ChezPerky

So on Wednesday Dr. G told me if I started having contractions any more frequently I should call immediately. I was then having contractions about 2-3 times per hour for several hours at a time. On Saturday, I was having a steady 3 contractions per hour for several hours at a time, but I wasn’t sure if that counted as more frequent or not, so I didn’t call. Today, on my way home from Baltimore, where I’d gone out for dinner with S, J, and a friend, figuring it’s probably the last time I’m going to be allowed out for a LONG TIME, I had at least four contractions on the 45 minute drive home. I came home, drank some water and laid down on my left side for 45 minutes, during which time I had another 3 contractions. And so I paged the doctor on call.

She agreed that 3-4 contractions per hour was worth paying attention to and said that if it persisted I should head over to L&D, but agreed that if I can sleep through them, they probably aren’t that worrisome. So, since I have a 10am appointment at the office tomorrow for a cervix check anyway, and since I really don’t want to be in L&D all night, I asked if it’s a rotten strategy to just try and sleep. She said no, and recommended benadryl. But, she cautioned, if the contractions are strong enough and frequent enough to wake me through the benadryl, I should go in, and I should also be sure to push fluids as much as possible.

This is creating quite the catch-22. The fluids, I mean. Because at one of my early appointments, Dr. P. warned me that a really full bladder can trigger contractions, and I’m pretty sure he’s right. So I’m peeing a lot, which is keeping me awake, but I’m also thirsty as hell, because, well, I’m peeing a lot, which is creating a vicious cycle. And I’m having a few contractions, but I don’t think it’s quite 4 per hour, but I couldn’t really tell you because I’m so tired and loopy I can hardly keep track. I’m guessing I should think about writing them down. They’re not comfortable, but I wouldn’t call them painful either. Suffice it to say, I’m guessing the next 10 weeks or so are going to be oh-so-fun-filled. If I make it that far. I hope I do.

Anywhozit, I do think the contractions have slowed down and I’ve decided not to worry about this until morning when I go see the doctor anyway. The one doctor I haven’t met and am not particularly interested in meeting, but I suppose it can’t hurt. I wish I were seeing Dr. G. Or Dr. P. Or Dr. M. Le Sigh. I guess a girl can’t have everything.

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So on Wednesday Dr. G told me if I started having contractions any more frequently I should call immediately. I was then having contractions about 2-3 times per hour for several hours at a time. On Saturday, I was having a steady 3 contractions per hour for several hours at a time, but I wasn't sure if that counted as more frequent or not, so I didn't call. Today, on my way home from Baltimore, where I'd gone out for dinner with S, J, and a friend, figuring it's probably the last time I'm going to be allowed out for a LONG TIME, I had at least four contractions on the 45 minute drive home. I came home, drank some water and laid down on my left side for 45 minutes, during which time I had another 3 contractions. And so I paged the doctor on call.

She agreed that 3-4 contractions per hour was worth paying attention to and said that if it persisted I should head over to L&D, but agreed that if I can sleep through them, they probably aren't that worrisome. So, since I have a 10am appointment at the office tomorrow for a cervix check anyway, and since I really don't want to be in L&D all night, I asked if it's a rotten strategy to just try and sleep. She said no, and recommended benadryl. But, she cautioned, if the contractions are strong enough and frequent enough to wake me through the benadryl, I should go in, and I should also be sure to push fluids as much as possible.

This is creating quite the catch-22. The fluids, I mean. Because at one of my early appointments, Dr. P. warned me that a really full bladder can trigger contractions, and I'm pretty sure he's right. So I'm peeing a lot, which is keeping me awake, but I'm also thirsty as hell, because, well, I'm peeing a lot, which is creating a vicious cycle. And I'm having a few contractions, but I don't think it's quite 4 per hour, but I couldn't really tell you because I'm so tired and loopy I can hardly keep track. I'm guessing I should think about writing them down. They're not comfortable, but I wouldn't call them painful either. Suffice it to say, I'm guessing the next 10 weeks or so are going to be oh-so-fun-filled. If I make it that far. I hope I do.

Anywhozit, I do think the contractions have slowed down and I've decided not to worry about this until morning when I go see the doctor anyway. The one doctor I haven't met and am not particularly interested in meeting, but I suppose it can't hurt. I wish I were seeing Dr. G. Or Dr. P. Or Dr. M. Le Sigh. I guess a girl can't have everything.

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Yeah, so, um… I finally did it. I set an end date at work. I thought it was reasonable. I set it for the 20th. I’ll be 24 weeks, 2 days. In fact, I thought maybe it was being slightly alarmist and silly. But I had gotten that lecture from my doctor two weeks ago about cutting back at work, and I thought it made sense to start thinking about an end date. Cutting back my hours was clearly only going to go so far. But two weeks ago, it still seemed a little silly, particularly with a 4cm, tightly closed cervix. Nevertheless, I DID set that end date, with the caveat to my client that the date could always change to an earlier date if my doctor slammed on the brakes. But that was never going to happen, you know. Because, seriously, did I mention that beautiful 4cm tightly closed cervix?

Yeah.

So I happen to know that the people that read my blog are smart and sophisticated as evidenced by your reactions to my informal froggy poll. See, I liked the froggies, Jess didn’t. Jess’s readers didn’t love the frogs. MY readers? You mostly loved the froggies. Therefore, I know you are smart, sophisticated, and highly evolved. So I have this sneaking suspicion that you know where I’m going with this story. Because, as I said, you are smart.

I went to the doctor today, and accused him of putting a Mayan curse on me. See, just a couple days after the lecture I got about not working so much, I felt like I’d been hit by a truck. All of a sudden, I was dragging. Walking became a zillion times more tedious. Breathing became a chore. Contractions started happening more often (but still not SO often that I was worried). Dragging myself to the office was questionably sane. Cutting back my hours suddenly seemed very wise. So my theory is that the doctor KNEW I wasn’t going to follow the strict letter of the law on the lecture I’d gotten, so he put a Mayan curse on me. So when he came in, he said, “How are you feeling?”

“I think you put a Mayan curse on me.”
“Oh? Why would you think that?” (Please note the distinct LACK of a specific DENIAL here)
“Because immediately after you lecturing me about cutting back on working or stopping work, I suddenly felt like I’d been hit by a truck. Did you just know I wouldn’t otherwise listen?”
“Pretty much. So does that mean you’ve stopped working?”
“Uh… no, but I’m going to soon?”
“Yeah, you’re going to REAL soon.”
“Can I squeeze out one more week?”
“Not so much.”
“Really?”

Yeah, so my cervix has shortened to 3cm, which is still astoundingly fabulous for a chick who is 23 weeks pregnant with triplets. Still, that’s a bit of a jump and he doesn’t love it. What he loves even less is that he’s starting to see some slight evidence of funneling, which is decidedly not good. He did say that many other doctors would look at these pictures and say there’s nothing wrong here at all. “BUT,” he cautioned, “With a triplet pregnancy, there’s a lot at stake and we try to look for any early sign of any possible problem so that it doesn’t become a big problem. It’s possible I’m being overly cautious where another doctor would choose not to be, and if you were pregnant with a singleton, I wouldn’t think twice about this.” Yup, and that’s why I’m seeing THIS practice and not another. They handle a LOT of triplets, but they take NO risks. I will do what they say. So what he’s saying today is that I may go to work tomorrow, and I may take my foster-son to his developmental evaluation on Friday as planned, but only on the condition that I return to the office on Monday for a cervical check. If nothing has changed, he will clear me to work from home for the week so that I can wrap up my final projects. If things have progressed, he will tell me I’m done, regardless of how my projects stand.

Oh, and he’s not so happy that I didn’t call about the contractions. But the last time I called about the contractions (when I was 17 1/2 weeks pregnant), I got “ho hum, could be normal” from the doctor on call…not a doctor I’ve ever seen in real life, and not a doctor it appears I’ll EVER see in real life as it sounds like she’s actually leaving the practice. Furthermore, the guidance I’d been told all along was to call if I get more than four contractions per hour. I don’t get more than four, I get 2-3 per hour. However, I now have strict instructions that if this increases even to a steady 3 per hour or more, I should call immediately. “We could do at home monitoring for you, but that’s really a pain in the ass, so we’d really rather not if we can avoid it,” he said. Anyway, he doesn’t think the contractions are too big a concern by themselves, but combined with the slight funneling, he’s not thrilled and wants to know if there is any change at all. Got it. I’m okay with that.

In other news, these little guys (or gals) are doing great… they are all measuring at 1 pound, 2 ounces each. They are all growing perfectly. They are fighting each other a lot, which is good. Apparently the constant stimulation in utero is good, because it’s part of what helps their lungs develop. I think that’s pretty cool. My blood pressure is still good and I asked about my high pulse and he’s not worried because it’s completely attributable to my increased blood volume. He said if it gets into the 120s that he’ll be worried, but in the low 100’s (where it’s been) he’s not worried at all (though I gotta tell you, it’s not real pleasant for ME!).

I’ll write more about how and what I’m feeling (physically) and what the kiddos looked like at the ultrasound in a separate post. Right now I’m tired and need to lay down for a bit. I might get motivated enough to scan todays ultrasound pictures eventually. We’ll see.

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Yeah, so, um… I finally did it. I set an end date at work. I thought it was reasonable. I set it for the 20th. I'll be 24 weeks, 2 days. In fact, I thought maybe it was being slightly alarmist and silly. But I had gotten that lecture from my doctor two weeks ago about cutting back at work, and I thought it made sense to start thinking about an end date. Cutting back my hours was clearly only going to go so far. But two weeks ago, it still seemed a little silly, particularly with a 4cm, tightly closed cervix. Nevertheless, I DID set that end date, with the caveat to my client that the date could always change to an earlier date if my doctor slammed on the brakes. But that was never going to happen, you know. Because, seriously, did I mention that beautiful 4cm tightly closed cervix?

Yeah.

So I happen to know that the people that read my blog are smart and sophisticated as evidenced by your reactions to my informal froggy poll. See, I liked the froggies, Jess didn't. Jess's readers didn't love the frogs. MY readers? You mostly loved the froggies. Therefore, I know you are smart, sophisticated, and highly evolved. So I have this sneaking suspicion that you know where I'm going with this story. Because, as I said, you are smart.

I went to the doctor today, and accused him of putting a Mayan curse on me. See, just a couple days after the lecture I got about not working so much, I felt like I'd been hit by a truck. All of a sudden, I was dragging. Walking became a zillion times more tedious. Breathing became a chore. Contractions started happening more often (but still not SO often that I was worried). Dragging myself to the office was questionably sane. Cutting back my hours suddenly seemed very wise. So my theory is that the doctor KNEW I wasn't going to follow the strict letter of the law on the lecture I'd gotten, so he put a Mayan curse on me. So when he came in, he said, "How are you feeling?"

"I think you put a Mayan curse on me."
"Oh? Why would you think that?" (Please note the distinct LACK of a specific DENIAL here)
"Because immediately after you lecturing me about cutting back on working or stopping work, I suddenly felt like I'd been hit by a truck. Did you just know I wouldn't otherwise listen?"
"Pretty much. So does that mean you've stopped working?"
"Uh… no, but I'm going to soon?"
"Yeah, you're going to REAL soon."
"Can I squeeze out one more week?"
"Not so much."
"Really?"

Yeah, so my cervix has shortened to 3cm, which is still astoundingly fabulous for a chick who is 23 weeks pregnant with triplets. Still, that's a bit of a jump and he doesn't love it. What he loves even less is that he's starting to see some slight evidence of funneling, which is decidedly not good. He did say that many other doctors would look at these pictures and say there's nothing wrong here at all. "BUT," he cautioned, "With a triplet pregnancy, there's a lot at stake and we try to look for any early sign of any possible problem so that it doesn't become a big problem. It's possible I'm being overly cautious where another doctor would choose not to be, and if you were pregnant with a singleton, I wouldn't think twice about this." Yup, and that's why I'm seeing THIS practice and not another. They handle a LOT of triplets, but they take NO risks. I will do what they say. So what he's saying today is that I may go to work tomorrow, and I may take my foster-son to his developmental evaluation on Friday as planned, but only on the condition that I return to the office on Monday for a cervical check. If nothing has changed, he will clear me to work from home for the week so that I can wrap up my final projects. If things have progressed, he will tell me I'm done, regardless of how my projects stand.

Oh, and he's not so happy that I didn't call about the contractions. But the last time I called about the contractions (when I was 17 1/2 weeks pregnant), I got "ho hum, could be normal" from the doctor on call…not a doctor I've ever seen in real life, and not a doctor it appears I'll EVER see in real life as it sounds like she's actually leaving the practice. Furthermore, the guidance I'd been told all along was to call if I get more than four contractions per hour. I don't get more than four, I get 2-3 per hour. However, I now have strict instructions that if this increases even to a steady 3 per hour or more, I should call immediately. "We could do at home monitoring for you, but that's really a pain in the ass, so we'd really rather not if we can avoid it," he said. Anyway, he doesn't think the contractions are too big a concern by themselves, but combined with the slight funneling, he's not thrilled and wants to know if there is any change at all. Got it. I'm okay with that.

In other news, these little guys (or gals) are doing great… they are all measuring at 1 pound, 2 ounces each. They are all growing perfectly. They are fighting each other a lot, which is good. Apparently the constant stimulation in utero is good, because it's part of what helps their lungs develop. I think that's pretty cool. My blood pressure is still good and I asked about my high pulse and he's not worried because it's completely attributable to my increased blood volume. He said if it gets into the 120s that he'll be worried, but in the low 100's (where it's been) he's not worried at all (though I gotta tell you, it's not real pleasant for ME!).

I'll write more about how and what I'm feeling (physically) and what the kiddos looked like at the ultrasound in a separate post. Right now I'm tired and need to lay down for a bit. I might get motivated enough to scan todays ultrasound pictures eventually. We'll see.

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It’s been a very busy week at work. I’m trying to get all the loose ends on my projects wrapped up so that my replacement can just step in with the new projects rather than dealing with all the ridiculous minutiae of the rest. Don’t know how successful I’ll be, but meanwhile, it’s keeping me quite busy.

On Tuesday, I faxed a request to my OB’s office to send all my OB & Prenatal records to the perinatology practice. It’s the chicken’s way out, but it works. On Thursday, I saw the perinatologist. The ultrasound took a very long time, but we got a great look at the babies. They measured the head circumference, belly circumference (I’m sure there’s a technical term for that, but I’m not sure what it would be), femur length and heart rate for each of the babies. The appointment was when I was 17w, 1d and they measured 17w 2d, 17w 0d and 17w 0d. They all measured six ounces, which seems astoundingly small to me: they’re the size of tuna cans. I have 18 ounces of baby in me! My cervix is still doing fine, though I did note that it has shortened slightly, but it’s still within a fine range, which makes me happy.

Then the doctor came in and took a look. Apparently my cervix tilts a bit, which made the original measurements a little sketchy, so they remeasured and the doctor was satisfied. She asked if I was still being followed by the OB practice and I said, “funny you should mention that…” So I explained the weirdness I’d gotten when I’d brought it up in person, and I told her I’d been back and forth about it and was very torn, but felt more comfortable just having one set of doctors so I’ve asked that my records be transferred over to them. No problem, she said. They’re very comfortable handling triplets themselves… it tends to be their preference, and it seems to be easier on the patients, since they’re in the office so often anyway that another set of appointments becomes cumbersome. So after she’d gotten a look at all the sonogram pictures (“Wow, these babies look great!”) she told me that I could go ahead and get dressed and come chat in her office. What? Talk to a doctor while fully clothed? I’m not sure I know HOW to do that!

We chatted for a bit in her office and pulled out a calendar to guesstimate an arrival time-ish for the babies. The perinatology practice gets most of their triplets to 34 weeks and rarely lets any triplet moms go past 34 weeks. I hit 34 weeks on September 26th (erev Succos) which is the day before my mother’s birthday. Mostly I want to avoid my foster-son’s birthday if possible, which should be easy, failing an emergency, because it’s a Sunday this year. The doctor isn’t concerned about me taking 2 prenatals a day yet… she said unless my blood work shows that I’m anemic (I’m not yet, but it’s likely to happen at some point), she’s not worried. She’d rather not double the vitamin because it could exacerbate constipation (a pregnancy symptom I’ve been lucky enough to avoid so far and I’d like to keep it that way!).

I mentioned that I feel a little guilty for not… how do I put this?… not finding more joy in the pregnancy experience. I’m incredibly grateful to be pregnant. I am looking forward to meeting my babies. I am blessed in so many ways, I don’t even know how to begin expressing it. But I could do without the endless nausea (yeah, that hasn’t stopped). I could do without the terminal exhaustion (that second-trimester energy burst? It’s a myth). I could live without the stress, the previa, the contractions (nope, those aren’t gone either), the random pains, the heartburn, the worry, and the migraines. And the doctor’s answer? “I did mine one at a time, twice, and I must say, I’m not a fan of pregnancy. I love my children, but I could have done without all the pregnancy yuck.” So you know? I feel a little less guilty. That being said, the pregnancy thing? It’s pretty nifty. And there are times, even now, that I’m surprised how good I do feel.

I go back in two weeks for a prenatal appointment (my first with this office) to set up my “prenatal chart” — whatever that is. They’ll also do a cervix check, which they’ll do at EVERY appointment (seriously? most women graduate from the RE’s office never to see a transvaginal ultrasound transducer again… me? it is still my life!). And they’re going to do at least part of the detailed anatomy scan. The doctor was worried that I’d be too uncomfortable to lay down through all three of the babies in a row for the detailed anatomy scan, so she figured if we could get at least one or two this time, then we can get the rest at the next appointment. So that’s pretty nifty. I’m expecting it to be about a three-hour appointment. Holy cow. It will be a wonder if I ever get any work done again at this rate with all these marathon appointments.

Today I called the doctor-on-call at the perinatologist’s office, because I’ve been having these pretty uncomfortable menstrual-like cramps sort of rhythmically throughout the day. They aren’t painful, exactly, but they’ve gotten worse through the day and they’re very uncomfortable and I’ve had a bit of very light spotting. I never really know what the threshold is on calling the doctor. I hate to be an alarmist, but on the other hand, I can’t tell anymore where that line is. Anyway, it was a doctor I don’t know and she was both completely reassuring and unhelpful at the same time. Basically she said that it’s just as hard for them as doctors on the other end of the phone to know where the line is, too. And she said that I could come in if I’m that uncomfortable, or I can stay home. Or I can wait a couple hours and see how it goes (that’s what I’ve decided to do). Spotting in early pregnancy, she says, can be very normal. Early pregnancy? Heck, I’m half-way through this pregnancy! Ahem. And don’t tell me about early pregnancy spotting. I know from early pregnancy bleeding. That’s what I do. But I haven’t had much in the way of spotting at all for five weeks. Besides, it’s not the spotting that’s freaking me out. Well, I’m not even particularly freaked out. But it’s not the spotting that prompted me to call. It’s the cramping. The very rhythmic, tightening/cramping that seems to be getting worse in the day. But that can be normal too, she says. Except when it isn’t. Which is why she suggests coming in to be evaluated if it doesn’t get better in a couple hours. So while that’s completely unhelpful, it’s very reassuring to know that no serious red-flags went off in the doctor’s head to make her say, “Oh my gosh, get thee to the doctor’s office NOW!”

The only really frustrating thing was that since my records haven’t officially transferred over from the OB’s office yet, she’s worried about stepping on toes, and she’d rather it go through them with the perinatology practice consulting. But I don’t want that. It’s my care. One of the reasons I wanted to transfer my care is that I have zero concerns about the perinatologist communicating their findings down to my OB, but I have some questions about whether there’s really two-way communication here. Will the OB really communicate it back up? And if I’ve made it clear I want my care transferred over as soon as possible, is there any benefit to not just proceeding as if my records really had been transferred over?

Sigh.

Anyway, my thoughts at this point are to just hang tight and if it doesn’t get worse I won’t go in. If it gets better or stays the same, I’ll just hang out here and go to sleep. Sleep is good.

Update: I did end up going to the hospital last night because the cramping/tightness got much more uncomfortable, much more frequent, and much more intense. I was instructed to go to triage at labor and delivery. The perinatologist said she’d call ahead and let them know I was coming and that she’d also call the OB practice and let them know so that they could see me. I expressed my concerns about my care being done through the OB, but she calmed me down about that. She said that since they have more of my records and background, they were in a better position to evaluate my condition. However, she said, since she was the physician initiating my care at the hospital, she would definitely be in the loop with whatever happened**.

However, when I got to labor and delivery, they sent me to the ER, because they won’t see me until I get to 20 weeks. The irony is that I’m pretty sure this is because they generally don’t use fetal monitors before then because the uterus isn’t big enough. Well…. my uterus is big enough. Anyway, I’ve been to the ER enough to know that I did NOT want to go to the ER right then. But on the other hand, I had gone to the hospital for a reason. Three and a half hours and one sonogram later, the babies were declared healthy. They were measuring 17w4days, 17w3days, and 18w1day. (I think that last one was a mis-measurement, because, honestly? That’s a BIG jump from last Thursday when it measured 17w0d). They all had good heartbeats (149, 139, 144). My cervix was fine (I didn’t hear the measurement). I was sent home feeling stupid and sheepish.

Today I’m supposed to follow up with the perinatologist, even though I feel even dumber now. Except… that cramping? Getting worse! I imagine it’s just everything stretching out, which would make sense, except it’s so… rhythmic. When I was trying to decide whether to call the perinatologist or not, I called a doctor-friend of mine (who has five children of her own) and asked whether she thought I should go in and described what was happening and she said, “You’re having contractions. It’s probably not a big deal, but why should you spend all night worrying?” I’ll tell you why. Because I would have gotten more sleep, that’s why. Still, it was the right thing to do. I just wish I’d been 2 weeks and 3 days further along so I could have gotten into L&D, where I would have been monitored for an hour and sent home. Then I might have felt stupid, but I would have been asleep well before midnight instead of closer to 2am.

**One of my main concerns, which led to my ultimate decision to leave the OB’s office, was that while I have absolute confidence that the perinatologist will communicate 100% of their findings with the OB, I don’t have the same level of confidence that the OB will communicate everything up to the perinatologist.

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It's been a very busy week at work. I'm trying to get all the loose ends on my projects wrapped up so that my replacement can just step in with the new projects rather than dealing with all the ridiculous minutiae of the rest. Don't know how successful I'll be, but meanwhile, it's keeping me quite busy.

On Tuesday, I faxed a request to my OB's office to send all my OB & Prenatal records to the perinatology practice. It's the chicken's way out, but it works. On Thursday, I saw the perinatologist. The ultrasound took a very long time, but we got a great look at the babies. They measured the head circumference, belly circumference (I'm sure there's a technical term for that, but I'm not sure what it would be), femur length and heart rate for each of the babies. The appointment was when I was 17w, 1d and they measured 17w 2d, 17w 0d and 17w 0d. They all measured six ounces, which seems astoundingly small to me: they're the size of tuna cans. I have 18 ounces of baby in me! My cervix is still doing fine, though I did note that it has shortened slightly, but it's still within a fine range, which makes me happy.

Then the doctor came in and took a look. Apparently my cervix tilts a bit, which made the original measurements a little sketchy, so they remeasured and the doctor was satisfied. She asked if I was still being followed by the OB practice and I said, "funny you should mention that…" So I explained the weirdness I'd gotten when I'd brought it up in person, and I told her I'd been back and forth about it and was very torn, but felt more comfortable just having one set of doctors so I've asked that my records be transferred over to them. No problem, she said. They're very comfortable handling triplets themselves… it tends to be their preference, and it seems to be easier on the patients, since they're in the office so often anyway that another set of appointments becomes cumbersome. So after she'd gotten a look at all the sonogram pictures ("Wow, these babies look great!") she told me that I could go ahead and get dressed and come chat in her office. What? Talk to a doctor while fully clothed? I'm not sure I know HOW to do that!

We chatted for a bit in her office and pulled out a calendar to guesstimate an arrival time-ish for the babies. The perinatology practice gets most of their triplets to 34 weeks and rarely lets any triplet moms go past 34 weeks. I hit 34 weeks on September 26th (erev Succos) which is the day before my mother's birthday. Mostly I want to avoid my foster-son's birthday if possible, which should be easy, failing an emergency, because it's a Sunday this year. The doctor isn't concerned about me taking 2 prenatals a day yet… she said unless my blood work shows that I'm anemic (I'm not yet, but it's likely to happen at some point), she's not worried. She'd rather not double the vitamin because it could exacerbate constipation (a pregnancy symptom I've been lucky enough to avoid so far and I'd like to keep it that way!).

I mentioned that I feel a little guilty for not… how do I put this?… not finding more joy in the pregnancy experience. I'm incredibly grateful to be pregnant. I am looking forward to meeting my babies. I am blessed in so many ways, I don't even know how to begin expressing it. But I could do without the endless nausea (yeah, that hasn't stopped). I could do without the terminal exhaustion (that second-trimester energy burst? It's a myth). I could live without the stress, the previa, the contractions (nope, those aren't gone either), the random pains, the heartburn, the worry, and the migraines. And the doctor's answer? "I did mine one at a time, twice, and I must say, I'm not a fan of pregnancy. I love my children, but I could have done without all the pregnancy yuck." So you know? I feel a little less guilty. That being said, the pregnancy thing? It's pretty nifty. And there are times, even now, that I'm surprised how good I do feel.

I go back in two weeks for a prenatal appointment (my first with this office) to set up my "prenatal chart" — whatever that is. They'll also do a cervix check, which they'll do at EVERY appointment (seriously? most women graduate from the RE's office never to see a transvaginal ultrasound transducer again… me? it is still my life!). And they're going to do at least part of the detailed anatomy scan. The doctor was worried that I'd be too uncomfortable to lay down through all three of the babies in a row for the detailed anatomy scan, so she figured if we could get at least one or two this time, then we can get the rest at the next appointment. So that's pretty nifty. I'm expecting it to be about a three-hour appointment. Holy cow. It will be a wonder if I ever get any work done again at this rate with all these marathon appointments.

Today I called the doctor-on-call at the perinatologist's office, because I've been having these pretty uncomfortable menstrual-like cramps sort of rhythmically throughout the day. They aren't painful, exactly, but they've gotten worse through the day and they're very uncomfortable and I've had a bit of very light spotting. I never really know what the threshold is on calling the doctor. I hate to be an alarmist, but on the other hand, I can't tell anymore where that line is. Anyway, it was a doctor I don't know and she was both completely reassuring and unhelpful at the same time. Basically she said that it's just as hard for them as doctors on the other end of the phone to know where the line is, too. And she said that I could come in if I'm that uncomfortable, or I can stay home. Or I can wait a couple hours and see how it goes (that's what I've decided to do). Spotting in early pregnancy, she says, can be very normal. Early pregnancy? Heck, I'm half-way through this pregnancy! Ahem. And don't tell me about early pregnancy spotting. I know from early pregnancy bleeding. That's what I do. But I haven't had much in the way of spotting at all for five weeks. Besides, it's not the spotting that's freaking me out. Well, I'm not even particularly freaked out. But it's not the spotting that prompted me to call. It's the cramping. The very rhythmic, tightening/cramping that seems to be getting worse in the day. But that can be normal too, she says. Except when it isn't. Which is why she suggests coming in to be evaluated if it doesn't get better in a couple hours. So while that's completely unhelpful, it's very reassuring to know that no serious red-flags went off in the doctor's head to make her say, "Oh my gosh, get thee to the doctor's office NOW!"

The only really frustrating thing was that since my records haven't officially transferred over from the OB's office yet, she's worried about stepping on toes, and she'd rather it go through them with the perinatology practice consulting. But I don't want that. It's my care. One of the reasons I wanted to transfer my care is that I have zero concerns about the perinatologist communicating their findings down to my OB, but I have some questions about whether there's really two-way communication here. Will the OB really communicate it back up? And if I've made it clear I want my care transferred over as soon as possible, is there any benefit to not just proceeding as if my records really had been transferred over?

Sigh.

Anyway, my thoughts at this point are to just hang tight and if it doesn't get worse I won't go in. If it gets better or stays the same, I'll just hang out here and go to sleep. Sleep is good.

Update: I did end up going to the hospital last night because the cramping/tightness got much more uncomfortable, much more frequent, and much more intense. I was instructed to go to triage at labor and delivery. The perinatologist said she'd call ahead and let them know I was coming and that she'd also call the OB practice and let them know so that they could see me. I expressed my concerns about my care being done through the OB, but she calmed me down about that. She said that since they have more of my records and background, they were in a better position to evaluate my condition. However, she said, since she was the physician initiating my care at the hospital, she would definitely be in the loop with whatever happened**.

However, when I got to labor and delivery, they sent me to the ER, because they won't see me until I get to 20 weeks. The irony is that I'm pretty sure this is because they generally don't use fetal monitors before then because the uterus isn't big enough. Well…. my uterus is big enough. Anyway, I've been to the ER enough to know that I did NOT want to go to the ER right then. But on the other hand, I had gone to the hospital for a reason. Three and a half hours and one sonogram later, the babies were declared healthy. They were measuring 17w4days, 17w3days, and 18w1day. (I think that last one was a mis-measurement, because, honestly? That's a BIG jump from last Thursday when it measured 17w0d). They all had good heartbeats (149, 139, 144). My cervix was fine (I didn't hear the measurement). I was sent home feeling stupid and sheepish.

Today I'm supposed to follow up with the perinatologist, even though I feel even dumber now. Except… that cramping? Getting worse! I imagine it's just everything stretching out, which would make sense, except it's so… rhythmic. When I was trying to decide whether to call the perinatologist or not, I called a doctor-friend of mine (who has five children of her own) and asked whether she thought I should go in and described what was happening and she said, "You're having contractions. It's probably not a big deal, but why should you spend all night worrying?" I'll tell you why. Because I would have gotten more sleep, that's why. Still, it was the right thing to do. I just wish I'd been 2 weeks and 3 days further along so I could have gotten into L&D, where I would have been monitored for an hour and sent home. Then I might have felt stupid, but I would have been asleep well before midnight instead of closer to 2am.

**One of my main concerns, which led to my ultimate decision to leave the OB's office, was that while I have absolute confidence that the perinatologist will communicate 100% of their findings with the OB, I don't have the same level of confidence that the OB will communicate everything up to the perinatologist.

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It's been a very busy week at work. I'm trying to get all the loose ends on my projects wrapped up so that my replacement can just step in with the new projects rather than dealing with all the ridiculous minutiae of the rest. Don't know how successful I'll be, but meanwhile, it's keeping me quite busy.

On Tuesday, I faxed a request to my OB's office to send all my OB & Prenatal records to the perinatology practice. It's the chicken's way out, but it works. On Thursday, I saw the perinatologist. The ultrasound took a very long time, but we got a great look at the babies. They measured the head circumference, belly circumference (I'm sure there's a technical term for that, but I'm not sure what it would be), femur length and heart rate for each of the babies. The appointment was when I was 17w, 1d and they measured 17w 2d, 17w 0d and 17w 0d. They all measured six ounces, which seems astoundingly small to me: they're the size of tuna cans. I have 18 ounces of baby in me! My cervix is still doing fine, though I did note that it has shortened slightly, but it's still within a fine range, which makes me happy.

Then the doctor came in and took a look. Apparently my cervix tilts a bit, which made the original measurements a little sketchy, so they remeasured and the doctor was satisfied. She asked if I was still being followed by the OB practice and I said, "funny you should mention that…" So I explained the weirdness I'd gotten when I'd brought it up in person, and I told her I'd been back and forth about it and was very torn, but felt more comfortable just having one set of doctors so I've asked that my records be transferred over to them. No problem, she said. They're very comfortable handling triplets themselves… it tends to be their preference, and it seems to be easier on the patients, since they're in the office so often anyway that another set of appointments becomes cumbersome. So after she'd gotten a look at all the sonogram pictures ("Wow, these babies look great!") she told me that I could go ahead and get dressed and come chat in her office. What? Talk to a doctor while fully clothed? I'm not sure I know HOW to do that!

We chatted for a bit in her office and pulled out a calendar to guesstimate an arrival time-ish for the babies. The perinatology practice gets most of their triplets to 34 weeks and rarely lets any triplet moms go past 34 weeks. I hit 34 weeks on September 26th (erev Succos) which is the day before my mother's birthday. Mostly I want to avoid my foster-son's birthday if possible, which should be easy, failing an emergency, because it's a Sunday this year. The doctor isn't concerned about me taking 2 prenatals a day yet… she said unless my blood work shows that I'm anemic (I'm not yet, but it's likely to happen at some point), she's not worried. She'd rather not double the vitamin because it could exacerbate constipation (a pregnancy symptom I've been lucky enough to avoid so far and I'd like to keep it that way!).

I mentioned that I feel a little guilty for not… how do I put this?… not finding more joy in the pregnancy experience. I'm incredibly grateful to be pregnant. I am looking forward to meeting my babies. I am blessed in so many ways, I don't even know how to begin expressing it. But I could do without the endless nausea (yeah, that hasn't stopped). I could do without the terminal exhaustion (that second-trimester energy burst? It's a myth). I could live without the stress, the previa, the contractions (nope, those aren't gone either), the random pains, the heartburn, the worry, and the migraines. And the doctor's answer? "I did mine one at a time, twice, and I must say, I'm not a fan of pregnancy. I love my children, but I could have done without all the pregnancy yuck." So you know? I feel a little less guilty. That being said, the pregnancy thing? It's pretty nifty. And there are times, even now, that I'm surprised how good I do feel.

I go back in two weeks for a prenatal appointment (my first with this office) to set up my "prenatal chart" — whatever that is. They'll also do a cervix check, which they'll do at EVERY appointment (seriously? most women graduate from the RE's office never to see a transvaginal ultrasound transducer again… me? it is still my life!). And they're going to do at least part of the detailed anatomy scan. The doctor was worried that I'd be too uncomfortable to lay down through all three of the babies in a row for the detailed anatomy scan, so she figured if we could get at least one or two this time, then we can get the rest at the next appointment. So that's pretty nifty. I'm expecting it to be about a three-hour appointment. Holy cow. It will be a wonder if I ever get any work done again at this rate with all these marathon appointments.

Today I called the doctor-on-call at the perinatologist's office, because I've been having these pretty uncomfortable menstrual-like cramps sort of rhythmically throughout the day. They aren't painful, exactly, but they've gotten worse through the day and they're very uncomfortable and I've had a bit of very light spotting. I never really know what the threshold is on calling the doctor. I hate to be an alarmist, but on the other hand, I can't tell anymore where that line is. Anyway, it was a doctor I don't know and she was both completely reassuring and unhelpful at the same time. Basically she said that it's just as hard for them as doctors on the other end of the phone to know where the line is, too. And she said that I could come in if I'm that uncomfortable, or I can stay home. Or I can wait a couple hours and see how it goes (that's what I've decided to do). Spotting in early pregnancy, she says, can be very normal. Early pregnancy? Heck, I'm half-way through this pregnancy! Ahem. And don't tell me about early pregnancy spotting. I know from early pregnancy bleeding. That's what I do. But I haven't had much in the way of spotting at all for five weeks. Besides, it's not the spotting that's freaking me out. Well, I'm not even particularly freaked out. But it's not the spotting that prompted me to call. It's the cramping. The very rhythmic, tightening/cramping that seems to be getting worse in the day. But that can be normal too, she says. Except when it isn't. Which is why she suggests coming in to be evaluated if it doesn't get better in a couple hours. So while that's completely unhelpful, it's very reassuring to know that no serious red-flags went off in the doctor's head to make her say, "Oh my gosh, get thee to the doctor's office NOW!"

The only really frustrating thing was that since my records haven't officially transferred over from the OB's office yet, she's worried about stepping on toes, and she'd rather it go through them with the perinatology practice consulting. But I don't want that. It's my care. One of the reasons I wanted to transfer my care is that I have zero concerns about the perinatologist communicating their findings down to my OB, but I have some questions about whether there's really two-way communication here. Will the OB really communicate it back up? And if I've made it clear I want my care transferred over as soon as possible, is there any benefit to not just proceeding as if my records really had been transferred over?

Sigh.

Anyway, my thoughts at this point are to just hang tight and if it doesn't get worse I won't go in. If it gets better or stays the same, I'll just hang out here and go to sleep. Sleep is good.

Update: I did end up going to the hospital last night because the cramping/tightness got much more uncomfortable, much more frequent, and much more intense. I was instructed to go to triage at labor and delivery. The perinatologist said she'd call ahead and let them know I was coming and that she'd also call the OB practice and let them know so that they could see me. I expressed my concerns about my care being done through the OB, but she calmed me down about that. She said that since they have more of my records and background, they were in a better position to evaluate my condition. However, she said, since she was the physician initiating my care at the hospital, she would definitely be in the loop with whatever happened**.

However, when I got to labor and delivery, they sent me to the ER, because they won't see me until I get to 20 weeks. The irony is that I'm pretty sure this is because they generally don't use fetal monitors before then because the uterus isn't big enough. Well…. my uterus is big enough. Anyway, I've been to the ER enough to know that I did NOT want to go to the ER right then. But on the other hand, I had gone to the hospital for a reason. Three and a half hours and one sonogram later, the babies were declared healthy. They were measuring 17w4days, 17w3days, and 18w1day. (I think that last one was a mis-measurement, because, honestly? That's a BIG jump from last Thursday when it measured 17w0d). They all had good heartbeats (149, 139, 144). My cervix was fine (I didn't hear the measurement). I was sent home feeling stupid and sheepish.

Today I'm supposed to follow up with the perinatologist, even though I feel even dumber now. Except… that cramping? Getting worse! I imagine it's just everything stretching out, which would make sense, except it's so… rhythmic. When I was trying to decide whether to call the perinatologist or not, I called a doctor-friend of mine (who has five children of her own) and asked whether she thought I should go in and described what was happening and she said, "You're having contractions. It's probably not a big deal, but why should you spend all night worrying?" I'll tell you why. Because I would have gotten more sleep, that's why. Still, it was the right thing to do. I just wish I'd been 2 weeks and 3 days further along so I could have gotten into L&D, where I would have been monitored for an hour and sent home. Then I might have felt stupid, but I would have been asleep well before midnight instead of closer to 2am.

**One of my main concerns, which led to my ultimate decision to leave the OB's office, was that while I have absolute confidence that the perinatologist will communicate 100% of their findings with the OB, I don't have the same level of confidence that the OB will communicate everything up to the perinatologist.

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