Meeting Our OB

Yesterday was very exciting, we met our OB for the first time.  He will be our doctor for the next 6 months and if all goes as planned, will deliver our babies.  He is part of a practice so it's kind of whoever is on duty at the time.  It was an exciting appoint because for the first time, we had an appointment where we talked about the babies actually coming into the world.  It was it all so real in an amazingly wonderful way.

Our doctor is an MFM which stands for maternal fetal medicine.  It is basically a specialized OB for high risk pregnancies.  This pregnancy is considered a high risk pregnancy because I am of advanced maternal age (I hate this phrase), anyone over 35 falls into that category, because I have multiples, because I am on blood thinners and because of the complications early on in the pregnancy.

About 2 minutes into meeting him, I knew he was the doctor for me.  He had actually delivered my friends twins so I knew he was capable, I just also really liked his personality.  He knew of my IF journey and he reassured me that since we had worked so hard to get where we were that he would do everything to ensure these babies are safe and healthy and so am I.

He made a comment about how I probably know a lot already about being pregnant and I said I really didn't.  The last 5 1/2 years I have spent researching getting pregnant, I have no idea what I am doing from this point on.  He assured me that even though I don't know what I am doing, my does and it is doing everything it can so that the babies are getting what they need.

He did an ultrasound and this part was very exciting.  It was an ultrasound from on top of my stomach, no more vaginal ultrasounds!!!! This alone is a reason to celebrate.  He said everything looked good and the babies looked great.  He didn't see anything to be concerned about.  He also did a pap smear because it had been two years since I had one done.  Thankfully he skipped the breast exam because mine are so painful right now.

We talked at length about a vaginal birth compared to a C-section.  He would prefer a vaginal birth which I would too.  He gave me a 60% chance of having one which is what all people carrying twins gets.  In order to deliver vaginally, the baby further down needs to be face down and needs to be bigger than the top baby.  We will figure this out much later, but he did tell me that baby B is the baby that is further down so that's the one to watch.  The other exciting news it that he calculated my due date.  For twins, they won't let you go past 38 weeks, so if my water doesn't break before that, they will induce on Dec 21st (my birthday) for a delivery on Dec 22nd.  I am so excited about that.  Our nephew was born on Dec 24th so lots of Christmas babies in this family.  I am also excited that I will deliver at Sharp hospital, which is the same hospital I was born at.

He then talked about what the next 6 months will be like.  He started by saying I come in every month for ultrasounds and an OB check.  I freaked out when he said this.  I am so used to weekly appointments that monthly sounded like an eternity.  He then said he would do an appointment very two weeks for me to help ease the anxiety and keep my calm.  This really did help and reassure my choice in doctors.

Here is the quick recap of my notes and the questions I had for him:

• My RE had a weaning protocol for baby aspirin but he wants me to stay on them the entire pregnancy
• for the next two weeks, I can walk and drive, then after that I can do yoga and swim.  After 68 days of bedrest, this was music to my ears.
• He wants me eating 2500 calories a day.  I am nowhere near that because food is super gross right now.  I'm working on it though..
• For nausea, he wants me to try taking B6
• I asked if there was anything I could do for breast tenderness and he said not really.  The good news though is that the height of the pain is around 11 weeks and that is less than a week away so it's almost over.
• I asked what books he recommended and he like What to Expect and the Mayo Clinic Guide

We finished the appointment by talking about all the testing to be done.  We walked next door to the lab and I gave about 10 vials of blood.  This was called first trimester screening.  We will get the results at our next appointment which is June 22nd.

Thanks for Reading,

HEATHER

10 Week Update - Graduation Day

Our graduation gift

Today was a very exciting day for us. Today was our graduation day.  That means that we have graduated from our RE and we are now patients of our perinatologist-OB.  This is another huge milestone and a giant accomplishment.  I still feel like I am dreaming.  It is so hard to grasp the fact that we are where we are.  We have dreamed and prayed for this for so long and have had so many failures along the way, I seriously doubted we would actually make it here.  It was so amazing to hear the words that we graduated.  Our doctor wished us the best of luck and shook our hands.  The rest of the staff have really come to follow our journey right alongside of us.  As soon as we get our ultrasound done, we exit the room and I excitedly show off our little ones.  Today we were greeted with a graduation gift and a very sweet card that everyone signed.  I hugged everyone.  I will miss our clinic so much.  They really have been right by my side every step of the way.

Baby B

Baby A

Today the babies are about 1 1/2" big and about the size of a kumquat.  Both babies measured right on schedule.  Baby A measured 9 weeks and 6 days and had a heart rate of 176.  Baby B measured 10 weeks and 1 day and also had a heart rate of 176.  Baby A was moving a bit, but Baby B was seriously rocking out.  That baby was moving its arms like crazy and was spinning around too.  It is so amazing to actually see them moving and finally see them as little beings.  They are much more human-like and less on the blob side.  They have arms and legs now and little noses.  Not sure when we'll find out the gender yet so they are still just Baby A and Baby B.  Look how cute they are!  

Today's lunch

As for me, I am hanging in there.  Still on limited activity.  I am in full swing of being pregnant and the side effects are really starting to kick in.  Everything smells to me, all food is pretty gross and everything makes me gag.  At the end of the day, I am so excited that the babies are doing well that I am trying my best not to complain about my symptoms.  

Thanks for Reading,

HEATHER

Current Medication List

A few people have asked what my current protocol is so I thought I would post it here.  Everything listed is to assist in maintaining the pregnancy. Levothyroxine is to regulate my thyroid.  Lovenox is a blood thinner to prevent miscarriage.  The addition of extra supplements to my prenatal is because I am a vegetarian and those vitamins I tend to run low on.

Medications:
levothyroxine 50mcg - 1 a day
estradiol 2 mg - 3 a day
oral progesterone 100mg - 3 a day
progesterone suppositories 400mg - 2 a day
lovenox - 1 a day

Supplements:
Thorne basic prenatal - 3 a day
algae omega 715mg omega 3 - 3 a day
baby aspirin - 1 a day
vitamin D 5,000 iu - 2 a day
vitamin C 500mg - 1 a day
iron 15mc - 2 a day
l-5-mthf 1,000mg - 1 a day
CoQ10 200mg - 1 a day

The good news is I received the go ahead to start weaning myself off of some the meds that I'm on because the placenta has been formed and my doctor has determined that some are no longer necessary. This is amazing news. I am so excited to say goodbye to progesterone and lovenox :)  Because I have been on these for so long, I can't just quit overnight, it would be too much of a shock to the babies, so I am doing a slow weaning process.  Here is my weaning schedule:

• Switch lovenox to every other day for 1 more week
• Switch oral progesterone to 2 a day this week, then 1 a day next week
• Switch estradiol to  2 a day this week, then 1 a day next week
• Continue progesterone suppositories 400 mg 2 a day for this  week, then 200 mg 2 a day next week,  then 200 at night only the following next week
• Continue baby aspirin for 3 weeks then discontinue

The more hurdles and obstacles we pass and overcome, the more real this pregnancy gets.  I'm still on bedrest for precautionary purposes but it's pretty exciting to make it this far and know that my body is starting to take care of the babies and I no longer need these medications.  We are still on weekly ultrasound appointments so I will have another update on Thursday.

Thanks for Reading,

HEATHER

9 Week Update

According to my pregnancy app Nurture, the babies are the size of green olives.  The main development between last week and this week is that they started to grow arms and legs.  Finally the babies are starting to look more human and less blobbish.

Baby A is on the left with the head on the left, Baby B is on the right
and was moving too much for a good photo today
so that's why it is all blurry

Today we went in for another ultrasound scan and measurements.  Bath babies measured perfect!  They both measured 9 weeks and 1 day which is right on schedule.  They both also had heart beats over 170 which is also wonderful news.  The most exciting part is that we could really see the babies moving today.  Baby A is now referred to as my little dancer.  We don't know the gender yet, but for some reason I want to refer to her as a girl.  Anyways, you could see her head shaking and her arms moving up and down.  The first time the doctor said she was wiggling, the truth is I couldn't see it.  But then later on he went back and she was moving a ton.  It was so amazing to see.  And now for Baby B, otherwise known as my yogi.  This one was head down with feet up in the air doing a headstand.  The doctor again said this one was moving but I never was able to see it.  They are starting to take on a more human form, but there is still a lot of blob action going on.

As for me, I'm doing OK.  I am on day 6 of no bleeding.  That is a huge sigh of relief.  The cramping is still there though.  Cramping is normal, except that mine only comes on when I stand up and it comes on really strong.  Because of this, he isn't comfortable letting me off bed rest, so he ordered bed rest for two more weeks and then told us to discuss it with our high risk pregnancy doctor and see what she says.  So two more weeks of bed rest for me.  But really, all that matters is that the babies are doing good.

Seeing movement on the screen is amazing.  Then not only can you see the heartbeat, but you can hear it too.  It is truly amazing and we both feel so very blessed to make it here.

Thanks for Reading,
HEATHER

8 Week Update

The week 8 doctor's appointment is not as critical as the previous ones have been.  At this appointment we just checked the heart rates again and took measurements to make sure the babies were still growing.

Baby A

Baby A measured 7 weeks and 6 days.  There is no reason to be concerned, when they are this small, the margin of error on the ultrasound machine is 4 days.  The baby was super active.  You could actually see it moving on the monitor.  The heart rate was 185. I asked if it was normal to go from 150 to 180.  His response was, just like if we go to the gym, our heart rate goes up.  Your baby is moving a lot so it's normal to have a higher heart rate.  He said anything between 120 and 220 is considered in normal range.  He said it was great news to have the baby moving but that it made it tough to get good photos.

Baby B was also a mover and a shaker and having a good time.  Its heart rate was also above 180 although I wasn't able to see it move on the monitor.  I was able to clearly see the head and the yolk sac which was pretty exciting.  This was the first time it looked more identifiable to me and less blob like.  Baby B also measured 7 weeks and 6 days, right on schedule.   You can still see how irregular the gestational sac is.  He again said that he was concerned about it. The good news though is that both gestational sacs are starting to be about the same size.  Up until now, Baby B was twice as big and that was also cause for concern.  So again we get good news and bad news at each appointment.  At this point though, we are so excited and feel so blessed that the babies keep growing and have strong hearts, that the most important thing and about the only thing we can test at this point.

Baby B

As for me, I'm still on bed rest and still having bleeding issues even though it has diminished a lot.  I still have some serious cramping that again the doctor says he is concerned about, so bed rest continues.  Right now I'm on day 58 of bed rest.  Its getting old but trying to keep everything in perspective and not complain too much.  

Thanks for Reading,

HEATHER

7 Week Update

This week was our 7 week check.  We were extremely nervous going into this appointment. With all the complications I've had, we just weren't confident in the outcome of today.  The point of the appointment was this was going to be the first appointment where we would be able to measure our progress and make sure that everything is developing as it should be and on schedule and healthy.

In the waiting room, trying to pass the time
and not think about how nervous we were.

We brought our good luck egg with us and I wore a new bracelet my Mom bought me for good luck.  I also had on my fertility charm necklace.  With crazy anxiety we headed off to our appointment.  Luckily we never wait too long at our clinic, but still the time passed so slowly.




I am very happy to report that we received wonderful news, every number came in perfect!  And drumroll please......, there are lots of numbers to report because we have two babies, we are having twins!!!!!!!!!!!!!!!!!!!!!!!

Meet our babies

Baby A measured 7 weeks exactly, right on schedule.  The heart rate was 153 bpm.  Baby B measured 7 weeks and 1 day and had a heart rate of 146 bpm.  These numbers are great.  At this stage we were looking for anything over 120 bpm to show a strong heart so we were just elated with our numbers.  The ultrasound machine can actually play the heart rate so we heard it for the first time.  It was all I could do to hold back the tears but I just didn't want to miss a thing he was saying.  It was such a blessing to finally hear our little miracles and see that they were both doing well.

Now for the other news, I'm still bleeding a lot but the good news is that he thinks he found the source of it.  I have a hairline tear in my cervix.  He believes that it is the result of the large amount of progesterone that I am on and exasperated by the blood thinners.  I still have the blood clot in my uterus too, but he really thinks the bleed is from the cervix.  So I still have to remain on bed rest.  He said that he will let me off of bed rest when I don't bleed for 5 days in a row but he cautioned that this probably won't happen until I'm off the progesterone and that isn't happening for another month.  So he told me to get comfy on the couch.

Our other reason to remain cautious is the irregular shape of Baby B's (on the right) gestational sac.  The gestational sac should be circular, just like Baby A (on the left).  This irregular shape is cause for concern.  I asked him when we will be able to be a little more confident in Baby B and his response was that if the babies make it to week 9, we can feel much better that they will make it to the end.

So while it is too early to really celebrate, we are over the moon that we passed the first big hurdle and at this point, both babies are doing great.  I will continue to see the doctor every week and get new measurements to track their growth.  According to my pregnancy app, that babies aren't really human looking yet and still have tails.  It showed a picture of a 7 week old and it looks more lizard like to me.  They are about 1/2" big and the size of blueberries.  Here's hoping and praying that our little blueberries keep growing and keep fighting!

Thanks for Reading,
HEATHER