35 Weeks and Appointment Update

I am 35 weeks pregnant today!  I can't believe there are only 3 weeks or less to go!

I had my almost 35 week appointment yesterday.  First was the ultrasound.  Just did a quick check on both babies, and they are still looking good.  I was shocked to find out that Baby B has turned back to head down.  I assumed they were out of room this late in the game.  I also thought for sure that I would feel them (painfully!) in the event they flipped, but he must have done it like a ninja in the night.  Unfortunately his position doesn't really matter, and Baby A is still hanging out nice and comfy with his head in my ribcage.  So a c-section it is.  The tech said he actually looks like he has enough room to move if he wanted to, but he is just stubborn.  We were able to snap a couple cute pictures of each of them this time.  Also the tech said that she can tell Baby B is going to have a lot of hair!

Then it was on to the non-stress test.  Again, fairly uneventful.  Baby A decided he did not enjoy the contraction monitor sitting on top of him, so after   a little while he started punching it.  It was pretty funny because I could see the whole monitor moving, and the monitor readout had all these weird spikes in random places.  Other than that, everything looked great, and it was off to see the doc.

Now that I have resigned myself to the idea of a c-section, my main question for the doctor was what to do if I went into labor on my own, and what would happen once I got to the hospital (they don't really walk you through a c-section scenario on the general hospital tour).  He told me to go ahead and come in right when I was pretty sure I was in labor - no laboring at home is encouraged in this situation.  He said they would do a quick evaluation, but they wouldn't wait around to see if I started dilating more or anything like that.  He said at this point if I come in pregnant with twins and contracting regularly and strongly, they will most likely just go ahead and do the c-section rather than wait around and risk having someone get too far down in the birth canal.

I go to a very large practice with many different doctors (probably about 10-15).  He said in most cases, whoever happens to be on call when I come in will be the one to deliver me.  He said that since we are somewhat of a special case, he has put into my chart to have the medical staff call him when I get to the hospital, and if possible he will come in and deliver me.  He did mention that he is going out of town from August 3-10, so he obviously won't be available those dates.  I told him that in that case I'm pretty sure that's the time frame when the babies will decide to come, and he said yes, that's usually the way it works.

Anyway, I go back in another week for more of the same.  They told me they will probably do a growth check on the babies next time (I'm thinking they should both be over 5lbs by then), and the doctor said we will schedule a c-section date for sometime around 38 weeks.  My IF will be able to come to the next appointment (IM probably won't be able to make it), so I'm excited for him to be able to see his kiddos again and ask any last minute questions he has.

As far as how I'm feeling this week, I seem to have gotten a second wind here at the end!  I think the fact that I got over my cold really helped, because being sick just makes me miserable in general and makes it so much harder for me to deal with anything else.  Also, I broke down and bought some compression socks that I have been wearing with tennis-shoe type shoes, even to work.  They are super sexy - black and knee high, but they help a lot!  The swelling isn't totally gone, but it's much better than it was before, and it doesn't hurt to move my toes or bend my ankles now. 

I am up to probably about 10 contractions a day now, but I haven't had anything strong or regular.  Other than that I feel like my body can probably handle cooking these boys until they are forced out, unless they decide they want to meet their parents sooner than that!

25 Weeks, Cardiac Echo Appointment

Yesterday was the cardiac echo with the MFM.  Unfortunately, my IPs weren't able to make it to this one due to a scheduling conflict.  So we ended up cancelling the hospital tour and will hopefully be doing that sometime in June.

The echo was performed by my favorite tech under the supervision of the MFM doctor.  As the tech explained, they were able to get every single heart measurement known to man on both babies, and everything looked perfect!  They were also able to get a few cute pictures that they gave to me to pass on to my IPs.  Baby B is on the left and A is on the right.

Their overall growth looked good.  Baby A has flipped and is now breech (BAD BABY!).  He is estimated at 1 pound, 14 oz.  Baby B is laying head down-ish across the top of Baby A, and is currently  hanging out at the bottom of my rib cage making it hard for me to bend over.  He is about 2 pounds, 5 oz.  That's over four pounds of baby in there!

Then they did another cervical length measurement.  It was measuring 4.3 cm today, which is awesome for 25 weeks.  They told me that I no longer have to get checks every two weeks on that.  They will only check again if there is a concern, like I start to feel pressure again or I start having a lot of contractions.

 My next appointment is in 3 weeks, which will be another ultrasound to check on the babies growth.  They want to make sure that Baby B doesn't get TOO much bigger than Baby A because that can indicate that he is stealing all of the nutrients.  Then I will have another regular OB appointment.  After this next appointment they I will have the screening test for gestational diabetes, and I will start having appointments with my OB every 2 weeks.  He didn't mention either way, but we will probably continue to have ultrasounds every 4 weeks just to keep an eye on the babies' growth and position.

18 Week Anatomy Scan

We had a fantastic appointment today! 

First up was the anatomy scan ultrasound, where they looked at each baby's organs and bones in detail to make sure everything looked the way it should.  Both babies look perfect and healthy!  They both weighed about 10 oz, and were measuring about a week ahead.  And, turns out the tech at the 12 week appointment was correct - they are both definitely BOYS!

My IPs were so thrilled that everything looked great and that they can eagerly await the arrival of two perfect blue bundles in the next 4 months or so.  They were able to get a nice 4D picture of Baby B's face, but they couldn't get one of Baby A because Baby B was in the way.

The only downside was that because of Baby B's position, the tech was not able to get all of the measurements she needed of his heart.  She said from what she could see it looked great and she was sure there would be no problems, but they always like to be able to make sure with measurements.  So we will have another ultrasound at our next regular OB appointment to check up on it and make sure everything is looking good.

They also used the ultrasound to measure the length of my cervix.  This is something they will do routinely throughout the pregnancy with twins, since there is such an increased risk of preterm labor.  If my cervix gets too short, I will likely be put on activity restrictions or even bedrest.  So the longer the better!  The tech said that anything over 4cm is great, and at around 2.5 they start to get concerned about preterm labor.  My cervix was measuring closer to 5cm, so nothing to worry about at this point!  That made me very happy, it was something I was a little worried about.  I haven't had any contractions or anything, but from reading other blogs of surros carrying twins, I know it can be a cause for bedrest very early in the pregnancy and I want to avoid that.

Then we met with the new OB that I saw for the first time a couple weeks ago.  I was a little nervous about it because my IPs had felt so left out with the last doctor we saw.  But this new one was fantastic!  He really took the time to make my IPs feel included and that all of their questions were answered.  If anything, he paid more attention to them than to me, which is fine by me.  As long as everything is going fine with my body, I'm happy...they are the expectant first time parents and should be treated as such!

This doctor is very pro-vaginal delivery, as long as Baby A is head down at delivery.  He also seems a little more laid back than the other doctor.  Instead of doing an ultrasound at every appointment, he just wants us to have the one next appointment so they can be sure about Baby B's heart, and then one closer to delivery to determine the babies' positions and to give the IPs a sneak peek of what their babies will look like.  Otherwise (assuming all is well), the appointment schedule will proceed just the same as my previous singleton pregnancy.  He also assured me that he is not planning on taking any vacation between now and when the babies come, which makes me happy.

Since I will be out of town 4 weeks from now (I had to squeeze my "summer" vacation in before we get to viability), our next appointment is in 3 weeks, on April 25.  I'm looking forward to seeing my IPs and their SONS(!) again at that time.  I might even go out and do a teensy bit of baby shopping between now and then as well!

8 Week Ultrasound

Yesterday was our 8 week ultrasound, and it went great!  I was very happy to get to go in yesterday, because I had had quite a bit of spotting the night before and that morning.  So it was a relief to see both babies with their strong heart beats.

Baby A was still measuring right on track with a heartbeat of 181, and Baby B (our overachiever, as the tech refers to him) was still measuring a day ahead with a heart beat of 173.

My IPs were able to make the trip down from Chicago to check out how much their babies have grown in the last two weeks.  They looked much bigger and had arm and leg buds this time, which is something they didn't have last week.  They were so excited to see them looking perfectly strong and healthy.  We got to use the brand new state of the art ultrasound machine that the office just got in.  The tech told us she had only used it a couple times before.  So IPs were able to take home pictures of their babies not only in 3D, but in color too!  It was really amazing, you could see every little detail of the cute little blobs.  They basically look like gummy bears right now, but that equipment is going to be amazing once their faces are more developed!

My next appointment will be my first OB appointment and NT screening ultrasound on February 20, at 12 weeks.  My IPs are going to be able to make it down to that one as well.  It's going to be so exciting to be able to see them see the 12 week ultrasound.  That was the first one my husband and I got to see for our own child, and I can't even describe the feelings I had when I saw that teeny tiny person bouncing around inside me that I couldn't even feel.  Even though they have gotten to see their babies twice already, by 12 weeks they will look like little people, with faces and arms and legs.  I can't wait for my IPs to get to experience that awe and elation!

As far as everything else, I have been doing really well with this pregnancy - probably better than I did with my last one.  I haven't had a single moment of morning sickness (I know I'm probably jinxing myself by typing this out), and hardly even a passing wave of nausea.  I have been extremely tired, but nothing I can't handle, even with a toddler this time around.  I also haven't had any problems with bloat.  Comparing my belly to pictures at this time from my previous pregnancy, I look much better this time around.  I lost about 4 pounds between the start of my meds and the first beta, and I am still a pound below my initial weight.  I have been battling a couple of colds that I've caught from my kiddo (oh, the joys of having a daycare baby!), but I have still been able to eat well and get enough fluids.  So I'd say that considering the fact that I'm growing two people right now, I'm doing pretty well! 

Second Ultrasound Results

Yesterday morning I went in for my second ultrasound.  I was by myself this time, as my IPs weren't able to make the long drive down this week.  I'm not sure if it was because there weren't a bunch of other people with me this time, or it was just a coincidence, but the tech had a med student and resident with her so they could observe the ultrasound.  It was actually kind of too bad that my IPs weren't there for it this time, as the tech was going over everything in a lot of detail as she explained things to the students.

Despite the bleeding I had last week, both babies looked perfect again.  Baby A was measuring right on track at 7 weeks 5 days, with a heart rate of 155.  Baby  B was measuring one day ahead with a heart rate of 165.  They looked bigger this week and the heart beat was much easier to see, but they still pretty much just look like little blobs at this point.

The SCH was still there in all its glory.  It looked huge to me.  It was almost as big as the babies' gestational sacs.  When I commented on it, the tech didn't seem concerned.  When I got the official call from the Chicago RE, they didn't even mention it.  So I guess I'm the only one who was worried about it.  I will just keep myself braced for more bleeding in the next few weeks.

Starting today I get to cut my meds in half.  The RE said I could stop using one method of progesterone.  So I could either drop the shots or drop the suppositories and increase to a shot every day.  I would have gladly dropped suppositories and increased shots, but unfortunately I don't have enough of the PIO left to make it through the first week of February without ordering more.  Since I know the meds are really expensive and I don't want to make my IPs pay for them just for my own convenience, I will just do the shots every third day as before, and skip the suppositories on those days.  I also get to drop down from 4 patches to 2, which will make my tummy skin happy!

I also set up my first regular OB appointment!  It will be February 20, and we will have the 12 week ultrasound (including nuchal translucency screening test) and then the appointment with the doctor.  This will be the first time meeting this doctor, since my last OB left the practice since I delivered by baby.  My IPs will be attending the appointment, so we will all get to meet her and decide if we want to continue the pregnancy with her or switch to someone else. 

Drumroll Please...

So bright and early this morning, My IPs, my husband, my kiddo, and I all met up at the doctor's office for our first ultrasound.  We shuffled into the ultrasound room, and I took off my pants and hopped onto the table and into stirrups.  Then we saw:

Yep, there are TWO babies there!  Sorry about the crappy quality of the picture, my husband took it with his phone from the back corner of the room (the babies' parents got to see the show from the front row).

They took measurements and both babies look great.  Baby A is measuring one day behind, at 6 weeks 4 days, and Baby B is measuring right on track at 6 weeks 5 days.  Both of them had nice strong heart beats at 125 bpm.

IM was overjoyed, IF was shocked.  After the ultrasound was all over, he needed clarification.  He asked the tech, "wait, there were two?"  They better start preparing for a busy future!

I will go back again in a week for another ultrasound, and then again in two weeks.  After that, they will release me to be seen by a regular OB for the rest of the pregnancy.

In less great news, the ultrasound also revealed that I have a subchorionic hematoma (SCH), which is basically an accumulation of blood that forms near the placenta.  It makes it very likely that I will have spotting/bleeding during the early weeks of my pregnancy.  SCHs are actually very common in IVF pregnancy and it will most likely eventually reabsorb back into the tissue.  The long shot risk is that the SCH could get big enough to actually cause the placenta to separate from the uterus, causing miscarriage.  So it's something we will definitely need to keep an eye on in the coming weeks.

Tomorrow's the Big Day!

Tomorrow is the day we find out how many babies are baking!  Our first ultrasound is at 8:00 in the morning.  My IPs are coming down to find out how many bundles of joy are on the way for them!  I'm hoping they are able to get a good show!

My RE originally wanted me to go in at the end of last week, right around the 6 week mark.  I decided to put it off to a little closer to 7 weeks, because the heart doesn't start beating until right around 6 weeks.  I was worried we would go in and see a sac but no heartbeat, and then have to spend a week or so worrying about whether the baby was alive before returning again at around this time anyway to find out.

Of course I am nervous that there won't be a heartbeat.  By now, there will be one if there is ever going to be one.  Since I am taking the pregnancy hormones artificially, it's possible that the baby could die but I wouldn't miscarry because I am fooling my body into thinking it's still pregnant.  So it's going to be a big relief to see at least one strong little heartbeat in there tomorrow!