cervix is long (6cm) and closed and didn’t show any change between last Thursday and this Tuesday so my restrictions were lifted.  My doc said there’s no medical evidence to support bed rest unless you cervix is actually dilating.

That being said, this pregnancy is kicking my ass.  Or, rather, taking care of a 2 year old (next week!) during this pregnancy is kicking my ass.  Once we officially close on the old house I am going to have to line up some kind of part-time help with L.  I am not sure if getting him into a daycare part-time or trying to find a part-time nanny (who could also help for a few months after the twins arrive) is the way to go?  In the short term, TFO has a business trip the week after next and my mom is flying out again to stay with L and me while he is gone.  She is a lifesaver.  We are scheduled to close on the house while TFO is out of town so after that I can hopefully line up some help.

I found out last week that I’m measuring 10 weeks ahead (I was measuring 28 weeks at 18.5 weeks) which certainly helps explain why I feel like a house.  The babies are measuring just a few days ahead, so no worries there.  I also failed an early 1-hour GTT this morning with a freaking 140 (the cut off) so I have to go in for the three hour next week.  I am not so much stressed about being diagnosed with GD (though I don’t want it) as I am about trying to gain weight with GD.  I’m overweight to begin with so I don’t need to gain as much as some twin moms, but I’m STILL on daily Zofran and I’m only up 4 lbs over my pre-pregnancy weight at 20 weeks (I was down about 7 pounds in the first trimester, so I have gained something).

In babies news, I feel them move on a daily basis now.  I have felt them sporadically for several weeks.  Last Sunday at 19 weeks TFO was able to feel baby boy kick.  Baby girl has an anterior/lateral placenta so I don’t feel much from her.  Though during the GTT today I could feel action high and low and some of it must have been her.  Baby boy (baby A) is head down on my left and baby girl (baby B) is transverse with her head up by her brother’s feet.  Between baby boy’s kicks and baby girl’s head I fear for my left-side ribs.

So that’s where I’m at — settling into the new house, trying to finish the first wave of unpacking before we host about 40 people for a housewarming/L’s 2nd birthday party on Sunday and trying not to end up back on bed rest in the process.  It doesn’t really feel like home yet, but at least I don’t feel like I’m squatting in someone else’s house anymore.

A boy and a birl

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We had an ultrasound today with my new clinic.  It was supposed to be just a quick check to get heart rates and measurements, but the ultrasound tech was AWESOME and spent about 20 minutes trying to get the sexes of the babies for us.  Baby A is a boy!  Baby B was having none of that and kept their legs closed and feet tucked up under their butt so there was no peeking.  The tech even tried a transvaginal shot since B is butt down, but no dice.  It was super sweet of her to try for so long though and it was fun to find out that Baby A is a boy.  Of course we have a lot of people hoping that B is a just a modest girl.  There is serious baby girl fever among our family and friends.  Both babies looked good, with heart rates of 158 and 145.

I’ve started to feel the babies move in the past week or so.  It’s really light and feels pretty different from what I experienced with L since his placenta was anterior and I couldn’t feel him until he could really pack a punch.  Feeling the baby(ies) move is the thing I have been looking forward to the most about pregnancy.

I am 15.5 weeks and still feel like crap.  I had my first actual appointment at the new clinic yesterday with an NP and I’ve managed to regain a couple of the pounds that I lost.  I’m supposed to stop taking my prenatal and see if that helps.  I am also experiencing cramping and contractions on a regular basis with over-exertion and dehydration.  Drinking enough water is hard with the nausea.  I’m really trying to stay on top of it and rest when I need to even though the point at which I need to is such a low threshold that I feel ridiculous. Let’s be clear that by “over-exertion” I mean made a dinner that took more than 20 minutes or walked 3 blocks at toddler pace (in 90 degree heat).  Should make moving interesting, but we have a lot of offers to help.

We still haven’t sold our house, but we are moving in 3 weeks!  We are also going on vacation in the interim.  It’s insanity.  But we have the movers booked and the fence installation starts the day we close.  My mom is awesome and extended her annual Labor Day visit to a full week to help us move.  TFO has been kicking ass on packing in the evenings while I collapse on the couch and watch the Olympics.  In one final fit of insanity we are also looking at hosting a birthday party for L/housewarming the week after we move since he will be turning 2 and it might be the cleanest that our house gets for the next 4 years.

Wish us luck!

Moving on up

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We reached final agreement with the sellers on a new house last night.  We are officially moving to the ‘burbs and upgrading from 2 bedrooms/2 baths to 5 bedrooms/3.5 baths.  I am not entirely sure what we are going to do with all that space, but people keep reminding me that we will soon be a big family…and eventually a family with 3 teenagers (oh my god).  One funny note is that the sellers have three kids – an older daughter and twin boys (they are all out of high school now).  So it’s been a crazy couple of weeks with house hunting, offers and negotiations but we had our inspection on Tuesday and they agreed to do our requested repairs last night, so we’re finally all set.  We close at the end of August.

Our house is still on the market.  Hopefully it will sell soon and all of the house stress (and the PITA that is having a house in show condition) will be over.  It has been so insanely hot the last few weeks that during showings I’ve been forced to drive around in the car for an hour or more with L and the dogs because it’s too hot to sit out at a park.  Good times.  We have another showing this afternoon and it will be the same situation.

We also had our NT scan yesterday and the babies look great.  I have been hesitant to post updates because I am afraid of jinxing something between ultrasounds.  I didn’t even post two weeks ago after I had another unplanned ultrasound for spotting.  Anyway, the babies looked great then and they looked great again yesterday.  I was 11w5d and they measured 12w2d and 12w0d with hear rates of 161 and 156.  Their NT measurements were 1.5 and 1.2 and they were able to visualize both nasal bones; all good news so far. Still waiting on the blood work, of course. We also confirmed that they have separate placentas (which we had been assuming, since we assume they are fraternal from the two follicles) and they are posterior and posterior/lateral — L’s was anterior, so I’m looking forward to stronger movement.

I have my 12 week doctors appointment next week with Dr. H and then I am going to be switching clinics to someone with a clinic and hospital privileges closer to our new house.  We already live 20-25 minutes from the clinic and we’ll be moving another 15-20 minutes away.  The hospital where we delivered L would also be about 30 minutes from the new house and doesn’t have a level 2 NICU. We also want to switch to someone who can deliver me at a hospital with a better NICU (and 10-15 minutes closer to the new house), just in case.  We talked to Dr. H about this at our 8 week appointment and he was completely supportive and had some recommendations for me.  We’ve just been so crazy with the house stuff that I haven’t had time to deal with making the transfer so we’ll do one more appointment at my current clinic.

I still feel like absolute shit with my nausea and it has been getting worse instead of better this week. I am getting a little depressed about the fact that I may not actually feel GOOD again until after these babies are born. Not that they aren’t worth months of misery, because they are, I just wish that I had some how more fully appreciated how nice it is when you don’t feel like you have the flu and a hangover at the same time before I got pregnant.  I’ve also started having dreams about the twins.  In the only dream where I knew their genders they were boy/girl twins.  My dreams about L were always correct (boy) even when I was certain he would be a girl, so I’ve been paying attention.

Turns out, I’m still pregnant

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I don’t think that I’ve ever engaged in so many major life stressors as I did today.  Our house is officially for sale as of today, we spent the morning at the doctor’s office checking up on the babies and we spent this afternoon looking at new houses.  Oh and tonight we’re packing to go camping for the weekend.  We might be insane and I amso tired.

First off, the babies look great.  I’m 8w5d today and they were measuring 8w5d (hr 171) and 8w3d (hr 176).  They actually looked like little shrimps with leg buds today instead of a vague collection of pixels on the screen.  The ultrasound tech also pointed out the beginning brain formation on one of the babies.  Yay for brains!  What I didn’t tell the internet (or very many people in general) is that I went in last Thursday for a reassurance ultrasound as well.  The stress of taking serious concrete steps to rearrange our lives for two new little ones got the best of me and I just needed to know they were still there. Unfortunately, we also found out today that I have a small (1cm x 1cm) subchorionic hematoma, but I haven’t had any bleeding with it (so far, *knock on wood*) and hopefully it will just resolve itself.  I also found out that my doc does not recommend travel after ~20 weeks, so that rules out going to a very good friends’ wedding in Atlanta at the end of October (26 weeks).  I’m not surprised and I was already leaning toward not going with the pregnancy, but it still made me sad all over again.

So, yes, after that we signed the listing agreement and our house went up for sale and we spent the afternoon looking at new houses.  We looked at 4 and saw one we would make an offer on if it’s still available when our house sells.  Our market is hot, but so is there’s, so there’s little guarantee it will still be available, but it was very informative to get in some houses and really see what’s out there.

I just keep thinking that 6 months from now and 1 year from now we won’t even recognize our life.  Not that this is a bad thing, but holy sh*t a lot is going to change.

Processing

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Thanks for all the congratulations and well wishes — especially those who assured me multiples are tons of fun. 😉

I think that the news is slowly sinking in — but at the same time I’ve been so distracted with the logistics of some big changes we need to make (read: sell our house and buy a new one) that I haven’t really had all the time I would like to fret and worry about how I will handle 3 under 3 on my own when TFO is at work.  This is probably a good thing.

We had no inkling this was going to be twins.  Of course we thought the whole cycle was kind of a crap shoot with my lax response to meds and TFO’s low motility numbers for the IUI.  Then my betas did NOT look like twin betas at all (11 dpo – 26, 13 dpo – 68, 17 dpo – 267) — they were a case study in average singleton betas on http://www.betabase.info.  OK, I shouldn’t say we had NO inkling — during the TWW, TFO cracked open an egg with a double yolk and enjoyed teasing me about it being a sign.  I did think maybe it was a girl because my nausea is MUCH worse this time around. I’m getting a prescription for Zofran.  Unfortunately I feel worse after eating, so the conventional wisdom to just snack and eat small meals regularly is a total bust.

We’ve had to tell quite a few people already because we need to sell our house and move.  We have a two bedroom house, with the bedrooms on different floors.  Currently L’s crib is in a “nook” in the master bedroom, but there’s no way we can fit three babies in our bedroom (nor do I want them all waking each other up) and I don’t want any little ones sleeping on a different floor.  And, just in general, the house is very small for 2 adults, 3 little ones, 3 dogs, a cat and all the extra hands I hope to have helping in the first few months. Obviously we could make it work if we absolutely had to, but we are fortunate to be in a position where we do not.  We are scrambling to get our house ready for sale as the market is actually pretty hot right now in our neighborhood and we should be able to sell in short order.  Our goal is to have it on the market in 2 weeks, which means TFO has been busting his butt every night (and all day today) while I’ll watch L, try not to puke and collapse on the couch at the end of the day.  It’s a little insane, but exciting too!