Monday, April 30, 2012

Great news

(CAUTION:  pregnancy mentioned)

No, not my pregnancy!   :-)

(As if!  Perish the thought. . . . gotta at least get the twins consistently sleeping through the night first!)

I have been following CeCe's journey for a long time.  She lost her first son at 21 weeks gestation and went on to conceive her rainbow baby C via IVF.  C was born in July 2010, and CeCe has long wanted to give him a (living) sibling.  To that end, she started TTC again over a year ago.

CeCe recently found out she is pregnant again!  I'm so excited for her and am praying that all goes well.

Stop by and congratulate her, if you're of a mind to.

Tuesday, April 24, 2012

"Left-over" embryos

I've been turning this post over in my mind for several days, ever since I read gwinne's post here.  Reading her post made me think that it's interesting how reasonable, rational people can approach the same dilemma and arrive at different decisions.

In her post, gwinne talks about how she "can't imagine anyone else having" the embryos left over from the cycle which produced her son, Tiny Boy.  She talks about how "these embryos have the potential to be Tiny Boy's full genetic siblings" and that she is not ready to donate them and doesn't know that she will ever be ready.  I can understand and appreciate her feelings.  I'm sure that many people in her situation would share them.

We have four embryos frozen at our clinic from our DE IVF cycle.  It's true that our four frozen embryos have the potential to become AJ and MJ's full genetic siblings, and more: to be MM's genetic children. Nonetheless, we have no qualms about donating them to someone else and have long intended to do so because we know we will not be using them.

Neither MM nor I is of the firm belief that "life begins at conception."  We aren't religious, and I am too scientific in my thinking to accept such a broad premise.  Nevertheless, we recognize that each of our frozen embryos has the potential to develop into a living, breathing human being and that there are other people who find themselves in the position in which we found ourselves--childless and unable to conceive--who cannot afford to pursue DE IVF as a family-building option.

MM and I have known since some time during my second trimester with the boys that we would not be having more children.  (Of course, this assumed that my pregnancy would end with living children, and it did.)  If I had conceived a singleton instead of twins from our DE IVF cycle, there is a chance we might have used one or more of our "left-over"** embryos to try and have a second child.  I say "a chance" because I think there is an equal chance we would have been content to have just one child.  MM is an only child and saw nothing wrong with the idea of stopping at one.  Once upon a time, I dreamed of having three children. . . but that was before it took us three years and $30K to get pregnant. 

Starting parenthood at nearly age 41, I'm not sure whether I'd have wanted to have another child.  (I realize that many women become first-time moms at even older ages, but I was already far older than I'd ever intended to be for that experience.  I'll be 59 when our boys graduate high school, which floors me when I think of it.)

When we first did our embryo transfer and knew we had four more embryos frozen from that cycle, we had agreed to *consider* the possibility of trying for a second when our first child was a year old.  I think that decision would've depended on a lot of things: how we adjusted to parenthood in general, the temperament of our first child, our financial situation, just to name a few.  Conceiving twins the first go around rendered that decision moot.

Although I tried not to complain much here, those of you who have been reading for a while may realize I had a miserable pregnancy with the twins.  I had extreme fatigue for all but a few weeks of the pregnancy, all-day nausea from week 6 to week 22, and food intolerances and heartburn throughout (as well as the more minor annoyances like hemorrhoids and skin changes which most pregnant women experience).  In addition to these symptoms, which, arguably, I could've perhaps expected and anticipated, my pregnancy was not without complications:  I developed gestational diabetes at 21 weeks and preeclampsia at 32 weeks. . . . which led to a c-section (with significant post-surgical hemorrhage) at 34 weeks.  Not to put too fine a point on it, I literally could've died, either from preeclampsia or hemorrhage.  (I don't feel that I was ever truly at risk of dying from either because I received prompt and excellent medical care, but it doesn't mean that the possiblity didn't exist.)

I am OK now, as are our boys, thank goodness. My blood pressure and blood sugars are normal, my anemia has resolved, and apart from some changes in my body shape which are likely permanent and the previously mentioned minor annoyances, I'm back to my old self.  HOWEVER, pregnancy is not something I would ever put my body through again.  I realize there is a chance that a second pregnancy wouldn't be as difficult as the first, especially if I were only carrying one baby.  But there is a chance it would be just as bad.  (Gestational diabetes and preeclampsia in particular are likely to recur in subsequent pregnancies.)  Knowing what I know now, having lived the experience, I just cannot go there again.

Because I know that I will never go through another pregnancy, I know for sure we won't use our embryos.  The only way we could do so is if we used a surrogate to carry them.  We couldn't afford surrogacy, as we are tapped out financially from paying for our DE cycle (I'm still paying it off), not to mention the expense of caring for the two boys we now have.  (Formula and diapers alone are mind-blowingly expensive!)  So that wouldn't be an option unless we won the lottery. . . and in that unlikely event, hell, I'd be willing to blow more money on additional cycles if we wanted more children.  (College funds and full-time help would no longer be significant financial considerations at that point.)

Even if, G-d forbid, something happened to one of our boys, we would still have another child.  We would still be parents.  Barring some far-reaching epidemic or a tragic accident, it's highly unlikely we'd lose both our sons.  So I don't know that even the death of one of our boys (something horrible to contemplate!) would lead us to want to use any of our frozen embryos.  And if something unthinkable like that happened, it's hard to know how we would feel.  Perhaps the pain of our loss would break up our marriage, send us over the edge, make us never want to parent again.  Who's to say?

Because we've known for a while that we would want to donate our remaining embryos from our cycle, I have been searching for appropriate recipients for them.  While I don't think of these embryos in the same way I think of our two sons, I am mindful and respectful of their potential as human beings and as our sons' genetic siblings.  That mindset makes me want to find the best possible "home" for them.

In the interest of preserving their privacy, I won't write much here about the recipient couple with whom we have almost arrived at an agreement.  (We considered some SMCs, too, but ultimately felt drawn to this couple.)  Suffice it to say that I found them through a popular internet networking site for such things (email me for the name if you are looking to donate/receive embryos), and they appear to be good, upstanding people who are childless and have exhausted their other fertility treatment options.  (DE IVF is not an option for them due to its cost.)  They aren't exactly like us, but there are a few similarities, and I believe they will be excellent, loving parents and provide any children they will have with a good life.

MM's only request vis a vis our embryos is that he is curious to know if they do, in fact, produce pregnancies and live babies and also what the gender(s) of those babies will be.  (Given that we had two boys, he is curious to know if our remaining embryos are boys, too, or girls.)  He is also willing to let the child(ren) meet him, at the discretion of the parents, if/when the time is right and there is a desire for contact.

So sometime in the next several months, it's possible that our donated embryos will make someone else a mother for the first time.  I feel good about that.

**I don't really like the term "left-over" in regard to our embryos.  Although I suppose it's not inaccurate, I think it has something of a negative connotation.

Thursday, April 19, 2012


Being busier these days than I've ever been in my life--no exaggeration there--I don't have the time for reading all my usual blogs like I used to.  So I am a few days late in coming across some heartbreaking news from one of my fellow bloggers but still wanted to share it here in case anyone reading isn't aware.

BB's baby girl arrived 15 weeks early Easter weekend due to the sudden onset of severe preeclampsia.  This news hit me especially hard, as this could so easily have been me and was something I feared throughout my pregnancy.  (Odd, but reading her posts, I found myself grateful for the prompt diagnosis of my own preeclampsia, its slow progression and my being able to get to 34 weeks before having to deliver our boys.)

Not only is little Ella very early and tiny, with all the attendant health struggles that entails, but she is hospitalized hours from her mom's home.  I am sure BB can use all the love and support we can offer her, so will you take a moment to stop by her blog and let her know they are in your thoughts?  Thanks.

Wednesday, April 18, 2012

Some follow-up

Wow, thank you for all your comments on my last post.  Given how infrequently I post these days, I wasn't sure anyone was still reading.  ;-)

Reading some of the comments helped because it was a reminder that we aren't the only parents who've dealt with this issue.  (It's also good to hear that it gets better and that medications are appropriate if they are needed; MM and I went back and forth on that point, not wanting to medicate our children unnecessarily.)  It also made me realize that I failed to provide the full backstory.  (Oops.)  So allow me to do so and to also address some of the comments here to fill in the blanks.
  • Both babies are exclusively formula-fed and have been since coming home from the hospital.  (Not what I would've preferred, but breast-feeding didn't work out for us. . . a topic for an entire post of its own which I lack both the motivation and the time to write at present.  Still a bit of a sore subject for me.) 
  • They have been on Similac NeoSure from day one, apart from a very few feedings of breast milk I was able to provide for them during the first week to ten days of their lives.  I have never felt that either AJ or MJ tolerated NeoSure well.  Both have been very gassy since day one and have often seemed to have discomfort with it, even apart from the reflux issues.  (I can often actually HEAR their intestinal workings when they're struggling with gas or BMs.)  I hate that they require this higher-calorie formula, but it is what it is.
  • Although NeoSure contains both lactose and soy ingredients, our pediatrician has not wanted us to take the babies off that formula until their weights "catch up" to other babies of their age.  (Remember that they arrived almost six weeks early, which is why they are "behind" in weight.  Their birth weights were actually above average for 34-weekers.)  Just last week at the appointment where he prescribed their medication, he did say that MJ could come off NeoSure once his reflux symptoms subside and he is once again consuming appropriate volumes of formula for his weight.  But AJ still needs to stay on NeoSure until his weight gets close to the 50th percentile for his chronological age.  So while I have considered changing their formula for a while, it doesn't seem to be an option for now, at least not for AJ.
  • We love our pediatrician and trust him.  He has been practicing medicine for nearly thirty years but also obviously keeps current on the latest research; he is also very gentle with the babies and patient with us and our (many) questions.  He was highly recommended by several other twin moms in my area, and in an odd coincidence, I realized that I had met him once a few years back when he testified as an expert witness in one of my cases.  So we are inclined to follow his advice, not because we are trusting of health care providers in general but because of our confidence in him specifically.
  • Because MJ has always been a "happy spitter" ever since he was born, we had already tried a lot of the intermediate measures which are recommended to reduce reflux symptoms: frequent burping, keeping him upright for 20-30 minutes after feedings, sleeping on an incline, and using gas-reduction bottles (we've tried both Dr. Brown's and Avent and are currently using Avent).  We haven't found that any of them helped much: MJ still spit up as much as ever (sometimes during a feeding), and his symptoms (crying, rejecting the bottle, arching his back and squirming during feedings) worsened even though we were already doing all this.
  • One pediatrician in our doctor's practice suggested the possiblity of thickening MJ's formula with rice cereal, but I expressed concern about doing so because he was so young at the time (only 6 weeks old, so really zero weeks adjusted age) and also because he was/is already gaining weight more rapidly than recommended.  She and our regular pediatrician understood and shared my concerns, so that's something we have not done so far.  (If problems continue, I may consider doing it for AJ, or both AJ and MJ, if necessary, now that they are a little older.)
  • We definitely have noticed a decrease in the amount and quality of both boys' sleep since their reflux symptoms have worsened.  Both babies have been swaddled for all sleep since day one.  It seems to really comfort them, and we intend to continue it as long as they will allow us to do so, or at least until they are rolling over (after which time I understand it's not considered safe to swaddle?).
  • The babies started taking nizatidine three times a day last Wednesday evening. The pediatrician said it would take about a week to have the full desired effect.
Today will be the seventh day that the boys have been on the nizatidine, and I think we may finally be seeing some relief with it: yesterday was the best day of feedings they have had in a few weeks.  They are still not back to the volumes they were eating before their symptoms worsened--or to the volumes they should be consuming for their weights--but we've been seeing less crying, less back-arching, and less rejecting of bottles.

Here's hoping they've turned a corner with this issue.  I hate seeing them suffer.  :-(

Tuesday, April 17, 2012

Infant reflux

(Children mentioned & discussed)

Looks like I spoke too soon when I mentioned in my last post that neither of our boys had reflux.

Our pediatrician (whom we love, by the way) assured us at our boys' two-month well-check that all babies have some reflux, that it's a normal result of the immaturity of the sphincter muscle between their stomaches and their esophaguses (esophagi?).  However, so long as the baby is able to eat without pain, isn't projectile vomiting regularly and is gaining weight, it is not considered a problem, and treatment is not indicated.

Beginning about two weeks ago, both our boys began having increasing amounts of difficulty with feedings.  MJ started having trouble first: eating OK at first but then shaking his head to reject the bottle, squirming and writhing around while feeding, and crying.  Oh, the crying.

To be honest, at first, MM and I were not overly concerned.  Although MJ has always been a baby who spits up some after nearly every feeding, the amounts never seemed excessive to us, and we had already talked with his pediatrician about this (as noted above).  There had been times before when MJ would squirm and cry during a feeding and then have a big poop afterwards--usually once every 2-3 days--so we had attributed those problems to gas and his tendency to be a little on the fussy side.  He has been gaining weight steadily, so much so, in fact, that although he only outweighed his brother by an ounce at birth, he is now a full two pounds heavier than AJ.

Gradually MJ's problems became more frequent, now happening about every other feeding instead of every few days.  AJ also started having trouble: refusing the bottle, crying inconsolably, and squirming and shaking his head in what appeared to be an attempt to escape the bottle.  (The saddest part was the look of fear on his face when he saw you bringing the bottle toward his mouth.)

Unlike his brother, AJ isn't a fussy baby; if he cries, it's because he needs something.  He is very easy-going, smiles often, and will happily recline on his Boppy pillow with his pacifier waiting for MJ to finish eating (something MJ will *not* do if AJ's feeding starts first).  So when AJ started having difficulty eating, at first a few times a day and then nearly every bottle, we knew something was wrong.

After two days of difficulties at nearly every feeding, both babies went to the doctor last Wednesday and were diagnosed with GERD and prescribed medication.  They have continued to have feeding difficulty, but the pediatrician told us it could take a week or so for the medication to take full effect.

So MM had a difficult first week home with the boys full-time last week.  To his credit, though, he handled it very well.

It's so sad to have your babies crying when they try to eat, and so frustrating and time-consuming trying to feed them when they can't eat.  :-(  I hope their medication takes effect soon.

Friday, April 6, 2012

Prematurity & things I hadn't considered

I want to start this post by saying that our boys are doing very well.  AJ is gaining weight at just the rate his pediatrician wants, and MJ is gaining even faster than that.  Neither baby has reflux or colic, both are relatively easily comforted, and they appear to be developing at an appropriate rate.

Also, we love our boys and feel so grateful to finally be parents.  Even so, having two newborns in your home is hard!  I'm not gonna lie.

When I thought of all the reasons I didn't want our boys to come early, I thought mostly of their health.  I didn't want them to have to spend time in the NICU battling health problems or to run the risk of suffering lifelong problems due to being born prematurely.

Since they have been home, I have discovered a few other downsides to having my babies prematurely which I hadn't previously considered.  I think the newborn phase is the hardest with any baby, and having preemies means that, in addition to all the other downsides, that phase lasts a lot longer.
  • My firm would not allow me extra time off for FMLA leave in view of the fact that I was on medical leave for two weeks prior to delivery (even though my leave was COMPLETELY unpaid).  Which meant that I had to return to work when the boys were 10 weeks old.  Which, because they were nearly 6 weeks premature, meant their adjusted age when I went back to work last week was only 4 weeks.
  • Trying to work full-time and take care of two 4-week-old babies in your "spare" time is really, really hard. . . much harder than taking care of two 12-week-old babies.
  • It seems like our boys have been newborns FOREVER!  This has more than one implication:
    1. My husband and I hear of some (lucky) parents whose babies are sleeping through the night, or nearly so, by 3 months of age.  Whatever age our boys might've achieved that goal, we can tack an extra 6 weeks on to that number.
    2. Although the calendar says they are 11 weeks old, they are not yet consistently smiling.  Or holding up their heads.  Or tracking objects.  Their pediatrician has assured us that this is normal, so we aren't worried; we just look forward to the time when they can do these things.
    3. Although they are no longer on a regimented, every-3-hours-around-the-clock feeding schedule, their tummies are small and they still need to eat quite frequently.  They often end up eating every 3 hours during the day and cannot usually go more than 4-5 hours at night.
I don't want to wish away our boys' babyhood.  I know this phase in their lives is brief and, because they will be our only children, that we will never get to experience it again.  It's hard when you're living through it day by day, though.