Keepin' it real

(Warning: this post is all about my pregnancy.  If you don't feel like reading about that right now, I understand.)



Some of my goals in continuing to write on the same blog I started while in the throes of infertility has been to be sensitive to my readers who are still trying to get pregnant, to not forget what it took me to get to this point, and to be grateful for--and enjoy--my pregnancy.

I feel that I would be remiss, though, if I don't candidly share some of my pregnancy experiences which I have not written about in detail so far.  Sure, I have shared some of the symptoms I've had in my weekly (and bi-weekly) updates, but I don't think I've given a complete picture.

Should another 40-ish woman who is contemplating transferring two embryos stumble across this blog and wonder about my experience, I want to give her a true impression of what twin pregnancy has been like for me.  I do believe knowledge is power, and while reading what I've written may not influence anyone's decision (and that's not truly my intent), I think it's important for this hypothetical woman who may be standing where I was eight months ago to know the whole story.

Allow me to preface the next part of this post by saying--as I have before on this blog--that I realize how very fortunate I am in relation to many others.  First, in just having the resources to pursue the fertility treatment we did to become parents and in having a husband who is supportive and on the same page as me.  Second, our DE IVF cycle worked on the first try.  I have made it to 25 weeks without apparent complications, and so far as I know, I am carrying two normal, healthy babies.  Also, I have now reached a point in my pregnancy when the odds of our boys surviving even an early delivery (albeit likely with a long hospital stay and possible ongoing problems) are greatly in their favor.

Having acknowledged all that, let me say that this pregnancy has not been all lollipops and rainbows for me.  Emotionally speaking, it has been mostly a very happy time for my husband and me.  We are both thrilled to finally be so close to being parents.

Physically, though. . . . simply put, I would say that this pregnancy is the single most difficult thing my body has done to date.  Since I hit 6 weeks, I have not had an entire single day when I have felt good physically.

Let me stop so you can think about that for a moment.  In almost 20 weeks, not.one.single.day.  Really.

And I haven't even reached "the hard part" of the pregnancy yet.

On the plus side, I've never had the experience I've heard some women report of "forgetting I'm pregnant."  No, my physical symptoms are a constant reminder that I am gestating.

Allow me to share the physical symptoms which have been the hardest for me:

• Fatigue.  My fatigue was crippling during the first trimester.  Up until around 14 weeks, I literally did nothing but go to my office each day.  I took an hour-long afternoon nap AT the office on the days when my schedule permitted it.  Evenings and weekends, I did nothing but lie on the couch.  I had little to no energy to read a book or talk with friends, let alone go anywhere or accomplish anything around the house.  During this period, my husband did all the household chores (which weren't being done by our housekeeper at her bi-weekly visits) and got most of my food for me.  I know everyone who gets pregnant experiences fatigue, but I do feel that mine was much more severe than what has been reported to me by most of my friends and acquaintances.
• Lack of energy.  Despite what the books and websites say, I never saw a "return to normal energy level" with the arrival of the second trimester.  I continued to have much less energy than pre-pregnancy.  I discussed this with my OB at two different appointments, hoping that there was some explanation which could be treated/fixed.  Nope.  I was told by two different OBs in the practice that this was "normal" for a pregnancy with multiples.  (And yes, possible medical explanations were ruled out.)
• Difficulty concentrating.  (I do think that this symptom is an outgrowth of the previous two more than anything.)  Tasks which would normally take me hardly any time to complete now take hours.  I have to read and concentrate for work (I'm a lawyer), but the idea of trying to do so when I don't "have to" is anathema to me.  This is a HUGE change from my normal self.  I suspect this one isn't going to return to normal too soon after our babies arrive either, if for no other reason, because of the sleep deprivation I'm sure to experience.
• Nausea.  Oddly enough, I have never vomited a single time since I've been pregnant.  BUT I had unremitting, severe, all-day nausea from 6 weeks to 15 weeks.  Between 15 weeks and 22 weeks, I was able to wean myself off Zofran (I was glad to quit it because of the BRUTAL constipation it caused) and only had nausea a portion of each day.  Since 22 weeks, I have had no true nausea but must be careful about what I eat, am still sensitive to smells, and occasionally get "gaggy" if I smell something bad or go too long without eating.  (Examples: this morning I had dry heaves in the car on the way to a deposition because I'd been awake for 40 minutes and hadn't eaten yet.  Last Saturday, I went into a bathroom at Babies R Us where there was a rancid smell and spent five minutes retching.)
• Heartburn.  At first, my heartburn was something which was associated with my nausea and only developed if my stomach was empty too long or I ate something which disagreed with me.  Since my nausea has subsided, my heartburn has stuck around.  My OB tells me that the babies are not yet big enough to be crowding my organs and that this heartburn is due to hormones, not mechanics.  (I still have the crowding-related heartburn to look forward to.)  The heartburn is the usual burning sensation in the esophagus with which we are all familiar, as well as sometimes feeling I have a large "lump" stuck midway between my mouth and my stomach.  So far I have tried Pe.pcid, Za.ntac, Pril.os.ec, and lots of Tums to treat it.  The first two didn't work at all, the Pril.os.ec helps a little (takes the edge off), and the Tums only work for a half-hour or so after I take them (in addition to tasting chalky and gross, which can also turn my stomach).  Ironically, drinking water--which is otherwise highly recommended; I'm supposed to drink 2-3 liters a day--seems to make my heartburn worse.
• Shortness of breath, dizziness.  I can no longer walk up a flight of stairs, or even walk at my normal (fairly brisk) pace without getting winded.  If I stand up quickly, I often feel dizzy.  Again, I am told these are normal, and I am not anemic.  I actually started this pregnancy in pretty good physical condition for me--readers who've been with me for a while may recall that I dropped 15 lbs and completed a month-long fitness boot camp just prior to our DE cycle--so I don't think I can attribute my shortness of breath to being out of shape.  (Though goodness knows, I have done very little exercise since I've been pregnant, between early activity restrictions, fatigue, nausea and the like.)  I also can't really attribute my shortness of breath to carrying more weight than I am used to: I only weigh 4 lbs more today than I did the morning of transfer, and I've weighed as much as 20 lbs more than this within the past five years (and I could still get around then without huffing & puffing).  It's also too early to blame the shortness of breath on the babies' crowding my lungs; they aren't big enough for that yet.

To leave nothing out, let me share these additional symptoms which most pregnant women probably experience and aren't likely due to increased stress on my body from carrying twins.

• Hemorrhoids. I don't think I need to go into great detail here. Moving on. . .
• New skin growths and moles.  I had a few moles pre-pregnancy, and I have had skin tags removed in the past, but I now have skin tags in (unmentionable) places I've never had them before.  I also have several moles on areolae of both breasts, a few of which are large enough and close enough to my nipples that they give me cause for concern, since I'm planning to breast-feed.  Again, I am told this is all normal.
• Other changes in my skin.  I've mentioned here before that I've never had a pregnancy glow.  My skin is dry, sometimes peeling--despite using more lotion and moisturizers than normal--and I just look old and tired.  I haven't had the "mask of pregnancy" develop, and so far no line or stretch marks on my belly--though they may still be coming, so I guess I've actually been pretty fortunate here so far.
• Headaches.  Actually, mine have been fewer and less severe since I've been pregnant.  (I usually average 2-3 migraines a month and have only had two in the six months I've been pregnant.)  The hard part about headaches in pregnancy, though, is that I'm not permitted to take anything which might actually help: "Tylenol only."  This means that a headache which would normally be cleared up in an hour by two Advil now persists all day and sometimes into the next day.

It's somewhat ironic to me that, during a time when I have felt emotionally GREAT (truly: I haven't been very moody and am obviously very happy to be pregnant), I have felt physically the worst I've ever felt in my life.  Infertility and weight issues notwithstanding, I've always been a healthy person.  I was used to waking up feeling good most days, working long hours without problems, eating whatever I wanted without adverse effects, and generally living my life.  Those days are gone now, and I'm not sure when/if they are coming back.

I think I knew that being pregnant would not necessarily be easy, but I don't think I truly knew how difficult it would be.  Based on what my OB has told me, I do think part of the reason it's been particularly hard is the fact that I'm carrying two instead of one.

I hope I've done a decent job of stating facts here and not whining.  I'm not trying to complain, just want to keep it real.