May 25, 2014

The End is in Sight!

We're just a week away from the absolute pregnancy finish line and I have felt the need to write down what I remember from this pregnancy.

October (weeks 6-9):

  • We're most assuredly expecting! I knew pretty early that I was pregnant- before the tests were accurate. I felt a little sicker, more tired and generally more blah. 
  • Because Miss Olivia was a spontaneous preterm baby, we had been told to get in as soon as possible after finding out we were expecting again because I would likely need to start progesterone shots to keep the preterm labor things away. I tried! 

November (weeks 10-14):

  • Found out at our first appointment we're having twins! Craig spotted two little heads as soon as Dr. Cloward put the ultrasound sensor on my stomach. I told him he was nuts, but nope! He cried, I laughed. I think that was an appropriate set of responses :) 
  • Visited grandma & grandpa Nasson in Tacoma
  • Monochorionic-diamnionic twins established. (Identical twins from one egg, sharing a placenta). By the way, identical twins-which come from the same egg- have to be the same sex. We've been asked a couple times... just think about it. 
  • Our insurance will not cover progesterone shots for twins because it's "not proven" with twins, just singletons. Thanks a lot! 
  • US technician suspected girls...

December (weeks 15-18):

  • Started seeing the perinatologists at UVRMC every other week for US growth scans
  • Learned all about the differences between the various varieties of twins, risks such as TTTS and so much more
  • Found out we're having identical girls!
  • Picked a different insurance plan...
January (weeks 16-19):
  • Continued seeing the peri's and Dr. Cloward frequently. Lots of US visits!
  • Gender confirmed again
  • Heart spots/calcifications (echogentic foci) spotted on the babies hearts. This is a "soft marker" for down syndrome. Naturally, I went a little nuts inside. Everything else looking good on the scans, including size and fluid levels. 
February (weeks 20-23):
  • Heart foci still there but babies both growing well and looking good! We were strongly encouraged to the the quad screening for birth defects as twins carry a higher risk and we had the soft marker. Our results came back negative and very low. Helped me calm down a tiny bit. 
  • No signs of Twin-to-Twin Transfusion Syndrome (TTTS)! With mono-di twins, there is a risk of one twin getting a greater share of the nutrients, oxygen and blood supply. Essentially, this turns one twin into a "donor" and one into a "recipient." There are not a lot of options available for treating TTTS and the options available don't have the greatest chance of both twins surviving. 

March (weeks 24-28):
  • We hit our high deductible early this month! Glad we changed our plan ;) 
  • More importantly, we hit the "threshold of viability" this month! Goal 1: check! 
  • Preterm Labor (PTL) issues started. Contractions, pelvic pressure... Very similar to Olivia. 
  • Discussed cutting hours at work, staying down more and hiring someone to do some cleaning in the house. 

April (weeks 29-32):
  • Hit goal #2- 29 weeks! Twins who make it to 29 weeks gestation have a 70%+ chance of survival!
  • After some debating, adjusted activity levels at home and work and the recommendation of Dr. Cloward, I finished teaching for the year the Friday before spring break. I love my job but the PTL and threat of super early babies made the choice for me. 
  • Hit goal #3- 32 weeks! Risk of long-term issues even smaller and survival rate is extremely good.
  • "Regular" visits to Labor & Delivery started. UTIs turing into kidney infections requiring antibiotic shots, extreme gastroenteritis requiring IV rehydration, many rounds of terbutaline to try to stop the contractions, Fetal Fibronectin tests (fFn- I'm not going into details here but they are MOST unpleasant swabs of the cervix to check the likelihood of delivering within 14 days of the test) and a couple rounds of steroid injections to help the babies lungs develop since the contractions didn't stop. Dilation started, though. 
  • We've passed the "safe" point for TTTS!! At this point, if the babies started showing signs of TTTS or IUGR (inter-uterine growth restriction), they would be very closely monitored and then born if things got scary. 
  • We started getting twice-weekly Non-Stress Tests (NSTs) at Maternal-Fetal Medicine and are only in for a growth scan once a month and a fluid and general quick scan once a month. Things are starting to get real in here! 

May (weeks 33-37):
  • Spent a LOT of time at the hospital in Labor and Delivery. 5 or 6 times as of the 25th when I'm typing this. 
  • As soon as we hit 34 weeks, all attempts to stop labor have ceased. No more terbutaline, no fFn tests... we're just allowed to let things do their thing now. 
  • For the last two weeks, I've been dilated to a 4+ and 80% effaced. 
  • Sleep in long stretches has become scarce. Between needing to go potty several times a night, contractions and general discomfort (and the occasional excruciating shooting pain), no one is really surprised by the lack of sleep. 
  • Because of the progress that had been made, mom decided to come for a week. We REALLY thought the babies would come during her short trip. Nope. We did get a LOT of projects done and are pretty darn ready for the babies to come now but, of course, this means she won't have been here for ANY of our 4 babies births. There was still some question about her actually being able to BE in the room when they were born. Twins are born in the L&D OR because of risk of complications and need for an emergency C-Section. Officially, only husbands are allowed in but sometimes a second person can be there, too. 
  • I've been admitted once already (May 17th-May 18th) because of regular, active and strong contractions- between 1 and 2 minutes apart. They stopped in the middle of the night so we were sent home the next morning since I was only 35 weeks. I do wonder if now at 36 + we'd go ahead and help things along a bit if my Dr. was on-call.
  • I've been concerned about the size/weight of the babies since the beginning. They've been on their own growth curve and been consistent but small babies are scary. Until this week, our babies were, at their biggest, 4 pounds, 1 ounce and 3 pounds, 11 ounces. This week (35 weeks), they were measuring 5 pounds, 3 ounces and 5 pounds 7 ounces. Baby A was head down still and engaged (-1, where she's been for a while) and baby B had decided to turn herself transverse.
  • We had a regular OB visit the same day and Dr. Cloward was awesome, as usual, but was then very clear that even if A was head down, some of the partners in the practice might not be okay with a vaginal birth and a c-section would be possible.  I understand not wanting to ask someone to do something they're not comfortable or experienced with (turning a second twin) so I'm just keeping my fingers crossed she's on call or we make it to our induction on the 2nd. 
  • I had an NST a few days later where the nurse saw baby B had turned head down again. Thank goodness! 
  • We have an induction date set! June 2nd. I will be 37 weeks and 2 days, unless, of course, the babies decide to come sooner on their own. :)