34 Weeks

I've been meaning to write this post for some time now. Although I'm 35 + 4 now, hitting 34 weeks was a huge milestone for me. 34 weeks is the most pregnant I've ever been. On Tuesday, September 3rd, 2013 I delivered my twins girls at exactly 34 weeks. 

As this milestone approached I felt myself getting more and more anxious. The crib still wasn't painted or assembled, the dresser was still in the garage, and all of the wall art was sitting in the "baby's room" on the floor. On top of that, I was planning and crafting for the girls' birthday party. I tried to explain to W how nervous this was all making me, and eventually he got the idea. By my 34 week date we had a crib assembled with bedding, a dresser in the room, and most of the wall art up. I was feeling so much better about things. 

Even though I know most babies don't come that early, I was still super anxious about hitting (and crossing) the 34 week mark. 

Tomorrow I will see my OB to get instructions on my switch from Lovenox to Heparin at 36 weeks. I never made it to that point last pregnancy, and it's a huge step towards (hopefully) having my VBAC. The lovenox was the reason I had to be under general anesthesia for the birth of the girls. I started weekly appointment and will have another ultrasound next week. 

To me, 34 weeks was a huge milestone that needed to be celebrated (despite all of the anxiety it came with). I'm so grateful every day to still be pregnant, even though it's not always the most glamorous thing. It's funny I was worried about having a preemie for so long and now that I'm almost past that point I'm hoping I don't have to worry about going a lot past my due date. It's amazing how your perspective can change so quickly. 

Stuck

Well, the good news is I'm done testing my blood sugar levels four times a day. This is a huge relief to me and I finally feel like I can eat when I'm hungry again. My heartburn has already been better because I'm not trying to stuff myself full for two hours. 

My fasting levels had started to creep up (no idea why) but the Dr was still okay with my levels. She said she'd like to see me test a little here and there before my next appointment in two weeks. 

Since the in-laws and my parents are all out of town I had to bring the girls with me to my appointment. They have two offices and it was my first time going to this new office. Well, it was insanely small and had like one seat in the back corner available for me and my giant double stroller. When a woman came into the waiting room from the office with her walker and I got called back at the same time, it was a joke. There was literally NO room to pass by or go anywhere. I felt like such a spectacle. As if I don't hear "you have your hands full" enough times every day already!

The reason I scheduled with this office is because when I asked which Dr I was seeing (over the phone during a conversation with a nurse about insurance coverage), I was told it was a NP. Seriously?! Why the heck would they have someone see me who doesn't stand a chance of delivering my baby when I've only met 2/5 Drs in the practice?! I wanted to see the same Dr because we had discussed me testing for two weeks and then being done as long as everything looked good. If I saw someone else and they told me otherwise, I think I would have lost it. I never saw NP's at my old office. I'm fine with it for my general healthcare, but not when it comes to delivering a baby and when I haven't met so many of the Drs still. 

The Dr almost seemed annoyed that I asked to see her again. She made it very clear to me that she documents things well and that I didn't need to meet with her. Any other Dr could read her notes and know what was going on. Well, thanks lady. Nice to see you too.

I'm really struggling. I feel like I've done a lot of complaining this pregnancy about my providers, but I'm just not happy. I thought changing to this practice was the best thing for me. I felt lucky when I was able to get in despite them not accepting new patients. The thing is, I love them on paper. Their statistics are amazing! The problem? I've now met two providers and I'm not impressed with the level and quality of care I'm receiving. 

So, yesterday I called my old Dr's office. Since I've complained to so many people they keep saying, "Why don't you just go back to your old Dr?" So, I called. I spoke with a nurse who transferred me to the nurse manager. The nurse manager was very matter of fact and said that because I transferred my care, I can no longer go back. I asked if I could even go back after this baby and they said we'll see. They said they inform their patients of this because they are so strict about it. 

The problem is, no one ever even spoke to me about transferring. Originally, I just wanted to meet with the new practice and see if I wanted to transfer. Since the nurse manager at the new office got me in she handled everything with the old office. She cancelled all of my appointments (when I honestly wasn't comfortable with it) and "transferred my care". My old office said it's too late in my pregnancy to switch and it's not a possibility. They also told me I was going to have a hard time finding anyone else to take me at this point in my pregnancy.  

I'm not going to lie. I got off the phone and cried. I know the only thing I can do moving forward is make the best of the situation I got myself into. It's just hard to feel so unhappy with my new Drs. I'm 99% sure this is my last pregnancy and I think that's a big part of it. I really wanted everything to be perfect, despite knowing that's not really being possible. I wanted to have a great provider that not only had great statistics, but also knew me and had a personal relationship with me. Since it is such a big practice and I switched so late I realize those are unrealistic expectations. It doesn't change the way I feel though. My old office also had 5 Dr's but all of them knew me and my history. I didn't have to bring my twins with me to remind them that they are a huge part of my life (and make some things more complicated, like testing blood sugar levels four times a day). I'm feeling like they're so conservative and impersonal, and it sucks. 

I've debated calling the old office back and really explaining things to the nurse, but I don't think that will make a difference. I know I need to make the best of things, but it doesn't change my feelings at the moment. Sorry for the negativity, I'm just really struggling. 

Two Weeks

I realized that I never updated about my last OB appointment. Overall, it went very well. The new Dr that I met listened well, addressed my concerns, and compromised with me about things. The only negative was that she didn't introduce herself when she came in the room. It was just a woman in scrubs without a name tag and I was left wondering who it was for the first few minutes. I eventually assumed it was her, but the conversation probably would have gone a lot smoother had she introduced herself to me. 

She said it was my choice to not take the 3 hr glucose test. Even though I had been keeping track of my blood sugar levels for the past week, it wasn't the four times a day they were looking for. She wanted me to continue to take them for the following two weeks, four times and day, and two hours after meals instead of the one I had been doing. As long as my levels were fine (as she suspected they would be looking at where they had been for the prior week) I'd be done with it. If 50% or more were elevated, we would have to discuss things further. 

It's been going well overall. My levels have been great but I've also been super strict about what I've been eating. To be perfectly honest, I just want to be done with it. I hate doing it four times a day. I hate forcing myself to eat a bigger meal than I would otherwise because I know I won't be able to eat again for two hours. All of my numbers have been under 105 after meals and I had one high fasting number (102) because I had a milkshake the night before. They like to see you under 130 two hours after meals and under 100 fasting. 

I go back this Friday and hope I'll be done with it then.

Other than that, things have been going well. I'm 32 weeks pregnant already and can't believe how fast time is flying. The nursery is painted and the ceiling fan and light have been installed. I wanted W to paint the crib since we got it used and it didn't match the newly painted white dresser. It's been slow going and I'm so ready to see it all come together. I've been busy buying stuff for the walls and crafting tassels to string below the wall art. To be honest, I'm feeling super impatient but trying not to be a pain.

Instead I've started focusing on planning Lucy and Clara's second birthday party. I can't believe they're turning two. We are celebrating with a Sesame Street themed party and I'm trying to make some decorations and games. I'm hoping to make pom pom characters, a bow wreath, some utensil holders, centerpieces for flowers, a game or two, and some simple favors. I've started working on things but haven't made a ton of progress.  

I've been feeling pretty good overall. I'm not sleeping great because I'm up a lot to pee. I've also found that having a baby head down means a lot more pressure on the bladder. Even though I had two babies in my belly last time I feel like I have to pee more often this time and need is definitely more urgent at times. I get tired easily but still want to play and do things with the girls. It's been hard feeling like I'm not as great of a mom, but I'm doing the best job that I can and I don't hear them complaining, lol. We use the stroller a lot when we're out because I just can't carry them very far anymore. I'm already carrying a baby! 

We went for an elective ultrasound last weekend and the girls loved seeing the baby on the tv screen. Lucy was so excited the whole time while Clara bounced between being excited and eating grapes or playing with the window blinds. It was so fun to see baby girl. She spent a lot of time with her hands in front of her face but also smiled and grimaced a few times. That's another way being pregnant with only one baby is different. They really don't give you many ultrasounds. 

The other biggest difference I've noticed is the amount of movement. I think because the girls were so crammed in there I didn't feel as much. I feel so much crazy movement from this little girl. She kicks with both feet at the same time super hard, rolls all around, and get hiccups often. The movements just feel more exaggerated than last time. I'm also better able to tell what I'm feeling. 

Viability!!!

Last Saturday I hit 24 weeks in my pregnancy. It's so amazing how fast the time has gone, and it's hard to believe how soon baby girl #3 is going to be here.

The newest nursery in our house still looks like a guest room. It's painted blue and has a full sized bed and large desk. I've been searching for a nice crib on Craigslist, but nothing really has come up. W's parents have a dresser we can paint and also use as a changing table. I think I've picked a theme/colors for the room, but sometimes it's hard to tell online. I ordered a crib skirt and am hoping it helps us with the rest of the room. It still hasn't shipped though, so progress isn't exactly happening yet. I know we have all summer, but I also feel like we were so much more ready last time. 

I'm feeling lots of movement and baby girl has even gotten the hiccups a few times. I love feeling those little movements. 

I'm still experiencing nausea and food aversion. Eating can be challenging. We spent last weekend in NJ for a bridal shower and eating was the most difficult part. I don't want just anything, so it was tough. Otherwise, we had a great time with family. It was a nice chance to re-set some of the patterns the girls seemed to be stuck in, like waking up before 6:30 and not eating well. Since getting back they've been napping better, sleeping in later, and inhaling all the food we give them.

I had my first appointment with my new OB yesterday. Unfortunately, the wait times weren't any better and I spent 45 minutes in the waiting room before being called back. Once I got called back I had to answer what felt like a million questions. It took quite a while before I got to see the dr. The dr was great! I learned this practice has a cesarean rate somewhere between 6 and 8% and a VBAC success rate above 80%. All of these things sounded great to me. The dr said my platelets were a bit low with my last round of blood work so they wanted to draw more blood that day and continue to monitor that. I was informed of the risks (and benefits) of a VBAC and signed a consent form. I then learned that this little baby is breech. I know I have a ton of time to get her to flip, but I didn't like hearing that. I feel like had it been my old practice they would have had a "told you so" attitude about it all. They would have been trying to schedule my c section then. Instead, this new dr stressed that we have tons of time to get baby to move and offered me exercises that can help. She also said there are things that can be done around 36 week to help if baby hasn't flipped by then. The chiropractor I see is trained in the Webster technique and is able to get a lot of babies to flip. I texted her and told her we better make this happen!

As I was leaving the office I was tempted to take a picture of their bulletin board. It was full of things that totally appeal to me: my prenantal yoga class fliers, breastfeeding help and support as well as a breastfeeding cafe, doula information, reiki and massage, chiropractic care, etc. It was like a breath of fresh air!

In other news we have hired a doula. She came to the house last week to meet with us and talk and I loved her. I actually talked to her when I was having difficulty with breastfeeding as she is a LLL leader locally. She's actually the one who referred me to the really great IBCLC that identified Lucy's problem and helped me work through it. Jen will come again next week for our first prenatal appointment. I'm really excited about having someone to help and support me through this process.

I've gained a total of 10 pounds now but am at the weight I was when I got pregnant with the girls. It's crazy to compare the pictures from last time to this time. Two babies make a huge difference! My belly is definitely obvious and I feel like people give me looks when I'm out with my toddler twins and big belly. I keep hearing about how I must have my hands full. I have developed diastasis recti of my upper abdominals, but my chiropractor is confident she can help me fix this once the baby gets here. I think all of the lifting of the girls has contributed to that since I didn't have it last time.

I'm feeling lots of movements, and learning about how the baby is positioned helps to try to figure out what I'm feeling. W has been able to feel a few movements, but none are huge yet. I'm craving salad like crazy as well as iced tea. I'm really trying to pair protein with most meals in an attempt to avoid gestational diabetes, but we'll see in 4 weeks when I take my test.

I can't believe we're already at 24 weeks! I'm hoping we can start to make some progress with the nursery so I can feel a little more confident about things. I'm so glad my appointment went so well yesterday, but baby girl better get on the move and start flipping! 

Interviewing Another OB: The Search Continues

On Thursday W and I met with another VBAC friendly OB in the Syracuse area. I was given his name through the ICAN group and was looking forward to meeting with someone else and getting another opinion. I was also excited that this practice offered appointments later in the day so that W could come with me. 

We unfortunately arrived a bit late due to me not being ready when W got home and encountering a bunch of traffic. The nurse was super friendly and nice and told me to stop apologizing for being late. 

She took a urine sample, my weight and blood pressure, and then brought us to a room and told me to undress completely and put a gown on. Being that I was super late for my appointment I didn't argue with her. I knew I was only there to talk with the Dr, so I changed and waited for him. 

When he came in my first impressions were fine. We joked about me wearing the gown and he offered to let me change, but I said whatever. In hindsight I really wish I had changed back into my own clothes. 

The Dr. spent quite a bit of time with us. He asked about my history and why I wanted to talk with him. In the end, I think he got the complete wrong impression of me and my reasons to want to attempt a VBAC. He said I needed to get over the emotional aspects and that lawsuits were so prevalent in NY state that he wouldn't tell me anything different from my current provider. He said, "The only person who really knows whether your VBAC is successful is your lawyer, two years later." He talked negatively about ICAN and told me I need to "stop talking to groups of women and watching movies." He acted like my blood clotting issues were a huge deal and like they'd be a complication in whether I'd be successful or not. I'm pretty sure he thought the reasons I want a VBAC is so that I can say I had a natural birth. That's not the reason. It has nothing to do with my ego. He basically told me to "get over" the negative experience I had last time. 

We left the appointment both feeling disappointed. I think he made a few valid points and got me thinking some, but I would never transfer my care to him. I'm quite sure he didn't want me as his patient either. I guess the feelings were mutual.  

To reiterate, I'm not opposed to a c section if I have to have one for my or my babies safety. I'm just opposed to the idea of an unnecessary c section because I reach an arbitrary date. 

Doppler Ultrasound

One of the things Dr. B recommends in the first trimester is weekly ultrasounds. This includes looking at doppler blood flow of the uterine artery. When I saw Dr. B at 7 weeks he did my ultrasound including the doppler measurements. I asked about his findings and he said he noted reduced blood flow to my uterus, but great blood flow between my uterus and the baby. He looked at my chart and said he wasn't going to change my current dosage of Lovenox since I'm already taking it twice a day. Last time I remember having to increase my Lovenox dosage and also using Viagra vaginally to help increase blood flow. 

Getting this done at Dr. B's office is fine and easy but getting it done outside has been a bit of a headache. At 8 weeks I went to my old fertility clinic for my ultrasound. The nurse practitioner came in and noted it on the ultrasound. She said, "We don't normally do that." When I asked why she said something about increased risk and exposure to the baby. She said she could get my old RE and see if he was able to do it, but I told her to just do the ultrasound. I didn't want to make a big deal out of it. When she was finished she said, "The hospital may be better able to accommodate you."  

At 8 1/2 weeks I had my first ob appointment that included an ultrasound. I asked the ultrasound technician if she could do the doppler. She also said it wasn't something that's normally done this early in a pregnancy. 

When I met with one of the Drs in my ob practice I told him Dr. B was requesting this information in addition to a weekly ultrasound. He was great about working with Dr. B and his suggestions and said he was willing to follow any of them. He asked his nurse about the ultrasound, she asked the ultrasound technician, and they all agreed I'd have to go to the hospital to get it done. With my pregnancy with my twins I had a few ultrasounds at the hospital so it didn't seem like a big deal. The nurse told me I would hear from her and I left. 

The following day she called and told me she needed to call Dr. B's office to get clarification for what she was requesting. The day after that she called to tell me I had an appointment scheduled for the next week at the hospital. 

Yesterday I had that appointment. Going to the hospital made it so much more complicated. I had to register (which included a ridiculous amount of paperwork) and my elevator confusion, sitting in some weird room without any kind of receptionist for at least 10 minutes, and then going to a room with two technicians. They were both somewhat confused by the script. They also commented that it was very early on to do doppler readings. I tried to explain to them to the best of my knowledge what Dr. B measured and why. Then they started. It felt like it took them forever. They did first check the baby so at least I saw that quick before they took their twenty plus minutes to do the doppler readings. All I could think was about those comments about it being done so early and the extra exposure. The technicians were so fascinated by the doppler as it is so early in my pregnancy and kept commenting on how "pretty" it was.  I think I made their days as it was definitely something out of the ordinary for them. 

From there I was sent to my doctors office. I called and asked the nurses if it was totally necessary and she made me feel like it was. The wait times are super long at my office and I really didn't feel like sitting there to find nothing out. I knew it was pretty much pointless. Another hour later I left the office. The dr basically agreed it was pointless since he didn't really know what the doppler measurements meant but did say everything was looking great and the baby was measuring right on target. 

Next week I'm supposed to go back to Dr. B's office to have an ultrasound. The week after that I'm supposed to return to the hospital. I'm honestly debating canceling it because of what a pain it was. I guess I'll just wait and see how I feel when the time comes but maybe asking Dr. B about all of the "it's so early for doppler" comments to help ease my mind may help too. It's quite apparent that the way Dr. B thinks and operates is very different from most doctors. 

Updates

The past few weeks have been a whirlwind. Due to having shared my blog with friends and family, I've been hesitant to share what's been going on. But, I've decided I need to get this off my chest. 

I had my follow up appointment with my ob/gyn on January 7th. They did an ultrasound and there was a large cyst on my left ovary (the ovary without a tube). Having had a positive ovulation test the week prior I assumed it was a corpus luteum cyst from ovulation. The ultrasound technician said it was hard to tell what kind of cyst she was looking at, but if I thought I had ovulated it was possible it was a corpus luteum cyst. I talked with my dr after the ultrasound. I was meeting with him because my cycle the prior month had been 62 days and I felt like a hormonal nightmare. He said he didn't feel like I needed to do anything specific, but he was happy to offer progesterone to help regulate my cycles. I told him that I had started taking Pregnitude (a myo-inositol and folic acid supplement) I had leftover from my IVF cycle with Lucy and Clara and felt like it was really helping with my moods and to shorten my cycles. 

I left the appointment feeling positive. I was feeling like my moods were better, my cycles were shortening, and I was tuned in enough to my body to have an idea of what was going on. Based on my ovulation test and ultrasound it seemed I ovulated the week prior on CD 16. That was way better than the prior month. Maybe the myo-inositol was helping. 

The next day I started to feel like taking another ovulation test was worth taking. Having been clued into my body and how I was feeling, I thought I was showing signs of ovulation. Within a minute of taking the test I had a super dark and obvious positive test. Compared to the week prior, it was a much more convincingly positive test. At one point I debated calling my drs office to find out the size of the cyst on the ultrasound. It made me wonder whether it was actually a follicle rather than a post ovulatory cyst. I never did call. 

At that point I started to feel frustrated and like I had no idea what was going on. Just the day before I had my appointment and left feeling so positive. I was frustrated my cycle was going to be longer, and who knew how many times I'd get positive ovulation tests that month. I had read that using ovulation tests with PCOS can yield inaccurate results. Was this going to happen every week? Were my cycles going to continue to be 50-60 days?

11 days later after my second round of positive ovulation tests (on January 20th) I wrote this post: 

Yesterday morning after putting the girls down I started to get myself ready since we had a play date scheduled with some friends. On a whim I took a cheapy pregnancy test. Prior to hopping in the shower I peeked at it and swore I saw a shadow of a second line.

While in the shower I talked myself down. There was no way. I knew I ovulated from the ovary without a tube. 

When I got out I took another look. There was definitely a shadow of a second line. So, like any sane person would do, I used two more tests. Both also showed a super faint second line. It was at that point that I started shaking and didn't stop for at least an hour. 

The first thing I did was to email Dr. Braverman. He said to get an HCG test done ASAP so I called my ob. They were happy to call a script in to my local hospital. 

The girls woke up and we went to our play date. It was nice to have a bit of a distraction from my racing mind. From her house I dropped the girls at home with my mom and went to the dentist. Luckily the dentist didn't take long and I was able to head over for blood work after without having to tell my mom. 

On the way home I stopped at he pharmacy to pick up my metformin and purchased some FRER pregnancy tests. I came home and took one only to see 2 lines again. 

I didn't want to tell W over the phone or text so I waited until he got home. As he was feeding the girls their afternoon snack I set up my camera and took a video while I handed him the tests. His face was absolute shock and confusion at first that quickly turned into happiness and excitement. 

I had to laugh that these were the shirts I picked out for Clara and Lucy that morning. 

Two days later I wrote this:

As I said, the first person I contacted when I discovered on Monday I was pregnant was Dr. B. He advised me to get a beta ASAP and I did that afternoon.

I called my ob's office to get the results on Tuesday. My HCG was 21 and my progesterone was 14. I had taken another FRER test that morning and the line was darker than the previous afternoon. With the positive result, my ob's office wanted me to repeat the test on Wednesday. 

I emailed Dr. B Tuesday afternoon with the results and he advised I call the office and register with their pregnancy management. I called that afternoon and talked with the receptionist. Despite telling me she'd email me the packet of info, she didn't that afternoon.

I didn't sleep well all night and finally emailed Dr. B early Wednesday morning saying I'd called but hadn't gotten the information. He replied quickly and I heard from the office shortly after. They sent me the packet of info I needed to fill out and fax or email back ASAP. 

After our Music Together class this morning (Wednesday) I headed for another blood test. From there I went somewhere to fax the paperwork. 

I got my protocol Wednesday afternoon and medications are being ordered. I will be on Lovenox, baby aspirin, neupogen, metformin, and calcium. 

I'm feeling so anxious and scared. I said it's impossible to embrace this pregnancy without getting excited and I'm too scared something will go wrong to get excited. 

Things moved quickly to get medications ordered. My second beta was 73. This was a doubling time of 25 hours. I found out my insurance needed to pre-approve the neupogen so we paid for the first vial OOP at $360 so I could get started ASAP.

A few days later I called the insurance company to find out an update on the medication. I was told it was denied because I didn't have any of the specified conditions listed for the medication. They told me I could appeal if I wanted. 

We've been forced to pay for this medication OOP. One vial lasts about three and a half days. To say I'm stressed about the price is an understatement. I'm not sure whether it's worth it to appeal to the insurance company as I've been through the process before without success. This expense is really unexpected for us.  

Things have been stressful. I've been so scared and anxious. I've had three early miscarriages. I need certain medications to sustain a pregnancy and I wasn't on them initially. We want to get excited about this amazing news, but we still are having a hard time. 

Starting the neupogen meant stopping breastfeeding. I wasn't planning to stop as suddenly, but was in the process of gradually weaning the girls. I wanted it to be more on their terms, but I stopped because it wasn't safe to continue. That's been another tough thing I've been dealing with emotionally. 

We've also found out that two sets of good friends will be moving in the next few months. 

I guess you could say we were trying to get pregnant... sort of.  We really didn't think it would happen, but said we'd be thrilled if it did. I knew my cycles were long and things weren't looking too good for it happening without assistance. We had talked about going back to Dr. B in the fall around the time the girls turned two.  

I finally scheduled an ultrasound with Dr. B for next Monday, February 9th. Based on my timing, I will be 6w3d. I was so scared to schedule anything. I'm still terrified to go all that way and receive anything but positive news. 

I've been in the early stages of pregnancy unsuccessfully more times than successfully. Twice I felt so positive and optimistic between my positive betas and ultrasounds only to get devastating news at an ultrasound appointment. I can't let myself feel that disappointment again. 

That's the hard part about all of this. I so badly wanted to be able to experience pregnancy like a normal fertile person. I'm quickly realizing that will never be the case. Someone who hasn't experienced loss can't understand the fear of it happening again. Immediately I also had to start injecting myself with medications three times a day. 

So, if you know me IRL and I haven't shared this news with you it's likely because I'm just not ready. It's nothing personal, it's just something I'm not really sharing with many people at this time. I'm hoping things will continue to progress, but I'm glad to have written it all down. I'm feeling ready to reclaim my blog as my space to voice it all. 

    

Hormones

Lately my hormones have been feeling all over the place. I've had 2 periods since the girls were born. I have no idea the length of my first cycle and my second one was 51 days long. I'm currently on day 60 with no period in sight. I feel so irritable and have little patience and I've am having issues with insomnia for the first time in my life. I am still breastfeeding and know that that can affect hormone levels. 

Recently I purchased ovulation tests to try to see what my body was doing. We're not trying to get pregnant, I just wanted to see if I was ovulating, and if so, on what day of my cycle. I never really used them consistently and always heard they aren't reliable with PCOS. I will have to agree. I didn't really take too many but I got 2 clear positives this current cycle. This tells me that my body is having LH surges but likely not ovulating= more ovarian cysts. 

I realized I needed to make an appointment to see some kind of dr, but just wasn't sure what kind. My ob? A regular endocrinologist? A reproductive endocrinologist since it's related to my reproductive health and hormones? I feel like a RE is the most appropriate person, yet most are just focused on fertility treatments and getting women pregnant. That's not my goal right now.

So, I have an appointment scheduled with my ob for next week. I emailed Dr. B last night just to get his input. He suggested taking progesterone every 3 months to get a period. I read more about progesterone to help manage PCOS and that seemed like a popular treatment. 

The thing is, I'm wondering if there are ways to restore regular cycles (ovulation) and minimize the PCOS symptoms without birth control pills. Due to blood clotting issues I was told I shouldn't ever use an estrogen based birth control because it will increase my chances of developing a blood clot. I'm currently taking 1500-2000 mg a day of Metformin, more often the 1500 since I have a hard time tolerating the full dose. I also don't want to go on birth control. We've both talked about it and we'd be fine with a spontaneous pregnancy. In fact, I'd love it if we got pregnant on our own. 

I know I have to do something. Having 50+ day cycles isn't healthy or normal and I feel like my mood and patience aren't in a great place. So, we'll see what my ob says next week and what he suggests. Has anyone else regulated their PCOS without birth control pills? Any suggestions or ideas?

33 Weeks

Today I'm 33 weeks and 1 day and I'm just so happy to be at this point. I'm so glad these babies are still cooking.

The best news of the week/month is that W accepted a job offer. We were worried about him accepting and getting time off to be home with the babies. He had been offered the job last Friday but he met with the director again yesterday to discuss taking time off. Originally, he was planning to take a month with the old company. He was going to get 2 weeks of paid vacation and then take 2 weeks without pay. We were planning and saving for that. 

He's done working at his current job at the end of next week. The new job said he could start at the very end of October. This means he's still going to get the 2 weeks paid time off from his old job, and that he will also be able to collect unemployment for his time home with the girls. It's really pretty fantastic. We are both so happy and relieved with this scenario.

The new job will be home care physical therapy. He's excited about this change as it was what he originally wanted to do. I'm so happy for him. 

In other news W's parents are leaving a week from yesterday for 2 weeks of vacation. They are going to Croatia and Italy. As our biggest sources of help and support, we are really hoping the girls hold off on making their arrival until they get home. 

I've been monitoring my blood sugar levels and they have been great. They aren't even slightly elevated so it's frustrating I have to prick my finger twice a day to test them. Flavored seltzer and sparkling water have become my new best friends. 

Babies- The should both be at least 4 pounds this week and around 17 inches long. 

Weight Gain- I'm up 25 pounds total. I really think most of the gain has been in my belly as I'm still wearing the same pants I was in the teens of this pregnancy. 

Belly- Still measuring 37 weeks. I asked my ob today about the fact that it hasn't changed in the past few weeks and he didn't seem concerned. He said this may be as big as I get. The stretch marks on my left side are reaching a little higher despite my best efforts to stay moisturized. My belly button is also about flush with the surrounding skin. The babies are still really high in my belly and up around my ribs. 

Cravings/Aversions- I have a lot of flexibility at night to indulge and my fasting blood sugar levels are always good the following morning. We made a peach pie the other night and it was absolutely amazing. I've been enjoying flavored seltzer as well and that helps to have some variety outside of plain water. I'm getting better with the meat since I don't have much of a choice, but I'm still not loving it. 

Symptoms- Not much has changed. I'm still low energy, peeing a ton, sleeping like crap, sore and tired physically, surviving nighttime heartburn, and there are still some braxton hicks. The girls are so active while I lie down and I feel little limbs rolling and moving in my belly. It's so amazing. Baby a gets the hiccups multiple times a day and one day they both had them at the same time. 

Mood- Feeling pretty good overall. I'm so happy to be to this point. There are days when I get a little bored and impatient being home, but I'm also trying to enjoy this time to myself. 

Memorable Moments- Seeing the girls on ultrasound again and seeing how big they are getting.

W getting a new job. 

Washing all of the newborn cloth diapers.

Holding and snuggling baby Car.mine and getting to see Tam.ara.

Seeing President Obama's motorcade drive by and having him stay the night in the town we live in. 

Taking a few more rides in our boat before we took it out of the lake for the year. 

New sewing projects to keep myself busy.  

First and second non-stress tests for the babies. Both babies were very cooperative. b n

Arriving at the wrong time for my appointment with the dietician and needing to reschedule. 

Upcoming- W's birthday is the 1st and he'll be 32. Upon discussion with my ob today it looks like if we schedule a c-section the girls will be born a month later on October 1st. I hope they stay put until then despite it feeling like a lifetime away to my very pregnant and tired body. 

My in-law's will be on vacation for 2 weeks and hoping the girls stay put a while longer.

Next ob appointment in another week with another NST. 

He's Back

Our kitty Hoback came home on Tuesday afternoon. He's doing very well and we're so happy to have him home. I'm not sure if he has seasonal allergies or a cold, but he is sneezing a lot and sniffly. His eyes are also very watery. He's on antibiotics so I don't think we need to worry much about it. Since he's been home he's been spending a lot of time hanging out next to open windows, sleeping on pillows on the couch, and drinking from the faucets in the bathrooms. He's got a tough life. 

My crazy dreams are also back. Every night for about the past week I've had crazy/bad dreams. This is something that happened a lot early on in my pregnancy, but disappeared for quite a few months. Last night I dreamt I had a baby boy. A family friend came to help out but was doing everything and not giving me a chance to take care of him. I then dreamt my baby was our cat and that I was trying to breast feed him and then give him a bottle. Neither was very successful. The other night I dreamt about 2 snakes, one of which that kept trying to attack me. It finally bit me on my big toe and wouldn't let go. 

I'm sure some of this anxiety in my dreams comes from the fear of having these babies so soon. At best we have 40 days until they arrive. 

I had an ob apointment yesterday with an ultrasound. The girls were measuring a bit different in size. Up until now they have been measuring about the same. A month ago there was a 7% difference between them. Yesterday there was a 13% difference. Baby a was estimated to be 3 lbs 13 oz and baby b was estimated to be 4 lbs 7 oz. They both looked great otherwise though. It's so crazy to have an ultrasound at this point because there are so many body parts everywhere. It's hard to keep it all straight. They had their little heads right next to each other. So cute! My cervix was also staying strong at a bit longer than 3 cm. It hadn't changed much from my last ultrasound a month ago. 

I also had my first non-stress test. Both babies cooperated very well so it didn't take much time. I met and talked with my ob after. It's looking like baby a is still breech and I'm sure very cramped for space. I hope she is able to move, but I'm not keeping my fingers crossed. I'm accepting the possibility of a c section at this point. Whatever gets them here the safest way is the most important. Dr. R said he doesn't worry about the size difference until there is a 20% difference between them. 

I can't believe how soon these girls will be here! It's getting really exciting. I just wish we could settle on some names for these girls. 

Poor Kitty

This afternoon I ended up rushing my cat Hoback to the vet. He seemed fine as he walked all over us at 4:30 this morning. W kicked him out of the bedroom and locked the door. This is his usual routine in the early morning during one of my many bathroom trips.  

When we got up this morning Hobie was no where to be found. Usually he's very vocal and keeps W company in the shower. He loves to stand between the shower curtain and liner and repeatedly lick the liner as the water runs down it. He's a weirdo. 

He also loves to eat and to not see him ready for breakfast was unusual. I asked W to look under the bed in the guest room (his absolute favorite place) but he wasn't there. As I headed downstairs to get my breakfast ready I saw him walking close to the bed. He seemed like he wasn't standing up completely, but I didn't think much of it. 

I went to my appointment and was home very briefly to get ready for the shower at W's work. The shower was great and his co-workers were so generous. 

When I got home I started to look for Hobie again and couldn't find him. When I went into the nursery I saw fresh blood on the dresser and spots on the changing pad along with some kitty hair. That was when I knew I had to find him. 

I went down to the basement (his other favorite spot) and called for him. I saw a pile of fresh vomit and got really concerned. I finally turned on the flashlight app on my phone and started searching through a slightly cluttered area for him. 

Finally I saw his little body curled up in a ball. When he didn't move I got a little scared. I grabbed him and pulled him out. He cried out very loudly when I picked him up. I carried him up to the bedroom and placed him on the bed. I looked him over and he just didn't seem like himself. He was lying there letting me pet him but it looked like his limbs were all quivering. I called the vet and they said to bring him right in. I then located that the source of the bleeding was from his penis. Poor guy 

I went to the attic and then the basement to find the carrier. When I went back to the bedroom he hadn't moved. 

I put him in the carrier and rushed him to the vet. He meowed almost the entire way there very loudly. 

The receptionist/nurse brought him right into the exam room. She felt his belly and said he wasn't able to pee. She went and got the vet immediately. 

When Dr. Nichols came in he asked me whether I was due tomorrow or not. I told him not until October 1st and that it was twins. He again felt Hobie's belly and told me the cat was going to have to stay. When I asked if that meant overnight he said it meant for a few days. He said they were going to have to catheterize him, flush things out, and probably use anesthesia. Can you say expensive??

The vet called W around 6:00.  He first congratulated W on the twins and then called him a stud. He said Hobie was doing well and that his condition had been very life threatening. If we had been out of town or not caught it he would have definitely died. He said he will likely have to stay until at least Monday and that the hardest part was over but that they needed to continue to watch him very closely. 

I feel so badly for our little kitty. I hope he's doing ok and I miss him terribly. 

Quite the Week!

This week was an emotional and exhausting one. 

On Monday W found out he was going to have to find a new job. Since that time he's been looking at ads, working on updating his resume, and looking to apply to a few positions. He knows that the new agency that comes into the facility will likely offer him a job, but he's heard terrible things about working for them. We both know that working for them is better than not having a job at all, but he's hoping for some better options. 

We've been looking at getting a new car. I took my car along with the carseats to the state trooper's station to get installed a few weeks ago. The trooper was able to get them in, but it meant having both front seats extremely far forward. It would not make for comfortable driving over long distances. Since my sister and dad live about 3 1/2 hours away, we know we will want to visit them with the girls. Let's not forgot the 2 big dogs we have. So, we started looking at SUV's that offer third row seating. W's dad insisted we look at some mini vans, and I hate to admit it, but we may get one. I joked that part of my soul was going to die in the process, but they just offer so many more features and comfort. In addition, they are more affordable than the SUV's. If anyone who reads this drives a van, please tell me how much you love it. Make me feel better about this decision. 

On Tuesday I got a call from one of the nurses at my ob's office regarding my 3 hour glucose test results. She told me I failed all 3 hours, 2 of which only by a few points. I got off the phone and cried. It was super upsetting and surprising to me considering I failed my 1 hour by only a few points. She said at my appointment Wednesday they would give me further instructions and teach me how to use the glucose meter. 

Since last Thursday I've started to feel a lot worse. I've been exhausted every day, having lots of Braxton Hicks contractions, and I noticed a slight increase in discharge. I debated calling my ob's office a few times, but decided to wait until my appointment on Wednesday. The cramping did not improve on Monday and Tuesday. I really wanted to stop working, but was too nervous to make that call myself. 

On Wednesday I had my ob appointment. When Dr. R asked me how I was feeling I told him everything that had been going on. He said he would do a FFN (Fetal Fibronectin) Test. 

"Fetal fibronectin is a protein that acts as a "glue" during pregnancy, attaching the amniotic sac — the fluid-filled membrane that cushions your baby in the uterus — to the lining of the uterus.

Fetal fibronectin is often present in vaginal discharge before week 22 of pregnancy. Fetal fibronectin also begins to break down and can be detected in vaginal discharge toward the end of pregnancy.

If your health care provider is concerned about preterm labor, he or she might test a swab of secretions near your cervix for the presence of fetal fibronectin between week 22 and week 34 of pregnancy. A positive fetal fibronectin test is a clue that the "glue" has been disturbed and you're at increased risk of preterm labor."

Dr. R said if it was positive we would be looking at steroid shots for the babies lungs, but also said a negative result was more accurate than a positive one. He told me results would be available that evening or the next day. He then checked my cervix for the first time. Let me tell you, I thought he was trying to shake hands with one of the babies. It. was. not. comfortable. I asked him about work and whether he thought I should continue and he directly said "no". In addition, he told me he wanted to see me weekly from this point on. Dr. R said he would write a note for me to be done working and then I asked about talking with the nurse regarding testing my blood sugar levels. 

We went to the nurses station and Dr. R asked the nurse to again check my levels and test results. Well, come to find out according to the College of Obstetrics and Gynecologists, only one of the three hour results was considered failing. He asked me how the test made me feel and I told him not too bad. He then said the best thing to do would be to repeat the test and check results again. Oh boy, lucky me!

I made my appointment for the following Wednesday and then the week after for our next ultrasound (at 32 weeks) and left. I called my boss that afternoon but didn't get through. I eventually talked with her on Thursday morning and gave her the update. We made a plan for all of my remaining cases and she was quite understanding. I spoke with the HR person regarding disability benefits and applying for the FMLA. 

I spent Thursday and Friday making phone calls and deciding what I was going to do with all of my new spare time. I decided I would work on some sewing projects and got to work. I made 2 super cute little dresses that came out amazing. I was very impressed with myself because I didn't think I could sew clothing. I used all fabric I had leftover from quilts. I spent some more time sewing this weekend and then we went to my in-law's lake house. 

Some pictures from today (31+5)

Sunday night has a whole new meaning when you don't have to work in the morning. I have to re-take my glucose test tomorrow, but have more sewing projects lined up. I have to say the week ended much better than it began. 

Also, here are a few other pictures I've taken with my new camera:

My birthday dinner. Our nephew Owen getting ready to try lobster.

Owen and my SiL

Mmmmm lobster

doggies

Pepper!

A look down the lake and at our boat

Cloud 9

On Monday I had an ob appointment with an ultrasound. Mama-Dukes attended but hasn't been feeling like herself lately so was a little detached from the whole thing. The ultrasound technician was running behind and took me in 20 minutes late. She is usually very prompt. She then said something about how they didn't book me a long enough appointment because it was twins. The scan was very quick and she didn't point much out. The babies had their heads right next to each other on my right side. She quickly measured their heads, abdomens, and femur bones to get an estimated weight for each baby. She printed one crummy picture for each baby and sent us into the waiting room. I was disappointed to say the least. 

We were then called back to see the ob. He was super positive and said that the babies were both around the 50th percentile and weighed around a pound and a half each. My cervix measured 5.4 with the help of my super full bladder. All of this was such great news and I left in an amazing mood. 

Yesterday marked 24 weeks. This is a huge milestone that we had been waiting for. 24 weeks, or viability, is described as, "The time in pregnancy when the baby, if born now and prematurely, has a reasonable chance of survival. The chances of survival increase with each day after 24 weeks, and the risk of complications decrease." 

W and I went out last night for a nice dinner to celebrate this milestone. He had a beer and I had a root beer and we exchanged huge smiles as clinked our glasses together. He also "bought" me some hydrangeas from our yard and put them in a vase on my bedside table. We went home and went up to bed fairly quickly. We played some music for the babies and W felt them bopping and moving around like crazy. 

Today we had an appointment with the perinatologist. W came along and I was so happy he did. The ultrasound technician was amazing and really took her time. She told us everything she was measuring and got some great profile pictures of each baby. I asked pretty early on whether they did 3D there or not and she said they had it but didn't do it unless necessary. As she neared the end of the scan she checked her schedule and said she could try 3D. We were so happy she did because the babies both cooperated and were absolutely adorable. We got some really great photos of their faces. They are so ridiculously cute. She then gave us the pictures with an envelope to put/hide them in since she wasn't supposed to do the 3D. 

We met with the doctor after waiting forever and she once again confirmed that everything was great. She also discharged us from the perinatal center. She said they could easily see me again if necessary, but that for now I no longer needed to be seen by them. 

Being at 24 weeks and having everything going so well (knocks on wood) is amazing. We are just so happy to finally be smooth sailing after all of the bumps we experienced getting to this point. I'm so happy and amazed with my body and how well everything is going. I honestly couldn't be happier. 

I figured I's do the 24 week update since it's such a huge milestone. Feel free to skip the following. I just like to document this amazing experience, and blogging has been the best way I've found so far. 

Babies- Both measured 1 lb 8 oz at today's appointment. Their faces are looking chubbier and they are moving like crazy. I love it!

Weight Gain- I'm up about 19 pounds from the starting point W and I agreed I should stick with. 

Belly- Tonight W and I both saw movements from the outside. It was all baby b, she's always the mover and shaker. My belly is definitely getting closer to my steering wheel of my car and I'm starting to wonder how this is going to work for much longer. Being only 5'2'' my arms and legs aren't the longest. Moving the seat back should be interesting. W said I need platform driving shoes. 

My uterus measured at 31 weeks on Monday. So much for things slowing down a bit, they've definitely picked up speed. I've been consistently 6 weeks ahead this whole pregnancy and now I'm up to 7. 

Someone today told me I looked like I "was close" and I just laughed at her. 

Cravings- Still the same. I do love a Starbucks decaf frappuccino when I can find one. 

Symptoms- Is euphoria considered one? Heartburn is better. Peeing at night is ridiculous. 

Sleep- Last night was the first night the girls have woken me up with their movements while I was sleeping. I got up so many times to pee and slept horribly. Oh well, hopefully tonight will be better. 

Mood- So overwhelmingly happy this week!!

Memorable Moments- Getting to see the babies twice this week and learning how big they are. I guess those milkshakes really are helping. Seeing their adorable faces in 3D. 

Being discharged from the perinatal center. 

Learning my cervix is super long and closed. 

Seeing movements on the outside of my belly. 

Buying wall art for the nursery.

Celebrating 24 weeks with a nice dinner out. 

Handling the first 90 degree days. 

Having a good conversation with my boss and feeling supported with what I want. 

Upcoming- Wedding in NJ this weekend.

Next ob appointment July 8th.

Receiving and hanging wall art in the nursery. 

I'll try to update the belly picture and ultrasound picture pages soon. 

Better Safe Than Sorry and Changes

On Friday I was out shopping with my MiL. As I waited in line at the checkout I felt some pretty intense cramping. It only got more intense and then came some back pain. I ended up having to sit down, but didn't make a big deal out of it. 

On Saturday morning I got out of the shower and once again felt cramping. My body told me to lie down so I did and it passed. 

Sunday night after getting up to pee in the middle of the night I felt the same thing. 

3 days in a row of a single episode of intense cramps. It was enough so that I had to sit or lie down until it passed. I figured the best thing to do would be to call my ob. 

They told me it was likely round ligament pain and I disagreed. I've had more round ligament pain then I ever cared to experience in this pregnancy, and know it wasn't that. When I told her it lasted about a minute and I felt the need to lie down she offered for me to come in and get checked out. I took her up on that offer and called my Mom (Mama-Dukes) to see if she could join me for the appointment. She said she would and would come over to my house before. 

I worked that morning and we left around 1:15 for the appointment. In the waiting room I ran into a co-worker I rarely see and we chatted while I waited. 

When they called me back they took my blood pressure, weight, and a urine sample as per the usual and then brought me to a room. They asked me to undress from the waist down in case he wanted to do an exam. 

I had requested the only ob in the practice I was yet to meet (#5 Dr R). He came in fairly quickly and first used his doppler. He easily picked up both babies' heartbeats and we chatted for a bit. He asked me what I did for work and whether I was going to get the summer off. I sadly informed him that no, I would be working this summer, but to a lesser degree. He told me that since I was past the half-way mark in my pregnancy if I started to feel like I was having more bad days than good days, it would be perfectly reasonable for me to stop working. I was really surprised to hear him say this. 

He basically told me the cramping was likely contractions but that they are nothing to worry about since they aren't consistent. Everything is growing so quickly and it's putting a lot of stress on my body. He said I really need to listen to my body and take it easy when it tells me to. He said if I was feeling the same thing 4 or more times per hour than I should call right away, especially if any discharge or bleeding accompanied it. 

So last night I emailed my boss back and declined a summer case for work. I figured since I was reducing my caseload it made sense to not add or any more right now. I want to work as long as possible, but not add anything at this time. This afternoon my boss responded by saying, "I know caseloads will be changing July 1st. Please let me know how many visits you need." 

Cue my stressed out tears. Technically, to be considered full time and continue to receive my benefits I need to do 35 visits per week. It always fluctuates and generally they understand that summers are slower. Well, my summer right now looks like about 17 visits per week and I'm not really interested in increasing that. 

I'm looking forward to cutting back. I've been doing a lot more than 17 for quite a while. Earlier in the year I was up to 43 visits. After this week everything is supposed to slow down. I still want to work. I know I would be bored if I wasn't and I still feel like I can. I just know I can't keep up the pace at which I've been going. 

 I came home this afternoon and made W call his insurance company. They said me cutting back on work is considered a life-changing event and that it would be a possibility to add me at that time. It's not cheap at all, but it's good to know the option exists. That's the plan for when the girls get here anyway. There's also the FMLA, but I'm not ready to take that yet. I'm not even positive my work offers it. 

I really thought my reduced caseload will slide by without them noticing it (at least for a little bit) but I guess declining that case last night made them think about it. I'm thinking about asking if I can sit down with my boss and go over everything with her. I have no idea right now who will be taking over my caseload when I go out and they don't know that I'm not planning to return to work right away. It's tough when families ask me who would take over when I leave and I have no idea. It's hard not knowing what is offered and not to me in case I need to stop working. 

When Dr. R said I could stop working if I I needed to, a small smile spread across my face. Then, when the logistics of it came into perspective, the tears started to flow. I've worked full time for 4 years at the same company doing the same thing. Changes can be good, but also incredibly scary.