ChezPerky

I was a bit unfair in my recent FAQ post. I posted all the snarky questions (some of which I'm sure weren't intended in a snarky way, but I'm all hyper-sensitive right now, so there you have it), but I gave absolutely no credit to the overwhelming support that I've received from much of the infertility blogging world. My friends inside the computer are the best people on the planet.

Mel has been especially helpful, as has Marie-Baguette. I've gotten amazingly supportive comments and emails from most of you. Kirby offered to help in anyway possible, even if it meant driving down to Baltimore to meet me. December Baby cracks me up with her comments. Thalia, who has enough to worry about on her own already, has given me some much needed support. Vanessa who is dealing with her own shock at the moment, has still popped in to send me her thoughts. Countless others have popped in out of the woodwork to check in and see how things are going. I wish I could name every single one of you, because honestly, all of you who comment on this blog are awesome. You're articulate, supportive, thoughtful, understanding, and unbelievably wonderful. If I didn't single you out, it's not because you're not awesome, it's because my hands are starting to hurt from all the typing. You all rock my world.

So you see, it really was unfair of me to focus only on the snarky and to ignore all the love and support I've gotten. Still, I think it's telling that at the time what stuck with me was the snarky stuff. I think it's because I was carrying around a lot of guilt. By all rights, I should be ecstatic. I should be thrilled beyond thrilled to have hit the infertility lottery. In a lot of ways I am. But it would be lying if I ignored the fact that I'm still utterly terrified. I've now got three strong beating hearts inside of me. That's a lot of responsibility. I don't know how we're going to handle it financially, emotionally, or physically. I don't know where we're going to squeeze them into our house. I can't figure out how on earth to deal with something as simple as childcare, because no matter how expensive childcare will be, it will still be less than my salary, so we can't afford for me not to work. Who wants to take care of triplets? Can you imagine?

And then I remember that I'm getting ahead of myself. I remember my friend who got pregnant a week after I did last summer, only she was pregnant with triplets. I had a miscarriage at 12 weeks. Two weeks later, when she was 13 weeks, she lost two of hers and she's due with a singleton next month. Am I ever going to be able to breathe in this pregnancy? Will I ever feel safe? Will I ever stop wondering if walking up that flight of stairs will mean the demise of my future children? Will I ever make it out of the house again? Will I be able to push a triple stroller? How will we deal with the hospital bill? How much of it will insurance cover?

Will we lose our foster son? Will a court side with his mother, who hasn't seen him in 11 months and 4 days, if we end up with triplets? Will they assume that we're now too busy to love our gorgeous boy? I can't imagine life without J. He was supposed to be with us for a year and then either go back to his mother or be adopted by us. Two and a half years later, nothing has changed. I am his mother. I am the one who stays up late with him. I am the one who worries about what he's eating. I am the one who comforts him when he throws up (admittedly, S is the one who actually cleans up the vomit, because, well, ew!). I am the one who feeds him and hugs him and tucks him in and sings to him and wakes up with him poking me. (None of this is meant to take away from the astounding amount that S does… S is a much better parent than I am) But what if we have triplets and some judge decides we simply can't take care of three infants plus J?

It sounds, in my blog, as though I'm walking around in a constant state of terror, but I'm not. This is where I go to vent it all out, but generally, I'm okay. I take a lot of deep breaths. I'm eating a lot of saltines (because seriously? It's what I can keep down now). I'm looking at each step individually. This is how I stay sane-ish.

Next steps:
4/2: Appointment with Perinatologist
4/3-4/10: Pesach, so can't think too much about the triplet factor anyway.
4/12: Appointment with my OB

Probably we'll tell our mothers about this here pregnancy by the end of April. I begrudgingly admit, I probably can't avoid mentioning the triplet part. When we thought we were having twins, S and I had agreed not to tell anyone but my father that there was more than one. But with triplets, I doubt we can avoid mentioning it. It's okay. I just don't want to tell anyone too soon. My father knows because I needed parental advice the day I found out there were three and he's great at objective advice even in completely screwy circumstances.

But see… the last time I was pregnant, I told my mother immediately, because we thought it wasn't real… we thought I was miscarrying. And so I missed her mother's funeral because my doctor didn't want me getting on a plane that week. So I had to tell her. And I was pregnant for three whole months. I was well past the scary part. I was well past the point of worrying whether I would make it all the way to April. No one expected me to miscarry. No one. But when I called my mom from the hospital to tell her what had happened, she sighed and said, "Oh sweetie, I thought that might happen." Nothing could have made me angrier at that moment. Nothing. She knew nothing of the kind. The doctors were shocked! We were all shocked! But she's got to act like she knew all along, which is crap. I had a perfectly perfect ultrasound of a healthy baby five days before. There is no way she "knew" or "thought" it might happen. And if she was sitting around worried it might happen, then she was projecting her own BS onto me, which is so not okay. (My mother had at least 8 miscarriages, most of which were very early, one of which was around three months…. very sad, yes, but also no reason to believe I'll have the same experience… my mother had NO problem GETTING pregnant, only a problem STAYING pregnant. Our circumstances are very different) I just can't bear to have her saying something stupid like that again if something should happen to this pregnancy. And that's why I can't tell her. She won't even know she's being hurtful. That's the worst part.

Two other irritating things and then I'll wrap up this embarrassingly long post. If you make it to the end, I'll give you a cookie. But you'll have to come get it.

The two things that really piss me off when people say them are these:
1. Well, at least you'll be done having kids after triplets!
2. Oh my gosh, triplets… are they natural/spontaneous/fertility-induced?

Let's start with #1: Maybe I won't be done! Maybe I didn't want to have just one pregnancy and poof! be done! Maybe I want a dozen kids (I don't, but still, I could!). Maybe I don't want to think about the fact that I'll be done after that, long before I'd planned on being done. Maybe I don't want to be reminded that I won't get to see my seven-year old interact with my 2 year old interacting with my newborn, like some women get to see. Maybe I don't know whether all three will even make it and then maybe I'll be even less likely to be done with the whole shebang. Maybe it's cruel to act like this is something that can be brushed off like that.

And number 2. Boy that one ticks me off badly. First of all, ALL children are natural. And who the hell cares if they're fertility-induced or spontaneous? Does it really make a difference? Is it really any of your business? Worse is the implication that if they were fertility-induced it was my own, irresponsible fault, but if they were spontaneous, well, they're a gift from God and how beautiful that I got such a surprise!

I swear I'm not this cranky in real life. You don't have to believe me, but I really am a rather pleasant person in real life. Anywhozit, enough whining. Thank you all for being awesome.

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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 »

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.

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.

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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.

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As several of you noted on my last post, I am calm. Unbelievably, inexplicably, undeniably calm. I’m not even entirely sure why. It really doesn’t make any sense. I mean, last week I was completely hysterical. But then again, we discovered three gestational sacs on a day my husband was out of town and also on a day we discovered that his car was definitely dead and in need of replacement, which sent me into such a panic by itself that I was near hyperventilation (very unusual for me… I’ve got a quick temper, but I’m not usually one for histrionics).

But here I am. There is nothing I can do about my present situation. I am currently pregnant with triplets. I will either stay that way or I won’t. Either it will resolve itself naturally or it won’t. And meanwhile, we will do as much research as possible to decide what options we have or don’t have. To that end I have:

1. Sent an email to my Rabbi requesting a meeting ASAP. This is a terrible time to ask this of him, given that it is almost Passover, but it is essential that we speak with him in a timely manner. He may tell us we have no options at all, which will render any other decision making moot. My understanding, however, is that under our specific circumstances, halacha isn’t so black-and-white about this.

2. I have set up an appointment with my OB for this Friday at 7:50 am. The office closest to my house gave me all sorts of stress about getting an appointment, and they heard the word “triplets” and freaked out. They offered me an appointment for April 17th. So I called the office closer to my office and lucked out. The person helping me heard the word “triplets” and said she would work me in ASAP. So Friday at 7:50 it is.

3. I have made an appointment with the maternal fetal medicine specialist (perinatologist). I made the appointment with the doctor that Dr. Amazing wants me to speak with about selective reduction. I have no intention of only speaking to him about selective reduction, however. I want to hear from him what I can expect of a triplet pregnancy and what risks would be involved with carrying all three. There seems to be a lot of variance in medical studies about whether reduced triplets fare that much better than triplets that are not reduced. It is much more clear-cut in the medical literature with quadruplets. (And no way would I consider quadruplets!) Then I want to hear about the risks/benefits of selective reduction. But I am by no means committing to such a decision. I’m not sure how I feel about it, I’m really not. My appointment, unfortunately is for 11:30 on April 2nd. That’s several hours before Passover, but I can’t put it off much longer than that anyway. So I’ll just have to make sure I’m completely ready for Passover on April 1st, which was my goal anyway.

And that’s where I am. Right now, I just want to make sure all my options are laid out before me. I want to make sure I have all the information I need. I want to make sure I’m not rushing into any decisions. And I want to make sure that I’m not acting emotionally, but rather, really understanding what’s going on and how to deal with it. A triplet pregnancy is not the end of the world, but it is still scary to me. I don’t like imagining my future children struggling for life in an incubator, and frankly, that’s really all I can think of right now when I try to figure out how I feel about this whole thing. Which is why I’m trying not to think about it too much, until I’ve got all the information before me.

One thing’s for sure… a lot can happen. I have another ultrasound in a week, and for all I know things will have naturally resolved themselves to twins by then. I’m not counting on it, but my worries may be for nothing. It definitely seems clear that I’ll at least be having twins, so no matter what, I’m going to be reading up on multiple pregnancy/birth/etc.

Thanks for bearing with me. I know this is a blessing. I know that I haven’t been given more than I can handle. I know that things will work out in whatever way they are meant to. And I know that there isn’t much I can do to change the outcome just yet anyway. So it will be as it needs to be.

Oh, as for other stuff…
1. I’m still bleeding, but I’ve decided to stop worrying about it. Sometimes it’s light spotting, sometimes it’s heavy. It hasn’t changed at all since the beginning. I will assume this is just “what I do” when I’m pregnant. Someday I’d like to know WHY I do this, but for now it’s not important.
2. I’m not feeling particularly nauseated, which is a miracle. I’m a bit queasy, but nothing I’d call real nausea.
3. I’m utterly, completely, indescribably exhausted and I expect this will only get worse.
4. I’m having a very hard time sleeping.
5. My hips are in agony, which makes no sense, because it’s certainly too early for anything to be spreading out.
6. I have lost almost 10 pounds since getting pregnant. I’m down 29 pounds since last July. I lost 19 pounds while I was pregnant the last time. This is not a recommended diet plan, by the way.
7. I am never hungry. I am always thirsty. My need to pee regularly appears to be strictly related to how much I’m drinking.

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