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Archive for August, 2007

30 week belly shot

So I feel like utter crap. I have a cold. Again. And I feel awful. Completely disgusting. And I felt just as disgusting last night when my husband took this picture (which was an utter nightmare… that man is USELESS with a camera!). So I wasn’t going to post this picture, but Jess said I should, and since she has posting access to my blog, I figure I ought to, you know, post this myself before she does it behind my back. So here’s me at 30 weeks:

Personally, I think I just look lumpy and whale-like, and I can’t begin to tell you how uncomfortable I was standing there glaring at my husband who could NOT figure out which button to push on the stupid point-and-shoot camera. But there you have it…. photographic evidence that I’m not making up this whole triplet pregnancy thing. And that’s me DOWN another four pounds since my last picture, and yet… far lumpier and oddly beached-whale-like. Go figure. Oh well.

P.S. And yes… as a couple people noted in my previous belly shot, I really am still wearing my wedding/engagement rings. They’re as loose, if not looser than they were before I was pregnant. It’s weird, really.

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30 week belly shot

So I feel like utter crap. I have a cold. Again. And I feel awful. Completely disgusting. And I felt just as disgusting last night when my husband took this picture (which was an utter nightmare… that man is USELESS with a camera!). So I wasn't going to post this picture, but Jess said I should, and since she has posting access to my blog, I figure I ought to, you know, post this myself before she does it behind my back. So here's me at 30 weeks:

Personally, I think I just look lumpy and whale-like, and I can't begin to tell you how uncomfortable I was standing there glaring at my husband who could NOT figure out which button to push on the stupid point-and-shoot camera. But there you have it…. photographic evidence that I'm not making up this whole triplet pregnancy thing. And that's me DOWN another four pounds since my last picture, and yet… far lumpier and oddly beached-whale-like. Go figure. Oh well.

P.S. And yes… as a couple people noted in my previous belly shot, I really am still wearing my wedding/engagement rings. They're as loose, if not looser than they were before I was pregnant. It's weird, really.

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30 week appt. (UPDATED)

Appointment today went okay. They did the fetal fibronectin check again. I should have the results of that tomorrow. Since it came back negative last week, I’m guessing it will come back negative today as well. If it doesn’t, that’s when they’ll talk about bringing me in for hospital bed-rest. Fair enough.

My cervix was 1.5cm. It’s short, but it’s been that short before. So is it worrisome? Sort of, but not much more worrisome than its been for the last 7-8 weeks. So all I can do is hang in there and hope it holds up for another four weeks. In other news, my blood pressure is still great and I’ve lost another four pounds. Babies all have good heart rates, as per usual.

Dr. R’s last day was today as she’s moving back to Boston tomorrow, so she and I chatted for a bit while the sonographer did the growth measurements after Dr. R. had measured my cervix. This meant I missed much of the growth ultrasound, which I normally would have watched really carefully. Babies A and B are just about 3 pounds. Baby C is smaller, and its growth curve has slowed from the last growth ultrasound. There’s really no telling at this point whether that’s something to worry about yet, but they’ll check again in a couple weeks to make sure Baby C is still growing, but at this point, there’s really no way to tell whether it’s worrisome. It probably isn’t. And if it is, we’ll deal with it when the time comes.

Also, the doctors are taking me off of home monitoring. It’s clear that I have a good handle on what’s normal for me. The last straw was essentially that last night I monitored, had to remonitor and still had 13 contractions. They wanted me to remonitor again, and I said I wasn’t inclined to do so because this was normal for me and nothing unusual was going on, so I recommended they call the doctor. As it happened, Dr. R. was on call and she said, “She doesn’t want to remonitor? Okay. Karen’s pretty smart, I’m sure she’d know if something was any different. Let her go to bed.” And that’s how that worked. Honestly, that’s mostly how it usually works. So the doctors pretty much feel like there’s not much point in continuing with it. They’ve pretty much gotten the data they need from the monitoring: I contract a lot. They know that now. I know that now. The key now is that I know to call them if there’s any significant change in the intensity or pattern. I noted to Dr. R. that I’ve been noting a bunch of subtle changes in my contractions in the last few days, but I wasn’t sure if that mattered and she said no… they’re looking for major changes in intensity. “You’re not going to miss when you’re in labor, I promise you.” I do believe her. The contractions I had with my miscarriage last fall were DECIDEDLY different than the contractions I’m having now. I couldn’t talk through them, they forced me instinctively into different positions in hopes of relief. So I’m pretty sure I’ll know the difference.

I told Dr. R. what a hard time I was having walking/moving around and she wasn’t surprised or alarmed. There’s not a lot to be done about it, and it’s just the way it’s going to be and it’s only going to get worse. I also told her I still don’t think I need a stinkin’ c-section and she did acknowledge that a triplet vaginal delivery ISN’T impossible. She cautioned that one of the things that makes it difficult in my case is that I’ve never delivered a baby before, which means I’d probably be facing a long, prolonged labor, which can present too much stress for the babies, or could leave me having to deliver one or two vaginally and STILL needing the c-section for the rest, and that’s the last thing anyone wants, because recovering from BOTH a vaginal and caesarean delivery at the same time isn’t pleasant… better to recover from one or the other. She said if I went into labor this week, it would absolutely not be an option, but if I make it to 34 weeks, I can probably talk about it with the remaining members of the practice, but of course, the first consideration will always be what is safest for me and for the babies. Understood and agreed.

I admit that part of why I don’t want a c-section is that I’m afraid this will be my last pregnancy and therefore my last opportunity to experience a vaginal delivery. I also admit that part of why I don’t want a c-section is because I hope this WON’T be my last pregnancy (as crazy as that sounds for a chick who’s about to have four kids in her life) and I don’t love the idea of having to convince a doctor to let me attempt a VBAC. But mostly… I just really don’t want drugs running through that epidural if I can help it. I hate the idea of losing that physical control. I just hate it and it terrifies me, even though I know I’ll get over it if it comes to that.

Edit: Two points of clarification: First, whether I have a c-section or a vaginal delivery, the doctor will make me have an epidural in place. The difference is whether there are actual drugs running through it. If I have a vaginal delivery, they won’t have to run drugs through it unless I want them to, they just need it in place in case they have to suddenly switch to a c-section. And either way, I’d deliver in an operating room, again, just in case.

Second, my objection to a c-section has far less to do with having surgery, being cut open. or “losing out” on a vaginal delivery.” It’s actually having the epidural. I have two issues with the epidural, the first of which I clearly have to get over regardless and that’s having a needle inserted into my spinal column. It’s not a rational fear, so rational explanations and comments really don’t help, and like I said, I obviously have to get over it regardless, so please don’t try to talk me out of this one, because it won’t work and will likely just cause me more anxiety. The other issue I have with the epidural is the actual drug going through the epidural, and this relates specifically to the loss of physical control of my lower half. I had a TIA (trans-ischemic attack, sort of a mini-stroke) when I was 23, so I’ve experienced the whole “you can’t move your limbs no matter how hard you try” sensation before, and it’s excruciating for me. I don’t relish the idea of doing it on purpose. Again, if I have a c-section this is just something I’ll take a deep breath and get over, so there’s no need to try and talk me out of it.. most attempts to try and soothe my fears about such a thing only make me more anxious about it, so trust me when I say that I really will just get past it, but I really do have a pretty straight-forward reason for not wanting an epidural, and therefore not wanting a c-section. (This, by the way, makes me even MORE opposed to having a spinal, which can’t just be turned off, so I’m REALLY hoping that’s not what happens)

As for pain relief, I really am not that concerned about it. I’m fully aware that my only real pain relief option is an epidural even with a vaginal delivery. But pain doesn’t worry me. I have a lot of chronic pain in my life. I know how to handle pain. I have a lot of techniques in my arsenal (so to speak) to handle pain. I have chronic migraines. I have chronic kidney stones, many of which I’ve gotten through without any pain relief (kidney stones are often likened to the pain of labor, and often women who have had both labor pains and kidney stone pain say that kidney stones are actually worse). Believe me, I’d much rather have to deal with pain, which is finite, than an epidural (which, admittedly, is also finite).

There is also the minor fact that I’m not loving the idea of taking care of triplets while recovering from a c-section, but I don’t imagine it’ll be all that fun to recover from delivery of triplets no matter what, so that’s a pretty minor issue. End of Edit

30 weeks, Dr. R. emphasized, is a big milestone. And 32 weeks will be a bigger milestone. And 34 weeks will be huge if I can get there. I’m definitely getting there. Not far now and I know I can get there. Back for another appointment next week.

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hangin’ in

A couple people have emailed to ask why I’ve been so quiet (and I got at least one comment on the blog about it as well). I’m mostly quiet because I’m exhausted. I have little energy for anything. I wrote last Friday that I don’t feel nearly as horrible as I would have expected to feel, and that’s still true, but I had imagined feeling truly, utterly, unbearably horrible, so it’s all relative.

I’ve gotten to a point that walking the 20 feet from my bed to my bathroom is excruciating not only for the time it takes, but the physical pain and exhaustion that it causes as a result. It’s worse in the morning than afternoon, but it’s not pleasant no matter what. I don’t sleep well, but I can’t keep my eyes open half the time anyway. I know I’m in the home stretch, and I’m grateful for that. In a lot of ways, I think I’ll miss having my little parasites inside me in a few weeks, but otherwise, I’m also looking forward to a time when getting up out of bed is no longer a two-person, five-minute effort.

I’m not complaining. I’m really not. Heaven knows I never thought this would be easy. And I certainly can’t say I didn’t ask for this (well, yes I can… I was pretty specific that I wanted a singleton, but that’s another story). But I knew the risks. And as cheesy as it sounds, I love these babies even though they’re not even here yet. So it’s not a complaint. Just an explanation for why I’ve been quiet. That, and I’ve been spending a fair bit of time on and off the stupid monitor because the contractions haven’t quit. Made some more changes to my medications today, though, so hopefully that will help in the next couple days.

Tomorrow I will be 30 weeks. I’ll have my growth ultrasound to see how the babies are growing, and they’ll check my cervix to make sure it’s stable. And hopefully, I’ll be told that I’ve got another four weeks of growing to do. Maybe I’ll even have the energy after the appointment to post about it. Right now, I really have to go to bed and snuggle with my snoogle.

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hangin’ in

A couple people have emailed to ask why I've been so quiet (and I got at least one comment on the blog about it as well). I'm mostly quiet because I'm exhausted. I have little energy for anything. I wrote last Friday that I don't feel nearly as horrible as I would have expected to feel, and that's still true, but I had imagined feeling truly, utterly, unbearably horrible, so it's all relative.

I've gotten to a point that walking the 20 feet from my bed to my bathroom is excruciating not only for the time it takes, but the physical pain and exhaustion that it causes as a result. It's worse in the morning than afternoon, but it's not pleasant no matter what. I don't sleep well, but I can't keep my eyes open half the time anyway. I know I'm in the home stretch, and I'm grateful for that. In a lot of ways, I think I'll miss having my little parasites inside me in a few weeks, but otherwise, I'm also looking forward to a time when getting up out of bed is no longer a two-person, five-minute effort.

I'm not complaining. I'm really not. Heaven knows I never thought this would be easy. And I certainly can't say I didn't ask for this (well, yes I can… I was pretty specific that I wanted a singleton, but that's another story). But I knew the risks. And as cheesy as it sounds, I love these babies even though they're not even here yet. So it's not a complaint. Just an explanation for why I've been quiet. That, and I've been spending a fair bit of time on and off the stupid monitor because the contractions haven't quit. Made some more changes to my medications today, though, so hopefully that will help in the next couple days.

Tomorrow I will be 30 weeks. I'll have my growth ultrasound to see how the babies are growing, and they'll check my cervix to make sure it's stable. And hopefully, I'll be told that I've got another four weeks of growing to do. Maybe I'll even have the energy after the appointment to post about it. Right now, I really have to go to bed and snuggle with my snoogle.

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30 week appt. (UPDATED)

Appointment today went okay. They did the fetal fibronectin check again. I should have the results of that tomorrow. Since it came back negative last week, I'm guessing it will come back negative today as well. If it doesn't, that's when they'll talk about bringing me in for hospital bed-rest. Fair enough.

My cervix was 1.5cm. It's short, but it's been that short before. So is it worrisome? Sort of, but not much more worrisome than its been for the last 7-8 weeks. So all I can do is hang in there and hope it holds up for another four weeks. In other news, my blood pressure is still great and I've lost another four pounds. Babies all have good heart rates, as per usual.

Dr. R's last day was today as she's moving back to Boston tomorrow, so she and I chatted for a bit while the sonographer did the growth measurements after Dr. R. had measured my cervix. This meant I missed much of the growth ultrasound, which I normally would have watched really carefully. Babies A and B are just about 3 pounds. Baby C is smaller, and its growth curve has slowed from the last growth ultrasound. There's really no telling at this point whether that's something to worry about yet, but they'll check again in a couple weeks to make sure Baby C is still growing, but at this point, there's really no way to tell whether it's worrisome. It probably isn't. And if it is, we'll deal with it when the time comes.

Also, the doctors are taking me off of home monitoring. It's clear that I have a good handle on what's normal for me. The last straw was essentially that last night I monitored, had to remonitor and still had 13 contractions. They wanted me to remonitor again, and I said I wasn't inclined to do so because this was normal for me and nothing unusual was going on, so I recommended they call the doctor. As it happened, Dr. R. was on call and she said, "She doesn't want to remonitor? Okay. Karen's pretty smart, I'm sure she'd know if something was any different. Let her go to bed." And that's how that worked. Honestly, that's mostly how it usually works. So the doctors pretty much feel like there's not much point in continuing with it. They've pretty much gotten the data they need from the monitoring: I contract a lot. They know that now. I know that now. The key now is that I know to call them if there's any significant change in the intensity or pattern. I noted to Dr. R. that I've been noting a bunch of subtle changes in my contractions in the last few days, but I wasn't sure if that mattered and she said no… they're looking for major changes in intensity. "You're not going to miss when you're in labor, I promise you." I do believe her. The contractions I had with my miscarriage last fall were DECIDEDLY different than the contractions I'm having now. I couldn't talk through them, they forced me instinctively into different positions in hopes of relief. So I'm pretty sure I'll know the difference.

I told Dr. R. what a hard time I was having walking/moving around and she wasn't surprised or alarmed. There's not a lot to be done about it, and it's just the way it's going to be and it's only going to get worse. I also told her I still don't think I need a stinkin' c-section and she did acknowledge that a triplet vaginal delivery ISN'T impossible. She cautioned that one of the things that makes it difficult in my case is that I've never delivered a baby before, which means I'd probably be facing a long, prolonged labor, which can present too much stress for the babies, or could leave me having to deliver one or two vaginally and STILL needing the c-section for the rest, and that's the last thing anyone wants, because recovering from BOTH a vaginal and caesarean delivery at the same time isn't pleasant… better to recover from one or the other. She said if I went into labor this week, it would absolutely not be an option, but if I make it to 34 weeks, I can probably talk about it with the remaining members of the practice, but of course, the first consideration will always be what is safest for me and for the babies. Understood and agreed.

I admit that part of why I don't want a c-section is that I'm afraid this will be my last pregnancy and therefore my last opportunity to experience a vaginal delivery. I also admit that part of why I don't want a c-section is because I hope this WON'T be my last pregnancy (as crazy as that sounds for a chick who's about to have four kids in her life) and I don't love the idea of having to convince a doctor to let me attempt a VBAC. But mostly… I just really don't want drugs running through that epidural if I can help it. I hate the idea of losing that physical control. I just hate it and it terrifies me, even though I know I'll get over it if it comes to that.

Edit: Two points of clarification: First, whether I have a c-section or a vaginal delivery, the doctor will make me have an epidural in place. The difference is whether there are actual drugs running through it. If I have a vaginal delivery, they won't have to run drugs through it unless I want them to, they just need it in place in case they have to suddenly switch to a c-section. And either way, I'd deliver in an operating room, again, just in case.

Second, my objection to a c-section has far less to do with having surgery, being cut open. or "losing out" on a vaginal delivery." It's actually having the epidural. I have two issues with the epidural, the first of which I clearly have to get over regardless and that's having a needle inserted into my spinal column. It's not a rational fear, so rational explanations and comments really don't help, and like I said, I obviously have to get over it regardless, so please don't try to talk me out of this one, because it won't work and will likely just cause me more anxiety. The other issue I have with the epidural is the actual drug going through the epidural, and this relates specifically to the loss of physical control of my lower half. I had a TIA (trans-ischemic attack, sort of a mini-stroke) when I was 23, so I've experienced the whole "you can't move your limbs no matter how hard you try" sensation before, and it's excruciating for me. I don't relish the idea of doing it on purpose. Again, if I have a c-section this is just something I'll take a deep breath and get over, so there's no need to try and talk me out of it.. most attempts to try and soothe my fears about such a thing only make me more anxious about it, so trust me when I say that I really will just get past it, but I really do have a pretty straight-forward reason for not wanting an epidural, and therefore not wanting a c-section. (This, by the way, makes me even MORE opposed to having a spinal, which can't just be turned off, so I'm REALLY hoping that's not what happens)

As for pain relief, I really am not that concerned about it. I'm fully aware that my only real pain relief option is an epidural even with a vaginal delivery. But pain doesn't worry me. I have a lot of chronic pain in my life. I know how to handle pain. I have a lot of techniques in my arsenal (so to speak) to handle pain. I have chronic migraines. I have chronic kidney stones, many of which I've gotten through without any pain relief (kidney stones are often likened to the pain of labor, and often women who have had both labor pains and kidney stone pain say that kidney stones are actually worse). Believe me, I'd much rather have to deal with pain, which is finite, than an epidural (which, admittedly, is also finite).

There is also the minor fact that I'm not loving the idea of taking care of triplets while recovering from a c-section, but I don't imagine it'll be all that fun to recover from delivery of triplets no matter what, so that's a pretty minor issue. End of Edit

30 weeks, Dr. R. emphasized, is a big milestone. And 32 weeks will be a bigger milestone. And 34 weeks will be huge if I can get there. I'm definitely getting there. Not far now and I know I can get there. Back for another appointment next week.

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Guess who doesn’t have gestational diabetes? Yep. That would be me. Apparently one of my levels was slightly high, but he said that isn’t diagnostic and when he heard what my fasting levels were (this morning’s was 75, yesterday’s was 65… usually it’s around 68-70), he said, “Yeah, you don’t have it.” So yay!

As for the rest of the appointment, it went well. My cervix is stable. The doctor basically said I’m just going to contract. It’s what I do. He’s not concerned with the quantity at this point, so much as the quality and the effect on my cervix. So we’re on the same page on that one, which is good. Contractions are definitely getting stronger and more uncomfortable. He assured me that if I were in labor, I’d be in enough pain that I would know it. I’m not so convinced, since kidney stones barely make me flinch, but I do think I’d recognize it. We’ll see.

He was concerned that all the monitoring was more trouble than it’s worth. He wanted to make sure that with all the contractions they weren’t making me re-monitor so much in the evening that it was keeping me from sleeping, and I promised him that I knew enough to tell them to just call the doctor if I wanted to sleep instead of re-monitoring and he said that was fine. The important thing is that he wants to make sure that I understand that I have to be assertive about letting Matria know if there’s a significant change in quality and that I’m not concerned about quantity alone. So if they’re pushing me to re-monitor, and I don’t want to or feel that it’s unnecessary, I shouldn’t feel guilty about having them call the doctor. That’s fair. And, he said, if we get a little further down the line and decide that the monitoring is just a bigger pain in the ass than it needs to be, then I won’t do it anymore. Mostly, he thinks I have a good enough handle on things that he thinks that I know when to call myself, but he doesn’t think the extra data point from the monitoring can hurt.

They want to keep a close eye on me, because things have been a bit dicey, but mostly, I’m doing great, all things considered. I’m astounded that I don’t feel crappier than I do… I’m a whale, but not as whalish as I thought I would be… I fit into most of my pre-pregnancy clothes despite the enormous pregnancy belly (that’s how much weight I’ve lost). I’m uncomfortable, but not NEARLY as uncomfortable as I’d imagined I would be. I have trouble walking, but the bed rest probably contributes to that, and I’m not allowed to walk much anyway (I only know how difficult -and painful- walking is because I had to walk down a long hallway to get to my doctor’s office today). I have difficulty breathing, but that’s not shocking. There are three babies in my very, very short torso. I’m tired all the time, but DUH! I’m still throwing up, but who cares at this point? I really expected MUCH worse. Or maybe I’m just handling it gracefully. Either way, I’m in the home stretch. I’m not there yet, but bit by bit, I’m getting there.

I go back for a growth ultrasound on Wednesday. I’ll be exactly 30 weeks. If you’re REALLY good, I might post another whale picture that day. We’ll see.

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