ChezPerky

Right. Well, that’s quite enough of the self-pity. Or at least, that particular variety. I will now move on to an entirely different kind of whining. Pregnancy whining. Okay, I get it, there are lots of you out there who would give nearly anything to have the opportunity to whine about pregnancy, and I get that. So I’m sorry if it offends you that I don’t find all of pregnancy all sunshine and light. Maybe I would if I had a singleton pregnancy, maybe I wouldn’t. What I do know is that we infertiles HAVE to give ourselves permission to accept that there’s nothing wrong with us for finding out that sometimes pregnancy isn’t glamorous and sometimes parenting isn’t perfect and sometimes we aren’t always gracious about either one. Therefore, disclaimers aside, here are some of the good and the bad of late:

Good: I had a pretty decent week last week in terms of contractions and other such things. My appointment went well, my cervix had stablized and in fact lengthened somewhat, I even got a little cocky about it (“I don’t need no stinkin’ bedrest!”) but not to the point that I violated doctor’s orders. Contractions weren’t done and over with, but I was generally having a good week, and they were definitely under better control than they had been.

The Less Good: The operative word in that last sentence, of course, is that they were under better control. Until Friday. I monitor contractions twice a day. I’m required to send them in every morning, but not in the evening unless I’m feeling symptomatic. I can also monitor any other time of day if I’m feeling off or feeling contractions or just feel like it or whatever. Friday around 5pm I felt a few contractions, but I sort of ignored them, because that’s not terribly uncommon and I didn’t think much of it. But then a little before 6, I had a few more and I thought, well, that’s 4-6 contractions within the same hour, so I probably should call about getting a demand dose of terbutaline. After any demand dose, I have to monitor and send in the data, so that meant my evening data WOULD get sent in, which was fine.

So I called, asked if I could give myself a demand dose, was told yes, and then told to monitor from 6:30-7:30 and send it in. Fine. Except I couldn’t get the pump to GIVE me a demand dose. It’s a different button than the rest of the buttons and that button stopped working. So they had a work around for it, but that took some time, which put off my monitoring time until about 7ish to 8ish. Which is fine, but Shabbos (the Sabbath) was starting at 8, so the timing wasn’t fabulous. I am allowed to do all the medical stuff I need to do on Shabbos, even though a lot of it isn’t stuff I’d normally be allowed to do (e.g. using the phone). It’s just that there are a couple things I had to do right at 8 (like light candles to bring in Shabbos), so it wasn’t terribly convenient. Still, I made it work.

I expected that the monitoring session would yieled nothing interesting since I’d just given myself a demand dose and usually that takes care of the contractions immediately, but the nurse called back and said I had 5 contractions, which is above my “allowed” threshhold. Which meant I was going to have to re-monitor. Great. Except it’s Friday night, late, I have a cranky 4 year old, my husband is at shul (synagogue), and I have to deal with remonitoring and once my husband gets home in theory we’re supposed to eat a “festive meal” in honor of the Sabbath. (Someday maybe I’ll explain the whole sabbath thing to my non-Jewish readers, but really, if you’re wondering if I’m completely nutso, yes I am, but if you want more details, just email me… there’s a link to my email address in my sidebar) Since 8pm is when one of my automatic doses happens anyway, the nurse wanted me to wait until about 8:30 to monitor again to give the dose some time to work its magic. And so, at 8:30, I strapped the monitor back on while attempting to appease J with some tortellini and some books and a couple cars (yes, he should have been in bed, but it’s not like I can struggle with him alone these days).

And at 9:30 I sent in the data again. And while waiting for the phone call back, we started to sit down to dinner, and then, of course, the phone rang. The contractions had gotten much better..3 short contractions, which is under the “allowed” amount (thank heavens, because otherwise, doctor’s orders would have mandated a phone call to the doctor on call and I REALLY didn’t want to deal with that!), but the nurse didn’t love that I’d been having a lot of cramping and it wasn’t getting a lot better. So she waffled for a bit about calling the doctor anyway, but I talked her out of it (my doctor didn’t seem OVERLY concerned when I’d mentioned it before, plus I promised to call if I couldn’t sleep through it which is always my gauge of whether I should be waking up a doctor). She had me give myself another demand dose and encouraged me to call if it got any worse through the night. Fine.

And the next morning was more of the same. Too many contractions, demand dose (which they still had to use the awkward work-around to do, because the demand-button wasn’t working) remonitor, better but not perfect, still a lot of cramping, so they changed my basal rate on the pump and got to work on getting a new pump programmed and couriered out to me. The increased basal rate did seem to help a bit throughout the day (it had also been increased the day before, so it had cumulatively been increased about 30% from two days prior). I didn’t do an evening monitoring until quite late because I had people here visiting on and off throughout the day. I felt a little funny, but decided not to send in the data until morning since I wasn’t required to and since it was so late. I figured I’d send it in the next morning. Turned out it was both a good and a bad choice not to send it in, because I’d had SEVEN contractions (nearly double my “allowed” threshhold) and a lot of irritability. So if I’d sent it in, I would have ended up having to do a demand dose and remonitor at midnight risking calling the doctor at 1 in the morning and blah blah blah. On the other hand, I’m lucky it didn’t become a huge deal, since I didn’t send it in… Anyway, this morning, all was clear, so life is good. I think I’ll do this evening’s monitoring somewhat early and go ahead and send it in just for the fun of it.

More Good: I did get the replacement pump around noon yesterday and it’s working just fine. I’ve haven’t been alarmingly uncomfortable today. I’ve got all the usual “hey I’m pregnant with triplets” discomforts, but nothing that’s making me go “hey that’s not good!” Also the babies have been kicking like mad and I’m pretty sure at least one of them has turned back around, so I’m hoping the others follow suit and SOON!

The Slightly Less Good: Baby A has discovered that JUMPING on my cervix is much more fun than punching it. I’m fairly certain that Baby A is still breech and is remaining that way simply to torture me. Youch!

Good: J is absolutely fascinated by my ever-expanding belly. “Oh Eema, your belly is getting bigger! It’s a giant belly now! Why is it getting so much bigger??” Yeah, uh, now that I think about it, I’m less convinced this belongs in the “Good” category! 😉 Anywhozit, I said, “Well, what’s IN Eema’s belly?” He giggled… “Bigger Babies!” “That’s right, so Eema’s belly has to get bigger so they can keep growing, right?” “Of course, Eema! You need a bigger belly so the babies can grow,” he said as if it had been all his idea and he was telling me how the world works. He’s really cute.

The Less Good: I absolutely cannot shake this cold. I feel disgusting, and it’s making it even harder than usual to keep food down, and worse, it’s making it difficult even to keep fluids down, which is bad, because the best thing I could possibly do for a cold is drink a lot of fluids. Sigh. So now in addition to waking up a lot with cramping and full bladder and general discomfort and leg cramps, I also wake up because I can’t breathe, I’m parched, and my throat hurts. It’s lovely. I’m not sure why I even bother trying to sleep anymore.

The Really Good: I haven’t been admitted to the hospital and I’m 26 1/2 weeks. That so rocks.

More Good: I’m no longer completey nauseated every time the babies move. This is a good thing, since they do it ALL THE FREAKING TIME, especially at night. Actually, I kind of love it now, and I think I might miss it some day. I mean, I could still do without the cervix stomping, because honestly, I’m not kidding when I say that really hurts. I mean REALLY hurts. But at least I know the kiddos are still moving around, right?

The Somewhat Annoying: Heartburn really sucks. Definitely in Stretch-Mark Land. I have a weird little hematoma right above my ever-shrinking (but not yet popping-out) belly button and I have no idea why or where it came from. Pregnancy has made my belly embarrassingly furry. I wish there were something I could do about this, but I figure my doctor has probably seen scarier bellies. Right? RIGHT? I’m still getting about 3 migraines a week and tylenol with codeine isn’t touching them but I don’t have a lot of other pain-relief options. I’m also getting lower-grade headaches from the terbutaline, but those are easier to knock out. The terbutaline also gives me a very annoying side effect of making it uncomfortable to breathe… as if I’d been breathing heavily after running a long distance or something for a while. It’s like my throat or lungs HURT when I breathe. It’s not like I can’t breathe, it’s just an unpleasant sensation that I keep hoping will go away and it hasn’t. The other terbutaline side effects have at least gotten less annoying even if they haven’t subsided completely, but this one is just as annoying as ever.

The Good: My husband? Completely rocks.

On a Completely Unrelated Note:
An anonymous poster has asked me twice now why there are 4-hour auto-doses in addition to a lower basal rate on the pump, rather than having just a higher basal rate that incorporates the auto doses over a longer period of time. I’m not ignoring the question, I’m actually trying to find a real answer rather than just having my own random guesses. My husband is a pharmacist, so you’d think this would be an easy one to get an answer to, right? Not so much. Never mind that he was sitting shiva for a week, so he couldn’t do any looking up for me, even now that he can he’s super-busy and the bit of research he’s done hasn’t turned up a lot of clear-cut answers.

What he has found is that generally the auto-doses are recommended to be timed with the peak periods of uterine activity if it is possible to predict that pattern (it often IS possible to do so, apparently). This makes a bit of sense to me as one suggestion that was made by my nurse at some point was to change the interval of the auto doses for more effective treatment.

He also found that taking 5mg pills every 4 hours is effective about 30% of the time for uterine contractions. But that terbutaline pump protocols are effective closer to 90% of the time, so for whatever reason, it works.

What he hasn’t found yet (and admittedly, he hasn’t had time while at work to wander over to the Health Sciences Library) is a clear cut answer about why it wouldn’t work to just have a high basal rate given out 24-7 with only denmand-doses as needed for breakthrough contractions. But if he DOES find an answer, I’ll let you know. Also, Erin has a PhD in Pharmacology, I believe, so maybe she can shed some light on this. Or maybe not. I don’t know. But if anyone else does happen to know, please let me know, because at this point, I’m intensely curious. Inquiring minds want to know.

(I also just reminded my husband, so he’s going to do some more digging around now to see what he can find… I’ll update this entry if he finds anything really interesting)

And that’s enough for now.

Update per Anonymous’ Comment:
Comment left last night: Hey, that’s great that you are looking into the auto-dose/basal issue. If there are other options that could serve you better, it would be good to know! Now, are there any at-home IVs you can use for when you can’t keep fluids down?

I’m looking into the basal vs. auto dose issue purely as a curiosity. I’m assuming this is a long tested issue at this point as this is very standard protocol that is used regularly for a large number of patients and has been for al ong time, so I’m not guessing that it would make more sense to raise the basal rate and eliminate auto-doses. It seems clear that the protocol of auto-doses combined with a low basal rate does work for most patients. It may be that it lowers the side effect profile to do it this way, and since the side effects aren’t real pleasant, that’s a good thing. At any rate, I’ve got my husband on it this week. He’s still playing a bit of catch up at work from being out after his father died, but I’m sure he’ll find some time to walk over to the library if I nudge him a little.

As for at-home IVs… the short answer is, yes, there are at-home IVs, but I don’t warrant one. If my nausea were so extreme that I were never keeping fluids down and I were severely dehydrated and had an electrolyte imbalance, they could do an at-home IV-line for Zofran (which I currently take orally). If that didn’t work, they’d admit me. However, my periods of not being able to keep fluids down are generally short-lived and haven’t resulted in real dehydration/electrolyte imbalances, so an IV line would be a bit on the extreme side (nor do I want one! I’m already the bionic woman!!). At any rate, yes, it’s an option, but not a likely one for me. Good idea though!

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Right. Well, that's quite enough of the self-pity. Or at least, that particular variety. I will now move on to an entirely different kind of whining. Pregnancy whining. Okay, I get it, there are lots of you out there who would give nearly anything to have the opportunity to whine about pregnancy, and I get that. So I'm sorry if it offends you that I don't find all of pregnancy all sunshine and light. Maybe I would if I had a singleton pregnancy, maybe I wouldn't. What I do know is that we infertiles HAVE to give ourselves permission to accept that there's nothing wrong with us for finding out that sometimes pregnancy isn't glamorous and sometimes parenting isn't perfect and sometimes we aren't always gracious about either one. Therefore, disclaimers aside, here are some of the good and the bad of late:

Good: I had a pretty decent week last week in terms of contractions and other such things. My appointment went well, my cervix had stablized and in fact lengthened somewhat, I even got a little cocky about it ("I don't need no stinkin' bedrest!") but not to the point that I violated doctor's orders. Contractions weren't done and over with, but I was generally having a good week, and they were definitely under better control than they had been.

The Less Good: The operative word in that last sentence, of course, is that they were under better control. Until Friday. I monitor contractions twice a day. I'm required to send them in every morning, but not in the evening unless I'm feeling symptomatic. I can also monitor any other time of day if I'm feeling off or feeling contractions or just feel like it or whatever. Friday around 5pm I felt a few contractions, but I sort of ignored them, because that's not terribly uncommon and I didn't think much of it. But then a little before 6, I had a few more and I thought, well, that's 4-6 contractions within the same hour, so I probably should call about getting a demand dose of terbutaline. After any demand dose, I have to monitor and send in the data, so that meant my evening data WOULD get sent in, which was fine.

So I called, asked if I could give myself a demand dose, was told yes, and then told to monitor from 6:30-7:30 and send it in. Fine. Except I couldn't get the pump to GIVE me a demand dose. It's a different button than the rest of the buttons and that button stopped working. So they had a work around for it, but that took some time, which put off my monitoring time until about 7ish to 8ish. Which is fine, but Shabbos (the Sabbath) was starting at 8, so the timing wasn't fabulous. I am allowed to do all the medical stuff I need to do on Shabbos, even though a lot of it isn't stuff I'd normally be allowed to do (e.g. using the phone). It's just that there are a couple things I had to do right at 8 (like light candles to bring in Shabbos), so it wasn't terribly convenient. Still, I made it work.

I expected that the monitoring session would yieled nothing interesting since I'd just given myself a demand dose and usually that takes care of the contractions immediately, but the nurse called back and said I had 5 contractions, which is above my "allowed" threshhold. Which meant I was going to have to re-monitor. Great. Except it's Friday night, late, I have a cranky 4 year old, my husband is at shul (synagogue), and I have to deal with remonitoring and once my husband gets home in theory we're supposed to eat a "festive meal" in honor of the Sabbath. (Someday maybe I'll explain the whole sabbath thing to my non-Jewish readers, but really, if you're wondering if I'm completely nutso, yes I am, but if you want more details, just email me… there's a link to my email address in my sidebar) Since 8pm is when one of my automatic doses happens anyway, the nurse wanted me to wait until about 8:30 to monitor again to give the dose some time to work its magic. And so, at 8:30, I strapped the monitor back on while attempting to appease J with some tortellini and some books and a couple cars (yes, he should have been in bed, but it's not like I can struggle with him alone these days).

And at 9:30 I sent in the data again. And while waiting for the phone call back, we started to sit down to dinner, and then, of course, the phone rang. The contractions had gotten much better..3 short contractions, which is under the "allowed" amount (thank heavens, because otherwise, doctor's orders would have mandated a phone call to the doctor on call and I REALLY didn't want to deal with that!), but the nurse didn't love that I'd been having a lot of cramping and it wasn't getting a lot better. So she waffled for a bit about calling the doctor anyway, but I talked her out of it (my doctor didn't seem OVERLY concerned when I'd mentioned it before, plus I promised to call if I couldn't sleep through it which is always my gauge of whether I should be waking up a doctor). She had me give myself another demand dose and encouraged me to call if it got any worse through the night. Fine.

And the next morning was more of the same. Too many contractions, demand dose (which they still had to use the awkward work-around to do, because the demand-button wasn't working) remonitor, better but not perfect, still a lot of cramping, so they changed my basal rate on the pump and got to work on getting a new pump programmed and couriered out to me. The increased basal rate did seem to help a bit throughout the day (it had also been increased the day before, so it had cumulatively been increased about 30% from two days prior). I didn't do an evening monitoring until quite late because I had people here visiting on and off throughout the day. I felt a little funny, but decided not to send in the data until morning since I wasn't required to and since it was so late. I figured I'd send it in the next morning. Turned out it was both a good and a bad choice not to send it in, because I'd had SEVEN contractions (nearly double my "allowed" threshhold) and a lot of irritability. So if I'd sent it in, I would have ended up having to do a demand dose and remonitor at midnight risking calling the doctor at 1 in the morning and blah blah blah. On the other hand, I'm lucky it didn't become a huge deal, since I didn't send it in… Anyway, this morning, all was clear, so life is good. I think I'll do this evening's monitoring somewhat early and go ahead and send it in just for the fun of it.

More Good: I did get the replacement pump around noon yesterday and it's working just fine. I've haven't been alarmingly uncomfortable today. I've got all the usual "hey I'm pregnant with triplets" discomforts, but nothing that's making me go "hey that's not good!" Also the babies have been kicking like mad and I'm pretty sure at least one of them has turned back around, so I'm hoping the others follow suit and SOON!

The Slightly Less Good: Baby A has discovered that JUMPING on my cervix is much more fun than punching it. I'm fairly certain that Baby A is still breech and is remaining that way simply to torture me. Youch!

Good: J is absolutely fascinated by my ever-expanding belly. "Oh Eema, your belly is getting bigger! It's a giant belly now! Why is it getting so much bigger??" Yeah, uh, now that I think about it, I'm less convinced this belongs in the "Good" category! 😉 Anywhozit, I said, "Well, what's IN Eema's belly?" He giggled… "Bigger Babies!" "That's right, so Eema's belly has to get bigger so they can keep growing, right?" "Of course, Eema! You need a bigger belly so the babies can grow," he said as if it had been all his idea and he was telling me how the world works. He's really cute.

The Less Good: I absolutely cannot shake this cold. I feel disgusting, and it's making it even harder than usual to keep food down, and worse, it's making it difficult even to keep fluids down, which is bad, because the best thing I could possibly do for a cold is drink a lot of fluids. Sigh. So now in addition to waking up a lot with cramping and full bladder and general discomfort and leg cramps, I also wake up because I can't breathe, I'm parched, and my throat hurts. It's lovely. I'm not sure why I even bother trying to sleep anymore.

The Really Good: I haven't been admitted to the hospital and I'm 26 1/2 weeks. That so rocks.

More Good: I'm no longer completey nauseated every time the babies move. This is a good thing, since they do it ALL THE FREAKING TIME, especially at night. Actually, I kind of love it now, and I think I might miss it some day. I mean, I could still do without the cervix stomping, because honestly, I'm not kidding when I say that really hurts. I mean REALLY hurts. But at least I know the kiddos are still moving around, right?

The Somewhat Annoying: Heartburn really sucks. Definitely in Stretch-Mark Land. I have a weird little hematoma right above my ever-shrinking (but not yet popping-out) belly button and I have no idea why or where it came from. Pregnancy has made my belly embarrassingly furry. I wish there were something I could do about this, but I figure my doctor has probably seen scarier bellies. Right? RIGHT? I'm still getting about 3 migraines a week and tylenol with codeine isn't touching them but I don't have a lot of other pain-relief options. I'm also getting lower-grade headaches from the terbutaline, but those are easier to knock out. The terbutaline also gives me a very annoying side effect of making it uncomfortable to breathe… as if I'd been breathing heavily after running a long distance or something for a while. It's like my throat or lungs HURT when I breathe. It's not like I can't breathe, it's just an unpleasant sensation that I keep hoping will go away and it hasn't. The other terbutaline side effects have at least gotten less annoying even if they haven't subsided completely, but this one is just as annoying as ever.

The Good: My husband? Completely rocks.

On a Completely Unrelated Note:
An anonymous poster has asked me twice now why there are 4-hour auto-doses in addition to a lower basal rate on the pump, rather than having just a higher basal rate that incorporates the auto doses over a longer period of time. I'm not ignoring the question, I'm actually trying to find a real answer rather than just having my own random guesses. My husband is a pharmacist, so you'd think this would be an easy one to get an answer to, right? Not so much. Never mind that he was sitting shiva for a week, so he couldn't do any looking up for me, even now that he can he's super-busy and the bit of research he's done hasn't turned up a lot of clear-cut answers.

What he has found is that generally the auto-doses are recommended to be timed with the peak periods of uterine activity if it is possible to predict that pattern (it often IS possible to do so, apparently). This makes a bit of sense to me as one suggestion that was made by my nurse at some point was to change the interval of the auto doses for more effective treatment.

He also found that taking 5mg pills every 4 hours is effective about 30% of the time for uterine contractions. But that terbutaline pump protocols are effective closer to 90% of the time, so for whatever reason, it works.

What he hasn't found yet (and admittedly, he hasn't had time while at work to wander over to the Health Sciences Library) is a clear cut answer about why it wouldn't work to just have a high basal rate given out 24-7 with only denmand-doses as needed for breakthrough contractions. But if he DOES find an answer, I'll let you know. Also, Erin has a PhD in Pharmacology, I believe, so maybe she can shed some light on this. Or maybe not. I don't know. But if anyone else does happen to know, please let me know, because at this point, I'm intensely curious. Inquiring minds want to know.

(I also just reminded my husband, so he's going to do some more digging around now to see what he can find… I'll update this entry if he finds anything really interesting)

And that's enough for now.

Update per Anonymous' Comment:
Comment left last night: Hey, that's great that you are looking into the auto-dose/basal issue. If there are other options that could serve you better, it would be good to know! Now, are there any at-home IVs you can use for when you can't keep fluids down?

I'm looking into the basal vs. auto dose issue purely as a curiosity. I'm assuming this is a long tested issue at this point as this is very standard protocol that is used regularly for a large number of patients and has been for al ong time, so I'm not guessing that it would make more sense to raise the basal rate and eliminate auto-doses. It seems clear that the protocol of auto-doses combined with a low basal rate does work for most patients. It may be that it lowers the side effect profile to do it this way, and since the side effects aren't real pleasant, that's a good thing. At any rate, I've got my husband on it this week. He's still playing a bit of catch up at work from being out after his father died, but I'm sure he'll find some time to walk over to the library if I nudge him a little.

As for at-home IVs… the short answer is, yes, there are at-home IVs, but I don't warrant one. If my nausea were so extreme that I were never keeping fluids down and I were severely dehydrated and had an electrolyte imbalance, they could do an at-home IV-line for Zofran (which I currently take orally). If that didn't work, they'd admit me. However, my periods of not being able to keep fluids down are generally short-lived and haven't resulted in real dehydration/electrolyte imbalances, so an IV line would be a bit on the extreme side (nor do I want one! I'm already the bionic woman!!). At any rate, yes, it's an option, but not a likely one for me. Good idea though!

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Sorry for the delay in actual pregnancy updates… several of you have asked. With my husband sitting shiva, it’s been hard to get real time to post anything significant. Things have mostly been okay, but have been a bit up and down. It seems like every time I want to post “Yesterday was a really good day” I end up having a really crappy day, so then I need to post “Yesterday was a really crappy day” except then things turn back around, so I just can’t keep it all straight. 😉 This is not an entirely bad thing.

The good news is that the up and down is largely confined to the contraction side of things. This is good news primarily because of the terbutaline pump. There’s a lot of leeway in how I can deal with dosages on the pump (or rather, how the nurses at Matria, the monitoring company, can deal with dosages). They have a lot of leeway in the doctors’ orders in terms of giving additional “demand doses” or changing basal rates or auto-dose rates. So we’ve been playing around a lot with that. We’ve increased my basal rate twice and yesterday increased my auto-dose rate by 10%, but there’s more wiggle room still if that doesn’t work.

What’s been tending to happen is that I go a day or a day and a half with no, or only one, contraction during each of my two daily monitoring sessions (which doesn’t mean I’m having zero throughout the day, but that’s another story), which is great. But then I’ll go a day or two with 5-6 during each monitoring session, which is when we start moving doses around. Most of the contractions aren’t painful, but they are fairly uncomfortable. What’s more painful is that I have a lot of cramping all of the time, which wakes me up a lot too, but even the increases in basal rate have helped that, so it’s likely that the cramping is low-level contractions that don’t really register as contractions themselves on the monitor (if they’re less than 40-seconds, they don’t call them contractions). See, and here I thought I got pregnant to avoid being plagued by painful menstrual-like cramps. Sigh.

The really astoundingly good news is that bed rest certainly seems to be doing its job, which is good because I really, really don’t want to be admitted to the hospital just now. Each appointment that I’ve had since that first alarming appointment where my cervix had gone down to 1.5cm has shown definite improvement in cervical length. I didn’t even know that could really happen. My last appointment, on Monday, it was, at its shortest, 2.8cm. Go me! This has also enabled me to return to weekly appointments instead of twice-weekly appointments, which is good, because with S dealing with shiva, I wouldn’t have wanted to abandon him too often.

What really astounds me is that I remember my first appointment with the perinatologist was at 8 weeks, 5 days, and this week’s appointment was 25 weeks, 5 days. 17 weeks have passed, but it feels like a lifetime ago. 17 weeks ago, I didn’t even have a clear idea whether all three were going to make it. 17 weeks ago I didn’t even know if it made more sense to consider a reduction and I was getting tremendous pressure in all directions to reduce. 17 weeks ago, I finally walked into an office that didn’t say my only option was to reduce the triplets. 17 weeks ago I had no idea if I was making the right choice, but today I have no question that I made the right choice. I didn’t know then if these little monsters had any chance of making it, but now, I have little doubt they will, though I have no idea what issues they’ll be facing on the other side. 17 weeks ago, I was in despair… yesterday, I was conspiring with Jess to create a baby registry, something I couldn’t possibly have contemplated even a month ago, let alone 17 weeks ago.

I remember clearly the day that it became obvious that I was attached to these little monsters. I blogged about it, even. April 19th. That’s when I realized it was okay to be attached to these little parasites… the little parasites I was still too terrified to refer to as babies. Now I often refer to them as babies, but I can’t remember when that shift took place. What I do know is that shift wasn’t insignificant. I never thought I’d call a baby a baby until it was born. I never thought I could bear having that level of attachment before it was a “sure thing”. But here I am, with three babies kicking me regularly, and that’s what they are to me… alternately babies and monsters (in the most endearing way possible, of course).

But I digress. Back to how I’m doing.

Contractions… today not bad, tomorrow, we’ll see. Check.
Cervical length… getting better, apparently bed rest works. Check.

Babies (!)… They are terrific. I haven’t had a growth ultrasound since the 11th, but will have another on Monday, so I’ll know more then, but they’ve all got perfect heartbeats, plenty of amniotic fluid, and they’re all quite active, so there don’t appear to be any serious concerns in that regard. Or minor concerns, for that matter. The one seriously annoying thing is that as of Monday, they had all turned breach. Even Baby A who has been head down for MONTHS! I know they all have PLENTY of time to turn right back around, but I’m bitter. Bit-ter, I tell you! They’d better move back around and fast. One good thing about it, though, is that Dr. M. thinks that it’s possible that part of the reason my cervix lengthened again this week was because the pressure had been taken off of it with the baby’s head not constantly pushing down on it, so I guess I can’t entirely complain. At first with them all turning around I couldn’t feel them moving much, but I think they must have shifted somewhat again, because now Baby A is most decidedly kicking me directly in the cervix on a regular basis, which is more painful than head-butting and honestly, more painful (and more persistent) than punching. So I’m not loving that. But the other two must also have shifted somewhat, because I can feel them fighting with each other again. I doubt that they’ve turned all the way around again already, but they’ve definitely moved somewhat since Monday.

Next Monday, they’ll do another fetal fibronectin test, talk to me more about steroid shots (though they’re still trying to put those off until at least 30 weeks if possible), and they’ll do the 1-hour glucose tolerance test. Yum. I wish I could just skip to the 3 hour, since I’m at such a high risk for gestational diabetes in the first place (triplet pregnancy, PCOS, overweight to begin with…), but it’s all good. Hopefully it won’t be an issue and I’ll only have to do this once. They will also, as I said, do the growth ultrasound on the babies, so it will be a long appointment, which is fine with me, because it’s the one excursion out of the house that I’m allowed.

The current bane of my existence is that I have a nasty cold, which I think is just adding insult to injury, and I’m quite bitter about it, but hoping that it will be short-lived. I hate colds because they are utterly miserable, but they are “just colds” so you can’t really complain about them without being a big whiner. Unless you’re pregnant with triplets, in which case, I think you’re perfectly justified in whining about basically anything. At least, that’s MY excuse!

And that’s where things are right now. I’m slowly catching up on blogs. I haven’t been purposely ignoring anyone, it’s just that things have been a bit crazy with everything going on between my dramarama and my husband’s father’s death. So hopefully things will calm down soon A girl can dream, right? Today my big plans are to be able to take a nap at some point.

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Sorry for the delay in actual pregnancy updates… several of you have asked. With my husband sitting shiva, it's been hard to get real time to post anything significant. Things have mostly been okay, but have been a bit up and down. It seems like every time I want to post "Yesterday was a really good day" I end up having a really crappy day, so then I need to post "Yesterday was a really crappy day" except then things turn back around, so I just can't keep it all straight. 😉 This is not an entirely bad thing.

The good news is that the up and down is largely confined to the contraction side of things. This is good news primarily because of the terbutaline pump. There's a lot of leeway in how I can deal with dosages on the pump (or rather, how the nurses at Matria, the monitoring company, can deal with dosages). They have a lot of leeway in the doctors' orders in terms of giving additional "demand doses" or changing basal rates or auto-dose rates. So we've been playing around a lot with that. We've increased my basal rate twice and yesterday increased my auto-dose rate by 10%, but there's more wiggle room still if that doesn't work.

What's been tending to happen is that I go a day or a day and a half with no, or only one, contraction during each of my two daily monitoring sessions (which doesn't mean I'm having zero throughout the day, but that's another story), which is great. But then I'll go a day or two with 5-6 during each monitoring session, which is when we start moving doses around. Most of the contractions aren't painful, but they are fairly uncomfortable. What's more painful is that I have a lot of cramping all of the time, which wakes me up a lot too, but even the increases in basal rate have helped that, so it's likely that the cramping is low-level contractions that don't really register as contractions themselves on the monitor (if they're less than 40-seconds, they don't call them contractions). See, and here I thought I got pregnant to avoid being plagued by painful menstrual-like cramps. Sigh.

The really astoundingly good news is that bed rest certainly seems to be doing its job, which is good because I really, really don't want to be admitted to the hospital just now. Each appointment that I've had since that first alarming appointment where my cervix had gone down to 1.5cm has shown definite improvement in cervical length. I didn't even know that could really happen. My last appointment, on Monday, it was, at its shortest, 2.8cm. Go me! This has also enabled me to return to weekly appointments instead of twice-weekly appointments, which is good, because with S dealing with shiva, I wouldn't have wanted to abandon him too often.

What really astounds me is that I remember my first appointment with the perinatologist was at 8 weeks, 5 days, and this week's appointment was 25 weeks, 5 days. 17 weeks have passed, but it feels like a lifetime ago. 17 weeks ago, I didn't even have a clear idea whether all three were going to make it. 17 weeks ago I didn't even know if it made more sense to consider a reduction and I was getting tremendous pressure in all directions to reduce. 17 weeks ago, I finally walked into an office that didn't say my only option was to reduce the triplets. 17 weeks ago I had no idea if I was making the right choice, but today I have no question that I made the right choice. I didn't know then if these little monsters had any chance of making it, but now, I have little doubt they will, though I have no idea what issues they'll be facing on the other side. 17 weeks ago, I was in despair… yesterday, I was conspiring with Jess to create a baby registry, something I couldn't possibly have contemplated even a month ago, let alone 17 weeks ago.

I remember clearly the day that it became obvious that I was attached to these little monsters. I blogged about it, even. April 19th. That's when I realized it was okay to be attached to these little parasites… the little parasites I was still too terrified to refer to as babies. Now I often refer to them as babies, but I can't remember when that shift took place. What I do know is that shift wasn't insignificant. I never thought I'd call a baby a baby until it was born. I never thought I could bear having that level of attachment before it was a "sure thing". But here I am, with three babies kicking me regularly, and that's what they are to me… alternately babies and monsters (in the most endearing way possible, of course).

But I digress. Back to how I'm doing.

Contractions… today not bad, tomorrow, we'll see. Check.
Cervical length… getting better, apparently bed rest works. Check.

Babies (!)… They are terrific. I haven't had a growth ultrasound since the 11th, but will have another on Monday, so I'll know more then, but they've all got perfect heartbeats, plenty of amniotic fluid, and they're all quite active, so there don't appear to be any serious concerns in that regard. Or minor concerns, for that matter. The one seriously annoying thing is that as of Monday, they had all turned breach. Even Baby A who has been head down for MONTHS! I know they all have PLENTY of time to turn right back around, but I'm bitter. Bit-ter, I tell you! They'd better move back around and fast. One good thing about it, though, is that Dr. M. thinks that it's possible that part of the reason my cervix lengthened again this week was because the pressure had been taken off of it with the baby's head not constantly pushing down on it, so I guess I can't entirely complain. At first with them all turning around I couldn't feel them moving much, but I think they must have shifted somewhat again, because now Baby A is most decidedly kicking me directly in the cervix on a regular basis, which is more painful than head-butting and honestly, more painful (and more persistent) than punching. So I'm not loving that. But the other two must also have shifted somewhat, because I can feel them fighting with each other again. I doubt that they've turned all the way around again already, but they've definitely moved somewhat since Monday.

Next Monday, they'll do another fetal fibronectin test, talk to me more about steroid shots (though they're still trying to put those off until at least 30 weeks if possible), and they'll do the 1-hour glucose tolerance test. Yum. I wish I could just skip to the 3 hour, since I'm at such a high risk for gestational diabetes in the first place (triplet pregnancy, PCOS, overweight to begin with…), but it's all good. Hopefully it won't be an issue and I'll only have to do this once. They will also, as I said, do the growth ultrasound on the babies, so it will be a long appointment, which is fine with me, because it's the one excursion out of the house that I'm allowed.

The current bane of my existence is that I have a nasty cold, which I think is just adding insult to injury, and I'm quite bitter about it, but hoping that it will be short-lived. I hate colds because they are utterly miserable, but they are "just colds" so you can't really complain about them without being a big whiner. Unless you're pregnant with triplets, in which case, I think you're perfectly justified in whining about basically anything. At least, that's MY excuse!

And that's where things are right now. I'm slowly catching up on blogs. I haven't been purposely ignoring anyone, it's just that things have been a bit crazy with everything going on between my dramarama and my husband's father's death. So hopefully things will calm down soon A girl can dream, right? Today my big plans are to be able to take a nap at some point.

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