Thursday, May 23, 2013

10 weeks - lots to update

First of all, I am really sorry it's been a week - and a big week at that - with no updates. I used to hate when bloggers did that to me, and even stopped following a few blogs because the women would get me so anxious / excited for their updates and then make me wait forever for them. That made me worry something terrible had happened.

I vow to try to never do that again.

Onto a more fun subject. I am 10 weeks pregnant today! "More pregnant than I've ever been." That sentence applies to every day I wake up until and unless someone tells me bad news.

Last Friday, at 9w1d, we went in for our graduation ultrasound. And we graduated! With flying colors, in fact. Both bubs were still in there, hearts beating away. We asked to see a doctor rather than the nurse practitioner since we have a high risk pregnancy and have a lot of questions. We lucked out and saw our former IVF doctor and she hugged us and spent so much time answering so many questions for us.

Really, though, the BEST NEWS of that ultrasound was that Dr. B found the membrane. So our pregnancy went from ultra high risk, a doctor will potentially suggest we abort, to just plain old high risk. Here's an explanation: our twins share the same placenta but have separate umbilical cords and separate embryonic sacs. The membrane we saw is so vital because without it, our twins would share everything, as they do now, but would also share embryonic sacs and be at a high high risk of having their umbilical cords get tangled and knotted around each other. If you'd like to learn more, you can google "momo twins" (the super scary, no membrane twins). Ours are now "modi twins."

We left on cloud 9.

Here they are, pictured at 9w1d. They're still little blobs, but we got to see them moving a little bit and saw and heard their heartbeats (each measuring at 178 bpm), each measuring right on track as far as their s. Our doc took this photo and told us "here's a family photo for you." Interestingly, you can still see the remnants of former-baby-A's sac in the top right hand corner. So it really is a family photo, with former-baby-A continuing to act as guardian angel to his / her brothers / sisters.

Back at our first ultrasound at 5 weeks, I made an OB appointment. That was just 5 days after our RE graduation appointment, and happened on May 21. We had an hour-long ultrasound where the tech measured everything. It was also my first tummy ultrasound (she also did a vaginal ultrasound) and it was so awesome to see the kiddos that way. Made me feel like a "normal pregnant lady" and like things might continue to go well for us (knock on wood). This ultrasound tech was ALSO able to see the membrane and, like last Friday, it was as clear as a well tuned bell. It was so cool to see and really made our hearts relax just a little bit.

We got to see them moving a LOT and saw baby A (the one I used to call baby B1) moving legs and arms. We also saw the BRAIN of one of them! We could see both lobes of the brain and the split between. That was wild as all get out.

We were just blown away with how quickly they have grown and how much they have changed. In just 5 short days, they went from the blobs pictured above to baby-shaped blobs! Here you go, them at 9w5d. The angle of the vag cam makes them look different sized, but they are the same size:

Our OB was out sick so we met with another doc in the practice. He didn't know us from arthur, which was annoying, and he said things like "so why IVF?" (to which I wanted to jump across the room and strangle him and my husband wanted to say "why not, the old fashioned way was too boring and we wanted to drop $60,000."). It also turned out that we knew more about our pregnancy than he did and he kept punting questions. I get to go back and actually see our OB on June 10, and I am really excited about that. She has helped us through everything, including the ectopic, the D&C and the emotional roller coaster of the last 3 years. I am thrilled to (hopefully) continue to see her as a pregnant lady!!!

Our next stop is on May 31, and it's with a perinatologist. We'll continue to see the OB but the perinatologist will take over this high risk pregnancy and monitor us closely (at least every 2 weeks but likely every week) to make sure twin-to-twin-transfusion and other complications don't go unnoticed.

There is almost no way we'll make it to our due date (December 19) and I will almost definitely have to have a c-section (fine by me!). That aside, today we are 10 weeks pregnant and over one quarter of the way there!

I am showing a little bit - have been for a few weeks because there were three in there for the first 6 weeks of pregnancy so my uterus stretched a LOT - but I want to try to find a blackboard this holiday weekend before I take my first bump shot. So, fingers crossed nothing terrible happens, and expect a bump date shot at 11 weeks.

Thursday, May 16, 2013

9 weeks today

And I am quite sure I'm still pregnant. Don't know whether I'm still pregnant with one or two, but I do feel confident I am still pregnant.

Had a scare on Monday. I passed some beige / fleshy stuff that was stringy and mucousy. It really freaked me out and I spent the morning writing emails and making phone calls. My OB's office said it was nothing to worry about as long as there was no blood (there was no blood - but telling an infertile not to worry is just plain stupid). My RE's office granted me an early ultrasound but when I called the local clinic to make an appointment for Tuesday, they could only get me in to see the nurse tech. We don't want to see her and our appointment tomorrow (Friday) is with our old IVF doctor, so we ended up deciding to just wait it out. I figured I'd either start bleeding or have a loss of symptoms if shit had gone really south.

Turns out my symtpoms are still here. And they're getting stronger.

New symptoms to add to this past week:

--- Insomnia (not new, but returned - it went away around 6 1/2 weeks but it's baaaack!)
--- Nausea, full on
--- And, today, the need to rush to the work bathroom because I was on the verge of puking. Turns out the beautiful peony roses a woman left for me yesterday (that I adored the smell of yesterday) were turning my stomach. They are now in a co-workers office and I have another co-worker's garbage can about 6 inches away from me. Pukey pukey perhaps? Not yet, but it's threatening.
--- Exhaustion - it's been here a while but this week I haven't been able to get to work before 9:30. I am so slow in the mornings, have to lie down a lot, feel nauseus, and just plain old exhausted. Fortunately, the weather has turned back to rainy and chilly and my cats are super happy to sit on topf of me and fall asleep / lull me back to sleep. It makes for a lovely but very late morning!

I have never been this pregnant before. Last summer, for those of you following my old blog, you remember that I blogged about "never being this pregnant before" when I made it to 5w3d. On Monday (the day of the scare), I reached my "never been this pregnant before" mark. Last summer, the fetus measured 8w4d at my ultrasound. So that's as far as I got. Given how I feel, I think I made it past that.

We breathed huge sighs of relief last time ... when we made it past ectopic diagnosis ... when we made it past 5w3d ... when we saw and heard a heartbeat ... and then we lost it all.

No sighs of relief this time. We have a long and potentially very bumpy road ahead of us. Provided tomorrow goes ok, we have our first OB appointment set for 5/21 and then our first MFM (specialist in idential twins) appointment on 5/31.

For now, though, I AM STILL PREGNANT!

Thursday, May 9, 2013

8 weeks today

Today, I am 8 weeks pregnant. I have been feeling rather confident that there is at least one still growing in there, so hopefully that confidence will continue.

I don't have another ultrasound until May 17 (when I'll be 9w1d) and I must admit that feels nice. Sure, it would be lovely to be able to use a wand at home and check they're still there, but going into a doctor's office and having the stress of waiting for them to come into the room to deliver good or bad news is just not in the cards for us this week. Or most of next week!

I didn't write any of the symptoms I've been having since I was really early pregnant, so I'm going to try to recount them here for my blog purposes.

3w3d (5dp5dt) I found out I was pregnant with an hpt. By that point, I had some twinges (not quite cramps) and was very bloated.

3w3d-3w5d I had some serious cramps, insomnia, food aversion and weird cravings (all I wanted, for example, were apples smothered in peanut butter - I salivated at the idea of them and wanted nothing else).

At 3w5d, my symptoms disappeared and I freaked out. That was my first OB beta.

The symptoms came back.

During weeks 4 through 6, I had tender boobs, cramps, hunger, food aversion, bloating, burping, itchy nipples, and exhaustion.

Weeks 6 and 7 were filled with hunger. All the time hunger. My symptoms did subside a little bit, and it turns out we had lost one of the three growing fetuses. I was also exhausted and took naps every day after work and for 2-3 hours each weekend day.

Some nausea set in around week 6, it went away, it came back at the end of week 7, and now it seems to have gone again. I haven't thrown up, I have gagged a few times, and generally just feel cruddy.

Week 8 symptoms (now that I'm sort of caught up):

--- my left nipple and boob was TO DIE FOR itchy last night. I woke up this morning with a hicky looking thing on my chest from, presumably, scratching during the night.
--- exhaustion still (not as bad, though)
--- some cramping, on and off
--- blood pressure was lower than normal at my naturopath's yesterday (120/62)
--- my boobs are enormous
--- total food aversion yesterday (followed by scarfing down the high-protein food I forced myself to eat)
--- interesting new addition to the symptom rack: loose stool (sorry, TMI). I am hoping it's because the placenta has started to take over, my body is now generating its own progesterone along with the injections I'm still taking, and the added progesterone has caused stomach problems
--- burping - after every meal, I burp a million times
--- white cottage-cheese-like (no odor) discharge - again, a new symptom and one I am hoping is a sign of increasing progesterone levels (I called my OB about this and they weren't worried provided there is no odor)

I officially (and hopefully) have 2 weeks of injections left. My hips are full of tiny knots that I massage and apply heat to. The injections themselves don't actually hurt, which is quite lovely.

Fruit season is happening here and I am excited to load my pregnancy up with local and fresh fruit. I found some local strawberries yesterday and, while not yet local, also found some CHERRIES! My favorite!

Mini resolve meeting tonight. I am really looking forward to seeing the women who have become good friends. There are two of us who are pregnant and one woman had her donor egg transfer on Tuesday and is PUPO. Of our small group of 14-16 women, we're slowly having some lucky ones (hopefully) exit this rat race.

Saturday, May 4, 2013

An explanation

I thought I'd send out a little information I've collected over the past few days. I don't think any of you think I'm "complaining" about having identical twins, but I wonder whether you understand just why I am so freaked out.

The chance of this happening is less than 1% (more like 1 in 60,000). What I have is likely "momo twins". If they see a membrane between the two fetuses, then it'll be "modi twins". The name refers to whether the fetuses share both a placenta and an amniotic sac (momo) or whether they share both but there is a membrane between them (modi). (I am not positive on modi because I haven't researched it fully yet)

There are a number of dangers that go with identical twins, including "twin on twin transfusion syndrome." Essentially, this is when one twin becomes the dominant twin and takes all the nutrients, leaving the other twin malnourished (and suffering severe birth defects). For the dominant twin, however, getting all those extra nutrients can also be dangerous, and both twins can die or be born with birth defencts. I know two women personally who went through TTTS; one gave birth to two babies and one is healthy while the other died at 18 months old. The other woman was diagnosed very early and had a lazer surgery to somehow do something that allowed both of her babies to thrive and survive; they are now almost 2 years old.

Additional dangers include the umbilical cords (they each have a separate one of these) getting all tangled and even knotted up, preventing any nutrients getting to either. That is less of a concern when they are smaller but as they grow and have less room in there, it becomes a higher concern.

I will need weekly monitoring at the very least, and perhaps more. I already have an appointment with a perinatologist to get the extra special care I will need.

Here is a pretty useful link on momo twins:

If these are momo twins, then there is a good chance, based on what I've read, that I will be hospitalized around week 24 and that the twins will be delivered sometime between 26 and 34 weeks. The earlier they come, the longer they will be in the NICU. They must be delivered by c-section because, in sharing a placenta, if one comes down the birth canal, it will cause a placental rupture of the other left behind.

This is all VERY early. Based on my history, even in this pregnancy with baby A dying, there is a very good chance that one or both of them won't make it much further. I have never gotten further than my 9w2d ultrasound, which is about 2 weeks from now. I am 7w2d today.

Also, based on some reading I came across, I do not know whether the problem is solved if one of the two dies. I read somewhere that damage could have been done at the splitting, meaning a surviving fetus may still have defects, even if there are no longer TTTS or entangled cord concerns.

It is really important to me that you realize why I am so terrified and scared and seemingly ungrateful for what is (hopefully still) growing inside of me. After all we've been through, we were hoping for a somewhat normal and easy path to parenthood. Apparently that is not in the cards for us.