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Archive for March, 2007

Graduation

Argh! I had a long eloquent post. I failed to copy to my clipboard (which I usually do) and I clicked "publish" and stupid blogger logged me out and forced me to log in again and lost my post.

GRR.

Short story: three heartbeats 147, 152, and 153. Three fetbryos, all measuring pretty close to exactly right.

Best news ever: Margaret was JOKING when she said, "Hey Dr. Amazing, we were going to tell her about the fourth one today, right?

Rest of story in brief: still haven't told my mother or MIL about this pregnancy because of the dumbass comments they made after my miscarriage last fall. Not sure if I'm going to tell them before the bar/bat mitzvah (s). Still considering it.

Too tired for more eloquence. I was funny. I was witty. I was eloquent and delightful. Just take my word for it.

Read Full Post »

I have a friend who had IVF twins in the Fall of 2005 and is now pregnant with a “whoops” baby (very much wanted, just very much a suprise since she was told she had, at best, a snowball’s chance in hell of conceiving spontaneously). She’s a pediatrician and I call her often for advice with our foster son. She’s a good friend who understands the frustration of infertility, having been there herself. She called me yesterday to apologize for a comment that she’d made that she perceived as possibly insensitive. I hadn’t even remotely remembered her saying any such thing and when she told me what the remark was, I didn’t think it insensitive at all. (She had said something about how this pregnancy was such a joy compared to her last because she got to be surprised by it and didn’t have constant monitoring all the time… didn’t bother me a bit at the time, nor does it bother me now).

I didn’t tell her then that I am pregnant…she lives in my neighborhood, and I just really don’t want people in my neighborhood knowing that I’m pregnant. And anyway, I was about to run off to a meeting with my rabbi and didn’t have much time to mention it anyway.

Oh, right, I met with my rabbi yesterday. Reduction is definitely not an option I love, but I was relieved to hear that it is not an entirely closed issue either. IF there is a specific, significant medical concern about either me or the babies if I keep all three AND one of the fetbryos looks to be less viable than the others, reduction is possible. These are basically the only circumstances under which I really wanted to consider reduction anyway. It is otherwise out of the question, as I suspected. I feel relieved simply to have answers. I was feeling nervous, but good after the meeting and I think I can move forward with the next steps.

I was feeling pretty good in general, actually. Passover cleaning had been going well, I had the teeniest bit of energy (not much, but enough to stay awake), all good. And then WHAMMO! I started throwing up. And couldn’t stop. And still couldn’t stop. And when I wasn’t throwing up I was in pain and praying to throw up. My husband, a pharmacist, wanted me to take some fenergan (I had some leftover from something or other), but I wasn’t convinced I should take it. He asked me for my OB’s number and I wouldn’t give it to him, because that’s ridiculous. Most pregnant women get nausea. Most of those throw up at some point or another. So he suggested I call A (my friend described above) and ask for her advice. “But I haven’t told A I’m pregnant!” So my husband, darling angel that he is, gave me a choice: either I could call A, or he would look up my OB’s number and call himself.

I called A. At work (she was on-call at the Pediatric ER she works at). I felt terribly about interrupting her actual work for something so trivial, but I called anyway.

“So, um, I wasn’t exactly planning to tell you like this, but, um, so… I’m pregnant.”
“Congratulations!” (I’m sure she was wondering why on earth I was calling her at work, which I never do, to tell her this news).
“With triplets.”
“Ohmygosh! When did that happen?”
“uh, well, about, uh, you know, 8 weeks ago…”
“So you’re throwing up all over the place now, right?”
“Well, I hadn’t been until today and now I can’t even see straight and S wants me to take fenergan, but I’m not sure if I can…”
“You can take 25mg every 4-6 hours. If that doesn’t work, call your OB and get Zofran. Also, eat lots of cheerios and ricecakes throughout the day, it will help with the nausea. Don’t let yourself get hungry or it will only be worse.”
“Got it. I just didn’t want to call my OB and say, ‘Oh I’m nauseated’ because EVERY pregnant woman gets nauseated.”
“Don’t be ridiculous. With triplets, you’re expected to be hyper-emetic, and if your OB isn’t sympathetic about that, change OBs. So when are you quitting your job?”

And all was solved. I took the fenergen, threw up fifteen minutes later, but then was able to hold a little food down and I fell asleep. I’ve been munching on animal crackers all day and sucking down water like it’s going out of style, and I’m mostly okay.

Tomorrow I have an ultrasound at Shady Hell, probably my last there before I graduate. I’ll be just about 8 weeks, which is still a LONG way away from seeing the light at the end of the tunnel, but I guess it is, at least, one small milestone that I can check off my list. Next week is the consult with the perinatologist (they’ll do another ultrasound then, except I’ll be able to keep my underwear on for that one!) and the week after that, I’ll see my OB again (no ultrasound, in all likelihood, but that’s okay). Then the fun begins. Or something.

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You know how I haven’t had much nausea in this pregnancy? Yeah. Um. I lied. A lot. I am very much regretting having been worried about my lack of nausea. YUCK.

Read Full Post »

You know how I haven't had much nausea in this pregnancy? Yeah. Um. I lied. A lot. I am very much regretting having been worried about my lack of nausea. YUCK.

Read Full Post »

I have a friend who had IVF twins in the Fall of 2005 and is now pregnant with a "whoops" baby (very much wanted, just very much a suprise since she was told she had, at best, a snowball's chance in hell of conceiving spontaneously). She's a pediatrician and I call her often for advice with our foster son. She's a good friend who understands the frustration of infertility, having been there herself. She called me yesterday to apologize for a comment that she'd made that she perceived as possibly insensitive. I hadn't even remotely remembered her saying any such thing and when she told me what the remark was, I didn't think it insensitive at all. (She had said something about how this pregnancy was such a joy compared to her last because she got to be surprised by it and didn't have constant monitoring all the time… didn't bother me a bit at the time, nor does it bother me now).

I didn't tell her then that I am pregnant…she lives in my neighborhood, and I just really don't want people in my neighborhood knowing that I'm pregnant. And anyway, I was about to run off to a meeting with my rabbi and didn't have much time to mention it anyway.

Oh, right, I met with my rabbi yesterday. Reduction is definitely not an option I love, but I was relieved to hear that it is not an entirely closed issue either. IF there is a specific, significant medical concern about either me or the babies if I keep all three AND one of the fetbryos looks to be less viable than the others, reduction is possible. These are basically the only circumstances under which I really wanted to consider reduction anyway. It is otherwise out of the question, as I suspected. I feel relieved simply to have answers. I was feeling nervous, but good after the meeting and I think I can move forward with the next steps.

I was feeling pretty good in general, actually. Passover cleaning had been going well, I had the teeniest bit of energy (not much, but enough to stay awake), all good. And then WHAMMO! I started throwing up. And couldn't stop. And still couldn't stop. And when I wasn't throwing up I was in pain and praying to throw up. My husband, a pharmacist, wanted me to take some fenergan (I had some leftover from something or other), but I wasn't convinced I should take it. He asked me for my OB's number and I wouldn't give it to him, because that's ridiculous. Most pregnant women get nausea. Most of those throw up at some point or another. So he suggested I call A (my friend described above) and ask for her advice. "But I haven't told A I'm pregnant!" So my husband, darling angel that he is, gave me a choice: either I could call A, or he would look up my OB's number and call himself.

I called A. At work (she was on-call at the Pediatric ER she works at). I felt terribly about interrupting her actual work for something so trivial, but I called anyway.

"So, um, I wasn't exactly planning to tell you like this, but, um, so… I'm pregnant."
"Congratulations!" (I'm sure she was wondering why on earth I was calling her at work, which I never do, to tell her this news).
"With triplets."
"Ohmygosh! When did that happen?"
"uh, well, about, uh, you know, 8 weeks ago…"
"So you're throwing up all over the place now, right?"
"Well, I hadn't been until today and now I can't even see straight and S wants me to take fenergan, but I'm not sure if I can…"
"You can take 25mg every 4-6 hours. If that doesn't work, call your OB and get Zofran. Also, eat lots of cheerios and ricecakes throughout the day, it will help with the nausea. Don't let yourself get hungry or it will only be worse."
"Got it. I just didn't want to call my OB and say, 'Oh I'm nauseated' because EVERY pregnant woman gets nauseated."
"Don't be ridiculous. With triplets, you're expected to be hyper-emetic, and if your OB isn't sympathetic about that, change OBs. So when are you quitting your job?"

And all was solved. I took the fenergen, threw up fifteen minutes later, but then was able to hold a little food down and I fell asleep. I've been munching on animal crackers all day and sucking down water like it's going out of style, and I'm mostly okay.

Tomorrow I have an ultrasound at Shady Hell, probably my last there before I graduate. I'll be just about 8 weeks, which is still a LONG way away from seeing the light at the end of the tunnel, but I guess it is, at least, one small milestone that I can check off my list. Next week is the consult with the perinatologist (they'll do another ultrasound then, except I'll be able to keep my underwear on for that one!) and the week after that, I'll see my OB again (no ultrasound, in all likelihood, but that's okay). Then the fun begins. Or something.

Read Full Post »

I have a friend who had IVF twins in the Fall of 2005 and is now pregnant with a "whoops" baby (very much wanted, just very much a suprise since she was told she had, at best, a snowball's chance in hell of conceiving spontaneously). She's a pediatrician and I call her often for advice with our foster son. She's a good friend who understands the frustration of infertility, having been there herself. She called me yesterday to apologize for a comment that she'd made that she perceived as possibly insensitive. I hadn't even remotely remembered her saying any such thing and when she told me what the remark was, I didn't think it insensitive at all. (She had said something about how this pregnancy was such a joy compared to her last because she got to be surprised by it and didn't have constant monitoring all the time… didn't bother me a bit at the time, nor does it bother me now).

I didn't tell her then that I am pregnant…she lives in my neighborhood, and I just really don't want people in my neighborhood knowing that I'm pregnant. And anyway, I was about to run off to a meeting with my rabbi and didn't have much time to mention it anyway.

Oh, right, I met with my rabbi yesterday. Reduction is definitely not an option I love, but I was relieved to hear that it is not an entirely closed issue either. IF there is a specific, significant medical concern about either me or the babies if I keep all three AND one of the fetbryos looks to be less viable than the others, reduction is possible. These are basically the only circumstances under which I really wanted to consider reduction anyway. It is otherwise out of the question, as I suspected. I feel relieved simply to have answers. I was feeling nervous, but good after the meeting and I think I can move forward with the next steps.

I was feeling pretty good in general, actually. Passover cleaning had been going well, I had the teeniest bit of energy (not much, but enough to stay awake), all good. And then WHAMMO! I started throwing up. And couldn't stop. And still couldn't stop. And when I wasn't throwing up I was in pain and praying to throw up. My husband, a pharmacist, wanted me to take some fenergan (I had some leftover from something or other), but I wasn't convinced I should take it. He asked me for my OB's number and I wouldn't give it to him, because that's ridiculous. Most pregnant women get nausea. Most of those throw up at some point or another. So he suggested I call A (my friend described above) and ask for her advice. "But I haven't told A I'm pregnant!" So my husband, darling angel that he is, gave me a choice: either I could call A, or he would look up my OB's number and call himself.

I called A. At work (she was on-call at the Pediatric ER she works at). I felt terribly about interrupting her actual work for something so trivial, but I called anyway.

"So, um, I wasn't exactly planning to tell you like this, but, um, so… I'm pregnant."
"Congratulations!" (I'm sure she was wondering why on earth I was calling her at work, which I never do, to tell her this news).
"With triplets."
"Ohmygosh! When did that happen?"
"uh, well, about, uh, you know, 8 weeks ago…"
"So you're throwing up all over the place now, right?"
"Well, I hadn't been until today and now I can't even see straight and S wants me to take fenergan, but I'm not sure if I can…"
"You can take 25mg every 4-6 hours. If that doesn't work, call your OB and get Zofran. Also, eat lots of cheerios and ricecakes throughout the day, it will help with the nausea. Don't let yourself get hungry or it will only be worse."
"Got it. I just didn't want to call my OB and say, 'Oh I'm nauseated' because EVERY pregnant woman gets nauseated."
"Don't be ridiculous. With triplets, you're expected to be hyper-emetic, and if your OB isn't sympathetic about that, change OBs. So when are you quitting your job?"

And all was solved. I took the fenergen, threw up fifteen minutes later, but then was able to hold a little food down and I fell asleep. I've been munching on animal crackers all day and sucking down water like it's going out of style, and I'm mostly okay.

Tomorrow I have an ultrasound at Shady Hell, probably my last there before I graduate. I'll be just about 8 weeks, which is still a LONG way away from seeing the light at the end of the tunnel, but I guess it is, at least, one small milestone that I can check off my list. Next week is the consult with the perinatologist (they'll do another ultrasound then, except I'll be able to keep my underwear on for that one!) and the week after that, I'll see my OB again (no ultrasound, in all likelihood, but that's okay). Then the fun begins. Or something.

Read Full Post »

So the OB/GYN practice I go to has a rather extensive website, including pictures and bios of all the doctors/midwives. The bios say where the doctor went to school, what their special medical interests are, and if they’re married and/or have kids they note that too (I guess for the personal touch). My OB, in case you were dying to know, is married with three kids. Among his medical interests is “high risk obstetrics.” So Dr. B came in to talk to me and said, “wow, you just don’t do anything half-way, do you?” (No, in fact, my last pregnancy made it a third of the way, so I didn’t even do THAT halfway!)

“Well, I see that you’re interested in high risk obstetrics, so I figure I’m doing you a favor!”
“Wow. Yeah. So, what happened?”

I gave him the history of the cycle, how it was almost cancelled, how IUI was supposed to avoid the cost, invasiveness and trauma of IVF (and look where it got me!), that we’ve got three little heartbeats. Lovely. He freaked the heck out. I mean, he was calmish, but very clear that this was not an ideal situation in his book. He’s delivered healthy successful triplets before. He’s not worried about how to manage a patient with triplets. He’s concerned about me… “You’re so little! Where are you going to put them? You’re only 5’1″!!” (5’1″ is a bit of a stretch, by the way…. and by little he meant short, not you know, little) He actually seemed to think that was one of the biggest problems with me having triplets. He said with as short as I am (and therefore, I have a shorter torso/abdomen) I’d be lucky to have 3 pound babies. He wasn’t saying it’s impossible. He wasn’t saying I should reduce. He was very clear that the absolute biggest problem I’m going to have is managing pre-term labor. If I make it to 32 weeks, he said, I’ll be lucky. He warned that if I went into preterm labor too early, I could lose all three (a thought that I’ve definitely had myself).

Typing it out, it sounds as though he was cruel, but that’s not how it came across. He was concerned. He knew I’d already had an unexplained 12 week loss. He was worried that I’m facing a potentially enormous loss. He also wanted to make sure that I understood the importance of following whatever instructions I’m given regarding activity level in this pregnancy. He was very clear that I wouldn’t be likely to avoid bedrest and he confirmed that I can definitely count on not working after I get to 20 weeks. That’s three months from now. That’s frightening.

I really don’t want to tell my manager or client about the pregnancy before I get to 12 or 13 weeks (remember that 12 week miscarriage? Yeah…), which would basically give only 2 months notice of my imminent disappearance. I wouldn’t normally feel badly about this, except it will take probably 3-4 months to find a replacement for me. I’m in a field with far more jobs than professionals (good for me, bad for my client) and it’s quite difficult to find folks who are looking for jobs in my field right now. I have six years experience, which doesn’t sound like much, but it meant a very short learning curve for me when I got here. If I’d come in with 2-3 years experience, I would have had a very steep learning curve. But I digress…

Dr. B. said he didn’t want to discuss reduction with me. He recognized that I first need to speak with my Rabbi (appointment set up for Sunday evening, time TBD). And he also recognized that it was more important that I speak with the perinatologist about the risk/benefit involved. He wanted me to go talk to Dr. P (the perinatologist) about what I could expect with a triplet pregnancy, what my specific health risks are, and so on. I should return the week after I see Dr. P. and we’ll talk about how to proceed.

Assuming I don’t reduce and all three embryos make it (which I can’t entirely count on, either), I asked how I could expect my care to be managed. Dr. B. emphasized that I would be seen far more often than if I had a singleton. He said that I would probably see Dr. P. as much as I see the OB practice, if not more. My care would be managed jointly, which I’m comfortable with. It was obvious that Dr. B. would defer to the perinatologist for critical care decisions and that his own role would essentially be to monitor growth and development. Both doctors would likely be at the delivery. I have a guaranteed C-section. No possibility that they will allow me to attempt to deliver vaginally. While occasionally doctors will allow an attempt at a vaginal delivery for triplets, it’s rare, and Dr. B said for me, the risk would be too great to warrant even attempting it. He reminded me that I don’t have a lot of room for babies to grow and that even if I’d managed to deliver one vaginally, I’d most certainly end up with a c-section for one or more. Safer bet, he says, to skip the risk all together, particularly given that odds are high that I’ll be in preterm labor, which has enough problems already.

I know it sounds like he was being all kinds of alarmist, but he wasn’t. He was comfortable with the possibility of managing my care with triplets, but obviously concerned about my ability to carry triplets safely and optimally.

I’m scared. I don’t want to reduce, because I’m afraid I’d be doing it for all the wrong reasons. I know I would love all of my babies. But what if they don’t make it? What if I don’t? How am I going to take care of three babies while recovering from a C-section? C-section recoveries are far worse after prolonged bedrest, which I can count on. I’m really scared. I’m not concerned that I won’t get appropriate medical care. I have full faith in my OB and I know I will receive excellent care from him and from the perinatologist. I also know that the greatest risk I’m facing is preterm labor. Dangerously pre-term. I’m terrified.

Read Full Post »

So the OB/GYN practice I go to has a rather extensive website, including pictures and bios of all the doctors/midwives. The bios say where the doctor went to school, what their special medical interests are, and if they're married and/or have kids they note that too (I guess for the personal touch). My OB, in case you were dying to know, is married with three kids. Among his medical interests is "high risk obstetrics." So Dr. B came in to talk to me and said, "wow, you just don't do anything half-way, do you?" (No, in fact, my last pregnancy made it a third of the way, so I didn't even do THAT halfway!)

"Well, I see that you're interested in high risk obstetrics, so I figure I'm doing you a favor!"
"Wow. Yeah. So, what happened?"

I gave him the history of the cycle, how it was almost cancelled, how IUI was supposed to avoid the cost, invasiveness and trauma of IVF (and look where it got me!), that we've got three little heartbeats. Lovely. He freaked the heck out. I mean, he was calmish, but very clear that this was not an ideal situation in his book. He's delivered healthy successful triplets before. He's not worried about how to manage a patient with triplets. He's concerned about me… "You're so little! Where are you going to put them? You're only 5'1"!!" (5'1" is a bit of a stretch, by the way…. and by little he meant short, not you know, little) He actually seemed to think that was one of the biggest problems with me having triplets. He said with as short as I am (and therefore, I have a shorter torso/abdomen) I'd be lucky to have 3 pound babies. He wasn't saying it's impossible. He wasn't saying I should reduce. He was very clear that the absolute biggest problem I'm going to have is managing pre-term labor. If I make it to 32 weeks, he said, I'll be lucky. He warned that if I went into preterm labor too early, I could lose all three (a thought that I've definitely had myself).

Typing it out, it sounds as though he was cruel, but that's not how it came across. He was concerned. He knew I'd already had an unexplained 12 week loss. He was worried that I'm facing a potentially enormous loss. He also wanted to make sure that I understood the importance of following whatever instructions I'm given regarding activity level in this pregnancy. He was very clear that I wouldn't be likely to avoid bedrest and he confirmed that I can definitely count on not working after I get to 20 weeks. That's three months from now. That's frightening.

I really don't want to tell my manager or client about the pregnancy before I get to 12 or 13 weeks (remember that 12 week miscarriage? Yeah…), which would basically give only 2 months notice of my imminent disappearance. I wouldn't normally feel badly about this, except it will take probably 3-4 months to find a replacement for me. I'm in a field with far more jobs than professionals (good for me, bad for my client) and it's quite difficult to find folks who are looking for jobs in my field right now. I have six years experience, which doesn't sound like much, but it meant a very short learning curve for me when I got here. If I'd come in with 2-3 years experience, I would have had a very steep learning curve. But I digress…

Dr. B. said he didn't want to discuss reduction with me. He recognized that I first need to speak with my Rabbi (appointment set up for Sunday evening, time TBD). And he also recognized that it was more important that I speak with the perinatologist about the risk/benefit involved. He wanted me to go talk to Dr. P (the perinatologist) about what I could expect with a triplet pregnancy, what my specific health risks are, and so on. I should return the week after I see Dr. P. and we'll talk about how to proceed.

Assuming I don't reduce and all three embryos make it (which I can't entirely count on, either), I asked how I could expect my care to be managed. Dr. B. emphasized that I would be seen far more often than if I had a singleton. He said that I would probably see Dr. P. as much as I see the OB practice, if not more. My care would be managed jointly, which I'm comfortable with. It was obvious that Dr. B. would defer to the perinatologist for critical care decisions and that his own role would essentially be to monitor growth and development. Both doctors would likely be at the delivery. I have a guaranteed C-section. No possibility that they will allow me to attempt to deliver vaginally. While occasionally doctors will allow an attempt at a vaginal delivery for triplets, it's rare, and Dr. B said for me, the risk would be too great to warrant even attempting it. He reminded me that I don't have a lot of room for babies to grow and that even if I'd managed to deliver one vaginally, I'd most certainly end up with a c-section for one or more. Safer bet, he says, to skip the risk all together, particularly given that odds are high that I'll be in preterm labor, which has enough problems already.

I know it sounds like he was being all kinds of alarmist, but he wasn't. He was comfortable with the possibility of managing my care with triplets, but obviously concerned about my ability to carry triplets safely and optimally.

I'm scared. I don't want to reduce, because I'm afraid I'd be doing it for all the wrong reasons. I know I would love all of my babies. But what if they don't make it? What if I don't? How am I going to take care of three babies while recovering from a C-section? C-section recoveries are far worse after prolonged bedrest, which I can count on. I'm really scared. I'm not concerned that I won't get appropriate medical care. I have full faith in my OB and I know I will receive excellent care from him and from the perinatologist. I also know that the greatest risk I'm facing is preterm labor. Dangerously pre-term. I'm terrified.

Read Full Post »

So the OB/GYN practice I go to has a rather extensive website, including pictures and bios of all the doctors/midwives. The bios say where the doctor went to school, what their special medical interests are, and if they're married and/or have kids they note that too (I guess for the personal touch). My OB, in case you were dying to know, is married with three kids. Among his medical interests is "high risk obstetrics." So Dr. B came in to talk to me and said, "wow, you just don't do anything half-way, do you?" (No, in fact, my last pregnancy made it a third of the way, so I didn't even do THAT halfway!)

"Well, I see that you're interested in high risk obstetrics, so I figure I'm doing you a favor!"
"Wow. Yeah. So, what happened?"

I gave him the history of the cycle, how it was almost cancelled, how IUI was supposed to avoid the cost, invasiveness and trauma of IVF (and look where it got me!), that we've got three little heartbeats. Lovely. He freaked the heck out. I mean, he was calmish, but very clear that this was not an ideal situation in his book. He's delivered healthy successful triplets before. He's not worried about how to manage a patient with triplets. He's concerned about me… "You're so little! Where are you going to put them? You're only 5'1"!!" (5'1" is a bit of a stretch, by the way…. and by little he meant short, not you know, little) He actually seemed to think that was one of the biggest problems with me having triplets. He said with as short as I am (and therefore, I have a shorter torso/abdomen) I'd be lucky to have 3 pound babies. He wasn't saying it's impossible. He wasn't saying I should reduce. He was very clear that the absolute biggest problem I'm going to have is managing pre-term labor. If I make it to 32 weeks, he said, I'll be lucky. He warned that if I went into preterm labor too early, I could lose all three (a thought that I've definitely had myself).

Typing it out, it sounds as though he was cruel, but that's not how it came across. He was concerned. He knew I'd already had an unexplained 12 week loss. He was worried that I'm facing a potentially enormous loss. He also wanted to make sure that I understood the importance of following whatever instructions I'm given regarding activity level in this pregnancy. He was very clear that I wouldn't be likely to avoid bedrest and he confirmed that I can definitely count on not working after I get to 20 weeks. That's three months from now. That's frightening.

I really don't want to tell my manager or client about the pregnancy before I get to 12 or 13 weeks (remember that 12 week miscarriage? Yeah…), which would basically give only 2 months notice of my imminent disappearance. I wouldn't normally feel badly about this, except it will take probably 3-4 months to find a replacement for me. I'm in a field with far more jobs than professionals (good for me, bad for my client) and it's quite difficult to find folks who are looking for jobs in my field right now. I have six years experience, which doesn't sound like much, but it meant a very short learning curve for me when I got here. If I'd come in with 2-3 years experience, I would have had a very steep learning curve. But I digress…

Dr. B. said he didn't want to discuss reduction with me. He recognized that I first need to speak with my Rabbi (appointment set up for Sunday evening, time TBD). And he also recognized that it was more important that I speak with the perinatologist about the risk/benefit involved. He wanted me to go talk to Dr. P (the perinatologist) about what I could expect with a triplet pregnancy, what my specific health risks are, and so on. I should return the week after I see Dr. P. and we'll talk about how to proceed.

Assuming I don't reduce and all three embryos make it (which I can't entirely count on, either), I asked how I could expect my care to be managed. Dr. B. emphasized that I would be seen far more often than if I had a singleton. He said that I would probably see Dr. P. as much as I see the OB practice, if not more. My care would be managed jointly, which I'm comfortable with. It was obvious that Dr. B. would defer to the perinatologist for critical care decisions and that his own role would essentially be to monitor growth and development. Both doctors would likely be at the delivery. I have a guaranteed C-section. No possibility that they will allow me to attempt to deliver vaginally. While occasionally doctors will allow an attempt at a vaginal delivery for triplets, it's rare, and Dr. B said for me, the risk would be too great to warrant even attempting it. He reminded me that I don't have a lot of room for babies to grow and that even if I'd managed to deliver one vaginally, I'd most certainly end up with a c-section for one or more. Safer bet, he says, to skip the risk all together, particularly given that odds are high that I'll be in preterm labor, which has enough problems already.

I know it sounds like he was being all kinds of alarmist, but he wasn't. He was comfortable with the possibility of managing my care with triplets, but obviously concerned about my ability to carry triplets safely and optimally.

I'm scared. I don't want to reduce, because I'm afraid I'd be doing it for all the wrong reasons. I know I would love all of my babies. But what if they don't make it? What if I don't? How am I going to take care of three babies while recovering from a C-section? C-section recoveries are far worse after prolonged bedrest, which I can count on. I'm really scared. I'm not concerned that I won't get appropriate medical care. I have full faith in my OB and I know I will receive excellent care from him and from the perinatologist. I also know that the greatest risk I'm facing is preterm labor. Dangerously pre-term. I'm terrified.

Read Full Post »

FAQs

NOTE: I don’t know why this originally posted with comments disallowed; it’s certainly not my default setting and I didn’t change it when writing the post, either. Anyway, the problem is fixed.

I’ve gotten a bunch of questions recently, some via email, some via my other blog (yes, I’m a two-timer! but I write very little about infertility over there). Technically, they’re not Frequently asked questions… just questions that have been asked, so I hope you’ll excuse my rather liberal use of the term “FAQ” in this case. I’ll paraphrase the questions and provide my answers:

1. Oh my gawd, you’re having triplets??? What were you thinking, you idiot!?
Okay, I told you I’d be paraphrasing. This question came from someone who essentially implied that I was irresponsible about my infertility treatment. I don’t know what the hell I was thinking, to be honest. I certainly had no intention of having triplets. I put MY order in for a singleton, but since God* and I haven’t been on the best of speaking terms since my miscarriage in October*, I think the message got garbled. “Please God, bless me with a child” somehow got translated to, “That whiny bitch*** down there keeps asking for stuff… let’s make her careful what she wishes for next time.”

2. Oh my gawd! How could you say such a thing! Aren’t you grateful you’ve got triplets? I mean, isn’t this the infertility jackpot??
Grateful? Sure. I’m grateful I got pregnant. I’m grateful I’m probably going to end up with a baby come… um, well, I’m due in November, but we’re probably looking at September if this stays triplets, and holy hell, NO I’M NOT GRATEFUL to be looking at the prospect of delivering 32 week preemies. Three of them. Three helpless little babies who can’t survive outside of the NICU. I’m not grateful for that. Infertility Jackpot my ass****. To me, this is actually the Infertility Nightmare. Go from spending tens of thousands of dollars trying to get pregnant to spending tens of thousands of dollars on a severely high risk pregnancy and delivery. This is your idea of a jackpot? I think not. Yes, I’ll have three babies, IF this makes it that far. And yes, that’s a bracha (blessing) times three. And yes, once they’re here, I’ll love them all no matter how many there are. But mostly, I’m terrified of the toll it’s going to take to get there.

3. Oh my gawd!***** You’re an Orthodox Jew? How could you even CONSIDER reduction? It’s not muttar! It’s akin to abortion! It’s a chilul Hashem! If you must consider it, you certainly shouldn’t be advertising it! Have you talked to your Rav (Rabbi)? He’ll tell you why it’s not okay! Please don’t do this without talking to your Rav!
Ahem. Oh you think I’m exaggerating? Um, maybe a tiny bit, but not as much as you might think. And if you didn’t understand all that Jewtalk in that question… well, you’re probably lucky. Let’s start with the first part. Yes, I’m an Orthodox Jew. I can still consider reduction. Here’s how: Halacha (the body of Jewish Law) does not blindly condone reduction, but it is not a black-and-white issue in halacha either. I didn’t go into this cycle with a reasonable expectation that I’d come out with triplets (while, if in an IVF cycle I’d transferred three brilliant embryos… it would be fair to say that it was a reasonable possibility that I’d end up with triplets). That’s part one.

Part two is consideration of the specific medical circumstances. I don’t know how much my medical history is going to come into play with this, but I would be irresponsible if I didn’t consider it. I had a stroke (minor, yes, but not to be ignored) when I was 23. I have a very small hole in my heart that isn’t usually problemmatic, but if I developed blood clots, could be very dangerous (i.e. leading to another stroke). I have a plethora of lesser ailments, but those two are at the top of my list. So yes, I will meet with the maternal-fetal medicine specialist (whom I will have to see regardless of whether I’m considering reduction, since this is defined as a high risk pregnancy already). I will meet with the doctor and I will ask him what I am to expect of a triplet pregnancy with my medical history. I will ask him whether there is a significant risk to me or the babies by the simple existence of triplets. I will assume that basically the answer will be that I CAN safely carry triplets, but will have to be monitored carefully. If that is the case, obviously, reduction is out of the question.

Yes, I’m fully aware that I need to speak with my Rav. Yes, I’ve told him I need a meeting with him before Pesach. I am waiting for him to find a time that works for both of us. I will absolutely make no decisions on how this pregnancy will progress without consulting with my Rav. I have several weeks before that decision would even come into play regardless. Seriously, if you’re that concerned about me following halacha, you have way too much time on your hands.

4. Oh my gawd!!!! I knew it! I just knew it when you triggered early with all those follicles, I absolutely knew you were going to have triplets. And when your beta came back so high (228), it was obvious you were having twins or triplets.
No you didn’t. You did not know I was going to have triplets. You are not smarter than my doctors. You are not omniscient. The high beta was still well within normal (right smack at average, actually) limits for a singleton. It was around average for twins, too. You may have thought it was high, but it wasn’t unbelievably, alarmingly high. You did not know when I triggered that I would have triplets. If anyone could have known that, I wouldn’t have triggered, I wouldn’t have done IUI and I wouldn’t have gotten pregnant. I would have been on birth control pills right now awaiting my IVF cycle start. That was the plan, remember? Ironically, odds are good that if I’d had IVF, I would not have ended up with triplets.

5. You sound awfully upset about this triplet thing. Aren’t you happy?
Happy? Sure. I’m ecstatic. And terrified. I’m thrilled. And scared. I want all three! I’m terrified to have all three! Yes, I’m upset. It’s not because I don’t want all three children. I couldn’t be more thrilled to have three children (though I do wish they wouldn’t all come at once!). I’m upset because there is so much to lose. If I lose one now, I don’t think it will be any easier than any other loss, even though there are “back ups.” I am petrified. If you think you wouldn’t be petrified, well, you’ve never found yourself pregnant with triplets.

6. You don’t know that they’ll all make it… so what are you worried about?
I’m worried that they won’t all make it. I’m worried that they will all make it. I’m worried that they’ll all make it and someday one of them will discover that sometimes I hoped they wouldn’t all make it, even though I’ll love them all no matter what. I’m worried that going through a triplet pregnancy will take an irreparable toll on my body. I’m worried that they’ll all survive the pregnancy, but not survive the NICU. I’m worried about paying for Jewish Day School tuition for three kids simultaneously. I’m worried about 3 simultaneous college tuitions. I’m worried I won’t be a good enough mom to three kids of the same age. I’m worried that J (my foster son) will be outnumbered immediately. I’m worried that I won’t be able to nurse my children. I’m worried that I’ll get sick and not be able to take care of them. I’m worried that I’ll never be able to go back to work, which would mean we can’t pay the mortgage, which would be bad! I’m worried that my kids will hate me. I’m worried that I won’t be the “cool” mom. I’m worried that all my friends will drop me because I’m too high maintenance. I’m worried that I’ll never see anyone ever again. So you see, plenty to worry about, most of it is irrational. I get that.

7. Oh my gawd!!!! You’re so negative! I can’t read your blog anymore!
Right. I know you aren’t going to stop reading my blog, so don’t even threaten it. After all, people love to watch train wrecks and if there’s one thing that my blog is probably going to closely resemble very soon, it’s a train wreck. Actually, I’m really not all that negative in real life. I’m pretty scared, but I am happy and I am excited and I am looking forward to meeting my baby or babies, as the case may be. I can’t wait until I can tell people. I can’t wait to watch them grow and develop. In some ways, I must grudgingly admit, this IS like hitting the infertility jackpot. Even if it IS terrifying.

*****
There are a few more questions, but I’m tired right now (shock of shocks), and I need to lay down. I’m happy to answer any other questions if you email or comment.
*****

———————-
* No, I don’t do the G -dash- D thing. It drives me crazy. First of all, I’m typing onto the internet, which means this isn’t a permanent writing. But far more importantly, God isn’t the proper name of, well, God. Sometimes I write “Hashem” to avoid the whole debate, but I get that most people who read my blog aren’t Jewish and probably won’t understand “Hashem” but perfectly well understand the name “God.” I see no reason to apologize for my lack of a dash, but people get all prickly about it, so I may as well.

**Actually, I’d started talking to God again recently… of course my foster son thinks God is shaped like a ceiling fan, since most of my conversations with God involve sarcastic comments that I make toward the ceiling (and consequently the ceiling fan). Anyway, ever since the triplet thing came up, I’ve been ambivalent, but I think I’m back to the silent treatment. My friend S (a rebbetzin) says it’s okay that I’m not speaking to God, because (AND I QUOTE!) “God hears you not talking to Him.” Well, that just ticked me off so I started talking to Him again, just so He’d stop being so self-righteous about it, and look where it got me! Triplets! Serves me right.

***Oh right. I’m an Orthodox Jew. Probably not so lovely for me to be swearing and cursing all over the place, and I try to keep it to a minimum (in writing, anyway, I have the mouth of a sailor), but sometimes a girl’s gotta do what a girl’s gotta do. Got it?

****See above.

*****Yeah, all the emails start out that way. Okay, not really, but it’s funnier my way, okay? Believe me, I’ve gotten some caring, loving, concerned, beautiful emails from people, but I get a lot of wretched, cruel, unfunny ones too. Plus, any excuse for yet another footnote, right?

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