Friday, May 27, 2011

Happy Anniversary To Us

Today is our 5 year anniversary and was our first visit to the specialist. While we were sitting in the waiting room we kept hearing someone frantically telling the nurses that she thought she had broken the machine and needed someone to come help her. She was running around in a panic. Luke and I kinda looked at each other, not sure what that was about, but didn’t think too much of it.
We got into the exam room and did the routine first visit stuff with the nurse – basically repeating everything we had told the previous doctor. Then the doctor comes in. To our surprise/concern, it was the seemingly crazy British lady that had been “breaking” the machine out in the hall. Even as she came in to see us she was all worked up because she couldn’t find her stethoscope and ran out of the room a couple times to go find it.

Fortunately the doctor pulled herself together and was less crazy while doing the initial exam. She walked in and shook my hand and immediately commented on how tiny my hands are. Luke added “that’s nothing – you should see how tiny her feet are!” to which the doctor responded “I haven’t gotten that far yet!” Later in the visit she asked if I had done this all by myself. I think she meant get pregnant with twins without fertility treatments, but it took a lot for me to not give her the smart-ass response that Luke helped.

My focus thus far had just been on how to keep the babies healthy and I hadn’t really given my own health too much thought. The doctor assured me that she would make sure the babies were okay, but that I needed to make sure I was fine too. My size, or lack thereof, seemed somewhat concerning to her. She told me to plan to be on bed rest as early as September because she expects as the babies get bigger I’ll have an increasingly hard time getting around. Since my torso is so short, she expects the babies will end up pushing on my chest and make it hard to breathe.

We learned a lot more during the visit than I was anticipating with regards to what to expect through the rest of the pregnancy. In addition to the doctor’s September bed rest prediction, the babies will need to be delivered via C-Section which will occur no later than at 36 weeks (December 1). They may need to be delivered sooner than that if my health is in danger or if they start to develop twin-twin transfusion. In the meantime, I’ll go in for an ultrasound every other week to monitor the babies and make sure they stay similar in size. As we get closer to the delivery date, that will likely increase to once a week. The doctor instructed me to gain 20 lbs by 20 weeks which should put me about the size of someone about to give birth to 1 baby. I’m sure there will be another weight gain goal once we get to that point. Based on one of the books I’m reading, it sounds like I’ll likely be close to 200lbs by the time I deliver. I’m not quite sure how I’m going to stay upright at that size. I guess we’re about to find out!

On the wall in the exam room was a framed picture of triplets and their stats at birth. Each weighed approximately 6 lbs – the doctor noted that although it might not be easy for me to carry 2 babies, the mom of those triplets was the same height as me (4’11’’) and they all came out fine. She is hoping for the same result for our babies. It’s not impossible, but is just going to take some close monitoring.

We had an ultrasound during the visit and the doctor confirmed that the babies are sharing a placenta. Here are some of the pictures from our visit. We had lunch before the appointment and the babies were very active - they looked like they were swimming on their backs. The ultrasound tech called it their "Pillsbury Dough Boy" stage - based on the second picture below, that's pretty accurate.


Monday, May 16, 2011

Beating the Odds Part 2: OhMyGoodness!

At 8 weeks it was time for my first prenatal check-up. I was very excited for the appointment because I was pretty sure it would include an ultrasound. I had to reschedule my first appointment because of jury duty, so I was even more anxious by the time the day came. Luke was with me and got his first experience of a trip to the OB/GYN and all the fun (not!) that goes along with the exam. We met with the doctor and talked through some of my concerns about health issues and started getting a plan together for the rest of the pregnancy – things like what supplements I would take and what warning signs to look for, etc. Then we moved down the hall to the ultrasound room.

While the ultrasound was being performed I was lying on the table and couldn’t see the screen. Luke was standing behind the technician watching what was going on, so all I could really go off of was his facial expressions. The technician was very quiet for the first few minutes which made me think something was wrong. I looked to Luke and he had a very confused look on his face. I kinda figured he just wasn’t sure what he was looking at. It’s so early in the pregnancy that I knew it probably would look more like a blob than a baby. Then came the conversation that would change our lives forever.

Ultrasound Tech: Do twins run in the family?
Me: That’s not funny – and no.
Ultrasound Tech: Well they do now!
Me: Really, that’s not a funny joke….

I looked over at Luke again. He wasn’t saying anything but had his hand over his mouth and just kept nodding his head. Eventually he said “I couldn’t figure out what I was looking at because I kept seeing 2!” Here is what he was seeing:

The ultrasound technician turned the screen for me to see – sure enough, there were 2 blobs on the screen. I kept saying “OhMyGoodness!” over and over. Looking back, I’m kinda proud of myself for not cursing like a sailor, but wow what a shock! I didn’t know what to think. Luke moved to the end of the table and rubbed my foot as we watched the monitor. I think that may have been all that was keeping him from ending up on the floor.

The technician was trying to figure out if the babies were identical or fraternal, but wasn’t having much luck. She went to track down the doctor and see if she had time to come look for herself. The doctor came in and started printing pictures of all different angles. She told us that she saw the membrane in between them and wanted to make sure she got it documented. Completely clueless about twins, I said “Oh, so they’re fraternal!” The doctor then realized that she was kinda talking above us and sat back and gave us a quick biology lesson.

Our twins are in the same placenta but in separate sacs (the membrane the doctor saw). Since they are sharing a placenta, they are definitely identical. She explained that there are 4 situations that can occur with identicals:
1.      2 placentas, 2 sacs
2.      1 placenta, 2 sacs
3.      1 placenta, 1 sac
4.      1 placenta, 1 sac – conjoined twins

It’s good that they’re in separate sacs because they can’t get tangled up in each other’s cord, and obviously we’re happy that they’re not conjoined, but sharing a placenta comes with risks too. The doctor explained that because of the shared placenta, this would be classified as a high risk pregnancy and she would no longer be able to see me. I needed to go to a specialist and would not be able to deliver outside of the medical center. Her nurses put together a package of information and a disc of images to bring with me to the specialist. They immediately put in a call to the best doctor in town and told them I needed an appointment ASAP. I asked the doctor what the concern was and she said twin-twin transfusion. She briefly explained what it was (basically the babies don’t share like they should) and told me there was lots of information online about it. I somewhat jokingly asked if I would get upset if I looked and she responded “actually maybe you shouldn’t do research…” Keep in mind, I’m being told all of this while still in a gown on the ultrasound table.

We walked out of there completely in shock. We weren’t sure what to think of it all. Within a half hour I got a call from the specialist’s office and made an appointment for a week and half later.

The whole day was such a whirlwind for me. I just really didn’t see all that coming. I (mistakenly) thought that you only would end up with twins if you had them in the family, were on fertility treatments, or if you were over 35. Since I don’t fall into any of those buckets, I didn’t think of it as an option. After doing some research we learned that that is generally true for fraternal twins (race can also be a factor), but identicals are just random and only occur in about 3 of every 1000 pregnancies. Lucky us…I think