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Archive for April, 2007

Lessons Learned

Posted in pregnancy: never a dull moment, reduction discussion on April 20, 2007| 6 Comments »

Generally speaking, I don't freak out about bleeding. As you can see from my two previous posts, this did not ring true today. I started cramping, discovered I was bleeding (not lightly) and freaked the hell out. Normally I'm pretty calm about these things, realizing that if something's wrong, there's not a darned thing that can be done about it, and knowing that probably nothing is wrong. But today? No such sense of serenity. Nope, I called my husband and burst into tears as soon as he answered his phone. I was near panic when I called my OB's office, though I managed a facade of calm as I spoke with the answering service. I nearly burst into tears in the waiting room at the OB's office, something which would have utterly mortified me had it actually happened.

And what lesson have we learned, boys and girls?

Obviously I'm growing quite attached to my three little parasites, troublemakers that they are. There is absolutely no way I can reduce this pregnancy under the circumstances that I have. There is no way. I want to be clear that this is a personal decision of mine. This isn't judging any decisions anyone else has ever made or will make. Every circumstance is different. Every person has their own needs to weigh. I've done my risk analysis. I've weighed my issues. And what I realized was that today all I could think was that I might have lost one and I freaked the hell out. Which means that for me, reduction is not an option right now.

So at least that's settled.

Beyond that, I'm okay. The cramping has not abated, but the bleeding has calmed down. I feel a bit foolish for flipping out so badly, but on the other hand, that's why I have doctors. My doctors are all there to take care of me if things go wrong. And it's not like I won't be getting a bill for today's services, so it's not like I inconvenienced anyone. So here's the second lesson I've learned today: it's okay to be high maintenance. I hate being a high maintenance patient. I feel like a hypochondriac enough as it is. But the thing is, I am pregnant with triplets. Triplets are a high risk pregnancy. I am therefore, by definition, a high maintenance patient, like it or not. I will have to learn that I'm not going to be one of those cute little pregnant women who never has a problem and spends her last trimester walking a mile a day because I can't stand being cooped up or need to walk off that bloated feeling after I eat (there's a chick in my community who walked a mile every day up until the day before her delivery because she couldn't handle how full she felt after eating). That won't be me. I'm going to have to learn to accept help, and more importantly, I'm going to have to learn how to ask for help when I need it.

It's okay to be high maintenance. It's okay to admit I'm attached to the little monsters.

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quick quick before shabbos

Posted in the fun just keeps on coming on April 20, 2007| 9 Comments »

I literally have only 2 minutes to Shabbos, so I can't do a long detailed update.

Anyway, they couldn't do the nuchal fold measurement because the little parasites a teeney bit too small just now. They were able to determine the cause of the bleeding: I've got a placenta previa and one seriously huge bleed. So I'm confined to my house (and largely my bed/couch/whatever) for 48-72 hours. I'll update more tomorrow night.

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Okay

Posted in pregnancy: never a dull moment, triplets? on April 19, 2007| 8 Comments »

I’m okay. My OB was working in the office that doesn’t have a very good ultrasound machine, so he sent me to the other office for an ultrasound and to meet with another OB in the practice. There are still three babies with three heartbeats. That, apparently, is all I need to know.

After the ultrasound I met with Dr. P, who I now know I despise. To be fair English isn’t his first language, but even though my Spanish is reasonable (I used to live in Spain), I don’t know how to say “cervix” in Spanish. And besides, he’s been in the US most of his life, so I’m not inclined to cut him much slack. After the ultrasound, I went into his office and he looked through the partial record of mine that had been faxed over from the office that holds my record. “Triplets, huh?” Yep. Triplets. “But you knew that before today, right?” Yep. I sure did.

He said, “well, the babies are fine.” Okay. Long pause. I waited for him to say something more interesting, but he didn’t. So eventually I said, “So I should assume the bleeding is nothing and not worry about it?” Well, he said, at this stage of pregnancy when a patient complains of bleeding (okay, seriously? I hate that! “complains of bleeding”… I wasn’t complaining! I was informing!) they check for viability and that’s the only thing I need to know.

Then he went on and on about my care and ultimately decided (without any input from me) that the real problem is getting me to term, or as close to it as possible. The delivery, he said, wouldn’t be any problem at all, because that’s easy and anyone in the practice can do that. But getting me there, well, obviously I’d need to be seeing the perinatologist. And now that he thinks about it, I should just have the perinatologist do all of my care until it comes time for that easy c-section. “I love my doctor. You are not taking him away from me.” But he persisted. “I’ll talk it over with Dr. B, but I’m inclined to think that since you’ll be seeing them so often, there’s no reason for you to see us.” I clenched my teeth. “You cannot stop me from seeing Dr. B. I love him.”

And by the way, telling a hormonal pregnant chick, who’s in the middle of a small nervous breakdown because God just won’t give her a break, that the c-section is the “easy” part is not wise. Easy for who? Certainly not for ME!

So, I totally get that I’m being a bitch. But you know, what I wanted to know was that my babies were fine. I wanted to know that the bleeding was nothing to worry about. I wanted to know that I could breathe. I did not want to know that in HIS opinion I needn’t bother seeing the doctors I’m supposed to trust to CUT OPEN MY ABDOMEN. The only good news of it all is that Dr. P (the doctor I saw today) is phasing out of obstetrical procedures and there is NO WAY HE’LL EVER GET NEAR ME WITH A SCALPEL. Ahem.

I love Dr. B. They are not taking him away from me. (And anyway, the perinatology practice will NOT see patients unilaterally. They only do care bilaterally. So at least I don’t have to fear Dr. P’s threat to have me stop seeing their practice)

So right: the good news is that there are three heartbeats so I have a temporary reprieve on worrying and I should get more information tomorrow, since I’m having the nuchal fold scan at the perinatologist’s office anyway. The bad news is, of course, I had to cancel my appointment at Georgetown and I’m just not sure it’s worth trying to reschedule at this point. Thanks for all your kind comments in my last freak-out post. I appreciate your concern.

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Don’t Panic

Posted in pregnancy: never a dull moment on April 19, 2007| 8 Comments »

I’m bleeding. And cramping. This isn’t spotting anymore, and it came on suddenly. I’m on hold with the doctor’s emergency line now.

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Questions for the doctor

Posted in triplets? on April 19, 2007| 2 Comments »

I’m meeting with a perinatologist at Georgetown today for a second opinion on this whole triplet thing. I had a list of questions that I wanted to ask the doctor, but I’m a moron and I left them at home and have no time to stop by home to get them (It is most assuredly not on the way for me). I’m normally ridiculously organised for doctor’s appointments, but this pregnancy-brain thing has really killed that aspect of my personality, it seems.

I’m trying to reconstruct a list of questions to ask, but a lot of my standard questions are questions I would ask if I were seeking longer-term prenatal care from the office. I don’t intend to get my prenatal care at Georgetown, so this is a one-time consult for information-gathering purposes only. So far I have the following:

1. My last detailed ultrasound, taken at 8weeks, 5days resulted in the following fetal measurements:

Baby A measured at 8w 5d
Baby B measured at 8w 4d
Baby C measured at 8w 2d

Is the difference in measurements (specifically Baby C) especially troublesome? If so, why? What could it indicate? It is probably that Baby C was the result of a later implantation. Does this affect the outlook at all?

2. What are all my options with regards to this pregnancy? (e.g. reduction, continuing the pregnancy, tests recommended, etc.)

3. Is my height (152 cm) a factor which should play an important role in the decision process?

4. What are the specific risks associated with a reduction procedure? How do these risks compare with the specific risks of expectant management in a triplet pregnancy?

5. To date, the majority of the argument I’ve heard for reduction is “Triplet pregnancies are harder and riskier than Twin pregnancies.” While this is obviously true, is it important that in fact I’m not comparing a triplet pregnancy to a twin pregnancy, but rather a triplet pregnancy to a triplet-reduced-to-twin pregnancy?

6. How much of a role do my specific medical issues play in my outlook if I do not reduce? Specifically, history of hemiplegic migraines, TIA, patent foramen ovale, and recurrent kidney stones/UTIs.

Anyone have any other suggestions of questions to ask?

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Okay

Posted in pregnancy: never a dull moment, triplets? on April 19, 2007| 3 Comments »

I'm okay. My OB was working in the office that doesn't have a very good ultrasound machine, so he sent me to the other office for an ultrasound and to meet with another OB in the practice. There are still three babies with three heartbeats. That, apparently, is all I need to know.

After the ultrasound I met with Dr. P, who I now know I despise. To be fair English isn't his first language, but even though my Spanish is reasonable (I used to live in Spain), I don't know how to say "cervix" in Spanish. And besides, he's been in the US most of his life, so I'm not inclined to cut him much slack. After the ultrasound, I went into his office and he looked through the partial record of mine that had been faxed over from the office that holds my record. "Triplets, huh?" Yep. Triplets. "But you knew that before today, right?" Yep. I sure did.

He said, "well, the babies are fine." Okay. Long pause. I waited for him to say something more interesting, but he didn't. So eventually I said, "So I should assume the bleeding is nothing and not worry about it?" Well, he said, at this stage of pregnancy when a patient complains of bleeding (okay, seriously? I hate that! "complains of bleeding"… I wasn't complaining! I was informing!) they check for viability and that's the only thing I need to know.

Then he went on and on about my care and ultimately decided (without any input from me) that the real problem is getting me to term, or as close to it as possible. The delivery, he said, wouldn't be any problem at all, because that's easy and anyone in the practice can do that. But getting me there, well, obviously I'd need to be seeing the perinatologist. And now that he thinks about it, I should just have the perinatologist do all of my care until it comes time for that easy c-section. "I love my doctor. You are not taking him away from me." But he persisted. "I'll talk it over with Dr. B, but I'm inclined to think that since you'll be seeing them so often, there's no reason for you to see us." I clenched my teeth. "You cannot stop me from seeing Dr. B. I love him."

And by the way, telling a hormonal pregnant chick, who's in the middle of a small nervous breakdown because God just won't give her a break, that the c-section is the "easy" part is not wise. Easy for who? Certainly not for ME!

So, I totally get that I'm being a bitch. But you know, what I wanted to know was that my babies were fine. I wanted to know that the bleeding was nothing to worry about. I wanted to know that I could breathe. I did not want to know that in HIS opinion I needn't bother seeing the doctors I'm supposed to trust to CUT OPEN MY ABDOMEN. The only good news of it all is that Dr. P (the doctor I saw today) is phasing out of obstetrical procedures and there is NO WAY HE'LL EVER GET NEAR ME WITH A SCALPEL. Ahem.

I love Dr. B. They are not taking him away from me. (And anyway, the perinatology practice will NOT see patients unilaterally. They only do care bilaterally. So at least I don't have to fear Dr. P's threat to have me stop seeing their practice)

So right: the good news is that there are three heartbeats so I have a temporary reprieve on worrying and I should get more information tomorrow, since I'm having the nuchal fold scan at the perinatologist's office anyway. The bad news is, of course, I had to cancel my appointment at Georgetown and I'm just not sure it's worth trying to reschedule at this point. Thanks for all your kind comments in my last freak-out post. I appreciate your concern.

Read Full Post »

Okay

Posted in pregnancy: never a dull moment, triplets? on April 19, 2007| 1 Comment »

I'm okay. My OB was working in the office that doesn't have a very good ultrasound machine, so he sent me to the other office for an ultrasound and to meet with another OB in the practice. There are still three babies with three heartbeats. That, apparently, is all I need to know.

After the ultrasound I met with Dr. P, who I now know I despise. To be fair English isn't his first language, but even though my Spanish is reasonable (I used to live in Spain), I don't know how to say "cervix" in Spanish. And besides, he's been in the US most of his life, so I'm not inclined to cut him much slack. After the ultrasound, I went into his office and he looked through the partial record of mine that had been faxed over from the office that holds my record. "Triplets, huh?" Yep. Triplets. "But you knew that before today, right?" Yep. I sure did.

He said, "well, the babies are fine." Okay. Long pause. I waited for him to say something more interesting, but he didn't. So eventually I said, "So I should assume the bleeding is nothing and not worry about it?" Well, he said, at this stage of pregnancy when a patient complains of bleeding (okay, seriously? I hate that! "complains of bleeding"… I wasn't complaining! I was informing!) they check for viability and that's the only thing I need to know.

Then he went on and on about my care and ultimately decided (without any input from me) that the real problem is getting me to term, or as close to it as possible. The delivery, he said, wouldn't be any problem at all, because that's easy and anyone in the practice can do that. But getting me there, well, obviously I'd need to be seeing the perinatologist. And now that he thinks about it, I should just have the perinatologist do all of my care until it comes time for that easy c-section. "I love my doctor. You are not taking him away from me." But he persisted. "I'll talk it over with Dr. B, but I'm inclined to think that since you'll be seeing them so often, there's no reason for you to see us." I clenched my teeth. "You cannot stop me from seeing Dr. B. I love him."

And by the way, telling a hormonal pregnant chick, who's in the middle of a small nervous breakdown because God just won't give her a break, that the c-section is the "easy" part is not wise. Easy for who? Certainly not for ME!

So, I totally get that I'm being a bitch. But you know, what I wanted to know was that my babies were fine. I wanted to know that the bleeding was nothing to worry about. I wanted to know that I could breathe. I did not want to know that in HIS opinion I needn't bother seeing the doctors I'm supposed to trust to CUT OPEN MY ABDOMEN. The only good news of it all is that Dr. P (the doctor I saw today) is phasing out of obstetrical procedures and there is NO WAY HE'LL EVER GET NEAR ME WITH A SCALPEL. Ahem.

I love Dr. B. They are not taking him away from me. (And anyway, the perinatology practice will NOT see patients unilaterally. They only do care bilaterally. So at least I don't have to fear Dr. P's threat to have me stop seeing their practice)

So right: the good news is that there are three heartbeats so I have a temporary reprieve on worrying and I should get more information tomorrow, since I'm having the nuchal fold scan at the perinatologist's office anyway. The bad news is, of course, I had to cancel my appointment at Georgetown and I'm just not sure it's worth trying to reschedule at this point. Thanks for all your kind comments in my last freak-out post. I appreciate your concern.

Read Full Post »

Don’t Panic

Posted in pregnancy: never a dull moment on April 19, 2007| 8 Comments »

I'm bleeding. And cramping. This isn't spotting anymore, and it came on suddenly. I'm on hold with the doctor's emergency line now.

Read Full Post »

Don’t Panic

Posted in pregnancy: never a dull moment on April 19, 2007| 3 Comments »

I'm bleeding. And cramping. This isn't spotting anymore, and it came on suddenly. I'm on hold with the doctor's emergency line now.

Read Full Post »

Questions for the doctor

Posted in triplets? on April 19, 2007| 2 Comments »

I'm meeting with a perinatologist at Georgetown today for a second opinion on this whole triplet thing. I had a list of questions that I wanted to ask the doctor, but I'm a moron and I left them at home and have no time to stop by home to get them (It is most assuredly not on the way for me). I'm normally ridiculously organised for doctor's appointments, but this pregnancy-brain thing has really killed that aspect of my personality, it seems.

I'm trying to reconstruct a list of questions to ask, but a lot of my standard questions are questions I would ask if I were seeking longer-term prenatal care from the office. I don't intend to get my prenatal care at Georgetown, so this is a one-time consult for information-gathering purposes only. So far I have the following:

1. My last detailed ultrasound, taken at 8weeks, 5days resulted in the following fetal measurements:

Baby A measured at 8w 5d
Baby B measured at 8w 4d
Baby C measured at 8w 2d

Is the difference in measurements (specifically Baby C) especially troublesome? If so, why? What could it indicate? It is probably that Baby C was the result of a later implantation. Does this affect the outlook at all?

2. What are all my options with regards to this pregnancy? (e.g. reduction, continuing the pregnancy, tests recommended, etc.)

3. Is my height (152 cm) a factor which should play an important role in the decision process?

4. What are the specific risks associated with a reduction procedure? How do these risks compare with the specific risks of expectant management in a triplet pregnancy?

5. To date, the majority of the argument I've heard for reduction is "Triplet pregnancies are harder and riskier than Twin pregnancies." While this is obviously true, is it important that in fact I'm not comparing a triplet pregnancy to a twin pregnancy, but rather a triplet pregnancy to a triplet-reduced-to-twin pregnancy?

6. How much of a role do my specific medical issues play in my outlook if I do not reduce? Specifically, history of hemiplegic migraines, TIA, patent foramen ovale, and recurrent kidney stones/UTIs.

Anyone have any other suggestions of questions to ask?

Read Full Post »

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