I don't have time for a long post but wanted to let you know that our boys arrived late Thursday night. Alexander (Twin A, hereafter AJ) weighed 5 # 5 oz, and Mason (Twin B, hereafter MJ) weighed 5 # 6 oz. Each has done well and avoided the NICU entirely so far.
I, on the other hand, have had a bit of a difficult time. I will write more detail when I can, as the boys are coming to be fed soon. They are doing great for 34-weekers!
I am behind in updating here, but with good reason. After spending an uneventful weekend on home bed rest last weekend--including a monitoring session at the hospital with a good NST and decent blood pressures on Sunday--I was admitted to the hospital on Monday afternoon.
Ironically, I thought there wasn't really even much need for me to go in for a doctor's appointment that day. While at the hospital on Sunday morning for my NST, I'd had my blood pressure checked every 10 minutes, and each reading was under 140/90. Not great, but not in a dangerous range and better than some recent measurements I'd had.
Nonetheless, I followed my doctor's orders and went to the office on Monday afternoon. Where my blood pressure was 160/90 and I was immediately sent to the hospital and admitted for further monitoring and work-up.
I was freaked out about getting admitted. Worried about the babies, yes, and also just generally unsettled at the idea of having to be hospitalized. (Although I worked in hospitals as a nurse for seven years, I had never spent a night in one as a patient for any reason prior to Monday.) The last 36 hours or so have turned out to be not as bad as I feared they might.
When I was initially admitted, because my blood pressures were running so high, I was bolused with IV magnesium sulfate and started on a continuous mag drip. (I had also never had an IV before.) The mag made me feel extremely hot/flushed--I had my room's thermostat on 65 degrees and would have moved it lower if possible--and also gave me a headache, though I was fortunate to avoid the nausea/vomiting and other symptoms some women experience on mag. I hardly slept at all the first night; although the nurse was great about not disturbing me unduly, and I have a private room, between the unfamiliar environment, the uncomfortable bed, and the sound of two continuous fetal monitors, I was only able to sleep about three hours total. (Ugh.)
The first of two shots of betamethasone (a steroid given to help mature the babies' lungs) which I also got upon admission probably contributed to my restlessness and overheated feeling. (Though I will say that after 10 weeks of PIO shots, betamethasone was a piece of cake.)
At this point, the news is more encouraging than it was when I was admitted. (On Monday night, we weren't sure if I might have to be delivered within hours.) I had a repeat 24-hour urine collection which continues to show protein (1015), increased from my last 24-hour urine. . . but still in the "mild" and not the "severe" range. Most of my liver function tests look OK, and my platelet levels are normal. My resting blood pressures are running in the 130-140/80-90 range. (After any small exertion, though, they can shoot up to 160s/100s.) I've had a second betamethasone shot, and my blood sugars are a little elevated as a result but not to the point of requiring insulin.
On the plus side, my doctors are currently terming my preeclampsia "mild," which means there is no rush to deliver the babies. On the negative side, I will have to continue to remain in the hospital until I deliver, as the course of preeclampsia is so unpredictable and can quickly take a turn for the worse (as many of you reading likely already know). It's clear that my preeclampsia is progressing. . . . it just doesn't appear to be progressing too quickly at this point, thank goodness. Here's hoping that continues to be the case.
The best news of all is that the babies appear to be doing very well in spite of mom's problems. Their monitoring has all been excellent, to the point where my OB ordered me to be off fetal monitoring last night to get some rest; she didn't feel continuous monitoring was necessary through a second night, given their condition. They had a comprehensive ultrasound yesterday, including a growth scan and check of their amniotic fluid levels and cord vessel blood flow, and everything looked great. Their estimated weights are now 5 lb 7 oz (Twin A) and 5 lb 4 oz (Twin B), which I'm told is very good for twins at nearly 34 weeks gestation.
I was uncharacteristically weepy yesterday thinking about all that could go wrong, but knowing that the babies appear to be doing well and that my pre-e symptoms aren't getting worse has helped. (Getting nearly a full night's sleep last night and being allowed to shower and wash my hair this morning probably helped some, too. Sometimes it's the little things.)
So that's where things are. I am still hoping to make it to 36 weeks, although I realize that may not be realistic at this point. Every day I can keep these boys in utero is another day they won't have to spend in the NICU, so I'm just trying to get through one day at a time.
Today we plan to have a tour of the NICU and visit with one of the neonatologists to prepare for the possibility of our boys' needing that care. I also plan to ask to meet with a lactation consultant, as I think I may need some help and guidance in building my milk supply for them, especially if they are premature and require NICU care. (Difficulty coordinating breathing with sucking is one problem common to babies born at 34 weeks.)
I remind myself that this possibility--the need for advanced care--is why I chose this OB group and this hospital (which is reckoned to have the best NICU in the metro area, if not the entire region) and why I established care with the maternal/fetal medicine specialists associated with this hospital. I can't control how my body is responding, but I believe I have done all I can to optimize the outcome for our babies. . . . which, at the end of the day, is all any of us can do.
It's been an eventful past few days. After my last post, I was on home bed rest, as I'd described. I continued to have a dull headache, but no other new developments: no increased swelling, no visual changes.
Monday afternoon I went to my OB's office for a follow-up appointment. My blood pressure was still up (140s/90s), and I was sent to the hospital for a non-stress test and some additional blood work. I was told that I would not permitted to return to work and would now be on bed rest for the remainder of my pregnancy.
Once at the hospital, I was given medication for my headache and released home after about five hours. (On the plus side, both babies looked just fine on their NST.) The OB for my group said she thought it was possible that I have chronic underlying hypertension which has just now begun to manifest itself due to the demands on my body from twin pregnancy and started me on lab.eta.lol (an antihypertensive which is safe for using during pregnancy).
Early Tuesday morning, I woke up with what felt the beginnings of a typical migraine. I had been instructed to take Tylenol for headaches and return to the hospital if Tylenol didn't relieve it. Tylenol never does anything for me, and this time was no exception. By 5:00 a.m., I was in a lot of pain and determined that I needed to go back to the hospital, just in case this was a symptom of a worsening of my condition.
Tuesday was an awful day. I stayed at the hospital for another five hours or so. I was first given Per.co.cet for my headache, which only helped a little and made me very groggy. The OB on call then decided it would be worthwhile to give me a dose of the Imi.trex I usually take for migraines. (I had been under the impression that it is not safe for use during pregnancy, but she said it could be used in the third trimester sparingly.)
The Imi.trex reduced my headache a little more, and I was allowed to go home, with instructions to continue bed rest and to start a 24-hour urine collection. I slept off and on during the rest of the day and was extremely groggy. I had a lot of nausea starting on the drive home--probably a combination of the two drugs I'd be given, lack of sleep and food, and the migraine itself--and actually vomited when I tried to eat lunch. (Despite 16 weeks of constant nausea earlier in my pregnancy, Tuesday was actually the first time I'd thrown up since I've been pregnant.) I hardly ate at all.
By Tuesday evening, I was feeling semi-normal, and I felt OK yesterday. I had to drive to the hospital to drop off my 24-hour urine collection but otherwise just took things easy.
This morning I was at the hospital again (fourth visit this week, for those keeping count) for another NST and measurement of amniotic fluid index. Once again, the babies both looked very good. My blood pressure is still hanging around the 140s/90s, despite taking lab.eta.lol twice a day. And I learned the results of my 24-hour urine test, which showed that I have enough protein in my urine for a confirmed diagnosis of preeclampsia.
So that's where things stand. My goal right now is just to take it as easy as I can and hope that we can delay delivery as long as possible. (I passed 33 weeks yesterday.) I will be going in for additional monitoring twice a week, and if I get worse, I may have to be admitted to the hospital. For now, though, I am just hoping things don't get any worse and that I am able to make it to 36 weeks.
At the end of my last post, when I said I was trying to finish up a few small projects at work so that everything would be in an OK position for when I started my leave. . . . yeah, that's not gonna happen.
Yesterday morning, I woke up early (around 3 a.m.) with a bad headache. The pain was similar to migraine pain but not similar to *my* typical migraines. (And I've only had two migraines since I've been pregnant.)
I slept fitfully off and on until around 7 a.m. I had made up my mind that I wasn't going to work, and I thought it would be a good idea to let my OB know about my headache, just in case it was a sign of something more serious going on.
Long story short, I went into the OB's office and my blood pressure was elevated. . . not dangerously high, 130s-140s/90s. Fortunately, apart from the elevated blood pressure and headache, I don't have any other symptoms of preeclampsia at this time. . . but I was told to go home to be on modified bed rest effective immediately and to return to the office on Monday for another appointment.
So I've spent most of the last two days lying on my left side on the couch. I haven't been able to tie up my loose ends at work, and it's not looking hopeful for me to be able to go back and do so next week. (I'm thinking it's unlikely that my blood pressure will spontaneously return to normal now that it's started to rise, and I'm still having headaches.)
On the plus side, I'm glad I went to the doctor as soon as I suspected something might be wrong. Also, my mother is in town, so she has been able to help me out and run some errands for me.
I am still hoping to keep these babies in utero until at least 36 weeks. I hope that's still a possibility.
(Today's post will be all about pregnancy. If you don't feel like reading about that right now, I completely understand. Hope to see you again soon.)
************************* Total Weight Loss/Gain: I have now gained 18 lbs from what I weighed the morning of our embryo transfer. (I lost 9 lbs in the first trimester and have regained it plus 18. . . so, in a way, a total gain of 27 lbs.)
Maternity Clothes: All maternity all the time now. Even some of my maternity shirts are snug.
Stretch marks: No new ones related to pregnancy.
Sleep: OK. Getting up to pee almost hourly all night. Ugh. I am pretty tired most of the time and have permanent bags/circles under my eyes (which I doubt will be going away any time soon). I take a nap in the afternoons when I can.
Movement: Both twins are active most of the time now. Twin A's movements continue to feel uncomfortable, as it usually feels like he is kneeing me in the bladder or behind my pubic bone. He is very low down there. Twin B's movements are often visible from the outside. (Twin A's might be, too, but I can no longer see that part of my belly, LOL.)
Cravings/Aversions: Still some smell aversions. I have been "craving" coffee and soda, but I think it's mainly because I can't have them. (I suppose I *could* drink caffeine at this point in my pregnancy, but having avoided it this long, I figure the best thing for the boys is to be born having never been exposed to it.)
Gender: We are (still) having two boys.
Symptoms: Same, no real changes. Daily Pri.los.ec has helped, but not cured, my heartburn. I've started having some pain in both hips (probably from lying on my left side so much). I've had some intermittent sharp pains in my groin which my OB thinks are round ligament pains.
As of this past weekend, I have started having more Braxton-Hicks contractions. I used to only get them if my bladder was full or if I walked a (relatively) longer distance. Now I get them randomly throughout the day and night also. They go away fairly quickly, especially if I lie on my left side and drink extra water.
What I miss: Being able to take a nice, deep breath. Getting up from a seated position without having to use my arms to push myself up! Being able to see my feet when I look down, being able to put on socks without assistance or pain.
What I look forward to: Meeting the babies (when they're ready), being able to eat and breathe normally again post-delivery. Being able to put on my own socks!
Milestones: I've now made it to 32 weeks! Whew! My next milestone will be 36 weeks; I hope I make it that far.
Medical concerns: I am still managing my gestational diabetes with a small dose of an oral medication at bedtime and diet. My blood pressure and everything else appear to be normal so far. Starting after my next OB appointment next week, I will be having twice weekly NSTs; I hope they go well.
Misc: My mother is in town now (though not staying at our house) and planning to stay until the babies are born.
I continue to be exceptionally tired, almost back to the level of fatigue I had during the first trimester. I keep reminding myself that I've gotten this far and that I can tough it out for the next 4-6 weeks. (My OB has said that the latest I will deliver is 38 weeks, although I may deliver as early as 36 weeks.)
Trying to finish up a few small projects at work so that everything is an OK position for when I start my leave (which, let's face it, may be before my delivery date if I continue to get huge and am this tired and uncomfortable).